"Dexamethasone" is a drug that belongs to the group of glucocorticosteroids and is considered a hormonal drug. It is actively used in various fields of medicine. What side effects and contraindications to the use of "Dexamethasone" has, find out in the article.
The drug is produced in three dosage forms:
- Eye drops 0.1% (in bottles of five and ten milliliters).
- Tablets 0.5 milligrams (fifty tablets).
- Injection solution 0.4% (ampoules one and two milliliters).
Structure
According to the instructions for use, Dexamethasone injections have the following components:
- dexamethasone sodium phosphate;
- glycerol;
- propylene glycol;
- disodium edetate;
- phosphate buffered saline;
- propyl parahydroxybenzoate;
- water.
Tablets are composed of:
- dexamethasone sodium phosphate;
- lactose in the form of a monohydrate;
- cellulose;
- silica colloidal anhydrous;
- magnesium stearate;
- croscarmellose sodium.
Drops in the eye have the following components in their structure:
- dexamethasone sodium phosphate;
- boric acid;
- benzalkonium chloride;
- sodium tetraborate;
- Trilon B;
- water.
Pharmacological properties
Dexamethasone is a hydrocortisone substitute. The hormone that is produced by the adrenal cortex. It interacts with glucocorticoid nerve endings, regulates the metabolism of sodium, as well as potassium, water balance and glucose homeostasis.
It activates the production of enzyme proteins in the liver, affects the connection of inflammatory mediators and allergic reactions, and inhibits their formation. Subsequently, the drug has anti-inflammatory, as well as anti-allergic, immunosuppressive and anti-shock effects.
With intramuscular injections, the therapeutic effect of the drug is observed eight hours later, after intravenous administration it occurs faster. The therapeutic effect lasts up to three weeks with local application. The drug has a powerful anti-inflammatory as well as anti-allergic effect. It is many times more effective than Cortisone. But still has a number of contraindications.
Indications "Dexamethasone"
The drug is recommended for use in the presence of the following conditions and diseases:
- Crohn's disease (a chronic disease that is characterized by inflammatory lesions of different parts of the digestive system).
- Ulcerative colitis (a chronic inflammatory disease of the colon mucosa that appears due to the interaction of genetic factors and the environment).
- Acute rheumatic heart disease (a disease that affects the walls and membranes of the cardiovascular system, resulting in the normal functioning of this organ).
- Systemic lupus erythematosus (chronic inflammatory and dystrophic lesions of the skin, as well as mucous membranes, nail plate).
- Thyroiditis (a chronic inflammatory disease of the endocrine system of autoimmune origin).
- Bursitis (an inflammatory lesion of the synovial bags, which is characterized by increased formation and accumulation of fluid in their areas).
- Rheumatoid arthritis (a disease of connective tissue with predominant damage to small capillaries of the type of erosive and destructive polyarthritis of unknown origin with complex autoimmune pathogenesis).
- Psoriatic and gouty arthritis (a joint disease that is provoked by a violation of purine metabolism and is characterized by the deposition of uric acid crystals in the articular and periarticular tissues).
- Osteoarthrosis (degenerative joint diseases of non-inflammatory genesis, which appears as a result of degenerative changes in cartilage tissue).
- Synovitis (an inflammatory process in the synovial membranes that line the cavity of large joints from the inside).
- Nonspecific tendosynovitis (inflammatory lesion of the synovial membrane of the joint surrounding the tendon).
- Ankylosing spondylitis (an inflammatory process in the joints of the spine, which is characterized by a chronic progressive course).
- Epicondylitis (a degenerative disease of the periarticular tissues of inflammatory genesis, which is localized in the elbow joint).
The drug is prescribed for:
- Contact and atopic dermatitis (a chronic inflammatory lesion of the skin that occurs with exacerbations and remissions).
- Asthmatic status (a severe, life-threatening lesion of bronchial asthma, which develops, as a rule, as a result of a prolonged attack).
- Serum sickness (a disease of allergic origin, the cause of which is considered to be the penetration of serum or other drugs into the body).
- Allergic manifestations on food and certain drugs.
- Allergic rhinitis (a disease that occurs due to contact of allergens with the nasal mucosa).
- Bronchial asthma (a chronic non-infectious disease of the respiratory tract of an inflammatory nature).
- Urticaria associated with blood transfusion (a disease of an allergic or toxic nature, which is characterized by dotted red spots).
- Severe erythema multiforme (acute inflammation affecting the skin and mucous membranes).
- Pemphigus (severe skin disease, which is manifested by the formation of blisters on the surface of the skin and mucous membranes).
- Fungicidal mycosis (a type of cancer that affects the skin).
- Psoriasis (chronic damage to the skin, which is accompanied by the appearance of rashes and peeling).
According to the instructions, dexamethasone drops are prescribed in the presence of the following ailments:
- Optic neuritis (an inflammatory disease that affects the fibers of the optic nerve).
- Symptomatic ophthalmia (damage to the choroid of a healthy eye, following damage to another).
- Allergic corneal ulcers (inflammation of the cornea of the eyeball due to exposure to exogenous or endogenous factors).
- Keratitis (inflammation of the cornea of the eye, which has a different origin, provoking blurred vision and impaired vision).
- Iridocyclitis (inflammation of the iris and ciliary body of the eyeball).
- Iritis (an ophthalmic disease in which the iris of the eye becomes inflamed).
- Uveitis (inflammation in the choroid).
- Allergic forms of conjunctivitis (the inflammatory process of the conjunctiva provoked by an allergic reaction of the body).
- Sclerite (a disease that damages the human organ of vision, and is characterized by the further development of inflammation in the protein coat of the eye).
- Episcleritis (an inflammatory lesion of the connective tissues of the eye, which is characterized by moderate discomfort, as well as lacrimation and pain).
Additional indications for the use of "Dexamethasone":
- Leffler's syndrome (an allergic disease in which the number of eosinophils increases in the peripheral blood, eosinophilic infiltrates form in one or two lungs).
- Tuberculosis (an infectious disease provoked by mycobacterium tuberculosis and accompanied by the formation of granulomas in different organs).
- Sarcoidosis of the 2nd and 3rd degree (a systemic disease that can affect various organs and tissues, but most often affects the respiratory system).
- Aspiration pneumonia (an inflammatory process in the tissues of the lungs that appears as a result of the penetration of a liquid or foreign object into an organ).
- Berylliosis (a lung disease that can occur in acute and chronic form; with chronic throughout the body, especially in the lungs).
- Idiopathic nephrotic syndrome (a disease characterized by peripheral or generalized edema).
- Leukemia (a tumor of a nature that is characterized by a systemic progressive proliferation of hematopoietic cells).
- Purple idiopathic thrombocytopenic (a kind of hemorrhagic diathesis, which is characterized by a lack of platelets, usually triggered by immune mechanisms).
- Erythroblastopenia (acquired red cell aplasia, characterized by severe regenerative anemia in the bone marrow).
- Congenital hypoplastic anemia (a hematologic disease that is triggered by a suppression of bone marrow function).
- Autoimmune hemolytic anemia (a decrease in hemoglobin due to a deficiency in bone marrow production of red blood cells).
- Thrombocytopenia (a pathological process that is associated with an instant drop in the number of red blood cells, or red blood plates).
- Trichinosis with neurological signs (an acute disease caused by roundworms of the class Trichinella - nematodes).
- Tuberculous meningitis (inflammation of the soft membrane of the brain).
Limitations
According to the instructions for use with "Dexamethasone", contraindications for injections will be as follows:
- Lesions of the heart and blood vessels.
- Thyroid disease.
- Gastritis (damage to the gastric mucosa).
- Esophagitis (an inflammatory process in the area of the gastric mucosa).
- Anastomosis (a necessary measure carried out after certain types of surgical interventions).
- Diverticulitis (the inflammatory process of one or more herniform protrusions of the walls of the large or small intestine).
- Kidney and liver disease.
- Nephrourolithiasis (a disease characterized by the formation of kidney stones).
- Hypoalbuminemia (a condition characterized by low levels of albumin in the blood).
- Polio (an infectious disease caused by damage to the gray matter of the spinal cord by poliovirus and characterized by pathology of the nervous system).
- Systemic osteoporosis (a serious pathology associated with a violation of the structure of bone tissue).
The use of "Dexamethasone" by women in the position and during breastfeeding, as well as children should be carried out strictly as prescribed by a medical specialist after taking into account the likely risks and according to the instructions.
"Dexamethasone": contraindications for eye drops
It is forbidden to use the drug in the presence of the following conditions and ailments:
- Tuberculosis, fungal, viral lesions of the organs of vision.
- Trachoma (a chronic infectious disease of the eye caused by chlamydia and characterized by lesions of the conjunctiva and cornea with the result in scarring of the conjunctiva, cartilage of the eyelids and complete blindness).
- Glaucoma.
- Epithelial lesion of the cornea.
The introduction of the drug into the auricle is prohibited if the integrity of the tympanic membrane is impaired.
Can I use a medication during pregnancy?
Contraindications to "Dexamethasone" pregnancy and breastfeeding are. If during lactation there is a need for therapy with this drug, then the baby is transferred to artificial mixtures.
Dexamethasone injections during pregnancy are carried out only for health reasons (in exceptional situations). For example, this medication can be prescribed in a situation where the immune system begins to perceive the embryo as a foreign object. The drug inhibits immune activity, which helps to neutralize the threat of miscarriage and maintain pregnancy.
How to use injections?
According to the instructions for use with Dexamethasone injections, it is known that the dosage regimen is considered individual and depends on the disease, as well as the patient’s health status and response to treatment.
In the acute period with various diseases and at the beginning of treatment, the drug "Dexamethasone" is used in high dosages. During the day, four to twenty milligrams of the drug can be used four times.
Introduced intravenously slowly in a stream or drip, as well as intramuscularly, "Dexamethasone". According to the instructions for use, it is known that local use of the drug is also possible. To prepare a solution for intravenous infusion, sodium chloride must be used.
Dosage of the drug for children
The concentration of the drug in case of insufficiency of the adrenal cortex is 0.0233 milligrams per kilogram of weight or 0.67 milligrams per square meter of body surface area, divided into three applications.
According to the instructions for use, Dexamethasone is intramuscularly administered at other indications in dosages from 0.02776 to 0.16665 milligrams per kilogram of body weight every twelve to twenty-four hours.
When the desired effect is achieved, the dosage is reduced to supportive or the therapy is completely canceled. The duration of parenteral administration, as a rule, is three to four days, then they switch to the maintenance treatment with Dexamethasone in tablet form.
According to the instructions for use with Dexamethasone injections, it is known that the prolonged use of elevated doses of the drug requires a gradual decrease in the concentration of the active substance to prevent the occurrence of acute adrenal insufficiency.
"Dexamethasone" in ampoules for inhalation
Such treatment is indicated for acute inflammatory lesions of the respiratory system, for example:
- Bronchitis (a disease of the respiratory system in which the bronchi are involved in the inflammatory process).
- Laryngitis (an inflammatory disease of the larynx that occurs against a background of a number of factors of a specific effect).
- Bronchial obstruction (a condition accompanied by a sudden or permanent decrease in bronchial patency).
Inhalations with this medicine for young children should be carried out three times a day, mixing 0.5 milliliters of the drug with an aqueous solution of sodium chloride (2-3 ml). The duration of such therapy varies from 3 to 7 days.
It is necessary to dilute "Dexamethasone" in saline in a ratio of one to six, and then use 4 milliliters of the finished preparation for the procedure for inhalation.
Tablets
Dosage for oral use of "Dexamethasone" is selected individually depending on the disease, as well as the activity of its course and the patient's condition.
The average daily concentration of the active substance varies from 0.75 to 9 milligrams. With severe diseases, the dosage can be increased, while taking it several times a day. The maximum dosage is 15 mg per day.
The optimal concentration for young patients is selected taking into account age, and, as a rule, it varies from 2.5 to 10 mg / m 2 / day. It must be divided into three to four uses.
The duration of therapy is also determined by the nature of the pathology and the response of the patient. In some situations, the use of "Dexamethasone" continues for several months.
Drops
In the instructions for drops "Dexamethasone" contraindications and side effects are described in detail. These limitations and negative effects were given above. In this form of release, the medication is widely used in ophthalmology to neutralize acute and chronic inflammation of the organs of vision, as well as for allergic reactions to the eyes or for prevention after surgery or injury.
According to the instructions for use, the drug is instilled in adult patients with two drops in the conjunctiva of the eye. The duration of treatment and daily dosing is determined by a medical specialist depending on the disease.
You need to know that hormone therapy based on dexamethasone sodium phosphate, including eye drops, is not recommended for longer than fourteen days, as this can lead to addiction and systemic adverse reactions.
Adverse reactions
During therapy with the Dexamethasone medication, the following negative reactions may occur in the patient's injections:
- Petechiae (small, round, flat, dotted, dark red spots caused by hemorrhages in the skin or mucous membrane).
- Ecchymoses (large hemorrhages in the skin or mucous membrane, which are characterized by an irregular shape and a diameter of more than 3-5 mm).
- Thinning of the skin.
- Steroid acne.
- Trophic changes in the cornea of the eye.
- Exophthalmos (a symptom that manifests itself as a pathological protrusion of one or both eyes, and the size of the eyeball remains the same).
- Hypokalemia (low concentration of potassium ions in the blood).
- Sudden loss of vision.
- Hypocalcemia (a pathological condition of a person that is characterized by a low concentration of calcium in the blood plasma).
- Weight gain.
- Hypernatremia (a disease characterized by a low water content in the body, which is accompanied by an increased concentration of sodium ions).
- Arrhythmia (a pathology that leads to a violation of the frequency, as well as the rhythm of excitation and contraction of the heart muscles).
- Myalgia (a pathological condition characterized by the appearance of muscle pain).
- Muscle spasm.
What other side effects does the drug cause? "Dexamethasone" can provoke the appearance of the following unpleasant conditions:
- Fatigue.
- ( , ).
- ( , ).
- .
- - ( , ).
- .
- ( ).
- .
- ( , , , ).
- Atrophy (eating disorder, intravital reduction in the size of organs or tissues of animals and humans).
- Delirium (a mental disorder accompanied by impaired consciousness, true hallucinations, as well as delirium, behavioral and emotional disorders).
- Disorientation.
- Euphoria (positively colored affect).
- Depression.
- Paranoia (a rare type of chronic psychosis, usually beginning in adulthood, which is characterized by the gradual development of logically built monothematic systematized delusions).
From the digestive organs can be observed:
- Nausea.
- Vomiting.
- Pancreatitis (an inflammatory disease of the pancreas).
- Erosive esophagitis (inflammation that develops on the mucous membrane of the esophagus and is characterized by the occurrence of erosion and ulcers).
- Perforation of the wall of the stomach and intestines.
- Loss of appetite.
- Flatulence (bloating).
Application features
Patients with liver function problems, Dexamethasone is recommended to use with extreme caution. To reduce the risk of negative phenomena, the patient must follow a diet with an increased concentration of potassium. Foods should be saturated with proteins, and carbohydrate and salt intake should be slightly reduced.
During drug therapy, people need to constantly monitor blood pressure, and also need to monitor the state of the organs of vision, water-electrolyte balance and blood.
Therapy is not recommended to be stopped abruptly, since in this situation the likelihood of withdrawal syndrome is increased - a condition that is accompanied by increased signs of the disease and suppression of the adrenal glands.
Persons with diabetes need regular monitoring of blood glucose and, if necessary, adjusting the daily dosage of hypoglycemic drugs.
When using the drug in pediatrics, it is necessary to monitor the growth dynamics of the child, since long-term use of Dexamethasone in elevated concentrations can provoke its suppression.
Interaction with other drugs
According to the instructions for use, "Dexamethasone" simultaneously with the following drugs causes certain conditions:
- Increases the effects of antimicrobial medications.
- Phenobarbital, as well as Ephedrine, reduce the effectiveness of Dexamethasone.
- Use with other glucocorticosteroids can lead to a decrease in potassium in the blood.
- When taken with oral contraceptives, the elimination time of "Dexamethasone" increases.
- "Ritodrin" is contraindicated to use in conjunction with the drug in question because of the risk of death.
- "Dexamethasone" reduces the effectiveness of hypoglycemic as well as anticoagulant drugs.
- For prophylactic purposes, to prevent nausea and vomiting after chemotherapy, it is necessary to use Dexamethasone and Diphenhydramine, Ondansetron, and Granisetron.
The direct analog of the eye drops "Dexamethasone Oftan" contraindications, as well as indications and side effects, are the same as the original remedy. It is used under the supervision of a physician.