Looking for more clarification on the types of steroid that are contraindicated for dexamethasone admin. For example, are PO drugs like spironalactone contraindicated? 

Corticosteroids are the drugs that are contraindicated for dexamethasone administration. Steroids by definition are a class of molecule with a four-ring carbon core. They include natural substances like cholesterol, bile acids but also natural and synthetic  corticosteroids. Spironolactone by structure is a steroid. But, it is not a corticosteroid and therefore, not contraindicated for dexamethasone administration in the Bronchoconstriction Medical Directive.  

Please see the comprehensive dexamethasone module on the Paramedic Portal of Ontario, under the 2022 MCME course. This course describes in detail the pathophysiology of the conditions treated by dexamethasone as well as the drug pharmacokinetics/pharmacodynamics and the Medical Directive, including the details of the contraindication of PO or parenteral corticosteroids. A list of common corticosteroids patients may be on, is included in this module. 

Airway/Breathing,Bronchoconstriction

Bronchoconstriction, Contraindication, Corticosteroids, Molecule, Spironolactone, Steroids

Dexamethasone. OBHG Education Subcommittee Module in the 2022 MCME. Paramedic Portal of Ontario.