Which medications in the drug class Corticosteroids are used in the treatment of Pediatric Pharyngitis?

Updated: Dec 11, 2018
  • Author: Harold K Simon, MD, MBA; Chief Editor: Russell W Steele, MD  more...
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Answer

Corticosteroids

Corticosteroids have anti-inflammatory properties and cause profound and varied metabolic effects. They modify the body’s immune response to diverse stimuli. These agents may be used adjunctively with antibiotics to hasten the onset of pain relief and are especially useful in patients with positive rapid streptococcal antigen test results.

Dexamethasone (Baycadron)

Dexamethasone decreases inflammation by suppressing migration of polymorphonuclear leukocytes (PMNs) and reducing capillary permeability. It possesses many pharmacologic benefits but also has significant adverse effects.

Dexamethasone stabilizes cell and lysosomal membranes, increases surfactant synthesis, increases serum vitamin A concentration, and inhibits prostaglandin and proinflammatory cytokines. The inhibition of chemotactic factors and factors that increase capillary permeability inhibits recruitment of inflammatory cells into affected areas. The drug suppresses lymphocyte proliferation through direct cytolysis, inhibits mitosis, breaks down granulocyte aggregates, and improves pulmonary microcirculation.

Potential adverse effects include hyperglycemia, hypertension, weight loss, GI bleeding or perforation synthesis, cerebral palsy, adrenal suppression, and death. Most of the adverse effects of corticosteroids are dose-dependent or duration-dependent.

Dexamethasone provides symptomatic relief for severe pharyngitis. In this setting, it must be administered in conjunction with antibiotics. Dexamethasone is readily absorbed via the GI tract and metabolized in the liver. Inactive metabolites are excreted via the kidneys. The drug lacks the salt-retaining property of hydrocortisone. Patients can be switched from an IV regimen to an oral regimen in a 1:1 ratio. A single IM dose is convenient and avoids compliance issues.


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