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Drug Monographs - JUN 24' > dexamethasone [Decadron] > Flashcards

dexamethasone [Decadron] Flashcards

1
Q

Class

dexamethasone

A

anti-inflammatory
systemic corticosteroid

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2
Q

INDICATIONS

dexamethasone

A

PCP/ACP* - adjuctive treatment for croup and broncospasm 2nd to asthma or COPD

requires BCEHS specific training

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3
Q

CONTRAINDICATIONS

dexamethasone

A
  • hypersensitivity or to other corticosteroids
  • systemic fungal infections
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4
Q

DOSAGE - ADULT

dexamethasone

A

8mg IV/IM/PO - PO preferred
☎️ cliniCALL required

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5
Q

DOSAGE - PEDIATRIC

dexamethasone

A

0.5mg/kg IV/IO/IM/PO - PO preferred
MAX dose 16mg
☎️ cliniCALL required

may combine w/ juice to improve palatbility

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6
Q

Pharmacodynamics

dexamethasone

A

supresses neutrophil migration, decreasing production of inflammatory mediators and reversing increased capillary permeability

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7
Q

Pharmacokinetics

dexamethasone

A

onset - minutes to hours; dependant on indication & route of admin
peak - 8hrs (IM); 1-2hrs (PO)
duration - short (IV)

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8
Q

cardiovascular

ADVERSE EFFECTs

dexamethasone

A
  • bradycardia
  • cardiac arrhythmia
  • cardiac failure
  • cardiomegaly
  • circulatory shock
  • edema
  • embolism (fat)
  • HTN
  • hypertrophic cardiomyopathy (premature infants)
  • myocardial rupture (post-MI)
  • syncope
  • tachycardia
  • thromboembolism
  • thrombophlebitis
  • vasculitis
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9
Q

central nervous system

ADVERSE EFFECTs

dexamethasone

A
  • depression
  • emotional lability
  • euphoria
  • HA
  • ICP
  • insomnia
  • malaise
  • myasthenia
  • neuritis
  • neuropath
  • parasthesia
  • personality changes
  • psedotumor cerebri
  • psychic disorder
  • seizure
  • vertigo
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10
Q

respiratory

ADVERSE EFFECTs

dexamethasone

A
  • pulmonary edema
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11
Q

gastrointestinal

ADVERSE EFFECTs

dexamethasone

A
  • abdo distention
  • GI hemorrhage
  • GI perforation
  • hiccups
  • increased appetite
  • nausea
  • pancreatitis
  • peptic ulcer
  • pruritus ani
  • ulcerative esophagitis
  • hepatomegaly
  • increased serum transaminases (produced by liver)
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12
Q

dermatologic

ADVERSE EFFECTs

dexamethasone

A
  • acne vulgaris
  • allergic dermatitis
  • alopecia
  • atrophic striae
  • diaphoresis
  • ecchymoses
  • erythema
  • facial erythema
  • fragile skin
  • hyperpigmentation
  • hypertrichosis
  • hypopigmentation
  • perianal skin irritation (itching, burning, tingling; following IV injections)
  • petechiae
  • skin atrophy
  • skin rash
  • subcutaneous atrophy
  • supression of skin test reaction
  • urticaria
  • xeroderma
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13
Q

endocrine & metabolic

ADVERSE EFFECTs

dexamethasone

A
  • adrenal suppression
  • carbohydrate intolerance
  • Cushing syndrome
  • decreased glucose tolerance
  • decreased serum potassium
  • diabete mellitus
  • fluid retention
  • flycosuria
  • growth supression (children)
  • hirsutism
  • HPA-axis supression
  • hyperglycemia
  • hypokalemic alklosis
  • menstrual disease
  • moon face
  • negative nitrogen balance
  • protein catabolism
  • redistribution of body fat
  • sodium retention
  • weight gain
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14
Q

neuromuscular & skeletal

ADVERSE EFFECTs

dexamethasone

A
  • amtotrophy
  • aseptic necrosis of bones (femoral & humoral heads)
  • bone fractures
  • Charcot-like arthropathy
  • myasthenia
  • myopath ( particularly in conjunction w/ neuromuscular disease or neuromuscular-blocking agents
  • osteoporosis
  • rupture of tendon
  • steroid myopathy
  • vertebral compression fracture
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15
Q

ophthalmic

ADVERSE EFFECTs

dexamethasone

A
  • exophthalmos
  • glaucoma
  • increased intraocular pressure
  • subcapsular posterior cataract
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16
Q

miscellaneous

ADVERSE EFFECTs

dexamethasone

A
  • wound healing impairment
  • local : postinjection flare (intra-artivular use)
  • hematologic & oncologic : Kaposi sarcoma, petechial, tumor lysis syndrome
  • genitourinary : defective (increased/decreased) spermatogenesis
17
Q

Warning // Precautions

dexamethasone

A
  • may cause hypercortisolism, particularly in younger children/when used for long periods of time at higher doses
  • should generally not be used for adrenal insufficiency - lacks mineralcorticoid activity
  • used w/ caution in pts w/ CHF or HTN - associated w/ fluid retention and electrolyte disturbance
  • corticosteroids have been associated w/ myocardial rupture when used in AMI
  • crosses the placenta - some studies found an association betwen use in 1st trimester and decreased birth weights and oral clefts
18
Q

DRUG INTERACTIONs

dexamethasone

A
  • may enhance adverse/toxic effects of NSAIDs and salicylates (i.e. GI ulceration and bleeding)
  • may reduce serum concentration of salicylates
  • may decrease serum concentraion of phenytoin
  • may enhance anticoagulant properties of warfarin
19
Q

Brand Names

dexamethasone

A

Decadron

20
Q

Supplied

dexamethasone

A

vial of 20mg in 5mL (4mg/mL)

injectable formulation can be mixed w/ juice to improve palatability

Drug Monographs - JUN 24' (21 decks)

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