Generic Name

Generic NameBrand NameClassificationMechanism of ActionIndicationsAdverse ReactionsNursing Considerations

betamethasone

POAllergic and inflammatory disorders; congenital adrenal hyperplasia 0.5-5 mg/day.

CelestonePharmacologic:

Corticosteroid, glucocorticoid, hormone

Therapeutic:

Anti-inflammatory

Pregnancy Category CBetamethasone is a corticosteroid with mainly glucocorticoid activity. It prevents and controls inflammation by controlling the rate of protein synthesis, depressing the migration of polymorphonuclear leukocytes and fibroblasts, and reversing capillary permeability and lysosomal stabilisation.Systemic administration

Hypercalcemia associated with cancer

Short-term management of inflammatory and allergic disorders, such as rheumatoid arthritis, collagen diseases (eg, SLE), dermatologic diseases (eg, pemphigus), status asthmaticus, and autoimmune disorders

Hematologic disorders: Thrombocytopenia purpura, erythroblastopenia

Ulcerative colitis, acute exacerbations of MS, and palliation in some leukemias and lymphomas

Trichinosis with neurologic or myocardial involvement Intra-articular or soft-tissue administration

Arthritis, psoriatic plaques, and so forth

Dermatologic preparations

Relief of inflammatory and pruritic manifestations of steroid-responsive dermatoses

Sodium and fluid retention, potassium and calcium depletion. Muscle wasting, weakness, osteoporosis. GI disturbances and bleeding. Increased appetite and delayed wound healing; hirsutism, bruising, striae, acne; raised intracranial pressure, headache, depression, psychosis, menstrual irregularities. Hyperglycaemia, DM. Suppression of pituitary-adrenocortical axis. Growth retardation in children (prolonged therapy). Increased susceptibility for infections.

Intradermal injection: Local hypopigmentation of deeply pigmented skin. Intra-articular injection: Joint damage, fibrosis, esp in load bearing joints.

Potentially Fatal: Abrupt withdrawal leading to acute adrenal insufficiency manifesting as malaise, weakness, mental changes, muscle and joint pains, dystonia, hypoglycaemia, hypotension, dehydration and death. Rapid IV inj may cause CV collapse.

Assessment History (systemic administration): Infections, fungal infections, amebiasis, vaccinia and varicella, and antibiotic-resistant infections; kidney or liver disease; hypothyroidism; ulcerative colitis with impending perforation; diverticulitis; active or latent peptic ulcer; inflammatory bowel disease; CHF; hypertension; thromboembolic disorders; osteoporosis; seizure disorders; diabetes mellitus; lactation

Physical: Baseline weight, T, reflexes and grip strength, affect and orientation, P, BP, peripheral perfusion, prominence of superficial veins, R and adventitious sounds, serum electrolytes, blood glucose

Interventions

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.

Teaching points

Do not stop taking the oral drug without consulting your health care provider.

Take single dose or alternate-day doses before 9 AM.

Avoid exposure to infections; ability to fight infections is reduced.

Wear a medical alert tag so emergency care providers will know that you are on this medication. Report unusual weight gain, swelling of the extremities, muscle weakness, black or tarry stools, fever, prolonged sore throat, colds or other infections, worsening of original disorder.