Talk:Dexamethasone
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Hi. I have some medical allergies to what I know as Keflex and Pertussin. I recentely underwent a surgery to get my wisdom teeth out where my doctor used the drug dexamethasone. I had a reaction and was rushed to ER with trouble breathing (my body was working on only 40% the regular oxygen level) and the doctors kept me there until I could breath but wouldn't tell me why I was there or what caused it. My question is, are there any significant links from this steroid to the medicines that I listed? Do they have any of the same chemical makeup? And why would my doctor not know to cross-reference these if there is? Also wondering if my doctor would be liable for the ER bills because of overlooking the listed allergies...?
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[edit] Short term use reactions
I was given a low dose for three days to counter some inflamation brought about by exposure to heavy amounts of airborne dusts. I was told there would be no side effects and the demamthasone cleared up my problems in one day. But........while taking the drug I felt fantastic, the best I'd ever felt emotionally, I mean I felt as if I could take over the world. It was amazing how great I felt. One day after stopping the drug, I experienced personality changes, sweating, visual distortions, anger, insomnia, and felt like I was in hell. It took several days and the loss of my job to get over felling that badly. I've researched this online but have found nothing regarding short term use (three days) and bad reactions. Any ideas on what caused this?
[edit] effects of decadron
--71.162.55.149 05:02, 26 August 2006 (UTC) To the first poster, pertussin is used to treat cough cuased by infections such as the flue, and keflex is an antibiotic. these 2 drugs are not related to steriods. the symptoms you are describing are most likely cuased by narcotics (or other anasthetics) that were given to you during or emmediatly after your proccedure, which can cause respiratory depression (the most common are opiods, such as morphine). Narcan is usualy given to counter this, but its effects are short and you must be constantly monitered for symponts of respiratory depression. As for legal actions againts your doctor... you probably signed a consent form that stats you are aware of the possible side effects and that you accept treatment anyways, and unless they made you sign it after giving you sedatives or other CNS-affecting drugs your options are probably limited. The one to "blame" would probably be the anathesiologist (spelling?) becuase they are the ones in charge of maintaining breathing and sedation during the procedure.
To the second poster, steroids cause a sence of well-being, which is one of the benefits of giving it to oncology patients as it increases appetite. All steriods must be tappered off slowly, to prevent the sympotms you described above (among others). Steroids also can cuase mood swings, and people taking them may have days were they feel euphoric and other days were they feel depressed.
hope this helps, and sorry for all the spelling errors.
[edit] How long does Dexamethasone stay in the body
I've been on dexamethasone for 7 to 8 weeks following spinal fusion for metastatic bone cancer, which is also in lungs. Prescribed 8mg daily which went on for several weeks, then dropped to 6mg immediately followed by sudden chest infection and extreme loss of energy. Prescribed antiobiotics and dexamethasone increased back to 8mg until antiobiotic course complete. Have decreased dexamethasone by 1mg dosage over period of weeks to a 2mg daily dosage. Today 10Nov decreased by 2mg so now dosage is 2mg. I gained 10kilos in 8 weeks and now taking appetite suppresant prescribed by doctor. I am also taking sleeping tablets at night so I don't stare at the ceiling for hours on end. If my dexamethasone dosage reduction goes to plan I should be dosage free in a week ie 17Nov. What I want to know is how long this drug stays in the body. Does it depend on how long I've been taking it and how much I have had? Or, is it a case of you stop taking the drug one day and the next day it is out of one's system?
- As the article already indicates, the half-life of the drug in the body is 36-54 hours. So 1/2 the amount remains in the body at around 2 days, 1/4 by about 4 days, and by 1 week under 10% left. However remember that this tail-off level will be from the final very low dosage that you take. Secondly is the issue of steroid action on you body - this does not in fact tail-off to zero (one hopes). High doses of steroids suppress the natural production of the body's own cortisone and a large part of having to slowly reduce oral steroid medication is to allow the body's own production to restart. Hence patients on high dose steroids are warned not to stop their medication abruptly else they risk having no corticosteroid activity in their body, which may result in the medical emergency of Addisonian crisis. So once the dose & effectiveness of dexamethasone is slowly dropped below a minimum level, you own body restarts making its own weaker low-potency steroid necessary for normal health. Hence at the point that you finally discontinue the dexamethasone, its dosage and hence effectiveness will already have been dropped below the suppressive physiological level and your body will be making up the difference. The practical short answer to you question is therefore that at the point you stop the dexamethasone, it will already be at an insignificant dose as your body's own normal steroid production will be back in operation.
- The weight gained may then be lost with suitable diet and exercise as for anyone else (generally doctors advocate 1/2 to 1 pound a week and certainly not more then 2 pounds a week). The weight you gained will not be entirely from the dexamethasone, but also in part due to the reduced activity following your surgery and this I hope should now be improving anyway. Of course wikipedia is not the forum for specific medical advice (your activity levels will also depend of pre-existing and ongoing health factors unknown to the rest of us) and issues are best discussed with your own doctors and healthcare team. :-) David Ruben Talk 02:33, 10 November 2006 (UTC)
[edit] IV vs PO
While working in an ER the question has come up; can you use IV Decadron as a PO medication? Several nurses say they have been taught yes, but now we cannot find documentation to back it up. Thanks for the input.
- Since Decadron is dexamethasone sodium phosphate, it seems it would be possible to give it orally. While we use a differend brand name in our country (CZ), according to the SmPC the sodium phosphate is rapidly hydrolysed into dexamethasone alone, which is rapidly absorbed. I don't know if that is any help to you. I would suggest checking the SmPC of your corresponding preparation. Janek78 08:24, 1 December 2006 (UTC)
[edit] time to PPC?
what is the time to peak plasma concentration in humans? This is difficult to find, since pages are endlessly talking about combinations with other drugs or else referring to dogs and rats. What is an authoritative source for pharmacokinetics in general?
4.238.161.211 19:49, 1 August 2007 (UTC)
[edit] dexamethasone suppression test
I'm not sure if the explanation of the dexamethasone suppression test is as clear as it could be... or wholly correct for that matter. Firstly, in a normal individual, a low dose of dexamethasone should cause a drop in cortisol levels. This should be added as a reference point. An ACTH-producing tumor (as the mentioned pituitary adenoma of Cushing's disease) would not change with a low dose, and the patient would still have high cortisol. A higher dose of dexamethasone (eg 8mg) would cause reduced cortisol, however. For a tumor that produces its own cortisol or for chronic steroid supplementation, the cortisol levels wouldn't change even with the higher dose of dexamethasone. It seems to me that it's better to frame this idea in terms of what's causing the syndrome rather than if there's feedback. rhetoric 13:22, 21 October 2007 (UTC)
