DEXAMETHASONE SODIUM PHOSPHATE

Dexamethasone DBL, Decadron

 Reviewed by Dr Carl Kuschel, Brenda Hughes, and Robyn Wilkinson
November 2002
DART schedule introduced November 2005
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

Management of Dexamethasone Administration

Description

Prescription

Administration

Slow IV Push

  1. Dilution not required. For dose volumes <0.05 ml dilute to 1mg/ml immediately prior to use by adding to NS or D5W using our usual dilution method.
  2. Filter prior to administration through a 0.2 micron filter.
  3. Administer by slow IV injection over 1-2 minutes.
  4. Compatible with D5W and NS.
  5. Do NOT mix with other drugs, IV solution, blood or blood products.
  6. Flush line with NS before and after administration of dexamethasone.

Oral

  1. Shake the bottle well. This mixture is in suspension, therefore the ingredients will settle to the bottom of the bottle on standing.
  2. Administer after milk.
  3. When dose is <0.05 ml dilute to 1 mg/5 ml.
    1. Measure 1 ml of dexamethasone oral suspension 1 mg/ml. Dispense this into an empty 5 ml syringe.
    2. Measure 4 ml of water for injection and add this to the measured dexamethasone.
    3. Mix well.
    4. Draw dose from this.
    5. Discard after use.

Nursing Considerations

  1. Observe for signs of adverse reactions.
  2. Monitor blood pressure 2-3 times daily.
  3. Test for glycosuria daily. If urine is positive for sugar, check each urine.
  4. Observe gastric aspirates and stools for bleeding.
  5. Observe closely for signs of infection.

Storage

IV Solution

Oral suspension

Store at room temperature <25°C

Unopened - store in the refrigerator until expiry

Protect from light and freezing

Opened - Expires 7 days from opening

Storage after use nil

  

References

1 Doyle LW, Davis PG, Morley CJ, McPhee A, Carlin JB, and the DART study invetigators.  Low-dose dexamethasone facilitates extubation among chronically ventilator-dependent infants: a multicenter, international, randomized, controlled trial.  Pediatrics 2006;117:75-83.
2 Cummings JJ, D'Eugenio DB, Gross SJ. A controlled trial of dexamethasone in preterm infants at high risk for bronchopulmonary dysplasia. N Engl J Med 1989; 320:1505-10.
3 Durand M, Sardesai S, McEvoy C. Effects of early dexamethasone therapy on pulmonary mechanics and chronic lung disease in very low birthweight infants: A randomised controlled trial.  Pediatrics 1995; 95:584-590.
4 Collaborative Dexamethasone Trial Group: Dexamethasone therapy in neonatal chronic lung disease: An international placebo-controlled trial. Paediatrics 1991; 88:421-7.
5 Rizi ZB, Aniol HS, Myers TF, Zelter WP, Fisher SG, Anderson CL. Effects of dexamethasone on the hypothalamic - pituitary - adrenal axis in preterm infants. J Pediatr 1992; 120:961-5.
6 Couser RJ, Ferrara B, Falde B, Johnson K, Schilling CG, Hoekstra RE. Effectiveness of dexamethasone in preventing extubation failure in preterm infants at increased risk for airway oedema. J Pediatr 1992; 121:591-6.
7 Doyle LW, Davis PG. Postnatal corticosteroids in preterm infants: systematic review of effects on mortality and motor function.  J Paediatr Child Health 2000; 36(2): 101-107.
8 Halliday HL , Ehrenkranz RA. Moderately early (7-14 days) postnatal corticosteroids for preventing chronic lung disease in preterm infants (Cochrane Review). In: The Cochrane Library, Issue 3, 2000. Oxford: Update Software. 
9 Halliday HL , Ehrenkranz RA. Early postnatal ( <96 hours) corticosteroids for preventing chronic lung disease in preterm infants (Cochrane Review). In: The Cochrane Library, Issue 3, 2000. Oxford: Update Software. 
10 Halliday HL , Ehrenkranz RA. Delayed ( >3 weeks) postnatal corticosteroids for chronic lung disease in preterm infants (Cochrane Review). In: The Cochrane Library, Issue 3, 2000. Oxford: Update Software.
11 Odd DE, Armstrong DL, Teele RL, Kuschel CA, Harding JE.  A randomized trial of two dexamethasone regimens to reduce side-effects in infants treated for chronic lung disease of prematurity.  J Paediatr Child Health 2004;40:282-9.
12 Doyle LW. Halliday HL. Ehrenkranz RA. Davis PG. Sinclair JC.  Impact of postnatal systemic corticosteroids on mortality and cerebral palsy in preterm infants: effect modification by risk for chronic lung disease.  Pediatrics 2005;115(3):655-61.