Page 164 - 2022 Ranger Medic Handbook

DEXAMETHASONE (DECADRON)
Class: Hormones and synthetic substitutes – steroid; adrenocorticoid; glucocorticoid
Action: Long-acting synthetic adrenocorticoid with intense glucocorticoid activity and minimal mineralocorticoid
activity; Anti-inflammatory and immunosuppression properties; prevents accumulation of inflammatory cells at sites
of infection; inhibits phagocytosis, lysosomal enzyme release, and synthesis of selected chemical mediators of inflam-
mation; reduces capillary dilation and permeability
Dose: 0.25–4mg PO bid–qid; 8–12mg IM/IV q1–3wk. AMS: 4mg qid; HACE: Initial: 8mg as a single dose; Mainte-
nance: 4mg PO qid until symptoms resolve
Onset/Peak/Duration: Onset hours/Peak in 8–12 hours/Duration 72 hours
Indications: For inflammatory conditions, allergic states, and cerebral edema
Contraindications: Systemic fungal infection, acute infections, tuberculosis, vaccinia, varicella, live virus vaccines (to
patient, family members), amebiasis; pregnancy category caution advised during pregnancy and consider alternative
while breastfeeding
Adverse/Side-effects: Euphoria, insomnia, convulsions, increased ICP, vertigo, headache, psychic disturbances;
SECTION 4 CHF, hypertension, edema; hyperglycemia; cushingoid state; hirsutism; cataracts, increased IOP, glaucoma, exoph-
thalmos; peptic ulcer or perforation, abdominal distension, nausea, increased appetite, heartburn, dyspepsia, pan-
creatitis, bowel perforation, oral candidiasis; muscle weakness, loss of muscle mass, vertebral compression fracture,
pathologic fracture of long bones, tendon rupture; acne, impaired wound healing, petechiae, ecchymoses, diaphore-
sis, dermatitis, hypo- or hyperpigmentation, skin atrophy
Interactions: May inhibit antibody response to vaccines and toxoids
Mission Impact: GROUNDING medication for personnel on flight status.
K9 Dosage: 3–4mg (0.5mg/kg) IV/IM

DEXTROSE (D50)
Class: Endocrine agent – caloric, monosaccharide
Action: Needed for adequate utilization of amino acids, decreases protein and nitrogen loss, and prevents ketosis
Dose: 0.5–1g/kg (1–2mL/kg) up to 25g (50mL) of 50% solution IV; if tolerating PO, provide glucose tabs
Indications: For treatment of hypoglycemic episode
Contraindications: Hyperglycemia, delirium tremens, cranial or spinal hemorrhage, CHF
Adverse/Side-effects: Confusion, loss of consciousness, dizziness; hypertension, CHF, pulmonary edema; glyco-
suria, osmotic diuresis; hyperglycemia, rebound hypoglycemia; chills, flushing, rash, urticaria
Interactions: No clinically significant interactions established

150 SECTION 4 RANGER MEDIC PHARMACOLOGY & FORMULARY