Small molecule
PubChem CID 5743
Dexamethasone
Decadron
- Mechanism of action
- Glucocorticoid receptor agonist (corticosteroid)
- In plain language
- A high-potency steroid that calms inflammation and the immune system through receptors inside cells, with little of the salt-and-water-retaining effect seen with some other steroids.
- How it works
- Dexamethasone is a synthetic glucocorticoid that binds the cytosolic glucocorticoid receptor; the activated complex translocates to the nucleus and modulates transcription of anti-inflammatory and pro-inflammatory genes, suppressing cytokine, prostaglandin, and leukotriene production while inducing anti-inflammatory mediators such as lipocortin-1. It is markedly more potent than hydrocortisone on a milligram basis and has a longer biological half-life, and the manufacturer's label specifically notes that at equipotent anti-inflammatory doses, dexamethasone almost completely lacks the sodium-retaining property of hydrocortisone and closely related derivatives, reflecting minimal activity at the mineralocorticoid receptor. As with other glucocorticoids, the label states that dexamethasone causes profound and varied metabolic effects and modifies the body's immune response to diverse stimuli. This combination of high anti-inflammatory potency with low mineralocorticoid activity makes it useful where fluid retention from steroid therapy is undesirable.
- Therapeutic applications
- Indicated for the same broad category of glucocorticoid-responsive conditions as other systemic corticosteroids: endocrine disorders (adrenocortical insufficiency, congenital adrenal hyperplasia, hypercalcemia of malignancy), rheumatic and collagen-vascular diseases including rheumatoid arthritis and systemic lupus erythematosus, and severe dermatologic, allergic, and ophthalmic inflammatory conditions. It is also indicated for respiratory conditions such as symptomatic sarcoidosis, hematologic disorders including autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura, palliative treatment of leukemias and lymphomas, edematous states such as nephrotic syndrome, and gastrointestinal flares of ulcerative colitis and regional enteritis. The label additionally lists tuberculous meningitis with subarachnoid block, trichinosis with neurologic or myocardial involvement, and diagnostic testing of adrenocortical hyperfunction among its uses.
- Class
- Small molecule
- Therapeutic area
- Endocrine / Anti-inflammatory
View
Related compounds