Corticosteroid
Dexamethasone
Decadron No ASTM class color (white) ⚠ 4 mg/mL (also 10 mg/mL)
Long-acting PONV prophylaxis given after induction.
Typical adult doses
| Indication | Dose | Onset | Duration |
|---|---|---|---|
| PONV prophylaxis | 4–5 mg IV after induction (8 mg also used) | — | — |
Mechanism
Glucocorticoid; antiemetic mechanism not fully defined.
Key effects
- Antiemetic, anti-inflammatory
Watch out for
- Perineal burning/itching if given awake
- Hyperglycemia
Pimp questions
Pimp question
Why give dexamethasone after induction rather than before?
Answer
Rapid IV push in an awake patient can cause intense perineal burning — and it needs time to work for PONV.