Dexametazon

Dexametazon, or dexamethasone in international terminology, is a potent synthetic glucocorticoid corticosteroid used for its anti-inflammatory and immunosuppressive properties. It exerts its effects by modulating gene expression to reduce inflammatory mediators, inhibit leukocyte migration, and suppress phospholipase A2, which lowers production of prostaglandins and leukotrienes. Compared with many other glucocorticoids, dexamethasone has minimal mineralocorticoid activity.

Dexametazon can be administered by several routes, including oral, intravenous, intramuscular, topical, and ophthalmic forms. It is characterized by high oral bioavailability and extensive hepatic metabolism, largely via the CYP3A4 system. The drug has a relatively long biological half-life among glucocorticoids, contributing to a duration of action that supports once-daily dosing in many regimens, though exact schedules depend on the condition being treated. Tissue distribution includes many sites of inflammation and immune activity.

Indications cover a broad range of inflammatory and autoimmune disorders, such as rheumatoid arthritis, inflammatory bowel disease, dermatitis, and asthma or COPD exacerbations. It is also used to treat cerebral edema, prevent chemotherapy-induced nausea and vomiting, and serve as an adjunct in certain hematologic and oncologic conditions. In some guidelines, dexamethasone is used in the management of severe COVID-19 to reduce mortality in patients requiring oxygen or ventilation.

Adverse effects may arise with short- or long-term use and include hyperglycemia, increased infection risk, osteoporosis, hypertension, fluid retention, mood changes, and gastrointestinal ulcers. Long-term therapy can suppress the hypothalamic-pituitary-adrenal axis and requires careful tapering to prevent withdrawal symptoms. Pregnancy and vaccination considerations require clinical judgment, as with other systemic corticosteroids.