Effect of methylprednisolone injection speed on the perception of intramuscular injection pain
Pain originating from intramuscular (IM) injection should not be underestimated, because a painful injection might incite severe fear of injection, which may lead a patient to delay seeking medical help. The aim of this study was to determine the impact of two different IM methylprednisolone injection speeds on pain intensity and pain duration. A one-group quasiexperimental design was used to study 10-second versus 30-second injection durations. According to the formula for one sample using average values, 25 patients were recruited from a dermatology clinic. Data were collected using the "Patient Characteristics Form" and the visual analog scale (VAS). The mean difference in pain levels according to the VAS in the postinjection period was significantly higher with administration of IM methylprednisolone in 10 seconds compared with 30-second administration (VAS 1.9 vs. 1.3; p < .05). The severity of pain peaked at 0 minutes for both injection speeds, but the duration of pain was longer with 10-second injections. The data showed that at multiple time points after 10-second injections, men and patients >40 years old experienced greater pain severity. Pain severity after 30-second injections was greater for patients of normal or low weight who had completed higher levels of education. In conclusion, slow IM injection of steroids improves pain management.
What is the most important information I should know about methylprednisolone?
You may not be able to receive a methylprednisolone injection if you have a fungal infection.
What is methylprednisolone?
Methylprednisolone is a steroid that prevents the release of substances in the body that cause inflammation.
Methylprednisolone is used to treat many different inflammatory conditions such as arthritis, lupus, psoriasis, ulcerative colitis, allergic disorders, gland (endocrine) disorders, and conditions that affect the skin, eyes, lungs, stomach, nervous system, or blood cells.
Methylprednisolone may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before receiving methylprednisolone?
You should not be treated with methylprednisolone if you are allergic to it. You may not be able to receive a methylprednisolone injection if you have a fungal infection.
Methylprednisolone can weaken your immune system, making it easier for you to get an infection. Steroids can also worsen an infection you already have, or reactivate an infection you recently had. Tell your doctor about any illness or infection you have had within the past several weeks.
Tell your doctor if you have ever had:
- heart disease, high blood pressure;
- a thyroid disorder;
- glaucoma or cataracts;
- kidney disease;
- cirrhosis or other liver disease;
- seizures, epilepsy or recent head injury;
- past or present tuberculosis;
- herpes infection of the eyes;
- a condition called scleroderma;
- stomach ulcers, ulcerative colitis, diverticulitis, or recent intestinal surgery;
- a parasite infection that causes diarrhea (such as threadworms);
- mental illness or psychosis;
- osteoporosis or low bone mineral density (steroid medication can increase your risk of bone loss);
- a muscle disorder such as myasthenia gravis; or
- an electrolyte imbalance (such as low levels of potassium in your blood).
It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
You should not breast-feed while using methylprednisolone.
How is methylprednisolone given?
Methylprednisolone is injected into a muscle or soft tissue, into a skin lesion, into the space around a joint, or given as an infusion into a vein. A healthcare provider will give you this injection.
Steroid medication can weaken your immune system, making it easier for you to get an infection. Call your doctor if you have any signs of infection (fever, chills, body aches).
If you have major surgery or a severe injury or infection, your methylprednisolone dose needs may change. Make sure any doctor caring for you knows you are using this medicine.
If you use this medicine long-term, you may need medical tests and vision exams.
What happens if I miss a dose?
Call your doctor for instructions if you miss an appointment for your methylprednisolone injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What should I avoid while receiving methylprednisolone?
Do not receive a "live" vaccine while using methylprednisolone. Live vaccines include measles, mumps, rubella (MMR), rotavirus, typhoid, yellow fever, varicella (chickenpox), zoster (shingles), and nasal flu (influenza) vaccine.
Avoid being near people who are sick or have infections. Call your doctor for preventive treatment if you are exposed to chickenpox or measles. These conditions can be serious or even fatal in people who are using methylprednisolone.
What other drugs will affect methylprednisolone?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
Many drugs can affect methylprednisolone. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.
Where can I get more information?
Your pharmacist can provide more information about methylprednisolone.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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pronounced as (meth il pred nis' oh lone)
Methylprednisolone injection is used to treat severe allergic reactions. Methylprednisolone injection is used in the management of multiple sclerosis (a disease in which the nerves do not function properly), lupus (a disease in which the body attacks many of its own organs), gastrointestinal disease, and certain types of arthritis. Methylprednisolone injection is also used to treat certain conditions that affect the blood, skin, eyes, nervous system, thyroid, kidneys, and lungs. It is sometimes used in combination with other medications to treat symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Methylprednisolone injection is in a class of medications called corticosteroids. It works to treat people with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It also works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.
Methylprednisolone injection comes as powder to be mixed with liquid to be injected intramuscularly (into a muscle) or intravenously (into a vein). It also comes as a suspension for injection to be injected intramuscularly, intra-articularly (into a joint), or intralesionally (into a lesion). Your personal dosing schedule will depend on your condition and on how you respond to treatment.
You may receive methylprednisolone injection in a hospital or medical facility, or you may be given the medication to use at home. If you will be using methylprednisolone injection at home, your healthcare provider will show you how to inject the medication. Be sure that you understand these directions, and ask your healthcare provider if you have any questions. Ask your healthcare provider what to do if you have any problems using methylprednisolone injection.
Your doctor may change your dose of methylprednisolone injection during your treatment to be sure that you are always using the lowest dose that works for you. Your doctor may also need to change your dose if you experience unusual stress on your body such as surgery, illness, or infection. Tell your doctor if your symptoms improve or get worse or if you get sick or have any changes in your health during your treatment.
Methylprednisolone injection is also sometimes used to treat nausea and vomiting from certain types of chemotherapy for cancer and to prevent organ transplant rejection. Talk to your doctor about the risks of using this medication for your condition.
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
Before receiving methylprednisolone injection,
- tell your doctor and pharmacist if you are allergic to methylprednisolone, any other medications, benzyl alcohol, or any of the ingredients in methylprednisolone injection. Ask your pharmacist for a list of the ingredients.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: aminoglutethimide (Cytadren; no longer available in U.S.); amphotericin B (Abelcet, Ambisome, Amphotec); anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven); aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) and selective COX-2 inhibitors such as celecoxib (Celebrex); carbamazepine (Equetro, Tegretol, Teril); cholinesterase inhibitors such as donepezil (Aricept, in Namzaric), galantamine (Razadyne), neostigmine (Bloxiverz), pyridostigmine (Mestinon, Regonol), and rivastigmine (Exelon); cholestyramine (Prevalite); cyclosporine (Gengraf, Neoral, Sandimmune); medications for diabetes including insulin; digoxin (Lanoxin); diuretics ('water pills'); erythromycin (E.E.S., Ery-Tab, Erythrocin, others); estrogens including hormonal contraceptives (birth control pills, patches, rings, implants, and injections); isoniazid (Laniazid, Rifamate, in Rifater); ketoconazole (Nizoral, Xolegel); phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); and rifampin (Rifadin, Rimactane, in Rifamate, in Rifater). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have a fungal infection (other than on your skin or nails). Your doctor will probably tell you not to use methylprednisolone injection. Also, tell your doctor if you have idiopathic thrombocytopenic purpura (ITP; an ongoing condition that may cause easy bruising or bleeding due to an abnormally low number of platelets in the blood). Your doctor probably will not give you methylprednisolone intramuscularly, if you have ITP.
- tell your doctor if you have or have ever had tuberculosis (TB: a type of lung infection); cataracts (clouding of the lens of the eye); glaucoma (an eye disease); Cushing's syndrome (condition where the body produces too much of the hormone cortisol); diabetes; high blood pressure; heart failure; a recent heart attack; emotional problems, depression or other types of mental illness; myasthenia gravis (a condition in which the muscles become weak); osteoporosis (condition in which the bones become weak and fragile and can break easily); seizures; ulcers; or liver, kidney, heart, intestinal, or thyroid disease. Also tell your doctor if you have any type of untreated bacterial, parasitic, or viral infection anywhere in your body or a herpes eye infection (a type of infection that causes a sore on the eyelid or eye surface).
- tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while receiving methylprednisolone injection, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are receiving methylprednisolone injection.
- do not have any vaccinations (shots to prevent diseases) without talking to your doctor.
- you should know that methylprednisolone injection may decrease your ability to fight infection and may prevent you from developing symptoms if you get an infection. Stay away from people who are sick and wash your hands often while you are using this medication. Be sure to avoid people who have chicken pox or measles. Call your doctor immediately if you think you may have been around someone who had chicken pox or measles.
Your doctor may instruct you to follow a low-salt or a diet high in potassium or calcium. Your doctor may also prescribe or recommend a calcium or potassium supplement. Follow these directions carefully.
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to methylprednisolone injection.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are using methylprednisolone injection.
If you are having any skin tests such as allergy or tuberculosis tests, tell the doctor or technician that you are receiving methylprednisolone injection.
Do not let anyone else use your medication. Ask your pharmacist any questions you have about refilling your prescription.
Ask your pharmacist any questions you have about methylprednisolone injection.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
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