Dexamethasone: Difference between revisions
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===[[Anaphylaxis]]=== | ===[[Anaphylaxis]]=== | ||
*10mg IV or PO | *10mg IV or PO | ||
===[[COVID]]=== | |||
*6mg Qday | |||
**Dexamethasone improves 28d mortality compared to placebo in patients requiring IMV (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29). | |||
**There was no benefit to patients not requiring oxygenation support and potentially harm | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
Revision as of 12:27, 16 January 2021
General
- Type: Corticosteroid
- Dosage Forms: PO; IM; IV, ophthalmic
- Common Trade Names: Decadron
Adult Dosing
Anaphylaxis
- 10mg IV or PO
COVID
- 6mg Qday
- Dexamethasone improves 28d mortality compared to placebo in patients requiring IMV (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).
- There was no benefit to patients not requiring oxygenation support and potentially harm
Pediatric Dosing
Anaphylaxis
- 0.6mg/kg
Asthma Exacerbation
- 0.6mg/kg once PO
Post-operative Airway Edema
- 0.5 mg/kg PO q6hrs x1-2 days
Special Populations
- Pregnancy Rating: C
- Lactation: Single doses are considered compatible however corticosteroids are present in breast milk and further discussion should be had with mother due to potential serious adverse reactions in breastfed infant.
- Renal Dosing
- Adult
- Not defined
- Pediatric
- Not defined
- Adult
- Hepatic Dosing
- Adult
- Not defined
- Pediatric
- Not defined
- Adult
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- There is some evidence to suggest small increases in the risk of sepsis, venous thromboembolism, and fractures in short courses of steroid use [1]
Common
Pharmacology
- Half-life:
- Adults: Oral 4 ± 0.9 hours, IV 1 - 5 hours
- Metabolism: Hepatic
- Excretion: Urine ~10%
- Mechanism of Action: surpasses neutrophil migration, decreases production of inflammatory mediators, reverses increased capillary permeability, suppresses normal immune response
See Also
References
- ↑ Waljee, A. K., Rogers, M. A. M., Lin, P., Singal, A. G., Stein, J. D., Marks, R. M., … Nallamothu, B. K. (2017). Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study. Bmj. doi: 10.1136/bmj.j1415
Dexamethasone (systemic): Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.