DEXAMETHASONE
Very potent and highly selective glucocorticoid. Long acting. Causes marked, pituitary-adrenal suppression, but fluid retention and hypertension are not a problem. It meets any emergency with intensified potency and strikingly rapid corticosteroid action, thus ensuring speedy reversal of the situation in the patients favour.Allergic reactions, pre & post-operatively. Acute stage of infections, poisoning, adrenocortical insufficiency, shock, acute dermatological disorders, rheumatic disorders, ophthalmologic disorders.
4-20 mg/day i.v. infusion or i.m. 0.5-5 mg/day orally.
Renal failure, diabetes mellitus, psychosis, osteoporosis. Pregnancy. CHF, tuberculosis & other systemic infections.
May reduce the response of the pituitary-adrenal axis to stress. Glaucoma, epilepsy, hypertension. Liver dysfunction. Elderly.
Cushing’s habitus (rounded face, narrow mout). Fragile skin, easy bruising, tele- ngiectasis, hirsutism. Cutaneous atrophy occurs with topical use. Hyperglycaemia, glycosuria, muscular weakness. Delayed healing of wounds & surgical incisions.
-Phenytoin, phenobarb -Ephedrine and rifampicin reduce efficacy G.I. absorption reduced by magnesium trisilicate. -Salicylates efficacy reduced. -Nonsteroidal anti-inflammatory drugs (NSAIDs) -Anticoagulants -Diabetes medications -Vaccines -Certain antibiotics (e.g., rifampin) -Antiepileptic drugs (e.g., phenytoin) -Antifungal medications (e.g., ketoconazole)
