dexAMETHasone

Indication

A corticosteroid used to reduce airway or lung inflammation to facilitate extubation. May also be used to prevent bronchopulmonary dysplasia (BPD) in patients assessed to be at significant risk of moderate to severe BPD.

Dosage Guidelines

Airway Edema and planned Extubation: 0.25 - 0.5 mg/kg/dose IV/ORAL q12 hours; start 12 to 24 hours prior to extubation and continue for 2 to 4 doses afterward

Administration

IV intermittent slow infusion over 30 minutes
IV direct given slowly over 3-5 minutes
ORAL: give with feeds to minimize gastric irritation
Administer at standard times of 1000h and 2200h

Adverse Effects

Glucose intolerance, hypertension, sinus bradycardia, irritability
Potiential complications include infections, growth impairment, GI bleeding, adrenal cortical suppression, adverse neurodevelopmental outcomes (doses higher than 0.5 mg/kg/day)
Gastrointestinal irritation; administer ORAL dose with enteral feed as able
Do not give concurrently with ibuprofen (increased risk of GI hemorrhage and perforation)

Comments

monitor infant's weight, blood pressure and serum glucose
DO NOT give to infants on ibuprofen as there is a significant risk of GI bleeding and/or perforation. Ensure there is a 48-72 hour period between finishing ibuprofen and starting steroids.

Supplied As

0.2mg/mL IV syringe prepared by Pharmacy for doses less than 0.8 mg
4 mg/mL IV syringe, 5 mL vial for IV doses larger than 0.8 mg
0.2 mg/mL or 1 mg/mL oral suspension

References

Lexicomp, Neofax, CPS July 2020 Position Statement on Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia in preterm infants