Drug information of Dexamethasone

Dexamethasone

Drug group:

The drug forms include tablets, syrups, spray and ampules.Dexamethasone is a corticosteroid that prevents the release of substances in the body that cause inflammation.

Dexamethasone is used to treat many different conditions such as allergic disorders, skin conditions, ulcerative colitis,arthritis, lupus, psoriasis, or breathing disorders.

Mechanism of effect

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reducing capillary permeability; stabilizes cell and lysosomal membranes, increases surfactant synthesis, increases serum vitamin A concentration, and inhibits prostaglandin and proinflammatory cytokines. suppresses lymphocyte proliferation through direct cytolysis, inhibits mitosis, breaks down granulocyte aggregates, and improves pulmonary microcirculation.

Pharmacodynamic

Dexamethasone is a long-term adrenocorticoid with low mineralocorticoid activity and strong anti-inflammatory activity. The strength of this drug is 25-25 times that of hydrocortisone.

Acetate form of This drug is a suspension and should not be injected intravenously. It is especially useful as an anti-inflammatory drug for intra-articular, intradermal, and intra-lesion injections.

Sodium phosphate form of drug is highly soluble and has a faster onset of action and a shorter duration than its acetate form. The most commonly used is brain edema and shock resistant. Also, this drug is used for inflammation in the joint, or soft tissue.

Pharmacokinetics

Absorption: Onset: Between a few minutes and several hours; dependent on indication and route of administration

Peak serum time: 8hr (IM); 1-2 hr (PO)

Metabolism:Metabolized in liver

Elimination:Half-life: 1.8-3.5 hr (normal renal function)

Excretion: Urine (mainly), feces (minimally)

Drug indications

Nausea/Vomiting - Chemotherapy Induced

• substitution in the adrenal gland failure
• treat symptoms of inflammatory and allergic disorders
• to suppress the immune system
• congenital hyperplasia of the adrenal gland
• cerebral edema
• rheumatic inflammatory diseases
• diagnosis of Cushing's syndrome and androgen depression
• Nausea and vomiting caused by chemotherapy

Dosage

Allergic Conditions

For control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, and serum sickness

Day 1: 4-8 mg IM

Days 2-3: 3 mg/day PO divided q12hr

Day 4: 1.5 mg/day PO divided q12hr

Days 5-6: 0.75 mg/day PO in single daily dose

Chemotherapy-Induced Nausea & Vomiting (Off-label)

8-12 mg PO/IV alone or in combination with other antiemetics before chemotherapy, then 8 mg PO/IV q24hr for 1-3 days after chemotherapy (days 2-4)

Inflammation

0.75-9 mg/day IV/IM/PO divided q6-12hr

Intra-articular, intralesional, or soft tissue: 0.2-6 mg/day

Multiple Sclerosis (Acute Exacerbation)

30 mg/day PO for 1 week; follow by 4-12 mg/day for 1 mo

Drug contraindications

systemic fungal infection

Systemic fungal infection
Documented hypersensitivity
Cerebral malaria
Administration of live or live, attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of corticosteroids.

Alerts

  • Long-term use of dexamethasone in children can lead to inhibition of growth. Following the use of this drug, may cause Examination tests of functioning of the hypothalamic-pituitary the adrenal gland may be disorder.
  • In the elderly, especially menopausal women, the chance of osteoporosis and blood pressure increased.
  • Caution if you need surgery or emergency treatment as well as in diabetic patients. In people taking the drug with the immunosuppressive amount ,injection of vaccine containing live viruses should be avoided.

Points of recommendation

  • To minimize gastrointestinal stimulation, the oral form of dexamethasone should be taken after a meal.
  • Avoiedof the Abrupt discontinuation of drug after prolonged use (more than 3 weeks).
  • During treatment, sodium intake should be limited and supplementation with potassium is recommended.
  • Ophthalmic examinations should be performed regularly during long-term treatment.


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