Dexamethasone injection solution (Vial and other release options) is recommended for use by a person in need of a powerful anti-inflammatory therapy. The presence of additional prefixes in the name of the product is determined by the manufacturer of the particular drug. All options for the release of "Dexamethasone" are glucocorticoid preparations of artificial origin. The effectiveness of the drug is due to the presence of a fluorine atom in the composition of the drug.
general information
According to the instructions for the Dexamethasone solution, the drug has a strong anti-inflammatory effect. The medication is used to combat an allergic reaction, reduces the sensitivity, susceptibility of various substances to the body. The use of a substance for injective administration shows an inhibitory effect on the immune system. Clinical trials have shown an insignificant accumulation of liquid, sodium in the body of the person receiving the drug. A similar result is due to the inhibition of the release of inflammatory mediators by eosinophils. Under the influence of the active compound, the concentration of mast cells decreases; instead, the content of lipocortins increases.
The use of a Dexamethasone solution according to the instructions allows one to achieve reduced capillary permeability and greater stability of cell membranes and organelles. Immunosuppression is associated with a slowdown in the release of cytokines from specific cellular structures. The effect on metabolism is due to protein catabolism, an increase in the activity of glucose generation in liver cells against the background of a weakening of its utilization by tissues on the periphery of the body.
When will it help?
In the instructions for use with the Dexamethasone injection solution, the manufacturer indicates what are the options for product release and in which pathological conditions it is reasonable to use them. The substance is injected into a vein or muscle. The solution is prescribed if internal use is not possible due to limiting phenomena.
The medicine is prescribed for malfunctions of the endocrine system. It can be used as an element of the replacement course in adrenocortical insufficiency. The solution of “Dexamethasone” (4 mg and other forms of release) is indicated both in the primary occurrence and in the case of the secondary form, that is, in case of insufficiency of the pituitary gland functioning. The drug is not prescribed if the patient has an insufficient kidney function in acute form - this requires the use of hydrocortisone or cortisone. The choice is explained by the inherent indicated funds expressed mineralocorticoid effect. Continuing consideration of the treatment of endocrine disruptions, it is necessary to mention: “Dexamethasone” is indicated for thyroiditis in subacute and radiation complicated forms. The medicine is used for congenital adrenal hyperplasia.
Options and diagnoses
For children, a solution of “Dexamethasone” is prescribed for rheumatoid arthritis that has developed in the form of a chronic. It is allowed to use an adult patient with a similar diagnosis. It is wise to use the drug if the disease provoked extra-articular symptoms, the processes affected the lungs, heart, and organs of vision. "Dexamethasone" is prescribed for skin vasculitis with rheumatoid arthritis. The drug is indicated for systemic pathologies that disrupt the work, the structure of connective tissue. It is used in case of vasculitis syndromes of a different nature.
Doctors may recommend Dexamethasone Injection Solution 4 mg to persons who have found quite severe skin pathologies. The active compound shows a pronounced effect in erythema, which developed in severe form (Stephen-Johnson), with pemphigus and dermatitis, including accompanied by a bullous rash. The drug alleviates the condition of people suffering from the severe course of psoriasis, exudative and nodular erythema, seborrheic dermatitis. Sometimes dexamethasone injections are resorted to if the patient has urticaria that does not respond to the classical therapeutic course. Hormonal anti-inflammatory is used to eliminate the symptoms of anaphylactic shock, mycosis, scleroderma. Often, the injective administration of "Dexamethasone" is indicated as an element of a comprehensive course of eliminating dermatomyositis.
Allergic and ophthalmic: a wide range of diagnoses
A solution of "Dexamethasone" (4 ml - dosage option) is prescribed for allergic reactions if the disease does not respond to the classical therapeutic course. Sometimes injections of the drug are administered to asthmatics, as well as to people who have an allergic reaction due to the drug program. You can use the drug for serum sickness and contact dermatitis, atopic type. Sometimes injections are prescribed if a blood transfusion has caused urticaria.
Among eye diseases, some forms of neuritis, chorioretinitis respond well to therapy with 0.1% Dexamethasone solution, which allows the composition to be used in cases where the patient is at risk of complete blindness. The substance is indicated for ophthalmic diseases of an allergic nature - scleritis, keratitis, iris inflammation, conjunctivitis. You can enter the drug by injection during the proliferation of tissues of the orbit of the eye, ophthalmia. If the patient has undergone an ophthalmic corneal transplant operation, Dexamethasone is indicated as an immune-suppressing product. In some cases, "Dexamethasone" is prescribed locally, but the doctor may decide on the systemic use of the composition.
GI tract and respiratory system
According to the instructions for use, the Dexamethasone solution shows a good effect in ulcerative colitis in the acute phase of the disease. The drug is prescribed for the relief of attacks of Crohn's disease and, if necessary, the selection of the components of a comprehensive course for autoimmune hepatitis in the form of a chronicle. If a person has had a liver transplant, Dexamethasone is indicated as a means of preventing the organ rejection reaction.
For symptomatic treatment, “Dexamethasone” is used for sarcoidosis, acute bronchiolitis, accompanied by manifestations of poisoning. The drug is indicated for asthmatics and people with chronic bronchitis - it is prescribed during an exacerbation. Instructions for use, Dexamethasone solution is recommended for the fight against pulmonary tuberculosis, if the disease has caused exceptional patient weakness. The drug is combined with the classic course of treatment for the disease. It is allowed to use "Dexamethasone" in the treatment of granulomatous inflammatory processes and with pneumonitis of a radiation nature, aspiration type.
Blood and internal organs
A solution of "Dexamethasone" for injection (4 mg - dosage form) is prescribed for a number of blood diseases. If the patient has aplastic anemia in the form of a pure chronicle, the drug is effective both in the case of acquired pathology and received from birth. You can prescribe hormonal anti-inflammatory with hemolytic anemia due to immune disorders. In adult patients, injections of the medication in question are given for secondary thrombocytopenia. As an element of induction therapy, "Dexamethasone" is indicated for leukemia. In the case of some forms of purpura, it is allowed to enter into a vein. Injections into the muscle of patients with such a diagnosis are strictly contraindicated.
The exclusion of rejection during kidney transplantation, a decrease in the protein content in urine, the induction of diuresis are goals that allow the use of different concentrations (in percent) of a solution of Dexamethasone. It is recommended to prescribe a remedy if nephrotic syndrome is not accompanied by uremia. It is allowed to use the medicine for impaired renal function, if a person is sick with lupus erythematosus.
With leukemia, lymphoma, Dexamethasone is indicated as an element of palliative treatment. For children, the drug is administered in acute leukemia. If a malignant formation has caused an excess of calcium in the blood, injections of the drug in question are indicated to correct this condition.
Pathologies and their treatment
The solution of “Dexamethasone” for injection (OKPD 2 21.20.10.182) is recommended to be used in case of cerebral edema, if the condition is provoked by the primary tumor process or metastases in this area. The drug is used if necessary, neurosurgical intervention. Sometimes it is prescribed during the recovery period after receiving a traumatic brain injury.
The use of a hormonal anti-inflammatory drug is allowed if the patient is in a state of shock, and the classic options for dealing with it do not show a pronounced result. "Dexamethasone" is recommended for use in case of shock against the background of insufficient functioning of the adrenal glands. After administering adrenaline to the patient in the event of anaphylactic shock, the next step may be injective delivery of the Dexamethasone solution into the vein (OKPD 2, 21.20.10.182). Often, medication is used shortly before the planned operation in order to prevent a shock condition if adrenal insufficiency is established or suspected.
The doctor may apply for a prescription for Dexamethasone if the patient has meningitis, a distinctive feature of which is the subarachnoid block. Such treatment is practiced if the disease is due to mycobacteria. In this case, "Dexamethasone" must be combined with the classic anti-tuberculosis course. Sometimes the drug is used if the patient has trichinosis, which manifests itself with neurological symptoms, impaired myocardial functionality. Hormonal anti-inflammatory drug shows a good effect in tumor processes like cysts in aponeurosis, tendon ganglion.
Intraarticular use
In this embodiment, a solution of “Dexamethasone” for injection (4 mg, ml - the doctor will choose the best option) is administered if the patient has rheumatoid arthritis, while the focus of inflammation is strictly localized, limited to one joint, and the pathological process is assessed as very strong. In soft tissues or the articular region, the drug is administered with certain forms of spondylitis (if the classic drug course does not show the desired result), with arthritis against psoriasis, as well as monoarthritis. Intra-articular administration of "Dexamethasone" is indicated for articular osteoarthritis (if exudate is detected), rheumatism outside the joint.
Topical application
Sometimes a hormonal anti-inflammatory drug is recommended for administration directly into the wound. A solution of "Dexamethasone" for injection (4 mg, ml - at the discretion of the attending physician) is administered if keloids are detected. The drug is used for lichen, which caused inflammation and hypertrophy of the area around the wound, and the process is accompanied by infiltration. Local use of the drug is allowed for some granulomas, folliculitis. The tool is used to alleviate the course of psoriasis, cutaneous sarcoidosis, alopecia with a strictly limited focus of activity. Local use of the solution for injective administration with lupus erythematosus progressing in discoid form is allowed.
Dose selection
In each case, the selection of volumes is carried out individually, taking into account the nuances of the course and the characteristics of the pathological condition, as well as the tone of the body and tolerability of the drug in question. Much depends on the application format: Dexamethasone solution for inhalation, injection into a vein and muscle tissue, into the articular region requires different modes, volumes and duration of the program. The doctor analyzes what course of treatment (probably) will be required, evaluates how well the patient’s body tolerates the drug, how pronounced the effect on the pathology is.
Parenterally, “Dexamethasone” is prescribed if the course of the pathology requires emergency medical intervention, oral administration is impossible, or the patient’s condition is one of those for which parenteral administration is a mandatory requirement. In addition to injections, the medication can be injected into a vein, dissolved in a physiological or glucose solution.
Initially, 0.5-0.9 mg of substance is used per day. If the condition of the patient requires this, the dose is increased. Such volumes are maintained until a clinical effect appears, after which they are gradually reduced for a minimally effective amount. Instruction, a solution of "Dexamethasone" for injection is recommended to be used as soon as possible. The manufacturer notes: if for several days the patient receives a high dose of the drug, the decrease should also last for several days, sequentially and with strict control of the result.
Application features
Following the instructions for a solution of "Dexamethasone" for injection, you can use the drug for intra-articular administration. A single dose varies between 0.4-4 mg. The doctor selects specific volumes, evaluating the dimensions of the affected area. If a large joint is affected by pathology, usually 2-4 mg of the drug is required, 0.8-1 mg is enough for a small one. It is allowed to repeat the therapeutic course 3-4 months after the completion of the primary program. In a joint bag "Dexamethasone" is usually administered in an amount of 2-3 mg, 0.4-1 mg must be infused into a tendon sheath. When injected into the tendon, the recommended volumes are 1-2 mg.
Inside the wound, the Dexamethasone solution is injected in amounts similar to the dosage for injection into the joint. It is allowed to simultaneously process one or two areas in this way, but no more. When infiltrating into soft tissues, a medication in the amount of 2-6 mg should be used.
Nuances
Assigning a course of treatment with a solution of "Dexamethasone" to a minor, the doctor selects the dosage, evaluating the features of the condition. With substitution treatment, the amount is calculated as 0.025 mg per kilogram. The daily volume is divided into three introductions.
Undesirable consequences
A solution of “Dexamethasone” can provoke side effects, but not all patients taking the medication have such effects. With a short course, the risk of transistor insufficient adrenal gland function is relatively high. Carbohydrate susceptibility may decrease. In some, appetite is activated, weight gain is observed. Mental disturbances are possible. Somewhat less often, a response is identified that indicates increased sensitivity. Occasionally, the concentration of triglycerides in blood serum increases in patients. There is a risk of gastric ulcers and acute inflammatory processes in the pancreas.
Against the background of prolonged administration of the Dexamethasone solution, prolonged adrenal insufficiency may occur injectively. For minors, the risk of developmental delay is relatively high. Central-type obesity, osteoporosis may develop. In some patients, muscle atrophy was noted. Much less often, the drug provoked a decrease in the immune response and an increase in the frequency of infectious diseases. There is a danger of cataracts, glaucoma, hypertension and aseptic bone necrosis.
Status Risks
As clinical observations have shown, with the use of the Dexamethasone solution for injective administration, the risk of atrophic processes in the adrenal gland region, as well as the insufficiency of the functioning of this organ, increases. Some had Cushing's syndrome. Women may be disturbed by the failure of the cycle of monthly discharge. The use of anti-inflammatory is sometimes associated with hirsutism, the transition of diabetes from latent to manifest. It is known that the use of glucocorticoids can cause myopathy and muscle weakness, excessive leaching of potassium from the body. Against the background of the therapeutic course, wounds heal more slowly, hemorrhages and striae, acne appear. Treatment can cause sweat glands to become active; skin tests give incorrect results.
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Long-term treatment with the described composition may cause corticoid drug withdrawal syndrome. To eliminate unwanted effects, the dosage is reduced slowly, over a long period.
A therapeutic course or drug withdrawal may be accompanied by a strong and unpredictable stressful situation. If the patient is in such conditions, it is reasonable to increase the dosage of the described drug or prescribe an additional course of cortisone, hydrocortisone. This is true, in particular, in case of a serious illness, an operation, or against the background of an injury. If severe stress has occurred after completion of the therapeutic program, the use of Dexamethasone should be resumed. Adrenal insufficiency associated with prolonged use may persist for months after completion of treatment.
Note
The use of “Dexamethasone” for injective administration, as well as the use of other glucocorticoid drugs, including natural products, can smear the clinical picture of infection, mask the signs of both a previous disease and a new one. Similar risks are associated with the risk of interstitial perforation. With systemic infection with pathological fungi, the use of the composition can cause a worsening of the process. Similar risks are associated with latent amoebiasis, pulmonary tuberculosis.
With an active form of tuberculosis, it is recommended to prescribe Dexamethasone in combination with the main course of treatment of the disease, if the case develops according to the weighted disseminated scenario. Glucocorticoid preparation is indicated for the fulminant variant. In case of latent tuberculosis and a positive tuberculin test, patients requiring injections of Dexamethasone should take chemicals to prevent the manifestation of the disease.
Particularly noteworthy are those receiving injections of the medication in question if they have osteoporosis, high blood pressure, heart failure. A special attitude is required for patients with tuberculosis and glaucoma, and insufficient functioning of the kidneys and liver. The use of "Dexamethasone" is associated with specific risks that require careful monitoring of diabetics, ulcers and people suffering from recently formed anastomosis of the intestinal tract. A specific careful attitude is required for epileptics and ulcerative colitis patients. “Dexamethasone” is prescribed with extreme caution to people who have recently had a heart attack, patients with thromboembolism, paralysis, hypothyroidism, and psychoneurosis. Dexamethasone is prescribed to elderly people only if possible to monitor the progress of the condition and all possible deviations.