What are the effects and side effects of dexamethasone?

Generally, dexamethasone is available in various formulations including tablets, creams, and injectable solutions. The effects of dexamethasone include anti-inflammatory action, suppression of immune responses, antitoxin effects, anti-shock properties, and relief of cerebral edema. Its side effects include increased risk of infection, gastrointestinal discomfort, endocrine system disturbances, changes in skin and appearance, osteoporosis, and fractures. A detailed analysis is as follows:

I. Therapeutic Effects of Dexamethasone

1. Anti-inflammatory

Dexamethasone inhibits the migration of inflammatory cells, such as neutrophils and monocytes, to inflamed areas, and reduces the synthesis and release of inflammatory mediators, such as prostaglandins and leukotrienes. This helps alleviate inflammatory responses and effectively relieves symptoms such as redness, swelling, heat, and pain. It is commonly used in the treatment of inflammatory diseases such as rheumatoid arthritis and rheumatic arthritis.

2. Immunosuppressive

Dexamethasone suppresses the proliferation and function of immune cells, thereby reducing immune responses. It is used in treating autoimmune diseases such as systemic lupus erythematosus and dermatomyositis, reducing the immune system's attack on the body's own tissues and alleviating disease symptoms.

3. Antitoxin

Dexamethasone enhances the body's tolerance to bacterial endotoxins, reduces the damage caused by endotoxins, stabilizes lysosomal membranes, decreases the release of endogenous pyrogens, and lowers the sensitivity of the thermoregulatory center to endogenous pyrogens, thus exerting antipyretic effects and helping alleviate systemic toxic symptoms such as fever in patients with infectious diseases.

4. Anti-shock

Through mechanisms such as enhancing myocardial contractility, improving microcirculation, and stabilizing lysosomal membranes, dexamethasone can be used in the treatment of septic shock and anaphylactic shock, improving patient survival rates.

5. Relief of Cerebral Edema

Dexamethasone reduces edema in brain parenchymal cells and lowers intracranial pressure. It is commonly used for cerebral edema caused by cranial trauma or brain tumors, helping alleviate symptoms such as headache and vomiting.

II. Side Effects of Dexamethasone

1. Increased Risk of Infection

As an immunosuppressant, dexamethasone may reduce the patient's immunity, making them more susceptible to infections caused by pathogens such as fungi, bacteria, and viruses. This risk is further increased with long-term or high-dose use.

2. Gastrointestinal Discomfort

Dexamethasone may irritate the gastrointestinal tract, causing symptoms such as nausea, vomiting, stomach pain, and indigestion. In severe cases, it may even induce pancreatitis, peptic ulcers, or gastrointestinal bleeding.

3. Endocrine System Disturbances

Long-term use of dexamethasone may interfere with normal endocrine function, leading to a series of endocrine disorders. For example, it may suppress the hypothalamic-pituitary-adrenal axis, resulting in adrenal insufficiency; it may also affect glucose metabolism, elevate blood sugar levels, and increase the risk of diabetes.

4. Skin and Appearance Changes

Long-term use of dexamethasone may cause thinning and dryness of the skin, increased susceptibility to injury, and may lead to facial acne and skin pigmentation. These symptoms may have negative psychological effects on patients.

5. Osteoporosis and Fractures

Dexamethasone inhibits osteoblast activity, reduces bone formation, and promotes bone resorption, leading to bone loss, increased risk of osteoporosis, and a higher likelihood of fractures, especially in areas such as the vertebrae and hips.

When using dexamethasone, patients should strictly follow medical instructions and appropriately adjust the dosage and duration of treatment according to their condition. If any adverse symptoms occur, they should promptly inform their physician for evaluation and management.