Dexamethasone Precautions and Side Effects

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Table

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.

Precautions

  • Evaluate in several days for favorable response, if none, discontinue treatment.
  • Maintain lowest effective dose.
  • If discontinuing after 3 days administration, taper dose.

Side Effects

  • 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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