DEXAMETHASONE (Decadron®)

Question 1

Drug Classification

Answer 1

Corticosteroid /Anti-inflammatory

Question 2

Mechanism of Action

Answer 2

Diffuses across the cell membranes of various cells present in all tissues, binds to DNA, regulates gene expression and increases synthesis of proteins and enzymes that inhibit inflammatory agents (cytokines, interleukin, interferon); inhibits synthesis of pro-inflammatory enzymes
Is an immunosuppressant

Question 3

Pharmacokinetics

Answer 3

Onset of Action <1 hour
Peak Effects <1 hour
Duration of Effect = Varies
Half-Life = 3-4 hours

Question 4

Indications/Field use

Answer 4

Allergic reaction/anaphylaxis
Asthma/COPD/RAD
Croup
Adrenal insufficiency

Question 5

Contraindications

Answer 5

none

Question 6

Side effects

Answer 6

Fluid retention, congestive heart failure, abdominal distention, nausea, hiccups, hypertension, headache, vertigo, malaise, psychosis

Question 7

Dose

Answer 7

Asthma/Anaphylaxis/RAD/COPD/Adrenal Insufficiency A: 10mg slow IV, IO
P: 0.6 mg/kg slow IV, IO, max dose 10mg

Croup

A: not indicated
P: 0.6mg/kg PO/IV/IM (PO preferred), max dose 10 mg

Question 8

Precautions

Answer 8

Give only one dose prehospitally, long term steroid use can cause bleeding, prolonged wound healing, and suppression of adrenocortical steroids

Question 9

Drug Interactions

Answer 9

none