Any experience with the steriod dexamethasone (Decadron) for asthma?

[selketine]

William unfortunately had an asthma episode today and my HMO insisted we call 911 and have him transported rather than go to their own after-hours care (so we did...I think it could have been handled by their own doctors but we did as told). He hasn't had a problem like this in over 2 years so I had no meds on hand.

He was treated at the ER with a drug called dexamethasone (decadron is the brand name or one of them). It was a colorless liquid steroid that the doctor said was "slow release" and would act over several days. He thought it would work as well as prelone (prednisone or whatever the usual asthma steriod is) but with only having to take one dose. He thought the affect on the bgl would be the same.

I have talked with our pedi endo a couple of times today and we are having a hard time keeping him below 400 - and haven't been below 300 all day - no ketones at all (using the blood). We have upped his basal and boluses 4x more than usual (so a 2 unit meal is an 8 unit meal, etc). I think he is actually going to need 6x the insulin (so from 18 units a day up to 108 - which is SCARY!).

Anyone with any experience on this med? With prelone he needed 3x the insulin. Having to up it to 6x more than usual is making me uncomfortable. I'm curious how long the med will last, etc. I've never seen it discussed on the boards but I thought I'd ask. I thought we were done with this asthma stuff.:(

[mom to a sports nut]

Steroids can cause a rise in blood sugar, or what appears to be. I'm not sure if that would be it for sure but I do know that it does do it.

[WestinsMom]

We just did a few days on prednisone and I have to say that CGMS was a huge help! We too were uping and uping the basal. I think maybe we should have upped the carb ratio too. Next time, if there is a next time, that is something I will experiment with. Even with CGMS we were rarely under 300. But we survived!

I will say that we saw an improvement after 1 day on prednisone but continued for the whole 4 days prescribed. (Of course we didn't have an all out asthma attack, just some weezing) Later when we went for a followup, the dr said to stop taking it when we saw improvement so we don't have to use the steriods any longer than needed. That too will help with the blood sugar.

I know that doesn't apply to you now. Sorry! :) I will say that it takes us a little while to get them out of his system. Hang in there :)

[Tamara Gamble]

No advice Carol. But I will be thinking of you and William.

Tami

[hypercarmona]

I was on a course of betamethasone for preterm labor (it's a different steroid but it has a similar duration of action), and it did the same thing to me as what's happening to your son. My dosages tripled the first day and then tripled again the next day. It could take up to five days for this to get out of his system (36-54 hours), but I started to see a good decrease around day three with "almost" normal dosages after nearly six days. YMMV. Be really careful with his overnight basals because they might be what needs to be lowered first.

[selketine]

Thanks for the replies - I haven't seen this particular steroid much discussed but I think it affects the bgl more than the prelone did...at least that first day.

We finally got him down below 200 last night but then he went too low twice but we think we caught both before it got bad (like a 78 and a 65). We got more cautious and pulled back on the basal and he shot up to almost 400 again this morning.

So...we're just guessing with the insulin. On the positive side he seems to be much better with the breathing. I don't know if I can send him to school even if I hang out up there tomorrow if he is like this with his bgl's though.

[bz'smom]

No advice here either - just wanted to send you guys some hugs! Hope his numbers come back down, and he's feeling better.

[selketine]

Thanks Brenda - he's doing better for sure. He is still needing more insulin and it is just a guess as to how much. It has really backed off though - he is needing about 1.5x more - much better than 6x times more!

[tuckerk]

Hi,

This reply is probably late, but any steriod esp. injections will significantly increase the BS for sevreral days. Steriods are used all the time in patients with resp. illnesses/infections (Asthma flares, Bronchitis)

Usu. resolves after a few days to a week. Keep checking the BS often.

[selketine]

Actually the effect was REALLY strong the first day and less so for about 4-5 more days. It was a different med than he'd taken before which was only one dose that was slow release as opposed to dosing every day for about 5 days.

That first day was a doozy though!:rolleyes: