Last Updated on February 19, 2017 by Dr.Derek Fhisher
Most popular brand: Decadron
Active ingredient: Dexamethasone
Available dosage forms: 0,5 mg
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Dexamethasone general information
Liver disease is among the typical disorders affecting mostly older dogs. There are various reasons for canine liver disease, a number of them being an unhealthy food regime, trauma, infections, metabolic diseases, etc.. This condition can be particularly annoying and disappointing for anybody, not just because it affects your look, but obesity may be the root cause for many health ailments, for example cardiac disease, diabetes, cancer, etc.. Quite frequently, the tumors don’t cause symptoms along with the condition is not diagnosed during someone’s lifetime. Also, inform the doctor of your own illnesses as well as the things you’re allergic to.
Prednisone is actually a synthetic corticosteroid which is used for remedying certain health conditions in humans together with animals. Therefore, patients who’ve relied on these sorts of injections possess an increased risk of creating infectious diseases. Generally, steroids are prescribed while the use of other drugs aren’t giving the desired effects. In summary, prednisone should not be taken sans the prescription of the doctor. As all of us know, steroids are hormones that aren’t only naturally produced within the body, but are also obtainable in supplemental form. When the cancer metastasizes, it’s hard to remove this, or it is hard to control its growth.
Canine diabetes happens when the body isn’t able to produce enough insulin, or when the body isn’t able enough to absorb the insulin which is being produced. Though asthma is a typical condition which affects adults together with children, it could be controlled with assistance from drug therapy and self-care measures. Prolonged usage of prednisone can bring about pain as well as inflammation within the joints, thereby making it tough for the dog to walk. Liver diseases in dogs might be cured with specific cure, and diet is likewise a critical part of it. Treating this issue after possible is essential to keep it from worsening.
The objective is to maintain cortisol levels through the day. This provides rise to breathing issues. Taking them in the most suitable dosage helps to restore wholesome cortisol levels. Once somebody has completely recovered from the surgery, one also needs to increase the degree of physical activity and follow a fitness regimen. Generally, in the event the individual experiences the aforementioned cortisol deficiency symptoms persistently, it’s important to undergo a health check up. Rather, go to a doctor with no delay.
Timely treatment is the greatest approach to handle the issue successfully. Additionally It is advised that you should always inform the physician about the other medications that he’s using, so the drug interactions may be avoided, if any. After investigation, the vet might be able to diagnose the status and, generally, it might be an easily treatable one. In such instances, delivering the right dosage under strict medical supervision is necessary for minimizing the adverse results. It’s also recommended to avoid taking any steroids with no prescription, as it can certainly lead to overdose, which may be dangerous. Whatever be the reason, spotting after menopause really should not be taken lightly and also you must consult with a doctor.
There are many factors which can cause spotting post menopause. As aforementioned, stress is among the major factors behind low thyroid levels in men. Decreased libido and impotence is, in addition, observed in men because of this disorder. Muscle weakness, nausea, very low BP, dizziness, epidermis disorders for example hyperpigmentation in some specific sections of the epidermis and reduced blood sugar are some of the usual symptoms related to cortisol deficiency. It truly is observed that many males suffer with weight gain when on these drugs. This can reinforce the risk of side outcomes.
Adrenal exhaustion or adrenal insufficiency results in adrenal gland issues in women. This causes accumulation of glucose within the blood, which then results in diabetes. Calcium supplements are regularly recommended to lessen the loss of bony tissue on account of osteoporosis. It is thought that the degree of ADH (anti-diuretic hormone) could increase on account of the high degrees of stress experienced by the patients who’ve undergone a significant surgery. The condition that arises is regarding the hormone which is being produced in excess.
Prednisone is among the most frequently prescribed synthetic glucocorticoid drugs. Prolonged utilization of prednisone can affect the entire body’s capacity to create natural corticosteroids, thereby increasing the probability of drug dependence. In summary, prednisone withdrawal treatment is principally achieved by administering the individual with prednisone. Although prednisone is a powerful drug, it should be administered carefully. Nonetheless, it is advisable to finish the recommended amount of prednisone dosage to find the best of recovery outcomes. There are particular oral medications which contain synthetically prepared cortisol.
The hormone helps maintain the body temperature, utilize the energy available for the entire body, and assists in operation of the many organs. In any case, calcium is, in addition, needed for the right performance of the body. Hormone replacement therapy might also be required sometimes.
Dexamethasone (Dexamethasone): instruction, and the use of a formula
substance Dexamethasone Characteristics
hormonal (glucocorticoid for systemic and topical). The fluorinated homologue hydrocortisone.
Dexamethasone ; white or almost white, crystalline powder. Solubility in water (25 ° C): 10 mg / 100 ml; soluble in acetone, ethanol, chloroform. Molecular weight 392,47.
dexamethasone sodium phosphate ; white or slightly yellow crystalline powder. Easily soluble in water, very hygroscopic. Molecular weight 516,41.
Mode of action – glucocorticoid, an anti-inflammatory, antiallergic, antishock, immunosuppressive.
Interacts with specific cytoplasmic receptors and form a complex that penetrates the cell nucleus; depression or induces expression of mRNA on ribosomes changing the formation of proteins, including lipocortin mediating cellular effects. Lipokortin inhibits phospholipase A 2 . liberatiou suppresses arachidonic acid inhibits the biosynthesis endoperekisey, PG. leukotrienes contribute to inflammation, allergies, etc. Prevents the release of inflammatory mediators from eosinophils and mast cells. It stops the activity of hyaluronidase, collagenase and proteases, normalizes the function of the extracellular matrix of cartilage and bone. Reduces capillary permeability, stabilizes cell membranes, including lysosomal inhibits the release of cytokines (interleukins 1 and 2, gamma – interferon) of lymphocytes and macrophages. Affects all phases of inflammation, anti-proliferative effect is due to inhibition of monocyte migration into the inflammatory focus and fibroblast proliferation. Causes of lymphoid tissue involution and lymphopenia, which causes immunosuppression. In addition to reducing the number of T – lymphocytes, reduced their impact on B – lymphocytes and inhibit the production of immunoglobulins. The effect on the complement system is to reduce the formation and improvement of the collapse of its components. Antiallergic action is a consequence of inhibition of synthesis and secretion of mediators of allergy and reducing the number of basophils. Restores adrenoceptor sensitivity to catecholamines. It accelerates the catabolism of proteins and reduces their content in the plasma, decreases glucose utilization by peripheral tissues and gluconeogenesis in the liver increases. It stimulates the formation of enzyme protein in the liver, surfactant, fibrinogen, erythropoietin lipomodulina. It is redistribution of body fat (adipose tissue lipolysis increases limbs and the deposition of fat in the upper half of the body and face). It favors the formation of higher fatty acids and triglycerides. It reduces absorption and increases excretion of calcium; delay sodium and water secretion of ACTH. It has protivoshokovym action.
Once inside quickly and completely absorbed from the gastrointestinal tract. T max ; . 1 – 2 hours in the blood is associated (60 – 70%) with a specific protein – carrier ; transcortin. Easily it passes through the blood-tissue barriers, including GEB and placenta. Biotransformed in the liver (mainly by conjugation with glucuronic acid and sulfuric acid) to inactive metabolites. T 1/2 from plasma ; 3 – 4,5 h, T 1/2 of fabrics ; 36 –. 54 hours excreted by the kidneys and through the intestine passes into breast milk.
After instillation in the conjunctival sac penetrates well into the epithelium of the cornea and conjunctiva, while in the aqueous humor of the eye are therapeutic concentrations of drugs. When inflammation or damage to the mucous membrane penetration rate increases.
Application of the substance Dexamethasone
for systemic use (parenteral and inside)
Shock (Burn, anaphylactic, post-traumatic, post-operative, toxic, cardiogenic, transfusion etc.); brain edema (including in tumors, cranial – brain trauma, neurosurgical intervention, stroke, encephalitis, meningitis, radiation injury); bronchial asthma, asthmatic status; systemic connective tissue disease (including systemic lupus erythematosus, rheumatoid arthritis, scleroderma, periarteritis nodosa, dermatomyositis); thyrotoxic crisis; hepatic coma; poisoning cauterizing liquids (to reduce inflammation and prevent scarring restrictions); acute and chronic inflammatory diseases of the joints, including arthritic and psoriatic arthritis, osteoarthritis (including post-traumatic), arthritis, frozen shoulder, ankylosing spondylitis (ankylosing spondylitis), juvenile arthritis, Still’s syndrome in adults, bursitis, nonspecific tenosynovitis, synovitis, epicondylitis; rheumatic fever, acute rheumatic heart disease; acute and chronic allergic diseases: allergic reactions to medicines and foods, serum sickness, urticaria, allergic rhinitis, hay fever, angioedema, drug rash; skin diseases: pemphigus, psoriasis, dermatitis (contact dermatitis with lesions of large surface of the skin, atopic, exfoliative, bullosa herpetiformis, seborrheic et al.), eczema, drug reaction, toxic epidermal necrolysis (Lyell’s syndrome), malignant exudative erythema (Stevens – Johnson ); allergic eye disorders: allergic corneal ulcers, allergic forms of conjunctivitis; inflammatory eye diseases: sympathetic ophthalmia, severe lingering front and rear uveitis, optic neuritis; primary or secondary adrenal insufficiency (including the state after removal of adrenal glands); congenital adrenal hyperplasia; kidney disease of autoimmune origin (including acute glomerulonephritis), nephrotic syndrome; subacute thyroiditis; diseases of hematopoiesis: agranulocytosis, panmielopatiya, anemia (including autoimmune hemolytic, congenital hypoplastic, erythroblastopenia), idiopathic thrombocytopenic purpura, secondary thrombocytopenia in adults, lymphoma (Hodgkin’s, non-Hodgkin’s), leukemia, lymphocytic leukemia (acute, chronic); lung disease: acute alveolitis, pulmonary fibrosis, sarcoidosis II – III Art .; tuberculous meningitis, pulmonary tuberculosis, aspiration pneumonia (only in combination with specific therapy); berylliosis, Loeffler’s syndrome (resistant to other therapy); lung cancer (in combination with cytotoxic drugs); multiple sclerosis; Gastrointestinal diseases (to remove the patient from the critical state): ulcerative colitis, Crohn’s disease, a local enteritis; hepatitis; prevention of transplant rejection reactions; tumor hypercalcemia, nausea and vomiting during cytostatic therapy; multiple myeloma; conduct tests in the differential diagnosis of hyperplasia (hyperfunction) and tumors of the adrenal cortex.
For topical use
intra-articular, periarticular. Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter’s disease, osteoarthritis (in the presence of pronounced signs of joint inflammation, synovitis).
Kongungualno . Conjunctivitis (purulent and allergic), keratitis, keratoconjunctivitis (without epithelial damage), iritis, iridocyclitis, blepharitis, Blepharoconjunctivitis, episcleritis, scleritis, uveitis of various origins, retinitis, optic neuritis, optic neuritis, superficial injuries of different etiologies of the cornea (after complete epithelialization cornea), inflammation after eye injuries and eye surgeries, sympathetic ophthalmia.
in the ear canal . Allergic and inflammatory diseases of the ear, including otitis media.
Hypersensitivity (for short-term use of the system for health is the only contraindication).
for systemic use (parenteral and inside). Systemic fungal infections, parasitic and infectious diseases of viral or bacterial origin (currently without the appropriate chemotherapy or recently transferred, including the recent contact with a patient), including .ch. herpes simplex, herpes zoster (viremicheskaya phase), chicken pox, measles, amoebiasis, strongyloidiasis (or suspected), the active form of tuberculosis; immunodeficiency (including AIDS or HIV – infection) before and after prophylactic vaccination (especially antiviral); systemic osteoporosis, myastenia gravis; gastrointestinal diseases (including gastric ulcer and duodenal ulcers, esophagitis, gastritis, acute or latent peptic ulcer, recently established intestinal anastomosis, ulcerative colitis, with the threat of perforation or abscess, diverticulitis); cardio – vascular system, including recent myocardial infarction, congestive heart failure, arterial hypertension; diabetes, acute renal and / or hepatic impairment, psychosis.
For intraarticular administration . Unstable joints previous arthroplasty, abnormal bleeding (endogenous or caused by the use of anticoagulants), chressustavnoy bone fracture, infected lesions of the joints, periarticular soft tissues and intervertebral spaces marked periarticular osteoporosis.
Ocular form. Viral, fungal and tubercular eye disease, including keratitis, caused by Herpes simplex, viral conjunctivitis, acute purulent eye infection (in the absence of antibiotic therapy), violation of the integrity of the corneal epithelium, trachoma, glaucoma.
The ear mold. The perforation of the eardrum.
Restrictions on the use
for systemic use (parenteral and inside): pituitary – Cushing, obesity III – IV degree, convulsive state, hypoalbuminemia and conditions predisposing to its occurrence; open-angle glaucoma.
For intraarticular administration: general grave condition of the patient, inefficient or short duration of action of the two previous administrations (including the individual properties used glucocorticoids).
Application of pregnancy and breastfeeding
The use of corticosteroids during pregnancy is possible if the expected effect of therapy outweighs the potential risk to the fetus (adequate and well-controlled studies safety of not performed). Women of childbearing age should be warned about the potential risk to the fetus (Corticosteroids cross the placenta). It is necessary to carefully monitor infants whose mothers during pregnancy were receiving corticosteroids (adrenal insufficiency may develop in the fetus and newborn).
dexamethasone demonstrated teratogenicity in mice and rabbits following topical ophthalmic applications of multiple therapeutic doses.
In mice, corticosteroids produce fetal resorption and specific violation ; development of cleft palate in the offspring. In rabbits corticosteroids cause fetal resorption and multiple disorders including malformations of the head, ears, limbs, palate, and others.
Category effects on the fetus by FDA ; C.
Nursing women should discontinue either breast-feeding or the use of drugs. especially at high doses (corticosteroids penetrate into breast milk and could suppress growth, the production of endogenous corticosteroids and cause undesirable effects in the newborn).
It should be borne in mind that the local application of glucocorticoids systemic absorption occurs.
Side effects of substance Dexamethasone
The frequency and severity of side effects depend on the duration of application, size of the dosage used and the possibility of compliance circadian rhythm of destination LAN.
From the nervous system and sensory organs: delirium (confusion, agitation, anxiety), disorientation, euphoria, hallucinations, manic / depressive episode, depression or paranoia, increased intracranial pressure syndrome stagnant nipple the optic nerve (brain pseudotumor ; more common in children, usually after too rapid dose reduction, symptoms ; headache, worsening of visual acuity or double vision); sleep disturbances, dizziness, vertigo, headache; sudden loss of vision (for parenteral administration in the area of the head, neck, nasal turbinate, the scalp), the formation of posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve, glaucoma, steroid exophthalmos, the development of secondary fungal or viral eye infections.
From the cardio – vascular system and blood (blood, hemostasis): arterial hypertension, chronic heart failure (in predisposed patients), myocardial, hypercoagulation, thrombosis, ECG – changes typical of hypokalemia ; when administered parenterally: flushing.
From the digestive tract: nausea, vomiting, erosive – ulcerative lesions gastrointestinal tract. pancreatitis, erosive esophagitis, hiccups, increased / decreased appetite.
On the part of metabolism: delay Na + and water (peripheral edema), hypokalemia, hypocalcemia, negative nitrogen balance due to protein catabolism, increased body weight.
From the endocrine system: suppression of adrenocortical function, impaired glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, Cushing’s syndrome – Cushing, hirsutism, violation of the regularity of menses, growth retardation in children.
From the musculo – skeletal system: muscle weakness, steroid myopathy, reduced muscle mass, osteoporosis (including spontaneous bone fractures, aseptic necrosis of the femoral head), tendon rupture; pain in the muscles or joints, back; with the intraarticular injection: strengthening joint pain.
For the skin: steroid acne, stretch marks, thinning of the skin, petechiae and ecchymosis, delayed wound healing, increased sweating.
Allergic reactions: skin rash, hives, swelling of the face, wheezing or difficulty breathing, anaphylactic shock.
Other: reduced immunity and activation of infectious diseases, withdrawal symptoms (anorexia, nausea, lethargy, abdominal pain, weakness, and others.).
Local reactions when administered parenterally: a burning sensation, numbness, pain, paresthesia, and infection at the injection site, scarring at the injection site; hyper – or hypopigmentation; atrophy of the skin and subcutaneous tissue (with the / m introduction).
Ocular form: long-term use (more than 3 weeks) may increase intraocular pressure and / or glaucoma with damage to the optic nerve, blurred vision and loss of visual field, posterior subcapsular cataract formation, thinning and perforation of the cornea; possible spread of herpes and bacterial infections; in patients with hypersensitivity to dexamethasone, or benzalkonium chloride may develop conjunctivitis and blepharitis.
Local reactions (in the application of eye and / or ear form): irritation, itching and burning of the skin; dermatitis.
Reduce the therapeutic and toxic effects of barbiturates, phenytoin, rifampicin (accelerate metabolism), growth hormone, antacids (reduce the absorption), enhance ; estrogensoderzhaschie oral contraceptives, the risk of arrhythmia and hypokalemia ; cardiac glycosides and diuretics, the probability of edema and hypertension ; sodium-containing medications or supplements, severe hypokalemia, heart failure and osteoporosis ; amphotericin B, and carbonic anhydrase inhibitors, the risk of erosive – ulcerative lesions and bleeding from the gastrointestinal tract ; NSAIDs.
While the use of live virus vaccines and immunization compared to other types of activation increases the risk of viruses and the development of infections. Weakens hypoglycemic activity of insulin and oral antidiabetic agents, anticoagulant ; coumarin, diuretic ; diuretics, immunotropnyh ; vaccination (suppresses antibody production). Worsens tolerance of cardiac glycosides (cause potassium deficiency), it reduces the concentration of salicylates and praziquantel in blood.
Symptoms: increased side effects.
Treatment: in the development of adverse events ; symptomatic therapy, the syndrome of Cushing – Cushing ; aminoglutethimide appointment.
Dosing and Administration
Inside, parenteral, topical, including conjunctival. The mode set individually, depending on the evidence, the patient’s condition and response to therapy.
Inside, once in the morning (a small dose) or 2-3 hours (high dose): 2-3 mg to 4-6 mg (10-15 mg) per day, after the effect of the dose is gradually reduced to a maintenance ; 0,5 – 1 mg (2 – 4,5 mg or more) per day; treatment should be stopped gradually (at the end of a few appointed corticotropin injection). Children (depending on age) ; 0,0833 – 0,3333 mg / kg or 0,0025 – 0,0001 mg / m 2 per day 3 – 4 reception.
Parenteral: intravenously. slow bolus or infusion (for acute and urgent conditions) or / m 4 – 20 mg (80 mg) 3 – 4 times daily maintenance doses of ; ingestion. Babies ;
It should not be used during the drivers of vehicles and people skills relate to the high concentration of attention.