Vol 70, No 3 (2012)
Case studies
Published online: 2012-03-19
Supplementation with hydrocortisone on the 3rd–5th day following dexamethasone premedicated chemotherapy eliminated severe dizziness and postural hypotension
DOI: 10.33963/v.kp.78981
Kardiol Pol 2012;70(3):273-274.
Abstract
We present the case of a 60 year-old woman with a stage III fallopian tube cancer submitted to hysterectomy and bilateral
salpingo-oophorectomy with partial omenectomy, followed by six courses of chemotherapy and revision surgery. After each
course of chemotherapy (paclitaxel + carboplatin) preceded by premedication with dexamethasone, she suffered from side-
-effects, of which the most unpleasant was severe dizziness appearing on the third, fourth and fifth day following the listed
combination of drugs. It was revealed that dizziness with concomitant sweating and rapid pulse, noted in the standing position,
was combined with marked postural hypotension. Considering the possibility of a temporary pituitary-adrenal axis suppression
caused by premedication with a very large dose of dexamethasone, during those three days she was supplemented with small
doses of hydrocortisone, which caused almost complete disappearance of the mentioned symptoms. Our conclusion is that
postural hypotension causing severe dizziness initially linked with chemotherapeutic drugs can be eliminated or markedly
reduced by three days supplementation with hydrocortisone applied after the expected wash out of the dexamethasone.
Keywords: dexamethasonepremedicated chemotherapypostural hypotension
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