"Dexamethasone" is a medicine from the group of glucocorticosteroid hormones. The drug has anti-inflammatory, as well as anti-allergic and anti-edematous effects on the body.
"Dexamethasone" is produced in several forms:
- injection solution;
- eye drops;
- pills;
- eye ointment.
Injectable solution is a clear liquid without odor or impurities. According to the instructions, the composition of "Dexamethasone" in ampoules:
- glycerol;
- sodium hydrogen phosphate dihydrate;
- disodium edetate dihydrate;
- dexamethasone sodium phosphate;
- water.
Tablets are for oral use. Available in blisters or in dark glass bottles.
According to the instructions, Dexamethasone tablets contain the substance of the same name.
Additional components are:
- monohydratelactose;
- colloidal anhydrous silica;
- starch;
- talc;
- polyvinylpyrrolidone;
- magnesium s alt and stearic acid.
Drops are available in plastic dropper bottles with a volume of five milliliters. Dexamethasone eye drops have the following composition:
- water;
- disodium edetat;
- dexamethasone sodium phosphate;
- borax;
- boric acid.
Dexamethasone nasal drops contain a substance of the same name.
Pharmacological actions
The drug has an anti-inflammatory, antihistamine and desensitizing effect. In addition, "Dexamethasone" has an immunosuppressive effect. In a small amount retains sodium and water in the body.
The drug inhibits the activity of cholecalciferol, which leads to a decrease in calcium absorption and increased excretion. "Dexamethasone" inhibits the synthesis of endogenous glucocorticoids. A feature of the influence of the drug is considered to be a strong slowdown in the function of the pituitary gland and the absence of mineralocorticoid activity.
When the drug is prescribed
"Dexamethasone" is recommended for use in the presence of the following conditions:
- Adrenal deficiencies.
- Thyroiditis (an inflammatory disease that occurs in the endocrine system).
- Congenital adrenal hyperplasia (increased volume of the adrenal glands inas a result of a defect in steroidogenesis enzymes in the cortical zone, which leads to compensatory growth of the organ to eliminate hormonal deficiency).
- Different types of shock.
- Lupus erythematosus (a chronic disease of autoimmune origin, which is accompanied by a violation of the connective tissue and capillaries).
- Rheumatoid arthritis (inflammation characterized by symmetrical damage to the joints and internal organs).
- Asthmatic status (a complication of bronchial asthma, which usually develops after a long non-stopping attack).
- Bronchospasm (a pathology that develops with contraction of the smooth muscles of the bronchi and their lumen).
- Anaphylactic shock (allergic manifestations that occur after repeated penetration of the allergen into the body).
- Severe Quincke's edema (a disease of allergic origin, which manifests itself through the appearance of a pronounced swelling of the skin, as well as subcutaneous tissue and mucous epithelium).
- Cerebral edema.
- Thrombocytopenic purpura in adult patients (a pathological condition characterized by a quantitative lack of platelets in the blood, accompanied by a tendency to bleed, as well as the occurrence of hemorrhagic syndrome).
- Severe diseases of the organs of the optic canal.
- Common infectious diseases.
- Conjunctivitis (lesion of the mucous membrane of the organs of vision, which is provoked by allergic manifestations or infection).
- Keratitis (an inflammatory lesion of the cornea of the eye, which is characterized, as a rule, by its clouding, ulceration, pain and redness of the eye).
- Blepharitis (bilateral lesion of the ciliary edge of the eyelids).
- Iridocyclitis (damage to the iris and ciliary body of the eyeball).
- Keratoconjunctivitis (a disease of inflammatory origin that affects the cornea and conjunctiva of the eye).
What other indications does the drug have
The drug is prescribed for the following conditions:
- Scleritis (an inflammatory disease that affects the entire thickness of the connective tissue membrane of the eyeball).
- Iritis (a disease of the organs of vision, in which the iris of the eye is affected).
- Uveitis (inflammatory lesion of the choroid of the visual organ).
- Injury to the cornea.
- Allergic rhinitis (allergic disease of the nasal mucosa).
- Exacerbation of chronic ulcerative colitis (inflammation of the mucous membrane of the colon, which is accompanied by the appearance of non-healing ulcers, as well as areas of necrosis and bleeding).
- Crohn's disease (severe intestinal inflammation).
- Severe forms of hepatitis as part of complex therapy (diffuse damage to the liver tissue as a result of a toxic, infectious or autoimmune process).
- Period after internal organ transplantation.
- Hemolyticanemia (a disease whose common symptom is increased destruction of red blood cells, characterized by anemia and increased formation of erythrocyte breakdown products).
- Aplastic anemia (a disease of the hematopoietic system, which is characterized by suppression of the hematopoietic function of the bone marrow and develops by a small formation of red blood cells, as well as white blood cells and platelets).
- Thrombocytopenia (a pathology characterized by a decrease in platelets circulating in the blood).
- Glomerulonephritis (inflammatory lesion of the glomeruli of the kidneys of autoimmune or infectious-allergic genesis, which is characterized by edema, increased blood pressure, decreased urine output).
- Interstitial nephritis (a disease characterized by acute or chronic inflammation in the interstitial tissue and tubules of the kidneys).
- Idiopathic nephrotic syndrome (a disease characterized by protein in the urine, as well as edema, hyperlipidemia).
- Rheumatoid arthritis (an inflammatory lesion characterized by symmetrical joint damage and inflammation of internal organs).
- Vasculitis (disorders that are associated with the destruction of blood vessels during inflammation).
- Systemic sclerosis (a disease with characteristic changes in the skin, as well as the musculoskeletal system, internal organs and common disorders based on connective tissue damage).
- Scleroderma (connective tissue damage, the main manifestations of whichassociated with impaired microcirculation, as well as compaction of organs and tissues).
- Dermatitis (inflammatory lesions of the skin, which develops as a result of the damaging effects of environmental factors on it).
- Exacerbation of neurodermatitis (a skin disease of a neurogenic and allergic type that occurs with remissions and exacerbations).
- Weeping eczema (dermatosis, which manifests itself with characteristic signs, as the formation of blistering rashes on the epidermis).
- Severe forms of psoriasis (a chronic disease that affects the skin).
Restrictions on the use of the medicine
The drug can be used for therapy only as prescribed by the doctor. Before treatment, it is necessary to carefully study the annotation, since Dexamethasone has certain prohibitions. For example:
- A gastric or duodenal ulcer (a defect in the skin or mucous membrane resulting from tissue malnutrition).
- Time of intensive growth in children.
- Ulcerative colitis (a chronic inflammatory bowel disease characterized by superficial mucosal inflammation, rectal bleeding, diarrhea and abdominal pain).
- Herpes simplex (a viral disease with a characteristic rash of clustered blisters on the skin and mucous membranes).
- Diseases of infectious, viral, fungal, parasitic origin.
- Human immunodeficiency syndrome (a weakened immunehuman system, which ultimately leads to more frequent infections with infectious diseases).
- Recent Myocardial Infarction
- Acute heart attack (one of the clinical forms of coronary heart disease, occurring with the development of ischemic necrosis of a myocardial area due to absolute or relative insufficiency of its blood supply).
- Severe arterial hypertension (persistent increase in blood pressure and above).
- Chronic heart failure.
- Diabetes mellitus (a metabolic disorder characterized by an increase in blood sugar).
- Itsenko-Cushing's disease (a severe multisystem disease resulting from hypersecretion of hormones of the adrenal cortex, the signs of which are obesity, stretch marks on the skin, muscle weakness).
- Obesity.
- Severe kidney and liver disease.
Additional prohibitions for use
The drug is contraindicated in the presence of the following conditions:
- First trimester pregnancies.
- Glaucoma (the term combines a large group of eye diseases characterized by a constant or periodic increase in intraocular pressure, followed by the development of typical visual field defects, decreased vision and atrophy of the optic nerve).
- Individual drug intolerance.
- Keratitis (inflammation of the cornea of the eye, manifested mainly by its clouding,ulceration, pain and redness of the eye).
- Diseases of the conjunctiva or cornea caused by viruses or fungi.
- Acute purulent inflammatory diseases of the organs of vision.
- Diseases of viral or fungal etiology.
- Parasitic diseases.
- Adverse reactions after vaccination.
- Lymphadenitis (inflammation of the lymph nodes resulting from the ingestion of various microorganisms and their toxins).
- Exacerbation of chronic diseases of the digestive system.
- Ulcerative colitis (a chronic inflammatory disease of the colonic mucosa resulting from an interaction between genetic and environmental factors).
- Ischemic heart disease.
- Strong increase in blood pressure.
- Itsenko-Cushing's disease (a severe multisystemic disease resulting from hypersecretion of hormones of the adrenal cortex, the signs of which are obesity, stretch marks on the skin, muscle weakness).
- Thyrotoxicosis (a pathological condition in which an excess of thyroid hormones is produced in the body).
- Hyperthyroidism (a set of symptoms that are caused by increased secretion and an inadequately high degree of secretion of thyroid hormones into the blood).
How to apply the mortar correctly
They use the composition for pain relief - "Dexamethasone 4 mg", "Lidocaine", vitamin B12. As a rule, a combination medication is used in rare situations.
The dosing regimen of Dexamethasone alone is individual for each patient and depends on the indications, as well as the patient's condition. The drug is administered intravenously slowly by stream or drip, as well as intramuscularly.
As you know, Dexamethasone injections contain the component of the same name. To prepare a solution for intravenous infusion, sodium chloride or dextrose must be used.
"Dexamethasone" is administered intravenously and intramuscularly at a dosage of 0.5-24 milligrams per day in 2 doses in a short course at a minimum concentration, therapy is stopped gradually.
Prolonged therapy should be carried out at a dose not exceeding 0.5 mg per day. Intramuscular injections in the same place apply no more than 2 milliliters of the solution.
In emergencies use a solution in higher concentrations. The initial dosage varies from 4 to 20 milligrams, which is repeated until a positive effect is achieved, the total daily content rarely exceeds 80 milligrams.
After reaching the pharmacological action, "Dexamethasone" is administered at 2-4 mg with the gradual withdrawal of the drug. To maintain a long-term effect, the drug is administered every 3-4 hours or as a long-term drip infusion. After elimination of acute diseases, the patient is transferred to the tablet form.
In shock conditions, the drug is administered strictly intravenously at a dosage that varies from 2 to 6 milligrams per kilogram of weight. If necessary, repeated concentrations are administered every six hours or aslong intravenous infusion at a concentration of 3 mg per kg per day.
Therapy with the drug should be carried out as part of a comprehensive treatment for shock. The use of pharmacological dosages is permissible only for serious problems.
In cerebral edema, an initial concentration of 10 milligrams of the drug is administered intravenously, then 4 mg every six hours until the symptoms disappear. After two to four days, the dosage is reduced and the use of the medication is gradually canceled over five to seven days.
Patients with malignant diseases may require maintenance therapy - 2 milligrams intramuscularly or intravenously three times a day.
For acute cerebral edema, short-term treatment is given to adult patients at a dose of 50mg IV followed by 8mg every 2 hours on the third day.
In acute allergic manifestations combined parenteral and oral use of "Dexamethasone":
- first day - 4 to 8 mg IV;
- twice a day - orally 1 milligram 2 times a day;
- on the fourth and fifth days - orally 0.5 mg twice a day.
Why are Dexamethasone injections given to children? According to reviews and instructions, the drug is used for acute cerebral edema in small patients weighing more than thirty-five kilograms, the load concentration is 25 milligrams intravenously, then on the third day 4 mg is administered every twohours, on the fourth day - 4 milligrams every 4 hours, on days 5-8 - 4 mg every six hours. In the future, the daily dosage is reduced by 2 milligrams per day until completely cancelled.
For children weighing less than thirty-five kilograms, the loading concentration is 20 mg intravenously, then on the third day, 4 milligrams every three hours, on the fourth day - 4 mg every 6 hours, on the eighth day - 2 milligrams every six hours hours, then the daily concentration is reduced by one milligram per day until the drug is completely discontinued.
Pills
The dosage of the drug "Dexamethasone" in tablet form is determined by the medical specialist on an individual basis for each patient.
The initial concentration of the drug for adolescents from fourteen years of age is from 500 micrograms per day, that is, one tablet. Gradually, if necessary, the dosage is increased to two or three tablets. "Dexamethasone" is consumed during a meal, without chewing, with water. The daily concentration of the drug is divided into several doses.
For small patients, the doctor calculates the daily dosage of the medication based on weight, general condition, and individual tolerance.
When the proper pharmacological effect is achieved, the daily concentration of the drug is reduced gradually, because with a sharp cessation of therapy, the patient experiences withdrawal syndrome and suppression of the function of the adrenal cortex.
If longer treatment is neededantacids are prescribed to patients in the intervals between taking the medication to prevent irritation of the mucous membrane of the digestive organs.
The composition of the ointment "Dexamethasone" includes the active ingredient of the same name. It is used for the same indications as drops in people from the age of six. Apply the drug three times a day. The maximum duration of therapy is not longer than twenty days.
Drops
"Dexamethasone" is prescribed to adults one or two drops in the conjunctiva according to indications. The duration of treatment and daily dosing is determined by the doctor depending on the diagnosis. According to the instructions for the drug "Dexamethasone", the composition of the drops also includes the substance of the same name.
It should be understood that study substance-based hormonal therapy is not recommended to be continued for more than two weeks as it may cause addictive side effects.
If there is no positive effect from the use of the medicine for two to three days, the patient is recommended to re-contact a medical specialist to clarify the diagnosis and adjust the therapy.
Composition of compound nose drops with dexamethasone
The structure of the drug includes several groups of medicines, as well as hormonal and antimicrobial, vasoconstrictive and antiallergic drugs. Dosing is adjusted by the otorhinolaryngologist.
Basic substances can be:
- "Dexamethasone".
- "Dioxidine".
- "Fenistil".
- "Naphthyzinum".
- "Xilen".
- "Ceftriaxone".
"Dioxydin" is effective against most pathogens. It is used in the treatment of purulent rhinitis with a bacterial pathogen. "Dexamethasone", "Dioxidin" and "Naphthyzinum" are prescribed, as a rule, to adults for the treatment of purulent rhinitis and sinusitis. Treatment should be carried out under the supervision of a physician.
In addition, dexamethasone is present in the preparation (as part of complex drops). A hormonal drug can inhibit anti-inflammatory immunity, with the help of which the inflammation in the nasopharynx subsides. "Dexamethasone" is prescribed for allergic rhinitis. As a rule, it is used with "Suprastin", it helps to eliminate swelling of the nasopharynx.
"Fenistil" has the ability to inhibit the sensitivity of histamine nerve endings and eliminate the runny nose of allergic origin. In most situations, it is used in the manufacture of combined products with the studied substance for children.
In addition to dexamethasone, complex drops include naphthyzine. The vasoconstrictor medication, upon contact with the mucous membrane, penetrates deep into the skin and connects to the walls of the capillaries, constricting the nasal vessels and reducing the amount of mucus in the nose.
Naphthyzine is added to complex nasal drops with abundant production of pathological secretions.
Xylen is part of dexamethasone nasal drops. This combination is prescribed for allergicrunny nose with swelling.
Ceftriaxone is a third-generation antibacterial agent that has a strong bactericidal effect on the infection. In combination with dexamethasone, it quickly suppresses the inflammatory process, even in its acute form.
How to use the drug in the "interesting position" and lactation
Why are Dexamethasone injections given to pregnant women? According to reviews and instructions, the use of the solution and tablets in the first three months of the "interesting situation" is not recommended. If necessary, drug treatment in the subsequent trimesters of pregnancy, doctors evaluate the possible risks to the fetus. Studies have shown that prolonged administration of the drug into the body of a woman "in position" can lead to impaired intrauterine development.
The drug in the form of a solution during lactation is not prescribed for women. If necessary, drug therapy should stop breastfeeding and transfer the baby to artificial nutrition.
The use of pills in the second and third trimesters is possible only for strict medical reasons under the supervision of a doctor. During therapy with Dexamethasone, especially at elevated concentrations, suppression of the adrenal cortex in an infant and a slowdown in intrauterine growth of the fetus were sometimes observed.
Eye drops are not prescribed for the treatment of lesions of the organs of vision in women in an "interesting position" in the first three months, because, although in small quantities, but dexamethasoneis still absorbed into the bloodstream. Since all the organs and systems of the fetus are formed in the first twelve weeks of pregnancy, the use of any means is undesirable.
The use of eye drops in the second and third trimester of the "interesting position" is likely only after assessing the indicators of benefit to the expectant mother and the likely risk to the fetus. Treatment is carried out according to medical indications and under the supervision of a doctor.
Adverse reactions
During therapy with Dexamethasone, certain negative effects may be observed:
- The development of steroid diabetes mellitus (an endocrine disease that occurs as a result of a high concentration of sugar in the blood of the hormones of the adrenal cortex and impaired carbohydrate metabolism).
- Disruption of the adrenal glands.
- Decreased glucose tolerance.
- The development of Itsenko-Cushing's syndrome (a disease in which there is a high content of glucocorticoid hormones in the blood of the adrenal cortex).
- Delayed puberty in adolescents.
- Increase in blood pressure.
- Development of pancreatitis (inflammation in the pancreas in which the development of a deficiency in the production of pancreatic enzymes of various etiologies occurs).
- Nausea.
- Gagging.
- Pain in the abdomen.
- Dyspeptic symptoms (disturbance of the normal activity of the stomach, difficult and painful digestion).
- Increased appetite.
- Changes in liver transaminases.
- Bradycardia (a decrease in heart rate less than sixty beats per minute in adults at rest).
- Irregular heart rhythms.
- Impaired blood clotting function.
- Change in electrocardiogram parameters.
- Overexcitement.
- Emotional lability.
- Disorientation in space.
- Depressive disorders or hallucinations.
- Insomnia.
- Dizziness.
- Convulsions.
- Increased intraocular pressure.
- Cataract (a pathological condition associated with clouding of the lens of the eye and causing various degrees of visual impairment up to its complete loss).
- Atrophy of the cornea and optic nerve.
- Development of bulging eyes.
- Deterioration of visual acuity.
- Sensation of a foreign body in the eye.
- Excessive sweating.
- Weight gain.
- Allergic manifestations on the skin.
- Poor healing wounds.
- Development of bruising under the skin.
- Increase or decrease in pigmentation.
- Hypotrophy of subcutaneous fat (a clinical syndrome that occurs in children on the background of serious illnesses or due to alimentary insufficiency).
- Thrombophlebitis (inflammation of the inner lining of the walls of the veins, with the deposition of thrombotic masses on them, which can completely clog the vessel or be located near the wall).
- Burning.
- Numbness of the skin.
- Death of surrounding tissues at the injection site.
- Feeling hot in the face.
- Withdrawal.
- Itching in the organs of vision.
- Blurred vision.
- Loss of sleep.
- Vertigo (a symptom known as dizziness, it is characteristic of an ear disorder or, less commonly, a brain lesion).
- Worry.
- Osteoporosis (a progressive skeletal disease with reduced bone density and increased risk of fractures).
- Weakness in muscles.
Storage conditions
The drug in the form of a solution for injections is dispensed by doctor's prescription. It is recommended to keep "Dexamethasone" away from children, at a temperature of no more than twenty-five degrees. It is not allowed to freeze the solution. Shelf life - 36 months.
Dexamethasone tablets must be kept in a dark place, away from children. Shelf life - 60 months.
Eye drops can be stored for two years at a temperature of no more than ten degrees. The opened vial must be tightly closed and kept in the refrigerator for no longer than one month, and then disposed of.
Analogues
What drugs contain dexamethasone:
- "Dexa-Allvoran".
- "Dexabene".
- "Dexaven".
- "Dexa-Gentamicin".
- "Dexacort".
- "Dexapos".
- "Dexafar".
- "Detazone".
- "Endomethasone".
- "Maxidex".
- "Maxitrol".
- "Oftan".
- "Polydex".
- "Sondex".
- "Tobradex".
- "Tobrazon".
- "Fortecortin".
The cost of the drug "Dexamethasone" varies from 45 to 300 rubles (depending on the form of release). Next, the compositions of the most used drugs will be considered.
"Endomethasone" contains - dexamethasone, hydrocortisone acetate, eugenol, paraformaldehyde, iodinated thymol and barium sulfate, anise and mint oils.
"Tobradex" - tobramycin and test substance, benzalkonium chloride, sodium chloride, sodium hydroxide, water.
"Polydex" - neomycin sulfate, dexamethasone sodium, phenylephrine hydrochloride, polymyxin B sulfate.
"Dexa-Gentamicin" - gentamicin sulfate and test substance, lanolin, liquid paraffin and vaseline.
The composition of "Oftan Dexamethasone" includes - cytochrome C, adenosine and nicotinamide, sorbitol, water, sodium dihydrophosphate dihydrate, benzalkonium chloride. And also the substance of the same name is present in the structure of the drug.
Conclusion
Reviews about injections and tablets "Dexamethasone" help to conclude that the drug is effective, and also has a wide range of indications. It can only be used as directed by a specialist.
Despite its effectiveness, the drug causes certain side effects, and this is considered its disadvantage.
Reviews of doctors about eye drops indicate that the danger of hormonal medications in most casesexaggerated.
The main thing to consider when using them is the presence or absence of contraindications. In addition, dosage selection should be based on weight, as well as age, test results.
