Source: ebmedicine.net
-A single dose of dexamethasone in the ED is efficacious for asthma exacerbation, and particularly valuable when patient/family compliance is a concern.
-There is no proven efficacy for giving corticosteroids in the setting of anaphylaxis; this should not delay epinephrine administration.
-In patients with bacterial meningitis, corticosteroids should ideally be administered before antibiotics, however, some sources support their administration up to 4 hours after antibiotics.
-Caution is indicated in patients with hypercoagulable states and bacterial meningitis, due to one citation suggesting the possible increased risk of central venous thrombosis.
-Patients on chronic steroids, immunodeficiency, or those with adrenal suppression, may require higher or additional doses of steroids and may not respond to standard dosing.
Thanks for reading,
Vish