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Dexamethasone is a fluorinated glucocorticoid medication used to treat rheumatic problems, a number of skin diseases, severe allergies, asthma, chronic obstructive pulmonary disease (COPD), croup, brain swelling, eye pain following eye surgery, superior vena cava syndrome (a complication of some forms of cancer), and along with antibiotics in tuberculosis. In adrenocortical insufficiency, it may be used in combination with a mineralocorticoid medication such as fludrocortisone. In preterm labor, it may be used to improve outcomes in the baby. It may be given by mouth, as an injection into a muscle, as an injection into a vein, as a topical cream or ointment for the skin or as a topical ophthalmic solution to the eye. The effects of dexamethasone are frequently seen within a day and last for about three days.
Read the full article on WikipediaDiabetic macular oedema (DMO) Clinical criteria: Treatment Phase: Initial treatment Patient must have visual impairment due to diabetic macular oedema, AND Patient must have documented visual impairment defined as a best corrected visual acuity score between 78 and 39 letters based on the early treatment diabetic retinopathy study chart administered at a distance of 4 metres (approximate Snellen equivalent 20/32 to 20/160), in the eye proposed for treatment, AND The condition must be diagnosed by optical coherence tomography; OR The condition must be diagnosed by fluorescein angiography, AND Patient must have had a cataract removed in the treated eye; OR Patient must be scheduled for cataract surgery in the treated eye, AND Patient must have a contraindication to vascular endothelial growth factor (VEGF) inhibitors; OR Patient must be unsuitable for treatment with VEGF inhibitors; OR Patient must have failed prior treatment with VEGF inhibitors, AND The treatment must be as monotherapy; OR The treatment must be in combination with laser photocoagulation, AND The treatment must be the sole PBS-subsidised therapy for this condition. Treatment criteria: Must be treated by an ophthalmologist or by an accredited ophthalmology registrar in consultation with an ophthalmologist. Authority approval for initial treatment of each eye must be sought. Details (date, unique identifying number/code or provider number) of one of the following diagnostic reports for each eye must be documented in the patient's medical records: (i) fluorescein angiogram report; (ii) optical coherence tomography report.
Non-infectious posterior segment uveitis Clinical criteria: Treatment criteria: Must be treated by an ophthalmologist or in consultation with an ophthalmologist. Patient must have documented visual impairment defined as a best corrected visual acuity score of approximate Snellen equivalent 6/12 or worse in the eye proposed for treatment, secondary to vitreous haze or macular oedema, AND Patient must have unilateral, asymmetric or bilateral flare-up where systemic treatment or further intensification of systemic treatment is not clinically indicated.
Branch retinal vein occlusion with macular oedema Clinical criteria: Treatment Phase: Initial treatment Treatment criteria: Must be treated by an ophthalmologist or by an accredited ophthalmology registrar in consultation with an ophthalmologist. Patient must have visual impairment due to macular oedema secondary to branched retinal vein occlusion (BRVO), AND Patient must have documented visual impairment defined as a best corrected visual acuity score between 73 and 20 letters based on the early treatment diabetic retinopathy study chart administered at a distance of 4 metres (approximate Snellen equivalent 20/40 to 20/400), in the eye proposed for treatment, AND The condition must be diagnosed by optical coherence tomography; OR The condition must be diagnosed by fluorescein angiography, AND Patient must have a contraindication to vascular endothelial growth factor (VEGF) inhibitors; OR Patient must have failed prior treatment with VEGF inhibitors, AND The treatment must be the sole PBS-subsidised therapy for this condition. Authority approval for initial treatment of each eye must be sought. The first authority application for each eye must be made via the Online PBS Authorities System (real time assessment) or in writing via HPOS form upload or mail and must include: (1) Details (date, unique identifying number/code or provider number) of the optical coherence tomography or fluorescein angiogram report. If the application is submitted through HPOS form upload or mail, it must include: (a) details of the proposed prescription; and (b) a completed authority application form relevant to the indication and treatment phase (the latest version is located on the website specified in the Administrative Advice). All reports must be documented in the patient's medical records.
Central retinal vein occlusion with macular oedema Clinical criteria: Treatment Phase: Initial treatment Treatment criteria: Must be treated by an ophthalmologist or by an accredited ophthalmology registrar in consultation with an ophthalmologist. Patient must have visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO), AND Patient must have documented visual impairment defined as a best corrected visual acuity score between 73 and 24 letters based on the early treatment diabetic retinopathy study chart administered at a distance of 4 metres (approximate Snellen equivalent 20/40 to 20/320), in the eye proposed for treatment, AND The condition must be diagnosed by optical coherence tomography; OR The condition must be diagnosed by fluorescein angiography, AND Patient must have a contraindication to vascular endothelial growth factor (VEGF) inhibitors; OR Patient must have failed prior treatment with VEGF inhibitors, AND The treatment must be the sole PBS-subsidised therapy for this condition. Authority approval for initial treatment of each eye must be sought. The first authority application for each eye must be made via the Online PBS Authorities System (real time assessment) or in writing via HPOS form upload or mail and must include: (1) Details (date, unique identifying number/code or provider number) of the optical coherence tomography or fluorescein angiogram report. If the application is submitted through HPOS form upload or mail, it must include: (a) details of the proposed prescription; and (b) a completed authority application form relevant to the indication and treatment phase (the latest version is located on the website specified in the Administrative Advice). All reports must be documented in the patient's medical records.
“As a glucocorticoid, dexamethasone is an agonist of the glucocorticoid receptor (GR). It is highly selective for the GR over the mineralocorticoid receptor (MR), and in relation to this, has minimal mineralocorticoid activity. This is in contrast to endogenous corticosteroids like cortisol, which bind to and activate both the GR and the MR. Dexamethasone is 25 times more potent than hydrocortisone (cortisol) as a glucocorticoid. Its affinity (Ki) for the GR was about 1.2 nM in one study.”
“biological half-life: 36 to 54 hours; plasma half-life: 4 to 5 hours”
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