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At least 145 records · Page 8Linked to original sources
PubMed1989

Chlorpromazine and dexamethasone versus high-dose metoclopramide and dexamethasone in patients receiving cancer chemotherapy, particularly cis-platinum: a prospective randomized crossover study.

Sixty-nine patients with malignant tumors receiving cancer chemotherapy, 90% including cis-platinum, were evaluated in a randomized crossover study for the antiemetic efficacy and the side effects of two antiemetic regimens: chlorpromazine (CPM) 2.5 mg/kg in 5 doses plus dexamethasone (DXM) 0.2 mg/kg in 2 doses, and high-dose metoclopramide (HD-MCP) 10 mg/kg in 5 doses plus the same dose of DXM. In 69% of 173 courses of chemotherapy, antiemetic response was achieved, and in 26% emesis was completely prevented. There was no statistical difference in the response to the antiemetic regimens, but 65% of the patients who completed 3 courses of chemotherapy preferred HD-MCP plus DXM. The main side effects of the treatment were drowsiness, nervousness, diarrhea and extrapyramidal reactions. HD-MCP plus DXM is recommended as a first line antiemetic treatment in patients receiving cancer chemotherapy. Patients resistant to this treatment should receive CPM plus DXM treatment.

Adolescent↗
PubMed1993

Dexamethasone plus ondansetron versus dexamethasone plus alizapride in the prevention of emesis induced by cisplatin-containing chemotherapies for urological cancers.

Thirty-six consecutive patients, who were to be treated with cisplatin-based chemotherapy for testicular or bladder cancer, underwent a single-blind randomized study to compare the antiemetic therapies with dexamethasone (DEX)+ondansetron (OND) and DEX + alizapride (ALI). Eighteen patients were assigned to each arm. DEX, 20 mg in 100 ml saline was administered i.v. 30 min prior to cisplatin, OND, 8 mg, or ALI, 100 mg in 100 ml saline were administered i.v. 15 min prior to cisplatin and repeated 4 and eventually 8 h later. Chemotherapy regimens contained cisplatin 25 mg/m2 for 4 consecutive days to be repeated for 4 courses every 4 weeks. During the first course a complete emetic control was observed in 15 (83%) and partial in 3 of the 18 patients treated with DEX + OND versus only 2 complete and 7 partial responses and 9 (50%) failures among the 18 patients treated with DEX + ALI. Thirty-one patients were evaluable for 4 courses of therapy. Complete emetic control was achieved in 11 (69%) and partial in 5 (31%) among the 16 patients treated with DEX + OND, versus only 1 (7%) partial response and 14 (93%) failures among the 15 treated with DEX + ALI (p < 0.001). Furthermore, DEX + OND gave a complete antiemetic control in 13 out of 14 patients who had failed DEX + ALI. Delayed vomiting was observed in 4 (22%) of 18 patients primarily treated with DEX + OND and in 1 (7%) of the 15 patients subsequently treated. Constipation and headache occurred more frequently among patients treated with DEX + OND, but there was no significant difference with DEX + ALI. Hiccup was significantly more frequent among patients treated with DEX + ALI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1978

"Normal suppression" to dexamethasone in Cushing's disease: an expression of decreased metabolic clearance for dexamethasone.

The adrenal cortical function of a patient with pituitary-dependent Cushing's syndrome exhibited normal responsiveness to conventional doses of dexamethasone (Dex) over several years of evaluation. "Periodic hormonogenesis" did not seem to explain the phenomenon. Plasma concentrations of Dex were measured to ascertain whether an abnormality in Dex metabolism might explain the apparent discrepancy in Dex responsiveness. Plasma levels of Dex after oral administration of the steroid were higher than normal, suggesting that decreased clearance of Dex accounts for the phenomenon of "normal suppression" in this patient with Cushing's syndrome.

Adrenocorticotropic Hormone↗
PubMed1998

Effect of dexamethasone pretreatment on the dexamethasone-dependent induction of tyrosine aminotransferase activity in primary cultured rat hepatocytes.

The effect of dexamethasone (Dex) pretreatment on the Dex-dependent induction of tyrosine aminotransferase (TAT) activity was studied in primary cultured rat hepatocytes. The extent of the Dex-dependent induction of TAT activity decreased during culture in untreated cells. Dex pretreatment prevented this decrease. A Scatchard plot analysis of the results of a [3H]Dex binding assay showed that hepatocytes cultured for 2.5 h possessed both high and low affinity binding sites in their cytosols. The number of both high and low affinity binding sites decreased during culture for a further 24 h in untreated cells. Dex pretreatment partly prevented the decrease in low affinity binding sites but had no effect on the decrease in high affinity binding sites. These results show that Dex pretreatment counteracts the usual decrease in the inducibility of TAT activity, and suggest that this action of Dex may be due to the maintenance of low affinity binding sites. These results also suggest that low affinity binding sites could possibly mediate the biological response to Dex.

Animals↗
PubMed1991

Alizapride alone or alizapride-dexamethasone compared with metoclopramide-dexamethasone in patients at high risk of acute emesis after cisplatin. A randomized cross-over study.

Alizapride (ALZ) is a new benzamide derivative with promising antiemetic activity. In the present study, high-dose ALZ (16 mg/kg) alone or in combination with dexamethasone (DXM, 40 mg) was compared to a combination of DXM (40 mg) and metoclopramide (MCP, 4 mg/kg) in a randomized cross-over trial conducted on 21 out-patients at high emetic risk after moderate-dose cisplatin. All but 3 patients completed the planned cross-over trial for a total of 60 evaluable courses. The patients completed a self assessment questionnaire evaluating the severity and duration of both nausea and vomiting, the toxicity, as well as their subjective opinion of the antiemetic trial. At the dose and schedule employed, ALZ alone or in combination with DXM provided not only a significantly lower rate of complete protection against nausea and vomiting (0 and 4.8%) than MCP + DXM (28.6%) but was also less effective in reducing the number of vomiting episodes and the duration of the vomiting. In addition, the MCP - DXM regimen was the most frequently preferred. Except for one case of orthostatic hypotension following ALZ, benzamide-induced toxicity was mild, whereas that related to DXM was negligible. The results of this study suggest that high-dose ALZ gives no advantage compared to MCP in patients at high risk for emesis after moderate-dose cisplatin.

Acute Disease↗
PubMed1976

Initiation of parturition in dairy cows with dexamethasone. II. Response to dexamethasone in combination with estradiol benzoate.

Parturition was initiated in 26 Holstein cows given dexamethasone (4.4 mg/100 kg body weight) in combination with 25 mg estradiol benzoate intramuscularly at day 273 of gestation. Parturition occurred at 40.8 +/- 9.6 h after injection. Twenty-six control cows had an average gestation length of 281.5 days. Calving difficulty was not different although birth weight of calves was 2.5 kg less for induced cows compared with control cows. Severity of udder edema did not differ between groups. Average daily milk production for the first 9 wk of lactation was lower (24.2 versus 27.7 kg) from induced than control groups. Incidence of retained placental membranes was 50 and 4% for induced and control cows. Serum estrogens were lower (290 versus 601 pg/ml) in induced than in control cows 2 days prior to parturition. Groups did not differ inserum calcium, phosphorus, magnesium, days to first heat, days to first breeding, days to conception, or in fat, protein, and total solids content of colostrum. Casein in colostrum of induced cows was lower. Results of California Mastitis Tests at 15 and 30 days postpartum were similar.

Animals↗
PubMed1992

Kinetic-dynamic modeling of lymphocytopenia induced by the combined action of dexamethasone and hydrocortisone in humans, after inhalation and intravenous administration of dexamethasone.

Ten healthy male volunteers received 5 mg of dexamethasone sodium phosphate (DEX) i.v. and, on an other occasion, by way of nebulization. Plasma DEX and hydrocortisone (HC) concentrations as well as blood lymphocyte count (BLC) were monitored over 12 hr and at 24 to 28 hr after DEX administration. Bioavailability of DEX after inhalation was about 27% of DEX i.v. DEX-induced depletion of plasma HC could be predicted with a pharmacokinetic model. The reonset rate of HC-production was dependent of DEX dose. BLCs declined after DEX administration, reaching a minimum between 4- and 8-hr postdosing. The DEX- and HC-induced depression of BLC could be described by an integrated pharmacokinetic-pharmacodynamic competitive-interaction model that assumes that both agonists act on the same receptor. With this model the potency and efficacy of DEX and HC with respect to lymphocytopenia could be estimated simultaneously. The potency of DEX was 10 times greater than the potency of HC. The estimated efficacy suggests that HC is only a partial agonist; the maximal lymphocytopenic effect (Emax) of HC was estimated at 80% (27-99%) of the efficacy of DEX. Our results indicate that DEX should be preferred instead of HC in conditions in which the lymphocytopenic effect is the primary systemic corticosteroid treatment goal.

Administration, Inhalation↗
PubMed2005

[A randomized crossover study of ramosetron plus dexamethasone for the prevention of nausea and vomiting induced by chemotherapy including cisplatin-comparison of ramosetron combined with 8 mg and 12 mg of dexamethasone].

A randomized crossover study between 0.3 mg of ramosetron (RAM) combined with 8 mg of dexamethasone (DEX) and 0.3 mg of RAM combined with 12 mg of DEX was performed to investigate the prevention of nausea and vomiting due to chemotherapy including 60 mg/m2 or 70 mg/m2 of cisplatin (CDDP) in patients with advanced head and neck squamous cell carcinoma (HNSCC). Twenty-five patients the study consisted of who received chemotherapy with CDDP were enrolled in the present study between January 2001 and December 2002 at the Yokohama City University School of Medicine or Yokohama City University Medical Center. The antiemetic effectiveness in the group receiving 12 mg of DEX was not significantly superior to the group receiving 8 mg of DEX. It was suggested that the antiemetic therapy of RAM 0.3 mg plus DEX 8 mg was effective for the prevention of nausea and vomiting induced by CDDP in patients with advanced HNSCC.

Adult↗
PubMed1994

Interleukin 1 beta enhances the response of rabbit synovial fibroblasts in vitro to dexamethasone injury: implication for the role of increased nuclear hypersensitive sites and the number of dexamethasone receptors.

OBJECTIVE: As a model system to understand the efficacy of patients with glucocorticoid (GC) treatment of joint inflammation of rheumatoid arthritis, we stimulated confluent rabbit synovial fibroblasts in culture with interleukin 1 beta (IL-1 beta) and studied the effects of dexamethasone (Dex). METHODS: Twenty-four h after IL stimulation Dex was added and the response of cells to Dex was estimated by [3H]thymidine uptake, cell count and lactate dehydrogenase release. Cellular and nuclear binding of [3H] Dex as well as the DNase sensitivity of isolated nuclei were estimated. RESULTS: Dex strongly inhibited the [3H]thymidine uptake by the stimulated cells in a dose dependent manner with Ki of lower than 10(-12) M, whereas it only slightly inhibited the unstimulated cells. With stimulation the sensitivity of cells increased 10-fold as estimated by lactate dehydrogenase release and 85-fold by counting the final cell density. We found also a 5-fold increase in the DNase I hypersensitive sites in the nuclei and a 2 to 3-fold increase in the cellular as well as the nuclear Dex binding sites following stimulation. CONCLUSION: In addition to the well documented inhibition of degradative enzyme production by the stimulated synovium, the efficacy of GC treatment of patients could be explained also on the basis of the sensitization of stimulated synovium to the GC mediated injury.

Animals↗
PubMed1997

Enhancement of gp130-mediated tyrosine phosphorylation of STAT3 and its DNA-binding activity in dexamethasone-treated AIDS-associated Kaposi's sarcoma cells: selective synergy between dexamethasone and gp130-related growth factors in Kaposi's sarcoma cell proliferation.

The soluble IL-6R (slL-6R alpha)/IL-6 complex and oncostatin M (OM), which exert biologic activities through the signal-transducing protein gp130, are potent growth factors for AIDS-associated Kaposi's sarcoma (KS) cells. Clinical observations indicate that glucocorticoid therapy is a possible risk factor in KS; however, little is known of specific interactions in KS cells between glucocorticoid and gp130-related growth factors. We obtained evidence that dexamethasone (Dex), in a synergistic manner, enhances gp130-mediated growth of KS cells. Anti-gp130 Abs or the glucocorticoid antagonist RU-486 abolished this synergistic effect. In addition, Dex had additive but not synergistic effects on stimulation of KS cell growth with IL-1beta or TNF-alpha, the signals of which are not mediated through gp130. Immunoblot analysis revealed sIL-6R alpha/IL-6- or OM-induced tyrosine phosphorylation of a similar set of proteins in KS cells, and which was augmented significantly in Dex-treated KS cells. Stimulation of KS cells with sIL-6R alpha/IL-6 or OM induced rapid tyrosine phosphorylation of the transcription factor STAT3, and Dex significantly enhanced the accumulation of tyrosine-phosphorylated STAT3. Electrophoretic mobility shift assays showed sIL-6R alpha/IL-6- or OM-induced DNA-binding activity of STAT3 in KS cells, and Dex further increased this activity. Thus, Dex appears to participate in the gp130-STAT3 signaling and transcriptional events by enhancing STAT3 activation, thereby leading to selective synergistic stimulation of KS cell growth with Dex and the gp130-related growth factors.

Acquired Immunodeficiency Syndrome↗