Medicinal forms
0.5mg pills

Manufacturers
Merck Sharp and Dohme (the Netherlands)

FarmGruppa
Due to glucocorticosteroid activity

The international nonproprietary name
Dexamethasone

The order of release
Released at a prescription

Synonyms
Vero-Dexamethasone, Daksin, Dekdan, Code-Allvoran, Deksabene, Deksaven, Deksazon, Deksakort, Deksamed, Dexamethasone, Dexamethasone 'Hafslund Nycomed', Dexamethasone, Nycomed, Dexamethasone phosphate, Dexamethasone-Betalek, Dexamethasone-Lance, Dexamethasone-Ferein, Dexamethasone sodium phosphate, Deksapos, Deksafar, Dexon-D, Detazon, Detametazon, Maksideks, Ophtan dexamethasone, Sondeks, Supertendin 2000 N, Fortekortin, Fortekortin mono

The Composition Of The
The international name - dexamethasone.

Pharmacological action
The drugs, the anti - inflammatory, protiwallergicescoe, desencibilizirutee, immunodepressivne, protivosokowoe. Oppressing fosfolipazu A2, reduces the synthesis of GHGS and LT, inhibits the release of mediators of inflammation. Stabilizes cell membranes, reduces the permeability of capillaries, has antiekssoudativoe action by stvbilizatsii membranes lizosom. Reduces the absorption and increases the excretion of calcium; delayed sodium (and water), the secretion of ACTH. After the introduction of the ingestion rapidly and completely absorbed. The blood is associated (60-70%) to a specific protein carrier - transcortin. Easily passes through gistogematicalkie barriers, including GEB and placental. Biotransformiroetsa in the liver (mainly by conjugation with glukuronova and sulphuric acids) to inactive metabolites. T1 / 2 - 36-54 hr. Return with urine (a small part lactating glands). When applied to the skin absorption is determined by many factors: pharmaceutical form (excipients), the integrity of the skin, the presence of occluzionna bandages, etc.

Indications for the use of Decadron
Addison's Disease, congenital gipoplasia napochechnikov, napochechnikovaya deficiency (usually in conjunction with mineralocorticoids), adrenogenital syndrome, tireoidit (acute, subacute), hypothyroidism, cancer gipercalziemia, shock (anaphylactic, post-traumatic, posleoperazionny, cardiogenny, blood transfusion, etc.), rheumatoid arthritis in the phase of deterioration, acute rheumatic heart disease, collagenoses (rheumatic diseases; disseminated lupus erythematosus, etc.), inflammatory and degenerative diseases of joints (arthritis, tendonitis, bursitis, epikondilit, styloiditis, osteoarthritis, osteoarthrosis, ankylosing spondylitis, etc. ), myositis, infectious-allergic bronchial asthma, asthma status (in / in, in / m), allergic and anaphylactoid reactions, including induced by drugs, dermatitis (contact, atopic, exfoliativei, bullate, herpetiformis, seborrhea, etc.), psoriasis, eczema, mnogoformnaya exudative erythema, pemphigus, mycobacterium, erythroderma and other skin diseases, cerebral edema (in tumors, traumatic brain injury, neurosurgical intervention, a brain haemorrhage, encephalitis, meningitis, radiation damage of the lungs (in / in, in / m), a nonspecific ulcerative colitis, hepatitis, sarcoidosis, berylliosis, disseminated tb (only in combination with anti-tb facilities), disease Leffler and other severe respiratory diseases, anemia (autoimmune, hemolytic, congenital, hypoplastic, idiopathic, erythroblastopenia) , idiopathic thrombocytopenic purpura (the adults), secondary thrombocytopenia, lymphoma (hodgkin's and non-hodgkin), leukemia, lymphocytic leukemia (acute, chronic), agranulozitos, plasmacytoma and other diseases of the blood, nephrotic syndrome, severe infectious diseases (with the obligatory combination with antibiotics), multiple sclerosis, nonsuppurative and allergic diseases of the eye (conjunctivitis, keratit, irit, iridotsyklit, blefarit, blefarokongunguit, episcleritis, scleritis), inflammatory processes after injuries eyes and operations, sympathetic ophthalmic, diagnostics adrenocortical failure of the pituitary stunting (children), affective disorders, including when the depression.

Contraindications Decadron
Hypersensitivity, systemic mikozy, amebic infection, the active form of tuberculosis, infectious lesions of joints and periarticular soft tissues, the period before and after vaccination (especially antiviral), obesity (III-IV degree (inside); eye drops - virus, including simple zoster, wind smallpox, fungal and tuberculosis of the eye, acute purulent eye infection (in the absence of antibacterial therapy), diseases of the cornea defects in the epithelium, trachoma, glaukoma.Ogranicheniya to the application: Pepticalkie STOMACH ulcer, stomach ulcer and duodenal ulcer, esophagitis, gastritis, intestinal anastomosis (in the near history), congestive heart failure, arterial hypertension, thrombosis, diabetes, osteoporosis, a disease Itsenko - Kushinga, acute kidney and / or liver failure, psychosis, apnoea condition, myasthenia gravis, otkratougolnaya glaucoma (inside, parenteral), AIDS, pregnancy, breast-feeding.

Side effect
Delay sodium and water, the loss of potassium and calcium, swelling, erosivno-azwenne defeat of the GASTROINTESTINAL tract (acute exacerbation of ulcer disease until perforation, bleeding), haemorrhagic pancreatitis, atony of the digestive TRACT, increased appetite, nausea and vomiting, hepatomegaly, muscle weakness, miopatia, osteoporosis, pathologic fractures, tendon rupture, arrhythmia, bradycardia, increase in blood pressure, congestive heart failure, stroke and myocardial dystrophy syndrome Itsenko - Kushinga, giperglikemia, hyperlipoproteinemy, the negative balance of nitrogenous, dysmenorrhea, suppression of growth in children, hirsutism, reduced immunity, the suppression of the regenerative and reparative processes, dizziness, headaches, mood disorders, psychosis, increase vnutricerepnogo pressure, convulsions, and thinning of the vulnerable skin, petechiaea €, ekhimozy, austria, erythema and pigmentation change of the person, increased sweating, an increase in intraocular pressure, exophthalmos, thrombosis and embolism, the syndrome (malaise, pain: headache, in the abdomen, joints and muscles), depression, secondary napochechnikovaya deficiency; rarely allergic reaction (rash , itching of the skin).

Interaction
Reduce the therapeutic and toxic effects of barbiturates, phenytoin, rifampicin (up metabolism), somatotropin, antatsida reduce intake (), increase - estrogen oral contraceptives, the risk of arrhythmias and gipokaliemii - heart glycosides, dioretiki, the probability of edema or hypertension - SODIUM drugs or additives, heavy gipokaliemii, heart failure and osteoporosis - amphotericin b and inhibitors carboangidraza, the risk of erosive and ulcerative lesions and bleeding from the digestive TRACT - NPVS. During simultaneous usage with living antiviral vaccines and on the background of other types of immunization increases the risk of activation of the virus and the development of infections. Weakens gipoglikemicescuu activity of insulin and oral protivodiabeticakih funds, anticoagulant - coumarines, diuretic - diuretics, immunotropic - vaccination (suppresses the antibody production). Worsens the portability of cardiac glycosides (causing a deficit of potassium), reduces the concentration of salicylates and praziquantel in the blood.

Overdose
Treatment: with the development of undesirable phenomena is symptomatic, syndrome Itsenko - Kushinga - purpose aminoglutethimide.

Way of application and dosage
Dose set individually, depending on the disease and the patient's condition. Inside (during or after a meal) once, in the morning (a small dose) or reception 2-3 (large dose): 2-3 mg up to 4-6 mg (10-15 mg) a day, after reaching effect dose gradually reduced to a supporting-0.5-1 mg, (2-4,5 mg or more) per day; treatment ceased gradually (at the end of the prescribed several injections of corticotrophin. Children - 0.25-25 mg, or 0,0833 -0,3333 mg / kg or for z0-0.007-0, 0001 mg / m 2/day in the reception 3-4 depending on age.

Special instructions
To use caution in nonspecific ulcerative colitis, diverticulitis intestine, hypoalbuminemia. The appointment in the case of interkurrentnykh infections, tuberculosis, septic conditions requires pre-and post-simultaneous antibacterial therapy. You must take into account the increase in the gipotireoze, cirrhosis of the liver, aggravation of psychotic symptoms and emotional lability with their high initial level, camouflage some of the symptoms of infection, the probability of preservation of in several months (up to a year ) relative adrenal insufficiency after the abolition of dexamethasone (especially in the case of long-term use). Breast-feeding for the period of treatment ceased. In the long course of carefully watching the dynamics of growth and development of children, systematically carry out ophthalmologic examination, control of the hypothalamus-pituitary-adrenal system, the level of glucose in the blood. Stop therapy only gradually. Caution is advised when carrying out any kind of operations, the occurrence of infectious diseases, injuries, avoid immunization, to exclude the use of alcoholic beverages. The children in order to avoid an overdose of dose calculations are based on the surface area of ​​the body. In case of contact with sick measles, chicken pox and other diseases appoint appropriate preventive therapy.

Storage conditions
List B. In a place protected from light at room temperature.

Literature
Drug encyclopedia 10 printing, 2003 god.Spravochnik Vidal, 2002.