Reduce tumor capillary permeability, inflammatory cytotoxicity
Dexamethasone IV bolus 10-20mg on initial presentation
Followed by 4mg IV q6hrs
PO and IV dosing equivalent bioavailability
May see improvement within 12-48hrs
Complications:
GI bleeds - ensure GI prophylaxis
Osteoporosis - avoid in pathologic fracture
Neuropsychiatric - avoid in acute psychosis
Steroid myopathy - consider nonfluorinated steroids, such as prednisone, over dexamethasone
Followed by 4mg IV q6hrs
PO and IV dosing equivalent bioavailability
May see improvement within 12-48hrs
GI bleeds - ensure GI prophylaxis
Osteoporosis - avoid in pathologic fracture
Neuropsychiatric - avoid in acute psychosis
Steroid myopathy - consider nonfluorinated steroids, such as prednisone, over dexamethasone
Cerebral edema in brain cancer
Brain abscess
Brain herniation syndromes
Vertebral and carotid artery dissection
Moderate-to-severe traumatic brain injury
Posterior reversible encephalopathy syndrome
Primary CNS lymphoma
Neoplastic meningitis