January 17, 2011 · Leave a Comment
Brand Name: Cortastat, Dalalone, Decadrol, Decaject, Deronil, Dexacorten, Dexameth, Dexasone, Dexone, Hexadrol, Primethasone, Solurex
Classification: Long- acting corticosteroid
- Management of cerebral edema
- Diagnostic agent in adrenal disorders
- Relieves inflammation
- Allergic disorders
Mechanism of Action
Dexamethasone suppresses inflammation and the normal immune response. It prevents the release of substances in the body that causes inflammation.
- Active untreated infection
- Systemic fungal infection
Use Cautiously in:
- Children (chronic use may result in decreased growth)
- Stress (surgery or infections)
- Potential infections as dexamethasone may mask the signs of infection such as fever and inflammation.
- Pregnancy (safety is not established with the sue of the drug during pregnancy)
- Decreased wound healing
- Easy bruising
- Increased hair growth
- Stomach irritation
- Irregular or absent menstruation
If these signs and symptoms will be noted instruct the patient to call or notify the physician immediately.
- Skin rash
- Swollen face, legs or ankles (fluid retention)
- Vision problems ( Dexamethasone may cause cataracts and increased intraocular pressure)
- Cold or infection that last for a long time
- Muscle weakness
- Black or tarry stool (suggestive of peptic ulceration caused by Dexamethasone use)
Route and Dosage
PO (Adults): 2 mg q 8-12 hours
IM, IV (adults): 10 mg initially IV, 4 mg q 6 hr, may be decreased to 2 mg q 8-12 hr, then change PO.
PO (Adults): 0.5-9 mg daily in single or divided doses
PO (children): 23.3 mcg/kg in 3 divided doses.
IV (Adults): 0.5-24 gm/day
IM (Adults): 8-16 mg q 1-3 wk
- Monitor intake and output of patient.
- Observe the patient for peripheral edema, steady weight gain, rales or crackles or dyspnea. Notify the physician immediately if these clinical manifestations are noted.
- Periodic growth evaluation for children should be done time to time.
- For patients with cerebral edema, assess then for level of consciousness changes and headache during the therapy.
- Guaiac-test stools should be carried out. Guaiac-positive stools should be reported to the physician immediately.
- Administer with meals to minimize GI irritation.
- For patients with difficulty swallowing, tablets can be crushed and administered with fluids or food. However, capsules should be swallowed whole.
- Educate the patient to take missed doses as soon as remembered, unless almost time for the next dose skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
- Instruct patient to avoid people with known infection and contagious illnesses as corticosteroids causes immunosuppression and may mask symptoms of infection.