Video transcript :-
Dexamethasone belongs to the drug class of corticosteroids, which are potent anti-inflammatory and immunosuppressant medications.
It is used to treat a wide range of disease conditions, including the following.
Inflammatory disorders such as rheumatoid arthritis, systemic lupus erythematosus, dermatitis, inflammatory bowel disease, asthma, and chronic obstructive pulmonary disease.
Allergic reactions, including allergic rhinitis, allergic dermatitis, and drug reactions.
Autoimmune diseases like multiple sclerosis, and autoimmune hepatitis.
Certain types of cancers such as leukemia, lymphoma, and multiple myeloma, to reduce inflammation and suppress the immune response.
To reduce swelling in the brain caused by tumors, injury, or surgery.
Endocrine disorders such as adrenal insufficiency and congenital adrenal hyperplasia.
To prevent nausea and vomiting in patients who undergo chemotherapy.
To induce fetal lung maturation and reduce the risk of respiratory distress syndrome in premature infants.
Dexamethasone, like other corticosteroids, exerts its effects by binding to intracellular glucocorticoid receptors.
Once bound, the dexamethasone-receptor complex translocates into the cell nucleus, where it acts as a transcription factor.
This complex regulates gene expression by either enhancing or suppressing the transcription of specific target genes.
The net result is a wide range of physiological effects, including anti-inflammatory, immunosuppressive, anti-allergic, and metabolic actions.
Dexamethasone inhibits the production of inflammatory mediators, such as prostaglandins and leukotrienes, and suppresses the activity of various immune cells, such as T cells and macrophages.
Additionally, it alters the expression of proteins involved in glucose metabolism, leading to increased blood glucose levels.
Dexamethasone is well-absorbed after oral administration, with peak plasma concentrations reached within 1-2 hours.
It can also be administered via intramuscular or intravenous routes for rapid onset of action.
Metabolism of dexamethasone primarily occurs in the liver, primarily via the enzyme cytochrome P450.
Metabolites are mostly inactive and undergo further conjugation before excretion.
Dexamethasone and its metabolites are primarily excreted via the kidneys.
Common adverse effects of dexamethasone include the following.
Immunosuppression, which increases the susceptibility to various infections.
Glucose Intolerance and Hyperglycemia.
Fluid and Electrolyte Imbalances.
Osteoporosis and Bone Fractures.
Gastrointestinal Effects, including gastric irritation, peptic ulcers, and pancreatitis.
Psychiatric Effects, including insomnia, mood swings, anxiety, depression, and cognitive changes such as memory impairment and confusion.
Ocular Effects such as increased intraocular pressure, leading to glaucoma or exacerbating pre-existing glaucoma.
It may also induce cataract formation with long-term use.
Skin Changes such as skin thinning, easy bruising, delayed wound healing, and exacerbation of existing skin conditions such as acne and rosacea.
Weight Gain.
Musculoskeletal Effects like muscle weakness, myopathy, and muscle wasting, particularly with prolonged use.
Endocrine Effects, including menstrual irregularities, hirsutism, and adrenal suppression.
In children, it can inhibit growth and development.
Cardiovascular Effects such as hypertension, myocardial infarction, and stroke.
Hematological effects such as leukopenia and thrombocytopenia.
Metabolic effects such as elevated blood cholesterol and triglycerides and hypokalemic metabolic alkalosis.
Contraindications for dexamethasone therapy include the following.
Systemic Fungal Infections.
Live Vaccines.
Hypersensitivity to dexamethasone
Systemic Viral Infections.
Active Peptic Ulcer Disease.
Uncontrolled Hypertension.
Diabetes.
Ocular Herpes Simplex.
Active Tuberculosis.
And Recent Myocardial Infarction.
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