Dexamethasone (Decadron)

Question 1

Class

Answer 1

Glucocorticoid

Question 2

Description

Answer 2

Synthetic steroid related chemically to the natural hormones secreted by the adrenal cortex

Suppresses acute & chronic inflammation, potentiate the relaxation of vascular & bronchial smooth muscle by beta adrenergic agonists, & possibly alters airway hyperactivity

Generally used in tx of allergic reactions & asthma & to reduce swelling in the CNS

Question 3

Onset & Duration

Answer 3

Onset: 4-8 hours after parenteral administration

Duration: 24-72 hours

Question 4

Indications:

Answer 4

Endocrine, rheumatic, & hematologic disorders

Allergic states

Septic shock

Chronic inflammation

Question 5

Contraindications

Answer 5

Hypersensitivity

Activate untreated infections (relative)

Question 6

Adverse Reactions

Answer 6

Decreased wound healing

Hypertension

GI bleeding

Hyperglycemia

Question 7

Drug interactions

Answer 7

Barbiturates & phenytoin can decrease affects

Question 8

How Supplied

Answer 8

Common IV preps:

4 mg/mL in 1-, 5-, 10-, 25-, 30-mL vials

10 mg/mL in 10-mL vials, 1-mL syringe, 1-mL ampule

20 mg/mL in 5-mL vials (IV or IM), 5-mL syringe (IV)

24 mg/mL (IV only) in 5- & 10-mL vials

Question 9

Dosage & Administration (Adult)

Answer 9

There is considerable variance in recommended doses

Usual range: 0.6 mg/kg (16 mg max dose) IV

Some physicians may prefer significantly higher doses (up to 100mg) for unusual indications

Question 10

Dosage & Administration (Ped)

Answer 10

1 dose of 0.6 mg/kg PO/IM/IV (16mg max dose)

Question 11

Special Considerations

Answer 11

Pregnancy safety: Category C (crosses the placenta & may cause fetal damage)

Should be protected from heat

Because of its slow onset of action (4-8 hours), should not be considered a first-line medication for allergic reactions