Dexamethasone

Dexamethasone is powerful synthetic glucocorticoid (containing adrenal hormones and their synthetic analogs) the drug intended for regulation of protein, carbohydrate and mineral metabolism.

Pharmacological action

Dexamethasone possesses antiinflammatory, desensibilizing (reduces sensitivity to allergens), antiallergic, antishock, immunodepressive (suppresses or reduces immunity) and anti-toxic properties.

Use of Dexamethasone allows to increase sensitivity of proteins of an external cellular membrane (beta adrenoceptors) to endogenous catecholamines (intermediaries of intercellular interaction).

Dexamethasone regulates protein metabolism, reducing synthesis and strengthening a protein catabolism in muscular tissue, reducing amount of globulins in plasma, increasing synthesis of albumine in a liver and kidneys.

Influencing carbohydrate metabolism, Dexamethasone promotes absorption of carbohydrates from a digestive tract, to increase in receipt in glucose blood from a liver, to development of a hyperglycemia that in turn activates production of insulin.

Participation of Dexamethasone in water and electrolytic exchange is shown in decrease in a mineralization of a bone tissue, a delay of sodium and water in an organism, reduction of absorption of calcium from digestive tract.

Antiinflammatory and antiallergenic properties of Dexamethasone on the activity by 35 times exceed similar effects of a cortisone.

Indications to Dexamethasone use

The instruction recommends to apply the tablets Dexamethasone at:

• acute and subacute tireodit (inflammation of a thyroid gland);
• hypothyroidism (a state at a resistant lack of hormones of a thyroid gland);
• the progressing ophthalmopathy (increase in volume of tissues of eye) connected with a thyrotoxicosis (intoxication hormones of a thyroid gland);
• Addison-Birmera's diseases (loss by adrenal glands of ability to produce hormones in enough);
• to bronchial asthma;
• diseases of connecting fabric;
• pseudorheumatism in an aggravation phase;
• autoimmune hemolitic anemias;
• serum disease (an immune response on foreign proteins of serum);
• agranulocytosis (decrease in level of neutrophils in blood);
• acute erythrosis (erubescence);
• pempigus (the skin disease which is shown in the form of bubbles on hands, genitals in a mouth, etc.);;
• to acute eczema;
• malignant tumors (symptomatic therapy);
• brain hypostasis;
• inborn adrenogenital syndrome (hyperfunction of bark of adrenal glands and the increased maintenance of androgens in an organism).

Dexamethasone in ampoules is applied at:

• shock of various genesis;
• asthmatic status;
• brain hypostasis;
• heavy allergic reactions;
• acute hemolitic anemias;
• thrombocytopenia;
• to agranulitsitoza;
• acute lymphoblastoid leukemia (the malignant disease affecting marrow, a spleen, lymph nodes, a thymus and other bodies);
• serious infectious diseases;
• acute croup (inflammation of a throat and upper respiratory tracts);
• acute insufficiency of bark of adrenal glands;
• diseases of joints.

Dexamethasone of a drop are used in ophthalmologic practice at:

• not purulent and allergic conjunctivitis (inflammation of a mucous membrane of an eye);
• keratitis (eye cornea inflammation);
• keratoconjunctivitis (simultaneous inflammation of a conjunctiva and cornea of an eye) without damage of an epithelium;
• iritis (inflammation of an iris of the eye of an eye);
• iridocyclitis (inflammation of an iris of the eye and ciliary body);
• blepharitis (inflammation of edges century);
• sclerite (inflammation of deep layers of a sclera of an eye);
• episcleritis (an inflammation of connecting fabric between a conjunctiva and a sclera);
• inflammatory processes after injuries of an eye or operations;
• sympathetic ophthalmia (inflammatory damages of an eye).

Application instruction of Dexamethasone

Oral administration of Dexamethasone in the form of tablets assumes purpose of 10-15 mg of drug a day at the initial stage of treatment with the subsequent reduction of a daily dose to 2-4,5 mg at a maintenance therapy.

The instruction recommends to divide a daily dose of the drug Dexamethasone into 2-3 receptions (after or during food). The supporting small doses should be accepted once a day, it is desirable in the morning.

Dexamethasone in ampoules is intended for intravenous (kapelno or struyno), intramuscular, perartikulyarny and intra joint introduction. The recommended daily dose of Dexamethasone at such ways of introduction – 4-20 mg. Dexamethasone in ampoules is usually applied 3-4 times a day for 3-4 days with the subsequent transition to tablets.

Dexamethasone of a drop are applied in ophthalmology: at acute states on 1-2 drops of drug dig in in a conjunctival sac each 1-2 hours, at improvement of a state – each 4-6 hours.

Chronic processes assume use Dexamethasone of drops 2 times a day. Duration of treatment depends on the clinical course of a disease therefore Dexamethasone of a drop can be applied from several days to four weeks.

Side effects

According to the instruction, Dexamethasone can be the cause of such undesirable reactions as:

• decrease in tolerance to glucose, oppression of function of adrenal glands, a steroid diabetes mellitus, an Icenco-Cushing syndrome (hyperfunction of bark of adrenal glands);
• hypocalcemia, hypopotassemia, hyponatremia, the increased calcium removal, increase in body weight, the increased sweating;
• increase in intracranial pressure, concern, depression, paranoia, dizziness, headache, spasms;
• vomiting, nausea. steroid ulcer, pancreatitis, erosive esophagitis (superficial inflammation of a gullet), hiccups, meteorism;
• bradycardia, arrhythmias, increase in arterial pressure;
• exophthalmos (eyeglobe shift forward or aside), trophic changes of a cornea, tendency to development of infections of eyes, increase in intraocular pressure, back subkapsulyarny cataract (phacoscotasmus);
• delay of ossification at children, a rupture of sinews of muscles, osteoporosis, decrease in muscle bulk, a steroid myopathy;
• dermatological and allergic reactions.

Contraindications to Dexamethasone use

Use of Dexamethasone is contraindicated to patients with hypersensitivity to drug components.

With care Dexamethasone is appointed at:

• peptic ulcer, gastritis, esophagitis, recently created intestines anastomosis, diverticulitis;
• parasitic and infectious diseases of various nature;
• immunodeficiency;
• diseases of cardiovascular system;
• endocrine diseases;
• to heavy liver or renal failure, nefrourolitiaza, hypoalbuminemia;
• glaucoma, poliomyelitis, acute psychosis, system osteoporosis.

Dexamethasone use by pregnant women and the feeding women, and also children has to happen only on doctor's orders after the accounting of all possible risks.