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Encyclopedia > Dexamethasone
Dexamethasone
Systematic (IUPAC) name
9-fluoro-11β,17,21-trihydroxy-16a-
methylpregna-1,4-diene-3,20-dione
Identifiers
CAS number 50-02-2
ATC code A01AC02 C05AA09, D07AB19, H02AB02, R01AD03, S01BA01, S02BA06, S03BA01
PubChem 5743
DrugBank APRD00674
Chemical data
Formula C22H29FO5 
Mol. mass 392.464 g/mol
Pharmacokinetic data
Bioavailability 80-90%
Protein binding 70%
Metabolism hepatic
Half life 36-54 hours
Excretion renal
Therapeutic considerations
Pregnancy cat.

C(US) Image File history File links Download high-resolution version (1100x846, 45 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Dexamethasone ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A division of the Anatomical Therapeutic Chemical Classification System A Alimentary tract and metabolism A01A Stomatological preparations A01AA Caries prophylactic agents A01AA01 Sodium fluoride A01AA02 Sodium monofluorophosphate A01AA03 Olaflur A01AA04 Stannous fluoride A01AA30 Combinations A01AA51 Sodium fluoride, combinations A01AB Anti-infectives and antiseptics for local oral treatment A01AB02 Hydrogen peroxide... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules. ... The DrugBank database available at the University of Alberta is a unique bioinformatics and cheminformatics resource that combines detailed drug (i. ... This article or section does not cite any references or sources. ... General Name, Symbol, Number carbon, C, 6 Chemical series nonmetals Group, Period, Block 14, 2, p Appearance black (graphite) colorless (diamond) Standard atomic weight 12. ... General Name, Symbol, Number hydrogen, H, 1 Chemical series nonmetals Group, Period, Block 1, 1, s Appearance colorless Atomic mass 1. ... General Name, Symbol, Number fluorine, F, 9 Chemical series halogens Group, Period, Block 17, 2, p Appearance Yellowish brown gas Atomic mass 18. ... General Name, Symbol, Number oxygen, O, 8 Chemical series nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Standard atomic weight 15. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... A drugs efficacy may be affected by the degree to which it binds to the proteins within blood plasma. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The liver is an organ in vertebrates including humans. ... It has been suggested that Effective half-life be merged into this article or section. ... Excretion is the process of eliminating waste products of metabolism and other materials that are of no use. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from...

Legal status

Prescription only The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ...

Routes Oral, IV, IM, SC and IO

Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid hormones. It acts as an anti-inflammatory and immunosuppressant. Its potency is about 40 times that of hydrocortisone. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Intramuscular injection is the injection of a substance directly into a muscle. ... In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... Intraosseous infusion is the process of injection directly into the marrow of the bone. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Steroid skeleton of lanosterol. ... Norepinephrine A hormone (from Greek όρμή - to set in motion) is a chemical messenger from one cell (or group of cells) to another. ... Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... Hydrocortisone is a synthetic corticosteroid drug which may be given by injection or by topical application. ...

Contents

Therapeutic use

Dexamethasone is used to treat many inflammatory and autoimmune conditions, e.g., rheumatoid arthritis. It is also given to cancer patients undergoing chemotherapy, to counteract certain side-effects of their antitumor treatment. Dexamethasone can augment the antiemetic effect of 5-HT3 receptor antagonists like ondansetron. It is also given in small amounts (usually 5-6 tablets) before and/or after some forms of dental surgery, such as the extraction of the wisdom teeth, an operation which often leaves the patient with puffy, swollen cheeks. An abscess on the skin, showing the redness and swelling characteristic of inflammation. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Chemotherapy is the use of chemical substances to treat disease. ... An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ... An antiemetic is a drug that is effective against vomiting and nausea. ... Ondansetron (INN) (IPA: ) is a serotonin 5-HT3 receptor antagonist used mainly to treat nausea and vomiting following chemotherapy. ... Dental Surgery is any number of medical procedures which involve artificially modifying the dentition. ... Wisdom teeth are third molars that usually appear between the ages of 17 and 24 (although they may appear when older, younger, or may not appear at all). ...


In brain tumours (primary or metastatic), dexamethasone is used to counteract the development of edema, which could eventually compress other brain structures. Dexamethasone is also given in cord compression where a tumor is compressing the spinal cord. A brain tumor is any mass created by an abnormal and uncontrolled growth of cells either found in the brain (neurons, glial cells, epithelial cells, myelin producing cells, etc. ... Edema (American English) or oedema (British English), formerly known as dropsy or hydropsy, is swelling of any organ or tissue due to accumulation of excess lymph fluid, without an increase of the number of cells in the affected tissue. ... Spinal cord compression develops when the spinal cord is compressed by a tumor, abscess or other lesion. ...


Dexamethasone is also used in certain hematological malignancies, especially in the treatment of multiple myeloma, in which dexamethasone is given alone or together with thalidomide (thal-dex) or a combination of adriamycin and vincristine (VAD). It is injected into the heel when treating plantar fasciitis, sometimes in conjunction with acetonide. Although hematological malignancies are a form of cancer, they are generally treated by specialists in hematology, although in many hospitals oncology specialists also manage these diseases. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ... // Thalidomide is a sedative, hypnotic, and anti-inflammatory medication. ... Doxorubicin or adriamycin is a DNA-interacting drug widely used in chemotherapy. ... Vincristine (Oncovin®) is a vinca alkaloid from the Madagascar periwinkle (Catharanthus roseus, formerly Vinca rosea and hence its name). ... Plantar fasciitis is a painful inflammatory condition caused by excessive wear to the plantar fascia of the foot. ... This article needs cleanup. ...


It is useful to counteract allergic shock, if given in high doses. It is present in certain eye drops and as a nasal spray (Dexacort®). Eye drops are saline-containing drops used as a vector to administer medication in the eye. ... Nasal sprays are used for the nasal delivery of a drug or drugs, generally to alleviate cold or allergy symptoms. ...


Dexamethasone can be used in the context of congenital adrenal hyperplasia, to prevent virilisation of a female fetus. If one or both parents are carriers of mutations to the CYP21A gene, the mother may start dexamethasone treatment within 7 weeks of conception. At the 12th week, a chorionic villus sample will determine whether the fetus is male (in which case the dexamethasone is stopped) or female. Subsequent DNA analysis can then reveal whether the female fetus is a carrier of the mutation, in which case dexamethasone treatment must continue until birth. The side-effects for the mother can be severe and the long-term impact on the child is not clear. Congenital adrenal hyperplasia (CAH) refers to any of several autosomal recessive diseases resulting from defects in steps of the synthesis of cortisol from cholesterol by the adrenal glands. ... In biology and medicine, virilization refers to the development of changes which make a male body different from a female body. ... The term conception can refer to more than one meaning: Concept Fertilisation This is a disambiguation page — a navigational aid which lists pages that might otherwise share the same title. ... Chorionic villus sampling (CVS) is a form of prenatal diagnosis to determine genetic abnormalities in the fetus. ...


Dexamethasone is used in the treatment of high altitude pulmonary edema. High altitude pulmonary edema (HAPE) is a life threatening form of non-cardiogenic pulmonary edema that occurs in otherwise healthy mountaineers at altitudes above 2500m. ...


Diagnostic use

Dexamethasone is also used in a diagnostic context, namely in its property to suppress the natural pituitary-adrenal axis. Patients presenting with clinical signs of glucocorticoid excess (Cushing's syndrome) are generally diagnosed by a 24-hour urine collection for cortisol or by a dexamethasone suppression test. During the latter, the response of the body to a high dose of glucocorticoids is monitored. Various forms are performed. In the most common form, a patient takes a nighttime dose of either 1 or 4 mg of dexamethasone, and the serum cortisol levels are measured in the morning. If the levels are relatively high (over 5 µg/dl or 150 nmol/l), then the test is positive and the patient has an autonomous source of either cortisol or ACTH, indicating Cushing's syndrome where the tumor does not have a feedback mechanism. If ACTH levels are lowered by at least 50%, this would indicate Cushing's Disease, since the pituitary adenoma has a feedback mechanism that has been reset to a higher level of cortisol. Longer versions rely on urine collections on oral dexamethasone over various days. The hypothalamic-pituitary-adrenal axis (HPA axis) is a major part of the neuroendocrine system that controls reactions to stress and has important functions in regulating various body processes such as digestion, the immune system and energy usage. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... The dexamethasone supression test is designed to diagnose and differentiate among the various types of Cushings syndrome and other hypercortisol states. ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... Cortisol is a corticosteroid hormone produced by the adrenal cortex (in the adrenal gland). ... Adrenocorticotropic hormone (ACTH or corticotropin) is a polypeptide hormone secreted from corticotropes in the anterior lobe of the pituitary gland in response to corticotropin-releasing hormone (CRH) released by the hypothalamus. ... Cushings syndrome or hypercortisolism is an endocrine disorder caused by excessive levels of the endogenous corticosteroid hormone cortisol. ... Pituitary adenomas are tumors that occur in the pituitary gland, and account for about 10% of intracranial neoplasms. ...


Veterinary use

Combined with Marbofloxacin and Clotrimazol, dexamethasone is available under the name Aurizon , CAS number 115550-35-1, and used to treat difficult ear infections, especially in dogs. To meet Wikipedias quality standards, this article or section may require cleanup. ... Clotrimazole is an antifungal medication commonly used in the treatment of fungal infections of both humans and animals such as vaginal yeast infections and ringworm. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences and alloys. ...


Contraindications

Some of these contraindications are relative: In medicine, a contraindication is a condition or factor that increases the risk involved in using a particular drug, carrying out a medical procedure or engaging in a particular activity. ...

An ulcer (from Latin ulcus) is an open sore of the skin, eyes or mucous membrane, often caused by an initial abrasion and generally maintained by an inflammation and/or an infection. ... This article or section does not cite any references or sources. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Tuberculosis (abbreviated as TB for Tubercle Bacillus) is a common and deadly infectious disease that is caused by mycobacteria, primarily Mycobacterium tuberculosis. ... Osteoporosis is a disease of bone in which the bone mineral density (BMD) is reduced, bone microarchitecture is disrupted, and the amount and variety of non-collagenous proteins in bone is altered. ...

Side effects

If dexamethasone is given orally or by injection (parenteral) over a period of more than a few days, side-effects common to systemic glucocorticoids may occur. These may include:

  • Stomach upset, increased sensitivity to stomach acid to the point of ulceration of esophagus, stomach, and duodenum
  • Increased appetite leading to significant weight gain
  • A latent diabetes mellitus often becomes manifest. Glucose intolerance is worsened in patients with preexisting diabetes.
  • Immunsuppressant action, particularly if given together with other immunosuppressants such as ciclosporine. Bacterial, viral, and fungal disease may progress more easily and can become life-threatening. Fever as a warning symptom is often suppressed.
  • Psychiatric disturbances, including personality changes, irritability, euphoria, mania
  • Osteoporosis under long term treatment, pathologic fractures (e.g., hip)
  • Muscle atrophy, negative protein balance (catabolism)
  • Elevated liver enzymes, fatty liver degeneration (usually reversible)
  • Cushingoid (syndrome resembling hyperactive adrenal cortex with increase in adiposity, hypertension, bone demineralization, etc.)
  • Depression of the adrenal gland is usually seen, if more than 1.5 mg daily are given for more than three weeks to a month.
  • Hypertension, fluid and sodium retention, edema, worsening of heart insufficiency (due to mineral corticoid activity)
  • Dependence with withdrawal syndrome is frequently seen.
  • Increased intraocular pressure, certain types of glaucoma, cataract (serious clouding of eye lenses)
  • Dermatologic: Acne, allergic dermatitis, dry scaly skin, ecchymoses and petechiae, erythema, impaired wound-healing, increased sweating, rash, striae, suppression of reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.
  • Allergic reactions (though infrequently): Anaphylactoid reaction, anaphylaxis, angioedema. (Highly unlikely, since dexamethasone is given to prevent anaphylactoid reactions.)

Other side-effects have been noted, and should cause concern if they are more than mild. Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction. ... Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction. ... Angioedema (BE: angiooedema), also known by its eponym Quinckes edema, is the rapid swelling (edema) of the skin, mucosa and submucosal tissues. ...


The short time treatment for allergic reaction, shock, and diagnostic purposes usually does not cause serious side effects.


Interactions

  • NSAIDs and alcohol: increased risk of gastrointestinal ulceration. Dexamethasone is not an NSAID. While glucocorticoid steroids are not known to interact with alcohol, NSAIDs are often used concomitantly with steroids. Since some steroids can cause gastrointestinal ulceration when used alone, concomitant use of steroids and NSAIDs and alcohol compounds the possibility for gastrointestinal ulceration.
  • Mineralocorticoids: increased risk of hypertension, edema and heart problems
  • Oral antidiabetic drugs and insulin: antidiabetic therapy may have to be adjusted

Other interactions (with certain antibiotics, estrogens, ephedrine, digoxin) are known.


Dosage

  • Shock: 4 to 8 mg intravenously initially, repeat if necessary to a total dose of 24 mg.
  • Autoimmune diseases and inflammations: longterm therapy with 0.5 to 1.5 mg oral per day. Avoid more than 1.5 mg daily, because serious side effects are more frequently encountered with higher doses.
  • Adjuvant to or part of chemotherapy: individual schedule
  • Diagnostic purposes: special schedule

Sports doping

In 2005, Polish cross country skier Justyna Kowalczyk was disqualified from the Under 23 (U23) OPA (Alpine nations) Intercontinential Competition in Germany and issued a 2-year suspension for her doping offenses on dexamethasone.[1] This was eventually reduced to one year during 2005 and later rescinded by the Court of Arbitration for Sport in December 2005.[2] She would later earn a bronze in the women's 30 km freestyle mass start at the 2006 Winter Olympics in Turin. Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ... Cross-country skiing (also known as XC skiing) is a winter sport popular in many countries with large snowfields, primarily Northern Europe and Canada. ... Justyna Kowalczyk (born 21 January 1983 in Limanowa, Poland) is a Polish cross-country skiier. ... The Court of Arbitration for Sport (CAS; Tribunal Arbitral du Sport or TAS in French) is an arbitration body set up to settle disputes related to sports. ... Neve and Gliz, the 2006 Olympics mascots, on display in Turin Italian €2 commemorative coin of 2006 celebrating the Turin games The 2006 Winter Olympics, officially known as the XX Olympic Winter Games, were celebrated in Turin, Italy from February 10, 2006, through February 26, 2006. ... “Torino” redirects here. ...


References

  1. ^ June 13, 2005 FIS Doping Control statement on Kowalcyzk (Digitized version). - Accessed July 30, 2006
  2. ^ December 14, 2005 FIS Newsflash on her overturned suspension (Digitized version). - Accessed July 30, 2006

July 30 is the 211th day of the year (212th in leap years) in the Gregorian calendar. ... For the Manfred Mann album, see 2006 (album). ...

External links

  • Understanding Dexamethasone and Other Steroids
  • Links to external chemical sources

  Results from FactBites:
 
812. Dexamethasone (WHO Food Additives Series 33) (4914 words)
EXPLANATION Dexamethasone is a potent synthetic analogue of hydro-cortisone that has a long history of use in veterinary medicine for the treatment of a range of metabolic diseases and inflammatory disorders in companion and farm animals.
Dexamethasone is rapidly excreted in urine and faeces.
In a study with rats orally dosed with 0.5, 1, 1.5, 2, or 4 µg/kg bw/day dexamethasone for 7 days the corticosterone concentration was reduced in the highest-dose group and the activity of tyrosine aminotransferase in the liver was increased in a dose-related manner at 2 and 4 µg/kg bw/day.
Dexamethasone Information on Healthline (951 words)
Dexamethasone may also be called by its brand name, Decadron, and is one of the corticosteroids.
Dexamethasone may be used to decrease abnormally high levels of potassium that develop in association with cancer.
Dexamethasone should be used cautiously in patients with kidney or liver problems, hypothyroidism, high blood pressure, or a history of heart attack.
  More results at FactBites »

 
 

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