Name

dexamethasone (Decadron®, Hexadrol®)

Class

Clucocorticoid

Description/Mechanism

Dexamethasone is a synthetic steroid that is chemically related to the natural hormones secreted by the adrenal cortex. The drug suppresses acute and chronic inflammation, potentiates the relaxation of vascular smooth muscle by beta-adrenergic agonists, and possibly alters airway hyper-reactivity. In emergency care, dexamethasone is generally used in the treatment of allergic reactions, asthma, spinal cord injury and occasionally the management of shock.

Onset

4-8 hours

Duration

24-72 hours

Indications

Cerebral edema (controversial)

Endocrine, rheumatic, hematologic disorders

Allergic states

Contraindications

Hypersensitivity to the product

Adverse Reactions

Hypertension

Sodium and water retention

GI bleeding

Prolonged wound healing

Suppression of adrenocortical steroid production

Drug Interactions

There are no significant drug interactions with other emergency medications

Supplied

Varies

Dose/Administration

Adult

There is considerable variance in recommended doses. The usual range in emergency care is 4-24 mg IV. Some physicians may prefer significantly higher doses (up to 100 mg)

Pediatric

0.25 – 0.5 mg/kg/dose IV/IO

Special Consideration

Pregnancy Safety: Not established, crosses the placenta and may cause fetal damage.

Medication should be protected form heat

Due to onset of action, dexamethasone should not be considered a first-line medication for allergic reactions