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41 - Dexamethasone

Published online by Cambridge University Press:  06 October 2020

Stephen D. Silberstein
Affiliation:
Thomas Jefferson University, Philadelphia
Michael J. Marmura
Affiliation:
Thomas Jefferson University, Philadelphia
Hsiangkuo Yuan
Affiliation:
Thomas Jefferson University, Philadelphia
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

THERAPEUTICS

Brands

• Decadron, Decadron-LA, Dexone

Generic?

• Yes

Class

• Corticosteroid

Commonly Prescribed for

(FDA approved in bold)

Nervous system: acute exacerbation of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor, craniotomy, or head injury

Dermatological diseases: pemphigus, bullous dermatitis herpetiformis, Stevens- Johnson syndrome, exfoliative erythroderma, mycosis fungoides, severe psoriasis, severe seborrheic dermatitis

Endocrine disorders: primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, non-suppurative thyroiditis, hypercalcemia associated with cancer

Hematological disorders: idiopathic thrombocytopenic purpura in adult, autoimmune hemolytic anemia, pure red cell aplasia, congenital hypoplastic anemia

GI diseases: to tide over a critical period of ulcerative colitis or regional enteritis

Neoplastic diseases: palliative management of leukemias and lymphomas

Respiratory diseases: symptomatic sarcoidosis, Loeffler syndrome not manageable by other means, berylliosis, fulminating or disseminating pulmonary tuberculosis, aspiration pneumonitis, idiopathic eosinophilic pneumonias

Renal diseases: to induce remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or due to lupus erythematosus

Rheumatic disorders: adjunctive therapy for short-term treatment in psoriatic arthritis, rheumatoid arthritis, acute rheumatic carditis, ankylosing spondylitis, acute bursitis, acute synovitis of osteoarthritis, epicondylitis, dermatomyositis, polymyositis, systemic lupus erythematosus, temporal arteritis

Severe allergic state: allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions

Diagnostic testing: adrenocortical hyperfunction

• Migraine headache

• Cluster headache

• Acute demyelinating encephalomyelitis (ADEM)

• Acute brain injury

• CNS lymphoma

• Infantile hemangioma

• Prevention or acute treatment of altitude sickness

• Chemotherapy-induced nausea and vomiting

How the Drug Works

• Glucocorticoids have anti-inflammatory effects, modify immune responses to stimuli, and have numerous metabolic effects. They cross cell membranes and bind with glucocorticoid receptors, then bind to DNA glucocorticoid response elements that in turn modify the protein synthesis required for inflammation. Dexamethasone is more potent than prednisolone and cortisone for suppression of inflammation but has minimal mineralocorticoid effect

Type
Chapter
Information
Essential Neuropharmacology
The Prescriber's Guide
, pp. 150 - 154
Publisher: Cambridge University Press
Print publication year: 2015

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