ACYCLOVIR-ANTIVIRAL
Brand Name
Zovirax, Avirax
Uses
Antiviral, used to treat initial and recurrent episodes of mucocutaneous herpes simplex virus (HSV-1 and HSV-2) infections in immunocompromised patients; varicella (chickenpox) infections in immunocompromised patients; acute herpes zoster infection in immunocompetent patients; herpes simplex encephalitis.
Availability
Suspension: 200 mg/5 mL. Tablets: 400 mg, 800 mg. Capsules: 200 mg. Injection: 500 mg/vial, 1 g/vial. Cream, Ointment.
Indications/Routes/Dosage
Varicella infection in immunocompromised patients: Children age 12 years or older: 800 mg PO q4h (5 times/day while awake) for 5 days. Children age 2 years or older and weighing < 40 kg: 20 mg/kg (max: 800 mg/dose) PO qid for 5 days.
Acute herpes zoster: Children age 12 years or older: 800 mg PO q4h (5 times/day) for 7-10 days.
Genital herpes (initial episode): Adults: 200 mg q4h (5 times/day) for 10 days.
Genital herpes (recurrent episode): Adults: 200 mg q4h (5 times/day) for 5 days.
Usual topical dosage: Adults: 3-6 times/day for 7 days.
Labial herpes: Apply cream to affected area 4-6 times/day for 10 days; apply ointment q3h 6 times/day for 7 days–use glove or applicator stick to apply.
Adverse Reactions
Malaise, headache, encephalopathic changes, nausea, vomiting, diarrhea hematuria, acute renal failure, thrombocytopenia, leukopenia, rash, itching, urticaria, inflammation or phlebitis at injection site.
Implications
May increase blood urea nitrogen (BUN) and creatinine levels. May decrease white blood count (WBC) and increase or decrease platelet count.
Use cautiously in patients with neurologic problems, renal disease, or dehydration. Monitor renal function.
Drink adequate fluids, do not touch lesions with fingers to prevent spreading infection to new site, use finger cot or rubber glove to apply topical ointment.
Avoid sexual intercourse while lesions present to prevent spread to partner.
ALBUTEROL–BRONCHODILATOR
Brand Name
Ventolin, Proventil
Uses
Relaxes bronchial, uterine, and vascular smooth muscle, to prevent or treat bronchospasm.
Availability
Aerosol inhaler: 90 mcg/metered spray, 100 mcg/metered spray. Albuterol sulfate: Capsules for inhalation: 200 mcg. Solution for inhalation: 0.083% mg/mL, 0.5% mg/ mL, 0.63 mg/mL, 1.25 mg/3 mL. Syrup: 2 mg/5 mL. Tablets: 2 mg, 4 mg. Tablets, extended-release: 4 mg, 8 mg.
Indications/Routes/Dosage
Prevention/treatment of bronchospasm in patients with reversible obstructive airway disease: Aerosol inhalation: Children 4 years old or older: 1 or 2 inhalations q4-6h. Capsules for inhalation: Children 4 years old or older: 200 mcg inhaled q4-6h. Solution for inhalation: Children 12 years old or older: 2.5 mg tid or qid by nebulizer. Children 2 -12 years old: initially, 0.1-0.15 mg/kg by nebulizer, with subsequent dosing titrated to response, not to exceed 2.5 mg tid or qid by nebulization.
Syrup or oral tablets: Children 2-6 years: initially, 0.1 mg/kg PO tid. Starting dose should not exceed 2 mg (1 tsp) tid. Do not exceed 4 mg tid. Children 6-14 years: 2 mg PO tid or qid. Do not exceed 24 mg daily. Adults, children 14 years old or older: 2-4 mg PO tid or qid. Do not exceed 8 mg qid.
Extended-release tablets: Children 6-12 years old: 4 mg PO q12h. Adults, children older than 12 years: 4-8 mg PO q12h.
To prevent exercise-induced bronchospasm: 2 aerosol inhalations 15 -30 min before exercise.
Adverse Reactions
Nervousness, dizziness, headache, weakness, insomnia, nasal congestion, hoarseness, tachycardia, hypertension, nausea, vomiting, heartburn, increased appetite, hypokalemia, muscle cramps, bronchospasm, cough, increased sputum.
Implications
Use caution in patients with diabetes mellitus, hypertension, or hyperthyroidism.
Teach family how to use inhaler properly.
Increase fluid intake.
Do not take more than 2 inhalations at any one time to prevent paradoxical bronchoconstriction.
Rinse mouth after inhalation.
AMOXICILLIN–ANTIBIOTIC
Brand Name
Amoxil (generic also available)
Uses
Treat otitis media, upper and lower respiratory tract, soft tissue, skin, GI, GU, and gonorrhea infections. Used to treat: Gram-positive cocci:a Staphylococcus aureus, Streptococcus pyogenes, Streptococcus faecalis, Streptococcus pneumoniae. Gram-negative cocci: Neisseria gonorrhoeae, Neisseria meningitides. Gram-positive bacillus: Corynebacterium diphtheriae, Listeria monocytogenes. Gram-negative bacillus: Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Salmonella; also used in bacterial endocarditis prophylaxis.
Availability
Suspension: 125/5 mL, 200/5 mL, 250/5 mL, 400/5 mL. Tablets: 500 mg, 875 mg. Pediatric drops: 50 mg/mL. Tablets, chewable: 125 mg, 200 mg, 250 mg, 400 mg. Capsules: 250 mg, 500 mg.
Indications/Routes/Dosage
Ear, nose, throat, GU, skin/structure infections: Children < 20 kg: 20-40 mg/kg/day divided q8-12h. Children, adults > 20 kg: 250-500 mg q8h or 500-875 mg 2 times/day.
Lower respiratory tract infections: Children < 20 kg: 40 mg/kg/day divided q8-12h. Children, adults > 20 kg: 500 mg q8h or 875 mg tablets 2 times/day.
Acute uncomplicated gonorrhea, epididymitis-orchitis: Adults: 3 g once with 1 g probenecid PO follow with tetracycline or erythromycin.
Acute otitis media: Children: 80-90 mg/kg/day divided bid for those at high risk.
Adverse Reactions
Mild diarrhea, rash, oral/vaginal candidiasis; superinfection, colitis, allergic reaction-anaphylaxis.
Implications
Take all of medication.
Report rash or severe diarrhea.
Discard suspension after 14 days.
AMOXICILLIN-CLAVULANATE–POTASSIUM ANTIBIOTIC
Brand Name
Augmentin
Uses
Treat lower respiratory infection, otitis media, sinusitis, skin infections, urinary tract infections caused by susceptible strains of Gram-positive and Gram-negative organisms.
Availability
Oral suspension: 125 mg/5 mL, 200 mg/5 mL, 250 mg/5 mL, 400 mg/5mL. Tablets: 250 mg, 500 mg, 875 mg. Tablets, chewable: 125 mg, 200 mg, 250 mg, 400 mg.
Indications/Routes/Dosage
Recurrent or persistent otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis: Augmentin ES-600. Children older than 3 months: 90 mg/kg/day, based on amoxicillin component, PO q12h for 10 days.
Lower respiratory infections, otitis media, sinusitis, skin infections, urinary tract infections caused by susceptible strains of Gram-positive and Gram-negative organisms: Adults, children weighing > 40 kg: 250 mg (based on amoxicillin component) PO q8h or 500 mg q12h. May use 500 mg PO q8h OR 875 mg PO q12h for more severe infections. Children weighing 40 kg: 20 to 45 mg/kg, based on amoxicillin component and severity of infection, PO daily in divided doses q8-12h.
Children 3 months of age or older: 30 mg/kg/day PO in divided doses q12h.
Adverse Reactions
Nausea, vomiting, diarrhea, agitation, confusion, dizziness, insomnia, enterocolitis, pseudomembranous colitis, abdominal pain, vaginitis, anemia, thrombocytopenia, hypersensitivity reactions.
Implications
May decrease effectiveness of hormonal contraceptives.
Note: oral suspensions have varying clavulanic acid content.
Continue antibiotic for full length of treatment, take with meals.
AZITHROMYCIN–MACROLIDE ANTIBIOTIC
Brand Name
Zithromax
Uses
Treat community-acquired pneumonia, otitis media, pharyngitis, tonsillitis, dental prophylaxis in patients allergic to penicillin, uncomplicated gonococcal infections, chlamydial infections.
Availability
Powder for oral suspension: 100 mg/5 mL, 200 mg/5 mL, 1000 mg/packet. Tablets: 250 mg, 500 mg, 600 mg. Injection: 500 mg.
Indications/Routes/Dosage
Otitis media: Children older than 6 months: 10 mg/kg PO daily for 3 days OR 10 mg/ kg PO on day 1 then 5 mg/kg once daily on days 2-5.
Pharyngitis, tonsillitis: Children older than 2 years: 12 mg/kg (max 500 mg) PO daily for 5 days.
Dental prophylaxis: Adults: 500 mg PO 1 hour before procedure. Children: 15 mg/ kg PO 1 h before procedure.
Chlamydial infections: Adults, adolescents older than 16 years: 1 g PO as a single dose.
Adverse Reactions
Dizziness, headache, fatigue, palpitations, chest pain, nausea, vomiting, diarrhea, abdominal pain, cholestatic jaundice, pseudomembranous colitis, candidiasis, vaginitis, rash, photosensitivity, angioedema.
Implications
Use cautiously with liver impairment.
Give oral suspension 1 hour before or 2 hours after meals.
Do not give with antacids.
BENZOCAINE–TOPICAL OTIC ANALGESIC
Brand Name
Auralgan Otic Solution
Uses
Topical analgesic to reduce pain associated with acute otitis media.
Availability
10-mL bottle.
Indications/Routes/Dosage
Instill drops until ear canal is full, put wick into ear canal. May repeat every 1-2 hours as needed.
Adverse Reactions
Irritation of ear canal.
Implications
Do not let dropper touch ear canal, do not rinse ear dropper after use, keep out of the reach of children.
Have child lay on side and tilt the affected ear upward, pull ear lobe up and instill medication, have child lay on side for 5 minutes then insert wick.
Do not use on perforated eardrum.
BUDESONIDE–INHALATION CORTICOSTEROID ANTI-INFLAMMATORY
Brand Name
Entocort EC, Pulmicort, Rhinocort
Uses
Manage symptoms of seasonal or perennial allergic rhinitis.
Availability
Nasal inhaler: 32 mcg/metered spray (Rhinocort AQ). Nasal spray: 50 mcg/dose (Pulmicort). Powder for inhalation: 200 mcg/inhalation (Pulmicort Turbuhaler). Suspension for oral inhalation: 0.25 mg/2 mL, 0.5 mg/2 mL (Pulmicort Respules).
Indications/Routes/Dosage
Intranasal: Children older than 6 years, adults: Rhinocort: 2 sprays each nostril 2 times/ day or 4 sprays to each nostril in morning. Rhinocort Aqua: 1 spray to each nostril once daily. Children younger than 12 years: 4 sprays/day. Children older than 12 years: 8 sprays/day.
Nebulization: Children 1-8 years: 0.25-1 mg/day titrated to lowest effective dosage.
Inhalation: Children older than 6 years, adults: initially 200-400 mcg 2 times/day to max 400 mcg 2 times/day.
Rhinitis: Nasal inhalation: Children older than 6 years: initial, 2 sprays/nostril twice daily. Adult: initial 2 sprays/nostril bid or 4 sprays/nostril in the morning. Max 4 sprays/ nostril per day. Nasal spray: Children older than 6 years: initial, 1 spray/nostril once a day. Max dose 4 sprays/nostril/day. Children younger than 12 years: 2 sprays/nostril once a day. Not recommended for children younger than 6 years. Children older than 12 years: 4 sprays/nostril, once a day. Nasal spray: initial, 1 spray/nostril once daily, max 4 sprays/nostril once a day.
Adverse Reactions
Mild nasopharyngeal irritation, burning stinging, headache, throat irritation, epistaxis, Cushing's syndrome, cataract, adrenal suppression, glaucoma.
Implications
Use caution in patients with cataracts, diabetes mellitus, exposure to viral infections, glaucoma, liver cirrhosis, peptic ulcer.
Do not consume grapefruit juice during oral treatment.
Reduce dose for hepatic insufficiency.
May take 3-7 days for full effect.
CEFDINIR–THIRD-GENERATION CEPHALOSPORIN ANTIBIOTIC
Brand Name
Omnicef
Uses
Treat susceptible infections due to Streptococcus pyogenes, S. pneumoniae, Haemophilus influenzae, H. parainfluenzae, Moraxella catarrhalis, acute maxillary sinusitis, chronic bronchitis, community-acquired pneumonia, otitis media, pharyngitis/tonsillitis, skin infections.
Availability
Suspension: 125 mg/5 mL; 250 mg/5mL; Capsule: 300 mg.
Indications/Routes/Dosage
Children older than 6 mos: 7 mg/kg PO q12h for 10 days or 14 mg/kg PO once a day for 10 days, max 600 mg/day.
Children: 20 kg: 2.5 mL (0.5tsp) q12h or 5 mL (1 tsp) q24h. 20-40 lbs: 5 mL (1 tsp) q12h or 10 mL (2 tsp) q24h. 41-60 lbs: 7.5 mL (1.5 tsp) q12h or 15 mL (3 tsp) q24h. 61-80 lbs: 10 mL (2 tsp) q12h or 20 mL (4 tsp) q24h. 81-85 lbs: 12 mL (2.5 tsp) q12h or 24 mL (5 tsp) q24h.
Adults: 300 mg PO q12h or 600 mg PO once a day for 10 days.
Adverse Reactions
Diarrhea, nausea, oral and vaginal candidiasis, headache.
Implications
May take with or without food.
Take antacids 2 hours before or after taking medication.
Take for full length of treatment.
Suspension can be stored at room temperature, discard after 10 days.
Adjust dose in renal impairment.
CEFPROZIL–SECOND-GENERATION CEPHALOSPORIN ANTIBIOTIC
Brand Name
Cefzil
Uses
Treat susceptible infections due to Streptococcus pneumoniae, S. pyogenes, Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, acute or chronic bronchitis, secondary bacterial infection, acute sinusitis, otitis media, pharyngitis/tonsillitis, skin infections.
Availability
Oral suspension: 125 mg/5 mL, 250 mg/5 mL. Tablets: 250 mg, 500 mg.
Indications/Routes/Dosage
Acute sinusitis: Children 6 months-12 years: 7.5-15 mg/kg PO q12h for 10 days. Adults: 500 mg PO q12h for 10 days.
Otitis media: Children 6 mos-12 years: 15 mg/kg PO q12h for 10 days (max 1 g/day).
Bronchitis: Adult: 500 mg PO q12h for 10 days.
Pharyngitis/tonsillitis: Children 2-12 years: 7.5 mg/kg PO q12h for 10 days. Adults: 500 mg PO q24h for 10 days.
Skin infections: Children 2-12 years: 20 mg/kg PO q24h for 10 days. Adults: 250 mg-500 mg PO q12-24h for 10 days.
Adverse Reactions
Diarrhea, nausea, vomiting; diaper rash, oral and vaginal candidiasis, dizziness, elevation of liver enzymes, severe hypersensitivity reactions.
Implications
Refrigerate suspension, discard after 14 days.
May take with or without food.
Adjust dose for renal impairment.
CEFTRIAXONE–THIRD-GENERATION CEPHALOSPORIN ANTIBIOTIC
Brand Name
Rocephin
Uses
Treat susceptible infections due to Gram-negative bacilli: Haemophilus influenzae, Escherichia coli, Proteus mirabilis, Klebsiella, Enterobacter, Salmonella, Shigella,
Neisseria, Serratia; Gram-positive organisms: Streptococcus pneumoniae, S. pyogenes, Staphylococcus aureus; serious lower respiratory tract, urinary tract, gonorrhea, meningitis, septicemia, bone, joint infections.
Availability
Powder for injection: 500 mg, 1 g, 2 g, 10 g.
Indications/Routes/Dosage
Children: 50-75 mg/kg/day divided q12h; adult 1-2 g daily. Max 2 g q12h.
Uncomplicated gonorrhea: adults: 250 mg IM as a single dose.
Meningitis: Children, adult: 100 mg/kg/day IM divided q12h. Max 4 g/day.
Adverse Reactions
Nausea, vomiting, diarrhea, anorexia, hypersensitivity, nephrotoxicity.
Implications
Assess sensitivity to penicillin and other cephalosporins (10% cross over).
Watch for adverse reactions.
CEFUROXIME SODIUM, CEFUROXIME AXETIL–SECOND-GENERATION CEPHALOSPORIN ANTIBIOTICS
Brand Name
Kefurox, Zinacef, Cefuroxime Axetil, Ceftin
Uses
Treat susceptible infections due to Group B streptococci, pneumococci, staphylococci, Haemophilus influenzae, Escherichia coli, Enterobacter, Klebsiella, bone and joint infection, gonorrhea, lower respiratory tract infections, meningitis, preoperative prophylaxis, septicemia, urinary tract infections.
Availability
Suspension: 125 mg/5 mL, 250 mg/5 mL. Tablet: 250 mg, 500 mg. Infusion: 1.5 g/ 50 mL, 750 mg/50 mL. Injection: 1.5 g, 7.5 g, 750 mg.
Indications/Routes/Dosage
Pharyngitis/tonsillitis: Tablets: 125 mg PO bid for 10 days. Children 3 mos-12 years: 30 mg/kg/day PO in 2 divided doses for 10 days. Max 500 mg/day.
Impetigo, otitis media, sinusitis: Children 3 mos-12 years: 30 mg/kg/day PO in 2 divided doses for 10 days. Max 1 g/day. Tablets: 250 mg PO bid for 10 days.
Susceptible infections: Neonates: 20-100 mg/kg/day IV in divided doses q12h. Children older than 3 months: 50-100 mg/kg/day IV/IM divided q6-8h.
Bone and joint infections: Children older than 3 mos: 150 mg/kg/day IV/IM divided q8h.
Meningitis: Children 3 months old or older: 200-240 mg/kg/day IV/IM divided q6-8h. Max 9 g/day.
Bronchitis: Adults: 250 or 500 mg PO bid for 10 days.
Gonorrhea: Adults: 1 g PO as a single dose; 1.5 g IM as a single dose with 1.5 g probenecid PO.
Gonococcal infections: Adults: 750 mg IV/IM q8h.
Pharyngitis/tonsillitis/sinusitis: Adults: 250 mg PO bid for 10 days.
Skin infections: Adults: 250-500 mg PO bid for 10 days.
Urinary tract infections: Adults: 125mg or 250 mg PO bid for 7-10 days.
Adverse Reactions
Local reactions at IV/IM site; diarrhea, abdominal cramping, nausea; oral and vaginal candidiasis.
Implications
Adjust dose for renal impairment.
Take antibiotic for full length of treatment.
CEPHALEXIN HYDROCHLORIDE–FIRST-GENERATION CEPHALOSPORIN ANTIBIOTIC
Brand Name
Keftab, Keflex, Biocef
Uses
Treat infections of respiratory tract, GI tract, skin, soft tissue, bone, joints, and otitis media caused by Escherichia coli and other coliform bacteria, Group A beta-hemolytic streptococci, Klebsiella species, Proteus mirabilis, Streptococcus pneumoniae, and staphylococci.
Availability
Cephalexin hydrochloride: Tablets: 500 mg. Cephalexin monohydrate: Oral suspension: 125 mg/5 mL, 250 mg/5 mL. Tablets: 250 mg, 500 mg, 1 g. Capsules: 250 mg, 500 mg.
Indications/Routes/Dosage
Children: 25-50 mg/kg/day PO in 2 to 4 equally divided doses. Adults: 250 mg-1 g PO q6h or 500 mg q12h. Max 4 g daily. Dose can be doubled in severe infections.
Adverse Reactions
Dizziness, headache, confusion, fatigue, hallucinations, nausea, vomiting, diarrhea, pseudomembranous colitis, oral candidiasis, vaginitis, genital pruritus, interstitial nephritis, neutropenia, anemia, thrombocytopenia, arthritis, joint pain, rash, urticaria, hypersensitivity reactions.
Implications
Take with food or milk.
There is a possibility of cross-sensitivity with penicillin and other beta-lactam antibiotics.
Adjust dose for renal impairment.
Avoid using with aminoglycosides, increases risk of nephrotoxicity.
CETIRIZINE–ANTIHISTAMINE
Brand Name
Zyrtec
Uses
Rhinitis, allergic symptoms.
Availability
Syrup: 5 mg/5 mL. Tablets: 5 mg, 10 mg.
Indications/Routes/Dosage
Child 2-6 years: 2.5 mg daily may increase to 5 mg daily or 2.5 mg bid.
Child older than 6 years, adult: 5-10 mg daily.
Zyrtec D (5 mg with 120 mg pseudoephedrine) once bid.
Adverse Reactions
Thickening of bronchial secretions, dry mouth, headache, drowsiness.
Implications
Avoid driving if drowsiness occurs; use sunscreen when in sunlight.
Notify provider of difficulty voiding.
CIPROFLOXACIN HYDROCHLORIDE–FLUOROQUINOLONE ANTI-INFECTIVE
Brand Name
Cipro
Uses
Treat conjunctival keratitis, keratoconjunctivitis, corneal ulcers, blepharitis, dacryocystitis, blepharoconjunctivitis.
Availability
Ophthalmic: 0.03%; Otic (Ciprodex).
Indications/Routes/Dosage
Conjunctivitis: 1-2 drops q2h for 2 days, then q4h next 5 days.
Corneal ulcer: 2 drops q15min for 6h, then 2 drops q30min remainder first day; 2 drops q1h second day; then q4h days 3-14.
Otic: older than 6 months, 4 drops in ear bid for 7 days.
Adverse Reactions
Ophthalmic: Sensitization may contraindícate later systemic use of ciprofloxacin.
Implications
Tilt patient's head back, put drops in conjunctival sac.
Do not use ophthalmic solution as injection.
CLARITHROMYCIN–MACROLIDE ANTIBIOTIC
Brand Name
Biaxin, Biaxin XL
Uses
Treat bronchitis, otitis media, acute maxillary sinusitis, pharyngitis, tonsillitis, pneumonia, skin infections.
Availability
Suspension: 125/5 mL, 250/5 mL. Tablets: 250 mg, 500 mg. Tablets, extended-release: 500 mg.
Indications/Routes/Dosages
Acute otitis media: Children: 15 mg/kg/day in 2 divided doses for 10 days.
Respiratory/skin infections: Children: 15 mg/kg/day in 2 divided doses for 10 days. Usual adult dose: 250-500 mg q12h for 7-14 days. Extended release: Two 500-mg tablets daily for 7-14 days.
Adverse Reactions
Antibiotic-associated colitis (severe abdominal pain, fever, watery diarrhea), superinfection, hepatotoxicity, thrombocytopenia.
Implications
Monitor bowel activity and stool consistency.
For minor GI effects take with food.
Doses should be evenly spaced.
Take with 8 oz water.
CLINDAMYCIN–ANTIBIOTIC
Brand Name
Cleocin
Uses
Treat infections from staphylococci, streptococci, Rickettsia, Pneumocystis cariniipneumonia.
Availability
Oral solution: 75 mg/mL. Capsules: 75 mg, 150 mg, 300 mg.
Indications/Routes/Dosage
Children younger than 1 month: 15-20 mg/kg/day divided q6-8h. Children older than 1 month 8-25 mg/kg/day divided q6-8h. Adult: 150-450 mg q6h. Max 1.8 g/day.
Adverse Reactions
Nausea, vomiting, diarrhea, pseudomembranous colitis (severe diarrhea), urinary frequency, vaginitis.
Implications
Take with full glass of water.
Give with food to reduce GI symptoms.
Antiperistaltic drugs may worsen diarrhea.
Do not break, crush, or chew capsules.
Call provider for diarrhea.
CLOMIPRAMINE HYDROCHLORIDE–TRICYCLIC ANTIDEPRESSANT
Brand Name
Anafranil
Uses
Treat obsessive-compulsive disorder manifested as repetitive tasks producing marked distress; off label: mental depression, panic disorder, neurogenic pain, bulimia.
Availability
Capsules: 25 mg, 50 mg, 75 mg.
Indications/Routes/Dosage
Children: starting dose of 10 mg/day; increase to 75-100 mg/day. Teens: starting dose of 10 mg/day increase to 100-200 mg/day.
Adverse Reactions
Dry mouth, dizziness, sleepiness, tremors, decreased libido, headache, aggressiveness, high doses may produce cardiovascular effects (severe postural hypotension, dizziness, tachycardia, palpitations, arrhythmias, seizures). Abrupt withdrawal from prolonged therapy may produce headache, malaise, nausea, vomiting.
Implications
Contraindicated within 14 days of MAO inhibitor ingestion.
Caution with history of seizures, hyperthyroidism, cardiac/hepatic/renal disease, diabetes mellitus.
May cause dry mouth, blurred vision, constipation, drowsiness.
Ability to tolerate postural hypotension, sedative, and anticholinergic effects occurs during early therapy.
Maximum therapeutic effect occurs in 2-4 weeks.
Do not abruptly stop medication.
Avoid tasks that require alertness, motor skills until drug response is established.
Wear sunscreen to prevent photosensitivity.
CROTAMITON–SCABICIDE, ANTIPRURITIC
Brand Name
Eurax
Uses
Treat parasitic infestation (scabies), pruritus.
Availability
Topical cream: 10%. Topical lotion: 10%.
Indications/Routes/Dosage
For itching, apply locally, massaging affected area until medication absorbed.
Adverse Reactions
Dermatitis, skin irritation.
Implications
Patient should wash entire body with soap and water.
Avoid application to face, eyes, mouth, or mucous membranes; avoid applying to inflamed skin or raw, oozing skin surfaces.
Remove any crusting and apply a thin layer of cream over entire body from the chin down.
Apply second coat. Wash medication off 48 hours after second coat applied.
Repeat treatment in 7-10 days if new lesions develop.
DIPHENHYDRAMINE HYDROCHLORIDE–ANTIHISTAMINE, ANTIPRURITIC, ANTITUSSIVE
Brand Name
Benadryl, Nytol, Allerdryl
Uses
Treat allergy symptoms, rhinitis, motion sickness, urticaria.
Availability
Elixir: 125 mg/5 mL. Syrup: 12.5 mg/5 mL. Tablets: 25 mg, 50 mg. Tablets, chewable: 25 mg. Capsules: 25 mg, 50 mg.
Indications/Routes/Dosage
Children younger than 2 years: 2 mg/kg q4-6h.
Children 2-6 years: 6.25 mg q4-6h. Max 37.5 mg/day. 6-12 years: 12.5-25 mg q4-6h. Max 150 mg/day. Children older than 12 years, adults: 25-50 mg q4-6h. Max 300 mg/day.
Moderate to severe allergic reaction: Children: 5 mg/kg/day divided q6-8h. Max 300 mg/day. Adults: 25-50 mg q4h. Max 400 mg/day.
Adverse Reactions
Dizziness, drowsiness, dry nose, throat.
Implications
Avoid tasks that require alertness, motor skills until response to drug is established, avoid alcohol.
ERYTHROMYCIN–ANTIBIOTIC
Brand Name
Erythromycin, EES
Uses
Treat upper and lower respiratory infections such as pneumonia, bronchitis, pharyngitis, otitis media, pertussis, Legionnaires' disease, prophylaxis for rheumatic fever, oral surgery, intestinal and skin infections, gonorrheal pelvic inflammatory infection (if penicillin is contraindicated), Lyme disease (younger than 9 years).
Availability
Tablets: 250 mg, 333 mg, 500 mg. Tablets, delayed-release: 333 mg. Capsules, delayed-release: 250 mg.
Estolate: Oral suspension: 125 mg/5 mL, 250 mg/5 mL. Tablets: 500 mg. Capsules: 250 mg.
Ethylsuccinate: Oral suspension: 200 mg/5 mL, 400 mg/5 mL. Tablets: 400 mg. Tablets, chewable: 200 mg.
Stearate: Tablets: 250 mg, 500 mg.
Indications/Routes/Dosage
Base and ethylsuccinate: Children: 30-50 mg/kg/day divided q6-8h up to 60-100 mg/ kg/day for severe infections for 10 days, not to exceed 2 g/day. Adults: delayed-release: 333 mg q8h increase up to 4 g/day.
Ethylsuccinate: Adults: 400-800 mg q6-12h.
Estolate: 30-50 mg/kg/day divided q6-12h. Do not exceed 2 g/day. Adults: 250-500 mg q6-12h.
Stearate: 30-50 mg/kg/day divided q6h. Do not exceed 2 g/day. Adults: 250-500 mg q6-12h.
Pertussis: 40-50 mg/kg/day divided q6h for 14 days.
Prophylaxis for rheumatic fever: 250 mg bid if penicillin allergy.
Chlamydia trachomatis: 50 mg/kg/day divided q6h for 10-14 days.
Adverse Reactions
Nausea, vomiting, abdominal pain, diarrhea, rash, anaphylaxis.
Implications
Avoid milk and acidic beverages 1 hour before or after a dose.
Take with food or snack to decrease GI upset.
Do not break or chew tablets or capsules.
Suspension is stable for 14 days at room temperature.
FERROUS SULFATE–IRON PREPARATION
Brand Name
Feosol, Fer-In-Sol
Uses
Treat iron-deficiency anemia.
Availability
Feosol: Tablets: 200 mg (65 mg elemental iron). Fer-In-Sol: Drops: 75 mg/0.6 mL (15 mg elemental iron/0.6 mL).
Indications/Routes/Dosage
Mild to moderate iron deficiency: 3 mg elemental iron/kg/day in 1-2 divided doses.
Severe iron deficiency: 4-6 mg elemental iron/kg/day in 3 divided doses.
Adverse Reactions
Nausea, diarrhea, black stools, constipation, black urine, teeth staining.
Implications
Interactions: antacids, tetracycline will reduce absorption. Vitamin C enhances absorption.
Give between meals with orange juice; do not give with milk. Give with a straw or brush teeth after giving.
May cause abdominal discomfort, keep out of the reach of small children.
FEXOFENADINE HYDROCHLORIDE–ANTIHISTAMINE
Brand Name
Allegra
Uses
Treat seasonal allergic rhinitis.
Availability
Tablets: 30 mg, 60 mg, 180 mg. Capsules: 60 mg. Capsules, extended-release: 180 mg.
Indications/Routes/Dosage
Children older than 12 years: 60 mg bid or 180 mg once daily.
Children 6-11 years: 30 mg bid.
Adverse Reactions
Dry mouth, nose, headache, fatigue, nausea, vomiting.
Implications
Avoid tasks that require alertness, motor skills until response to drug is known.
Avoid alcohol, coffee, or tea; may decrease drowsiness.
FLUOXETINE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI), ANTIDEPRESSANT
Brand Name
Prozac, Sarafem (Prozac weekly)
Uses
Treat major depression, obsessive-compulsive disorder (OCD), bulimia nervosa, premenstrual dysphoric disorder (PMDD).
Availability
Oral solution: 20 mg/5 mL. Tablets: 10 mg, 20 mg. Capsules: 10 mg, 20 mg, 40 mg.
Indications/Routes/Dosage
Anxiety disorders: starting dose of 5 mg/day, increase to 15-30 mg/day for children and 10-40 mg/day for teens.
Major depression: starting dose of 5 mg/day increase to 15-40 mg per day for children, 10-60 mg/day for teens.
Adverse Reactions
Headache, nervousness, insomnia, drowsiness, anxiety, tremor, dizziness, sedation, poor concentration, abnormal dreams, decreased libido, dry mouth, diarrhea, weight loss.
Implications
Take with food and milk for GI symptoms.
Can crush tablet if patient unable to swallow.
Take at night to decrease oversedation.
Therapeutic effect may take 1-4 weeks.
Use sunscreen to prevent photosensitivity.
Avoid alcohol and other CNS depressants.
Notify prescriber if pregnant, plan to become pregnant, or are breastfeeding.
Change position slowly due to orthostatic hypotension.
Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants, monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.
FLUVOXAMINE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR, ANTIDEPRESSANT, ANTIANXIETY
Brand Name
Luvox
Uses
Treat obsessive-compulsive disorder (OCD), major depression, anxiety disorders.
Availability
Tablets: 25 mg, 50 mg, 100 mg.
Indications/Routes/Dosage
Starting dose of 25 mg/day, increase to 50-200 mg/day for children and 150-300 mg/ day for teens.
Adverse Reactions
Headache, drowsiness, dizziness, convulsions, nausea, vomiting, anorexia, constipation, diarrhea, decreased libido, increased effect with St. John's wort. Fatal reactions: MAO inhibitor interactions increase action of propranolol, diazepam, lithium, warfarin, carbamazepine, theophylline.
Implications
Give with food, milk for GI distress.
Therapeutic effects may take 2-3 weeks. Use caution when driving.
Do not use with other CNS depressants, e.g., alcohol, barbiturates, benzodiazepines, St. John's wort.
Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants; monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.
FOLIC ACID–NUTRITION SUPPLEMENT
Brand Name
Folate, Folvite
Uses
Treat anemia due to folate deficiency, nutritional supplement to prevent neural tube defects.
Availability
Tablets: 0.4 mg, 0.8 mg, 1.0 mg.
Indications/Routes/Dosage
Recommended daily intake for children: 6 months-3 years: 50 mcg (15 mcg/kg/day). 4-6 years: 75 mcg. 7-10 years: 100 mcg. 11-14 years: 150 mcg. Older than15 years: 200 mcg.
Dosage: Infants: 15 mcg/kg/daily. Children: 1 mg/day initial dosage. Maintenance dose, 1-10 years: 0.1-0.4 mg/day. Children older than 11 years, adults: 1 mg/day initial dose; maintenance dose 0.5 mg/day.
Adverse Reactions
Flushing, irritability, difficulty sleeping, malaise, rash, itching, GI upset, hypersensitivity reactions.
Implications
Take everyday.
Call provider if adverse reactions.
LACTULOSE–HYPEROSMOTIC LAXATIVE
Brand Name
Constilac, Constulose, Enulose
Uses
Treat constipation.
Availability
Syrup: 10 mg/15 mL. Packets: 10 g, 20 g.
Indications/Routes/Dosage
Children: 7.5 mL/day after breakfast. Adults: 15-30 mL/day up to 60 mL/day.
Adverse Reactions
Cramping, flatulence, increased thirst, abdominal discomfort, diarrhea indicates an overdose.
Implications
Drink water, juice, milk with each dose.
Evacuation occurs in 24-48 hours of initial dose.
Patients should also be on a high-fiber diet and exercise to promote defecation.
LEVALBUTEROL–BRONCHODILATOR
Brand Name
Xopenex
Uses
Prevention of bronchospasm due to reversible obstructive airway disease.
Availability
Solution for nebulization: 0.63 mg OR 1.25 mg in 3-mL vials (no dilution necessary).
Indications/Routes/Dosage
Children older than12 years: 0.63-1.25 mg q6-8h (tid), with max of 1.25 mg tid.
Adverse Reactions
Tremors, nervousness, headache, throat dryness/irritation, palpitations, chest pain, extrasystole.
Implications
Monitor rate, depth, rhythm, and type of respiration.
Increase fluid intake.
Rinse mouth with water after inhalation.
Avoid caffeine.
LITHIUM CARBONATE–ANTIMANIC, ANTIDEPRESSANT
Brand Name
Eskalith, Dura-Lith
Uses
Prophylaxis, treatment of acute mania, manic phase of bipolar disorder.
Availability
Syrup: 300 mg/5 mL. Tablets: 300 mg. Tablets, slow-release: 300 mg, 450 mg. Capsules: 150 mg, 300 mg, 600 mg.
Indications/Routes/Dosage
Start at 25 mg/kg/day, gradually increase until serum level reaches therapeutic range of 0.9-1.1 mEq/L.
Adverse Reactions
Headache, drowsiness, dizziness, anorexia, nausea, vomiting, diarrhea, hypotension, dry mouth. May increase effects of antithyroid medication, iodinate glycerol, potassium iodide. Nonsteroidal anti-inflammatory drugs (NSAIDs) and diuretics may increase concentration, toxicity. May decrease absorption of phenothiazines.
Implications
Give with meals, milk.
Limit alcohol, caffeine.
May cause dry mouth.
Do not crush, chew, or break extended-release or film-coated tablets.
Assess serum lithium levels q3-4 days during initial phase of therapy, q1-2 months thereafter and weekly if no improvement.
Monitor for signs of lithium toxicity vomiting, diarrhea, drowsiness, incoordination, hand tremor, muscle twitching, mental confusion, ataxia.
LORATADINE–ANTIHISTAMINE
Brand Name
Claritin
Uses
Treat seasonal rhinitis.
Availability
Syrup: 5 mg/5 mL. Tablet: 10 mg.
Indications/Routes/Dosage
Children 2-12 years: 5 mg daily. Children older than12 years, adult: 10 mg daily.
Adverse Reactions
Sedation is more common with larger doses, headache.
Implications
Use sunscreen (photosensitive).
Avoid driving if drowsiness occurs.
Additive CNS effects with alcohol and antidepressants.
MEBENDAZOLE–ANTHELMINTIC
Brand Name
Vermox
Uses
Treatment of Enterobius vermicularis (pinworms), Ascaris lumbricoides (roundworm), Trichuris trichiura (whipworm), and Ancylostoma duodenale (common hookworm).
Availability
Tablets, chewable: 100 mg.
Indications/Routes/Dosage
Enterobiasis: Children, adults: 100 mg PO as a single dose. Other infestations: Children, adults: 100 mg 2 bid for 3 days.
Adverse Reactions
GI transient abdominal pain. Carbamazepine and phenytoin can increase metabolism of mebendazole.
Implications
Tablets may be chewed, swallowed, or crushed and mixed with food.
Do not administer to children younger than 2 years or pregnant and lactating women.
If patient is not cured in 3 weeks following treatment, retreatment is necessary.
All family members should be treated at the same time.
Discuss hygiene, transmission, and reinfection.
MONTELUKAST–ANTIASTHMATIC
Brand Name
Singulair
Uses
Prophylaxis and chronic treatment of asthma.
Availability
Tablets: 10 mg. Tablets, chewable: 4 mg, 5 mg. Oral granules: 4 mg.
Indications/Routes/Dosages
Children 1-5 years: one 4-mg tablet taken in the evening. 6-14 years: one 5-mg chewable tablet taken in the evening. Children older than 14, adults: 10 mg daily taken in the evening.
Adverse Effects
Headache, abdominal pain, fever, restlessness, irritability.
Implications
Do not use to reverse bronchospasm as in an acute asthma attack.
Increase fluid intake.
Continue other asthma medications while taking this one.
Chewable table contains phenylalanine.
Patients sensitive to aspirin should avoid aspirin and NSAIDs while on this medication.
NITROFURANTOIN–ANTIBIOTIC
Brand Name
Furadantin, Macrobid, Macrodantin
Uses
Treat urinary tract infections caused by Escherichia coli, Klebsiella, Pseudomonas, Proteus vulgaris, Staphylococcus aureus, Salmonella, Shigella.
Availability
Suspension: 25 mg/5 mL. Tablets: 50 mg, 100 mg. Capsules: 25 mg, 50 mg, 100 mg.
Indications/Routes/Dosage
Active infections: Children 1 month old to 3 years: 5-7 mg/kg/day divided qid; 1-3 mg/ kg/day for long-term treatment. Children older than 12 years, adult: 50-100 mg qid PO or 50-100 mg at bedtime for long-term treatment.
Chronic suppression: Children: 1 mg/kg/day every night. Adults: 50-100 mg every night.
Adverse Reactions
Dizziness, headache, nausea, vomiting, abdominal pain, diarrhea.
Implications
Do not use in infants younger than 1 month old.
Take with food or milk.
Avoid alcohol.
Drowsiness may occur; do not drive or operate machinery until response to drug is established.
Do not crush tabs or open capsules.
May turn urine rust-yellow to brown.
OFLOXACIN–FLUOROQUINOLONE ANTIINFECTIVE
Brand Name
Floxin Optic, Floxin Otic Drops, Ocuflox
Uses
Ophthalmic: Treat bacterial conjunctivitis, corneal ulcers. Otic: Treat otitis externa, acute/chronic otitis media.
Availability
Ophthalmic solution: 3 mg/mL. Otic solution: 0.3%.
Indications/Routes/Dosage
Bacterial conjunctivitis: 1-2 drops q2-4h for 2 days then 4 times/day for 5 days.
Corneal ulcers: Ophthalmic: 1-2 drops q30min while awake for 2 days, then q60min while awake for 5-7 days, then 4 times/day. Otic: twice daily.
Adverse Reactions
Allergic reaction.
Implications
Ophthalmic:
Tilt patient's head back, place solution in conjunctival sac.
Do not use ophthalmic solution for injection.
Otic:
Eardrops should be at room temperature.
Instruct patient to lie down with head turned so affected ear is upright.
Pull the auricle down and posterior in children, pull up and posterior in older adolescents and adults.
Instill toward canal wall.
OMEPRAZOLE–GASTRIC ACID PUMP INHIBITOR
Brand Name
Prilosec
Uses
Short-term treatment (4-8 weeks) and maintenance of erosive esophagitis, gastroesophageal reflux disease (GERD), poorly responsive to other treatments. Unlabeled treatment of Helicobacter pylori-associated duodenal ulcer.
Availability
Tablets: 10 mg, 20 mg, 40 mg.
Indications/Routes/Dosage
Children older than 2 years: 20 mg/day, 20 kg 10 mg/day.
Adverse Reactions
May increase concentration of oral anticonvulsants diazepam; phenytoin may increase serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alanine aminotransferase (ALT).
Implications
Report headache to provider.
Take before meals.
Swallow capsule whole; do not crush or chew.
PAROXETINE HYDROCHLORIDE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR, ANTIDEPRESSANT, ANTIPANIC, ANTIANXIETY
Brand Name
Paxil, Paxil CR
Uses
Treat major depressive disorder, obsessive-compulsive disorder (OCD), panic and generalized anxiety disorders.
Availability
Oral suspension: 10 mg/kg. Tablets: 10 mg, 20 mg, 30 mg, 40 mg. Tablets, controlled-release (CR): 12.5 mg, 25 mg, 37.5 mg.
Indications/Routes/Dosage
Children, adolescents: initial dose 5-10 mg, titrate up to 20 mg and monitor for side effects. Paxil CR: Children, adolescents: initial dose 12 mg titrate up to 25 mg.
Adverse Reactions
Nausea, headache, nervousness, insomnia, sedation, agitation, fatigue, dry mouth, constipation, diarrhea, decreased libido/sexual dysfunction.
Implications
Dose changes should occur at 1-week intervals for both drugs.
Do not use with MAO inhibitor.
Use with cimetidine may increase concentrations.
Use with phenytoin may decrease concentrations.
Use with risperidone may increase paroxetine concentration enough to cause extrapyramidal symptoms.
May cause dry mouth; avoid alcohol.
Therapeutic effect may occur in 1-4 weeks.
Do not abruptly discontinue medication.
Avoid tasks that require alertness or motor skills until response to drug is established.
Give with food or milk if GI symptoms.
Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants, monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.
PENICILLIN V POTASSIUM–ANTIBIOTIC
Brand Name
Pen VK, V-cillin-K
Uses
Treatment of mild to moderate infections of respiratory tract, skin/skin structures, otitis media, prophylaxis for rheumatic fever, dental procedures.
Availability
Oral solution: 125 mg/5 mL, 250 mg/5 mL. Tablets: 125 mg, 250 mg, 500 mg.
Indications/Routes/Dosage
Children younger than 12 years: 25-50 mg/kg/day divided q6-8h. Max 3 g/day.
Children older than 12 years, adults: 125-500 mg q6-8h.
Rheumatic fever prophylaxis: Children, adults: 250 mg 2-3 times/day.
Adverse Reactions
Hypersensitivity reaction, colitis, fever, rash, pruritus.
Implications
Question history of drug allergies.
Continue antibiotic for full treatment.
Notify provider of rash, sensitivity reaction.
PREDNISOLONE–ANTI-INFLAMMATORY
Brand Name
Pediapred, Prelone, Orapred
Uses
Treat reactive airway disease and asthma flare.
Availability
Syrup: 5 mg/5 mL, 15 mg/5 mL. Tablets: 5 mg.
Indications/Routes/Dosage
1-2 mg/kg/day in divided doses bid usually for 5 days, although longer may be required.
Adverse Reactions
Insomnia, heartburn, nervousness, abdominal distention, mood swings, increased sweating, and delayed healing. Long term: hypocalcemia, hypokalemia, muscle wasting especially the arms and legs, osteoporosis, spontaneous fractures, amenorrhea, cataracts, glaucoma, peptic ulcer disease.
Sertraline–SSRI, Antidepressant, Antipanic Agent 643
Implications
Notify healthcare provider of fever, sore throat, muscle aches, swelling, weight gain.
Avoid alcohol, caffeine.
Avoid exposure to chickenpox or measles.
RANTIDINE–ANTIULCER AGENT, GASTRIC ACID SECRETION INHIBITOR
Brand Name
Zantac
Uses
To prevent and treat gastric and duodenal ulcers.
Availability
Syrup 15 mg/5 mL; Tablets 75 mg, 150 mg, 300 mg; effervescent capsules 150 mg, 300 mg.
Indications/Routes/Dosage
GERD and ulcers: Children 1 month-16 years. 2-4 mg/kg bid; effervescent tabs 2.5-5 mg/kg bid; adults and adolescents 150 mg bid.
SERTRALINE–SEROTONIN SELECTIVE REUPTAKE INHIBITOR, ANTIDEPRESSANT, ANTIPANIC AGENT
Brand Name
Zoloft
Uses
Treat major depression, obsessive-compulsive disorder (OCD), post-traumatic stress disorder, panic disorder, PMDD.
Availability
Oral liquid: 20 mg/mL. Tablets: 25 mg, 50 mg, 100 mg.
Indications/Routes/Dosage
Anxiety: Children: starting dose of 25 mg/day increase to 50-100 mg/day; 50-200 mg/ day for teens.
Major depression: Children: starting dose of 25 mg/day increase to 50-150 mg/day; 50-200 mg/day for teens.
Adverse Reactions
Headache, nausea, diarrhea, insomnia, drowsiness, fatigue, rash, dry mouth, anxiety, sexual dysfunction.
Implications
Do not give within 14 days of MAO inhibitor.
Therapeutic effect may take 2-3 weeks.
Avoid tasks that require alertness, motor skills until response to drug is established.
Take with food or milk, avoid alcohol.
Weigh weekly: appetite may decrease.
Notify provider if intending to become pregnant, are pregnant, or are breastfeeding.
Do not use with St. John's wort, Sam-e.
Avoid CNS depressants.
Do not stop quickly, need to taper.
Educate parents about FDA concerns of suicide risk in patients on SSRI antidepressants, monitor suicidal risk closely during course of treatment especially in the first 30 days of treatment.
SULFAMETHOXAZOLE/TRIMETHOPRIM–ANTI-INFECTIVE
Brand Name
Bactrim, Septra
Uses
Treat acute/complicated and recurrent urinary tract infections, Shigella, enteritis, otitis media, traveler's diarrhea, enteritis, Pneumocystis carinii pneumonia.
Availability
Oral suspension: 40 mg trimethoprim/200 mg, 400 mg sulfamethoxazole/5 mL. Tablets: 80 mg trimethoprim/400 mg sulfamethoxazole; 160 mg/800 mg.
Indications/Routes/Dosage
Urinary tract infection caused by Escherichia coli, Klebsiella, Proteus mirabilis, Enterobacter, enteritis, acute otitis media: Children older than 2 months: 7.5-8 mg/kg/ day divided q12h for 10 days. Adults: 160 mg q12h for 7-14 days.
|
Weight: lbs, kg |
Suspension |
Tablets |
|
22, 10 |
1 tsp (5 mL) |
½ |
|
44, 20 |
2 tsp (10 mL) |
1 |
|
66, 30 |
3 tsp (15 mL) |
1½ |
|
88, 40 |
4 tsp (20 mL) |
2 tablets or 1 DS tablet |
Travelers' diarrhea, bronchitis: Adults: 1 double-strength tablet q12h for 5 days.
Adverse Reactions
Anorexia, nausea, vomiting urticaria, diarrhea, abdominal pain, rash, fever, sore throat, cough, shortness of breath.
Implications
Take each dose with one glass water and increase fluid intake.
Take for full treatment time as prescribed.
Do not use in children younger than 2 months.
Do not use in patients sensitive to sulfa drugs.
Note: all patients weighing > 100 pounds should be dosed according to adult dosage guidelines.