DEXAMETHASONE TABLET: USE IN COVID-19, PHARMACOLOGICAL PROFILE, PHARMACOLOGICAL ACTIVITY, ROLE OF NANOMEDICINE

Dexamethasone is a long-acting synthetic glucocorticosteroid with vast anti- inflammatory and immunosuppressive activities. Dexamethasone became a significant drug during the COVID-19 pandemic based on evidence showing a decrease in hospital-related fatality rates for patients requiring supplementary oxygen therapy or mechanical ventilation. Dexamethasone pharmacologically inhibits inflammation by interacting with intracellular glucocorticoid receptors, which in turn inhibits pro-inflammatory cytokines, suppresses the activation of immune cells, and stabilizes cellular membrane function. In COVID-19, dexamethasone mainly exerts a modulating effect in terms of mitigating the exaggerated immune response in addition to controlling the resultant cytokine storms, thus improving pulmonary function and clinical outcomes in severe COVID-19. Dexamethasone has a long biological half- life, an oral route of administration, a low incidence of mineralocorticoid effects, and thus it can be used systemically. Adverse effects that can be encountered with dexamethasone administration include immuno-suppression, hyperglycemia, hypertension, irritation of the gastrointestinal mucosa, emotional dysregulation, and susceptibility to secondary infections, particularly if there is inappropriate administration for a long period of time.