Dexamethasone Therapy in Patients With Brain Tumors - A Focus on Tapering

Ann E. Nahaczewski; Susan B. Fowler; S. Hariharan

Disclosures

J Neurosci Nurs. 2004;36(6):340-343. 

In This Article

Introduction

Corticosteroids, a class of agents similar to natural corticosteroid hormones produced by the adrenal gland, are routinely prescribed for patients with brain tumors. These agents decrease tissue swelling and control signs and symptoms of brain tumors, including headaches, seizures, motor deficits, and altered mental status. Synthesized in the adrenal cortex, corticosteroids may be further divided into two classes, glucocorticoids and mineralocorticoids, based on their biologic activity.

Originally, the term glucocorticoid was given to agents such as hydrocortisone and prednisone to describe their effects on carbohydrate and protein metabolism, and the term mineralocorticoid was given to aldosterone and fludrocortisone and described their effects on regulating electrolyte and water homeostasis. However, carbohydrate metabolism is only one of a multitude of effects that glucocorticoids produce within the body, and the activity produced is a function of the specific receptor activated (i.e., glucocorticoid versus mineralocorticoid), as well as the agent and the prescribed dose (Gans & Smith, 1999).

This article provides an overview of the mechanism of action of corticosterioids and rationale for their use in patients with brain tumors. Practical implications on dosing, tapering, and side effects of dexamethasone are discussed as well.

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