DRUG NAME MECHANISM OF ACTION INDICATION / ADVERSE EFFECT NURSING RESPONSIBILITIES

CONTRAINDICATION

GENERIC: INDICATIONs: CNS: euphoria, insomnia, Assessment and drug effects

Dexamethasone Decreases inflammation by Cerebral edema,Palliative psychotic behavior,
suppression of neutrophil management of recurrent or Question for hypersensitivity to any corticosteroids.
pseudotumor cerebri, vertigo,
BRAND: inoperable brain Obtain baselines for height, weight,
migration, decreases headache,
Decadron, tumors,Inflammatory B/P, serum glucose, electrolytes.
production of inflammatory paresthesia, seizures,
Dexamethasone Intensol, conditions, neoplasias,Acute, Question medical history as listed in Precautions.
mediators. Reverses increased depression. CV: HF, HTN, Monitor I&O, daily weight, serum glucose.
Dexasone, Solurex, and self-limited allergic disorders;
capillary permeability. acute exacerbations of edema, arrhythmias, Assess for edema.
Baycadron.
CLASS: Suppresses normal immune chronic allergic thrombophlebitis, Evaluate food tolerance.
response disorders,Dexamethasone thromboembolism. EENT: Report hyperacidity promptly.
THERAPEUTIC suppression test for Cushing cataracts, glaucoma. GI: Check vital signs at least twice daily.
Corticosteroids syndrome
peptic ulceration, GI irritation, Be alert to infection (sore throat, fever, vague
increased symptoms).
PHARMACOLOGIC: SOURCE:Kizior, R. J., Bs, R. J. K., CONTRAINDICATION:
• Contraindicated in patients appetite, pancreatitis, nausea, Monitor serum electrolytes, esp. for
Glucocorticoids RPh, & Hodgson, K. (2022).
Saunders Nursing Drug hypersensitive to drug or its vomiting. GU: menstrual hypercalcemia, hypokalemia, paresthesia
DOSAGE: Handbook 2023. Saunders. ingredients, in those with irregularities, increased urine (esp. lower extremities, nausea/vomiting,
Elixir: 0.5 mg/5 mL* systemic glucose irritability). Assess emotional status, ability to sleep.
Oral concentrate: 1 mg/mL* fungal infections, and in those
and calcium levels. Abrupt withdrawal may cause
Oral solution: 0.5 mg/5 mL receiving immunosuppressive
Metabolic: hypokalemia, adrenal insufficiency; taper dose gradually
Tablets: 0.5 mg, 0.75 mg, 1 doses together with live-virus
hyperglycemia, carbohydrate
mg, 1.5 mg, 2 mg, 4 mg, 6 mg vaccines. IM administration is Family/Patient Teaching
intolerance,
contraindicated in patients
hypercholesterolemia,
with ITP. Do not change dose/schedule or stop
hypocalcemia, sodium
ROUTE: • Use cautiously in patients taking drug. • Must taper off gradually
retention, weight gain.
ORAL with recent MI. under medical supervision. • Report
Musculoskeletal: growth
• Use cautiously in patients fever, sore throat, muscle aches, sudden
suppression in children,
with GI ulcer, renal disease, weight gain, edema, exposure to
muscle weakness,
HTN, osteoporosis, diabetes measles/chickenpox. • Severe stress (serious
osteoporosis, tendon rupture,
mellitus, infection, surgery, trauma) may require increased
myopathy. Skin:
hypothyroidism, cirrhosis,
diverticulitis, nonspecific
ulcerative colitis, recent
intestinal
anastomoses,
thromboembolic disorders,
seizures, myasthenia gravis,
HF, TB, active hepatitis,
ocular HSV infection,
emotional instability, or
psychotic tendencies.
• Because some forms
contain sulfite preservatives,
also use cautiously in patients
sensitive to
sulfites.
DRUG TO DRUG INTERACTION:
Antidiabetics, including
insulin: May decrease
response. May need dosage
adjustment.
Aspirin, indomethacin, other
NSAIDs: May increase risk of GI
distress and bleeding. Use
together cautiously.
Barbiturates, carbamazepine,
phenytoin, rifampin: May
decrease corticosteroid
effect. Increase
corticosteroid dosage.
Cardiac glycosides: May
increase risk of arrhythmia
hirsutism, delayed wound dosage. • Avoid alcohol,
healing, acne, various skin limit caffeine.
eruptions, atrophy at IM
injection site, thin
fragile skin. Other: cushingoid
state, susceptibility to
infections, acute adrenal
insufficiency
after increased stress or
abrupt withdrawal after long-
term therapy, angioedema.
After abrupt withdrawal:
rebound inflammation,
fatigue, weakness, arthralgia,
fever, dizziness,
lethargy, fainting, orthostatic
hypotension, dyspnea,
anorexia, hypoglycemia. After
prolonged
use, sudden withdrawal may
be fatal.
(Highlight or emphasize
adverse effects manifested by
the patient by underlining the
sign and symptoms)
resulting from hypokalemia.
May need
dosage adjustment.
Cyclosporine: May increase
toxicity. Monitor patient
closely.
Ketoconazole: May decrease
metabolism of
dexamethasone and increase
risk of corticosteroidrelated
adverse effects. Consider
therapy modification.
Oral anticoagulants: May alter
dosage requirements. Monitor
PT and INR closely.
Potassium-depleting drugs
such as thiazide diuretics: May
enhance potassium-wasting
effects of
dexamethasone. Monitor
potassium level.
Salicylates: May decrease
salicylate level. Monitor
patient for lack of salicylate
effectiveness.
Skin-test antigens: May
decrease response. Postpone
skin testing until therapy is
completed.
Toxoids, vaccines: May
decrease antibody response
and may increase risk of
neurologic
complications. Avoid using
together
DRUG TO FOOD INTERACTION:
interferes with calcium
absorption.