Dexamethasone

Dexamethasone

1. Routes

   • Per oral (PO)
   • Intramuscular Injection (IMI)
   • Intravenous injection (IVI)
   • Topical
   • Aerosol
   • Eye drops
   • Intranasal
   • Intra-articular
     • Can cause septic necrosis of bone and joint damage

2. Side effects

   • Vomiting / GI upset
     • Emesis bag, sit pt up
   • Depression
     • Monitor mood and raise concerns, ask social worker to see pt, ask family/friends to visit if appropriate
   • Fluid retention
     • Monitor FBC / weight
   • Anxiety
   • Increases the risk of haematomas
     • Monitor skin integrity, do waterlow and implement strategies to reduce pressure injury
   • Increased hair growth
   • Constipation / Diarrhoea
     • Monitor bowel chart and report concerns, medications
   • Dizziness
   • Insomnia
     • Settle the pt in bed, help the pt relax prior to bed time, minimise light pollution, minimise noise, speak with MO about sleeping tablets
   • Can increase BGL
     • Random daily BGL for non-diabetic pts, and continue BGL monitoring plan for diabetic pts
   • Headache
     • Monitor pain and administer pain relief accordingly

3. Adverse effects

   • Anaphylaxis
     • MET CALL
   • Any of the side effects which put the pt at great risk
     • Report concerns
   • Osteoporosis
     • Falls risk assessment tool (FRAT) and implement strategies to reduce falls risk
   • Peptic ulcer
     • Monitor for bleeding eg. blood in stool
   • Glaucoma
   • Pancreatic dysfunction

4. Corticosteroid

   • Mimics cortisol, binds to glucocorticoid receptors, decreases inflammation, supresses normal immune response

5. Nursing Considerations

   • Fluid balance chart (FBC)
   • Monitor vital signs and pay close attention to RR, SpO2, BP and HR
   • Monitor BGLs

6. Skin conditions eg. Psoriasis, eczema

7. Colitis

8. Certain types of cancer

9. Rheumatic disorders

10. Supress undesirable inflammatory or immune responses

11. Severe allergies

12. Autoimmune conditions eg. Lupus

13. Respiratory conditions eg. asthma