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Betamethasone

Systems	General Systemic
Category	Corticosteroid

Pharmacokinetics

Betamethsone after penetrating the cell, binds with the specific receptors in the cytoplasm or the nucleus. After the steroid receptor interaction, the receptor is activated and the steroid receptor complex binds with the DNA. This regulates the formation of specific mesenger RNA and later synthesis of protein. The bio-availablity of Betamethasone is moderate after oral administration. It is metabolised in the liver by hepatic enzymes.

Indications

Betamethazone has powerful anti-inflammatory action and immune response modification. Betamethasone is used in allergic states[dermatitis, bronchial asthma, drug sensitivity], endocrine disorders, SLE, fulminating pulmonary tuberculosis, and ulcerative colitis. They can produce adverse effects that can be serious especially in diseases of the adrenal glands.

Routes of Administration and Dosage

Oral : Adults = 0.6 milligrams (mg) to 7 mg a day. Children = based on body weight. Parentral : Adults = 4-20 mgs upto 4 times a day. A dose upto 1 mg can be used for infants[upto 1 year]; 2-4 mg for children 1-12 years. Rectal: Adults = 5 mg (betamethasone), given as directed, each night.

Contra Indications

It may be contraindicated in: Bone disorders[osteoporosis], acute infections, peptic ulcer and in uncontrolled diabetes. Special precaution should be taken in patients with CRF, hypertention, glaucoma, diabetes mellitus, hypothyroidism, cardiac failure

Precautions

Allergic reaction to Betamethasone may occur .Special precautions should be taken in patients with CCF,hypertension, diabetes, CRF, epilepsy and infections.

Interactions

Antacids, Barbiturates, Carbamazepine, Griseofulvin, Mitotane, Phenylbutazone, Phenytoin, Primidone, Rifampin : these drugs may reduce the effectiveness of corticosteroids. Amphotericin B : Corticosteroids used with this drug decreases the amount of potassium in the blood, thus serious side effects could occur if hypokalemia occurs. . Digitalis glycosides : Corticosteroids reduce the amount of potassium in the blood. Digitalis can cause Cardiac arrhythmias if hypokalemia occurs. Duretics: Using corticosteroids with diuretics may cause the diuretic to be less effective. Also, corticosteroids may increase the risk of hypokalemia, which is also a problem with some diuretics. Potassium supplements or potassium sparing diuretics are used in treating hypertension in those who have problems maintaining their blood potassium at a normal level: Corticosteroids may make these drugs less effective in maintaining the potassium levels. Immunization (vaccinations) : Immunization should be done with great precaution. Skin test injections: Corticosteroids may cause false results in skin tests. Sodium-containing drugs: Corticosteroids cause edema. Excessive sodium levels may cause hypernatremia, hypertension, and water retention.

Brand Names

Belar (Comed), Betacortril (Pfizer), Betnelan (Glaxo Allenburys), Betnesol (Glaxo), Celsetone (Fulford), Cortril (Micro Labs), Solubet (Lupin), Stemin (Ind-Swift), Walacort (Wallace)