- the treatment of bronchopulmonary dysplasia (BPD), cerebral edema, airway edema and persistent hypoglycaemia
- dexamethasone is a synthetic glucocorticoid with potent anti-inflammatory activity; it possesses minimal mineralocorticoid effects
- its anti-inflammatory activity may be related to stabilization of cell and lysosomal membranes, inhibition of prostaglandin and leukotriene synthesis and reduction of edema
- systemic hypertension, GI upset and bleeding, glucose intolerance, possible increased susceptibility to infections, hypernatremia, hypokalemia, failure to gain weight, suppression of hypothalamus - pituitary - adrenal axis
- long term effects, especially on growth and development, have not been carefully evaluated
- monitor infant's weight, blood pressure, serum electrolytes, serum and urinary glucose
** RECENT LITERATURE SUGGESTS CAUTION IN THE USE OF DEXAMETHASONE BECAUSE OF POSSIBLE EFFECTS ON LONG TERM NEURODEVELOPMENT. IT IS RECOMMENDED THAT DEXAMETHASONE IS USED ONLY IN THOSE CASES WHERE THE POTENTIAL BENEFIT OUTWEIGHS THE RISKS. A LOW DOSE IS RECOMMENDED.**
- may be given IV push over 2 minutes or via slow IV administration over 30 minutes
BRONCHOPULMONARY DYSPLASIA (BPD)
- 0.05 mg/kg IV q12h (for 3 to 5 days, depending on response)
(may also be given as 0.1 mg/kg daily)
- 0.25 mg/kg IV Q12H, (our clinical practice is 3 days before and 48 h after extubation of an infant suspected of having probable reactive airway edema)
- 0.1 mg/mL, 0.5mg/mL and 4 mg/mL syringe, prepared by Pharmacy
- 4 mg/mL, 5 mL vial
- 0.2mg/mL, 1 mg/mL oral solution, prepared by Pharmacy (refrigerate)
- Gomella TL (Ed): Neonatology - Management, Procedures, On-Call Problems, Diseases, Drugs, 1992, Appleton and Lange, Norwalk, Connecticut.
- Bhatt DR, Furman GI, Reber DJ et al: Neonatal Drug Formulary, 1990-1991, 2nd Edition, Fontana, California 92334.
- Knoppert DC and Mackanjee H: Current strategies in the Management of Bronchopulmonary Dysplasia - The Role of Steroids, Neonatal Network 1994;13:1-8.
- Mammel MC et al: Short-term dexamethasone therapy for bronchopulmonary dysplasia: Acute effects and l year followup, Developmental Pharmacology and Therapeutics 1987; 10:1-11.
- Cumming JJ, D'Eugenio DB and Gross SJ: A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia, New England Journal of Medicine 1989; 320:1505-1510.
- Noble - Jamieson CM, Roger R and Silverman M: Dexamethasone in neonatal chronic lung disease - pulmonary effects and intracranial complications, European Journal of Pediatrics 1989; 148:365-367.