Dexamethasone: Difference between revisions

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**Dexamethasone improves 28d mortality compared to placebo in patients requiring IMV (NNT = 8.5) and those patients requiring oxygen therapy (NNT = 29).   
**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
**There was no benefit to patients not requiring oxygenation support and potentially harm
===[[Nausea and Vomiting]]===
*5mg<ref>Wang, Jhi-Joung MD, DMS*,; Ho, Shung-Tai MD, MS†,; Uen, Yih-Huei MD‡,; Lin, Mao-Tsun PhD*,; Chen, Kuan-Ting MD*,; Huang, Jeng-Chai PhD*,; Tzeng, Jann-Inn MD* Small-Dose Dexamethasone Reduces Nausea and Vomiting After Laparoscopic Cholecystectomy: A Comparison of Tropisetron with Saline, Anesthesia & Analgesia: July 2002 - Volume 95 - Issue 1 - p 229-232 doi: 10.1097/00000539-200207000-00042</ref>


==Pediatric Dosing==
==Pediatric Dosing==

Revision as of 21:56, 8 August 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

Nausea and Vomiting

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
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

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 [2]

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

  1. ↑ Wang, Jhi-Joung MD, DMS*,; Ho, Shung-Tai MD, MS†,; Uen, Yih-Huei MD‡,; Lin, Mao-Tsun PhD*,; Chen, Kuan-Ting MD*,; Huang, Jeng-Chai PhD*,; Tzeng, Jann-Inn MD* Small-Dose Dexamethasone Reduces Nausea and Vomiting After Laparoscopic Cholecystectomy: A Comparison of Tropisetron with Saline, Anesthesia & Analgesia: July 2002 - Volume 95 - Issue 1 - p 229-232 doi: 10.1097/00000539-200207000-00042
  2. ↑ 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.

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