Home Drug Guide Dexamethasone Acetate

Drug Guide

Generic Name

Dexamethasone Acetate

Brand Names Decadron-la

Classification

Therapeutic: Anti-inflammatory, Corticosteroid

Pharmacological: Glucocorticoid receptor agonist

FDA Approved Indications

Inflammatory conditions (e.g., arthritis, severe allergies)
Cerebral edema
Certain cancers
Endocrine disorders

Mechanism of Action

Dexamethasone binds to glucocorticoid receptors, modulating gene expression to exert anti-inflammatory and immunosuppressant effects.

Dosage and Administration

Adult: Dose varies depending on condition; commonly 0.75-9 mg per day orally, divided or as a single dose.

Pediatric: Dosing is based on weight and condition, typically 0.02-0.3 mg/kg/day divided into 2-4 doses.

Geriatric: Start at lower end of dosing range; monitor for side effects.

Renal Impairment: Use with caution; adjust dose as needed.

Hepatic Impairment: Use with caution; monitor for altered metabolism.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Extensively distributed; crosses cell membranes.

Metabolism: Hepatic metabolism primarily via CYP3A4.

Excretion: Mostly via urine as metabolites.

Half Life: 3-4.5 hours (but effects may last longer due to receptor binding)

Contraindications

Systemic fungal infections
Known hypersensitivity

Precautions

Use with caution in infections, osteoporosis, diabetes, hypertension, ocular herpes simplex, and in pregnancy/lactation.

Adverse Reactions - Common

Fluid retention, edema (Common)
Increased appetite, weight gain (Common)
Insomnia, mood changes (Common)

Adverse Reactions - Serious

Peptic ulcers, gastrointestinal bleeding (Uncommon)
Immunosuppression leading to infections (Uncommon)
Adrenal suppression with long-term use (Uncommon)
Osteoporosis (Uncommon)
Psychiatric disturbances (Uncommon)

Drug-Drug Interactions

NSAIDs (increased risk of GI bleeding)
Vaccines (reduced effectiveness)
Antidiabetic drugs (affects glucose control)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of infection, blood glucose levels, fluid status, and electrolyte balance.

Diagnoses:

Risk for infection
Imbalanced nutrition: more than body requirements
Fluid volume excess

Implementation: Administer with food to minimize gastric irritation; monitor blood glucose; observe for signs of infection.

Evaluation: Assess for improvement of symptoms, side effects, and adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report signs of infection, unusual mood changes, or gastrointestinal discomfort.
Do not stop medication abruptly.
Follow-up appointments for monitoring blood sugar and bone health.

Special Considerations

Black Box Warnings:

Long-term use can lead to adrenal suppression, osteoporosis, and increased risk of infections.

Genetic Factors: N/A

Lab Test Interference: May cause elevated blood sugar, decreased lymphocyte counts, and changes in serum electrolytes.

Overdose Management

Signs/Symptoms: Hyperglycemia, edema, hypertension, sweating, behavioral changes.

Treatment: Supportive care, discontinue medication, treat specific symptoms (e.g., hypoglycemia if occurs).

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until expiration date on label.