Dexamethasone eye drops, injections and pills - instructions for use

Instruction for use Dexamethasone indicates that this drug is on the list of vital drugs and is a strong synthetic glucocorticosteroid with immunosuppressive, antitoxic and anti-inflammatory properties. The basis of the drug is a synthetic analogue of the hormone produced by the adrenal cortex. It is this substance that allows to regulate carbohydrate, protein, lipid and water-electrolyte metabolism in the body.

Description Dexamethasone

Dexamethasone is a potent hormone, a corticosteroid,( akin to fluoroprenisolone) obtained synthetically. Has a wide range of therapeutic effects and exhibits the following properties:

• anti-inflammatory;
• antiallergic;
• antitoxic;
• anti-shock;
• immunosuppressive;
• desensitizing.

Under the influence of the active substance, the sensitivity of β-adrenoreceptors( cell membrane proteins) to endogenous catecholamines increases.

Dexamethasone takes a direct part in the regulation of metabolic processes in the body:

1. Protein metabolism - helps reduce the number of globulins in the plasma, while enhancing the protein catabolism in muscle tissue and accelerating the synthesis of albumin in the liver and kidneys.
2. Carbohydrate metabolism - stimulates the production of insulin and promotes the development of hyperglycemia due to the fact that it attacks the absorption of carbohydrates from the digestive tract and activates the flow of glucose from the liver into the blood.
3. Lipid metabolism - accelerates the synthesis of fatty acids and triglycerides, promotes the redistribution of fats, which begin to be deposited in the abdomen and shoulder girdle.
4. Water-electrolyte exchange - delays water and sodium in the body, slows the absorption of calcium from the digestive tract, provokes "washing away" of calcium from the bones, reduces the mineralization of bone tissue.

The anti-inflammatory effect of the drug is achieved by reducing the permeability of small vessels, inhibition of the production of inflammatory mediators and the activity of eosinophils. Slowing down the severity of allergic reactions occurs due to a decrease in the synthesis of histamine and other biologically active substances that provoke the immune response of the body.

Dexamethasone inhibits the production of certain hormones by the pituitary gland, its active substances penetrating into cells, activate the production of ribonucleic acids and normalize the functions of the nervous system. In diseases of the respiratory tract the drug exhibits anti-inflammatory effect, it can exacerbate the mucosal edema, reduces the viscosity of bronchial sputum, suppresses its production and facilitates the breathing.

The anti-shock effect of the drug is based on its ability to increase blood pressure, the antitoxic effect is due to the acceleration of excretion of decay products from the body. In addition, the drug prevents the formation of scar tissue, as it inhibits the formation of connective tissue reactions in the course of the inflammatory process. The active substance easily penetrates the placental and blood-brain barrier, is metabolized in the liver, excreted from the body by the kidneys.

Thus, the effect of the drug is directed to the binding of certain substances produced by the pituitary gland, participation in metabolic processes, the effect on the central nervous system and the hematopoiesis system. In fact, the action of Dexamethasone extends to the entire body.

Release forms of Dexamethasone

The drug is produced in the following dosage forms:

• tablets Dexamethasone( 0.5 mg);
• Dexamethasone in ampoules of 4 mg / ml( solution for intravenous and intramuscular injections);
• Oftan - eye drops Dexamethasone( 0.1%);
• Eye suspension Dexamethasone( 0.1%).

Each form of the drug has its own indications for use and the particular use that the doctor should take into account when prescribing. What is dexamethasone for?

The oral form of the drug( tablets) is used in the following conditions:

• endocrine diseases( hypotension, thyroiditis, progression of ophthalmopathy associated with thyrotoxicosis);
• autoimmune pathologies( hemolytic anemia, hematopoietic disorders, serum sickness);
• adrenocortical insufficiency( acute, primary, secondary), hyperplasia of the adrenal cortex( congenital);
• bronchial asthma;
• ulcerative colitis( NUC);
• exacerbation of rheumatoid arthritis;
• skin diseases( acute eczema, erythroderma, pemphigus);
• connective tissue diseases;
• cerebral edema;
• malignant tumors.

Dexamethasone injections are prescribed during the treatment of the following diseases:

• severe infections( in combination with antibacterial agents);
• shock states of various origins;
• cerebral edema( due to craniocerebral trauma, tumor, hemorrhage, radiation, encephalitis or meningitis);
• dangerous allergic reactions( Quincke's edema, bronchospasm, anaphylactic and pyrogenic reactions);
• joint disease;
• acute croup;
• exacerbation of bronchial asthma, obstructive bronchitis, accompanied by bronchospasm;
• acute severe dermatoses;
• blood diseases( hemolytic anemia, agranulocytosis, acute lymphoblastic leukemia, thrombocytopenia);
• adrenal insufficiency in acute form;
• oncological diseases( lymphoma and leukemia, acute leukemia in children).Dexamethasone eye drops and injections of this drug in ophthalmic practice are used for a wide range of pathological conditions( allergic conjunctivitis, keratoconjunctivitis, keratitis, iritis, iridocyclitis, blepharitis, etc.), are prescribed to eliminate the inflammatory process after surgical procedures and eye injuries, and also useas an immunosuppressive therapy after corneal transplantation. In addition, the drug in droplets is buried in the ear canal with allergic and inflammatory ear lesions.

  How to use Dexamethasone?

  

  When taking Dexamethosan tablets inside, the dosage and the treatment regimen is selected by the doctor individually, taking into account the type of the disease, the severity of the symptoms, the general condition of the patient and possible contraindications. In severe disease, at the initial stage of therapy, 1 to 9 mg of the drug is prescribed per day, followed by a decrease in the daily dose to 0.5-3 mg at the stage of maintenance treatment.

  The maximum dose of Dexamethasone should not exceed 15 mg / day. The daily dose of the drug is divided into three doses, taking the medicine best while eating. The duration of the course of treatment largely depends on the nature of the pathological process, the severity of the symptoms and how the sick person tolerates the drug. In some, especially severe cases, the duration of therapy with Dexamethasone may be several months.

  Dexamethasone is administered intramuscularly and intravenously in urgent conditions, as well as in those situations when taking the drug in tablets is not possible. The solution for injections is also used for intraarticular and periarticular( periarticular) administration. In a vein a preparation enter slowly( strujno or a drop).

  According to the instructions, the drug can be administered up to four times a day, at a dose of 4 to 20 mg. When preparing the solution for a dropper, an isotonic sodium chloride solution is used.

  How much can I chop Dexamethasone? The duration of the injections is usually no more than 4 days, after that they switch to taking the drug in tablet form. The peculiarity of the therapy is that when acute conditions are cut off, Dexamethasone is used in higher doses, then, as it improves, the dosage is gradually reduced to a maintenance dose, or the drug is completely canceled.

  In the ophthalmic practice, drops of Dexamethasone for the relief of acute conditions are instilled in the conjunctival sac every 2 hours( 1-2 drops each).Then, as the inflammatory process subsides, the interval between procedures is increased to 4-6 hours. The duration of treatment depends on the clinical picture of the disease and can last from 2 days to several weeks.

  Dexamethasone in ampoules can be used for inhalations in acute inflammatory lesions of the upper respiratory tract( bronchitis, laryngitis).To do this, the drug should be diluted in physiological saline in a proportion of 1: 6 and a ready-made solution( in a volume of 4 ml) used for inhalation.

  Dexamethasone for children

  Is it possible for Dexamethasone to children and how to correctly apply the drug in the treatment of small patients? Optimal dosage of tablets should be selected by the attending physician, taking into account the severity of the underlying disease, the individual characteristics of the child, his age and weight. The standard daily dosage is from 2.5 to 10 mg, which is divided into several doses.

  Inhalations with dexamethasone for children are made based on 0.5 ml of the drug on 3 ml of saline. Treatment usually lasts 7 days, the procedure is done three times a day.

  Dexamethasone in pregnancy

  

  The drug in the form of tablets and drops during pregnancy and lactation is prohibited. If during breastfeeding there is a need for treatment with Dexamethasone, the child is transferred to artificial mixtures.

  Dexamethasone injections during pregnancy are made only for vital indications. For example, a drug can be prescribed in the case when the immune system begins to perceive the embryo, as a foreign body. Dexamethasone suppresses immune activity, which helps to eliminate the threat of miscarriage and keep the pregnancy.

  Contraindications

  

  For short-term use of the drug according to vital signs, the only limitation is the individual intolerance of dexamethasone or other components of the medication. In children, the hormonal remedy should only be used according to the indications and under the supervision of the attending physician.

  Contraindications to the administration of dexamethasone injections are the following conditions:

  • immunodeficiency diseases;
  • systemic mycoses( fungal diseases);
  • bacterial, viral or parasitic infections;
  • peptic ulcer of the digestive tract, colitis, diverticulosis;
  • diabetes;
  • hepatic or renal failure( in acute form);
  • period before and after preventive vaccinations;
  • systemic osteoporosis, myasthenia gravis;
  • mental illness.

  Intra-articular injections are forbidden for joint instability, the presence of foci of infection in the joints and periarticular tissues, manifestations of osteoporosis, bleeding, previously performed arthroplasty.

  In ophthalmology Dexamethasone in the form of drops can not be used for glaucoma, trachoma, corneal damage, viral, fungal or tubercular lesions of the eyes. Bury the drug in the auditory canal if the tympanic membrane is damaged.

  For the entire period of application of Dexamethasone, it is necessary to refuse the intake of alcohol, since the combination of a hormonal agent with ethanol can provoke dangerous unpredictable consequences.

  Adverse reactions

  

  Dexamethasone is well tolerated by patients, but, like many hormones, can cause systemic side reactions. Their severity and frequency largely depend on the dosage and duration of the drug. In medical practice, the following side effects from the use of Dexamethasone are described:

  From the cardiovascular system - arrhythmias, slowing of the heartbeat( bradycardia), until cardiac arrest, development or exacerbation of heart failure, increased blood pressure. Patients with myocardial infarction( acute and subacute) may spread foci of necrosis, which can lead to rupture of the heart muscle.

  From the gastrointestinal tract - a violation of appetite and digestive processes, nausea, vomiting, flatulence, symptoms of pancreatitis, the formation of ulcers in the stomach and duodenum, perforation of the digestive system and internal bleeding.

  Endocrine system - acute diabetes mellitus, increased pressure, pituitary obesity, suppression of adrenal cortex functions, muscle weakness, painful menstruation, delay in sexual development in adolescents. Often there is a violation of metabolic processes, sodium fluid retention, leading to peripheral edema, weight gain, increased weakness and fatigue.

  Nervous system - increased intracranial pressure, increased nervousness, anxiety combined with headaches and dizziness, disorientation in space, depressive states, insomnia. In severe cases, convulsions, hallucinations, manifestations of paranoia or manic-depressive psychosis are possible.

  Musculoskeletal system - slowing of growth processes in children, osteoporosis, leading to pathological fractures of the bones, rupture of tendons, muscle atrophy.

  From the side of the skin, slow healing of wounds, appearance of striae, acne, hyperpigmentation, thinning of the skin. Allergic reactions are possible, accompanied by skin itch, rashes, in rare cases, there is such a severe reaction as anaphylactic shock.

  Local reactions include a burning sensation and pain in the area of ​​drug administration, redness of the skin. Sometimes at the injection site, scars are formed, necrosis of surrounding tissues, atrophy of subcutaneous tissue.

  Analogues

  

  Dexamethasone has quite a few structural analogues containing the same active substance. These include:

  • Dexaven;
  • Dexazone;
  • Dexamed;
  • Dexafar;
  • Maxidec;
  • Dexamethasone-Nycomed;
  • Dexamethasone-Ferein;
  • Fortecortin, etc.

  The price of the preparation

  Dexamethasone is dispensed without a doctor's prescription. Average drug prices in the pharmacy chain:

  • Dexamethasone tablets 0.5 mg( 10 pcs.) - from 38 rubles;
  • Dexamethasone solution in ampoules 4 mg / ml( 25 ampoules) - from 180 rubles;
  • Eye drops Dexamethasone - from 80 rubles.

  Dexamethasone is inexpensive, but this does not mean that you need to self-medicate. It should be understood that this is a strong hormone with many side effects, which can only be used for the intended purpose and under the supervision of a doctor.

  Reviews

  Reviews of injections and tablets Dexamethasone indicate that this is a very effective tool that has a wide range of indications for use, including helps with such severe pathologies as cerebral edema, shock conditions, oncology. But it should be used only according to the doctor's prescription, short courses and only after identifying possible contraindications.

  The main drawback of the drug users call an extensive list of adverse reactions. To reduce their severity, the physician should precisely select the dosage taking into account the individual characteristics of the patient.

  Review No.1

  For a long time I can not get pregnant due to problems with the ovaries. Constantly I am flied, this time the doctor has appointed or nominated to me a hormonal agent Dexamethazonum. You should drink 1/2 tablet before bedtime for a month. After a week of treatment, appetite was gone, nausea appeared, but I quickly gained weight. For all the time of therapy I added 5 kilograms. But all this is not so essential, the main thing is that the drug helps me solve the main problem. I hope for a positive result.

  Ulyana, Perm

  Reviewed №2

  My son Dexamethazon saved from meningitis. In hospital we with him have arrived already in a bad status, since the wrong diagnosis was initially put and accordingly the wrong treatment is appointed. He was given a dropper with Dexamethasone, and a number of other medical measures were taken to detoxify the body. Three days later my son became better, the dropper was canceled and this drug was given in tablets. I was afraid that taking the medicine would have a negative effect on the stomach and intestines, since he has many contraindications, but it all worked out because they took the drug with a short course.

  Polina, Magnitogorsk

  Review No.3

  Last year, she was in the hospital, had problems with the intestines. In addition to drugs in tablets, Dexamethasone injected me with intramuscular injection. The injections are painful, after them there was a burning sensation, the skin reddened and swelled at the injection site. I discharged from the hospital in 2 weeks. But the problem is that with the hormonal treatment I recovered by 8 kg and now I can not lose weight.

  Ulyana, Penza