Dexamethasone: Drug study guide for Nurses

a drug study guide about dexamethasone

1. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)


CATEGORY
MECHANISM O F
ACTIO N
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICA-
TION

GLUCOCORTICOIDS

ANTI-
INFLAMMATORY
AGENT


-Suppresses
inflammation
and the
normal
immune
response. Has
numerous
intense
metabolic
effects

-Suppresses
adrenal
function at
chronic doses
of
0.75mg/day.
Practically
devoid of
mineralocortic
oid (sodium-
retaining)
activity

CNS: headache
dizziness,
spinning
sensation;

GI: nausea,
vomiting

INTEGU-
MENTARY:
acne, dry skin,
thinning skin,
bruising or
discoloration;
slow wound
healing;
increased
sweating;

MUSCULO-
SKELETAL:
muscle
weakness
EENT: problems with
vision; increased
intraocular pressure

METABOLISM:
swelling, rapid
weight gain, feeling
short of breath;

CNS: severe
depression, unusual
thoughts or behavior,
seizure (convulsions);

GI: bloody or tarry
stools, coughing up
blood; pancreatitis
(severe pain in upper
stomach spreading to
back, nausea and
vomiting, fast heart
rate);
-Used
systematically
and locally in
a variety of
disorders
including:
Chronic
Inflammatory
Disorders,
Allergies,
Hematologic
Diseases,
Neoplasm,
Autoimmune
Disease,
Management
of Cerebral
Edema and
Septic shock,
Diagnostic
agent in
adrenal
disorders
-This drug is
indicated for
many conditions.
Assess involved
systems prior to
and periodically
throughout the
course of therapy
-Monitor intake
and output ratios
and daily
weights. Observe
patient for
appearance of
peripheral
edema, steady
weight gain,
rales/crackles, or
dyspnea. Notify
physician if
these occur
-Children should
have periodic
evaluation of
growth

-Active untreated
infectious (exceprt
for certain forms
of meningitis)
-Avoid chronic use
during
lactation;may
affect child’s
growth
-Bisulfie, paraben
or alcohol
hypersensitivity—
some products
contain Bisulfie,
paraben or alcohol

-Use caustiously:
chronic treatment
(will lead to
adrenal
suppression);
should never be
abruptly
discontinue

2. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)
CATEGORY
MECHANISM O F
ACTIO N
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING CARE CONTRAINDI
CATION
-Suppression of
inflammation
and
modification of
normal immune
response

FLUID &
ELECTROLYTES:
Low potassium
(confusion, uneven
heart rate, extreme
thirst, increased
urination, leg
discomfort, muscle
weakness or limp
feeling);


CARDIO-
VASCU-
LAR: dangerously
high blood pressure
(severe headache,
blurred vision,
buzzing in ears,
anxiety, confusion,
chest pain,
shortness of breath,
uneven heartbeats,
seizure).

-Short-term
administration
to high-risk
mothers before
delivery to
prevent distress
syndrome in the
newborn

-Assess patient for
changes in level of
consciousness and
headache throughout
the therapy
-Monitor pain, edema,
ROM of affected
joints.
-Assess affected skin
prior to and daily
during therapy
-Monitor respiratory
status and lung sounds
-Monitor serum
electrolytes
-Promptly report
presence of guaiac
positive stools
-If dose is ordered
daily, administer in the
morning to coincide
with the body’s
normal secretion of
cortisol.
-Administer with
meals to minimize
gastric irritations.
-Instruct the patient to
take the medication
exactly as indicated
and not to skip doses
or double up on

3. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)

CATEGORY
MECHANISM O F
ACTIO N
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING CARE CONTRAINDICATION


missed doses
-Encourage the
patient on long-
term therapy to eat
diet high in protein,
calcium and
potassium and low
in sodium and
carbohydrates
-Instruct the patient
to avoid people
with contagious
disease because this
drug causes
immunosuppression
-Caution the patient
to avoid
vaccination without
doctor’s advise
-Instruct the patient
to report severe
abdominal pain,
tarry stools,
unusual swelling,
weight gain, bone
pain, visual
disturbances or
behavior changes

4. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)

5. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)


CATEGORY
MECHANISM O F
ACTIO N
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICATION

6. Dexamethasone (Ak-Dex, Dalalone, Decadrol, Decadron, Decaject, Dexon, Hexadrol, Mymethasone, Solurex)

CATEGORY
MECHANISM O F
ACTIO N
SIDE
EFFECTS
ADVERSE
EFFECT
INDICATION NURSING
CARE
CONTRAINDICATION