Dexamethadone

Question 1

Brand Name

Answer 1

Decadron

Question 2

Broad Category

Answer 2

Antiemetic / Anti-inflammatory

Question 3

Pharmacological Class

Answer 3

Corticosteroid / synthetic glucocorticoid (long-acting)

Question 4

MOA

Answer 4

Anti-inflammatory: decreases production of inflammatory mediators and inhibits phospholipase A2, thereby reducing surgical inflammation

Antiemetic: Unclear, proposed to centrally inhibit prostaglandin synthesis and control endorphin release

Question 5

Indications / clinical uses

Answer 5

PONV prophylaxis
Airway inflammation
ENT
Traumatic intubations
postintubation laryngeal edema
Regional anesthesia adjunct (prolongs duration)

Other:
Cerebral edema
asthma
allergic therapy
immunosuppression
septic shock

Question 6

Adult dose PONV

Answer 6

4-12 mg IV

Question 7

Pediatric dose

Answer 7

150 mcg/kg (MAX 8 mg)

Question 8

Timing

Answer 8

Should be given prior to or at induction of anesthesia due to delayed action

Question 9

Awake vs asleep admin

Answer 9

Absolutely give after patient asleep (genital burning)

Question 10

Onset

Answer 10

˜1 hour

Question 11

Duration

Answer 11

up to 24 hours

Question 12

General SE

Answer 12

Severe genital burning/itching (esp. females)

Question 13

Precautions

Answer 13

Diabetics: risk of delayed wound healing

Question 14

Hypoglycemia?

Answer 14

apparently new studies are saying no, but textbooks still saying it may which can increase risk of infection

Question 15

Drug-Drug interactions

Answer 15

CYP3A4 INDUCER!
- increase metabolism of other drugs

Synergistic with other antiemetics

Question 16

Metabolism

Answer 16

Extensive Hepatic
- CYP3A4 mediated pathways

Question 17

Elimination

Answer 17

Renal

Question 18

Vd

Answer 18

moderate