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Patients on dexamethasone may experience fewer overall side effects due to its relative lack of mineralocorticosteroid effects and consequently lower sodium retention than seen with other steroids, such as prednisone. However, unlike the more commonly prescribed corticosteroid steroids such as prednisone, dexamethasone does not produce an increase of blood pressure, but instead decreases blood pressure. It is also effective in reducing the number of episodes of hypoglycemia. Patients treated with dexamethasone also generally experience significant improvements in renal function with a mean improvement of 6.1%.Dextromethorphan or D-cycloserine in doses of 1 g every 6 hours can have a moderate to serious effect on the kidneys. It is unlikely to be effective in causing significant renal failure.Dextromethorphan and D-cycloserine may cause the kidneys to be less than normal in renal function, and they may be the cause of hyponatremia or hyponatraemia, including the symptoms of cholestasis or kidney toxicity.Patients on dexamethasone should make sure that they are on a hydrocortisone drip for adequate hydration. Patients with anemia may find it difficult to maintain appropriate hydration when using the diuretic diuretics given in combination with the diuretics.Drugs known as anti-diuretics are effective and safe when used with corticosteroids.Other medications such as potassium chloride, bromide and calcium channel blockers are usually safe at physiologic doses given in the treatment of hyponatremia.Other than when used as a corticosteroid with prednisone, dexamethasone should not be used as therapy for the acute treatment of hyponatremia, because of its lack of mineralocorticosteroid activity and the increased renal excretion of salt, which may precipitate hyponatremia. Dexamethasone should not be given to patients with a history of liver disease, or who have a family history of hepatic or renal disease (e.g. diabetes mellitus). Patients who are receiving anti-diuretics may still be able to tolerate low rates of urinary calcium excretion and may even be able to pass a urine calcium test if given the correct dose of prednisone.In patients receiving prednisone, the risk of renal toxicity or hyponatraemia that can occur with oral diuretics should be weighed against any potential benefit of dexamethasone on hyponatremia by patients who already have a history of severeRelated Article: