Dexamethasone Precautions and Side Effects
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Criteria for Use
- Perform Complete Physical Assessment including:
- Vital signs, cardiovascular, pulmonary, GI systems, specifically constipation/urinary retention.
- Pertinent Medical History: diabetes, CHF, hypertension, PUD/GI bleed, psychosis, depression, glaucoma, osteoporosis, myasthenia gravis, hypothyroidism, tuberculosis, systemic fungal infections, herpes infection, hepatic disease. Recent surgery, MI or vaccination.
- Review OTC and prescription meds for safety of concomitant use.
- Documented corticosteroid responsive pain syndrome: soft tissue or bone pain, nerve compression, visceral distention, lymphedema, headache associated with increased intracranial pressure, acute spinal cord compression, intractable vomiting.
- Evaluate in several days for favorable response, if none, discontinue treatment.
- Maintain lowest effective dose.
- If discontinuing after 3 days administration, taper dose.
- Hyperglycemia, fluid tension, hypertension, oral candidiasis, gastritis, ulcer potential, anticipate and manage with appropriate pharmacologic interventions.
- Insomnia, excitability, and psychosis should be treated with dose reduction, time of administration change or discontinuation.
- Proximal myopathy can occur with chronic use; treat with dose reduction if possible and physical therapy.
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