What is Dexamethasone 4mg?

Dexamethasone 4mg appears in your prescriptions from inflammatory or allergic diseases, even in prescriptions taken after surgery. So what is dexamethasone 4mg? How does Dexamethasone work when used?

1.1 What is Dexamethasone 4mg? Dexamethasone 4mg is a drug of the hormonal group fluomethylprednisolone, a synthetic glucocorticoid, almost insoluble in water. The drug dexamethasone reduces the body's natural defense response and reduces accompanying symptoms.
1.2 Dosage form and dosage On the market you can find dexamethasone in oral tablet form with dexamethasone 4mg ingredient. Or dexamethasone 4mg/ml in the form of injection with the main ingredient is Dexamethasone sodium phosphate 4mg/1ml, the drug can be injected locally, intramuscularly, intravenously, injected into the lesion or injected into the soft tissue.
Dosage:
The initial dose for adults is 0.75-9 mg/day, depending on the disease and usually divided into 2 to 4 doses. Children receive an oral dose of 0.024 - 0.34 mg/kg/day, or 0.66 - 10 mg/m2/day in 4 divided doses. 1.3 Mechanism and main effects of Dexamethasone 4mg Glucocorticoids act through the mechanism of binding to receptors in cells, translocating into the cell nucleus and they will affect a number of genes that are translated here. In addition, glucocorticoids also have some direct effects, which may not be mediated by binding to the receptor.
Dexamethasone 4mg has the main effects of glucocorticoids such as:
Anti-inflammatory: from all causes (Chemical, mechanical, immunological, bacterial) Anti-allergic: glucocorticoids inhibit phospholipase C thereby reducing H1 release. and allergenic chemical mediators. Immunosuppression: atrophy of lymphoid organs leading to a decrease in lymphocyte count, inhibition of phagocytosis, inhibition of antibody production, inhibition of enzyme release and action, inhibition of cell migration. white blood cells.

Repeated ulcers due to allergies or intoxication. Respiratory diseases: sinusitis, allergic bronchitis. Replacement therapy when the adrenal cortex does not secrete enough glucocorticoids (due to acute and chronic adrenocortical insufficiency, adrenocortical insufficiency secondary to pituitary or hypothalamic disorders). In cancer, it is effective in treating nausea and vomiting caused by chemotherapy. Treatment of autoimmune diseases: lupus erythematosus, rheumatoid arthritis, rheumatic heart disease, rejection reactions in organ transplants Treatment of nerve root pain, sciatica, low back pain. Prophylaxis of respiratory distress syndrome in premature infants Pneumococcal meningitis. Cerebral edema, shock due to various causes Some cases of skin diseases, ophthalmology, ENT during delivery in preterm labor (between 24 and 34 weeks)
Dexamethasone 4mg/ml is available in an injectable form so it works faster, so it should be used more in cases such as:
Emergency for severe allergic cases , cerebral edema, surgical shock, adrenal insufficiency. For intra- and peri-articular injection in patients in cases of bursitis, arthritis, periarthritis, rheumatoid arthritis, tendonitis, osteochondrosis.

Due to the immunosuppressive effect or the effects of Dexamethasone 4mg when metabolizing the drug in the body, it causes the following side effects:
Fat distribution disorder, Cushing's syndrome: due to glucocorticoids increasing fat synthesis in body, reducing fat synthesis in the extremities. Hyperglycemia, diabetes or aggravation of diabetes: by increasing glycogen production in the liver, stimulating liver enzymes to increase glucose production from proteins and amines, it also increases glucose synthesis, reduces insulin synthesis. Muscle fatigue, myasthenia gravis, muscle atrophy, bone spongy: because glucocorticoids inhibit protein synthesis, promote protein catabolism to transfer amino acids in muscle and bone into the liver to create glucose. Osteoporosis, thin bones, spongy, fragile, rickets, growth retardation: Consequences of glucocorticoid antagonism The effect of vitamin D is to reduce Ca 2+ ions in the blood, which the body must regulate by causing hyperparathyroidism Thyroid stimulates osteoclasts, causing bone resorption to draw Ca2+ into the blood. Confusion, irregular heartbeat, intense thirst, frequent urination, leg discomfort, muscle weakness due to low potassium in the blood. Edema, hypertension, severe headache, dizziness, tinnitus, anxiety, chest pain, lack of breath, irregular heartbeat, convulsions due to sodium and water retention due to increased sodium and water reabsorption. Wounds are slow to heal, easy to get infections: Because drugs inhibit the regeneration of granules and whole fibers, slow scarring, slow wound healing, immunosuppression makes wounds susceptible to infection. Gastroduodenal ulcers: Drugs that increase gastric secretion, reduce mucus production (protective agent) Acute adrenal insufficiency when abruptly stopped: systemic dexamethasone inhibits pituitary release of corticotropin (ACTH), causes the adrenal cortex to stop secreting endogenous corticosteroid hormones (resulting in secondary adrenocortical insufficiency). Glucocorticoids cause nerve stimulation causing severe depression, thinking, behavior changes, convulsions. When using Dexamethasone 4mg/ml because the drug is in the form of injection, there are additional side effects at the injection site such as: infection, inflammation or calcification in the joints.

Barbiturates, phenytoin, rifampicin, rifabutin, carbamazepine, ephedrine, aminoglutethimide can increase the clearance of corticosteroids, thus reducing the therapeutic effect.
Glucocorticoids reduce the hypokalemic effect of acetazolamide, loop diuretics, and carbenoxolone.
Diuretics that reduce blood potassium (such as furosemide, thiazides), amphotericin B may increase the hypokalemic effect of glucocorticoids. Concomitant administration of anticoagulant coumarin derivatives with corticosteroids may increase the potency of the drug, so the coagulation time should be closely monitored to avoid spontaneous bleeding.
Clearance of salicylates is increased when co-administered with corticosteroids, so when corticoids are discontinued, salicylate toxicity is likely. Glucocorticoids antagonize the effects of hypoglycemic agents (including insulin), antihypertensives, and diuretics.

Precautions for use in pregnant women: The drug can reduce placental weight and fetal weight. In infants, prolonged use of the drug by the mother may lead to adrenal suppression. However, in premature infants, glucocorticoids have been shown to protect against the risk of respiratory distress syndrome and bronchopulmonary dysplasia.
Dexamethasone should not be used for more than 6 months, as it may cause adrenal insufficiency. Do not self-medicate in cases of fungal infections, viral infections or are receiving live vaccines.
When using the drug, do not suddenly take it when you are well without consulting your doctor, the dose should be gradually reduced until the drug is no longer needed.
Tell your doctor if you are taking Dexamethasone 4mg if you are going to have surgery.
Make a list of the medications you are taking to your doctor.
Some diseases affect the use of Dexamethasone 4mg, tell your doctor if you have any of these conditions:
Cataracts Congestive heart failure Cushing's syndrome Fluid accumulation in the body Diabetes Sugar Hypertension Eye infection Glaucoma Myasthenia gravis Osteoporosis Personality changes Tuberculosis Pulmonary infection Eye infection due to herpes simplex For injectable Dexamethasone 4mg/ml, extra attention should be paid: do not inject into infected skin. bacteria.

Take medicine as directed by your doctor. Take with food or milk to avoid stomach upset, should be taken with a full glass of water (240 mL). Drink at the same time of day, preferably in the morning for best results. Do not arbitrarily stop the drug suddenly In case of overdose: the use of glucocorticoid overdose causing acute poisoning or death is very rare. There is no specific antidote. There is no indication for the treatment of chronic poisoning, except in cases where the patient is hypersensitive to corticosteroids, causing pathology, at which time symptomatic treatment is required. If you forget to take a dose: If you miss a dose and it is almost time for your next dose, you can skip the missed dose and continue your dosing schedule. Do not use a double dose to make up for a missed dose of Dexamethasone. Storage of dexamethasone 4mg and dexamethasone 4mg/ml: Store the drug in a cool, dry place, the temperature is below 30oC. The injectable form of dexamethasone 4mg/ml will be stored at medical facilities according to regulations. Keep medicine out of reach of small children.