What is dexamethasone?
Dexamethasone is a widely used glucocorticoid drug that has attracted much attention in recent years for its use in the treatment of COVID-19. This article will introduce in detail the pharmacological effects, indications, side effects and recent hot topics of dexamethasone.
1. Basic information about dexamethasone
| Project | content |
|---|---|
| common name | Dexamethasone |
| drug class | Glucocorticoids |
| Dosage form | Tablets, injections, eye drops, etc. |
| Approval date | 1958 (US FDA) |
| WHO essential medicines | Yes |
2. Pharmacological effects
Dexamethasone has potent anti-inflammatory, immunosuppressive and anti-allergic effects. It mainly works through the following mechanisms:
1. Inhibit the production and release of inflammatory mediators
2. Reduce the migration of white blood cells to the inflammatory site
3. Stabilize lysosomal membrane
4. Suppress immune response
3. Clinical application
| Indications | Remarks |
|---|---|
| inflammatory diseases | Such as rheumatoid arthritis, systemic lupus erythematosus, etc. |
| allergic diseases | severe allergic reaction, status asthmaticus |
| blood system diseases | Leukemia, lymphoma, etc. |
| endocrine diseases | Adrenocortical insufficiency |
| COVID-19 treatment | Used during oxygen therapy or mechanical ventilation in critically ill patients |
4. Recent hot topics
1.Dexamethasone in COVID-19 Treatment
The UK RECOVERY trial showed dexamethasone could reduce mortality in COVID-19 patients requiring mechanical ventilation by about a third. The discovery makes it the first drug proven to reduce COVID-19 mortality.
2.Global supply tight
Due to the surge in demand due to the epidemic, dexamethasone supply shortages occurred in many places in 2020. The World Health Organization calls for ensuring equitable global distribution.
3.Risk of improper use
Experts warn that the use of dexamethasone in patients with mild symptoms may do more harm than good and clinical guidelines should be strictly followed.
5. Adverse reactions
| system | adverse reactions |
|---|---|
| endocrine | Cushing's syndrome, elevated blood sugar |
| digestive system | Peptic ulcer, pancreatitis |
| nervous system | Insomnia, mood swings |
| cardiovascular | High blood pressure, water and sodium retention |
| immune system | Increased risk of infection |
6. Precautions for use
1. Do not stop the drug suddenly after long-term use, but gradually reduce the dosage.
2. Diabetic patients need to monitor blood sugar closely
3. Use with caution in patients with active infection
4. Pregnant women need to weigh the pros and cons when using it.
5. Avoid simultaneous use with certain vaccines
7. Summary
Dexamethasone, as a powerful glucocorticoid, plays an important role in the treatment of various diseases. During the COVID-19 epidemic, its value in the treatment of critically ill patients has been confirmed. However, this drug has many adverse reactions and should be used rationally under the guidance of a doctor to avoid abuse.
Recent research data shows that rational use of dexamethasone can significantly improve the prognosis of some critically ill patients, but it also reminds us to pay attention to its potential risk of side effects. More research is still needed in the future to optimize its clinical application.
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