Dexamethasone (EENT)
Kelas obat: Agen Antineoplastik
Panganggone Dexamethasone (EENT)
Inflamasi Ophthalmic
Relief gejala saka kondisi inflamasi responsif kortikosteroid saka konjungtiva palpebra lan bulbar, kornea, lan segmen anterior globe (contone, konjungtivitis alergi, acne rosacea, keratitis punctate superficial, herpes zoster keratitis, iritis, siklitis, konjungtivitis infektif sing dipilih).
Pengobatan uveitis anterior kronis.
Pengobatan cedera kornea saka bahan kimia, radiasi, utawa kobong termal utawa penetrasi benda asing.
Infeksi Ophthalmic Bakteri
Digunakake kanggo sifat anti-inflamasi bebarengan karo terapi anti-infèksi sing cocok ing sawetara infeksi bakteri ing mripat; digunakake ing kombinasi tetep karo neomycin lan polymyxin B sulfat utawa tobramycin nalika terapi kombinasi kasebut dituduhake. Yen kortikosteroid ophthalmic digunakake ing kombinasi karo anti-infèksi ophthalmic, nimbang keuntungan saka risiko. (Deleng Infeksi ing Caution.)
Inflamasi Otik
Ngilangake gejala saka kondisi inflamasi sing responsif kortikosteroid ing saluran kuping (contone, otitis eksterna alergi).
Infeksi Otik Bakteri
Digunakake kanggo sifat anti-inflamasi bebarengan karo ciprofloxacin kanggo perawatan otitis eksterna akut lan ing pasien pediatrik karo tabung tympanostomy kanggo otitis media akut.
Digunakake kanggo nyuda edema lan inflamasi ing sawetara kasus otitis eksterna infèksi purulen lan nonpurulen.
Yen kortikosteroid digunakake piyambak utawa digabungake karo anti-infektif otik, timbang keuntungan saka risiko. (Deleng Infeksi ing Caution.)
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Carane nggunakake Dexamethasone (EENT)
Administrasi
Olesake ing mripat utawa kuping.
Administrasi Ophthalmic
Olesake topikal ing mripat minangka salep, larutan, utawa suspensi ophthalmic.
Ora kanggo injeksi.
Goyang suspensi sadurunge digunakake.
Singkirake kontaminasi wadhah persiapan.
Aja menehi solusi utawa suspensi sing ngandhut benzalkonium klorida nalika nganggo lensa kontak alus. Enteni ≥15 menit sawise instilling tetes sadurunge masang lensa kontak. (Deleng Saran kanggo Pasien.)
Administrasi Otik
Olesake topikal menyang kuping minangka suspensi otic utawa solusi ophthalmic.
Ora kanggo injeksi. Aja nglebokake preparat otik ing mripat.
Bisa nggunakake solusi mata deksametason natrium fosfat ing kuping.
Goyang suspensi sadurunge digunakake.
Kanggo ngindhari pusing sing bisa disebabake saka nyisipake preparat kadhemen menyang kuping, anget preparat kasebut kanthi nyekel botol ing tangan nganti 1-2 menit sadurunge administrasi.
Kalen kuping sing resik lan garing sadurunge kanggo administrasi; pH preparat otik kudu netral utawa ngandhut asam.
Gorong karo kuping sing kena munggah lan nyelehake tetes. Kanggo pasien pediatrik kanthi otitis media lan tabung tympanostomy, pompa tragus kaping 5 kanggo nggampangake penetrasi tetes menyang kuping tengah. Kanggo otitis eksterna akut, tarik cuping kuping njaba munggah lan mundur kanggo nggampangake mlebune obat menyang saluran kuping.
Tetepake kuping sing kena pengaruh munggah nganti ≥60 detik sawise administrasi obat. Yen perlu, baleni prosedur kanggo kuping ngelawan.
Gunakake kortikosteroid otik kanthi sithik kanggo nyegah akumulasi lebu sing berlebihan ing saluran kuping.
Dosis
Kasedhiya komersil piyambak utawa ing kombinasi tetep karo anti-infèksi; kasedhiya minangka Dexamethasone utawa dexamethasone sodium fosfat. Solusi kasedhiya minangka dexamethasone sodium fosfat; dosis ditulis ing syarat-syarat dexamethasone fosfat.
Pasien Pediatrik
Infeksi Ophthalmic BakteriSuwene terapi gumantung saka jinis lan keruwetan penyakit lan respon kanggo therapy. Aja mandheg kanthi prematur.
Nalika mandhegake terapi, alon-alon nyuda frekuensi dosis kanggo nyegah eksaserbasi penyakit.
Dexamethasone 0,1% lan Tobramycin 0,3% Suspensi OphthalmicBocah umur ≥2 taun: Awal 24-48 jam, 1 utawa 2 tetes menyang kantung konjungtiva mata sing kena pengaruh saben 2 jam. Banjur, 1 utawa 2 tetes saben 4-6 jam. Kurangi frekuensi dosis kanthi bertahap amarga infèksi saya mundhak.
Salep OphthalmicBocah ≥2 taun: Lebokake pita 1,25 cm menyang kantung konjungtiva mata sing kena pengaruh nganti kaping 3 utawa 4 saben dina.
Infeksi Otik Bakteri Suspensi Otitis Eksterna Akut (Deksametason 0,1% lan Ciprofloxacin 0,3%)Bocah ≥6 sasi: 4 tetes menyang kuping sing kena pengaruh kaping pindho saben dina suwene 7 dina.
Suspensi Otitis Media Akut (Dexamethasone 0,1% lan Ciprofloxacin 0,3%)Bocah ≥6 sasi umur karo tabung tympanostomy: 4 tetes menyang kuping sing kena pengaruh kaping pindho saben dina suwene 7 dina.
Dewasa
Inflamasi Ophthalmic lan Infeksi BakteriSuwene terapi gumantung saka jinis lan keruwetan saka penyakit lan respon kanggo therapy. Aja mandheg prematur.
Nalika mungkasi terapi, alon-alon nyuda frekuensi dosis kanggo nyegah eksaserbasi penyakit.
Dexamethasone 0,1% Suspensi OphthalmicKanggo inflamasi ringan: 1 utawa 2 tetes menyang konjungtiva kantung mripat sing kena nganti 4-6 kaping saben dina.
Kanggo inflamasi sing abot: 1 utawa 2 tetes menyang kantung conjunctival saka mripat sing kena saben jam. Frekuensi dosis lancip nalika inflamasi suda.
Dexamethasone Sodium Phosphate 0,1% Solusi OphthalmicKaping pisanan, 1 utawa 2 tetes menyang kantung konjungtiva mata sing kena pengaruh saben jam ing wayah awan lan saben 2 jam ing wayah wengi . Yen respon sing apik ditindakake, nyuda nganti 1 tetes saben 4 jam. Bisa nyuda dadi 1 tetes 3 utawa 4 kaping saben dina kanggo ngontrol gejala.
Deksametason 0,1%, Neomycin 0,35%, lan Polymyxin B Sulfates 10.000 unit Suspensi OphthalmicKanggo inflamasi ringan: 1 utawa 2 tetes menyang kantung conjunctival saka mripat sing kena pengaruh nganti 4-6 kaping saben dina.
Kanggo inflamasi abot: 1 utawa 2 tetes menyang kantung konjungtiva saka mripat sing kena pengaruh saben jam. Nalika inflamasi suda, mboko sithik nyuda frekuensi dosis kanggo mandheg.
Ophthalmic OintmentLebokna pita 1,25 cm menyang kantung konjungtiva mata sing kena pengaruh nganti 3 utawa 4 kaping saben dina.
Deksametason 0,1% lan Tobramycin 0,3% Suspension OphthalmicKawitan 24-48 jam, 1 utawa 2 tetes menyang kantung conjunctival saka mripat sing kena pengaruh saben 2 jam; sakwise, 1 utawa 2 irungnya saben 4 kanggo 6 jam. Kurangi frekuensi dosis kanthi bertahap amarga infeksi saya mundhak.
Ophthalmic OintmentLebokake pita 1,25 cm menyang kantung konjungtiva saka mripat sing kena pengaruh nganti 3 utawa 4 kaping saben dina.
Otic Inflammation Dexamethasone Sodium Fosfat 0,1% Solusi Ophthalmic OticKaping pisanan, 3 utawa 4 tetes larutan ophthalmic menyang saluran kuping 2 utawa 3 kaping saben dina. Bisa nyuda frekuensi dosis nalika gejala saya tambah. Taper obat kasebut kanthi bertahap nalika mandheg.
Utawa, sumbu katun sing jenuh karo larutan ophthalmic bisa dilebokake ing saluran kuping; njaga wick lembab kanthi solusi ophthalmic; copot wick jenuh saka kuping sawise 12 nganti 24 jam. Baleni maneh yen perlu.
Suwene perawatan bisa sawetara dina nganti pirang-pirang minggu.
Infeksi Otik Bakteri: Otitis Externa Akut Dexamethasone 0,1% lan Ciprofloxacin 0,3% Otic4 tetes menyang kuping sing kena pengaruh. ) kaping pindho saben dina kanggo 7 dina.
Populasi Khusus
Ora ana rekomendasi dosis populasi khusus ing wektu iki.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Efek Okular
Risiko glaukoma kanthi kemungkinan karusakan ing saraf optik, cacat ing ketajaman visual lan lapangan penglihatan, lan pembentukan katarak subkapsular posterior kanthi nggunakake kortikosteroid sing dawa. Gunakake kanthi ati-ati ing pasien glaukoma amarga IOP bisa nambah.
Yen digunakake nganti ≥10 dina, ngawasi IOP kanthi rutin sanajan pemantauan bisa uga angel kanggo bocah lan pasien sing ora kooperatif.
Ing kahanan sing nyebabake penipisan kornea utawa sclera, perforasi dilapurake kanthi nggunakake kortikosteroid topikal.
Panganggone kortikosteroid dosis dhuwur bisa nundha penyembuhan. Gunakake sawise operasi katarak bisa nundha penyembuhan lan nambah insiden pembentukan bleb.
InfèksiPenggunaan sing dawa bisa nyuda respon host lan kanthi mangkono nambah risiko infeksi okular sekunder.
Ing kondisi purulen akut ing mripat utawa kuping, kortikosteroid bisa nutupi infeksi utawa nambah infeksi sing ana. (Deleng Contraindications ing Cautions.)
Herpes SimplexPanganggone kortikosteroid ing perawatan saka infèksi herpes simplex liyane saka epithelial herpes simplex keratitis, kang kortikosteroid sing contraindicated, mbutuhake ati-ati banget; mikroskopi slit-lamp periodik penting.
Pancegahan Umum
Evaluasi Kondisi OkularResep awal utawa nganyari maneh pesenan obat ngluwihi 8 g salep 0,1% utawa 20 ml suspensi 0,1% kudu diwenehake mung sawise pemeriksaan pasien kanthi bantuan perbesaran (contone, biomikroskopi lampu irisan, pewarnaan fluorescein yen cocog).
Infeksi JamurAplikasi kortikosteroid lokal jangka panjang sing digandhengake karo perkembangan infeksi jamur ing kornea. Coba kemungkinan infeksi jamur ing pasien kanthi ulcerasi kornea sing terus-terusan sing wis utawa lagi nampa terapi kortikosteroid.
Reepitelialisasi KorneaPanganggone salep ophthalmic bisa nyuda tingkat reepitelialisasi kornea.
Panganggone Kombinasi TetepYen digunakake ing kombinasi tetep karo ciprofloxacin, neomycin lan polymyxin B sulfates, utawa tobramycin, nimbang ati-ati, pancegahan, lan kontraindikasi sing gegandhengan karo agen sing bebarengan.
Populasi Spesifik
KandhutanKategori C.
LaktasiOra dingerteni manawa administrasi topikal kortikosteroid bisa nyebabake penyerapan sistemik sing cukup kanggo ngasilake jumlah sing bisa dideteksi ing susu.
Ati-ati yen digunakake ing wanita sing nyusoni.
Dexamethasone sodium fosfat ophthalmic solution lan dexamethasone ing kombinasi tetep karo ciprofloxacin suspension otic: Produsen nyaranake kanggo mungkasi nyusoni utawa obat kasebut.
Panggunaan PediatrikAman lan khasiat suspensi deksametason ophthalmic utawa larutan natrium fosfat deksametason durung ditetepake.
Aman lan khasiat deksametason ophthalmic ing kombinasi tetep karo neomycin lan polymyxin B sulfates ora ditetepake.
Aman lan khasiat dexamethasone ophthalmic ing kombinasi tetep karo tobramycin ora ditetepake ing bocah-bocah <2 taun.
Keamanan lan khasiat suspensi dexamethasone otic ing kombinasi tetep karo ciprofloxacin ora ditetepake ing bayi <6 sasi.
Panggunaan GeriatrikOra ana bedane signifikan ing safety utawa khasiat relatif kanggo pasien sing luwih enom.
Efek Umum sing Sabar
Pemberian Ophthalmic: TIO munggah pangkat, pembentukan katarak subkapsular posterior, karusakan saraf optik, penyembuhan tatu sing tundha.
Pemberian otik: nyeri kuping, nyeri kuping, pruritus kuping.
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