DEXAMETHASONE instructions for use (injections in ampoules, eye drops, tablets). DEXAMETHASONE is a powerful synthetic glucocorticoid (containing adrenal cortex hormones and their synthetic analogues) drug designed to regulate protein, carbohydrate and mineral metabolism.

Dexamethasone instructions for use, reviews, analogs and forms of release (tablets 0.5 mg, injections in ampoules (solution for injection), eye drops oftan) drugs for the treatment of inflammation in adults, children and pregnancy.

Composition

• Active substance - dexamethasone sodium phosphate (in terms of dexamethasone phosphate) - 4.0 mg / 8.0 mg;
• Excipients - glycerin, disodium phosphate dihydrate, disodium edetate, water for injection.

Release forms

1. Tablets 0.5 mg;
2. Solution in ampoules for intravenous and intramuscular administration (injections for injections) 4 mg/ml;
3. Eye drops Oftan 0.1%;
4. Eye suspension 0.1%

DEXAMETHASONE instructions for use of the drug

Oral administration of Dexamethasone in the form of tablets involves the appointment of 10-15 mg of the drug per day at the initial stage of treatment, followed by a decrease in the daily dose to 2-4.5 mg with maintenance therapy. The instruction recommends dividing the daily dose of the drug Dexamethasone into 2-3 doses (after or during meals).

Maintenance small doses should be taken once a day, preferably in the morning. Dexamethasone in ampoules is intended for intravenous (drip or jet), intramuscular, periarticular and intraarticular administration. The recommended daily dose of Dexamethasone for these routes of administration is 4-20 mg. Dexamethasone in ampoules is usually used 3-4 times a day for 3-4 days, followed by switching to tablets.

Dexamethasone drops are used in ophthalmology: in acute conditions, 1-2 drops of the drug are instilled into the conjunctival sac every 1-2 hours, when the condition improves, every 4-6 hours. Chronic processes involve the use of Dexamethasone drops 2 times a day.

The duration of treatment depends on clinical course diseases, so Dexamethasone drops can be used from several days to four weeks.

Indications for the use of Dexamethasone

Diseases requiring the introduction of a fast-acting GCS, as well as cases where oral administration of the drug is not possible:

• Shock (burn, traumatic, surgical, toxic) - with the ineffectiveness of vasoconstrictors, plasma-substituting drugs and other symptomatic therapy;
• Severe allergic reactions, anaphylactic shock;
• Blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults;
• Endocrine diseases: acute insufficiency of the adrenal cortex, primary or secondary insufficiency, congenital hyperplasia, subacute thyroiditis;
• Local application (in the area of ​​pathological formation): keloids, discoid lupus erythematosus, granuloma annulare;
• Rheumatic diseases - Dexamethasone instructions for use;
• IN ophthalmic practice(subconjunctival, retrobulbar or parabulbar administration): allergic conjunctivitis, keratitis, keratoconjunctivitis without epithelial damage, iritis, iridocyclitis, blepharitis, blepharoconjunctivitis, scleritis, episcleritis, inflammatory process after eye injuries and surgical interventions, sympathetic ophthalmia, immunosuppressive treatment after corneal transplantation;
• Acute severe dermatoses;
• Malignant diseases: palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors, when oral treatment is not possible;
• Severe infectious diseases (in combination with antibiotics);
• Cerebral edema (with a tumor, traumatic brain injury, neurosurgical intervention, hemorrhage, encephalitis, meningitis, radiation injury);
• Systemic diseases connective tissue;
• Asthmatic status; severe bronchospasm (exacerbation bronchial asthma, chronic obstructive bronchitis).

What are Dexamethasone tablets used for?

• With hypothyroidism (a condition with a persistent lack of thyroid hormones);
• At rheumatoid arthritis in the acute phase;
• With congenital adrenogenital syndrome (hyperfunction of the adrenal cortex and increased content androgens in the body)
• With Addison-Birmer disease (loss of the ability of the adrenal glands to produce hormones in sufficient quantities);
• With pemphigus (a skin disease that manifests itself in the form of blisters on the hands, genitals, mouth, etc.);
• In acute and subacute thyroiditis (inflammation of the thyroid gland);
• With acute erythroderma (reddening of the skin);
• With progressive ophthalmopathy (an increase in the volume of eye tissues) associated with thyrotoxicosis (intoxication with thyroid hormones);
• With acute eczema;
• In diseases of the connective tissue;
• With malignant tumors (symptomatic therapy);
• With autoimmune hemolytic anemia;
• With cerebral edema;
• With agranulocytosis (decrease in the level of neutrophils in the blood);
• With bronchial asthma;
• With serum sickness (immune reaction to foreign serum proteins).

What are Dexamethasone drops prescribed for?

• With scleritis (inflammation of the deep layers of the sclera of the eye);
• With keratitis (inflammation of the cornea of ​​\u200b\u200bthe eye);
• With sympathetic ophthalmia (inflammatory lesions of the eye);
• With non-purulent and allergic conjunctivitis (inflammation of the mucous membrane of the eye);
• With iritis (inflammation of the iris of the eye);
• With blepharitis (inflammation of the edges of the eyelids);
• In inflammatory processes after eye injuries or operations;
• With iridocyclitis (inflammation of the iris and ciliary body);
• With episcleritis (inflammation of the connective tissue between the conjunctiva and the sclera);
• With keratoconjunctivitis (simultaneous inflammation of the conjunctiva and cornea of ​​the eye) without damage to the epithelium.

Why are injections prescribed in ampoules Dexamethasone

• With acute hemolytic anemia;
• With acute insufficiency of the adrenal cortex;
• With asthmatic status;
• Acute lymphoblastic leukemia (a malignant disease that affects Bone marrow, spleen, The lymph nodes, thymus and other organs). Dexamethasone instructions for use;
• With cerebral edema;
• With severe infectious diseases;
• With shock of various genesis;
• With diseases of the joints;
• With thrombocytopenia;
• With severe allergic reactions;
• With acute croup (inflammation of the larynx and upper respiratory tract);
• with agranulocytosis.

Contraindications

For short-term use for health reasons, the only contraindication is hypersensitivity to dexamethasone or the components of the drug.

In children during the period of growth, corticosteroids should be used only according to absolute indications and under the most careful supervision of the attending physician.

Carefully the drug should be prescribed for the following diseases and conditions:

The therapeutic and toxic effects of Dexamethasone are reduced by barbiturates, phenytoin, rifabutin, carbamazepine, ephedrine and aminoglutethimide, rifampicin (accelerate metabolism); somatotropin; antacids (reduce absorption), enhance - estrogen-containing oral contraceptives. Simultaneous use with cyclosporine increases the risk of seizures in children.

The risk of arrhythmias and hypokalemia is increased by cardiac glycosides and diuretics, the likelihood of edema and arterial hypertension is increased by sodium-containing drugs and nutritional supplements, severe hypokalemia, heart failure and osteoporosis - amphotericin B and carbonic anhydrase inhibitors; the risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract - non-steroidal anti-inflammatory drugs. Dexamethasone instructions for use.

When used simultaneously with live antiviral vaccines and against the background of other types of immunization, it increases the risk of virus activation and infection.

Simultaneous use with thiazide diuretics, furosemide, ethacrynic acid, carbonic anhydrase inhibitors, amphotericin B can lead to severe hypokalemia, which can increase the toxic effects of cardiac glycosides and non-depolarizing muscle relaxants.

Weakens the hypoglycemic activity of insulin and oral antidiabetic agents; anticoagulant - coumarins; diuretic - diuretic diuretics; immunotropic - vaccination (suppresses antibody production).

It worsens the tolerance of cardiac glycosides (causes a potassium deficiency), reduces the concentration of salicylates and praziquantel in the blood. May increase the concentration of glucose in the blood, which requires dose adjustment of hypoglycemic drugs, sulfonylurea derivatives, asparaginase.

GCS increase the clearance of salicylates, so after the abolition of Dexamethasone, it is necessary to reduce the dose of salicylates. When used simultaneously with indomethacin, the Dexamethasone suppression test may give false negative results.

Dosage and administration

It is intended for intravenous, intramuscular, intraarticular, periarticular and retrobulbar administration. The dosage regimen is individual and depends on the indications, the patient's condition and his response to therapy.

In order to prepare for intravenous drip infusion, an isotonic sodium chloride solution or a 5% dextrose solution should be used. The introduction of high doses of dexamethasone can be continued only until the patient's condition stabilizes, which usually does not exceed 48 to 72 hours.

Adults with acute and emergency conditions administered in / in slowly, stream or drip, or / m at a dose of 4-20 mg 3-4 times a day. Maximum single dose-80 mg. Maintenance dose - 0.2-9 mg per day. The course of treatment is 3-4 days, then they switch to oral administration of Dexamethasone. Children - in / m at a dose of 0.02776-0.16665 mg / kg every 12-24 hours.

1. Soft tissues: 2 to 6 mg;
2. Large joints (eg. knee-joint): 2 to 4 mg;
3. Articular bags: 2 to 3 mg;
4. Small joints (eg, interphalangeal, temporal joint): 0.8 to 1 mg;
5. Nerve ganglia: 1 to 2 mg;
6. Tendons: 0.4 to 1 mg.

The drug is prescribed repeatedly with an interval of 3 days to 3 weeks as needed; maximum dose for adults - 80 mg per day. In shock, adults - in / in 20 mg once, then 3 mg / kg for 24 hours as a continuous infusion or in / in a single dose of 2-6 mg / kg, or in / in 40 mg every 2- 6 o'clock.

With cerebral edema (adults) - 10 mg IV, then 4 mg every 6 hours / m until symptoms disappear; the dose is reduced after 2-4 days and gradually - within 5-7 days - stop treatment. In case of insufficiency of the adrenal cortex (children) in / m at 0.0233 mg / kg (0.67 / mg / m2) per day in 3 injections every third 24 hours, or daily at 0.00776-0.01165 mg / kg ( 0.233-0.335 mg/m2) per day.

With an acute allergic reaction or exacerbation of a chronic allergic disease, dexamethasone should be administered according to the following schedule, taking into account the combination of parenteral and oral administration: dexamethasone instructions for use injection 4 mg / ml: 1 day, 1 or 2 ml (4 or 8 mg) intramuscularly; dexamethasone tablets 0.75 mg: the second and third days, 4 pieces in 2 doses per day, the fourth - 2 pieces in 2 doses, the fifth and sixth days - 1 pc. daily, on the seventh - without treatment, day 8 - observation.

Side effects

Dexamethasone is usually well tolerated. It has low mineralocorticoid activity, i.e. its impact on water-electrolyte exchange small. As a rule, low and medium doses of Dexamethasone do not cause sodium and water retention in the body, increased potassium excretion.

The following side effects have been described:

1. From the sensory organs: posterior subcapsular cataract, increased intraocular pressure with possible damage optic nerve, tendency to develop secondary bacterial, fungal or viral infections eye, trophic changes cornea, exophthalmos, sudden loss of vision (with parenteral administration in the head, neck, turbinates, scalp, crystals of the drug may be deposited in the vessels of the eye);
2. On the part of the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, striae, a tendency to develop pyoderma and candidiasis;
3. From the side endocrine system: decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, adrenal suppression, Itsenko-Cushing's syndrome (moon face, pituitary-type obesity, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae), delayed sexual development in children;
4. From the side of metabolism: increased excretion of calcium, hypocalcemia, weight gain, negative nitrogen balance (increased protein breakdown), excessive sweating. Due to mineralocorticoid activity - fluid and sodium retention (peripheral edema), hypnatremia, hypokalemia syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue);
5. From the musculoskeletal system: growth retardation and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely, pathological bone fractures, aseptic necrosis of the head of the humerus and femur), rupture of muscle tendons, steroid myopathy, decreased muscle mass (atrophy). Dexamethasone instructions for use;
6. From the side of cardio-vascular system: arrhythmias, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of heart failure, changes in the electrocardiogram characteristic of hypokalemia, increased blood pressure, hypercoagulability, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing down the formation of scar tissue, which can lead to rupture of the heart muscle;
7. From the side digestive system: nausea, vomiting, pancreatitis, steroid gastric ulcer and duodenum, erosive esophagitis, gastrointestinal bleeding and wall perforation gastrointestinal tract, increase or decrease in appetite, indigestion, flatulence, hiccups. In rare cases, an increase in the activity of hepatic transaminases and alkaline phosphatase;
8. From the side nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, cerebellar pseudotumor, headache, convulsions.

allergic reactions: skin rash, itching, anaphylactic shock, local allergic reactions.

Local for parenteral administration: burning, numbness, pain, tingling and infection at the injection site, rarely - necrosis of surrounding tissues, scarring; atrophy of the skin and subcutaneous tissue with intramuscular injection (it is especially dangerous to inject into the deltoid muscle).

Other: development or exacerbation of infections (the appearance of this side effect is facilitated by jointly used immunosuppressants and vaccination), leukocyturia, "flushing" of blood to the face, "withdrawal" syndrome.

The price of the drug DEXAMETHASONE

• Dexamethasone, tablets 0.5 mg, 10 pcs. - 45 rubles;
• Dexamethasone, eye drops 0.1%, 5 ml - 34 rubles;
• Dexamethasone, ampoules 4 mg, 1 ml, 25 pcs. - 202 rubles;
• Dexamethasone solution for injections 4 mg/ml 1 ml ampoules, 25 pcs. 144 rubles;
• Dexamethasone eye drops, 10 ml - 82 rubles.

special instructions

• Caution should be used in acute and subacute myocardial infarction - it is possible to spread the focus of necrosis, slow the formation of scar tissue and rupture the heart muscle;
• During treatment with Dexamethasone, vaccination should not be carried out due to a decrease in its effectiveness (immune response).
  When prescribing Dexamethasone for intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously treat with bactericidal antibiotics;
• Patients with latent infectious diseases of the kidneys and urinary tract Dexamethasone can cause leukocyturia, which may be of diagnostic value;
• With sudden withdrawal, especially in the case of previous use of high doses, the development of a “withdrawal” syndrome (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness), as well as an exacerbation of the disease, for which Dexamethasone was prescribed;
• During treatment with Dexamethasone (especially long-term), it is necessary to observe an ophthalmologist, control blood pressure and the state of water and electrolyte balance, as well as pictures of peripheral blood and blood glucose levels;
• In children during long-term treatment with Dexamethasone, careful monitoring of the dynamics of growth and development is necessary. Children who during the treatment period were in contact with patients with measles or chicken pox, prophylactically prescribe specific immunoglobulins.
  Due to the weak mineralocorticoid effect for replacement therapy in adrenal insufficiency, Dexamethasone is used in combination with mineralocorticoids;
• Dexamethasone increases the content of metabolites of 11- and 17-hydroxyketocorticosteroids;
• In order to reduce side effects you can prescribe antacids, and you should also increase the intake of K + in the body (diet, potassium supplements). Food should be rich in proteins, vitamins, with limited content of fats, carbohydrates and salt;
• In patients with diabetes mellitus, blood glucose levels should be monitored and, if necessary, therapy should be adjusted.
  X-ray control of the osteoarticular system (images of the spine, hand) is shown;
• The effect of the drug is enhanced in patients with hypothyroidism and cirrhosis of the liver. The drug may increase existing emotional instability or psychotic disorders. When indicating a history of psychosis, Dexamethasone in high doses is prescribed under the strict supervision of a physician;
• In stressful situations during maintenance treatment (for example, surgery, trauma or infectious diseases), the dose of the drug should be adjusted due to an increase in the need for glucocorticosteroids. Patients should be carefully monitored for a year after the end of long-term therapy with Dexamethasone due to the possible development of relative insufficiency of the adrenal cortex in stressful situations. Dexamethasone instructions for use.

Video review of the drug DEXAMETHASONE (DEXAMETHASONE)

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Should be given credit modern pharmacology, which was able to achieve unprecedented success in the field of application hormonal drugs for the treatment of both acute and chronic ailments. The basis of such drugs are synthesized analogues of the body's own hormones. Inflammatory diseases are treated by the use of hormonal drugs, which are more analogous to the secretion of the adrenal cortex. Such drugs allow you to quickly and effectively remove inflammatory processes, which is important to take into account in the development of allergic reactions and in diseases of the joints.

One such drug is a drug called Dexamethasone. This drug refers to glucocorticosteroids, and has a number of beneficial effects. Why Dexamethasone is so useful, let's find out in more detail.

Features of the drug

Dexamethasone is a synthetic type of glucocorticosteroid (hormonal) substances, which is a derivative of fluoroprednisolone. The drug has anti-allergic, anti-inflammatory, immunosuppressive effects, and also allows you to increase the sensitivity of adrenergic receptors. Presented as a solution for injection in ampoules of 1 and 2 ml. The package contains 25 ampoules, and the cost of the drug is about 200 rubles. The solution for injection is a clear or yellowish liquid, depending on the release series. One 1 ml ampoule contains the following components:

• dexamethasone sodium phosphate 4 mg;
• sodium chloride;
• disodium edatate;
• sodium hydrogen phosphate dodecahydrate;
• water.

The effectiveness of the drug is determined by the mechanism of its action. This mechanism is associated with several fundamental effects, which are:

1. After the active substances of the drug enter the human body, their reaction with the receptor protein is observed. After entering the reaction, the active substances penetrate directly into the nucleus of membrane cells.
2. A number of metabolic processes are activated by inhibiting the phospholipase enzyme.
3. There is a blocking of the extraction of mediators of inflammatory reactions from the immune system.
4. Inhibition of the functioning of enzymes that are responsible for the breakdown of proteins. This action has a positive effect on the process of metabolism of cartilage and bone tissue.
5. Blocking proteins that are involved in the process of inflammatory processes.
6. Reducing the permeability of small vessels, which contributes to inhibition of the excretion of inflammatory cells.
7. Decrease in the intensity of production of leukocytes.

Through all of the above factors, it can be noted that the drug Dexamethasone has the following properties:

• anti-inflammatory;
• immunosuppressive;
• antiallergic;
• anti-shock.

It's important to know! Dexamethasone has an immediate effect on intravenous administration, and with intramuscular injection after 8 hours.

Like any other medicine, the drug Dexamethasone has negative properties, through which an adverse effect is exerted on the human body.

The negative effect of the drug

Dexamethasone has a number of negative factors, which include:

• depressing effect on immune system, thereby increasing the likelihood of severe infectious diseases and the formation of tumors;
• an interfering effect on the formation of bone tissue, which becomes possible through an inhibitory effect on calcium absorption;
• performs the redistribution of fat cells on the body, as a result of which the main amount of adipose tissue is deposited in the body area;
• retention of water and sodium ions in the kidneys, which prevents the excretion of adrenocorticotropic hormone.

Such negative reactions medicinal product allow you to understand what side effects can be. You can avoid the development of side effects by using the drug in the lowest possible doses, which will reduce the negative impact on the body.

Indications for use

Dexamethasone is popular in many areas of medicine. The drug is used to treat diseases of the joints, as well as to relieve allergic manifestations. Indications for the use of Dexamethasone are the following diseases and pathologies:

1. Shock conditions of the patient.
2. swelling of the brain due to the following signs Key words: tumors, craniocerebral injuries, neurosurgical interventions, meningitis, hemorrhages, encephalitis and radiation injuries.
3. With the development of acute insufficiency of the adrenal cortex.
4. Sharp Species hemolytic anemia, thrombocytopenia, agranulocytosis, as well as severe infectious diseases.
5. Acute laryngotracheitis in children.
6. Rheumatic diseases.
7. Skin diseases: psoriasis, eczema, dermatitis.
8. Multiple sclerosis.
9. Intestinal diseases with unexplained genesis.
10. Shoulder-scapular periarthritis, bursitis, osteochondrosis, osteoarthritis and others.

Solution for injection Dexamethasone is used in the development of acute and urgent conditions, when a person's life depends on the speed of exposure to the drug. The drug is intended primarily for short-term use in connection with vital indications.

How to apply

Dexamethasone is indicated for use not only for adults, but also for children from the first year of life. Instructions for use of the drug Dexamethasone in the form of injections informs that the drug can be used not only for intramuscular injection, but also intravenously by jet or drip. The dosage of the drug depends on such factors as the severity and form of the disease, the age of the patient and the presence of negative reactions. For intravenous administration by drip infusion, a solution must first be prepared. For preparation, it is necessary to dilute the drug with saline or glucose solution. Let us consider in more detail the features of the use of Dexamethasone for adults and children.

For adults, Dexamethasone is used both intramuscularly and intravenously in an amount of 4 to 20 mg. The maximum dosage per day should not exceed 80 ml, so the drug can be administered 3-4 times a day. If there are acute dangerous cases in which a fatal outcome may occur, then on an individual basis, as directed by a doctor, the daily dose may be increased. The duration of parenteral use of the drug is no more than 3-4 days. If it is necessary to continue treatment, then the oral form of the drug in the form of tablets is used. In the event of a positive effect, the dosage is reduced until a maintenance dose is identified. The decision to stop taking the drug is made by the attending physician.

It is unacceptable to use Dexamethasone in the form of intravenous administration in large doses. fast way. This can lead to the development of cardiac complications, so the drug should be administered slowly. Intramuscularly, the drug should also be administered slowly. With the development of cerebral edema, the initial dosage of the drug should not exceed 16 mg. The subsequent dosage is 5 mg intravenously or intramuscularly every 6 hours until a positive result is achieved. If surgical interventions were performed in the brain area, then such dosages may be required for several more days. Continuous use of the drug can significantly affect the reduction of increased intracranial pressure, which occurs due to the presence of a tumor in the brain.

For children, Dexamethasone injections are prescribed in the form of intramuscular injection. Children's dosage depends on the weight of the child and is 0.2-0.4 mg / kg of body weight per day. Treatment should not be prolonged, and dosages for children should be kept to a minimum, depending on the nature of the disease.

Features of use in articular diseases

Treatment of joint diseases with Dexamethasone is a necessary measure when non-steroidal types of drugs are not able to provide the necessary healing effect. The main indications for the use of Dexamethasone in articular diseases are:

• Bechterew's disease.
• Rheumatoid arthritis.
• Articular syndrome in the development of psoriasis.
• Lupus and scleroderma with articular involvement.
• Bursitis.
• Still's disease.
• Polyarthritis.
• synovitis.

In such diseases, Dexamethasone is supposed to be used for both local and general treatment.

It's important to know! The drug is injected into the joint area only in an amount of not more than 1 time. Re-injection of Dexamethasone into the joint area is allowed after 3-4 months. In a year, the number of injections for the joint should not exceed 3-4 times. If the norm is exceeded, then this threatens the development of damage to cartilage tissues.

The dosage for intra-articular use is from 0.4 to 4 mg. The dose is influenced by such features as the age of the patient, the size of the shoulder joint, as well as weight. The dosage should be prescribed by the attending physician after a preliminary examination of the patient. Below is a table that shows the approximate doses for the treatment of articular diseases.

The data in the table are indicative, so it is very important not to prescribe dosages yourself.

It's important to know! Prolonged intra-articular administration of the drug is unacceptable, as this can lead to tendon ruptures.

Application for allergic diseases

allergic reactions various forms treated with antihistamines. If the inflammatory processes are very strong, then antihistamines do not cope with the task. Dexamethasone comes to the rescue, which is a derivative of prednisone. Active substances act on mast cells, reducing allergic symptoms, resulting in the disappearance of symptoms.

Dexamethasone is used to eliminate allergic manifestations. It is effective for the following allergic abnormalities:

1. allergic skin diseases such as dermatitis and eczema.
2. Quincke's edema.
3. Hives.
4. Anaphylactic shock.
5. The development of inflammatory reactions in the nasal mucosa.
6. Angioedema, manifested on the face and neck.

With the development of allergic reactions, you should immediately contact an allergist who will select the necessary dosage of the drug and will be able to provide timely and correct assistance to the patient.

Features of use during pregnancy

The period of pregnancy and lactation in the life of every woman is a very important stage. During pregnancy, a woman's body is more susceptible to negative factors, due to a decrease in the immune system.

The main feature of Dexamethasone is the fact that its active and metabolic forms of the drug have the ability to penetrate through any barriers. It follows from this that during pregnancy it is necessary to use the drug with extreme caution. When carrying a child, the need to use Dexamethasone is taken by the doctor in each individual case.

An international organization has assigned Class C status to Dexamethasone. This means that the drug can have a negative effect on the fetus, but if there is a risk to the health of the mother, then its use is possible.

Mothers who feed their babies with natural milk should know that it is forbidden to use the medicine in any form during this period. If it is impossible to do without the use of Dexamethasone to cure the disease, then the child should be transferred to artificial feeding. When using Dexamethasone during pregnancy and breastfeeding, the following complications may develop in the fetus and already born child:

• insufficiency of the adrenal cortex;
• the formation of congenital malformations;
• abnormal development of the head and limbs;
• deterioration in growth and development.

When prescribing Dexamethasone during pregnancy and breastfeeding the physician takes responsibility.

Presence of contraindications

With the development of serious severe complications, such as angioedema or anaphylactic shock, the main contraindication to the use of the drug is the presence of signs of individual intolerance. In all other cases, Dexamethasone will save a life by resuscitating the patient.

If the drug is prescribed as a prophylaxis for chronic ailments, then it is important to take into account some types of contraindications. In the presence of such contraindications, the use of the drug can be harmful, so it is very important to take this seriously. The main types of contraindications are:

1. In the presence of active types of infectious diseases: viral, bacterial and fungal.
2. With the development of immunodeficiency, which can be both congenital and acquired.
3. Tuberculosis in the active form of the disease.
4. Severe osteoporosis.
5. In the presence of a peptic ulcer of the gastrointestinal tract.
6. Esophagitis.
7. With myocardial infarction.
8. At diabetes.
9. Mental types of disorders.
10. Joint fractures.
11. Internal bleeding.

The main contraindication is intolerance to any component of the drug. All these contraindications should be considered in each individual case. If you use the drug in the presence of contraindications, then this will lead to a deterioration in the condition and the development of side effects. What are the side effects, find out further.

Adverse symptoms

With improper use of Dexamethasone, the following may occur: adverse reactions:

1. Hives, allergic dermatitis, rash and angioedema.
2. Arterial hypertension and encephalopathy.
3. Heart failure, cardiac arrest or rupture.
4. Decrease in the number of lymphocytes and monocytes, as well as thrombocytopenia.
5. Swelling of the optic disc. The development of neurological side effects as well as seizures, dizziness and sleep disturbances.
6. Mental disorders, insomnia, depressive psychosis, hallucinations, paranoia, schizophrenia.
7. Adrenal atrophy, growth problems in children, disorders menstrual cycle, increased appetite and weight, hypocalcemia.
8. Nausea, vomiting, hiccups, stomach ulcers, internal bleeding in the gastrointestinal tract, pancreatitis and gallbladder perforation.
9. Muscle weakness, osteoporosis, articular cartilage damage and bone necrosis, tendon rupture.
10. Delayed wound healing, itching, bruising, erythema, excessive sweating.
11. Excessive intraocular pressure, glaucoma, cataracts, exacerbation of bacterial and viral eye infections.
12. development of impotence.
13. Pain at the injection site. Atrophy of the skin, scarring at the injection site.

The development of nosebleeds, as well as increased pain in the joints. The development of side effects in patients who, after undergoing a course of therapy, abruptly completed treatment, is not excluded. These side effects include the following ailments: adrenal insufficiency, arterial hypotension, and death.

It's important to know! With the development of side symptoms, as well as with complications and ailments, you must immediately inform your doctor about this. The course of treatment should be stopped immediately if the patient's condition worsens.

Dexamethasone is available from several manufacturers. In addition, it should be noted that the drug has analogues:

• Dexaven;
• Dexamed;
• Dexon;
• Decadron;
• Dexafar.

Advantages and disadvantages

What are the advantages and disadvantages of Dexamethasone? Having received an answer to this question, we can conclude that the use of the drug is appropriate. But when it comes to life, the doctor does not think about the presence of contraindications and side effects, and prescribes the medicine urgently. Another thing is when systemic long-term treatment is planned, then in this case it is important to weigh all the pros and cons.

The main advantages of Dexamethasone are:

1. Rapid and pronounced positive effect after the administration of the drug.
2. Wide range of influences.
3. The possibility of using the drug in various convenient forms. The injectable has the fastest effect.
4. The low cost of the drug, since the packaging will cost 200 rubles.
5. The possibility of using the drug both in a single dosage and with maintenance.

It is also important to take into account the disadvantages of the drug, which are not so few:

1. Large list of adverse reactions.
2. Limited possibility of prescribing the drug during breastfeeding and pregnancy.
3. The need to choose the lowest possible dosage of the drug.
4. The need to control the intake of the drug.
5. Absence dosage forms in the form of ointments and gels, which would be useful for articular pathologies.
Glucose during pregnancy: intravenous administration for the correction of physiological processes Injection with Mydocalm: instructions for use

Catad_pgroup Systemic corticosteroids

Catad_pgroup Preparations for ophthalmology

Dexamethasone for injection - instructions for use

INSTRUCTIONS for medical use drug

Name of the medicinal product:

Trade name of the drug:

International non-proprietary name:

Dosage form:

Composition

Excipients:
glycerol (distilled glycerin) - 22.5 mg
disodium edetate (trilon B) - 0.1 mg
sodium hydrogen phosphate dodecahydrate (sodium phosphate disubstituted 12-water) - 0.8 mg
water for injection - up to 1 ml

Pharmacotherapeutic group:

ATC code:

Description:

pharmachologic effect

Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell nucleus and stimulates mRNA synthesis; the latter induces the formation of proteins, incl. lipocortin mediating cellular effects. Lipocortin inhibits phospholipase A2, inhibits the release of arachidonic acid and inhibits the biosynthesis of endoperoxides, prostaglandins, leukotrienes, which promote inflammation, allergies, and others.

Protein metabolism: reduces the amount of protein in plasma (due to globulins) with an increase in the albumin / globulin ratio, increases the synthesis of albumins in the liver and kidneys; enhances protein catabolism in muscle tissue.

Lipid metabolism: increases the synthesis of higher fatty acids and triglycerides, redistributes fat (accumulation of fat mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia.

Carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract; increases the activity of glucose-6-phosphatase, which leads to an increase in the flow of glucose from the liver into the blood; increases the activity of phosphoenolpyruvate carboxylase and the synthesis of aminotransferases, leading to the activation of gluconeogenesis.

Antagonistic action in relation to vitamin D: "washing out" of calcium from the bones and increasing its renal excretion.

The anti-inflammatory effect is associated with inhibition of the release of inflammatory mediators by eosinophils; inducing the formation of lipocortins and reducing the number of mast cells that produce hyaluronic acid; with a decrease in capillary permeability; stabilization of cell membranes and organelle membranes (especially lysosomal ones).

The antiallergic effect is due to a decrease in the number of circulating eosinophils, which leads to a decrease in the release of immediate allergy mediators; reduces the effect of allergy mediators on effector cells.

The immunosuppressive effect is due to inhibition of the release of cytokines (interleukin1 and interleukin2, interferon gamma) from lymphocytes and macrophages.

Suppresses the synthesis and secretion of adrenocorticotropic hormone and secondarily - the synthesis of endogenous glucocorticosteroids. The peculiarity of the action is a significant inhibition of the function of the pituitary gland and the almost complete absence of mineralocorticosteroid activity.

Doses of 1-1.5 mg / day inhibit the function of the adrenal cortex; the biological half-life is 32-72 hours (the duration of the inhibition of the hypothalamus-pituitary-adrenal cortex system).

According to the strength of glucocorticosteroid activity, 0.5 mg of dexamethasone corresponds to approximately 3.5 mg of prednisone (or prednisolone), 15 mg of hydrocortisone, or 17.5 mg of cortisone.

Pharmacokinetics
In the blood, it binds (60-70%) to a specific protein - the carrier - transcortin. Easily passes through histohematic barriers (including through the blood-brain barrier and placental). A small amount is excreted in breast milk. Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Excreted by the kidneys.

Indications for use:

Contraindications for use: