Dexamethasone Affected to COVID-19

Dexamethasone is a synthetic (man-made) corticosteroid. Corticosteroids are naturally occurring chemicals produced by the adrenal glands above the kidneys. Corticosteroids affect the function of many cells inside the body and suppress the immune system. Corticosteroids also prevent inflammation and are widely used in inflammatory diseases affecting many organs. The FDA approved dexamethasone in October 1958.

A major study of about 7,000 patients in the UK in June 2020 made dexamethasone the standard of care for COVID-19 patients with a high need for oxygen with symptoms. Researchers have shown that dexamethasone ventilators can save the life of one in eight patients and supplemental oxygen (not internal) can save the lives of one in 25 patients, according to the MedsePak Medical Reference.

Dexamethasone is used in many situations to reduce inflammation. Some examples include:

1. Rheumatoid arthritis,
2. Systemic lupus,
3. Acute gouty arthritis,
4. Psoriatic arthritis,
5. Ulcerative colitis
6. Crohn's disease.

Chronic allergic and inflammatory conditions of the uvea, iris, conjunctiva, and optic nerves of the eyes also are treated with dexamethasone.

Dexamethasone is used in the treatment of cancers of the white blood cells (leukemias), and lymph gland cancers (lymphomas). Blood diseases involving destruction by the body's own immune system of platelets are also treated with dexamethasone, disease like idiopathic thrombocytopenic purpura, and red blood cells (autoimmune hemolytic anemia.

As an Inflammatory Drug:

Dexamethasone also used in conditions like inflammatory and autoimmune, such as rheumatoid arthritis and bronchospasm. Idiopathic thrombocytopenic purpura, a decrease in platelet count due to an immune problem, responds to 40 mg daily for four days. It can be arranged in 14-day cycles. It is not clear whether dexamethasone is significantly better than other glucocorticoids in this condition.

• It is also given in small amounts before and/or after dental surgery, such as tooth extraction, an operation in which the patient often leaves the swollen cheeks.
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• It is injected into the heel when treating plantar fasciitis, sometimes in combination with tramadol.
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• It is useful to treat allergic anaphylactic shock if given in large quantities.
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• It is present in certain eye drops - especially after eye surgery - and as a nasal spray (trade name Dexacort), and some ear drops (Sofredex, when combined with antibiotics and antifungals) ۔ Dexamethasone intrauterine steroid implants (trade name Ozordex) have been approved by the FDA to treat ocular conditions such as diabetes mellitus, central retinal vein obstruction, and uveitis.

Dexamethasone is used in the transcranial screw-in cardiac pacing to minimize the inflammatory response of the myocardium. As the screw expands, the steroid is released into the myocardium and can play an important role in minimizing severe packing thresholds due to a reduction in the inflammatory response. The normal amount of lead tip is less than 1.0 mg.

In cases of bacterial meningitis, dexamethasone can be administered before antibiotics. It works to reduce the body's inflammatory response to bacteria killed by antibiotics (bacterial death releases inflammatory mediators that can cause reactions that are harmful), thus hearing loss. And reduces nerve damage.

Used in Cancer:

Cancer patients undergoing chemotherapy are often given dexamethasone to counteract some of the side effects of antitumor treatment.

Dexamethasone may enhance the antiemetic effect of 5-HT3 receptor antagonists, such as ondansetron.

The exact mechanism of this interaction is not well defined, but it has been speculated that this effect may be due, among many other reasons, to the prevention of prostaglandins.

Synthesis, anti-inflammatory effects, immunosuppressive effects, decreased release of endogenous opioids, or a combination of the above.

In brain tumors (primary or metastatic), dexamethasone is used to develop edema, which can eventually, compress other brain structures.

It is also applied to the bone under pressure, where the tumor is compressing the spinal cord.

Dexamethasone is also used as a direct chemotherapeutic agent in certain hematological disorders, especially in the treatment of multiple myeloma, in which dexamethasone alone or in combination with other chemotherapeutic

(Velcade, Valdez), or a combination of doxorubicin (adriamycin) and vincristine or bortezomib/lenalidomide/dexamethasone.

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