Dexamethasone

Aliases: Decadron  

Indications: Inflammation to the respiratory tract. Adrenal insufficiency/crisis   

Contraindications: None in emergency setting  

Concentrations: 

Injection: 2-10mg/mL

Dosing

Adult:

Indication Dose Route Note 
Bronchospasm
Airway edema/croup
Adrenal Insufficiency/Crisis		10mgPO/IV/IMUse the IV form
for any route

Pediatric:

Indication Dose Route Note 
Bronchospasm
Airway edema/croup
Adrenal Insufficiency/Crisis		0.6mg/kg
(Max: 10mg)		PO/IV/IMUse the IV form
for any route
Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer 

Precautions: Avoid rapid IV push 

Adverse/Side Effects: Agitation, perineal/body burning sensation, pruritus, nausea/vomiting 

Class: Corticosteroid, anti-inflammatory drugs   

Mechanism of Action: Potent glucocorticoid with minimal to no mineralocorticoid activity. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reducing capillary permeability; stabilizes cell and lysosomal membranes, increases surfactant synthesis, increases serum vitamin A concentration, and inhibits prostaglandin and proinflammatory cytokines; suppresses lymphocyte proliferation through direct cytolysis, inhibits mitosis, breaks down granulocyte aggregates, and improves pulmonary microcirculation 

Onset of ActionPeak EffectDuration of Action 
Few minutes60 minutes36-54 hours