DEXAMETHASONE

CLASSIFICATION OF DRUG:

> Corticosteroid


THERAPEUTIC EFFECT:

> Enters target cells and binds
to specific receptors, initiating
many complex reactions that
are responsible for its anti
inflammatory and
immunosuppressive effects.


DOSAGES, ROUTE & FREQUENCY:

FOR CEREBRAL EDEMA:
--PO(Adults): 2 mg every 8 to 12
hours
--IM,IV (Adults): 10 mg initially IV, 4
mg every 6 hr., may be decreased to
2 mg every 8- 12 hr., then change
PO.

>FOR ADENOCORTICAL
INSUFFICIENCY/ ANTI
INFLAMMATORY:
--PO(Adults): 0.5 9 mg daily in
single dosage or divided doses
--IV(Adults): 0.5 25 gm/day
--IM(Adults):8-16 mg q 1-3wk.
CONTRAINDICATION& SIDE EFFECT:
CONTRAINDICATION:
1. Hypersensitivity
2. Active untreated infection
3. Lactation
4. Systemic fungal infection

SIDE EFFECT:
> acne, decreased wound healing,
depression, vomiting, easy
bruising, headache, increased
hair growth, insomia,
restlessness, stomach irritation,
irregular or absent
menstruation, dizziness
NURSING RESPONSIBILITY:
1. Monitor intake and output of
patient.
2. Observe the patient for
peripheral edema, steady weight
gain, rales or crackles or
dyspnea. Notify physician
immediately if these clinical
manifestation are noted.
3. Periodic growth evaluation for
children should be done time to
time.
4. For patients with cerebral
edema, assess then for level of
conciousness changes and
headache during the therapy





NURSING RESPONSIBILITY:
5. Guaiac- test stools should be
carried out.
6. Administer with meals to
minimize GI irritation.
7. For patients with difficulty
swallowing tablets can be crushed
and administered with fluids or
food. However, capsules should be
swallowed whole.
8. Educate the patient to take
missed doses as soon as
remembered, unless almost time
for the next dose skip the missed
dose to continue your regular dosing
schedule. Do not take double dose to
make up for a missed one.




CLASSIFICATION OF DRUG:
> Beta- adrenergic blocker
(nonselective)

THERAPEUTIC EFFECT:
> Propanolol competitively
blocks beta1- and beta 2-
receptors resulting to
decreased heart rate
myocardial contractility, bp
and myocardial oxygen
demand. It only possesses
membrane- stabilizing
properties.


DOSAGES, ROUTE & FREQUENCY:
Adults(PO):
Hypertension: 40 mg regular
propanolol bid or 80 mg SR daily
initially; usual maintenance dose
120- 240 mg/day given bid or tid or
120-160 mg SR daily (maximum
dose, 640 mg/day)
Angina: 80-320 mg/ day divided
bid, tid or qid or 80 mg SR daily
initially; gradually increase dosage
at 3- to 7- day intervals; usual
maintenace dose, 160 mg/ day
(maximum dose, 320 mg/day)


DOSAGES, ROUTE & FREQUENCY:
Parenteral:
Life threatening arrythmias: 1- 3
mg IV with careful monitoring, not
to exceed 1 mg/ min: may give
second dose in 2 min, but then do
not repeat for 4 hr.

CONTRAINDICATION& SIDE EFFECTS:
CONTRAINDICATION:
> Sinus bradycardia, cargiogenic
shock, pulmonary edema, severe
hyperactive airway disease,
compensated cardiac failure,
hypoglycemia, severe hemorrhage,
metabolic acidosis, severe
peripheral arterial disease

SIDE EFFECTS:
> Cold extremities, insomnia,
fatigue, dizziness, nausea,
constipation or diarrhea, vomiting,
anorexia, stomach discomfort,
impotence, weaknewss.

NURSING RESPONSIBILITY:
1. provide continuous cardiac and
BP monitoring with IV form.
Change to oral form as soon as
possible.
2. Give oral drug with food to
facilitate absorption.
3. Consult with physician about
withdrawing drug if patient is to
undergo surgery