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Objective: - To ascertain the adverse events and changes in vital signs (heart rate (HR), systolic (SBP), diastolic blood pressure (DBP), and serum potassium level during and after intravenous methylprednisolone (IVMP) in multiple sclerosis exacerbation.Design: retrospective review study conducted at Hamad General Hospital (HGH), all patients who are admitted 2019-2020 with MS exacerbation without any other comorbidities will be categorized into 2 groups depending on infusion rate, one group received conventional intravenous methylprednisolone pulse dose over 30minutes to one hour, while the second group received methylprednisolone pulse dose intravenously over an extended period)(four to six hours). Multiple readings of vital signs and, potassium level through steroid administration time will be assessed to determine if there is an infusion-related significant difference in adverse events between both groups.Methods: 74 adult patients with MS relapse who have been admitted at Hamad General Hospital (HGH) and satisfied pre-specified inclusion criteria were invited to participate in the study.Results: 74 patients with MS included in the study, 61 patients (83.6%) were received methylprednisolone dose 500 mg -1000 mg in conventional infusion rate while 12 patients (16.4%) were received pulse steroid in extended duration. There was no significant difference in mean blood pressure before and after IVMP in both groups. There was a small but statistically significant increase in mean heart rate in the conventional group immediately after first and second but not 3rd dose of IVMP compared to baseline 3.5± 8.9 and 4.85± 13.9 P < 0.003. There was a minimal non-significant increase in potassium level in the conventional group (P = 0.17), while there is a non-significant decrease in potassium level in the extended group (P=0.72).Conclusion: IVMP is considered safe and effective in the treatment of MS exacerbation regardless of intravenous infusion duration. There was no significant difference in vital signs among different infusion rates. However, there was a small but statistically significant increase in mean heart rate in the conventional group immediately after first and second but not 3rd dose of IVMP compared to baseline. No significant difference was observed in potassium levels before and after IVMP. We, therefore, recommend that potassium level monitoring should be only restricted to patients with other risk factors of hypokalemia. |
