DRUGS--G

Gallamine Triethiodide

Trade Name(s): Flaxedil

Pregnancy Category: Problems in humans have not been documented

Medical Category: Neuromuscular blocking agent

Accepted Indications: Muscle relaxation, convulsions

Mechanism of Action: Nondepolarizing neuromuscular blocking agent

Half life: 16 min (distribution), 150 min (elimination)

IV: 3–{endash}5 min

Metabolism: Not metabolized

Elimination: Renal

Research Notes: Onset of action 1–{endash}2 min, duration of peak effect 15–{endash}30 min

Adult Dosage: IV: 1 mg/kg initially, then 500 m{mu}g–{endash}1 mg/kg after 30–{endash}40 min if necessary

Elderly Dosage: May require lower dose

Child Dosage: Same as adult dose

Infant Dosage: Use with caution

Dosage Forms: Injection: 20 mg/mL

Warnings: Protect from freezing

Frequent Side Effects: Increased blood pressure, flushing, tachycardia

Occasional Side Effects: Decreased blood pressure

Rare Side Effects: Bronchospasm, hypersensitivity reaction, bradycardia, circulatory depression, edema, erythema, laryngospasm, itching, rash

Contraindications: Dehydration, hypotension, cardiac disease

Disease States: Hypothermia, respiratory depression, myasthenia gravis

Other Drugs: Aminoglycosides, clindamycin, capreomycin, parenteral/local anesthetics, lincomycin, polymyxins, citrate-anticoagulated blood, antimyasthenics, edrophonium, calcium salts, beta blockers, doxapram, lithium, procainamide, quinidine, neuromuscular blocking agents, physostigmine, potassium-depleting medications

Lab Tests: Serum potassium

Ganciclovir Sodium

Trade Name(s): Cytovene

Pregnancy Category: C

Medical Category: Systemic antiviral

Accepted Indications: Cytomegalovirus retinitis, severe disease caused by cytomegalovirus

Mechanism of Action: Inhibits DNA synthesis

Absorption/Distribution: Poorly absorbed after oral administration, widely distributed to all tissues

Half life: 2.5–{endash}3.6 h

IV: End of infusion

Metabolism: Little or no metabolism

Elimination: Renal

Adult Dosage: IV: 5 mg/kg b.i.d. for 14–{endash}21 d initially; maintenance: 5 mg/kg once daily for 7 d or 6 mg/kg once daily for 5 d

Elderly Dosage: May require lower dose

Child Dosage: Not established

Infant Dosage: Not established

Dosage Forms: Sterile injection: 500 mg

Frequent Side Effects: Granulocytopenia, thrombocytopenia

Occasional Side Effects: Anemia, CNS effects, hypersensitivity, phlebitis, GI disturbances, bacterial endophthalmitis, conjunctival scarring, detached retina, subconjunctival hemorrhage

Contraindications: Low neutrophil count

Disease States: Renal function impairment

Other Drugs: Radiation therapy, blood dyscrasia–{endash}causing medications, bone marrow depressants, imipenem with cilastin, zidovudine, probenecid

Lab Tests: Serum bilirubin, platelet count

Gemfibrozil

Trade Name(s): Lopid

Chemically Related To: Clofibrate

Pregnancy Category: C

Medical Category: Antihyperlipidemic

Accepted Indications: Hyperlipidemia

Mechanism of Action: Reduces LDLs, increases HDLs

Absorption/Distribution: Well absorbed from GI tract

Half life: 1–{endash}5 h

PO: 1–{endash}2 h

Metabolism: Hepatic

Elimination: 70% renal; 6% fecal

Research Notes: If response is inadequate after 3 m of treatment, withdraw therapy

Adult Dosage: Oral 1.2 g/d taken in 2 divided doses

Elderly Dosage: Reduced dosage may be required

Dosage Forms: Tablets: 600 mg; capsules: 300 mg

By System: Cardiovascular

Warnings: Comply with prescribed diet; if gallstones are found, discontinue therapy

Precautions: Check with physician before discontinuing medication because blood lipid levels may increase significantly

Frequent Side Effects: Stomach pain, gas, heartburn

Occasional Side Effects: Diarrhea, nausea or vomiting, rash, extreme tiredness

Rare Side Effects: Anemia or leukopenia, gallstones, myositis

Contraindications: Primary biliary cirrhosis

Disease States: Gallbladder disease, gallstones, hepatic function impairment, severe renal function impairment

Other Drugs: Anticoagulants, lovastatin

Lab Tests: Hematocrit, potassium, leukocyte counts, hemoglobin, bilirubin, creatine kinase

Administrative Notes: If patient experiences muscle pain or weakness, evaluate myositis

Gentamicin Sulfate

Trade Name(s): G-Mycin, Garamycin, Jenamicin

Chemically Related To: Aminoglycosides

Pregnancy Category: C

Medical Category: Antibacterial

Accepted Indications: Serious systemic infections

Unaccepted Indications: Staphylococcal infections, uncomplicated urinary tract infections

Mechanism of Action: Interferes with messenger RNA

Absorption/Distribution: Rapidly and completely absorbed after IM administration

Half life: 5–{endash}15 min (distribution); 2–{endash}4 h (elimination)

IM: 0.5–{endash}1.5 h

IV: 30 min after end of infusion

Metabolism: Not metabolized

Elimination: Renal

Adult Dosage: Up to 3–{endash}8 mg/kg/d

Elderly Dosage: Use with caution

Child Dosage: 2–{endash}2.5 mg/kg t.i.d. for 7–{endash}10 d

Infant Dosage: Up to 1 w: 2.5 mg/kg once daily or b.i.d. for 7–{endash}10 d; over 1 w: 2.5 mg/kg q8–{endash}16h for 7–{endash}10 d

Dosage Forms: In sodium chloride injection: 40 mg/50 mL, 40 mg/100 mL, 60 mg/50 mL, 60 mg/100 mL, 70 mg/50 mL, 80 mg/50 mL, 80 mg/100 mL, 90 mg/100 mL, 100 mg/50 mL, 100 mg/100 mL, 120 mg/100 mL, 160 mg/100 mL, and 180 mg/100 mL; injection: 10 mg/mL, 40 mg/mL, and 2 mg/mL (intrathecal)

Frequent Side Effects: Nephrotoxicity, ototoxicity, neurotoxicity, peripheral neuritis

Occasional Side Effects: Hypersensitivity, optic neuritis

Rare Side Effects: Neuromuscular blockade

Contraindications: Botulism, eighth cranial nerve function impairment

Overdosage: Loss of hearing, dizziness, vomiting

Antidotal Therapy: May include dialysis, calcium salts

Disease States: Dehydration, parkinsonism, myasthenia gravis, renal function impairment

Other Drugs: Nephrotoxic medications, ototoxic medications, polymyxins, aminoglycosides, capreomycin, methoxyflurane, neuromuscular blocking agents

Lab Tests: BUN, creatinine

Gentamicin Sulfate (Ophthalmic)

Trade Name(s): Garamycin, Genoptic Liquifilm, Gentacidin, Gentafair, Gentak, Gentrasul, Ocu-Mycin, Spectro-Genta

Chemically Related To: Aminoglycosides

Pregnancy Category: Problems not documented

Accepted Indications: Blepharitis, blepharoconjunctivitis, conjunctivitis, dacryocystitis, keratitis, keraconjunctivitis, meibomianitis

Mechanism of Action: Binds to specific receptor protein on the 30S subunit of bacterial ribosomes, interferes with messenger RNA

Absorption/Distribution: May be absorbed in very small quantities

Adult Dosage: Ophthalmic solution: up to 1 drop/h; ophthalmic ointment: topical, to the conjunctiva, 1 cm b.i.d. to t.i.d.

Elderly Dosage: Same as adult dose

Child Dosage: Same as adult dose

Dosage Forms: Ophthalmic solution: 5 mg gentamicin sulfate (equal to 3 mg gentamicin base)/mL; ophthalmic ointment: 5 mg gentamicin sulfate (equal to 3 mg gentamicin base)/g

Frequent Side Effects: Blurred vision

Occasional Side Effects: Hypersensitivity, burning sensation, stinging

Gentamicin Sulfate/Prednisolone Acetate

Trade Name(s): Pred-G, Pred-G S.O.P.

Medical Category: Ophthalmic anti-infective

Accepted Indications: Steroid-responsive inflammatory ocular conditions; ocular bacterial infections; chronic anterior uveitis; corneal injury from chemical, radiation, or thermal burns or from foreign bodies

Adult Dosage: Ointment: apply to the affected eye q3–{endash}4h; suspension: 1–{endash}2 drops in the affected eye q3–{endash}4h

Dosage Forms: Ophthalmic ointment: 0.37%/0.6%; ophthalmic suspension: 0.3%/1%

Glipizide

Trade Name(s): Glucotrol

Chemically Related To: Sulfonamides

Pregnancy Category: C

Medical Category: Antidiabetic

Accepted Indications: Noninsulin-dependent diabetes mellitus

Unaccepted Indications: Insulin-dependent diabetes

Mechanism of Action: Promotes release of insulin from beta cells of the pancreas

Absorption/Distribution: Rapid absorption

Half life: 2–{endash}4 h

PO: 1–{endash}3 h

Metabolism: Liver

Elimination: Renal

Adult Dosage: 5–{endash}40 mg/d

Dosage Forms: Tablets: 5 mg and 10 mg

By System: Endocrine, pancreas

Warnings: Elderly may require reduced dosage

Precautions: Photosensitivity possible; carry medical identification card or bracelet

Frequent Side Effects: Constipation, diarrhea, dizziness, mild drowsiness, headache, heartburn, nausea and vomiting, stomach pain

Occasional Side Effects: Photosensitivity; skin redness, itching, or rash

Rare Side Effects: Agranulocytosis, aplastic anemia, bone marrow depression, thrombocytopenia, hepatitis, cholestatic jaundice

Contraindications: Severe burns, infections, or trauma; diabetic coma; major surgery; significant ketosis or acidosis

Overdosage: Cold sweats; coma; confusion; cool pale skin; seizures; continuing headache; tachycardia; unsteady gait; extreme tiredness; vision changes

Antidotal Therapy: May include immediate ingestion of sugar or administration of IV glucose

Disease States: Adrenal or pituitary insufficiency (untreated), high fever, prolonged nausea and vomiting, hepatic function impairment, malnourishment

Nutrition: Follow prescribed diet low in refined carbohydrates

Other Drugs: Alcohol, coumarin anticoagulants, sulfonamides, beta-adrenergic blockers, bone marrow depressants, insulin, fluconazole, miconazole

Lab Tests: BUN, uric acid, creatinine, alkaline phosphatase

Glucagon

Trade Name(s): Glucagon Emergency Kit

Pregnancy Category: B

Medical Category: Antihypoglycemic, diagnostic aid adjunct, antispasmodic, antidote

Accepted Indications: Hypoglycemia, GI radiography adjunct, abdominal imaging adjunct, pelvic imaging adjunct, GI bleeding diagnosis adjunct, beta blocker and calcium channel blocker toxicity antidote, foreign body esophageal obstruction

Unaccepted Indications: Birth asphyxia or hypoglycemia in infants, chronic hypoglycemia

Mechanism of Action: Promotes hepatic glycogenolysis and gluconeogenesis

Half life: 10 min

Metabolism: Hepatic, renal

Adult Dosage: IM, IV or SQ: 0.5–{endash}1 mg, repeated in 20 min if necessary

Child Dosage: IM, IV or SQ: 25 m{mu}g/kg, repeated in 20 min if necessary

Dosage Forms: Parenteral: 1 mg and 10 mg

Occasional Side Effects: Allergic reaction, nausea, vomiting

Contraindications: Hyperglycemia, insulinoma, pheochromocytoma

Overdosage: Nausea, vomiting, hypokalemic syndrome

Antidotal Therapy: May include potassium, fluids

Disease States: Allergy to beef or porcine proteins, pheochromocytoma

Other Drugs: Anticoagulants

Administrative Notes: Check expiration date

Glutethimide

Trade Name(s): Generic only

Scheduled Class: II

Pregnancy Category: C

Medical Category: Sedative-hypnotic

Unaccepted Indications: Has generally been replaced by safer, more effective agents

Mechanism of Action: Unknown

Absorption/Distribution: Absorbed erratically from GI tract

Half life: 10–{endash}12 h

Peak activity: 1–{endash}6 h

Metabolism: Hepatic

Elimination: Renal, fecal

Research Notes: Onset of action, 0.5 h; duration of action, 4–{endash}8 h

Adult Dosage: Capsules and tablets: 200–{endash}500 mg at bedtime; dose may be repeated if necessary, but not less than 4 h before patient arises

Elderly Dosage: Lower dosage may be required

Child Dosage: Safety and efficacy not established

Infant Dosage: Safety and efficacy not established

Dosage Forms: Capsules: 500 mg; tablets: 500 mg

Frequent Side Effects: Daytime drowsiness

Occasional Side Effects: Rash, blurred vision, clumsiness, confusion, dizziness

Rare Side Effects: Blood dyscrasias, blurred vision

Contraindications: Porphyria

Overdosage: Bluish skin, convulsions, fever, low body temperature, muscle spasms

Antidotal Therapy: May include induced vomiting, gastric lavage

Disease States: Glaucoma, peptic ulcer, bladder neck obstruction, porphyria

Other Drugs: Alcohol, CNS depressants, anticoagulants

Lab Tests: Phentolamine, urinary steroid

Administrative Notes: Prolonged use may result in dependence

Glyburide

Trade Name(s): Diab{beta}eta, Micronase

Chemically Related To: Tolbutamide

Pregnancy Category: B

Medical Category: Antidiabetic (sulfonylurea)

Accepted Indications: Noninsulin-dependent diabetes mellitus

Unaccepted Indications: Insulin-dependent diabetes

Mechanism of Action: Promotes release of insulin from the beta cells of pancreatic tissue

Absorption/Distribution: Rapid absorption

Half life: 10 h

PO: 4 h

Metabolism: Hepatic

Elimination: Renal

Research Notes: Duration of action, 24 h

Adult Dosage: 2.5–{endash}20 mg/d

Elderly Dosage: Initially, 1.25–{endash}2.5 mg/d

Dosage Forms: Tablets: 1.25 mg, 2.5 mg, and 5 mg

By System: Endocrine, pancreas

Warnings: Avoid alcohol

Precautions: Carry medical identification card or bracelet; photosensitivity possible

Frequent Side Effects: Changes in taste; constipation; diarrhea; dizziness; mild drowsiness; headache; heartburn; increase in appetite; nausea

Occasional Side Effects: Hives; photosensitivity; skin redness, itching, or rash

Rare Side Effects: Agranulocytosis, aplastic anemia, bone marrow depression, jaundice, hepatic function impairment, thrombocytopenia

Contraindications: Significant acidosis or ketosis; severe burns, infections, or trauma; diabetic coma; major surgery; ketoacidosis

Overdosage: Hypoglycemia, difficulty in concentrating, drowsiness, excessive hunger, continuing headache, seizures, unsteady gait

Antidotal Therapy: May include immediate ingestion of sugar; if severe, rapid IV administration of 50% dextrose

Disease States: Adrenal or pituitary insufficiency (untreated); high fever; prolonged nausea and vomiting; thyroid, hepatic, or renal function impairment; malnourishment

Nutrition: Adhere to a diet low in refined carbohydrates that provides a counted caloric intake

Other Drugs: Alcohol, anticoagulants, MAO inhibitors, beta-adrenergic blocking agents, insulin, bone marrow depressants

Lab Tests: BUN, uric acid, lactate dehydrogenase, creatinine, alkaline phosphatase

Administrative Notes: In some patients receiving a maintenance dose of 10 mg/d or more, administration in divided doses b.i.d. may improve the control of hyperglycemia

Glycerin

Trade Name(s): Fleet Babylax, Osmoglyn, Sani-Supp

Pregnancy Category: C for diuretic and antiglaucoma agent

Medical Category: Hyperosmotic laxative; diuretic; systemic antiglaucoma agent

Accepted Indications: Constipation, bowel evacuation, laxative dependency treatment, glaucoma, cerebral edema

Mechanism of Action: Attracts water into stool, lubricates and softens fecal mass; elevates blood plasma osmolality

PO: 60–{endash}90 min

Elimination: Poor absorption; fecal elimination

Adult Dosage: Suppositories: 1 adult suppository once daily; oral solution: 1–{endash}1.5 g/kg as single dose, additional doses may be given at 6 h intervals

Elderly Dosage: Use with caution

Child Dosage: Under 6 y: 1 pediatric suppository once daily; 6 y and over: 1 adult suppository once daily; pediatric rectal solution: over 1 y: entire contents of applicator once daily; oral solution: 1–{endash}1.5 g/kg as single dose, may be repeated in 4–{endash}8 h

Infant Dosage: Suppositories and rectal pediatric solution: not recommended; oral solution: 1–{endash}1.5 g/kg as single dose may be repeated in 4–{endash}8 h

Dosage Forms: Suppositories: adult, pediatric; pediatric rectal solution; oral solution: 50% and 75%

Frequent Side Effects: Headache, nausea, vomiting

Occasional Side Effects: Rectal irritation, confusion, diarrhea, dizziness, dry mouth

Rare Side Effects: Arrhythmias

Contraindications: Appendicitis, CHF, hypertension

Disease States: Diabetes, rectal bleeding, intestinal obstruction, cardiac disease, confused mental states, severe dehydration, hypovolemia, renal disease

Other Drugs: Potassium-sparing diuretics, potassium supplements

Glycopyrrolate

Trade Name(s): Robinul

Pregnancy Category: B

Medical Category: Anticholinergic, antiarrhythmic, antidiarrheal

Accepted Indications: Peptic ulcer, irritable bowel syndrome, gastric hypersecretory conditions in anesthesia prophylaxis, cholinesterase inhibitor toxicity prophylaxis, diarrhea

Mechanism of Action: Decreases motility of GI tract

Half life: 1.7 h

Metabolism: Hepatic

Elimination: Renal

Adult Dosage: Tablets: 1–{endash}2 mg b.i.d. or t.i.d., up to 8 mg/d; injection: 100–{endash}200 m{mu}g up to q.i.d.

Elderly Dosage: May require lower dose

Child Dosage: Not established

Infant Dosage: Not established

Dosage Forms: Tablets: 1 mg and 2 mg. Injection: 200 m{mu}g/mL

Frequent Side Effects: Constipation, dryness of mouth, decreased sweating, redness at injection site

Occasional Side Effects: Decreased breast milk flow, decreased salivation

Rare Side Effects: Confusion, bloating, allergic reaction, increased intraocular pressure, difficult urination, blurred vision, drowsiness, headache, dizziness, memory loss, sensitivity of eyes to light, nausea, vomiting, tiredness, weakness

Contraindications: Cardiac disease, glaucoma, acute hemorrhage

Overdosage: Blurred vision, confusion, tachycardia

Antidotal Therapy: May include 4% tannic acid, adequate hydration

Disease States: Brain damage, Down syndrome, hiatal hernia, reflux esophagitis, GI tract obstructive disease, intestinal atony, paralytic ileus, myasthenia gravis, prostatic hypertrophy, urinary retention, obstructive uropathy, pyloric obstruction, tachycardia, ulcerative colitis

Other Drugs: Antacids, haloperidol, antidiarrheals, anticholinergics, cyclopropane, potassium chloride, ketoconazole

Lab Tests: Gastric acid secretion, thyroid function, serum uric acid

Gonadorelin Acetate

Trade Name(s): Lutrepulse

Pregnancy Category: B

Medical Category: Gonad stimulating principle

Accepted Indications: Primary hypothalamic amenorrhea

Mechanism of Action: Induces ovulation by synthesizing and releasing LH

Half life: 2–{endash}10 min (initial); 10–{endash}40 min (terminal)

Elimination: Renal

Research Notes: Intended for use only with Lutrepulse pump

Adult Dosage: IV: 5 m{mu}g/90 min initially

Child Dosage: Under 18 y: safety and efficacy not established

Infant Dosage: Safety and efficacy not established

Dosage Forms: For injection: 0.8 mg/vial and 3.2 mg/vial

Frequent Side Effects: No incidence given for ovarian hyperstimulation, inflammation, infection, mild phlebitis, hematoma at catheter site

Gonadorelin Hydrochloride

Trade Name(s): Factrel

Pregnancy Category: B

Medical Category: Gonad-stimulating principle; diagnostic aid

Accepted Indications: Hypogonadism (diagnosis), delayed puberty, amenorrhea, infertility

Mechanism of Action: Stimulates release of LH

Half life: 2–{endash}10 min (initial), 10–{endash}40 min (terminal)

Metabolism: Rapidly metabolized

Elimination: Renal

Adult Dosage: SQ or IV, 100 m{mu}g

Child Dosage: 12 y and over: same as adult dose

Infant Dosage: Not recommended

Dosage Forms: For injection: 100 m{mu}g and 500 m{mu}g

Warnings: Store at room temperature

Frequent Side Effects: No incidence given for anaphylaxis, rash, itching, pain at injection site

Rare Side Effects: Stomach discomfort, flushing, headache, lightheadedness, nausea

Other Drugs: Digoxin, estrogens, adrenocorticoids, androgens, progestins, oral contraceptives, levodopa, spironolactone, metoclopramide, phenothiazines

Lab Tests: LH levels

Goserelin Acetate

Trade Name(s): Zoladex

Medical Category: Antineoplastic, synthetic luteinizing hormone releasing hormone (LHRH) analog

Accepted Indications: Prostatic carcinoma

Mechanism of Action: Suppresses secretion of LH and FSH and results in fall in testosterone concentrations

Half life: 4.2 h

Peak activity: 12–{endash}15 d (implants)

Adult Dosage: SQ: 3.6 mg every 28 d

Elderly Dosage: Same as adult dose

Child Dosage: Not recommended

Infant Dosage: Not recommended

Dosage Forms: Implants: 3.6 mg (base)

Frequent Side Effects: Hot flashes, impotence

Occasional Side Effects: Anemia, MI, arrhythmias, cerebrovascular accident, hypertension, gout, rash, anxiety, mental depression, COPD, CHF, edema, diarrhea, constipation, weight gain, trouble sleeping, breast tenderness, nausea, vomiting, dizziness, headache, appetite loss

Disease States: Vertebral metastases, obstructive uropathy

Lab Tests: Serum acid phosphatase

Gramicidin

Trade Name(s): Not available as a single agent

Chemically Related To: Polypeptides; produced by growth of Bacillus brevis

Medical Category: Antibacterial

Accepted Indications: External infections caused by gram positive organisms

Mechanism of Action: Cationic membrane dissolver

Gramicidin/Neomycin Sulfate/Polymyxin B Sulfate

Trade Name(s): AK-Spore, Neosporin, Ocu-Spor-G, Ocutricin

Medical Category: Antibiotic

Accepted Indications: Ocular infections

Adult Dosage: Acute infections: topical to the conjunctiva, 1 drop every 15–{endash}30 min initially, frequency reduced gradually; other infections: topical to the conjunctiva, 1 drop b.i.d. to q.i.d. for 7–{endash}10 d

Elderly Dosage: Same as adult dose

Child Dosage: Same as adult dose

Dosage Forms: Ophthalmic solution: 0.025 mg/1.75 mg/10,000 units/mL

Griseofulvin

Trade Name(s): Fulvicin P/G, Fulvicin-U/F, Grifulvin V, Grisactin, Grisactin Ultra, Gris-PEG

Chemically Related To: Furantoins

Pregnancy Category: C

Medical Category: Antifungal (systemic)

Accepted Indications: Tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea pedis, and tinea unguium

Unaccepted Indications: Minor or trivial infections, bacterial infections

Mechanism of Action: Stops division of fungus at metaphase

Absorption/Distribution: Absorption: 25%–{endash}70% of oral dose; distributed to keratin layer of skin, hair, and nails

Half life: 24 h

PO: 4 h

Metabolism: Hepatic

Elimination: Renal

Research Notes: Diseased keratin is lost and replaced with healthy tissue

Adult Dosage: 250–{endash}500 mg b.i.d.

Elderly Dosage: Same as adult dose

Child Dosage: 2.75–{endash}5 mg/kg b.i.d.

Infant Dosage: Up to 2 y: no studies available

Dosage Forms: Capsules (microsize): 250 mg; oral suspension (microsize): 125 mg/5 mL; tablets (microsize): 250 mg and 500 mg; tablets (ultramicrosize): 125 mg, 165 mg, 250 mg, and 330 mg

By System: Systemic

Warnings: May cause dizziness; avoid alcohol and sun/sun lamp

Frequent Side Effects: Headache

Occasional Side Effects: Confusion, hives, thrush, photosensitivity

Rare Side Effects: Leukopenia, granulocytopenia, hepatitis, peripheral neuropathy

Disease States: Liver problems, lupuslike syndrome, porphyria

Other Drugs: Anticoagulants, estrogen contraceptives, barbiturates, alcohol, primidone

Administrative Notes: Include measuring device with oral suspension

Guaifenesin

Trade Name(s): Anti-Tuss, Breonesin, Glycotuss, Hytuss-2X, Nortussin, Robitussin

Chemically Related To: Unique compound

Pregnancy Category: C

Medical Category: Expectorant

Accepted Indications: Productive cough

Unaccepted Indications: As a cough suppressant; dry, persistent cough

Mechanism of Action: Reduces viscosity of respiratory secretions

Absorption/Distribution: Readily absorbed

Elimination: Renal

Research Notes: Therapy should be combined with deep breathing exercises

Adult Dosage: 200–{endash}400 mg q4h, not to exceed 2400 mg/d

Elderly Dosage: Same as adult dose

Child Dosage: 2–{endash}6 y: 300 mg b.i.d. up to 600 mg/d; 6–{endash}12 y: 600 mg b.i.d. not to exceed 1200 mg/d

Infant Dosage: Up to 2 y: individualize dose

Dosage Forms: Capsules: 200 mg; extended-release capsules: 300 mg; oral solution: 200 mg/5 mL; syrup: 100 mg/5 mL; tablets: 100 mg and 200 mg; extended-release tablets: 600 mg

By System: Respiratory

Warnings: Swallow extended-release tablets whole

Precautions: Monitor cough type and frequency

Occasional Side Effects: Diarrhea, drowsiness, GI upset

Overdosage: Vomiting

Other Drugs: Heparin

Lab Tests: Urine tests of 5-hydroxyindoleacetic acid and vanillylmandelic acid, platelet aggregation

Administrative Notes: Drink water after each dose

Guaifenesin/Hydrocodone Bitartrate

Trade Name(s): Bertuss, Codiclear DH; Entuss, Hycotuss, Kwelcof, Prolex DH

Scheduled Class: III

Abuse Potential: Moderate

Pregnancy Category: C

Medical Category: Antitussive

Accepted Indications: Cough

Dosage Forms: Syrup: 100 mg/5 mg, 10%/100 mg/5 mg; tablet: 300 mg/20 mg

Guaifenesin/Hydrocodone Bitartrate/Phenindamine Tartrate

Trade Name(s): P-V-Tussin

Scheduled Class: III

Abuse Potential: Moderate

Pregnancy Category: C

Medical Category: Antitussive, decongestant

Accepted Indications: Cough, cold

Dosage Forms: Tablet: 200 mg/5 mg/25 mg

Guaifenesin/Hydrocodone Bitartrate/Pheniramine Maleate/Phenylpropanolamine Hydrochloride/Pyrilamine Maleate

Trade Name(s): Triaminic Expectorant DH

Scheduled Class: III

Abuse Potential: Moderate

Pregnancy Category: C

Medical Category: Antitussive, decongestant

Accepted Indications: Cough, cold

Adult Dosage: 10 mL q4h

Elderly Dosage: Same as adult dose

Child Dosage: 1–{endash}6 y: 2.5 mL q4h; 6–{endash}12 y: 5 mL q4h

Dosage Forms: Oral solution: 100 mg/1.67 mg/6.25 mg/12.5 mg/6.25 mg/5 mL

Guaifenesin/Hydrocodone/Phenylephrine Hydrochloride

Trade Name(s): Donatussin DC

Scheduled Class: III

Abuse Potential: Moderate

Pregnancy Category: C

Medical Category: Antitussive, decongestant

Accepted Indications: Cough, cold

Dosage Forms: Syrup: 50 mg/2.5 mg/7.5 mg

Guaifenesin/Hydromorphone Hydrochloride

Trade Name(s): Dilaudid Cough Syrup

Scheduled Class: III

Abuse Potential: Moderate

Pregnancy Category: C

Medical Category: Antitussive

Accepted Indications: Cough

Dosage Forms: Syrup: 100 mg/1 mg

Guaifenesin/Oxtriphylline

Trade Name(s): Brondelate, Theocon

Pregnancy Category: C

Medical Category: Antiasthmatic, bronchodilator

Accepted Indications: Asthma

Dosage Forms: Elixir: 50 mg/100 mg/5 mL; some preparations contain 20% alcohol. Tablet: 100 mg/200 mg

Guaifenesin/Phenylephrine Hydrochloride

Trade Name(s): Chemdal; Deconsal; Endal; Guaifed; Phenmax; Quindal

Pregnancy Category: C

Medical Category: Decongestant, mucolytic

Accepted Indications: Cough, cold, allergy

Dosage Forms: Tablet: 300 mg/20 mg

Guaifenesin/Phenylephrine Hydrochloride/Phenylpropanolamine Hydrochloride

Trade Name(s): Contuss, Despec, Dura-Gest, Enomine, Entex

Pregnancy Category: C

Medical Category: Antihistamine, decongestant, mucolytic

Accepted Indications: Cough and colds

Adult Dosage: Oral solution, 10 mL q.i.d., capsules, 1 capsule q.i.d.

Dosage Forms: Capsules: 200 mg/5 mg/45 mg; oral solution: 100 mg/5 mg/20 mg/alcohol 5%

Guaifenesin/Phenylpropanolamine Hydrochloride

Trade Name(s): Contuss TD; Enomine LA; Entex LA; Guaipax; Lantex-LA; Vanex-LA

Pregnancy Category: C

Medical Category: Decongestant, mucolytic

Accepted Indications: Cough and cold, allergy

Dosage Forms: Tablet: 400 mg/75 mg, 200 mg/75 mg

Guaifenesin/Pseudoephedrine Hydrochloride

Trade Name(s): Anatuss LA; Entex PSE; Guaifed-PD; Nasatab LA, Respinol-G; Sinufed

Pregnancy Category: C

Medical Category: Decongestant, mucolytic

Accepted Indications: Cough, cold, allergy

Dosage Forms: Capsule: 250 mg/30 mg, various other strengths; syrup; tablet: 200 mg/120 mg, various other strengths

Guaifenesin/Theophylline

Trade Name(s): Asbron G, Broncomar GG, Ed-Bron G, Elixophyllin GG, Equibron G, Glyceryl-T, Mudrane GG-2, Slo-Phyllin, Synophylate-GG, Theolate

Pregnancy Category: C

Medical Category: Bronchodilator, expectorant

Accepted Indications: Bronchial asthma, bronchitis, pulmonary emphysema, chronic obstructive pulmonary disease

Metabolism: Hepatic

Elimination: Renal (10% unchanged)

Adult Dosage: 5–{endash}8 mg of anhydrous theophylline/kg/d to a maximum of 400 mg/d in 3 or 4 divided doses

Elderly Dosage: 3–{endash}5 mg/kg/d

Child Dosage: Varies by indication and form

Dosage Forms: Varies by preparation

By System: Respiratory

Frequent Side Effects: Nausea, nervousness, palpitations

Occasional Side Effects: Gastroesophageal reflux, nausea

Overdosage: Confusion, convulsions, diarrhea, tachypnea, tachycardia, GI tract bleeding, headache, increased urination, irritability, loss of appetite, muscle twitching, nausea, tremor, arrhythmia, vomiting

Disease States: Gastritis, peptic ulcer

Nutrition: Caution in eating or drinking large amounts of xanthine–{endash}containing foods or beverages during therapy with this medication

Other Drugs: Adrenocorticoids, phenytoin, beta-adrenergic blocking agents, cimetidine, erythromycin, ranitidine, troleandomycin, ciprofloxacin, norfloxacin, nicotine chewing gum, smoking tobacco

Lab Tests: Serum theophylline determinations

Administrative Notes: May be taken with meals to lessen GI irritation

Guanabenz Acetate

Trade Name(s): Wytensin

Pregnancy Category: C

Medical Category: Antihypertensive

Accepted Indications: Hypertension

Mechanism of Action: Alpha2-adrenergic agonist

Absorption/Distribution: 75% absorbed from GI tract

Half life: 6 h

Peak activity: 2–{endash}4 h

Metabolism: Hepatic

Elimination: Renal, fecal

Research Notes: Onset of action, 1 h; duration of action, 12 h

Adult Dosage: 4–{endash}8 mg b.i.d. up to 32 mg/d

Elderly Dosage: Lower dosage may be required

Child Dosage: Safety and efficacy not established

Infant Dosage: Safety and efficacy not established

Dosage Forms: Tablets: 4 mg and 8 mg

Frequent Side Effects: Dizziness, dry mouth, drowsiness, weakness

Occasional Side Effects: Nausea, headache, decreased sexual ability

Overdosage: Severe dizziness, pinpoint pupils, bradycardia, irritability, nervousness, extreme tiredness or weakness

Disease States: Cerebrovascular disease, recent myocardial infarction, hepatic/renal impairment, coronary insufficiency

Other Drugs: Beta blockers, estrogens, alcohol, NSAIDs, hypotension–{endash}producing medications, sympathomimetics

Lab Tests: Cholesterol, blood pressure

Administrative Notes: Need for lifelong therapy possible; withdrawal syndrome possible

Guanadrel Sulfate

Trade Name(s): Hylorel

Chemically Related To: Adrenergic blockers

Pregnancy Category: B

Medical Category: Antihypertensive

Accepted Indications: Hypertension

Mechanism of Action: Postganglionic adrenergic blockade. Decreases release of norepinephrine

Absorption/Distribution: Rapidly absorbed from GI tract

Half life: Approximately 10 h

Peak activity: 4–{endash}6 h

Metabolism: Hepatic

Elimination: Renal

Research Notes: Onset of action, 2 h; duration of action, 9 h

Adult Dosage: Initial: 5 mg b.i.d., increased as necessary; maintenance: 20–{endash}75 mg/d in 2–{endash}4 divided doses

Elderly Dosage: Lower dose may be required

Child Dosage: Safety and efficacy not established

Infant Dosage: Safety and efficacy not established

Dosage Forms: Tablets: 10 mg and 25 mg

Warnings: Do not take other medicines without physician's permission

Frequent Side Effects: Peripheral edema, difficulty in ejaculation, drowsiness, tiredness, orthostatic hypotension

Occasional Side Effects: Angina, dyspnea, diarrhea, dry mouth, headache, muscle pain, tremors, nocturia

Contraindications: CHF, pheochromocytoma

Overdosage: Blurred vision, severe dizziness

Antidotal Therapy: May include supportive treatment, vasoconstrictor

Disease States: Recent myocardial infarction, asthma, peptic ulcer, fever, cerebrovascular or coronary insufficiency, diarrhea, sinus bradycardia, pheochromocytoma

Nutrition: Need for sodium restriction, weight reduction

Other Drugs: Tricyclic antidepressants, loxapine, thioxanthines, trimeprazine, MAO inhibitors, metaraminol, sympathomimetics

Lab Tests: Blood pressure

Administrative Notes: Important to take medicine even when feeling well

Guanethidine Monosulfate

Trade Name(s): Ismelin

Pregnancy Category: C

Medical Category: Antihypertensive

Accepted Indications: Hypertension

Mechanism of Action: Postganglionic adrenergic blockade. Decreases release of norepinephrine

Absorption/Distribution: Highly variable

Half life: 1.5–{endash}8 d

Peak activity: 8 h

Metabolism: Hepatic

Elimination: Renal

Research Notes: Blood pressure returns to baseline levels 1–{endash}3 w after withdrawal

Adult Dosage: Initial: 10–{endash}12.5 mg once daily, increased as necessary; maintenance: 25–{endash}50 mg once daily

Elderly Dosage: Lower dose may be required

Child Dosage: 0.2 mg/kg/d

Dosage Forms: Tablets: 10 mg and 25 mg

Warnings: Do not take other medicines without physician's permission

Frequent Side Effects: Bradycardia, nasal congestion, peripheral edema, diarrhea, difficulty in ejaculating, orthostatic hypotension, extreme tiredness or weakness

Occasional Side Effects: Angina, pulmonary edema, blurred vision, drooping eyelids, dry mouth, headache, muscle pain, tremors, nausea, vomiting, nocturia, rash

Rare Side Effects: Loss of scalp hair

Contraindications: CHF, pheochromocytoma

Antidotal Therapy: May include lavage, treatment of circulatory failure, vasopressors

Disease States: Asthma, cerebrovascular or coronary insufficiency, recent myocardial infarction, diabetes mellitus, diarrhea, sinus bradycardia, fever, hepatic function impairment, peptic ulcer, renal function impairment, pheochromocytoma

Other Drugs: Minoxidil, MAO inhibitors, metaraminol, antidiabetic agents, tricyclic antidepressants, loxapine, thioxanthenes, trimeprazine, sympathomimetics

Lab Tests: Blood pressure

Guanethidine Monosulfate/Hydrochlorothiazide

Trade Name(s): Esimil

Pregnancy Category: C

Medical Category: Antihypertensive

Accepted Indications: Hypertension

Adult Dosage: 2 tablets/d as determined by individual titration

Elderly Dosage: May be more sensitive to drug's effects

Child Dosage: Must be individualized

Dosage Forms: Tablets: 10 mg/25 mg

Guanfacine Hydrochloride

Trade Name(s): Tenex

Pregnancy Category: B

Medical Category: Antihypertensive

Accepted Indications: Hypertension

Mechanism of Action: Central alpha-adrenergic stimulation, leading to decreased sympathetic outflow

Absorption/Distribution: Complete rapid absorption

Half life: 17 h

PO: 8–{endash}12 h

Metabolism: Hepatic

Elimination: Renal

Research Notes: Duration of action, 24 h

Adult Dosage: Up to 3 mg/d

Elderly Dosage: More problems with hypotension and sedation

Dosage Forms: Tablets: 1, 2, and 3 mg

By System: Cardiovascular

Warnings: Avoid alcohol; keep container tightly closed

Precautions: Use caution if surgery required

Frequent Side Effects: Constipation, dizziness, dry mouth

Occasional Side Effects: Confusion, depression, headache, nausea/vomiting

Overdosage: Respiratory problems, dizziness, bradycardia, tiredness

Antidotal Therapy: May include symptomatic therapy; could include cardiac monitoring, gastric lavage, infusion of isoproterenol

Disease States: Myocardial infarction, depression, liver problems, coronary insufficiency, cerebrovascular disease

Other Drugs: Estrogens, CNS depressants, sympathomimetics, NSAIDs, antihypertensives

Lab Tests: Plasma growth hormone and urinary catecholamine concentrations

Guanidine Hydrochloride

Trade Name(s): Available as generic only

Chemically Related To: Nucleic acid base

Pregnancy Category: Safe use during pregnancy not established

Medical Category: Muscle stimulant

Accepted Indications: Eaton-Lambert syndrome (muscle weakness symptoms)

Unaccepted Indications: Myasthenia gravis (treatment of cause)

Mechanism of Action: Increases the release of acetylcholine

Research Notes: Soluble in water and alcohol

Adult Dosage: Initially 10 mg/kg or 15 mg/kg in 3–{endash}4 divided doses

Child Dosage: Safety not established

Infant Dosage: Safety not established

Dosage Forms: Tablets: 125 mg

Warnings: Fatal bone-marrow depression can occur; excreted in breast milk

Precautions: Frequent red and white blood cell counts, regular urine examination

Side/Adverse Effects: Bone marrow depression, sore throat, rash, fever, nervousness, irritability, psychosis, GI problems, sweating, hypotension, tachycardia

Overdosage: Nervous irritability, tremors, convulsions, vomiting, diarrhea, hypoglycemia, circulatory problems

Antidotal Therapy: May include atropine, IV calcium gluconate

Disease States: Kidney problems

Other Drugs: Bone marrow depressants

Lab Tests: Liver function tests, blood creatinine

Administrative Notes: Individual tolerance varies greatly; dosage must be titrated