Top 300 Pharmacy Drug Cards

DEXAMETHASONE ORAL: Decadron, Various

Class: Adrenal Corticosteroid

Dosage Forms.Tablet: 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 4 mg, 6 mg; Solution: 0.5 mg/5 mL; Elixir: 0.5 mg/5 mL

Common FDA Label Indication, Dosing, and Titration.

Image

Dosing for indications listed below: Adults: 0.75-9 mg/d po; Children: 0.02-0.3 mg/kg/d in 3-4 divided doses; for all patients, adjust dose according to patient response

1. Allergic states (eg, asthma, etc)

2. Dermatologic diseases (eg, exfoliative erythroderma, etc)

3. Endocrine disorders (eg, adrenocortical insufficiency, etc)

4. Gastrointestinal diseases (eg, regional enteritis, ulcerative colitis, etc)

5. Hematologic disorders (eg, acquired hemolytic anemia, etc)

6. Neoplastic diseases (eg, palliative management of leukemias and lymphomas, etc)

7. Nervous system (eg, multiple sclerosis, cerebral edema, etc)

8. Renal diseases (eg, idiopathic nephrotic syndrome, systemic lupus erythematosus, etc)

9. Respiratory diseases (eg, idiopathic eosinophilic pneumonia, etc)

10. Rheumatic disorders (eg, rheumatoid arthritis, etc)

Off-Label Uses.

1. Chemotherapy-induced nausea and vomiting: 20 mg IV before chemotherapy, 8 mg IV or po bid × 3 d after chemotherapy

MOA. Glucocorticosteriods are naturally occurring and synthetic adrenocortical steroids cause varied metabolic effects, modify the body’s immune responses to diverse stimuli, and are used primarily for their anti-inflammatory effects in disorders of many organ systems.

Drug Characteristics: Dexamethasone Oral

Image

Medication Safety Issues: Dexamethasone Oral

Image

Drug Interactions: Dexamethasone Oral

Image

Adverse Reactions: Dexamethasone Oral

Image

Efficacy Monitoring Parameters. Improvement or resolution of clinical signs and symptoms; monitor for decrease in ESR, or improvement of PFT.

Toxicity Monitoring Parameters. Monitor for signs of hyperglycemia, osteoporosis, and adrenocortical insufficiency and infection; frequency and severity of adverse effects are dependent on the length of treatment and dose.

Key Patient Counseling Points. For short-term treatment, inform patients to take doses with meals to prevent GI upset. For high dose or longer-term treatment, inform patients to monitor for signs of hyperglycemia, osteoporosis, adrenocortical insufficiency and infection.

Clinical Pearls. Available in a wide variety of dosage forms for various indications, including injectable, topical, otic, and ophthalmic preparations. Use lowest effective and discontinue as soon as possible to avoid serious long-term adverse effects.