Adverse reactions of dexamethasone

Glucocorticoids, such as dexamethasone, have no obvious adverse reactions in the application of physiological dose replacement therapy, and most of the adverse reactions occur in the application of pharmacological dose, which is closely related to the course of treatment, dose, drug type, usage and route of administration. Common adverse reactions are as follows:

1. Long-term use can cause the following side effects: face and posture, weight gain, edema of lower limbs, purple stripes, bleeding tendency, poor wound healing, acne, menstrual disorder, ischemic necrosis of humerus or femoral head, osteoporosis and fracture (including vertebral compression fracture and pathological fracture of long bone), muscle weakness, muscle atrophy, hypokalemia, gastrointestinal irritation (nausea)

2. Patients may have mental symptoms: euphoria, excitement, delirium, anxiety, disorientation or inhibition. Mental symptoms include people who are prone to chronic wasting diseases and people who have mental disorders in the past.

3. Infection is the main adverse reaction of adrenocortical hormone. Mainly fungi, tuberculosis, staphylococcus, Proteus, Pseudomonas aeruginosa and various herpes viruses.

4. Glucocorticoid withdrawal syndrome. Sometimes patients have dizziness, fainting tendency, abdominal pain or backache, low fever, loss of appetite, nausea, vomiting, muscle or joint pain, headache, fatigue and weakness after stopping taking the drug. If careful examination can rule out adrenal hypofunction and recurrence of primary disease, it can be considered as glucocorticoid dependence syndrome.

Disorder of substance metabolism and water and salt metabolism Long-term and large-scale application of glucocorticoids can cause disorder of substance metabolism and water and salt metabolism, resulting in adrenocortical syndrome, such as edema, hypokalemia, hypertension, diabetes, skin thinning, full moon face, buffalo back, centripetal obesity, hirsutism, acne, myasthenia gravis, muscular atrophy, etc., which generally do not need special treatment and can subside automatically after stopping taking drugs. But the recovery of myasthenia is slow and incomplete. Measures such as low salt, low sugar and high protein diet and adding potassium chloride can alleviate these symptoms. In addition, glucocorticoid can delay the wound healing of trauma patients by inhibiting the synthesis of protein. In children, it can lead to negative nitrogen balance by inhibiting the secretion of growth hormone, thus affecting growth and development.

Glucocorticoid can inhibit the immune function of the body and has no antibacterial effect, so long-term application can often induce or aggravate the infection, which can spread the potential infection focus in the body or rekindle the static infection focus, especially for patients with decreased original resistance, such as nephrotic syndrome, tuberculosis, aplastic anemia and so on. Because patients often feel good about themselves when taking glucocorticoids, it masks the symptoms of infection development. Therefore, before deciding to take long-term treatment, they should check their bodies to eliminate potential infection, be vigilant in the application process, use effective antibacterial drugs when necessary, and pay special attention to the prevention and treatment of potential tuberculosis lesions.

Gastrointestinal complications can stimulate the secretion of gastric acid and pepsin, inhibit the secretion of gastric mucus and reduce the resistance of gastric mucosa, so it can induce or aggravate peptic ulcer, and glucocorticoid can also cover up the initial symptoms of ulcer, leading to sudden bleeding, perforation and other serious complications, which should be paid attention to. Long-term use will aggravate gastric or duodenal ulcer. This side effect is more likely to occur when combined with other drugs with gastric irritation (such as aspirin, indomethacin and butazolamide). A few patients can induce pancreatitis or fatty liver.

Long-term use of glucocorticoids to treat cardiovascular complications can lead to sodium and water retention and elevated blood lipids, which can induce hypertension and atherosclerosis.

Osteoporosis and vertebral compression fracture Osteoporosis and vertebral compression fracture are serious complications of glucocorticoid treatment for patients of all ages. Ribs and vertebrae have high beam-column structures and are usually the most seriously affected. This may be related to glucocorticoid inhibiting osteoblast activity, increasing calcium and phosphorus excretion, inhibiting intestinal calcium absorption and increasing the sensitivity of bone cells to parathyroid hormone. If osteoporosis occurs, the drug must be stopped. D (To prevent and treat osteoporosis, vitamin D, calcium salt and anabolic steroids from protein should be supplemented.

If taken in large quantities, it is easy to cause diabetes and class library syndrome. Long-term use is more likely to cause mental symptoms and psychosis. If you have a hypothetical history and a history of mental illness, it is best not to use it. Patients with ulcer, thrombophlebitis, active pulmonary tuberculosis and intestinal anastomosis should not use it or use it with caution. For other precautions, please refer to the application precautions of this kind of drugs. Specification: 1. Demisone acetate tablets: 0.75 mg per tablet. Dexamethasone sodium phosphate injection: 1mg( 1ml), 2mg( 1ml) and 5mg( 1ml) respectively.

Glucocorticoid dexamethasone, commonly known as "skin opium", is a banned ingredient in cosmetics. When consumers use cosmetics containing dexamethasone, their skin will feel obviously better at first, but long-term use will not only lead to dependence, but also lead to dermatitis and even various diseases.