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, hirsutism, delayed wound dosage. • Avoid alcohol, diverticulitis, nonspecific healing, acne, various skin limit caffeine. ulcerative colitis, recent eruptions, atrophy at IM intestinal injection site, thin anastomoses, fragile skin. Other: cushingoid thromboembolic disorders, state, susceptibility to seizures, myasthenia gravis, infections, acute adrenal HF, TB, active hepatitis, insufficiency ocular HSV infection, after increased stress or emotional instability, or abrupt withdrawal after long- psychotic tendencies. term therapy, angioedema. • Because some forms After abrupt withdrawal: contain sulfite preservatives, rebound inflammation, also use cautiously in patients fatigue, weakness, arthralgia, sensitive to fever, dizziness, sulfites. lethargy, fainting, orthostatic hypotension, dyspnea, anorexia, hypoglycemia. After DRUG TO DRUG INTERACTION: prolonged Antidiabetics, including use, sudden withdrawal may insulin: May decrease be fatal. response. May need dosage adjustment. Aspirin, indomethacin, other NSAIDs: May increase risk of GI (Highlight or emphasize distress and bleeding. Use adverse effects manifested by together cautiously. the patient by underlining the Barbiturates, carbamazepine, sign and symptoms) phenytoin, rifampin: May decrease corticosteroid effect. Increase corticosteroid dosage. Cardiac glycosides: May increase risk of arrhythmia 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.