Bethamethasone Drug Study

Friday, February 20, 2009

In making a Drug Study, the following elements must be present: Generic Name and the Brand name (not all brands, just the brand used by the patient), Action, Indication, Pregnancy Category, Drug Classification, and Contraindication, Adverse Effect, Drug interaction and Nursing Consideration/Intervention…. Most clinical instructors preferred this to be in a long bond paper in printed or handwritten with paper in landscape.

Betamethasone

Brand Name: betamethasone benzoate, Topical dermatologic ointment, cream, lotion, gel: Bepen (CAN), Uticort, betamethasone dipropionate

Pregnancy Category C

Drug classes: Corticosteroid (long acting), Glucocorticoid, Hormonal agent


Therapeutic actions

Binds to intracellular corticosteroid receptors, thereby initiating many natural complex reactions that are responsible for its anti-inflammatory and immunosuppressive effects.


Indications

• Systemic administration: Hypercalcemia associated with cancer
• Short-term management of inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (SLE), dermatologic diseases (pemphigus), status asthmaticus, and autoimmune disorders
• Hematologic disorders: thrombocytopenia purpura, erythroblastopenia
• Ulcerative colitis, acute exacerbations of multiple sclerosis, and palliation in some leukemias and lymphomas
• Trichinosis with neurologic or myocardial involvement
• Unlabeled use: Prevention of respiratory distress syndrome in premature neonates
• Intra-articular or soft-tissue administration: Arthritis, psoriatic plaques, and so forth
• Dermatologic preparations: Relief of inflammatory and pruritic manifestations of steroid-responsive dermatoses


Contraindications

• Systemic (oral and parenteral) administration: Contraindicated with infections, especially tuberculosis, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections, lactation.


Adverse effects

Vertigo, headache, paresthesias, insomnia, convulsions, psychosis, cataracts, increased intraocular pressure, glaucoma (long-term therapy), Hypotension, shock, hypertension, and CHF secondary to fluid retention, thromboembolism, thrombophlebitis, fat embolism, cardiac arrhythmias, Na+ and fluid retention, hypokalemia, hypocalcemia, Amenorrhea, irregular menses, growth retardation, decreased carbohydrate tolerance, diabetes mellitus, cushingoid state (long-term effect), increased blood sugar, increased serum cholesterol, decreased T3 and T4 levels, hypothalamic-pituitary-adrenal (HPA) suppression with systemic therapy longer than 5 days, Peptic or esophageal ulcer, pancreatitis, abdominal distention, nausea, vomiting, increased appetite, weight gain (long-term therapy, Muscle weakness, steroid myopathy, loss of muscle mass, osteoporosis, spontaneous fractures (long-term therapy), Immunosuppression, aggravation, or masking of infections; impaired wound healing; thin, fragile skin; petechiae, ecchymoses, purpura, striae; subcutaneous fat atrophy; hypersensitivity or anaphylactoid reactions


Drug Interactions

• Risk of severe deterioration of muscle strength in myasthenia gravis patients receiving ambenonium, edrophonium, neostigmine, pyridostigmine
• Decreased steroid blood levels with barbiturates, phenytoin, rifampin
• Decreased effectiveness of salicylates with betamethasone
Interactions with lab-test
• False-negative nitroblue-tetrazolium test for bacterial infection
• Suppression of skin test reactions


Nursing considerations

In Systemic use:
• Give daily dose before 9 AM to mimic normal peak corticosteroid blood levels.
• Increase dosage when patient is subject to stress.
• Taper doses when discontinuing high-dose or long-term therapy.
• Do not give live virus vaccines with immunosuppressive doses of corticosteroids.
In Topical dermatologic preparations:
• Examine area for infections, skin integrity before application.
• Administer cautiously to pregnant patients; topical corticosteroids have caused teratogenic effects and can be absorbed from systemic site.
• Use caution when occlusive dressings, tight diapers cover affected area; these can increase systemic absorption of the drug.
• Avoid prolonged use near eyes, in genital and rectal areas, and in skin creases.

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