Dexamethasone is an artificially produced active substance belonging to the group of glucocorticoids. In the human body, natural glucocorticoids (hormones) are produced in the adrenal cortex and fulfil a variety of regulatory tasks. The synthetic glucocorticoid dexamethasone has an inhibitory effect on inflammation and the immune system.
Compared to the hormones produced in the adrenal gland, its effectiveness is increased by a factor of 25. Taking dexamethasone generally has a throttling effect on the production rate of the adrenal cortex. This means that the higher the dexamethasone concentration in the organism, the lower the glucocorticoid synthesis in the cells of the adrenal cortex. This interaction can be used effectively in medical diagnostics.
Fields of application
Dexamethasone fulfils a wide range of functions in the human organism and can therefore be used in many different ways:
- On the one hand it has an anti-inflammatory effect, but on the other hand it has a strong inhibitory effect on the immune system. – In addition, the active ingredient dexamethasone is able to stabilise cell walls and alleviate the symptoms of an allergic reaction. – Furthermore, dexamethasone has a soothing effect on gastrointestinal problems such as nausea and vomiting.
- It is used for the acute treatment of accidents involving the inhalation of toxic fumes, gases or smoke and the resulting accumulation of water in the lungs (toxic edema). – It can also be used to treat water retention in the brain (brain edema). The active ingredient can also be used to compensate for a hormone deficiency (cortisol) in the organism. – In cases of severe allergic reactions and/or a prolonged asthma attack, the administration of dexamethasone can achieve considerable therapeutic success. – The most medically relevant area of application, however, is the exclusion or diagnosis of the Cushing syndrome by means of a dexamethasone inhibition test (or dexamethasone suppression test).
Action of dexamethasone
Dexamethasone is an active substance from the group of corticosteroids or glucocorticoids, which also includes the best-known representative cortisone. Dexamethasone has anti-inflammatory and immunosuppressive effects, i.e. it suppresses the immune system. Dexamethasone is a very strong glucocorticoid, it has 30 times the potency of cortisone.
It is used to treat various diseases: In cerebral edema associated with a dangerous increase in intracranial pressure, for example, a brain tumour. In severe skin diseases with extensive skin infections such as erythroderma. In some autoimmune diseases such as lupus erythematosus or in acute attacks of vasculitis affecting the whole body.
In rheumatism with pronounced severe courses. In addition, in some lung diseases such as a severe asthma attack. In daily clinical practice, however, prednisolone is used significantly more frequently than dexamethasone – except for brain edema.
Dosage
The dosage cannot be given as a lump sum because it depends on the indication. Dexamethasone can be administered either orally or intravenously (via a venous access), depending on the clinical picture. For skin diseases, for example, it is often taken in tablet form. Here the daily dose is usually between 8 and 40 mg, in individual cases up to 100 mg can be given. The dose must be determined by the treating physician and can vary greatly.
