Instruction for use: Methylprednisolone (Methylprednisolonum)I want this, give me price
Nosological classification (ICD-10)
A09 Diarrhea and gastroenteritis of allegedly infectious origin (dysentery, bacterial diarrhea)
Bacterial diarrhea, Bacterial dysentery, Bacterial infections of the digestive tract, Bacterial gastroenteritis, Diarrhea bacterial, Diarrhea or dysentery of amoebic or mixed etiology, Diarrhea of infectious genesis, Diarrhea on the background of antibiotic therapy, Traveler's Diarrhea, Travelers diarrhea due to changes in diet and habitual diet, Diarrhea due to antibiotic therapy, Dysenteric bacteriocarrier, Dysenteric enteritis, Dysentery, Dysentery bacterial, Dysentery mixed, Gastrointestinal infection, GI tract infections, Infectious diarrhea, Infectious Disease of the GI tract, Infection of the gastrointestinal tract, Infection of the biliary tract and gastrointestinal tract, GI tract infection, Summer diarrhea, Nonspecific acute diarrhea of infectious nature, Nonspecific chronic diarrhea of infectious nature, Acute bacterial diarrhea, Acute diarrhea in food poisoning, Acute dysentery, Acute bacterial gastroenteritis, Acute gastroenterocolitis, Acute Enterocolitis, Subacute dysentery, Diarrhea chronic, Refractory diarrhea in AIDS patients, Staphylococcal enteritis in children, Staphylococcal enterocolitis, Toxic diarrhea, Chronic dysentery, Enteritis, Enteritis infectious, Enterocolitis
A16.2 Tuberculosis of lungs without mention of bacteriological or histological confirmation
Disseminated tuberculosis, Caseous pneumonia, Pulmonary tuberculosis, Pulmonary tuberculosis, Tuberculosis of the lung chronic multidrug-resistant, Pulmonary tuberculosis, Fulminant tuberculosis of the lungs, Chronic tuberculosis of the lungs, Disseminated tuberculosis of the lungs
A17.0 Tuberculous meningitis (G01 *)
Tuberculosis of serous membranes, Tuberculous meningitis, Meningitis tuberculosis
B49 Mycosis, unspecified
Common mycoses, Visceral mycosis, Deep endemic mycoses, Keratomycosis, Cutaneous mycosis, Pulmonary mycosis, Mycosis, Mycosis eyes, Mycoses of the gastrointestinal tract, Mycosis of large skin folds, Mycosis with secondary bacterial infection, Mycoses in patients with immunodeficiency, Systemic fungal infections, Tropical mycoses, Fungal infections of the skin, Fungal lesions of skin folds, Fungal infection, Fungal skin lesions, Fungal lesions of the bronchial mucosa, Fungal lesions of the oral mucosa, Infections fungal, Infections of skin fungal, Skin mycoses, Mycosis systemic, Mycosis of the mucous membranes
Trichinosis with myocardial manifestations, Trichinosis with neurological manifestations, Trichinosis with myocardial infarction, Trichinosis with damage to the nervous system, Trichinosis with myocardial involvement, Trichinosis with CNS involvement, Multiple nematodes, Trichinosis
C34 Malignant neoplasm of bronchi and lung
Small cell anaplastic lung tumors, Small cell and non-small cell lung cancer, Small cell lung cancer, Locally-distributed small cell lung cancer, Locally advanced non-small cell lung cancer, Undifferentiated lung cancer, Non-small cell lung cancer, Bronchogenic Cancer, Non-small cell lung cancer, Inoperable locally advanced non-small cell lung cancer, Cancer of the bronchi, Lungs' cancer, Small cell lung cancer, Lung cancer, Small cell lung cancer, Non-small cell lung cancer, Lung cancer of squamous cell, Recurrent non-small cell non-small cell lung cancer, Small cell lung carcinoma, Inoperable metastatic non-small cell lung cancer, Lung carcinoma, Ovsyocellular carcinoma of the lung, Disseminated lung cancer, Tumors of the lungs
C81 Hodgkin's disease [lymphogranulomatosis]
Paltauf-Sternberg disease, The generalized form of Hodgkin's disease, Lymphogranulomatosis, Hodgkin's disease, Hodgkin's lymphoma, Hodgkin's malignant lymphoma, Hodgkin's lymphoma, Lymphoproliferative diseases, Reticulosis fibromyaloid, Pelya-Ebstein fever
C85 Other and unspecified types of non-Hodgkin's lymphoma
Lymphoma of mixed type, Lymphomas from cells of the mantle zone, Malignant lymphoma, Lymphoma non-Hodgkin's disease, Lymphocytic lymphoma
C90.0 Multiple myeloma
Myeloma multiplication, Myeloma
C95.0 Acute leukemia of unspecified cell type
Leukemia acute, Acute leukemia, Acute leukemia in children, Acute leukemia in adults
C95.9 Other specified leukemia
Leukemia, Acute leukemia after chemotherapy and / or radiation, Lymphoproliferative disorders, Pre-malignant state
D59.1 Other autoimmune hemolytic anemia
Autoimmune hemolytic anemia, Immune hemolytic anemia, Autoimmune hemolytic anemia
D60.9 Acquired pure red cell aplasia, unspecified
Hematopoietic disorders, Partial red cell aplasia of hematopoiesis, Erythroid anemia
D61.0 Constitutional aplastic anemia
D69.3 Idiopathic thrombocytopenic purpura
Werlhof's disease, Idiopathic autoimmune thrombocytopenia, Idiopathic thrombocytopenic purpura of adults, Idiopathic thrombocytopenic purpura in adults, Immune idiopathic thrombocytopenic purpura, Immune thrombocytopenia, Bleeding in patients with thrombocytopenic purpura, Evans Syndrome, Thrombocytopenic purpura, Thrombocytopenia of immune origin, Chronic idiopathic thrombocytopenic purpura, Essential thrombocytopenia, Autoimmune thrombocytopenic purpura in pregnancy, Posttransfusion purpura
Agranulocytosis is hereditary, Aleicia, Aleykocytosis, Agranulocytic angina, Angina agranulocytic, Primary cytopenia
D86.0 Lung sarcoidosis
E06.1 Subacute thyroiditis
De Cherven's disease, De Kervena granulomatous goiter, Thyroiditis granulomatous giant cell
E27.1 Primary insufficiency of the adrenal cortex
Addison's Disease, Addisonism, Adrenocortical insufficiency, Hypofunction of the adrenal cortex, Collapse with Addison's Disease, Insufficiency of the adrenal cortex primary, Primary adrenocortical insufficiency, Primary adrenal insufficiency
E27.4 Other and unspecified adrenocortical insufficiency
Hypocorticism, Hypoaldosteronism, Adrenal insufficiency, Insufficiency of the adrenal cortex, Insufficiency of the adrenal cortex, Secondary adrenocortical insufficiency, Secondary adrenal insufficiency, Secondary insufficiency of the adrenal cortex, Temporary decrease in the function of the adrenal cortex, Dysfunction of the adrenal cortex
E27.8 Other specified disorders of the adrenal gland
E83.5.0 * Hypercalcemia
Hypercalcemic crisis, Idiopathic hypercalcemia of newborns, Milk-alkaline syndrome
E88.1 Lipodystrophy, not elsewhere classified
G35 Multiple sclerosis
Disseminated sclerosis, multiple sclerosis, Relapsing Multiple Sclerosis, Secondary progressive multiple sclerosis, Exacerbation of multiple sclerosis, Mixed forms of multiple sclerosis
G70 Myasthenia gravis and other disorders of the neuromuscular synapse
Myasthenic syndrome, Myasthenic syndromes, Myasthenia gravis, Myasthenic syndrome, Severe myasthenia gravis (Myasthenia gravis)
G93.6 Edema of the brain
Intraoperative cerebral edema, Cerebral edema, Post-traumatic swelling of the brain, Brain edema associated with radiation therapy, Brain edema associated with head trauma, Post-traumatic cerebral edema, Edema of the brain in poisoning
H10.1 Acute atopic conjunctivitis
Allergic conjunctivitis, Allergic eye disease, Allergic conjunctivitis, Allergic conjunctivitis is caused by chemical and physical factors, Allergic rhinoconjunctivitis,Allergic inflammation of the eye, Spring catarrh, Spring keratitis, Spring conjunctivitis, allergic Conjunctivitis, Perennial allergic conjunctivitis,Exacerbation of pollen allergy in the form of Syndrome rinokonyunktivalnogo, Acute allergic keratoconjunctivitis, Acute allergic conjunctivitis,Superficial bacterial eye infections,rhinoconjunctivitis, Seasonal allergic conjunctivitis, Seasonal conjunctivitis, Sennoz, Chronic allergic keratoconjunctivitis, Chronic allergic conjunctivitis
H10.9 Conjunctivitis, unspecified
Trahomny conjunctivitis, catarrhal conjunctivitis, Giperpapillyarny conjunctivitis, Non-infectious conjunctivitis, purulent conjunctivitis, Purulent conjunctivitis form, Year-round conjunctivitis, purulent conjunctivitis, Subacute conjunctivitis, Secondarily infected with conjunctivitis
Adenoviral keratitis, Bacterial keratitis, Spring keratitis, Deep keratitis without epithelial damage, Discoid keratitis, Dendritic keratitis, Keratitis rosacea, Keratitis with destruction of the cornea, Superficial keratitis, Point keratitis, Traumatic keratitis, Superficial point keratitis
H16.0 Corneal ulcer
Allergic corneal ulcer, Erosion of the cornea, Regional ulcer, Purulent corneal ulcer,Corneal ulcer, Trophic ulcers of the cornea, Traumatic erosion of the cornea, Ulceration of the cornea, Keratitis with corneal ulceration, Ulcerative keratitis, Purulent corneal ulcers, Epithelial point keratitis, Ulceration of superficial corneal layers, Keratomalacia, Corneal ulcer, Recurrent erosions of the cornea, Recurrent ulcers of the cornea, Bacterial corneal ulcer, Septic ulcer of the cornea, Corneal edge ulcer
recurrent iritis, sympathetic iridocyclitis, Sluggish posterior uveitis, Sluggish posterior uveitis, Posterior uveitis, the posterior segment of the eye Iridocyclitis, Iridocyclitis and other uveitis, Irit, Keratoiridotsiklit, Acute iritis, uveitis, cycle of Acute iridocyclitis, Acute non-infectious uveitis
H20.9 Iridocyclitis Unspecified
Iridocyclitis, Diffuse posterior uveitis, keratouveit, Uveitis middle or rear portion of the eye, Sight-threatening uveitis middle or rear portion of the eye,keratouveitis, Anterior uveitis, Flaccid anterior uveitis, Endogenous uveitis, Inflammation of the ciliary body, Uveitis anterior portion of the eyeball, sympathetic uveitis
H30 Chorioretinal inflammation
Retinitis, Chorioretinitis, Central and peripheral chorioretinal dystrophy
H30.9 chorioretinal inflammation, unspecified
Choroiditis, myopic chorioretinitis, Violation of choroidal circulation, Central retinitis
H44.1 Other endophthalmitis
Ophthalmic sympathetic, Egyptian ophthalmia,Endophthalmitis
H46 Optic neuritis
Leber Retinitis, Inflammatory optic neuritis of the optic nerve, Strona syndrome, Inflammation of the optic nerve, Papillitis
I00 Rheumatic fever without mention of cardiac involvement
Acute rheumatism, Rheumatic arthritis acute, Rheumatism is active, Rheumatic fever, Acute attack of rheumatic joint disease
I01 Rheumatic fever with involvement of the heart
Rheumatic carditis acute
J30 Vasomotor and allergic rhinitis
Allergic rinopatiya, Allergic rhinosinusopathy, Allergic respiratory diseases, Allergic rhinitis, nasal allergy, Seasonal Allergic Rhinitis, Vasomotor rhinitis, Long-allergic rhinitis, Perennial allergic rhinitis, Perennial allergic rhinitis, Year-round or seasonal allergic rhinitis, Year-round allergic rhinitis nature, Rhinitis allergic vasomotor, Exacerbation of pollen allergy in the form of Syndrome rinokonyunktivalnogo, Acute allergic rhinitis, Edema of the nasal mucosa, Edema of the nasal mucosa, Swelling of the mucosa of the nasal cavity, Swelling of the nasal mucosa, Swelling of the nasal mucosa, pollen disease, Permanent allergic rhinitis, rhinoconjunctivitis, rhinosinusitis,rhinosinusopathy, Seasonal allergic rhinitis, Seasonal Allergic Rhinitis, Haymarket rhinitis, Chronic allergic rhinitis, Allergic respiratory diseases
J38.4 Laryngeal edema
Laryngeal edema of allergic genesis and on the background of irradiation, Acute non-infectious edema of the larynx
Asthma physical effort, status asthmaticus, Bronchial asthma, Asthma lung flow, Bronchial asthma with obstruction of sputum discharge, Bronchial asthma heavy currents, Bronchial asthma physical effort, hypersecretory asthma, Hormone-dependent form of bronchial asthma, Relief of asthma attacks in bronchial asthma, Non-allergic asthma, nocturnal asthma, Exacerbation of asthma, Asthma attacks, Endogenous forms of asthma, Night asthma, Cough with bronchial asthma
J69 Pneumonitis caused by solids and liquids
J82 Pulmonary eosinophilia, not elsewhere classified
Pulmonary infiltrate, Eosinophilic pulmonary infiltrate, Leffler's syndrome, Leffler's disease
K51 Ulcerative colitis
Colitis acute ulcerative, Colitis ulcerative, Ulcerative-necrotic colitis, Colitis ulcerative-hemorrhagic nonspecific, Colitis ulcerative and trophic, Colitis ulcerative idiopathic, Colitis ulcerative nonspecific, Nonspecific ulcerative colitis, Proctocolitis ulcers, Hemorrhagic purulent rectoxitis, Rectoccolitis ulcerative-hemorrhagic
K52 Other noninfectious gastroenteritis and colitis
senile Bowel Syndrome, sigmoid, Gastroenteritis noninfectious, gastroenterocolitis, Colitis, Colitis non-dysenteric, Colitis noninfectious, Colitis is a chronic, Colitis is a chronic non-infectious, Local enteritis, sigmoid noninfectious, Chronic inflammatory bowel disease, Chronic inflammatory disease of the small intestine, Chronic enterocolitis, Chronic atrophic gastroenteritis, Chronic gastroenteritis, Chronic colitis, Chronic enterocolitis, Enteritis, non-infectious enteritis, Enterocolitis chronic noncommunicable, colon disease
K73.9 Chronic hepatitis, unspecified
Chronic hepatitis, Chronic hepatitis with signs of cholestasis, Inflammatory liver disease, Infection of the liver, Chronic reactive hepatitis, Chronic inflammatory liver disease, Hepatitis chronic
L10 Pemphigus [pemphigus]
Benign pemphigoid of mucous membranes, Bubble dermatosis, Pemphigus, Dermatitis, vesicular, Benign pemphigus, Ordinary pemphigus, Pemphigus, Bubble dermatitis, Family benign pemphigus Hailey-Hailey
L13.9 Bullous changes, unspecified
L20 Atopic dermatitis
Itchy atopic eczema, Common neurodermatitis, Allergic skin diseases, Allergic skin diseases of non-infectious etiology, Allergic skin diseases of non-microbial etiology, Allergic skin diseases, Allergic skin lesions, Allergic manifestations on the skin, Allergic dermatitis, Allergic diathesis, Allergic itching dermatosis, Allergic Skin Disease, Allergic skin irritation, Dermatitis allergic, Atopic dermatitis, Dermatosis allergic, Diathesis exudative, Skin Allergic Disease, Skin allergic reaction to medicinal and chemical preparations, Skin reaction to medication, Skin and allergic disease, Acute eczema, Chronic atopic dermatitis, Exudative diathesis, Itching allergic dermatosis
L21 Seborrheic dermatitis
Dermatitis seborrheic, Increased sebum separation, Seborrheic Eczema, Seborrheic dermatitis of the scalp, Seborrheic pyodermatitis, Seborrhea, Eczema seborrheic
L25.9 Unspecified contact dermatitis, cause not specified
L26 Exfoliative dermatitis
Dermatitis exfoliative, Exfoliative dermatitis generalized
L28.0 Simple chronic lichen
Common lichen, Chronic and simple lichen, Chronic lichen
Chronic psoriasis with diffuse plaques, Generalized psoriasis, Psoriasis of the scalp, Psoriasis of the scalp, Generalized form of psoriasis, Psoriasis dermatitis, Psoriasis complicated by erythroderma, Invalidative psoriasis, Isolated psoriatic plaque, Exfoliative psoriasis, Psoriatic Erythroderma, Psoriasis with eczematosis, Hyperkeratosis in psoriasis,Inverse psoriasis,Psoriasis eczematous, Dermatosis of psoriasis, Psoriasis of the genitals, Psoriasis with lesions of hairy areas of skin, Erythrodermal psoriasis, Chronic psoriasis of the scalp, Chronic psoriasis, Ordinary psoriasis, Refractory psoriasis, Kebner phenomenon, Scaly lichen
L40.5 Arthropathy psoriasis (M07.0-M07.3 *, M09.0 *)
Arthritis psoriatic, Arthropathic form of psoriasis
L43 Red Leaf Flat
Lishay Wilson, Erosive-ulcerative form of red flat lichen, Warty forms of red lichen, Red lichen, Flat lichen, Kebner phenomenon
L63.2 Nest patchiness (ribbon shape)
L91.0 Keloid cicatrix
Hyperlusculation, Keloid, Keloid cicatrix, Kelloid scars
L92 Granulomatous changes in the skin and subcutaneous tissue
L93.0 Discoid lupus erythematosus
Chronic discoid lupus erythematosus, Red discoid lupus, Discoid lupus, Discoid erythematosis
L98.8 Other specified diseases of skin and subcutaneous tissue
Favre-Canculo disease, Interdigital erosion, Ultrasonic cystic skin elastosis with comedones, Benign skin change
M06.9 Other specified rheumatoid arthritis
Rheumatoid arthritis,Pain syndrome in rheumatic diseases, Pain in rheumatoid arthritis, Inflammation in rheumatoid arthritis, Degenerative forms of rheumatoid arthritis, Children's rheumatoid arthritis, Exacerbation of rheumatoid arthritis, Acute articular rheumatism, Rheumatic arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatoid arthritis of active course, Rheumatoid arthritis, Rheumatoid polyarthritis, Acute rheumatoid arthritis, Acute rheumatism
M08 Juvenile [juvenile] Arthritis
Juvenile arthritis, Juvenile chronic polyarthritis, Juvenile chronic arthritis, Juvenile rheumatoid arthritis, Arthritis juvenile chronic
M10.0 Idiopathic Gout
M19.9 Arthrosis, unspecified
Change in brush with osteoarthritis, Osteoarthritis, Osteoarthrosis, Arthrosis of large joints, Pain syndrome in osteoarthritis, Pain syndrome in acute inflammatory diseases of the musculoskeletal system, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Deforming arthrosis, Deforming osteoarthritis, Deforming osteoarthritis of joints, Osteoarthritis in the acute stage, Osteoarthritis of large joints, Acute pain syndrome with osteoarthritis, Post-traumatic osteoarthritis, Rheumatic osteoarthritis, Spondylarthrosis, Chronic osteoarthritis
M32 Systemic lupus erythematosus
Lupus erythematosus red disseminated, Disseminated lupus erythematosus, Chronic lupus erythematosus
Muscle weakness in polymyositis, Polymyositis in children, Polyartralgia in polymyositis
M35.9 Unspecified systemic involvement of connective tissue
Hyperplasia of connective tissue, Diffuse connective tissue disease, Collagen diseases, Collagenosis, Systemic diseases of connective tissue, Diffuse connective tissue diseases
M45 Ankylosing spondylitis
Ankylosing spondylarthrosis, Marie-Strumpel disease, Ankylosing spondylitis, Pain syndrome in acute inflammatory diseases of the musculoskeletal system, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Bechterew's disease, Ankylosing spondylitis, Diseases of the spinal column, Rheumatic spondylitis, Bechterew-Marie-Strumpel disease
M65.9 Synovitis and tendosynovitis, unspecified
Synovitis, Inflammation of the tendon sheath, Acute nonspecific tenosynovitis, Reactive synovitis
M67.8 Other specified disorders of synovium and tendon
Cystic swelling of the tendons, Synovitis in osteoarthritis
M71.9 Bursopathy, unspecified
Bursites, Alberta disease, Acute bursitis
M79.0 Other unspecified rheumatism
Degenerative rheumatic disease, Degenerative and rheumatic diseases of the tendons, Degenerative rheumatic diseases, Localized forms of rheumatism of soft tissues, Rheumatism, Rheumatism with a pronounced allergic component, Rheumatism of the articular and extraarticular, Rheumatic attack, Rheumatic complaints, Rheumatic diseases, Rheumatic disease of the spine, Relapses of rheumatism, Articular and extra-articular rheumatism, Articular and muscular rheumatism, Articular rheumatism, Articular syndrome with rheumatism, Chronic rheumatic pain, Chronic articular rheumatism, Rheumatoid diseases, Rheumatic diseases of the intervertebral disc
R11 Nausea and vomiting
Postoperative vomiting, Nausea, vomiting, Vomiting in the postoperative period, Vomiting drug, Vomiting on the background radiation therapy, Vomiting indomitable, Vomiting with radiation therapy, persistent vomiting, anacatharsis, Postoperative nausea, Vomiting during chemotherapy, Vomiting of central origin, Vomiting on the background of cytostatic chemotherapy, persistent hiccups, repeated vomiting
R57.0 Cardiogenic shock
R57.8.0 * Burn shock
Pain shock with burns, Burn shock
R60.9 Edema, unspecified
Dropsy of joints, Inflammatory swelling of soft tissues, Dysprostainemic edema, Fluid retention in the body, Fluid retention for obesity, Edema, Hypothyroid edema, Edema of renal genesis, Osteoarthritis in musculo-articular diseases, Increased accumulation of fluid in the tissues of the body, Swelling of high-altitude
T78.2 Anaphylactic shock, unspecified
Anaphylactic shock, Anaphylactoid reaction, Anaphylactic shock, Anaphylactic reactions, Anaphylactic shock to drugs
T78.4 Allergy, unspecified
Allergic reactions to insulin, Allergic reactions to insect stings, Allergic reactions similar to systemic lupus erythematosus, Allergic diseases, Allergic diseases of mucous membranes, Allergic diseases and conditions resulting from increased release of histamine, Allergic diseases of mucous membranes, Allergic symptoms, Allergic symptoms in the mucous membranes, Allergic reactions, Allergic reactions caused by insect bites, Allergic reactions, Allergic conditions, Allergic laryngeal edema, allergopathy, allergic conditions, Allergy, House dust allergy, Anaphylaxis, Cutaneous reactions to medications, Skin reaction to insect stings, Cosmetic allergy, Drug allergy, Acute allergic reaction, Laryngeal edema allergic genesis and background radiation, Food and drug allergy
T79.4 Traumatic shock
Hemorrhagic shock, Crush syndrome, hemorrhagic shock, postoperative shock, post-traumatic shock, traumatic shock, hemorrhagic shock and encephalopathy syndrome
T80 Complications associated with infusion, transfusion and medical injection
Post-transfusion complication, Transfusion hemolytic reaction
T80.6 Other serum reactions
Serum sickness, Allergic reaction of the type of serum sickness, Serous disease accelerated
Y57 Adverse reactions in the therapeutic use of other and unspecified drugs and medications
Z100 * CLASS XXII Surgical practice
Abdominal surgery, adenomectomy, Amputation, Coronary angioplasty, Angioplasty of the carotid arteries, Antiseptic skin treatment for wounds, Antiseptic Hand, Appendectomy, atherectomy, Balloon coronary angioplasty, Vaginal hysterectomy, The coronary bypass, Interventions in the vagina and cervix, Interventions on the bladder, Intervention in the mouth, Restoration and reconstructive surgery, Hand hygiene of medical personnel, Gynecologic surgery, Gynecological intervention, Gynecological surgery, Hypovolemic shock during operations, Disinfection of purulent wounds, Disinfection of wounds edges, Diagnostic intervention, Diagnostic procedures, Cervical Diathermocoagulation, Long-surgery, Replacing the fistula catheters, Infection in orthopedic surgery, Artificial heart valve, cystectomy, Short-term outpatient surgery, Short-term operation, Short surgical procedures, Krikotireotomiya, Blood loss during surgery, Bleeding during surgery and in the postoperative period, Kuldotsentez, laser photocoagulation, laser coagulation, retinal laser coagulation, Laparoscopy, Laparoscopy in Gynecology, CSF fistula, Small gynecological operations, Small surgical procedures, Mastectomy and subsequent plastic, mediastinotomy, Microsurgical operations on the ear, Mukogingivalnye operation, suturing, Minor surgery, neurosurgical operation, Immobilization of the eyeball in ophthalmic surgery, testectomy, pancreatectomy, Perikardektomiya, The period of rehabilitation after surgery, The period of, convalescence after surgery, Percutaneous transluminal coronary angioplasty, Pleural thoracentesis, Pneumonia postoperative and posttraumatic, Preparation for surgical procedures, Preparation for surgery, Preparation of the surgeon's hands before surgery, Preparation of the colon for surgical procedures, Postoperative aspiration pneumonia in neurosurgical and thoracic surgery, Postoperative nausea, Postoperative bleeding, postoperative granuloma, postoperative shock, The early postoperative period, myocardial revascularization, Radiectomy, gastric Resection, bowel resection, uterine Resection, liver Resection, enterectomy, Resection of part of the stomach, Reocclusion of the operated vessel, Bonding tissues during surgical procedures, Removal of sutures, Condition after eye surgery, Condition after surgery, Condition after surgery in the nasal cavity, Condition after gastrectomy, Status after resection of the small intestine, Condition after tonsillectomy, Condition after removal of the duodenum, Condition after phlebectomy, Vascular surgery, Splenectomy, Sterilization of surgical instruments, Sterilization of surgical instruments, sternotomy, Dental surgery, Dental intervention in periodontal tissues, strumectomy, Tonsillectomy, Thoracic surgery, total gastrectomy, Transdermal intravascular coronary angioplasty, Transurethral resection, Turbinektomiya, Removal of a tooth, cataract surgery, Removal of cysts, tonsillectomy, Removal of fibroids, Removing the mobile primary teeth, Removing polyps, Removing broken tooth, Removal of the uterus body, Removal of sutures, Urethrotomy, Fistula likvoroprovodyaschih ways, Frontoetmoidogaymorotomiya, Surgical infection, Surgical treatment of chronic limb ulcersm, Surgery, The surgery in the anal area, The surgery on the colon, Surgical practice, The surgical procedure, Surgical interventions, Surgery on the gastrointestinal tract, Surgical procedures on the urinary tract, Surgical procedures on the urinary system, Surgical intervention of the genitourinary system, Surgical procedures on the heart, Surgical manipulation, surgery, Surgery on the veins, Surgical intervention, Vascular surgery, Surgical treatment of thrombosis, cholecystectomy, Partial gastric resection, transabdominal hysterectomy, Percutaneous transluminal coronary angioplasty, Percutaneous transluminal angioplasty, Coronary artery bypass, tooth Extirpation, Extirpation of milk teeth, pulpectomy, pulsative cardiopulmonary bypass, tooth Extraction, teeth Extraction, cataract extraction, Electrocoagulation, endourological intervention, episiotomy, Etmoidotomiya, Complications after tooth extraction
Z94 Presence of the transplanted organ and tissue
Allogeneic transplantation, Allotransplantation, Autotransplantation, Gomotransplant, Isotransplantation, Transplantation, Orthotopic transplantation
Code CAS 83-43-2
Characteristics of Methylprednisolone
Hormonal remedy (glucocorticoid).
In medical practice, methylprednisolone (tableted form), methylprednisolone acetate (for intramuscularly), intraarticular, periarticular, intra-bursal administration, as well as insertion into soft tissues, into the pathological focus, instillation into the rectum), methylprednisolone sodium succinate In / in (intravenously) and in / m (intramuscular) administration).
Methylprednisolone is a white or almost white crystalline powder, odorless. It is soluble in ethyl alcohol, dioxane and methanol, slightly soluble in acetone and chloroform, very slightly soluble in ether, practically insoluble in water. Molecular weight 374.47.
Methylprednisolone acetate is a white or almost white, crystalline, odorless powder, which melts at a temperature of about 215 ° C (with a slight decomposition). Soluble in dioxane, hardly soluble in acetone, ethyl alcohol, chloroform and methanol, slightly soluble in ether, almost insoluble in water. Molecular weight 416.51.
Methylprednisolone sodium succinate is white or almost white, odorless, hygroscopic, amorphous. Very soluble in water, ethyl alcohol, very slightly soluble in acetone, insoluble in chloroform. Molecular weight 496.52. Methylprednisolone sodium succinate is so readily soluble in water that it can be administered in a small amount of solvent in situations where IV administration is indicated and it is necessary to create a high level of methylprednisolone in the blood.
Pharmacological action - anti-inflammatory, antiallergic, immunosuppressive, anti-shock, glucocorticoid.
Interacts with specific receptors in the cytoplasm of the cell, the resulting complex penetrates into the nucleus of the cell, induces mRNA expression / depression and changes the formation of proteins on the ribosomes that mediate cellular effects. The mechanism of anti-inflammatory action is due to increased production of lipocortins inhibiting phospholipase A2 and inhibiting the liberation of arachidonic acid from membrane phospholipids, followed by inhibition of the synthesis of cyclic endoperoxides, leukotrienes, PG (prostaglandins), thromboxane, hydroxy acids. Affects all phases of inflammation. Stabilizing the lysosomal membranes, reduces the yield of lysosomal enzymes, inhibits the synthesis of hyaluronidase, reduces the permeability of capillaries and the formation of inflammatory exudates, improves microcirculation, inhibits the production of lymphokines (interleukin 1 and 2, gamma-interferon) in lymphocytes and macrophages, inhibits macrophage migration, infiltration and granulation , Suppresses the release of eosinophils mediators of inflammation, reduces the production of collagen and mucopolysaccharides, the activity of fibroblasts.
The antiallergic and immunosuppressive effect is caused by a decrease in the synthesis and secretion of mediators of allergy, inhibition of release from sensitized mast cells and basophils of histamine and other biologically active substances, a decrease in the number of circulating basophils, suppression of proliferation of lymphoid and connective tissue, a decrease in the number of T- and B-lymphocytes, mast cells . Suppresses the migration of B cells and the interaction of T and B lymphocytes, inhibits the release of lymphokines and the production of immunoglobulins. Reduces the sensitivity of effector cells to mediators of allergy, inhibits antibody formation, changes the immune response of the body.
It has a pronounced effect on metabolism: it reduces synthesis and increases protein breakdown in muscle tissue, increases protein synthesis in the liver, synthesizes higher fatty acids and triglycerides, causes fat redistribution and hyperglycemia, stimulates gluconeogenesis, increases glycogen content in the liver and muscles, breaks the mineralization of the bone Tissue.
Methylprednisolone acetate is a preparation for parenteral administration with slow absorption and prolonged action. The duration of action (18-36 h) depends on the route of administration, the solubility, the dosage form used, the dose and the condition of the patient. After a / m (intramuscular) injection of 80 mg of the drug, its effect lasts for 12 hours, and the suppressive effect on the plasma cortisone level is observed for another 17 days. When ingested quickly and completely absorbed from the gastrointestinal tract (gastrointestinal tract), mainly in the proximal part of the small intestine (2 times more than in the distal department). With / m (intramuscular) introduction succinate is absorbed more quickly, acetate is slower (the beginning of its action in 6-48 hours). Methylprednisolone acetate and methylprednisolone sodium succinate are rapidly hydrolyzed by the action of serum cholinesterases with the formation of free methylprednisolone. The binding of methylprednisolone with blood proteins is approximately 40-90%. Biotransformation occurs in the liver. The main metabolites are 20β-hydroxymethylprednisolone and 20β-hydroxy-6α-methylprednisolonePasses through the GEB (blood-brain barrier) and the placenta, penetrates into breast milk. T1 / 2 from the plasma is about 3 hours, T1 / 2 from the body - 12-36 hours. It is excreted as metabolites, mainly with urine.
Application of Methylprednisolone
Methylprednisolone, methylprednisolone acetate and methylprednisolone sodium succinate.
For systemic use (parenteral and oral). Endocrine diseases: primary or secondary adrenocortical insufficiency (drugs of choice - hydrocortisone or cortisone, synthetic analogues can be used in combination with mineralocorticoids, especially in pediatric practice), congenital adrenal hyperplasia, neural thyroiditis, hypercalcemia in malignant neoplasms; Rheumatic diseases (as an additional therapy in acute or acute exacerbations); Collagenosis (exacerbation or maintenance therapy), rheumatoid arthritis (including juvenile - in some cases, maintenance therapy with low doses may be required), acute rheumatic carditis, systemic lupus erythematosus, systemic dermatomyositis (polymyositis), psoriatic arthritis, acute gouty arthritis, posttraumatic osteoarthritis, ankylosing spondylitis , Acute or subacute bursitis, acute nonspecific tenosynovitis, synovitis in osteoarthritis, epicondylitis; Respiratory tract diseases: symptomatic sarcoidosis, Leffler's syndrome not responding to other means of therapy, berylliosis, fulminant or disseminated pulmonary tuberculosis in combination with appropriate antituberculous therapy, aspiration pneumonia; Hematological diseases: idiopathic thrombocytopenic purpura in adults (only intravenously, intramuscularly contraindicated), secondary thrombocytopenia in adults, acquired (autoimmune) hemolytic anemia, erythroblastopenia, congenital (erythroid) hypoplastic anemia, agranulocytosis, oncological diseases: leukemia and Lymphomas in adults, acute leukemia in children, myeloma, lung cancer (in combination with cytostatics); Edematous syndrome (to stimulate diuresis or achieve regression of proteinuria in patients with nephrotic syndrome without uremia, idiopathic type, or caused by systemic lupus erythematosus); Diseases of the digestive tract (for removing the patient from a critical condition): ulcerative colitis, Crohn's disease, local enteritis, hepatitis; Neurological diseases: exacerbation of multiple sclerosis; Myasthenia gravis; Tuberculous meningitis with a subarachnoid block or with its threat (in combination with appropriate anti-tuberculosis chemotherapy); Trichinosis with damage to the nervous system or myocardium; Suppression of immunological incompatibility in organ transplantation; Nausea and vomiting during cytostatic therapy; Skin diseases: pemphigus, bullous herpetiform dermatitis, Stevens-Johnson syndrome, exfoliative dermatitis, mycoses, psoriasis, seborrheic dermatitis; Allergic conditions (severe conditions in which conventional therapy is ineffective): seasonal or all-the-year-round allergic rhinitis, serum sickness, bronchial asthma, hypersensitivity reactions to medications, contact dermatitis, atopic dermatitis; Anaphylactic and anaphylactoid reactions; Eye diseases (severe acute and chronic allergic and inflammatory processes with eye damage): allergic corneal ulcers, ophthalmia caused by herpes zoster, anterior segment inflammation, diffuse posterior uveitis and choroiditis, sympathetic ophthalmia, allergic conjunctivitis, keratitis, chorioretinitis, optic neuritis, Iritis and iridocyclitis.
For methylprednisolone acetate and methylprednisolone sodium succinate additionally: acute adrenal insufficiency (it may be necessary to add mineralocorticoids); Posttransfusion reactions like hives; Acute non-infectious edema of the larynx (the drug of choice is epinephrine).
For methylprednisolone sodium succinate additionally: acute conditions, which require a rapid hormonal effect of maximum intensity, incl. Shock, which is a consequence of adrenal insufficiency, or shock, resistant to therapy by conventional methods, when there may be an adrenal insufficiency (including anaphylactic, burn, traumatic, cardiogenic); In the preoperative period, in case of severe trauma or serious illness, in patients with established or suspected adrenal insufficiency; Cerebral edema, acute traumatic spinal cord injuries (treatment should be started within the first 8 hours after injury).
For intraarticular, periarticular, intra-abdominal application or introduction into soft tissues (aqueous suspension of methylprednisolone acetate): as an auxiliary therapy for short-term use (for removing the patient from an acute condition or exacerbating the process) with the following diseases: synovitis in osteoarthritis, rheumatoid arthritis, acute And subacute bursitis, acute gouty arthritis, epicondylitis, acute nonspecific tendosynovitis, posttraumatic osteoarthritis.
For introduction into the pathological focus (aqueous suspension of methylprednisolone acetate): keloid scars and localized foci of inflammation with red flat lichen (Wilson lichen), psoriatic plaques, ring-shaped granulomas, simple chronic lichen (neurodermatitis limited), discoid lupus erythematosus, diabetic lipodystrophy, ; Cystic tumors of the aponeurosis and tendons.
For instillation into the rectum (aqueous suspension of methylprednisolone acetate): ulcerative colitis.
For methylprednisolone, methylprednisolone acetate and methylprednisolone sodium succinate in systemic use: acute and chronic bacterial or viral diseases, systemic fungal infections, HIV (human immunodeficiency virus) or AIDS (acquired immunodeficiency syndrome), active and latent tuberculosis (without appropriate chemotherapy), stagnant Heart failure, arterial hypertension, a recent myocardial infarction (possibly spreading the focus of necrosis, slowing the formation of scar tissue And, in consequence, rupture of the heart muscle), severe impairment of liver and / or kidney function, intestinal anastomosis (in the nearest history), esophagitis, gastritis, acute or latent peptic ulcer, diabetes mellitus, myasthenia gravis, glaucoma, severe osteoporosis, hypothyroidism , Mental disorders, poliomyelitis (except bulbar-encephalic forms), lymphomas after BCG vaccination, vaccination period.
For methylprednisolone acetate suspension: for intra-articular application: artificial joint, disruption of the blood coagulation system, intraarticular fracture, periarticular infectious process (including in the anamnesis); In / in (intravenously) and intrathecal administration.
For some dosage forms of methylprednisolone acetate and methylprednisolone sodium succinate: (may contain benzyl alcohol, which can cause a "gasping syndrome" with a fatal outcome): use in preterm infants.
pregnancy and lactation
The use of corticosteroids during pregnancy is possible if the expected effect of therapy exceeds the potential risk to the fetus (adequate and strictly controlled safety studies have not been conducted). Women of childbearing age should be warned about the potential risk to the fetus (corticosteroids pass through the placenta). Care must be taken to monitor newborns whose mothers received corticosteroids during pregnancy (possibly developing adrenal insufficiency in the fetus and newborn). Do not use often, in high doses, for a long period of time.
The action category for fetus by FDA is C.
It is recommended that breastfeeding women stop breastfeeding or use of drugs, especially in high doses (corticosteroids penetrate into breast milk and can inhibit the production of endogenous corticosteroids, inhibit growth and cause undesirable effects in offspring).
The frequency of development and severity of side effects depend on the duration of application and the amount of dose used.
On the part of the endocrine system: the Itenko-Cushing syndrome, adrenocortical atrophy, hypothalamic-pituitary insufficiency (especially during stressful situations such as illness, trauma, surgery), reduced tolerance to carbohydrates, steroid diabetes, increased insulin requirements or oral hypoglycemic LS in patients with diabetes mellitus, glucosuria, menstrual irregularity, hirsutism, impotence, growth retardation in children.
On the part of metabolism: negative nitrogen balance, sodium and water retention, swelling, loss of potassium, hypokalemic alkalosis, weight gain.
On the part of the digestive tract (gastrointestinal tract): peptic ulcer with possible perforation and bleeding, nausea, vomiting, ulcerative esophagitis, pancreatitis, bloating.
From the nervous system and sensory organs: headache, dizziness, increased intracranial pressure, pseudotumor brain, mental disorders, convulsions, increased intraocular pressure, exophthalmos.
From the cardiovascular system and blood (hematopoiesis, hemostasis): arterial hypertension, congestive heart failure (in predisposed patients), arrhythmia, thrombophilia. There are reports of cardiac arrhythmias and / or development of vascular insufficiency and / or cardiac arrest after rapid IV injection of high doses of methylprednisolone sodium succinate (administration of more than 0.5 g for less than 10 min); During or after the administration of large doses of methylprednisolone sodium succinate, bradycardia was noted (no association with speed and duration of administration).
From the musculoskeletal system: muscle weakness, steroid myopathy, decreased muscle mass, osteoporosis (especially in women and children); Ruptures of tendons, first of all Achilles; Compression fractures of the vertebrae, aseptic necrosis of the head of the humerus and femur, pathological fractures of long bones.
From the skin: thinning and atrophy of the epidermis, dermis and subcutaneous tissue, deterioration of regeneration, slow healing of wounds, petechiae, striae, steroid acne, pyoderma, candidiasis, hypo- and hyperpigmentation, ecchymosis,
Allergic reactions: urticaria, anaphylactic shock, bronchospasm.
Other: reduced resistance to infectious diseases; Reactions at the injection site: burning, numbness, pain, paresthesia and infection at the injection site, hyper or hypopigmentation, scar formation at the injection site; Atrophy of the skin and subcutaneous tissue, sterile abscess.
Joint use of methylprednisolone and cyclosporine causes mutual inhibition of metabolism and an increased likelihood of side effects (with the combined use of methylprednisolone and cyclosporine, seizures have been noted). Phenobarbital, diphenhydramine, phenytoin, rifampicin and other inducers of hepatic enzymes increase the rate of elimination and reduce the therapeutic effectiveness (dose adjustment may be required). Methylprednisolone can increase the clearance of acetylsalicylic acid, taken at high doses for a long time, which can lead to a decrease in its level in the blood (with the cancellation of methylprednisolone, the level of acetylsalicylic acid in the blood increases and the risk of its side effects increases). Caution should be used acetylsalicylic acid in conjunction with corticosteroids in patients with hypoprothrombinemia. Methylprednisolone affects the effect of oral anticoagulants: it is possible both to enhance and decrease the effect of anticoagulants taken concomitantly with methylprednisolone (constant monitoring of coagulation indicators is recommended to maintain the desired anticoagulant effect). In combination with paracetamol, the risk of hepatotoxicity increases (induction of hepatic enzymes and the formation of a toxic metabolite of paracetamol). The action intensifies ACTH (adrenocorticotropic hormone). Alcohol, antacids (inhibit absorption), NSAIDs (non-steroidal anti-inflammatory drugs), incl. Salicylates, phenylbutazone, indomethacin increase the likelihood of ulceration of the gastric mucosa and bleeding, amphotericin B and inhibitors of carbonic anhydrase - hypokalemia, heart failure, osteoporosis, cardiac glycosides - arrhythmia, sodium-containing drugs - edema and hypertension.
Ergocalciferol and parathyroid hormone prevent osteopathy caused by methylprednisolone. High doses of methylprednisolone reduce the effectiveness of somatotropin.
Reduces the activity of oral antidiabetic drugs, the effectiveness of vaccines (live vaccines against methylprednisolone may cause the disease). Mitotane and other inhibitors of adrenal cortex function may necessitate an increase in the dose of methylprednisolone.
Symptoms: edema, the appearance of protein in the urine, a decrease in the volume of filtration, arterial hypertension, arrhythmias, cardiopathy, hypokalemia. Repeated frequent use of the drug (daily or several times a week) for a long time can lead to the development of the Itenko-Cushing syndrome (necessitating the discontinuation of taking the drug).
Treatment: forced diuresis, potassium chloride, with depression and psychosis - dose reduction or withdrawal of the drug and the appointment of phenothiazine drugs or lithium salts (tricyclic antidepressants are not recommended).
Routes of administration
Inside, injectable (intravenously), intramuscularly, epidurally, into synovial bags and vaginas, into the joint cavity, into the area of skin lesions) and rectally.
Since the complications of glucocorticoid therapy depend on the magnitude of the applied dose and the duration of treatment, in each specific case it is necessary to compare the risk / benefit ratio for making decisions about glucocorticoid therapy, the dosing regimen, and the duration of treatment. After treatment with corticosteroids, the level of ALT (alanine aminotransferase), AST (aspartate aminotransferase) and alkaline phosphatase (alkaline phosphatase) in blood serum increased. Usually, these changes are insignificant, not associated with any clinical syndromes, and are reversible after discontinuation of treatment. Prolonged use of glucocorticoids can lead to the development of posterior subcapsular cataracts, glaucoma with possible damage to the optic nerve, possibly an increase in the incidence of secondary viral or fungal infections of the eyes. When parenteral corticosteroids are used, acute myopathy is possible, and most often when high doses of glucocorticoids are used in patients with neuromuscular transmission disorders (eg, in myasthenia gravis) or in patients receiving peripheral muscle relaxants (eg pancuronium bromide). Such acute myopathy has a generalized character, it can affect the muscles of the eye and respiratory system, lead to the development of tetraparesis. It is possible to increase the level of creatine kinase. In this case, clinical improvement or recovery after corticosteroid withdrawal can occur only after many weeks or even several years. Use the lowest dose of the drug, providing a sufficient therapeutic effect. To finish the course it is necessary, gradually reducing the dose. Depo-forms should not be introduced by non-recommended methods (including IV). With prolonged use, it is necessary to monitor the function of the hypothalamic-pituitary-adrenal system, the level of glucose in the blood serum, and to conduct ophthalmological studies.
It is not recommended to enter the deltoid muscle. With the / c and / m introduction should change the injection site. Intra-articular applications are performed no more than once in 3 weeks.
It should be taken into account that benzyl alcohol in the composition of certain dosage forms of methylprednisolone sodium succinate and acetate is potentially dangerous when applied topically to nervous tissue.
Can promote the spread or attachment of infections caused by viruses, fungi, protozoa and parasites (worms). The risk of these complications increases with increasing doses or the combination of methylprednisolone with other immunosuppressants.
Patients taking immunosuppressive doses of methylprednisolone should be warned of the dangers of contact with patients with chicken pox and measles.
In children during growth, glucocorticoids should be used only in absolute indications and by careful monitoring of the doctor. With prolonged use in children, growth may slow down.
Cancellation can be accompanied by pain in the abdomen and joints, weakness, nausea, headache, dizziness, fever, loss of appetite, weight loss.
With prolonged use, you should reduce the calorie content of food, increase the intake of potassium, reduce sodium. Calculation of the dose in children is best done not on the body weight (kg), but on the surface area (m2). Dosage forms for injections should not be mixed with other injectable solutions.