Dexamemet

Dexamethasone Na phosphate

Primary or secondary adrenocortical insufficiency, non-endocrine corticosteroid responsive conditions, including allergy/angioneurotic oedema & anaphylaxis, GI, Crohn's disease & ulcerative colitis, infection (w/ appropriate chemotherapy), miliary TB & endotoxic shock, neurological disorders, raised ICP secondary to cerebral tumours & infantile spasms, resp, bronchial asthma & aspiration pneumonitis, skin disorders, TEN, shock. As palliative care for symptoms eg, fatigue, anorexia, refractory nausea & vomiting or adjuvant analgesia & symptomatic treatment of cord compression or raised ICP. Adjunct therapy for short-term administration in soft-tissue disorders eg, carpal tunnel syndrome & tenosynovitis, IA disorders eg, RA & OA w/ inflammatory component. Selected skin disorders eg, cystic acne vulgaris, localised lichen simplex, & keloids.

IM/IV As directed by the physician & according to the treatment of the disease.

Hypersensitivity. Systemic fungal infection; systemic infection unless specific anti-infective therapy is employed. Live virus vaccines.

Patient w/ history of allergy to any drug; anaphylactoid & hypersensitivity reactions in patients receiving parenteral corticosteroid therapy. May exacerbate systemic fungal infections, do not use in the presence of such infections unless it is needed to control drug reactions due to amphotericin B. Increase dosage of rapidly acting corticosteroids before, during & after stressful situation in patients on therapy subjected to any unusual stress. Rapid w/drawal may result to drug induced secondary adrenocortical insufficiency. May mask signs of infection, & new infections may appear during use; decreased resistance & inability to localise infection. Cerebral malaria. Rule out latent active amebiasis before initiating therapy in patient who has spent time in the tropics or w/ unexplained diarrhea. Prolonged use may cause posterior subcapsular cataracts, glaucoma w/ possible damage to optic nerves & enhance establishment of secondary ocular infections due to fungi or viruses. Concomitant use w/ amphotericin B may cause cardiac enlargement & congestive failure. False -ve result in nitroblue tetrazolium test for bacterial infection. Pregnancy & lactation.

Na retention, fluid retention, CHF in susceptible patients, K loss, hypokalaemic alkalosis, HTN, increased Ca excretion; muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis (postmenopausal females), vertebral compression fractures, aseptic necrosis of femoral & humeral heads, pathological fracture of long bones, tendon rupture & post-inj flare (following IA use); peptic ulcer w/ possible perforation & hemorrhage, perforation of small & large bowel (particularly in inflammatory bowel disease patients), pancreatitis, abdominal distention, ulcerative esophagitis, dyspepsia, oesophageal candidiasis; impaired wound healing, thin fragile skin, petechiae & ecchymoses, erythema, striae, telangiectasia, acne, increased sweating, possible suppression of skin tests, burning or tingling in the perineal area (after IV inj), other cutaneous reactions eg, allergic dermatitis, urticaria, angioneurotic oedema & hypo- or hyper-pigmentation; convulsions, increased ICP w/ papilloedema (pseudotumor cerebri), vertigo, headache, cerebral palsy in pre-term infants; affective disorders (eg, irritable, euphoric, depressed & labile mood, & suicidal thoughts), psychotic reactions (eg, mania, delusions, hallucinations, & aggravation of schizophrenia), behavioural disturbances, irritability, anxiety, sleep disturbances, & cognitive dysfunction including confusion & amnesia; menstrual irregularities, amenorrhoea, development of Cushingoid state, suppression of growth in childn & adolescents, secondary adrenocortical & pituitary unresponsiveness, decreased carbohydrate tolerance, manifestation of latent DM, increased requirements for insulin or oral hypoglycaemic agents in diabetes, hirsutism; increased susceptibility & severity of infections w/ suppression of clinical symptoms & signs; opportunistic infections, recurrence of dormant TB; posterior subcapsular cataracts, increased IOP, papilloedema, corneal or scleral thinning, exacerbation of ophth viral disease, glaucoma exophthalmos; -ve nitrogen/Ca balance; myocardial rupture following recent MI, hypertrophic cardio-myopathy in low birth wt infants; hypersensitivity, including anaphylaxis, leucocytosis, thromboembolism, wt gain, increased appetite, nausea, malaise, hiccups & sterile abscess.

Concomitant use w/ aspirin in hypoprothrombinaemia. Increased renal clearance of salicylates. May enhance metabolic clearance, resulting in decreased blood levels & reduced physiological activity w/ phenytoin, barbiturates, ephedrine, rifabutin, carbamazepine, rifampicin & aminoglutethimide. False -ve results in dexamethasone suppression test w/ indometacin. Change in the efficacy of coumarin anticoagulants. Antagonises the desired effects of hypoglycaemic agents (including insulin). May develop hypokalaemia w/ K-depleting diuretics. May produce false -ve result in nitroblue tetrazolium test. May increase clearance, resulting in lowered plasma conc of antiretroviral PIs (ritonavir, darunavir, indinavir, lopinavir, saquinavir & efavirenz). May increase plasma conc w/ ritonavir, indinavir.

Corticosteroid Hormones

H02AB02 - dexamethasone ; Belongs to the class of glucocorticoids. Used in systemic corticosteroid preparations.

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