Which of the following statements about intravenous administration of steroids is true?
A. Steroids administered intravenously must be diluted.
B. Steroids administered intravenously can be either in diluted or undiluted form.
C. Steroids should be given IV push only.
D. Intravenous administration of steroids is contraindicated in acutely ill clients.
Correct Answer: B. Steroids administered intravenously can be either in diluted or undiluted form.
IV steroids can either be diluted or given without dilution. The route of administration for corticosteroids depends on many factors, primarily being the disorder treated. The route can be parenteral, oral, inhaled, topical, injected (intramuscular, intraarticular, intralesional, intradermal, etc.), and rectal. The clinician must keep many factors in mind upon deciding to initiate corticosteroid therapy, including the route of administration, preparation, dosing, frequency, and duration of treatment.
Option A: Parenteral administration is often used in more emergent therapy as well as in those unable to tolerate medication by mouth. Oral administration is more common for chronic treatment. Patients should receive non-systemic therapy whenever possible, to minimize systemic exposure.
Option C: When administering Methylprednisolone sodium succinate in high doses intravenously it should be given over a period of at least 30 minutes. Doses up to 250 mg should be given intravenously over a period of at least five minutes.
Option D: The toxicity of corticosteroids accounts for one of the most common causes of iatrogenic illness in patients on chronic therapy. No specific reversal agent exists for corticosteroids. Their effect in excess is manageable by gradual taper and addressing the particular complication (e.g., hyperglycemia, infection, hypertension).