Zicks of dexamethasone - when they are necessary, indications and precautions of injection injections. Dexamethasone (injections) - for which they are prescribed, and how to determine the dosage for adults and children? Dexamethasone indications for application in ampoules

Zicks of dexamethasone - when they are necessary, indications and precautions of injection injections. Dexamethasone (injections) - for which they are prescribed, and how to determine the dosage for adults and children? Dexamethasone indications for application in ampoules

03.11.2020 Popular treatment

GKS for injection

Active substance

Dexamethasone phosphate (in shape sodium salt) (DexameThasone)

Release form, composition and packaging

Injection Transparent, colorless or pale yellow.

Auxiliary substances: methylparaben, propylparaben, sodium metabisulfite, Dinatari Edetat, sodium hydroxide, water d / and.

2 ml - dark glass ampoules (25) - cardboard boxes.
2 ml - dark glass vials (25) - cardboard boxes.

pharmachologic effect

Synthetic glucocorticoid (GKS), methylated fluoroprednisolone derivative. It has an anti-inflammatory, immunosuppressive effect, increases the sensitivity of beta-adrenoreceptors to endogenous catecholaminam.

Interact with specific cytoplasmic receptors (receptors for GCS are in all tissues, especially there are many of them in the liver) with the formation of a complex inducing proteins (including enzymes that regulate vital processes in cells.)

Protein exchange: Reduces the number of globulins B, increases the synthesis of albumin on the liver and kidney (with an increase in albumin / globulin coefficient), reduces the synthesis and enhances the catabolism of the protein in muscle tissue.

Lipid exchange: increases the synthesis of higher fatty acids and triglycerides, redistribute fat (the accumulation of fat occurs mainly in the field of shoulder belt, facial, abdomen), leads to the development of hypercholesterolemia.

Carbohydrate: Increases carbohydrate absorption from gastrointestinal tract; increases the activity of glucose-6-phosphatase (increasing the flow from the liver into blood); Increases the activity of phosphoenolpiruwatkarboxylase and the synthesis of aminotransferase (activation of gluconeogenesis); Promotes the development of hyperglycemia.

Water-electrolyte exchange: delays Na + and water in the body, stimulates the removal of K + (mineralocorticoid activity), reduces the absorption of Ca + from the gastrointestinal tract, reduces the mineralization of bone tissue.

The anti-inflammatory effect is associated with the oppression of release of eosinophils and fat cells of inflammation mediators; induction of lipocortion formation and reducing the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; Stabilization of cell membranes (especially lysosomal) and organelle membranes. Acts on all stages of the inflammatory process: inhibits the synthesis of prostaglandins (PG) at the level of arachidonic acid (lipocortine inhibits phospholipase A2, suppresses the liberation of arachidonic acid and inhibits the biosynthesis of endoperosis, leukotrienes, contributing to the processes of inflammation, allergies, etc.), synthesis of "pro-inflammatory cytokines" ( Interleukin 1, factor of necrosis of the Alpha tumor, etc.); Increases the stability of the cell membrane to the action of various damaging factors.

The immunosuppressive effect is due to the resulting lymphoid tissue involution, the inhibition of lymphocyte proliferation (especially T-lymphocytes), suppressing the migration of B cells and the interaction of T- and limfocytes, the braking of the release of cytokines (interleukin-1, 2; gamma interferon) from lymphocytes and macrophages and a decrease in antibody formation.

The antiallergic effect develops as a result of a decrease in the synthesis and secretion of allergy mediators, inhibition of release of the release of sensitized fat cells and basophils of histamine and other biologically active substances, reducing the number of circulating basophils, t- and deformphocytes, fat cells; suppressing the development of lymphoid and connective tissue, reduce the sensitivity of effector cells to allergy mediators, oppression of antibody formation, changes in the body's immune response.

For obstructive diseases respiratory tract The action is mainly due to the braking of inflammatory processes, the prevention or decrease in the severity of edema of mucous membranes, a decrease in the eosinophilic infiltration of the submembraty layer of the epithelium of the bronchi and sediments in the mucous membranes of circulating immune complexes, as well as inhibition of erosion and desquamation of the mucous membrane. Increases the sensitivity of beta-adrenoreceptors of bronchi small and medium caliber to endogenous catecholamps and exogenous sympathomimetics, reduces the viscosity of the mucus by reducing its products.

Suppresses the synthesis and secretion of ACTH and the secondary - synthesis of endogenous GKS.

Inhibits the connective tissue reactions during the inflammatory process and reduces the possibility of forming scar tissue.

Action feature is a significant inhibition of the pituitary function and almost complete absence of mineralocorticosteroid activity.

Doses 1-1.5 mg / day depress the function of the adrenal cortex; The biological half-life - 32-72 h (the duration of the oppression of the hypothalamus-pituitary-hypophy-cortical substance of the adrenal glands).

Approximately 3.5 mg of prednisone (or), 15 mg of hydrocortisone or 17.5 mg of cortisone correspond to 0.5 mg of dexamethasone.

Pharmacokinetics

Blood binds (60-70%) with a specific protein-transceiver - transcertine. Easily passes through histohematic barriers (including through hematophephalic and placental).

Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites.

Excreted by kidneys (small part - lactating glands). T 1/2 dexamethasone from plasma - 3-5 h.

Indications

Diseases requiring the introduction of high-speed GCS, as well as cases where oral administration is impossible:

- endocrine diseases: acute insufficiency of adrenal cortex, primary or secondary insufficiency of adrenal cortex, congenital hyperplasia of adrenal cortex, subacute thyroiditis;

- shock (burn, traumatic, operational, toxic) - with the ineffectiveness of vasoconstrictor means, plasma-substituting drugs and other symptomatic therapy;

- edema of the brain (with a brain tumor, cranial and brain injury, neurosurgical intervention, hemorrhage in the brain, encephalitis, meningitis, radiation lesion);

- asthmatic status; Heavy bronchospasm (aggravation of bronchial asthma, chronic obstructive bronchitis);

- severe allergic reactions, anaphylactic shock;

- rheumatic diseases;

- systemic connecting tissue diseases;

- sharp heavy dermatoses;

— malignant diseases: Palliamental treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors, with impossibility of oral treatment;

- blood diseases: acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults;

- severe infectious diseases (in combination with antibiotics);

- in ophthalmological practice (Subconjunctive, retrobulbar or parabulbar administration): Allergic conjunctivitis, keratitis, keratoconjunctivitis without damage to the epithelium, irrit, iridocyclitis, blepharitis, blefaroconjunctivitis, sclerites, episclerite, inflammatory process after injuries of the eye and operational interventions, sympathetic ophthalmia, immunosuppressive treatment after cornea transplantation;

- Local use (in the area of \u200b\u200bpathological education): keloids, discoomed red lupus, ring-shaped granuloma.

Contraindications

For short-term use on life indications, the only contraindication is increased sensitivity to dexamethane or components of the drug.

FROM caution The drug should be prescribed under the following diseases and states:

- Diseases of the tract - ulcerative ulcer of the stomach and duodenum, esophagitis, gastritis, acute or latent peptic ulcer, recently created intestinal anastomosis, nonspecific ulcerative colitis with a threat of perforation or abscess, diverticulitis;

- Pre- and post-2 weeks (8 weeks before and 2 weeks after vaccination), lymphadenitis after vaccinations BCG.;

- immunodeficiency states (including AIDS or HIV infection);

- diseases of the cardiovascular system (incl. Recently suffered myocardial infarction - in patients with acute and subacted myocardial infarction possible, the focus of necrosis is possible, slowing down the formation of scar tissue and, as a result, is the gap of the heart muscle), severe chronic heart failure, arterial hypertension, hyperlipidemia);

- endocrine diseases - diabetes mellitus (including violation of the tolerance for carbohydrates), thyrotoxicosis, hypothyroidism, the disease of Izeno-Custine, obesity (III-IV Art.)

- severe chronic renal and / or liver failure, nephrowolithiasis;

- hypoalbuminemia and states predisposing to its occurrence;

- systemic osteoporosis, Miasthenia gravis, acute psychosis, poliomyelitis (except for the shape of the bulbar encephalitis), open and closed-coronal glaucoma;

- Pregnancy.

Dosage

Dosing mode is individual and depends on the indications, the state of the patient and its reaction to therapy. The drug is introduced into / in slowly inkjet or drip (with acute and urgent states); per / m; Local (in pathological education) is also possible. In order to prepare a solution for in / in drip infusion, an isotonic solution should be used or a 5% dextrose solution.

In the acute period under various diseases and at the beginning of therapy, dexamethasone is used in higher doses. During the day, you can enter from 4 to 20 mg of dexamethasone 3-4 times.

Dose drug for children (in / m):

The dose of the drug during substitution therapy (in case of insufficiency of the adrenal cortex) is 0.0233 mg / kg of body weight or 0.67 mg / m 2 of the body surface area, divided by 3 doses, every 3rd day or 0.00776 - 0.01165 mg / kg body weight or 0.233 - 0.335 mg / m 2 body surface area daily. With other indications, the recommended dose is from 0.02776 to 0.16665 mg / kg of body weight or 0.833 - 5 mg / m 2 of the body surface area every 12-24 hours.

When the effect is reached, the dose is reduced to supporting or before discontinuation. The duration of parenteral use is usually 3-4 days, then go to the supporting therapy with dexamethasone in tablets.

The long-term use of high doses of the drug requires a gradual reduction in the dose in order to prevent the development of acute insufficiency of adrenal cortex.

Side effects

Usually dexamethasone is well tolerated. It has low mineralocorticoid activity, i.e. Its influence on water-electrolyte exchange is small. As a rule, low and medium doses of dexamethasone do not cause sodium delays and water in the body, an increased excretion of potassium. The following side effects are described:

From the endocrine system:reducing glucose tolerance, steroid diabetes or manifestation of latent diabetes mellitus, inhibition of adrenal functions, Itsenko-Cushing syndrome (moon-like face, hypophized obesity, girsutism, increase arterial pressure, Dysmenorrhea, Amenorrhea, Muscular Weakness, Stria), Sexual Delay in Children.

From the digestive system:nausea, vomiting, pancreatitis, steroid ulcer of the stomach and duodenum, erosive esophagitis, gastrointestinal bleeding and perforation of the gastrointestinal tract, increase or decreased appetite, disruption of digestion, flatulence, ICOT. In rare cases - an increase in the activity of hepatic transaminases and alkaline phosphatase.

From the side of the cardiovascular system:arrhythmias, bradycardia (up to a heart stop); Development (in predisposed patients) or strengthening the severity of heart failure, changes on the electrocardiogram characteristic of hypokalemia, an increase in blood pressure, hypercoagulation, thrombosis. In patients with acute and subacted myocardial infarction - the spread of the focus of necrosis, slowing down the formation of scar tissue, which can lead to the rupture of the heart muscle.

From side nervous system: delium, disorientation, euphoria, hallucinations, manico-depressive psychosis, depression, paranoia, increasing intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudo-turn cerebellum, headache, cramps.

From the senses:rear subcapsular cataract, raising intraocular pressure With possible damage spectator nerve, a tendency to the development of secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, exophthalm, a sudden loss of vision (with parenteral administration in the head, neck, nasal shells, the scalp skin is possible deposition of the drug crystals in the eye vessels).

From the metabolism:increased excretion of calcium, hypocalcemia, body weight increase, negative nitrate balance (increased protein decay), increased sweating.

Conditioned mineralocorticoid activity- Liquid delay and sodium (peripheral edema), plasternatrhythmia, hypocalaminessindrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).

From the musculoskeletal system:the slowdown in the growth and processes of ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rarely pathological fractures of bones, aseptic necrosis of the head of the shoulder and femur), the gap of the muscle tendons, steroid myopathy, a decrease in muscle mass (atrophy).

From the side of the skin and mucous membranes:slowed healing of wounds, petechia, ekkimosis, skin thinning, hyper- or hypopigmentation, steroid eels, strry, tendency to the development of pyodermia and candidiasis.

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

Local with parenteral administration:burning, numbness, pain, tingling at the place of administration, infection at the injection site, rarely - necrosis of the surrounding tissues, the formation of scars at the injection site; Atrophy of the skin and subcutaneous tissue at a per / m administration (the introduction into the deltoid muscle is especially dangerous).

Others:the development or aggravation of infections (jointly used immunosuppressants and vaccination and vaccination), leukocyturia, "tides" of blood to the face, "cancellation" syndrome contribute to the appearance of this side effect.

Overdose

It is possible to strengthen the side phenomena described above.

It is necessary to reduce the dose of dexamethasone. Treatment is symptomatic.

Medicinal interaction

Pharmaceutical incompatibility of dexamethasone with others in / in the injected drugs is possible - it is recommended to be administered separately from other drugs (in / in bolus, or through Dr. dropper, as a second solution). When mixing a solution of dexamethasone, a sediment is formed with heparin.

Simultaneous purpose of dexamethasone C:

- Inductors of hepatic microsomal enzymes(phenobarbital, rifampicin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration;

— diuretics(especially tiazide and carboanhydrase inhibitors) and amphotericin in - It may lead to an increase in the elimination of the K + organism and an increase in the risk of developing heart failure;

— with sodium-containing drugs- to the development of edema and an increase in blood pressure;

— cardiac glycosides -their portability deteriorates and the likelihood of the development of ventricular extrasytoly increases (due to the caused hypokalemia);

— indirect anticoaguppy- weakens (less often enhanced) their action (dose correction is required);

— anticoagulants and thrombolitics -rises the risk of developing bleeding from ulcers in the gastrointestinal tract;

— ethanol and npvp - the risk of erosive-ulcer lesions in the gastrointestinal tract and the development of bleeding is increasing (in combination with NSAIDs in the treatment of arthritis it is possible to reduce the dose of glucocorticosteroids due to the summation of the therapeutic effect);

— paracetamol- the risk of hepatotoxicity is increasing (induction of hepatic enzymes and the formation of toxic paracetamol metabolite);

— - accelerates its elimination and reduces blood concentration (when dexamethasone cancels, the level of salicylates in the blood increases and the risk of developing side effects) is increasing);

— insulin and oral hypoglycemic drugs, hypotensive means -their effectiveness decreases;

— vitamin D -it decreases its effect on the suction of CA 2+ in the intestine;

— somatotropic hormone -reduces the effectiveness of the latter, and with praziquantel -its concentration;

— M-cholinoblocators(including antihistamines and tricyclic antidepressants) and nitrates -contributes to an increase in intraocular pressure;

— isoniazid and Mexylethine- increases their metabolism (especially in "slow" acetylastors), which leads to a decrease in their plasma concentrations.

Carboangeerase and "loop" diuretics inhibitors can increase the risk of osteoporosis.

Indomethacin, ousting dexamethasone due to albumin, increases the risk of developing its side effects.

ACTH enhances dexamethasone action.

Ergocalciferol and pararathgamon prevent the development of osteopathy caused by dexamethasone.

Cyclosporine and ketoconazole, slowing down dexamethasone metabolism, can in some cases increase its toxicity.

The simultaneous purpose of androgens and steroidal anabolic preparations with dexamethasone contributes to the development of peripheral edema and girsutism, the appearance of acne.

Estrogens and oral estrogen-containing contraceptives reduce dexamethasone clearance, which can be accompanied by an increase in the severity of its action.

Mitanka and other inhibitors of the adrenal cortex functions can determine the need to increase the dose of dexamethasone.

With simultaneous use with alive antiviral vaccines and against the background of other types of immunization increases the risk of activating viruses and the development of infections.

Antipsychotic means (neuroleptics) and azathioprine increase the risk of cataracts when appointing dexamethasone.

With simultaneous use with antihydride preparations, decreases, and with thyroid hormones - the clearance of dexamethasone increases.

special instructions

During treatment with dexamethasone (especially long), observation of the eyepiece, control of the blood pressure and state of the water and electrolyte balance, as well as the pattern of peripheral blood and blood glucose levels are necessary.

In order to reduce side effects, antacids can be prescribed, and also to increase the admission to + in the body (diet, potassium preparations). Food should be rich in squirrels, vitamins, with limiting the content of fats, carbohydrates and cooking salts.

The effect of the drug is enhanced in patients with hypothyroidism and cirrhosis of the liver. The drug can strengthen existing emotional instability or psychotic disorders. When specifying psychosis, a history of dexamethasone in high doses is prescribed under the strict control of the doctor.

With caution, it should be used in acute and subacted myocardial infarction - it is possible to spread the focus of necrosis, slowing down the formation of scar tissue and the gap of the heart muscle.

In stressful situations during supportive treatment (for example, surgical operations, injury or infectious diseases), a dose correction should be corrected due to the increase in glucocorticosteroid need. It should be carefully observed for patients during the year after the end of long-term therapy with dexamethasone due to the possible development of the relative failure of the adrenal cortex in stressful situations.

With a sudden cancellation, especially in the case of the preceding use of high doses, the development of the "Cancellation" syndrome (anorexia, nausea, inhibition, generalized muscular-skeletal pain, general weakness), as well as the aggravation of the disease, was assigned to the dexamethasone.

During treatment with dexamethasone, vaccination should not be carried out in connection with the decline in its effectiveness (immune response).

Assigning dexamethasone at intercurrent infections, septic conditions and tuberculosis, it is necessary to simultaneously carry out antibiotics of bactericidal action.

In children during long-term treatment, dexamethasone needs careful monitoring of growth and development dynamics. Children, which during the treatment period were in contact with sick cute or chickenpasses, prophylactically prescribe specific immunoglobulins.

Due to the weak mineralocorticoid effect for substitution therapy with adrenal insufficiency, dexamethasone is used in combination with mineralocorticoids.

In patients with diabetes mellitus, the content of blood glucose should be monitored and corrected therapy if necessary.

X-ray control over the bone-articular system (spinal shots, brushes) are shown.

In patients with latent infectious diseases of the kidneys and urinary tract, dexamethasone is able to cause leukocyturia, which may have a diagnostic value.

Dexamethasone increases the content of metabolites of 11- and 17-oxytocorticosteroids.

Pregnancy and lactation

During pregnancy (especially in the first trimester) the drug can be applied only when the expected therapeutic effect Exceeds the potential risk to the fetus. With long-term therapy during pregnancy, the possibility of breach of fetal growth is not excluded. In the case of use at the end of pregnancy, there is a danger of atrophy of the adrenal cortex at the fetus, which may require substitution therapy in a newborn.

If it is necessary to carry out treatment with a drug during breastfeeding, then breastfeeding should be stopped.

Childcare

In children during the growth period, GCS should be applied only in absolute indications and under particularly thorough observation of the attending physician.

Dexamethasone is a hormonal drug, which is considered in modern medicine, as one of the vital pharmaceutical funds belonging to the group of synthetic glucocorticosteroids. Dexamethasone is able to penetrate the fabric of all organs and systems, including the brain and the nervous system, and affect the entire body. With severe states - shock, acute systemic allergies, pronounced inflammation, pathological immune reactions, the medicine can save life.

For treatment of different types Dexamethasone diseases are produced in 4 dosage forms whose therapeutic basis is sodium dexamethasone phosphate.

This substance is a synthetic analogue of a natural steroid hormone, which in the body produces adrenal glands.

Main forms:

Tablets of 0.5 mg (0.5 mg of the active component) in a bundle of 10 units.
Injection solution (0.4%) in 1 ml ampoules containing 4 mg active substance (5 or 25 units per pack). Used to introduce into the muscle, vein (inkjet or drip), inside the joint, in soft fabrics surrounding it, into the fiber of the eyeball.
Dexamethasone Eye drops (ear) 10 ml with an active substance concentration of 0.1% (1 mg per 1 ml).
Eye ointment - Tuba 2.5 g

All forms of the medical preparation as auxiliary components contain substances that are necessary for stabilization, formation and transportation of dexamethasone to a painful hearth, as well as preservatives and additives that facilitate the absorption of medication.

Each medical form It has its purposefulness in the application, certain testimony and contraindications, therefore it is not necessary to deal with their own treatment - only a specialist is able to develop the necessary chart of therapy, calculate doses and frequency of use.

The medicine is released by the recipe, where the name of the drug in Latin is denoted as DexameThasoni.

Pharmacological properties and pharmacokinetics

Medical properties

The mechanism of therapeutic effect of the drug is based on its ability to create a high concentration of the component in the blood and foci of inflammation, penetrate all tissues and have an effect at the cellular level.

This allows the active substance to operate in brain and nerve tissues, to remove the edema of the brain, the lungs during hemorrhage, poisoning, injuries, tumors, withdrawing a patient from the threatening life of the state of the shock, to inhibit the course of cancer processes, eliminate the manifestations of acute allergies.

The glucocorticosteroid activates a series of processes, which lead to a decrease in the permeability of the vessel walls, strengthen the protection of cell shells and inflammation blocking in any stage of development.

Suppressing an acute reaction immune system On allergens, the drug stops the development of an allergic reaction, including anaphylactic shock, reduces the degree of edema of the mucosa of the respiratory organs, bronchi, restoring the air intake at the swelling of the larynx or an asthmatic seizure.

At the same time, the medicine slows down the production of histamine, stopping the pathological manifestations of allergies.

Slows down the formation of scar changes in the tissues of various organs.

Suction and elimination of the body

The corticosteroid is actively and almost completely absorbed not only after injection, but also after internal reception. The bioavailability or the amount of the healing substance that reaches the focus of the impact is 77 - 79%, due to which the therapeutic effect of the drug is maximum.

In blood, 65 - 70% of dexamethasone binds to the transport protein transcertin, which provides a high concentration of the drug in the blood. With blood flow, protein delivers dexamethasone throughout the body, penetrating into intracellular fabric spaces.

The greatest amount of the active substance in the blood, providing the maximum therapeutic effect, is observed in the range from 40 to 90 minutes depending on the method of application.

The active substance is processed by the enzymes of the liver to inactive intermediates. It is removed from the body along with the urine and in small quantities (about 10%) is derived by the intestine. The small volume of dexamethasone penetrates women's milk, which should be considered when appointing a nursing mother's preparation.

For which the drug is prescribed

The effect of medication is used in many diseases internal organs, systemic, autoimmune pathologies, in diseases of the joints, eyes, skin and in many other areas of medicine.

The list of pathological conditions in which the injection or tablets decxamethasone are required:

threatening life shock states of all forms, including pain shock, toxic, cardiogenic, allergic, postoperative, hemotransphusion (after blood transfusions);
brain tissue swelling (with hemorrhage, meningitis, tumors, encephalitis, injury, operations);
attack of bronchial asthma or long-term asthmatic status;
light pathology: berylliosis, tuberculosis, alveolo, pneumonia, Lefeler syndrome (resistant to other medical environments);
allergic reactions: urticaria, swelling of quinque, pollinosis, drug allergies and products, serum disease;
endocrine disorders - insufficiency of adrenal glands, thyroid disease, thyrotoxic crisis, thyroiditis, adrenogenital syndrome;
autoimmune diseases - rheumlockitis, multiple sclerosis, system red lupus, pemphigus, sclerodermia, systemic vasculitis;
pain in the inflammation of reproductive organs, including prostatitis; various types of myositis;
difficult skin diseases - eczema, dermatitis of different types, psoriasis, toxidermy, Layella and Stevens-Johnson syndromes, Discoidal red lupus, keloid scars (local application);
eye lesions of an allergic and inflammatory character: scarce, corneal ulcers, different types conjunctivitis (except purulent), uveitis, keratitis, blepharitis, inflammation of the visual nerve, ophthalmopathy against the background of diabetes;
sweets of larynx and voice gap with acute croup;
inflammation of the joints of various flows: arthritis of different forms, osteoarthritis, polyarthritis, ankylosing spondylitrite, bursitis, tendosiveit and others;
blood breeding: Addison, lymphoma disease, agranulocytosis, anemia of different origin, thrombocytopenia;
critical conditions with damage to the gastrointestinal system: enteritis, including granulomatous, hepatitis and hepatic coma, ulcerative colitis;
allergo toxic reaction with massive glider aggression;
lesions of the esophagus and stomach in alkali poisoning, acids to suppress inflammation and prevent scar escautional congestion;
acute renal pathologies - glomerulonephritis, nephrotic syndrome;
malignant processes in lungs, leukemia, lympholoicosis, myeloma disease;
nausea and vomiting against the background of taking cytostatics.

Dexamethasone Application Instructions

Dexamethazone treatment and dosing regimen establishes only the attending physician to obtain the maximum therapeutic effect with the minimum risk of unwanted adverse reactions.

Pills

Usually prescribed chronic flow pathology or after removing the acute state.

The dose is determined for each patient separately, given the nature and severity of the disease, the planned course duration, age, the portability of the medication and the patient's reaction.

The usual minimally effective dose for adults per day is 0.5 - 9 mg. A small dose is taken at a time greater - divide by 3 - 4 receptions. The greatest amount of dexamethasone per day should not exceed 10 - 15 mg.

The average maintenance dose per day is 0.5 - 3 mg.

With long-term use of medication in a large dose, the reception of medication is combined with food. At the same time, it is desirable to use products that reduce gastric acidity (antacids) between meals.

After improving the patient's condition, the dose should be gradually reduced - every 3 days by 0.5 mg to the supporting dose.

The duration of the application varies from 3 to 5 days to several months.

It is unacceptable to drastically stop treating dexamethason in order not to cause cancellation syndrome,

which is expressed in the exacerbation of the underlying disease and painful manifestations of abstinence syndrome (weakness, weight loss, vomiting, diarrhea, blood sugar and pressure, muscle pain, fever).

Dosing for children

Minor patients are prescribed according to body weight or body area, age and weight of the pathological process.

Approximate children's dose per day 0.0833 - 0.333 mg per 1 kilogram of the body mass of the child. Thus, according to the calculation, the child weighing 25 kg can take a maximum of 0.333 x 25 \u003d 8.36 mg of the drug, separated by 3 to 4 receptions. The minimum dose that will give the healing effect for a small patient with such weight 0.0833 x 25 \u003d 2.08 mg.

A more accurate children's dose is calculated on the surface area of \u200b\u200bthe child's body at the rate of 0.0025 - 0.0001 mg per 1 meter square per day at 3 - 4 receptions depending on age.

Injection

Cripsamethasone injections with systemic diseases are made inside the muscles, or administered intravenously, which is preferable in life-in-giving situations when high risk for the patient's life. The solution immediately enters blood, providing a rapid therapeutic effect.

For emergency short-term or one-time use of the drug, only the intolerance of any of the substances as part of dexamethasone is considered to be contraindicated. In critical situations, the side effects of the drug are neglected.

Adults during acute and urgent states can be 3 - 4-20 mg in 4-20 mg. In the acute phase of pathology, as well as at the beginning of therapy use higher doses of corticosteroid. The greatest dose is 80 mg, but in critical cases - above.

Children's doses for intramuscular administration are calculated by weight of the child at the rate of 0.02776 - 0.16665 mg per kilogram of body weight after 12 to 24 hours.

The duration of injecting administration with a gradual decline in the dose usually does not exceed 3 - 4 days, after which the patient is transferred to the reception of the tablets in the maintenance dose.

Eye drops and ear

In acute inflammation, patients over 12 years for 48 hours 4 - 5 times a day, an ophthalmic solution is dripped during the lower eyelid 1 - 2 drops. When the degree of inflammation decreases, the treatment continues to 4 - 6 days, reducing the multiplicity of the instillation to 3 times a day.

In chronic processes, the tool is used twice a day no longer than 20 - 40 days.

With allergic eye damage, similar doses are used to 5 times a day for 48 hours, further - gradually reduce the frequency of the instillation to 2 times a day and cancellation of treatment by 7 - 12 days.

Patients 6 - 12 years old to eliminate inflammatory and allergic phenomena are injected over eyelid 1 drop to 4 times a day no longer than 10 days.

The solution is used from 8 days after the operation to eliminate cataracts, retinal detachment, strains up to 4 times a day for 2 to 4 weeks.

With the inflammation of the ear (otitis), no viral nature is buried in a patient's ear in a warm form 3 - 4 drops (children 1 - 2) three times a day.

The lenses before injection means are removed. You can wear them only after 15 minutes.

Eye ointment dexametazone

Used under the same indications as ophthalmic drops in patients from 6 years. Mazi strip 10 - 15 mm long laid out for the lower eyelid 3 times a day. The maximum treatment duration of not more than 20 days.

Use during pregnancy and lactation

In the study on small mammals, it was revealed that dexamethasone, like many other hormonal agents, penetrates the placenta in the embryo tissue and is able to lead to the death of the embryo on early stage and fetal deformities. The class of action of the medical preparation on the fruit - C (by FDA).

Therefore, dexamethasone is used during pregnancy, only if there is a threat to life for the mother.

If pregnant has received dexamethasone, after delivery, it is necessary to observe the health of the baby - since the child can be diagnosed with adrenal dysfunction, which requires immediate intensive treatment.

As the medicine penetrates women's milk, nursing mothers need to go to artificial feeding or abandon the drug.

With long-term use of ointments or drops, partial absorption of the drug in blood takes place. Therefore, these dosage forms are allowed to use future mothers after 12 weeks of gestation, very short courses up to 3 days and in minimal doses.

During lactation, it is permissible for the treatment of ointments and drops no longer than 7 to 10 days.

Is it possible to drink alcohol when taking the drug

The treatment of dexamethasone is incompatible with the use of alcohol, otherwise the consequences of parallel use will be very serious.

The likelihood of such severe manifestations as:

indoor diarrhea;
partial loss of vision;
abdominal pain, vomiting;
acute pain in the injection site;
redness of the skin on the chest, urticaria, the rash of acne on the face;
uziznoje mucous digestive organs;
internal bleeding.

If the patient has a serious alcohol addiction and is not capable of abandoning alcohol to therapy, it is required to assign other drugs.

Drug interaction with other drugs

The combination of dexamethasone and non-phonal anti-inflammatory pharmaceuticals (aspirin, paracetamol) increases the likelihood of formation or deepening of the ulcers of digestive organs.

The effect of the corticosteroid decreases with parallel use:

antacids that reduce the absorption of the attending substance in the stomach;
somatotropin;
preparations from the CYPZ4 isoenzyme system series (for example, phenobarbital, phenobarbital, rifabutin, rifampicin, carbamazepine);
aminoglutortimide and Ephedrine.

With parallel use, dexamethasone is capable of:

reduce therapeutic effects of insulin, hypoglycemic drugs, drugs from high blood pressure, prazicvantel and diuretic-sodium students;
strengthen the effect of heparin, albendazole.
increase potassium removal when combined with diuretic; influence the effect of Kumarin anticoagulants;

Antifungal agents based on ketoconazole, contraceptive tablets, macrolide antibiotics are able to lengthen the dexamethasone time with urine and increase the frequency and degree of unwanted reactions.

The combination of the medical preparation with thalidomide can provoke the development of Layella syndrome, with antiholinergic agents - glaucoma, with antipsychotic drugs and apartments - cataracts; With heart glycosides - arrhythmia.

The combination with anabolic steroids, androgens, contraceptive, estrogens can cause increased sophistication, chest, swelling, and the development of acne.

The use of antiviral vaccines parallel to dexamethasone therapy increases viral aggressiveness against the background of immunity reduction.

Contraindications, side effects and overdose

Contraindications

If dexamethasone is emergency to rescue life, all contraindications, (except for intolerance of the medication), and probable side reactions are ignored.

With any heavy injection infections and tablets, dexamethasone is permissible to be appointed only with simultaneously conducting the specific treatment of these diseases.

Contraindications for intra-design injections:

tendency to bleeding;
intra-art bone fracture;
infection, osteoporosis, instability, deformation in the field of joint, bone destruction, ankylosis;
surgical intervention (arthroplasty);
necrosis of the articular bone;
low efficiency after 2 previous injections.

Contraindications for local forms (ointment, drops):

damage to the eye tuberculosis stick, fungus, viruses, including herpes;
glaucoma;
acute suppuration of the structures of the eye (if treatment with antibiotics is not carried out);
injury and corneal ulcers, period after removing the foreign object;
hole in the eardrum.

Important! Ointment and drops dexamethasone can reduce the severity of manifestations in the development of bacterial and fungal lesions of the ears and eyes.

Therefore, after clarifying the diagnosis and detection of infection, the drug must be applied with appropriate antimicrobial treatment.

Side effects

The hormonal remedy has a profound effect on all organism systems. The task of the attending physician is to reduce the risk, frequency and severity of adverse reactions with a high therapeutic effect of the drug to a minimum.

Unwanted manifestations depend on the duration of the course, dosages, age and patient state.

Basic side manifestations:

allergic rash, skin itching, urticaria, edema on face, respiratory disorders, bronchospasm, anaphylactic shock;
anxiety, loss of orientation, depressive, paranoid states or euphoria;
twist in the eyes, eye disorders, pain in the head due to an increase in intracranial pressure characteristic of a rapid reduction in the dose;
insomnia, dizziness;
persistent increase in blood pressure;
weakening of myocardial work, arrhythmia;
potassium deficiency and cardiac disorders associated with hypokalemia;
reducing the function of adrenal glands, the development of diabetes, Incenco-Cushing syndrome, excess extension, disorder of a monthly cycle, development delay in children;
sharp increase in blood viscosity and thrombosis;
nausea, attacks of vomiting, ulceration of digestive organs, gastritis, pancreatitis, colitis;
frequent infections against the oppression of immunity;
osteoporosis, abnormal fractures, articular and muscle pain, hip head necrosis, tenders' gap;
acne rash, sweating, dry skin, slow healing of damage;
edema extremities, weight set;
a sharp impairment of view (with injections in the facial, neck and head zone);
strengthening pain in injection into the joint;
the burning, itching of mucous and skin (ointment and drops), in the treatment of longer than 20 days, the development of allergies, glaucoma and cataracts are possible, reduced visual function.

Drivers of transport and workers, from which increased concentration, should be careful when treating dexamethasone, since the concentration of attention is violated.

Overdose

Excessive doses of corticosteroid or long-term treatment can lead to an overdose, which manifests itself in strengthening unwanted adverse reactions.

The drug immediately cancel and eliminate the symptoms of overdose by drugs that are able to remove certain manifestations.

With long-term therapy, constant monitoring of children's development is required, periodic examination of organs of vision, control of intraocular, intracranial pressure, sugar and blood coagulation, adrenal functions and hypothalamic-pituitary system.

Analogs of dexamethasone

Synonyms - medications with the same active component as at dexamethasone, and similar to therapeutic effects: dexamethasone-virgin, dexamethasone fréin, eye drops - dexamethamblong, Maxidge, Offantian dexamethasone, Ozdex.

Analogs with similar action, but by another:

drops with dexamethasone and other active components: Sofradex, Deckon;
Prednisolone - corticosteroid medical agent, with similar, but weaker therapeutic effect.

Catad_pgroup System Corticosteroids

Catad_pgroup preparations for ophthalmology

Dexamethasone for injection - instructions for use

Medical use instructions for the drug

Name of the drug:

Trade name of the drug:

Dexametanone

International non-proprietary name:

dexametanone

Dosage form:

injection

Structure

Active substance:
Sodium dexamethasone phosphate (dexamethasone phosphate dinodium salt) in terms of 100% substance - 4.0 mg

Excipients:
Glycerol (distilled glycerin) - 22.5 mg
Dinatari Edetat (Trilon B) - 0.1 mg
Sodium hydrophosphate dodecahydrate (sodium phosphorous acid-made 12-aqueous) - 0.8 mg
Water for injection - up to 1 ml

Pharmacotherapeutic Group:

glucocorticosteroid

ATX code:

H02Av02.

Description:

Transparent colorless or light yellow liquid.

pharmachologic effect

Synthetic glucocorticosteroid is a methylated fluoroprednisolone derivative. It has anti-inflammatory, anti-allergic desensitizing, anti-shock, antitoxic and immunosuppressive effect.

Interacts with specific cytoplasmic receptors and forms a complex that penetrates the cell core and stimulates the synthesis of mRNA; The latter induces the formation of proteins, incl. Lipocortin, mediated cell effects. Lipocortine inhibits phospholipase A2, suppresses the release of arachidonic acid and inhibits the biosynthesis of endoperosis, prostaglandins, leukotrienes that contribute to the processes of inflammation, allergies and others.

Protein exchange: Reduces the amount of protein in plasma (due to globulins) with an increase in albumin / globulin coefficient, increases the synthesis of albumin in the liver and kidneys; Enhances catabolism protein in muscle tissue.

Lipid Exchange: Increases the synthesis of higher fatty acids and triglycerides, the fat redistributes (the accumulation of fat is mainly in the field of shoulder belt, facial, abdomen), leads to the development of hypercholytenerine.

Carbohydrate: Increases carbohydrate absorption from the gastrointestinal tract; increases the activity of glucose-6-phosphatase, leading to an increase in the admission of glucose from the liver into blood; Increases the activity of phosphoenolpiruwatkarboxylase and the synthesis of aminotransferase, leading to the activation of glukegenesis.

Antagonistic action in relation to Vitamin D: "Washing" calcium from bones and increasing its renal excretion.

The anti-inflammatory effect is associated with the oppression of the release of inflammation mediators by eosinophils; induction of lipocortion formation and reducing the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; Stabilization of cell membranes and organelle membranes (especially lysosomal).

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

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

Suppresses the synthesis and secretion of the adrenocorticotropic hormone and the secondary - synthesis of endogenous glucocorticosteroids. Action feature is a significant inhibition of the pituitary function and almost complete absence of mineralocorticosteroid activity.

Doses of 1-1.5 mg / day depress the function of the adrenal cortex; The biological half-life - 32-72 h (the duration of the oppression of the hypothalamus-pituitary-hypophy-cortical substance of the adrenal glands).

Approximately 3.5 mg of prednisone (or prednisone), 15 mg of hydrocortisone or 17.5 mg of cortisone correspond to 0.5 mg of dexamethasone.

Pharmacokinetics
Blood binds (60-70%) with a specific protein - carrier - transcertin. Easily passes through histohematatic barriers (including through the hematorencephalic barrier and placental). In small quantities stand out with breast milk. Metabolized in the liver (mainly by conjugation with glucuronic and sulfuric acids) to inactive metabolites. Excreted by the kidneys.

Indications for use:

The drug is used for diseases requiring the introduction of high-speed glucocorticosteroid, as well as in cases where oral administration is impossible:

Endocrine diseases (acute lack of adrenal cortex, primary or secondary insufficiency of adrenal cortex, congenital hyperplasia of adrenal cortex, subacute thyroiditis);
- Shock, resistant to standard therapy; anaphylactic shock;
- edema of the brain (with a brain tumor, cranial and brain injury, neurosurgical intervention, hemorrhage in the brain, encephalitis, meningitis, radiation lesion);
- asthmatic status; Heavy bronchospasm (aggravation of bronchial asthma, chronic obstructive bronchitis);
- severe allergic reactions;
- rheumatic diseases;
- systemic connecting tissue diseases;
- sharp heavy dermatoses;
- malignant diseases (palliative treatment of leukemia and lymphoma in adult patients; acute leukemia in children; hypercalcemia in patients suffering from malignant tumors, with the impossibility of oral treatment);
- diagnostic study of adrenal hyperfunction;
- blood diseases (acute hemolytic anemia, agranulocytosis, idiopathic thrombocytopenic purpura in adults);
- severe infectious diseases (in combination with antibiotics);
- intra-articular and intrasinovial administration: arthritis of various etiologies, osteoarthritis, acute and subacute bursitis, acute tendovaginitis, epicondylitis, synovit;
- Local use (in the area of \u200b\u200bpathological education): keloids, discoomed red lupus, ring-shaped granuloma.

Contraindications for use:

For short-term use on "life" testimony, the only contraindication is hypersensitivity.

For intra-articular administration: preceding arthroplasty, pathological bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammatory process in the joint and periarticular infections (including in history), as well as a general infectious disease, pronounced near Osteoporosis, the absence of signs of inflammation in the joint (the so-called "dry" joint, for example, with osteoarthritis without synovitis), pronounced bone destruction and deformation of the joint (sharp narrowing of the articular gap, ankylosis), the unstability of the joint as the outcome of arthritis, the aseptic necrosis forming the joint epiphysis bones.

A post permanent period (a period of 8 weeks before and 2 weeks after vaccination), lymphadenitis after the BCG vaccination. Immunodeficiency states (including AIDS or HIV infection).

Diseases of the gastrointestinal tract (ulcerative ulcer of the stomach and 12-rosewood, esophagitis, gastritis, acute or latent peptic ulcer, recently created anastomosis of the intestine, nonspecific ulcerative colitis with a threat of perforation or abscess, diverticulitis).

Diseases of the cardiovascular system, incl. The recently suffered myocardial infarction (in patients with acute and subacted myocardial infarction, it is possible to spread the focus of necrosis, the slowdown in the formation of scar tissue and as a result - the gap of the heart muscle), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.

Endocrine diseases are diabetes mellitus (including violation of carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Incenko-Cushing disease.

Heavy chronic renal and / or liver failure, nephrowolithiasis. Hypoalbuminemia and states predisposing to its occurrence.

Systemic osteoporosis, Miasthenia GRAVIS, acute psychosis, obesity (III-IV Art.), Poliomyelitis (except for the shape of bulbar encephalitis), open and closed-coronal glaucoma, pregnancy, lactation period.

For intra-articular administration: the general severe condition of the patient, inefficiency (or short-term) action 2 of previous administrations (taking into account the individual properties of glucocorticosteroids used).

Method of use and dose:

Intrautly, in the lesion center - 0.2-6 mg, with a repetition of 1 time in 3 days or 3 weeks.

Intramuscularly or intravenously - 0.5-9 mg / day.

For the treatment of brain edema - 10 mg in the first administration, in the following 4 mg intramuscularly every 6 hours before the disappearance of symptoms. The dose can be reduced in 2-4 days with a gradual cancellation in a period of 5-7 days after eliminating brain edema. Supporting dose is 2 mg 3 times / day.

For the treatment of shock - intravenously 20 mg in the first administration, then 3 mg / kg in 24 hours in the form of intravenous infusions or intravenously, from 2 to 6 mg / kg as a single injection or 40 mg in the form of a single injection appointed every 2- 6 h; possibly intravenous administration 1 mg / kg once. Shock therapy should be canceled as soon as the patient's condition stabilizes, the usual duration of no more than 2-3 days.

Allergic diseases - intramuscularly in the first injection of 4-8 mg. Further treatment is carried out by oral dosage forms.

With nausea and vomiting, during chemotherapy - intravenously 8-20 mg 5-15 minutes before chemotherapy session. Further chemotherapy should be carried out when using oral dosage forms.

For the treatment of respiratory distress syndrome of newborns - intramuscularly 4 administration of 5 mg every 12 hours for two days.

Maximum daily dose - 80 mg.

For children: for the treatment of adrenal insufficiency - intramuscularly, 23 μg / kg (0.67 mg / sq. M) times in 3 days or 7.8-12 μg / kg (0.23-0.34 mg / sq. M / SUT), or 28-170 μg / kg (0.83-5 mg / sq. M) Once at 12-24 hours

Precautions when applied

Children who during the treatment are in contact with sick cute or chickenpox, special immunoglobulins are propyly prescribed.
In children during the growth period, glucocorticosteroids should be used only in absolute indications and under particularly thorough observation of the doctor.
It should be borne in mind that in patients with hypothyroidism, the clearance of glucocorticosteroids is reduced, and in patients with thyrotoxicosis - rises.

Overdose

Symptoms:enhance arterial pressure, swelling, peptic ulcer, hyperglycemia, violation of consciousness.
Treatment: Symptomatic, specific antidote no.

Side effect

The frequency of development and severity of side effects depend on the duration of use, the value of the dose used and the possibility of compliance with the circadian rhythm of the destination.

From the metabolism: sodium delay and water in the body; hypokalemia; Hypographicalemic alcohol; A negative nitrogen balance caused by increased catabolism of proteins, an increase in appetite, an increase in body weight.

From the side of the cardiovascular system: Higher risk of thrombosis (especially in immobilized patients), arrhythmias, increase blood pressure, development or exacerbation of chronic heart failure, myocardiodestrophia, steroid vasculitis.

On the side of the musculoskeletal system:muscular weakness, steroid myopathy, reduction of muscle mass, osteoporosis, compression vertebral fractures, aseptic necrosis of the femoral head and shoulder bones, pathological fractures of long bones.

From the digestive system:nausea, vomiting, erosive-ulcerative lesions of the gastrointestinal tract (which may cause perforations and bleeding), hepatomegaly, pancreatitis, ulcerative esophagitis.

Dermatological reactions: thinning and vulnerability of skin, petechia and subcutaneous hemorrhages, ekkimosis, strry, steroid acne, slowing down wound healing, reinforced sweating.

From the central nervous system:increased fatigue, dizziness, headache, mental disorders, convulsions and false symptoms of brain tumors (increasing intracranial pressure with a stagnant disk of optic nerve).

From the endocrine system:reducing glucose tolerance, "steroid" diabetes mellitus or manifestation of latent diabetes mellitus, inhibition of adrenal functions, Izsenko-Cushing syndrome (moon-like face, hypophized obesity, hirsutism, enhancement of blood pressure, dysmenorrhea, amenorrhea, miastic, strry), penal delay in children.

From the authorities of the vision: Rear subcapsular cataract, an increase in intraocular pressure, Exophthalm.

Side effects associated with immunosuppressive action: More frequent occurrence of infections and aggravation of the severity of their flow.

Others:allergic reactions.

Local reactions (at the place of administration): Hyperpigmentation and leukoderma, atrophy of subcutaneous tissue and leather, aseptic abscess, hyperemia at the injection site, arthropathy.

Interaction with other medicines

Simultaneous use with phenobarbital, rifampicin, phenythine or ephedrine can accelerate the biotransformation of dexamethasone, thereby weakening its effect. Hormonal contraceptives enhance dexamethasone action.

Simultaneous use with diuretics (especially "looped") can lead to increased removal from the potassium body.

With simultaneous purpose with cardiac glycosides, the possibility of heart rate disorders increases.

Dexamethasone weakens (less often increases) the effect of Cumarine derivatives, which requires the correction of their dose.

Dexamethasone enhances the side effect of non-steroidal anti-inflammatory agents, especially their influence on the gastrointestinal tract (enhancing the risk of erosive-ulcerative lesions and bleeding from the gastrointestinal tract). In addition, reduces the concentration of non-steroidal anti-inflammatory agents in serum and thereby their effectiveness.

Carbonithih inhibitors: increase the risk of hypernatremia, swelling, hypokalemia, osteoporosis.

Reduces insulin efficiency and oral hypoglycemic drugs, hypotensive drugs.

Antacids weaken the effect of dexamethasone.

In combination with paracetamol, leads to an increase in the risk of hepatotoxicity, due to the induction of hepatic enzymes and the formation of the toxic metabolite of paracetamol.

The simultaneous use of androgens, steroidal anabolics contributes to the appearance of edema, hirsutism and acne; Estrogen, oral contraceptives - leads to a decrease in clearance, an increase in the toxic effects of dexamiatason.

The risk of cataracts is rising when applied on the background of dexamethasone antipsychotic means (neuroleptics) and nastyopril.

Simultaneous appointment with M-cholinoblocators (including antihistamines, tricyclic antidepressants) and nitrates contribute to the development of glaucoma.

With simultaneous use with alive antiviral vaccines and against the background of other types of immunization increases the risk of activation of viruses and the development of infections.

Amphotericin in increases the risk of heart failure.

In combination with anticoagulants and thrombolitics, the risk of developing ulcers of gastrointestinal fact and bleeding is increased.

Reduces the concentration in the plasma of salicylate (increases the excretion of salicylates).

Increases mexyleletine metabolism, reducing its plasma concentration.

Opportunities and features of the use of the drug during pregnancy

(especially in the first trimester) The drug can be applied only when the expected therapeutic effect exceeds the potential risk to the fetus. With long-term therapy during pregnancy, the possibility of breach of fetal growth is not excluded. In the case of use at the end of pregnancy, there is a danger of atrophy of the adrenal cortex at the fetus, which may require substitution therapy in a newborn.

If it is necessary to carry out treatment with a drug during breastfeeding, then breastfeeding should be stopped.

The effect of the drug on the ability to control vehicles, mechanisms

During treatment, it is not recommended to manage vehicles, as well as occupation of activities requiring the speed of psychomotor reactions and accurate movements.

Release form:

Solution for injection 4 mg / ml.

1 ml in the ampoules of neutral glass.

10 ampoules along with the instructions for use and the knife for opening ampoules or scarifier ampulos are placed in a box of cardboard.

5 ampoules in the contour cellular packaging of polyvinyl chloride film.

1 or 2 contour cellular packages along with the instructions for use and the knife for opening the ampoules or scarifier ampulos are placed in a pack of cardboard.

When using ampoules with notches, rings and dot points, scarifier ampool or knife for opening the ampoules is allowed not to invest.

Shelf life:

2 years. Do not use the expiration date specified on the package.

Storage conditions:

In a dark place at a temperature of from 5 to 25 ° C.
Keep out of the reach of children.

Conditions of vacation from pharmacies:

Recommended by recipe.

The name, address of the manufacturer and the address of the place of production of the drug / organization accepting complaints

OJSC Dalkhimfarm, 680001, Russian Federation, Khabarovsk Territory, Khabarovsk, ul. Tashkent, 22.

Description dosage form

Release form, composition and packaging

10 pieces. - Packaging cell contour (1) - packs cardboard.
10 pieces. - Dark glass vials (1) - packs cardboard.

Clinical and Pharmacological Group

GKS for oral administration

pharmachologic effect

Glucocorticosteroid (GKS) is a methylated fluoroprednisolone derivative, inhibits the release of interleukin-1 and interleukin-2, interferon gamma from lymphocytes and macrophages. It has anti-inflammatory, anti-allergic, desensitizing, anti-shock, antitoxic and immunosuppressive effect.

Suppresses the release of the hypophysia of the adrenocorticotropic hormone (ACTH) and beta-lipotropin, but does not reduce the content of the circulating beta-endorphine. Inhibits the secretion of the thyrotropic hormone (TSH) and the follicle-sufficient hormone (FSH).

Increases the excitability of the central nervous system (CNS), reduces the number of lymphocytes and eosinophils, increases - erythrocytes (stimulates the production of erythropoietins).

Interacts with specific cytoplasmic receptors, forms a complex penetrating into the cell core, stimulates the synthesis of mRNA, which induces the formation of proteins, incl. Lipocortin, which mediate cell effects. Lipocortine inhibits phospholipase A2, suppresses the release of arachidonic acid and suppresses the synthesis of endoperosis, Pg, leukotrienes that contribute to the processes of inflammation, allergies, etc.

Protein exchange: Reduces the amount of protein in plasma (due to globulin) with an increase in albumin / globulin coefficient, increases albumin synthesis in liver and kidney; Enhances catabolism protein in muscle tissue.

Lipid sharing: Increases the synthesis of higher fatty acids and triglycerides (TG), the fat redistributes (fat accumulation mainly in the field of shoulder belt, facial, belly) leads to the development of hypercholesterolemia.

Carbohydrate: Increases the absorption of carbohydrates from the gastrointestinal tract (gastrointestinal tract); increases the activity of glucose-6-phosphatase, leading to an increase in the admission of glucose from the liver into blood; Increases activity
phosphoenolpiruvatatkoxylase and aminotransferase synthesis leading to glukegenesis activation.

Water and electrolyte exchange: It delays Na + and water in the body, stimulates the removal of K + (ISS activity), reduces the absorption of Ca2 + from the gastrointestinal tract, "" "Wash" "Ca2 + from the bones, increases the excretion of Ca2 + kidneys.

The anti-inflammatory effect is associated with the oppression of the release of inflammation mediators by eosinophils; induction of lipocortin formation and a decrease in the number of fat cells producing hyaluronic acid; with a decrease in permeability of capillaries; Stabilization of cell membranes and organelle membranes (especially lysosomal).

The antiallergic effect develops as a result of suppressing the synthesis and secretion of allergy mediators, inhibition of release from sensitized fat cells and histamine basophils, and other biologically active substances, reduce the number of circulating basophils, suppressing the development of lymphoid and connective tissue, reducing the number of T- and B-lymphocytes cells, reducing the sensitivity of effector cells to allergy mediators, oppression of antibody formation, changes in the body's immune response.

With chronic obstructive pulmonary disease (COPD), the action is based mainly on the braking of inflammatory processes, the inhibition of the development or prevention of edema of mucous membranes, the braking of the eosinophilic infiltration of the submembraty layer of the epithelium of the bronchi, sediments in the mucous membrane of the bronchi circulating immune complexes, as well as braking erosion and desquamation of the mucous membrane . Increases the sensitivity of beta-adrenoreceptors of bronchi small and medium caliber to endogenous catecholamines and exogenous sympathomimetics, reduces the viscosity of the mucus due to the oppression or reduction of its products.

Anti-shock and antitoxic effects are associated with an increase in blood pressure (due to an increase in the concentration of circulating catecholamines and the restoration of the sensitivity to adrenoreceptors, as well as vasoconstrictions), a decrease in the permeability of the vascular wall, membranctotective properties, activation of liver enzymes involved in the metabolism of endo and xenobiotics.

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

Suppresses the synthesis and secretion of ACTG, and the secondary - synthesis of endogenous GKS. Inhibits the connective tissue reactions during the inflammatory process and reduces the possibility of forming scar tissue.

Action feature is a significant inhibition of the pituitary function and the almost complete absence of an ISS activity. Doses 1-1.5 mg / day depress the adrenal bark; Biological T 1/2 - 32-72 h (duration of the oppression of the hypothalamus-pituitary-cortical layer of adrenal glands).

Approximately 3.5 mg of prednisone (or prednisone), 15 mg of hydrocortisone or 17.5 mg of cortisone correspond to 0.5 mg of dexamethasone.

Pharmacokinetics

Dexamethasone is quickly and virtually completely absorbed after receiving inside. The bioavailability of dexamethasone tablets is approximately 80%. C MAX in blood plasma and the maximum effect after receiving inside are achieved after 1-2 hours; After receiving a single dose, the effect is maintained for about 2.75 days.

In the blood plasma, approximately 77% of dexamethasone binds to proteins, mainly with albumin. A minor amount of dexamethasone binds to non-Buman proteins. Dexamethasone is a fat soluble substance that can penetrate out and intracellular spaces. In the central nervous system (hypothalamus, pituitary gland), its effects are due to binding with membrane receptors. In peripheral tissues, it binds to cytoplasmic receptors. His decay occurs at its place of its action, i.e. in a cage. Metabolized mainly in the liver before the formation of inactive metabolites. Excreted by the kidneys.

Indications for the use of the drug

The replacement therapy of the primary and secondary (pitpofizar) adrenal insufficiency, congenital hyperplasia of adrenal glands, subacute thyroiditis and heavy forms of village-coolant thyroiditis. Rheumatic diseases: rheumatoid arthritis (including juvenile chronic arthritis) And embracing lesions with rheumatoid arthritis (lung, heart, eyes, skin vasculitis).

Systemic diseases of connective tissue, vasculitis and amyloidosis (as part of combined therapy): Systemic Red Volchanka (treatment of polyporosites and lesions of internal organs), SHEGREEN syndrome (treatment of lesions of light, kidney and brain), systemic sclerosis (treatment of mositeitis, pericarditis and alveolitis), polyimositis, dermatomyositis, systemic vasculites, amyloidosis (replacement therapy for adrenal insufficiency ), sclerodermia.

Skin diseases: PEMFIGOID, BULLENESS DERMALITATE, HERPETIFORD DERMALITATES, Exfoliative dermatitis, exudative erythema (heavy forms), novel erythema, seborrheic dermatitis (heavy forms), psoriasis (heavy forms), deprive, fantoid myoses, schoq quinque, bronchial asthma, contact dermatitis, atopic dermatitis, serum disease, allergic rhinitis, dosage disease (increased sensitivity to medicinal preparations), urticaria after blood transfusion, systemic immune diseases (sarcoidosis, temporal arteritis).

Eye diseases: Proliferative changes in orbit (endocrine ophthalmopathy, pseudo-turn), sympathetic ophthalmia, immunosuppressive therapy for corneal transplantation.

Ulcerative colitis (heavy exacerbations), Crohn's disease (heavy aggravations), chronic autoimmune hepatitis, reaction reaction after liver transplantation.

Blood Diseases: Congenital or acquired acute pure aplastic anemia, autoimmune hemolytic anemia, secondary thrombocytopenia in adults, erythroblasting, acute lymphoblastic leukemia (induction therapy), myelodsplastic syndrome, angioimmunoblastic malignant T-cell lymphoma (in combination with cytostatics), plastocytoma (in combination with cytostatics) , anemia after myelofibrosis with myeloid metaplasia or lymphoplasmacitoid immunocyte, systemic histiocytosis (system process).

Diseases of the kidneys: Primary and secondary glomerulonephritis (Hoodpasher syndrome), kidney lesions in systemic diseases of the connective tissue (system red lupus, SHEGREEN syndrome), systemic vasculites (usually in combination with cyclophosphamide), glomerulonephritis with nodule polyarteritis, CHARGA-Strauss syndrome, Purple Purple GranuoMatosis Genoha, mixed cryoglobulinemia, kidney lesions in the arteri interstitial nephritis, Immunosuppressive therapy after kidney transplantation, diurea induction or reduction of proteinhemia with idiopathic nephlastic syndrome (without uremium) and with kidney damage against the background of systemic red lupus.

Malignant diseases: Palliamentary therapy of leukemia and lymphoma in adults, acute leukemia in children, hypercalcemia with malignant neoplasms.

Other readings: Tuberculosis meningitis with a subarachnoid blockade (in combination with adequate anti-tuberculosis therapy), trichoinosis with neurological or myocardial manifestations.

Dosing mode

Doses are established individually for each patient, depending on the nature of the disease, expected duration of treatment, tolerance of the drug and the patient's reaction to the therapy conducted.

Normal support Dose - from 0.5 mg to 3 mg / day.

Minimally efficient Daily dose - 0.5-1 mg.

Maximum daily Dose - 10-15 mg.

The daily dose can be divided into 2-4 admission.

After reaching the therapeutic effect, the dose is gradually reduced (usually by 0.5 mg every 3 days before the maintenance dose is achieved).

With prolonged use of high doses inside, the drug is recommended to be taken during meals, and in the intervals between eating foods, the reception of antacids is necessary. The duration of the application of dexamethasone depends on the nature of the pathological process and the effectiveness of treatment and ranges from several days to several months or more. Treatment is stopped gradually (at the end several corticotropin injections are prescribed).

- Ply bronchial asthma, rheumatoid arthritis, ulcerative colitis - 1.5-3 mg / day;

- Ply system Red Volchanka. - 2-4.5 mg / day;

- Ply oncohematological diseases - 7.5-10 mg.

For treating sharp allergic diseases It is advisable to combine parenteral and oral application: 1 day - 4-8 mg parenterally; 2 day - inside, 4 mg 3 times a day; 3, 4 days - inside, 4 mg 2 times a day; 5, 6 day - 4 mg / day, inside; 7 day - cancellation of the drug.

Dosing in children

Children (depending on age) are prescribed 2.5-10 mg / m 2 of the body surface area / day., Dividing the daily dose by 3-4 receptions.

Diagnostic samples in hyperfunction of adrenal cortex

Short 1 mg dexamethasone test: 1 mg of dexamethasone inside at 11.00; Blood fence to determine serum cortisol at 8.00 the next day.

Special 2-day test with 2 mg of dexamethasone: 2 mg of dexamethasone inside every 6 hours for 2 days; Daily urine is assembled to determine the concentration of 17-hydroxycorticosteroids.

Side effect

Classification of the frequency of side effects (WHO): Very often\u003e 1/10, often from\u003e 1/100 to< 1/10, нечасто от > 1/1000 BC< 1/100, редко от >1/10000 BC< 1/1000, очень редко от < 1/10000, включая отдельные сообщения.

From the immune system: Infrequently - reactions of increased sensitivity, reducing the immune response and an increase in susceptibility to infections.

From the endocrine system: Often - transient adrenal insufficiency, growth slowdown in children and adolescents, insufficiency and adrenal atrophy (reducing the response to stress), Izsenko-Cushing syndrome, imagination of the menstrual cycle, girsuitism, the transition of latent diabetes in clinically manifestation, increasing the need for insulin or oral administration hypoglycemic drugs in patients with diabetes, sodium and water delay, strengthening potassium loss; Very rarely - hypokalemic alkalosis, negative nitrogen balance due to catabolism proteins.

Violations of metabolism and nutrition: Often - a decrease in carbohydrate tolerance, an increase in appetite and weight gain, obesity; Infrequently - hyperitriglyceridemia.

From the nervous system: often - mental disorders; Infrequently - the edema of the papillary of the optic nerve and an increase in intracranial pressure (pseudo-turn of the brain) after the cancellation of therapy, dizziness, headache; Very rarely - convulsions, euphoria, insomnia, irritability, hyperkinosis, depression; Rarely - psychosis.

From the digestive system: infrequently - peptic ulcers, acute pancreatitis, nausea, hiking, stomach ulcers or a 12-rosewoman; Very rarely - esophagitis, perforation of ulcers and bleeding of the gastrointestinal tract (hematomesis, melan), pancreatitis, perforations of the gallbladder and intestines (especially in patients with chronic inflammatory diseases of the colon).

From the senses: Infrequently - rear subcapsular cataract, an increase in intraocular pressure, a tendency to the development of secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, Exophthalm.

From the side of the cardiovascular system: infrequently arterial hypertension, hypertensive encephalopathy; Very rarely - polyphocal ventricular extrasystoles, transient bradycardia, heart failure, myocardial break after a newly transferred acute heart attack.

From the side of the skin: often - erythema, thinning and fragility of the skin, slow wound healing, strry, petechia and ekkimosis, increased sweating, steroid acroy, suppression of the skin reaction during allergological tests; Very rarely - anginaurotic edema, allergic dermatitis, urticaria.

From the musculoskeletal system: Often - muscle atrophy, osteoporosis, muscle weakness, steroid myopathy (muscle weakness due to the catabolism of muscle tissue); infrequently - aseptic necrosis bones; Very rarely - compression fractures of vertebrae, tendons breaks (especially with the joint use of some quinolones), damage to the articular cartilage and necrosis of bones (are associated with frequent intra-articular injections).

From the hematopopitation system: Rarely, thromboembolic complications, a decrease in the number of monocytes and / or lymphocytes, leukocytosis, eosinophilia (as in other glucocorticosteroids), thrombocytopenia and lowcomitoenic purpura.

Allergic reactions: Rarely - skin rash, itching, angioedema, bronchospasm, anaphylactic shock.

From the urogenital system: Rarely impotence.

Symptoms and symptoms of glucocorticosteroids

If a patient, long-term taking glucocorticosteroids, quickly reduce the dose of the drug, may develop signs of adrenal insufficiency, arterial hypotension, death.

In some cases, the symptoms of cancellation may be similar to the symptoms and signs of exacerbation or recurrence of the disease, over which the patient receives treatment. In the development of heavy undesirable phenomena treatment with the drug Dexametanone must be discontinued.

Contraindications for the use of the drug

For short-term use on "life" indications, the only contraindication is increased sensitivity to active substance or the auxiliary components of the drug.

A drug Dexametanone Contraindicated patients with galactosemia, lactase deficiency and glucose-galactose maleabsorption syndrome, due to the fact that lactose is included in the drug.

Diseases of the gastrointestinal tract: Ulcery disease of the stomach and 12-rosewood, esophagitis, gastritis, acute or latent peptic ulcers, recently created anastomosis of the intestine, ulcerative colitis with a threat of perforation or abscess, diverticulitis.

Cardiovascular diseases, including The recently suffered myocardial infarction (in patients with acute and subacted myocardial infarction, it is possible to spread the focus of necrosis, the slowdown in the formation of scar tissue and as a result - the gap of the heart muscle), decompensated chronic heart failure, arterial hypertension, hyperlipidemia.

Endocrine diseases: Sugar diabetes (including violation of carbohydrate tolerance), thyrotoxicosis, hypothyroidism, Incenko-Cushing disease.

Severe chronic renal and / or liver failure, nephrowolithiasis; hypoalbuminemia and states predisposing to its occurrence; Systemic osteoporosis, Miasthenia GRAVIS, acute psychosis, obesity (III-IV Art.), Poliomyelitis (except for the shape of bulbar encephalitis), open-dectorial and closed-coronal glaucoma, lactation period.

Application of the drug during breastfeeding and breastfeeding

During pregnancy (especially in the first trimester) the drug Dexametanone It can only be applied when the expected therapeutic effect exceeds the potential risk to the fetus. With long-term therapy with dexamethasone during pregnancy, the possibility of breach of fetal growth is not excluded. In the case of drug Dexametanone In the last trimester of pregnancy, there is a danger of atrophy of the adrenal cortex at the fetus, which may require substantive therapy in a newborn.

If the woman during pregnancy received glucoroids, in the process of childbirth, additional use of glucocorticosteroids is recommended. If the generic activity is delayed or a caesarean section is planned, during the period period, it is recommended to intravenously to introduce 100 mg of hydrocortisone every 8 hours. In case of need for therapy by the drug Dexametanone Breastfeeding should be stopped.

special instructions

In patients who need long-term therapy with dexamethasone, after discontinuation of therapy, the abolition syndrome may develop (also without clear signs of adrenal insufficiency): fever, discharge from the nose, conjunctiva hyperemia, headache, dizziness, drowsiness and irritability, muscle pain and joints , vomiting, weight loss, weakness, cramps. Therefore, dexamethasone must be canceled by a gradual reduction in the dose. Fast abolition of the drug may be fatal.

In patients who received long-term therapy with dexamethasone and underwent stress after its cancellation, it is necessary to resume the use of dexamethasone, due to the fact that induced adrenal failure can be maintained within a few months after canceling the drug.

Dexamethazone therapy can mask signs of existing or new infections and signs of intestinal perforation in patients with ulcerative colitis. Dexamethasone can exacerbate the course of systemic fungal infections, latent amoebiasis or tuberculosis of lungs.

Patients with acute tuberculosis lung dexamethasone can be prescribed (together with anti-tuberculosis drugs) only in the case of a fulminant or heavy disseminated process. Patients with inactive tuberculosis of lungs, receiving therapy with dexamethasone, or patients with positive tuberculin tests must be prepared in parallel to obtain anti-tuberculosis chemoprophylaxis.

Special attention and careful medical observation is necessary to patients with osteoporosis, arterial hypertension, cardiac insufficiency, tuberculosis, glaucoma, liver or renal failure, diabetes, active peptic ulcers, fresh intestinal anastomoses, ulcerative colitis and epilepsy. Carefully The drug is appointed in the first weeks after an acute myocardial infarction, patients with thromboembolism, with miastenia, glaucoma, hypothyroidism, psychosis or psychoneurosis, as well as patients older than 65 years.

During dexamethazone therapy, sugar diabetes is made or the transition of latent in clinically manifelic diabetes.

With long-term treatment, control of serum potassium is needed.

During therapy, dexamethazone is contraindicated vaccination with alive vaccines.

Immunization killed viral or bacterial vaccines does not give the expected growth of the titer of specific antibodies and therefore does not provide the necessary protective effect. Dexamethasone is usually not prescribed for 8 weeks before vaccination and within 2 weeks after vaccination.

Patients taking high doses of dexamethasone for a long time should avoid contact with cortal patients; When random contact occurs, it is recommended preventive treatment Immunoglobulin.

Care must be taken in the treatment of patients who have recently carrying surgical interference or bone fracture, since dexamethasone can slow down the healing of wounds and fractures.

The action of glucocorticosteroids is enhanced in patients with liver cirrhosis or hypothyroidism.

Dexamethasone applies in children and adolescents only by strict indications. In the course of treatment, strict control of the growth and development of a child or a teenager is necessary.

Special information about some components of the drug

The drug dexamethasone includes lactose, and therefore, the use of it in patients with galactosemia, lactase deficiency and glucose-galactose maleabsorption syndrome is contraindicated.

Impact on the ability to control vehicles and other complex mechanisms

Dexamethasone does not affect the ability to manage vehicles and work with technical devices that require the concentration of attention and speed of psychomotor reactions.

Overdose

The one-time use of a large number of tablets does not lead to clinically significant intoxication.

Symptoms: It is possible to strengthen dose-dependent side effects. In this case, the dose of the drug should be reduced.

Treatment: Supporting and symptomatic.

Specific antidote does not exist.

Hemodialysis is ineffective.

Medicinal interaction

The simultaneous use of dexamethasone and non-steroidal anti-inflammatory drugs (NSAIDs) increases the risk of developing and forming an umber of the gastrointestinal tract.

The effect of dexamethasone decreases while using the CYPZ4 isoenzyme inducers simultaneously (for example, phenytoin, phenobarbitone, carbamazepine, prison, rifabutin, rifampicin) or drugs that increase the metabolic clearance of glucocorticoids (ephedrine and aminogllutetimide); In such cases, it is necessary to increase the dose of dexamethasone.

The interaction between dexamethasone and the above preparations can distort the results of dexamethasone suppression samples. If samples with dexamethazone should be carried out during therapy with one of the above drugs, this interaction must be taken into account when interpreting sample results.

The simultaneous use of dexamethasone and inhibitors of the CYPZ4 isoenzyme (for example, ketoconazole, macrolide antibiotics) can lead to an increase in the concentration of dexamethasone in the blood.

The simultaneous use of drugs that are metabolized by Cyppz4 (for example, Indinavir, erythromycin) can increase their clearance, which can be accompanied by a decrease in their serum concentrations.

Dexamethasone reduces the effectiveness of hypoglycemic drugs, hypotensive drugs, a praziquantener and sodiumuretics (it is necessary to increase the dose of these drugs); Increases the activity of heparin, albendazole and potassium-saving diuretics (if necessary, the dose of these drugs decrease).

Dexamethasone can change the effect of kumarine anticoagulants, so during therapy, more frequent control of prothrombin time is recommended. Antacids reduce the suction of dexamethasone in the stomach. Smoking does not affect the pharmacokinetics of dexamethasone.

With the simultaneous use of oral contraceptives, T 1/2 of glucocorticosteroids may increase, with the corresponding enhancement of their biological effects and an increase in the frequency of adverse side effects.

The simultaneous use of riteodine and dexamethasone in the period of generic activity is contraindicated, as this may lead to the death of the mother because of the eighty edema. The joint use of dexamethasone and thalidomide can cause toxic epidermal necroliz.

Potential, therapeutically favorable interactions:the simultaneous use of dexamethasone and methoclopramid, diphenhydraminamine, coolness of 5-NT 3 receptors (serotonin or 5-hydroxytripetamine type 3), such as ondansetron or ripps, are effective in preventing nausea and vomiting caused by chemotherapy (cisplatin, cyclophosphamide, methotrexate, fluorouracyl ).

Conditions of vacation from pharmacies

The drug is released by the prescription.

Terms and Storage Terms

The drug is stored at a temperature not higher than 25 ° C, in the original packaging. Keep out of the reach of children.

Shelf life - 5 years. Do not use the drug after the expiration date.

Dexamethasone is a hormonal preparation that is used to treat various diseases. Apply only by appointing a doctor in strictly installed dosages. The drug is produced in the form of eye drops, tablets and injection solutions.

In contact with

Composition and mechanism of impact

Dexamethasone has the following component composition:

dexamethasone phosphate in the amount of 4 mg;
propylene glycol;
edetat Dinataria;
buffer solution.

Pharmacological impact The drug is to provide antihistamine, anti-inflammatory, antitoxic, immunosuppressive, anti-shock action.

Hormonal drug has synthetic origin.

Posseably affect the following processes in the body:

reduction of permeability of capillaries;
elimination of glucose disposal;
reduction of calcium suction and its elimination;
fluid delay and sodium;
acceleration of catabolism of protein structures.

If such a medicine is injected intramuscularly, then there is a quick Suction of the active substance in the body, therapeutic effect occurs within 3 days. The decay process takes place in the liver, and the final products are removed through the intestines and the kidneys naturally.

Purpose of Ukolov

What is prescribed damasametazone injections, testimony for the use of medication:

strong aggravation of rheumatic diseases;
extensive manifestations allergic reactions in organism;
shock condition of various origin;
brain edema;
autoimmune disorders;
blood disease and respiratory organs;
dermatosis during exacerbation periods;
conducting special therapy in the shortage of hormones.

Important! Pricks can be used and prick only under the control of the attending physician, since the use of drugs of hormonal origin is fraught with the development of a large number of side effects and contraindications.

Dexamethasone children are prescribed with allergies, colds, inflammatory processes and many other diseases.

How to use

Dexamethasone instructions for use advises intramuscular administration of the drug when heavy flow diseases or in the case when the inner reception of the tablets is impossible A number of certain reasons.

The amount of medication depends on the disease. Dexamethasone injections apply:

at a shock, it is introduced from 2 to 6 mg every 6 hours. Therapy lasts no more than 72 hours and is carried out as necessary when human health is in danger;
under the brain edema, the introduction of the primary dosage in the amount of 10 mg is required and for further relief of 4 mg pain after 6 hours.
as supporting therapy for oncology, the amount of medication is 2 mg three times throughout the day;
when aggravating the disease, the dosage for adults is 50 mg, and for children with a body weight up to 35 kg - 20 mg. After receiving the required effect, the volume of drug intake is reduced, in accordance with the prescribed course of treatment;
allergic reactions are stopped by jokes of dexamethasone only at the beginning of treatment, and in the future they are transferred to the internal use of the drug. The primary dosage is 4-8 mg, and for 8 days of treatment, up to 0.5 mg decreases depending on the resulting effect of therapy.

Important!The maximum daily dosage of dexamethasone for intramuscular administration is no more than 80 mg. In the same place, no more than 2 mg of medication is possible.

How much can I use the decxamethasone injections and whether it is hormonal.

The drug by origin is a synthetic corticosteroid, so the duration of its application should be monitored by the attending physician.

The uncontrolled use of the drug leads hard consequences.

Under the overdose of dexamethasone risk increases The appearance of side effects. To eliminate the negative reaction of the body, symptomatic therapy is prescribed in the form of cleansing the body drip.

The drug is released in a pharmacy only by prescription. The shelf life is 2 years from the moment of production. After the expiration of the period specified on the package, the use of medication is strictly prohibited. It is required at a temperature not higher than 15 degrees in a dry, dark place, inaccessible to children.

Dexamethasone injections like a sedative, widely used in veterinary medicine to eliminate cats and shock state dogs during the exacerbation of various diseases.

Use during pregnancy

Qualified doctors do not recommend dexamethasone during pregnancy, if it proceeds normally. The need for admission arises only if the woman has the body tightens the attached embryo and There is a threat to miscarriage.

The drug suppresses the body's immune activity, therefore contributes to pregnancy pregnancy. In parallel, the medicine has a considerable number of side effects in the form of a change in body weight, the appearance of depression and hormonal failure in the body.

Side effects of dexamethasone depend on many factors, but at the same time constitute quite an impressive list:

development of euphoria, depression, disorders of a manic nature by the nervous system;
inflammation of the optic nerve, impairment of vision and the emergence of headaches;
hallucinations, insomnia, migraine;
possible appearance of cataracts and glaucoma;
arterial hypertension, thrombosis, strengthening blood inflow to the brain;
peptic manifestations in the stomach, intestines, pancreatic pancreatitis;
changing body weight, water delay in the body;
the appearance of hidden diabetes, the absence of menstruation, a violation of the growth of children due to the poor functioning of the endocrine system;
the weakness of muscle mass, the development of osteoporosis, an increase in pain in the intra-articular administration of the drug;
various rashes on the skin, weak tightening of the Russian Academy of Sciences;
harridge in the form of sebum, anaphylactic shock.

When using UkolovDexamethasone must be taken into account all the contraindications for the use of medication:

infectious diseases of bacterial and viral origin;
mICKES OF SYSTEM;
state of immunodeficiency;
period before or after vaccination;
diabetes in progressive form;
ulcer stomach, intestines;
serious disorders of the kidneys, liver;
the presence of miastic and systemic osteoporosis;
nervous disorders (psychosis, protracted depression).

Important!In the presence of the above-described contraindications, the implementation of injections is prohibited, as this may lead to exacerbation of available chronic diseases and cause severe complications.

Analogs

If dexametanone causes a side effect, then the doctor can change it on similar Preparations with similar composition and pharmacological impact.

Common substitutes:

Dexazone. Analogue of dexamethasone hormonal origin in the form of tablets and solution for injection. Scope of medication - Treatment and removal acute syndrome With the development of various diseases. Contraindications: Systemic Mikoses, Osteoporosis, non-continuousness of components, virus type infection, polio, lymphadenitis, vaccination. Price 150-200 rubles.

Metalone. A close substitute with the content of the identical active substance of the new generation.

The drug is represented as an ampoules containing a solution for internal administration. The medicine is prescribed with acute diseases of various nature of origin.

Contraindications: Allergic manifestations, myoses, viral infections, pregnancy, breastfeeding, children's age. Price 150-180 rubles.

Maksidek. Effective analogue of dexamethasone high exposure. Indications for use: allergic and acute diseases eye. Contraindications: intolerance of the active substance, chickenpox, purulent infections, the development of keratitis. Price 180-200 rubles.

Dexamed. Hormonal preparation of synthetic origin in the form of tablets and a solution for injection. The medicine is prescribed for the treatment of an extensive spectrum of diseases developing in vital systems of the body. Contraindications: allergic manifestations, micoses, viral infections, pregnancy, lactation, liver dysfunction, kidneys. Price 1000-1200 rubles.

Megachexan. Structural analogue with dexamethasone content used to treat diseases of various etiology of origin. Contraindications: the first trimester of pregnancy, breastfeeding, systemic mixture, violation of the liver, kidney, gastric ulcer, intestines, viruses, lactose intolerance. Price 550-600 rubles.

Important! To decide whether to take dexamethasone patient or not, should the doctor who carefully studied the clinical picture of the current disease.

Video: Dexamethasone in ampoules

Output

Dexamethasone belongs to a number of hormonal drugs with high degree efficiency. The medicine has a considerable number of contraindications and side effects, so requires careful application under the control of the doctor. Obtaining the expected effect depends on the observance of the prescribed dosage and taking into account the feasibility of the reception of the solution.

In contact with