Solu-Medrol

solu-medrol

I rank Solu-Medrol 21 of the 33 drugs we carry.

Solu-Medrol is a systemic steroid that works as an anti-inflamatory.

We used to carry 1 gram vials of Solu-Medrol to give to head injured patients until studies showed that it wasn’t the best thing for them to be getting. Now we give 125 mg Solu-Medrol slow IV to patients having asthma and COPD exacerbations, and those having allergic reactions.

The drug has a funny little mechanism on the vial, where we push down on the top and it releases the rubber chamber divider enabling you to shake the bottle and mix the powered drug with the solution so you can draw it up. I always enjoy watching my preceptees try to figure out how it works the first time they have to give it. “Like this,” I always end up saying as I demonstrate.

It is my understanding that Solu-Medrol doesn’t reach its peak effect for 6-12 hours after we give it, but that studies have shown the earlier it is given, the less likely the patient will have to be admitted to the hospital.

I had a hard time remembering to give the drug when we first got it for these indications, but now I am getting better and am fairly used to giving it and do it routinely now, perhaps not on all calls I should, but certainly on the more serious ones.

You could say we go without carrying the drug without much harm to the patients, but the question is how quickly does the hospital jump to give the drug if EMS has failed to. I would say our giving the drug right away may save the patient an hour (from when we can give the drug to when he would otherwise get it in the hospital), which may make a difference.

***

Methylprednisolone (Solu-Medrol)

Class: Steroid
Glucocorticoid
Anti-inflammatory

Action: Thought to stabilize cellular and intracellular membranes

Indication: Asthma attack of greater than 2 hour’s duration,
Anaphylactic reaction

Contraindication: none for emergency field use

Dose: Reactive airway disease – 40 to 125mg

Pedi dose: Reactive airway disease – 2 mg/kg (max 125 mg)

Route: IV push – slow

5 Comments

  • CBEMT says:

    We got our Solu-Medrol changed out in favor of Solu-Cortef by the state. Works the same as -Medrol- even packaged the same- with the bonus that we can also use it for shock with a history of adrenal issuficiency. Dose and packaging is 100mg.

  • medicscribe says:

    thanks for the comment. Sounds like a good drug. I will have to have our region look into this during our next guideline rewrite.

    Peter

  • totwtytr says:

    You could say we go without carrying the drug without much harm to the patients, but the question is how quickly does the hospital jump to give the drug if EMS has failed to.

    Of course I’d say that there is line between giving patients medications that provide a benefit and giving patients medications because the ED staff is to frigging lazy or inefficient. One is clearly within our job scope, the other isn’t.

    That’s just cranky old TOTWTYTR, though.

  • McGee says:

    TOTWTYTR:
    How can you say that ED staff are lazy or inefficient? You don’t know what are you talking about mate!!!
    Big difference between EMT/Paramedics and ED staff…is you can give medication when you want and you don’t need to wait for a medic to prescribe that drug.

  • Tanya says:

    I was given solu medrol through a Iv at the er today 125 mg. is it gonna make me have withdrawls. I have RA and have been on steriods before and I know if your not slowly taken of of them you have withdrawls and I don’t want that cause you seriously think your going to go crazy

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Peter Canning

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  • Comments
    Sandy
    The Ideal Medic
    As a 24 year medic, I finally figured out it wasn't me. Thank you for your article. You can't teach that in any classroom. I have always found that empathy is a great tool. Use it to benefit the patient and teach others what it is all about.
    2015-03-24 22:24:30
    Joseph Eriksen
    The Ideal Medic
    As a 30 year, now retired medic I completely agree. There is nothing wrong with second guessing although one should go with their gut. There are times to be aggressive and times to not. Also humor is one of the most powerful pre-hospital tools in the toolbox although it can't be taught. When appropriate it…
    2015-03-24 19:37:25
    Shawn McCormick
    The Ideal Medic
    I totally agree. To me those make great paramedics. I work as a Operation Supervisor and encourage teamwork/backup whenever the situation calls for it. I encourage feedback from a difficult call my crews responded to. 1) they have the chance to recall the events that took place and they may self evaluate the call. 2)…
    2015-03-24 17:14:14
    Sean Fitch
    The Ideal Medic
    Totally agree Peter, For too long I had the same interpretation and like you now, I would by far take your current description.
    2015-03-24 17:05:33
    tom combs - ER doc/author
    The Ideal Medic
    Twenty-five years as an ER doc in level one trauma centers has me in total agreement. I Interestingly what you say regarding paramedics also, in many ways, applies to ER docs. "Tries to learn from each call...puts the patient first." A great post. I salute to your wisdom!
    2015-03-24 17:04:06

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