地塞米松

Brand Name: Decadron, Dexamethasone Intensol, Dexasone, Solurex, Baycadron

Generic Name: dexamethasone

Drug Class: Corticosteroids; Anti-Inflammatory Agents

地塞米松用于治疗诸如arthritis,blood/hormone/免疫系统说或者ders, allergic reactions, certain皮肤和眼睛状况s,breathing问题，确定肠说或者ders, and certain cancers. It is also used as a test for anadrenal gland说或者der (Cushing's综合征）。

地塞米松is acorticosteroid激素（激素糖皮质激素）。它减少了身体的自然防御反应，并减少了肿胀和过敏反应等症状。

地塞米松may also be used to preventnausea和vomiting caused bycancerchemotherapy.

地塞米松is available under the following different brand names:十二王，地塞米松突触，增墨酮，enurex和baycadron。

地塞米松的剂量：

Dosage Forms & Strengths

药片as钾

• 0.5毫克
• 0.75 mg
• 1 mg
• 1.5 mg
• 2 mg
• 4毫克
• 6毫克

注射悬架

• 4毫克/mL
• 10 mg/mL

Elixir/口服解决方案

• 0.5毫克/5mL

Oral concentrate

• 1 mg/1mL

Powder packet for oral solution

• 50毫克

剂量考虑 - 应如下给出：

Inflammation

• 成人：0.75-9 mg/天在travenous/在tramuscular/oral (IV/IM/PO) divided every 6-12 hours
• Intra-articular, intra-lesional, or softtissue：0.2-6毫克/天
• 小儿: 0.08-0.3 mg/kg/day intravenous/intramuscular/oral (IV/IM/PO) divided every 6 hours or every 12 hours

Multiple Sclerosis(急性Exacerbation)

• 30毫克/天口服1周；跟随4-12 mg/天1个月

Cerebral Edema

• 1-6 mg/kg intravenously (IV) once or 40 mg IV every 2-6 hours as needed
• 替代方案：连续IV输注20 mg IV，然后3 mg/kg/天
• High-dose treatment not to be continued beyond 48-72 hours

Allergic Conditions

• For控制of severe or incapacitating allergic conditions在tractableto adequate trials of conventional treatment在哮喘,特应性皮炎,contact dermatitis, drug hypersensitivity reactions, perennial or seasonalallergic rhinitis， 和serumsickness
• Day 1: 4-8 mg intramuscularly (IM)
• 第2-3天：3毫克/天口服每12小时分裂
• Day 4: 1.5 mg/day orally divided every 12 hours
• Days 5-6: 0.75 mg/day orally in single daily dose
• Day 7: No treatment

地塞米松Suppression Test

• Low-dose test
• Screening for库欣综合症
• 隔夜测试：1毫克口服11:00 pm至午夜之间；cortisollevel tested between 8:00 and 9:00AMon following morning
• 标准2天测试：每6小时口服0.5毫克（9:00 am，3：00 pm，9：00 pm，3：00 am），持续2天；最终剂量后6小时（上午9:00）测试了皮质醇水平

High-dose test

• 确认的库欣综合症，需要进一步的检查以确定激素过量是库欣综合症还是其他原因的结果
• 标准2天测试：确定后baselineserum cortisol or 24-hrurinary免费皮质醇，每6小时口服2毫克，持续2天；urinefor free cortisol is collected during test, and serum cortisol is checked 6 hours after final dose
• Overnight test: After determination of baseline serum cortisol, 8 mg (typically) orally between 11:00 pm and midnight; cortisol level tested between 8:00 and 9:00 AM on following morning
• Intravenous (IV) test: After determination of baseline serum cortisol, 1 mg/hour by continuous IV infusion for 5-7 hours

小儿

呼吸道Edema

• 0.5-2 mg/kg/day oral/intravenous/intramuscular (PO/IV/IM) divided every 6 hours, starting 24 hours before拔管和continued for 4-6 doses afterward

Croup, Pediatric

• 0.6 mg/kg oral/intravenous/intramuscular (PO/IV/IM) once; not to exceed 16 mg

Meningitis

• 6周以上的儿童：0.6 mg/kg/天静脉内（IV）每6小时分割每6小时，前2-4天antibiotictherapy，从前10-20分钟开始或与第一次抗生素剂量同时开始

CerebralEdema Associated WithBrain Tumor

• 1-2 mg/kg oral/intravenous/intramuscular (PO/IV/IM) once; maintenance: 1-1.5 mg/kg/day IV/IM divided every 4-6 hours; not to exceed 16 mg/day

Spinal Cord Compression

AdrenalCortical高功能测试

• After determination of baseline cortisol level, 1 mg orally at bedtime
• Plasmacortisol level then determined at 8:00 AM on following morning; level will be decreased in normal individuals but at baseline level in Cushing syndrome

副作用associated with use of Dexamethasone, include the following:

• 异常心rhythm (arrhythmia)
• 粉刺
• Adrenal suppression
• 肛门瘙痒
• 心脏arrest
• Cataracts
• 在某一方面的变化spermatogenesis
• Delayed wound healing
• Depression
• Diabetes mellitus
• 情绪不稳定
• Enlarged liver
• Euphoria
• Excess fluid in the肺(pulmonary edema)
• Exophthalmos
• GIperforation
• Glaucoma
• Glucose不宽容
• Glucosuria
• Hives
• Hypokalemicalkalosis
• 增加在tracranial压力
• 增加transaminases
• Insomnia
• Kaposi'ssarcoma
• 月经不规则
• Moon face
• Muscle说ease
• Nervepain
• Osteoporosis
• Peptic ulcer
• 垂体adrenalaxissuppression
• Pseudotumor cerebri(on withdrawal)
• Psychosis
• Rash
• 发红
• Seizure
• 慢的心rate
• 小红或紫色斑点在皮肤上
• Sperm生产改变（增加或减少）
• Spinningsensation(vertigo)
• 溃疡食道炎
• Weight gain

Postmarketing side effects of dexamethasone reported include:

• 流体和electrolyte说turbances:Tumor裂解综合征

本文档不包含所有可能的副作用，可能还会发生其他副作用。与您的检查physician有关副作用的更多信息。

如果您的医疗医生is using this medicine to treat your pain, your doctor orpharmacist可能已经意识到任何可能的药物相互作用，并且可能正在为您监视您。在与医生检查之前，请勿开始，停止或更换任何药物的剂量，健康护理提供者或药剂师首先。

Severe interactions of dexamethasone include:

• apixaban
• artemether/lumefantrine
• 甲磷脂
• cobimetinib
• dienogest/雌二醇valerate
• elbasvir/grazoprevir
• elvitegravir/cobicistat/emtricitabine/tenofovir DF
• lumacaftor/ivacaftor
• lumefantrine
• lurasidone
• mifepristone
• naloxegol
• ombitasvir/paritaprevir/ritonavir
• ombitasvir/paritaprevir/ritonavir and dasabuvir
• Panobinostat
• praziquantel
• regorafenib
• rilpivirine
• roflumilast
• vandetanib

地塞米松has serious interactions with at least 118 different drugs.

地塞米松与至少298种不同的药物具有中等相互作用。

地塞米松有轻微的我nteractions with at least 136 different drugs.

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

警告

• This药物包含地塞米松。如果您对地塞米松过敏或此药物中所含的任何成分
• 让儿童接触不到的地方。在过量的情况下, get medical help or contact a毒物控制中心immediately

禁忌症

• 系统性fungal在fection
• 已记录了超敏反应
• Cerebralmalaria
• Administration of live or live,attenuatedvaccines接受的患者禁忌免疫抑制剂量的皮质类固醇

Effects of Drug Abuse

• Agent is potent利尿剂如果给出过多的话，可能会导致深刻diuresiswithwater和electrolyte depletion

Short-Term Effects

• See "What Are Side Effects Associated with Using Dexamethasone?"

Long-Term Effects

• Corticosteroids can produce reversible hypothalamic-pituitary adrenal (HPA) axis suppression with potential for glucocorticosteroid insufficiency after withdrawal of treatment; adrenocortical insufficiency may result from too rapid withdrawal; may be minimized by gradual reduction of dosage; relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation ofstressoccurring during that period, reinstitutehormone therapy;ifpatient正在接受类固醇，可能会增加剂量
• 长时间的皮质类固醇使用可能会导致升高在traocular pressure, glaucoma, or cataracts; ifsteroidtherapy is continued for more than 6 weeks, monitor在traocular压力
• 长时间的治疗与developmentof Kaposi's sarcoma
• See "What Are Side Effects Associated with Using Dexamethasone?"

Cautions

• Use with caution in肝硬化,diverticulitis,肌无力重症, pepticulcer说ease,ulcerative colitis,renal不足，怀孕
• 平均剂量和大剂量皮质类固醇会导致升高血压,sodium和保留水， 和在creased excretion of potassium; these effects are less likely to occur with synthetic derivatives except when used in large doses; dietarysaltrestriction and potassium supplementation may be necessary; all corticosteroids increasecalciumexcretion
• Literature reports suggest apparent协会在使用皮质类固醇和左之间ventricularfree wallruptureafter recentmyocardial infarction;这些患者应谨慎使用皮质类固醇治疗
• Corticosteroids can produce reversible hypothalamic-pituitary adrenal (HPA) axis suppression with potential for glucocorticosteroid insufficiency after withdrawal of treatment; adrenocortical insufficiency may result from too rapid withdrawal; may be minimized by gradual reduction of dosage; relative insufficiency may persist for months after discontinuation of therapy; therefore, in any situation of stress occurring during that period, reinstitute hormone therapy; if patient is receiving steroids already, may increase dosage
• Metabolic甲状腺功能减退患者的皮质类固醇清除率降低，并增加hyperthyroid患者;改变在thyroidstatus of patient may necessitate adjustment in dosage
• 皮质类固醇可能exacerbate系统性真菌感染；除非需要控制威胁生命的药物反应，否则不适用于这种感染。同时使用两性霉素B和氢化可的松followed by cardiac enlargement and充血性心力衰竭报告
• Latent说ease may be activated or there may be an exacerbation of intercurrent infections due to pathogens, including those caused byAmoeba, Candida, Cryptococcus,分枝杆菌，Nocardia，Pneumocystis, toxoplasma;排除latentamebiasis或者active amebiasis before initiating corticosteroid therapy in any patient who has spent time in the tropics or any patient with unexplaineddiarrhea
• Corticosteroids should be used with great care in patients with known or suspected Strongyloides (threadworm) infestation; corticosteroid-inducedimmunosuppressionmay lead to Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal公克-消极的化粪池emia;not for use in cerebral malaria
• 如果在潜伏的患者中指示皮质类固醇，则需要仔细观察tuberculosis或者tuberculinreactivity; reactivation of the disease may occur; during prolonged corticosteroid therapy, these patients should receivechemoprophylaxis
• Use of oral corticosteroids not recommended in treatment of光学元件neuritis和may lead to increase in risk of new episodes; corticosteroids should not be used in activeocularherpes单纯形
• Use lowest possible dose to control状况under treatment; risk/benefit decision must be made in each individual case as to dose and duration of treatment and as to whether daily or intermittent therapy should be used
• 可能会导致抑制bonegrowth in pediatric patients and development of osteoporosis at any age; special consideration should be given to patients at increased risk of osteoporosis (e.g.,绝经后women) before initiating corticosteroid therapy
• Psychic derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations; existing emotional instability or psychotic tendencies may also be aggravated by corticosteroids
• Minimal mineralocorticoid activity
• Thromboembolic disorders
• 肌病已经被报告了
• Delayed wound healing
• Withdraw therapy with gradual tapering dose
• 可能具有系统性和局部影响；检查jointfluid, as necessary to exclude a化粪池process;avoid injection into infected site; frequent intra-articular injections may result in damage to joint tissue
• 如果接触chickenpox,预防with水痘zoster免疫globulin (VZIG) may be indicated; if exposed to麻疹, prophylaxis with immune globulin (IG) may be indicated; if chickenpox develops, treatment withantiviralagents should be considered
• 潜在的结核病可能会重新激活（应监测结核蛋白阳性的患者）
• Some suggestion (not fully substantiated) of slightly increasedcleft palaterisk if corticosteroids are used in pregnancy
• 长时间的皮质类固醇使用可能导致眼内压，青光眼或白内障升高。如果持续超过6周的类固醇治疗，请监测眼内压
• 长时间的治疗与development of Kaposi's sarcoma
• 可能affectvelocity growth in children; monitor routinely
• Killed or inactivated vaccines may be administered; however, the response to such vaccines cannot be predicted
• Patient may require higher doses when主题to stress
• Immunizationprocedures may be undertaken in patients who are receiving corticosteroids as replacement therapy inphysiologic剂量（例如，对于Addison病）
• Epidural在jection:
• Serious neurologic events, some resulting indeath据报道硬膜外注射
• 报告的具体事件包括但不限于spinal cord在farction,截瘫,四肢瘫痪,cortical blindness， 和stroke
• 这些严重的神经系统事件已在有没有使用的情况下报告透视
• Safety and effectiveness of epidural administration of corticosteroids have not been established, and corticosteroids are not approved for this use

Pregnancy andLactation

• Use dexamethasone with caution during pregnancy if benefits outweigh risks. Animal studiesshowrisk and human studies are not available, or neither animal nor human studies were done
• Some suggestion (not fully substantiated) of slightly increased cleftpalaterisk if corticosteroids are used in pregnancy
• 地塞米松is excreted inbreast milk;不建议在breastfeeding