title: Cardiorespiratory decompensation following methylprednisolone administration.
abstract: A 2-year-old white female receiving multidrug chemotherapy for treatment of a primitive neuroectodermal tumor developed acute hypotension, bradycardia, and shock following administration of ondansetron and high-dose methylprednisolone. The subsequent clinical course is described, and cardiovascular reactions to ondansetron and methylprednisolone are reviewed. While the etiology of this severe reaction is uncertain, it is possible that it represents an idiosyncratic reaction to the rapid administration of high-dose adrenal corticosteroids. Patients receiving high-dose corticosteroid therapy should be closely monitored, and slow rates of infusion are recommended.
authors.affiliation: Department of Pediatrics, Children's Hospital of Pittsburgh.
authors.forename: K G
authors.initials: KG
authors.lastname: Lucas
authors.forename: D L
authors.initials: DL
authors.lastname: Howrie
authors.forename: C K
authors.initials: CK
authors.lastname: Phebus
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination; D000707:Anaphylaxis / Q000139:chemically induced; D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy; D002675:Child, Preschool; D002945:Cisplatin / Q000008:administration & dosage; D002969:Clavulanic Acids / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004285:Dogs; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced*; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage; D008130:Lomustine / Q000008:administration & dosage; D008775:Methylprednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D017599:Neuroectodermal Tumors / Q000188:drug therapy; D017294:Ondansetron / Q000009:adverse effects* / Q000627:therapeutic use; D010033:Otitis Media / Q000150:complications / Q000188:drug therapy; D011344:Procarbazine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D002969:Clavulanic Acids; D003561:Cytarabine; D011344:Procarbazine; D017294:Ondansetron; D014750:Vincristine; D019980:Amoxicillin-Potassium Clavulanate Combination; D008130:Lomustine; D000658:Amoxicillin; D003520:Cyclophosphamide; D002945:Cisplatin; D008775:Methylprednisolone; D006918:Hydroxyurea