Anti-inflammatory. 

Glucorticoids include - Short acting- Cortisone, Hydrocortisone Intermediate acting - Prednisolone, Triamcinolone, Methylprednisolone Long acting- Dexamethasone, Betamethasone Refer- Dexamethasone 

Abrupt withdrawal leading to acute adrenal insufficiencymanifasting as malaise, weakness, mental changes,muscle and joint pains, dysponea, hypoglycaemia, hypotension, dehydration and death.

Rapid I.V. injection may cause cardiovascular collapse. Sodium and fluid retension. Potasium and calcium depletion. Muscle wasting, weakness, osteoporosis

. GI disturbances and bleeding. Increased appetite and delayed wound healing. Bruising, straie, hirsutism, acne, flushing.

Raised intracranial pressure, headache, depression,psychosis, menstrual irregularities. Hyperglycaemia, glycosuria, activation of latent diabetes mellitus,obesity, moon face, buffulo hump. Suppression of pituitary-adreocortical system.

Growth retardation in children(prolonged therapy). Increased susceptibility for infection. Tropical use: Dermal atrophy, local irritation, folicutilis, hypertrychosis.

HPA axis supression when used on large parts for prolonged time. Inhaled cortocosteroids: May cause hoarseness, candidiasis of mouth and throat, dysponea, pulmonary infiltrates.

Topical application to eye: Can produce corneal ulcers, raised intraocular presssure and reduced visual function.

Intralesional injection: Local hypopigmentation of deeply pigmented skin. Intra-artricular injection: Joint damage, fibrosis especially in load bearing joints.

For replacement therapy no contraindication except allergy. For anti inflammatory uses Peptic ulcer,osteoporosis, psychosis, psychoneurosis, acute infections.

Special precautions:

CCF, hypertension, diabetes, epilepsy, CRF, elderly, regular monitoring of patients on long term therapy. Gradual withdrawal.

Indications:

Anti-inflammatory.

Dosage:

For intralesional, intra-aerticular or soft tissue injections- 25mg, occassionally 37.5mg Small joints- 10 to 25mg

For Availability/supplies 

Anaphylaxis - ( 342 )

Definition- Life trhreatening anaphylactic response of a sensitized human apears withi minutes after administration of specific antigen andis manifested by respiratory distress, often followed by vascular collapse or shock without antecedent respiratory difficulty. Cutanious manifestation exemplified by pruritus and urtcicaria with or without angioedema are cgaracterstic of such sysyemic anaphylactic reactions.

Treatment- Early recognition of an anaphylactic reaction is mandatory since death occurs within minutes to hours after the first symptoms. Mild symptoms such as pruritus and urticaria can be controlled by administration of 0.2 to 0.5ml of 1:1000 epinephrine subcutaneously with repeated doses as required at 3 min interval for a severe reaction.

Drugs causing adverse reaction- anaphylaxis

1. Bromosulphothalein

2. Penicillins

3. Cephalosporins

4. Streptomycin

5. Dexrtran

6. Iron dextran

7. Procaine

8. Insulin

9. Democycline

10. Iodinated drugs or contrast media

11. Lidocine

Refer- Dexamethasone

Refer Dexamethasone

Refer Dexametrhasone

Refer Dexamethasone