Dexamethasone Precautions and Side Effects -

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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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