Decadron uses?

mlynn · Oct 16, 2004

Our hospice medical directors sometimes use a decadron/haldol combination for intractable nausea and vomiting with very good results. We establish a sc site and are usually able to teach families how to administer meds safely.

nightwatcher · Oct 30, 2004

Another idea i have seen for appeteite and a host of other problems is Marinol, a synthetic marajuana. really helps pain, anorexia and nausea. its worth getting it for many people in this situation.

I occasionally see Decadron or Prednisone used as an appetite stimulant in terminally ill patients. It can improve appetite, but usually the effect does not last long. Some patients and families are so upset about anorexia that it is worth a try, even with the side effects. Megace is also used sometimes, but is much more expensive. These are often meds that have come along for the ride from chemo or radiation and nobody has stopped them even though they probably aren't doing much good by the time hospice steps in. I personally feel that emotional support and instructing to accept the changes brought about by the disease process is a more appropriate hospice type treatment. However, many physicians continue to offer drug panaceas rather than have those uncomfortable conversations. Leaving the mess, of course, to be sorted out at the end by the hospice nurse.
BTW, before ordering steroids, you should look causes of anorexia that can be fixed, like oral thrush, nausea, constipation, hypercalcemia, or psychological issues.
Gail

osiris7 · Nov 21, 2004

Dedadron is amazingly good stuff, in my opinion. It

1. Helps with neuropathic pain

2. stimulates appetite

3. increases overall energy levels

4. decreases inflammation

5. decreases nausea --we even use it in a custom-compounded

anti-nausea suppository along with reglan and benadryl. Works great!

I've just seen some amazingly immediate, positive effects on people. We use it frequently at our organization.

It does not have quite the same mineralcorticoid effects as does prednisonse (moon face, etc.). While emotional lability is certainly possible, you'll know pretty quickly if this is present. The other negative effects are usually over the long term, and most of our patients are looking at the long term. :nurse:

FranEMTnurse, CNA, LPN, EMT-I · Nov 21, 2004

stimulates appetite

Ooh honey, does it ever! I practically inhaled everything that was put before me. I think the only 2 reasons I was placed on it were

1. because I was near death (Had pneumonia and septicemia) and went into respiratory failure in the ER. However, I was so weak I literally trembled, and was placed on Klonopin to help that, but I still tremple, although not as much as I did back then.

2. I had a life-threatening reaction to Solu-Medrol. It gave me a PE that nearly killed me just one year earlier.

The only thing is, it did alter my personality completely. I became very aggressive, and said and did things I would have done only if I was plastered drunk. The stories that came back were embarassing.

z's playa · Nov 21, 2004

Wondering if anyone can help me with some info. When I was given Decadron in the ER for a migraine, my tongue swelled to the point where I spoke funny and it made me very agitated. Is this a normal side effect, an adverse reaction or an allergy? Or just plain strange? :rolleyes:

aimeee, BSN, RN · Nov 23, 2004

No! Not normal! Tongue swelling is a sign of allergic reaction. Make sure its on your allergy list.

Allow Mystery · Oct 28, 2007

Hi everyone, I'm reviving this old post. I've a patient with some progressive weight loss, "just not hungry", and I'm considering an

appetite stimulent. Megace cost prohibitive and unable to tolerate

Periactin due to sedative effect of the antihystamine. At a Hospice I worked for a few years back, we had standing order for Prednisone 10mg tid for 3 days, if this stimulated appetite, then we would leave

patient on Prednisone 10mg/day. I haven't seen much use of steroids as an appetite stimulent since. I would appreciate any input here.

Thanks

KJB_65 · Oct 28, 2007

I have not seen It used just for appetite stimulation at either of the 2 Hospice agencies I have worked for. I know that I have a ot now dx is lung ca mets to the brain. She is now up to Decadron 4mg QID. She is a different person on it. She had debilitating H/A and was put in our care center for 3 weeks while they adjusted pain control. She came home last week and has never looked better to me. She is gaining a lot of weight but for her the choice between h/a and "getting fat" (her term) is an easy one. SHe is actually much happier now. Do you have a medical director that you feel comfortable talking to about this. If not, I'm doing joint visits with my doc on Tuesday. I'll be happy to get her opinion for you.

Allow Mystery · Oct 28, 2007

I have not seen It used just for appetite stimulation at either of the 2 Hospice agencies I have worked for. I know that I have a ot now dx is lung ca mets to the brain. She is now up to Decadron 4mg QID. She is a different person on it. She had debilitating H/A and was put in our care center for 3 weeks while they adjusted pain control. She came home last week and has never looked better to me. She is gaining a lot of weight but for her the choice between h/a and "getting fat" (her term) is an easy one. SHe is actually much happier now. Do you have a medical director that you feel comfortable talking to about this. If not, I'm doing joint visits with my doc on Tuesday. I'll be happy to get her opinion for you.

I'd feel comfortable discussing with Medical Director, but not sure I get much of a discussion. It would be Megace, wouldn't even consider alternative. Our Medical Director is an excellent physician, just not Hospice approriate; administration believes "will learn" but it has been a slow road. This is why I seek other opinions from experienced Hospice professionals, I would greatly appreciate any input from you and/or your doc. Thanks!

FranEMTnurse, CNA, LPN, EMT-I · Oct 28, 2007

oh yes!! i was on the stuff once. it made me have a whole new personality when i needed it too. it seems to give you the personality opposite of your real one. i'm allergic to prednisone. i told that old doc of mine off in a hurry, and it made him ask me what type of steroid i wanted to take home with me. i went home on a z pack. have since renamed that old doc, and got myself a brand new one who believes me.

FranEMTnurse, CNA, LPN, EMT-I · Oct 28, 2007

i have not seen it used just for appetite stimulation at either of the 2 hospice agencies i have worked for. i know that i have a ot now dx is lung ca mets to the brain. she is now up to decadron 4mg qid. she is a different person on it. she had debilitating h/a and was put in our care center for 3 weeks while they adjusted pain control. she came home last week and has never looked better to me. she is gaining a lot of weight but for her the choice between h/a and "getting fat" (her term) is an easy one. she is actually much happier now. do you have a medical director that you feel comfortable talking to about this. if not, i'm doing joint visits with my doc on tuesday. i'll be happy to get her opinion for you.

i'm very happy for her. it sounds like it was what she needed. god bless the poor soul.

FranEMTnurse, CNA, LPN, EMT-I · Oct 28, 2007

dedadron is amazingly good stuff, in my opinion. it
1. helps with neuropathic pain
2. stimulates appetite
3. increases overall energy levels
4. decreases inflammation
5. decreases nausea --we even use it in a custom-compounded
anti-nausea suppository along with reglan and benadryl. works great!
i've just seen some amazingly immediate, positive effects on people. we use it frequently at our organization.
it does not have quite the same mineralcorticoid effects as does prednisonse (moon face, etc.). while emotional lability is certainly possible, you'll know pretty quickly if this is present. the other negative effects are usually over the long term, and most of our patients are looking at the long term.

totally cool. i'm all for the stuff.