Patient group direction (PGD) for administration
Of IM methylprednisolone acetate (Depo-Medrone®)
Staff Characteristics

A Registered General Nurse with a current NMC registration and currently
practising as a rheumatology nurse specialist with greater than one year of
clinical experience working within the Rheumatology department, OR

A Pharmacist registered with the Royal Pharmaceutical society of Great
Britain who is practising as a specialist rheumatology pharmacist and who
has satisfied the following assessments during each year they wish to use
this PGD:
o Three F1 DOPS assessments specific for methylprednisolone
acetate IM injection certified by a consultant rheumatologist to
the standard ‘meets expectations or above’
Has undertaken appropriate training to carry out clinical assessment of
patient leading to diagnosis that requires treatment according to the
indications listed in the PGD
Has undertaken appropriate training for working under patient group
directions for the supply and administration of medicines.
Has undertaken training appropriate to this PGD
Anyphalaxis training
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Clinical Details
Indication
Inclusion criteria
Exclusion criteria
Management of excluded patients
Action for patients not wishing to
receive care under this PGD

Previously diagnosed inflammatory arthritis presenting
with pain, stiffness or inflammation in the joints

Where triamcinolone has been used previously and found
to be ineffective

Adults and children 16 years with an established
diagnosis of inflammatory arthritis and who have
previously had an appointment with a consultant
rheumatologist
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Children under the age of 16

Pregnancy

Breastfeeding

Previous adverse reaction to the drug
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Current systemic infection on questioning (e.g. skin
infection, chest infection, urinary infection)

Less than 4 weeks since last methylprednisolone or
triamcinolone injection

Bleeding disorders from medical notes and patient
history
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Anti coagulant therapy from medical notes and patient
history

Established renal disease from medical notes and patient
history

Heart failure from medical notes and patient history
Advise patient of alternative sources of treatment. Refer to
consultant rheumatologist, GP or A&E as appropriate.
Document action in patients’ records
Advise patient of alternative sources of treatment. Refer to
consultant rheumatologist, GP or A&E as appropriate.
Document refusal and action taken in patients’ records
Drug details
Name, composition, form and strength of
medicine
Legal classification
Route
Dosage
Frequency
Duration of treatment
Maximum or minimum treatment period
Quantity to administer
Cautions
Side effects
Advice to patient
Methylprednisolone Acetate BP 40 mg/ml injection
in type I flint glass vials of 1, 2 and 3ml
POM
Intra muscular
Adults only: <50kgs (8st) 80mgs
>50kgs (8st) 120mgs
At least 4 weeks between injections. No more than
4 injections a year
Single dose
Single dose
Single dose
As per data sheet
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Facial flushing

Alteration in glycaemic control (relevant to
diabetes)

Subcutaneous atrophy/skin depigmentation at
injection site

Small risk of infection at injection site (1:10,000)
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Anaphylactic reaction

Many other adverse effects listed in SPC but are
not applicable following a single dose
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Discuss potential side effects
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Product information sheet/ARC leaflet offered to
the patient

If diabetic, inform patient that blood glucose
levels may be elevated for upto one week
following injection. If persisting elevation, patient
should discuss with GP

In the event of a serious or persistent adverse
effect the patient will be advised to contact their
GP / A&E or the rheumatology department
Records and Follow up
Records/audit trail
Patients’ name, address, date of birth and GP
Diagnosis
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Dose and form administered
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Advice given to patient
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Product and expiry date
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Name of person who administered medication
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Details of any adverse drug reaction and actions
taken
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Documentation in the patients medical record
Appointment in rheumatology follow up clinic
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Follow up
Managerial content of patient group direction for IM methylprednisolone acetate
(Depo-Medrone®)
This patient group direction must be agreed to and signed by all health care professionals involved
in its use. The Trust PGD chairperson should hold the original signed copy. The PGD must be
easily accessible in the clinical setting.
Organisation
Brighton and Sussex University hospitals NHS
Trust
Authorisation
Lead Pharmacist
Name:
Position:
Date:
Lead Consultant
Signature:
Name:
Position:
Signature:
Name:
Position:
Date:
Lead Nurse
Signature:
Name:
Position:
Date:
Signature:
Name:
Position:
Date:
Signature:
Name:
Position:
Date:
Signature:
Date:
Organisational authorisation by:
Date for review: