Alteplase, Recombinant
Trade Name(s): Activase
Chemically Related To: Recombinant enzymes
Pregnancy Category: C
Medical Category: Plasminogen activator
Accepted Indications: Acute pulmonary thromboembolism, coronary thrombosis
Unaccepted Indications: Superficial thrombophlebitis
Mechanism of Action: Activates fibrinolytic system
Absorption/Distribution: Not absorbed orally; must be injected
Half life: 4 min distribution; 35 min elimination
IV: 20 min–{endash}2 h
Metabolism: Hepatic
Elimination: Renal
Research Notes: Effects disappear within a few h of stoppage of drug
Adult Dosage: Patients weighing less than 65 kg: IV 1.25 mg/kg over a period of 3 h; patients over 65 kg: 100 mg over 3 h
Elderly Dosage: Careful monitoring
Dosage Forms: For injection: 20 mg, 50 mg, or 100 mg
By System: Cardiovascular
Warnings: Strictly enforce bed rest
Precautions: Reconstituted solution should be used within 8 h
Frequent Side Effects: Bleeding from cuts, hypotension
Occasional Side Effects: Bruising, internal bleeding, allergic reaction
Contraindications: Aneurysm, bleeding, brain tumor, neurosurgery, hypertension, trauma, recent major surgery
Overdosage: Effects on hemostasis
Antidotal Therapy: May include replacement of lost blood, fresh frozen plasma, plasma volume expanders (do not use dextrans)
Disease States: Bleeding, tuberculosis, endocarditis, childbirth, coagulation defects
Other Drugs: NSAIDs, antifibrinolytic agents, anticoagulants, heparin, valproic acid, enoxaparin, cefamandole, cefoperazone, cefotetan, plicamycin, other platelet aggregation inhibitors
Lab Tests: Blood pressure, fibrinogen concentration, hematocrit values, tests for systemic fibrinolysis, coagulation tests
Administrative Notes: Do not add other medications through alteplase recombinant IV line
Altretamine
Trade Name(s): Hexalen
Chemically Related To: S-triazine derivative; synthetic, alkylating agent
Pregnancy Category: D
Medical Category: Antineoplastic
Accepted Indications: Ovarian carcinoma
Mechanism of Action: Inhibits RNA and DNA synthesis
Absorption/Distribution: Rapidly absorbed, distributed to tissue with high lipid content
Half life: 4.7–{endash}10.2 h
Metabolism: Hepatic
Elimination: Renal (<1%>
Research Notes: Usually used after first-line therapy with cisplatin or alkylating agent
Adult Dosage: 260 mg/m2/d in 4 divided doses
Elderly Dosage: Renal problems necessitate caution
Dosage Forms: Capsules: 50 mg
By System: Ovarian tissue
Warnings: Take medication despite GI distress
Precautions: Avoid immunizations; use caution if bone marrow depression occurs
Frequent Side Effects: Anemia, leukopenia, anxiety, nausea and vomiting, thrombocytopenia, neurotoxicity
Occasional Side Effects: Diarrhea, loss of appetite, GI cramping
Rare Side Effects: Liver problems, itching, convulsions
Disease States: Bone marrow depression, chickenpox, infection, hepatic or renal function impairment, neurologic toxicity, herpes zoster
Other Drugs: Bone marrow depressants, vaccines, MAO inhibitors, blood dyscrasia–{endash}causing medications
Lab Tests: Alkaline phosphatase, BUN, creatinine concentrations
Administrative Notes: Toxicity is dose-related and is cumulative; take after meals
Aluminum Chloride Hexahydrate
Trade Name(s): Drysol, Xerac AC
Chemically Related To: Unique compound
Medical Category: Antiperspirant
Accepted Indications: Acne vulgaris, hyperhidrosis
Research Notes: Aluminum chloride hexahydrate is a solution 20% w/v in anhydrous ethyl alcohol
Adult Dosage: Apply aluminum chloride hexahydrate to affected area once daily
Dosage Forms: Topical solution
By System: Dermal
Warnings: Keep out of reach of children, avoid contact with eyes
Precautions: Keep away from open flame
Side/Adverse Effects: Burning sensation or prickling effect, rash
Administrative Notes: Do not apply to broken, irritated, or recently shaved skin
Aluminum Hydroxide Gel
Trade Name(s): ALternaGEL, Alu-Cap, Alu-Tab, Basaljel, Dialume, Nephrox
Pregnancy Category: Studies not done in humans
Medical Category: Antacid, antiurolithic, antihyperphosphatemic
Accepted Indications: Hyperacidity, gastric ulcer, duodenal ulcer, gastric hypersecretory conditions, Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenoma, GI reflux, stress-related mucosal damage, hyperphosphatemia
Unaccepted Indications: Prevention of acid aspiration in patients undergoing anesthesia or labor
Mechanism of Action: Neutralizes existing quantities of stomach acid
Absorption/Distribution: Small amounts absorbed from intestine
Elimination: Renal, fecal
Adult Dosage: Varies among patients because of amount of acid and buffering capacity of antacid
Dosage Forms: Tablets: 300 mg, 500 mg, and 600 mg. Gel: 320 mg, 400 mg, and 600 mg. Capsules: 475 mg and 500 mg
Frequent Side Effects: No incidence given for chalky taste, mild constipation, stomach cramps, neurotoxicity, fecal impaction, swelling of legs, hypercalcemia, phosphorus depletion syndrome, nausea, vomiting, whitish stools
Contraindications: Alzheimer's disease, appendicitis, GI bleeding, constipation, fecal impaction
Disease States: Intestinal obstruction, diarrhea, gastric outlet obstruction, hemorrhoids, renal function impairment
Other Drugs: Ciprofloxacin, citrates, urinary acidifiers, amphetamines, quinidine, anticholinergics, lomefloxacin, norfloxacin, ofloxacin, digitalis glycosides, enteric-coated medications, folic acid, histamine H2-receptor agonists, iron preparations, isoniazid, ketoconazole, mecamylamine, methenamine, penicillamine, phenothiazines, phenytoin, phosphates, salicylates, sodium fluoride, sucralfate, tetracyclines
Amantadine Hydrochloride
Trade Name(s): Symadine, Symmetrel
Chemically Related To: Unique compound
Pregnancy Category: C
Medical Category: Antiviral, antidyskinetic, antifatigue
Accepted Indications: Influenza A, extrapyramidal reactions, parkinsonism, fatigue associated with multiple sclerosis
Unaccepted Indications: Influenza B and parainfluenza
Mechanism of Action: Interferes with virus penetration into susceptible cells; increases dopamine levels centrally
Absorption/Distribution: Rapidly and almost completely absorbed
Half life: 11–{endash}15 h
Peak activity: 2–{endash}4 h
Elimination: Renal
Research Notes: Antidyskinetic onset of action happens within 48 h
Adult Dosage: 100 mg once or twice daily
Elderly Dosage: Increased side effect of confusion; dosage reduction recommended
Child Dosage: 1–{endash}9 y: 1.5–{endash}3 mg/kg t.i.d. up to 150 mg; 9–{endash}12 y: 100 mg b.i.d.
Infant Dosage: Up to 1 y: not established
Dosage Forms: Capsules: 100 mg; syrup: 50 mg/5 mL
By System: Systemic on CNS dopaminergic receptors
Warnings: May cause dizziness; avoid alcohol
Precautions: Caution if eyesight is impaired; for possible dry mouth, use sugarless candy or gum
Frequent Side Effects: CNS toxicity, GI problems
Occasional Side Effects: Anticholinergic-like effects, fainting, vomiting
Rare Side Effects: Corneal deposits, CHF, rash
Overdosage: Arrhythmias, pulmonary edema, status epilepticus, hallucinations
Antidotal Therapy: No specific antidote; may include activated charcoal, supportive therapy
Disease States: Peripheral edema, CHF, epilepsy, psychosis, renal function impairment
Other Drugs: Alcohol, anticholinergics, levodopa, CNS stimulants, triamterene, hydrochlorothiazide
Amcinonide
Trade Name(s): Cyclocort
Chemically Related To: Corticosteroids
Pregnancy Category: C
Medical Category: Adrenocorticoid, anti-inflammatory
Accepted Indications: Skin disorders, eczema, psoriasis, sunburn, sarcoidosis
Unaccepted Indications: Dermatitis, acne, routine gingivitis
Mechanism of Action: Complexes with specific cytoplasmic receptors that stabilize cell membranes to decrease inflammatory response
Absorption/Distribution: Absorbed systemically across the stratum corneum
Metabolism: Primarily in skin, once absorbed systemically in liver
Elimination: Renal
Research Notes: Increased percutaneous absorption of adrenocorticoids occurs when the skin or mucosa is abraded or inflamed
Adult Dosage: Topical to skin: cream and lotion b.i.d. or t.i.d.; as an ointment, b.i.d. (all as 0.1%)
Child Dosage: Pediatric: topical to skin as a 0.1% cream, lotion, or ointment once daily
Infant Dosage: Same as child dose
Dosage Forms: Cream: 0.1%; lotion: 0.1%; ointment: 0.1%
By System: Dermal
Warnings: Do not use in or around the eyes
Occasional Side Effects: Contact dermatitis, numbness in fingers, skin atrophy, stripping of epidermal layer
Rare Side Effects: Acneiform eruptions, cataracts, Cushing's syndrome, edema, hypopigmentation
Antidotal Therapy: May include discontinuation of topical adrenocorticoid therapy; treatment symptomatic and supportive
Disease States: Infection at treatment site, pre-existing skin atrophy. In long-term therapy, amcinonide may promote progression of cataracts, glaucoma, tuberculosis, or diabetes mellitus
Administrative Notes: Adrenal function assessment may be advisable
Amikacin Sulfate
Trade Name(s): Amikin
Chemically Related To: Aminoglycosides
Pregnancy Category: D
Medical Category: Systemic antibacterial
Accepted Indications: Serious systemic infections, strains of Pseudomonas aeruginosa resistant to tobramycin and netilmicin
Mechanism of Action: Interferes with messenger RNA
Absorption/Distribution: IM: rapidly and completely absorbed
Half life: 5–{endash}15 min (distribution), 2–{endash}4 h (elimination)
IM: 0.5–{endash}1.5 h
IV: 15–{endash}30 min
Metabolism: Not metabolized
Elimination: Renal
Adult Dosage: IV or IM: 5 mg/kg t.i.d. or 7.5 mg/kg b.i.d. for 7–{endash}10 d, 15 mg/kg/d maximum
Elderly Dosage: Use with caution
Child Dosage: Same as adult dose
Infant Dosage: Premature neonates: IM or IV, 10 mg/kg, then 7.5 mg/kg q18–{endash}24h for 7–{endash}10 d; neonates: IM or IV, 10 mg/kg, then 7.5 mg/kg b.i.d. for 7–{endash}10 d
Dosage Forms: Injection: 50 mg/mL and 250 mg/mL
Frequent Side Effects: Nephrotoxicity, neurotoxicity, auditory ototoxicity, vestibular ototoxicity
Occasional Side Effects: Optic neuritis, hypersensitivity
Rare Side Effects: Neuromuscular blockage
Contraindications: Botulism, parkinsonism, eighth cranial nerve impairment
Overdosage: Loss of hearing, dizziness, change in urinary frequency
Antidotal Therapy: May include supportive treatment, dialysis, anticholinesterase agents
Disease States: Myasthenia gravis, renal function impairment, dehydration
Other Drugs: Nephrotoxic and ototoxic medications, neuromuscular blocking agents, aminoglycosides, capreomycin, antimyasthenics, beta-lactam antibiotics, indomethacin, methoxyflurane
Lab Tests: Audiograms, urinalyses
Amiloride Hydrochloride
Trade Name(s): Midamor
Chemically Related To: Triamterenes
Pregnancy Category: B
Medical Category: Diuretic, antihypertensive, antihypokalemic
Accepted Indications: Edema, hypertension, hypokalemia
Mechanism of Action: Interferes with sodium reabsorption in distal convoluted tubule
Absorption/Distribution: Incomplete absorption
Half life: 6–{endash}9 h
Metabolism: Not metabolized
Elimination: Renal, fecal
Research Notes: Onset of action 2 h; duration of action 24 h
Adult Dosage: 5–{endash}20 mg/d
Elderly Dosage: More risk of hyperkalemia
Dosage Forms: Tablets: 5 mg
By System: Cardiovascular
Warnings: Do not take additional medications; take medication even if no symptoms
Precautions: Caution if surgery planned
Frequent Side Effects: Hyperkalemia
Occasional Side Effects: Headache, constipation, dizziness, GI distress, muscle cramping
Contraindications: Hyperkalemia
Antidotal Therapy: May include emesis/gastric lavage; supportive treatment, including monitoring kidneys and electrolytes
Disease States: Hyperkalemia, hepatic function impairment, diabetic nephropathy, anuria, hyponatremia, metabolic or respiratory acidosis
Other Drugs: Anticonvulsants, diuretics (potassium–{endash}sparing), NSAIDs, probenecid, antihypertensives, lithium
Lab Tests: BUN, calcium excretion, uric acid concentrations, sodium, potassium concentrations
Amiloride Hydrochloride/Hydrochlorothiazide
Trade Name(s): Amiloride HCl with Hydrochlorothiazide, Hydro-Ride, Moduretic
Pregnancy Category: B
Medical Category: Antihypertensive
Accepted Indications: Diuresis (potassium sparing), hypertension
Adult Dosage: 1–{endash}2 tablets/d
Child Dosage: Not established
Dosage Forms: Tablets: 5 mg/50 mg
Warnings: Elderly may be more sensitive to drug's effects
Aminocaproic Acid
Trade Name(s): Amicar
Pregnancy Category: C
Medical Category: Antifibrinolytic, antihemorrhagic
Accepted Indications: Hyperfibrinolysis-induced hemorrhage, postsurgical hemorrhage prophylactic, recurrence of subarachnoid hemorrhage
Mechanism of Action: Inhibits activation of plasminogen, reducing conversion to plasmin
Absorption/Distribution: Rapid absorption
Peak activity: Within 2 h
Elimination: Renal
Adult Dosage: Syrup and tablets: 5 g for first h, 1–{endash}1.25 g/h for 8 h; 36 g/24 h maximum; injection: 4–{endash}5 g administered over 1 h initially, followed by 1 g/h for 8 h, up to 36 g/d
Child Dosage: Syrup and tablets: 100 mg/kg for first h, followed by 33.3 mg/kg; injection: 100 mg/kg initially for 1 h, followed by 33.3 mg/kg/h
Dosage Forms: Syrup: 250 mg/mL; tablets: 500 mg; injection: 250 mg/mL
Warnings: Use exact amount prescribed, do not miss dose
Precautions: Rapid IV administration may induce hypotension
Frequent Side Effects: Myopathy, ringing in ears, stomach cramps
Occasional Side Effects: Bladder obstruction caused by blood clot formation, hypotension, dizziness, headache, myopathy, red or bloodshot eyes, renal failure, ringing or buzzing in ears, rash, bradycardia or arrhythmia, stomach cramps, stuffy nose, thrombosis or thromboembolism, unusual tiredness or weakness, diarrhea, dry ejaculation, nausea, unusual menstrual discomfort
Rare Side Effects: Rhabdomyolysis with myoglobinuria and renal failure
Contraindications: Intravascular clotting
Disease States: Cardiac disease, liver or renal disease, thrombosis, hematuria, or upper respiratory tract origin
Other Drugs: Estrogens, contraceptives, clotting factor replacement drugs, thrombolytics
Lab Tests: Estrogens, contraceptives
Administrative Notes: Protect injection and syrup from freezing
Aminoglutethimide
Trade Name(s): Cytadren
Pregnancy Category: D
Medical Category: Antiadrenal; antineoplastic
Accepted Indications: Cushing's syndrome, breast carcinoma, prostatic carcinoma
Unaccepted Indications: Use as anticonvulsant
Mechanism of Action: Suppresses adrenal cortex, blocks synthesis of adrenal steroids
Absorption/Distribution: Rapidly and completely absorbed from GI tract
Half life: 12.5 h
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: 250 mg b.i.d. to q.i.d. up to 2 g/d maximum for up to 2 w
Elderly Dosage: Lower dose may be required
Child Dosage: Safety and efficacy not established
Infant Dosage: Safety and efficacy not established
Dosage Forms: Tablets: 250 mg
Frequent Side Effects: CNS effects, loss of appetite, measles-like skin rash
Occasional Side Effects: Agranulocytosis, leukopenia, adrenocortical insufficiency, thrombocytopenia
Rare Side Effects: Hypersensitivity, hypothyroidism, muscle pain, headache, vomiting, goiter, hypotension, hirsutism
Contraindications: Chickenpox, herpes zoster infection
Antidotal Therapy: May include gastric lavage, supportive treatment, dialysis
Disease States: Hepatic function impairment, hypothyroidism, renal function impairment
Other Drugs: Dexamethasone, anticoagulants, digoxin, theophylline, corticosteroids, ACTH
Lab Tests: Blood pressure, thyroid function
Aminophylline
Trade Name(s): Aminophyllin, Phyllocontin, Somophyllin, Truphylline
Chemically Related To: Theophylline
Pregnancy Category: C
Medical Category: Bronchodilator, asthma prophylaxis, respiratory stimulant
Accepted Indications: Bronchial asthma, bronchitis, pulmonary emphysema, pulmonary disease, neonatal apnea, Cheyne-Stokes respiration
Unaccepted Indications: Antispasmodic, cardiac stimulant, diuretic, adjunctive management of CHF and pulmonary edema
Mechanism of Action: Inhibits enzymes that degrade cyclic AMP, blockade of adenosine receptor
Absorption/Distribution: Rapid and complete absorption
Half life: 7–{endash}10 h (adult non-smoker)
Metabolism: Hepatic
Elimination: Renal/fecal
Adult Dosage: Tablets: 6–{endash}8 mg/kg up to 400 mg per day in 3 or 4 divided doses. Monitoring of serum theophylline concentration useful
Elderly Dosage: Caution in patients over 55 y
Child Dosage: Much variation in ages and dosing–{endash}check specific age and dosage form
Infant Dosage: Caution recommended in neonates
Dosage Forms: Oral solution: 105 mg/5 mL; tablets: 100 mg and 200 mg; enteric coated tablets: 100 mg and 200 mg; extended-release tablets: 225 mg; injection: 25 mg/mL; enema: 65.14 mg/mL; suppositories: 250 mg and 500 mg
By System: Respiratory
Frequent Side Effects: Nausea, nervousness, palpitations
Occasional Side Effects: Heartburn, burning sensation in rectum
Overdosage: Confusion, convulsions, diarrhea, tachycardia or cardiac arrhythmias, GI bleeding, headache, muscle twitching, nausea/vomiting, insomnia, trembling, weakness
Antidotal Therapy: No specific antidote; may include emesis, gastric lavage, IV diazepam, establishment of airway, vasopressors, consider charcoal hemoperfusion for severe toxicity
Disease States: Alcoholism, prolonged fever, respiratory infections, hyperthyroidism, liver problems, cardiac failure
Nutrition: Avoid caffeine–{endash}containing food and water
Other Drugs: Beta-adrenergic blocking agents, lithium, ciprofloxacin or norfloxacin, erythromycin, cimetidine, xanthines, nicotine, phenytoin
Lab Tests: Serum theophylline determinations
Administrative Notes: Dosage must be individualized
Aminophylline/Ephedrine/Phenobarbital/Potassium Iodide
Trade Name(s): Mudrane
Pregnancy Category: C
Medical Category: Antiasthmatic
Accepted Indications: Asthma
Mechanism of Action: Bronchial dilation
Adult Dosage: 1 tablet t.i.d. or q.i.d.
Dosage Forms: Tablets: 130 mg (anhydrous)/16 mg/8 mg/195 mg
Aminophylline/Guaifenesin
Trade Name(s): Mudrane GG-2
Pregnancy Category: C
Medical Category: Antiasthmatic
Accepted Indications: Asthma
Mechanism of Action: Bronchial dilation
Adult Dosage: 1 tablet t.i.d. or q.i.d.
Dosage Forms: Tablets: 130 mg/100 mg
Aminophylline/Potassium Iodide
Trade Name(s): Mudrane-2
Pregnancy Category: C
Medical Category: Antiasthmatic
Accepted Indications: Asthma
Mechanism of Action: Bronchial dilation
Adult Dosage: 1 tablet t.i.d. or q.i.d.
Dosage Forms: Tablets: 130 mg/195 mg
Amiodarone Hydrochloride
Trade Name(s): Cordarone
Chemically Related To: Antiarrhythmics
Pregnancy Category: D
Medical Category: Antiarrhythmic
Accepted Indications: Ventricular arrhythmias, supraventricular arrhythmias resistant to regular treatment
Mechanism of Action: Prolongs action potential duration and refractory period in cardiac tissues
Absorption/Distribution: 20%–{endash}55% of oral dose absorbed
Half life: Biphasic, initial 2.5–{endash}10 d; terminal 26–{endash}107 d
Peak activity: 3–{endash}7 h
Metabolism: Hepatic
Elimination: Biliary
Research Notes: Onset of action 2–{endash}3 d to 2–{endash}3 m
Adult Dosage: Ventricular arrhythmias, loading: 800 mg–{endash}1.6 g/d for 1–{endash}3 w; maintenance: 400 mg/d, supraventricular tachycardia, loading, 600–{endash}800 mg/d, supraventricular tachycardia, loading: 600–{endash}800 mg/d for 1 w; maintenance: 200–{endash}400 mg/d
Elderly Dosage: Studies not done
Child Dosage: 10 mg/kg/d for 10 d; maintenance: 2.5 mg/kg/d
Dosage Forms: Tablets: 200 mg
Frequent Side Effects: Neurotoxicity, photosensitivity, pulmonary fibrosis, interstitial pneumonitis/alveolitis, ataxia, arrhythmias, constipation, headache, loss of appetite, nausea and vomiting
Occasional Side Effects: Blue-gray coloring of face, neck, and arms; CHF; hyperthyroidism, hypothyroidism, noninfectious epididymitis, sinus bradycardia, bitter or metallic taste, decreased sexual ability or interest, dizziness, flushing of face, arrhythmias
Rare Side Effects: Allergic reaction, hepatitis
Contraindications: AV block, bradycardia episodes, sinus node function impairment
Overdosage: Painful breathing, cough
Antidotal Therapy: May include emesis, beta-adrenergic agonist
Disease States: CHF, hepatic function impairment, hypokalemia, thyroid function impairment
Other Drugs: Inhalation anesthetics, antiarrhythmics, anticoagulants, beta-adrenergic or calcium channel blockers, digitalis glycosides, diuretics, indapamide, phenytoin, photosensitizing medications, sodium iodide I 123 or sodium iodide I 131, sodium pertechnetate Tc 99m
Lab Tests: EKG, serum reverse T3 concentrations, thyroid function changes, liver enzymes
Amitriptyline Hydrochloride
Trade Name(s): Elavil, Endep, Enovil
Chemically Related To: Tricyclic antidepressants
Pregnancy Category: C
Medical Category: Antidepressant, antienuretic, antineuralgic, antibulimic
Accepted Indications: Mental depression, enuresis, neurogenic pain, bulimia nervosa
Mechanism of Action: Increases synaptic concentrations of norepinephrine and/or serotonin
Absorption/Distribution: Rapidly absorbed
Half life: 10–{endash}26 h
Metabolism: Hepatic
Elimination: Renal
Research Notes: Onset of action, 2–{endash}3 w
Adult Dosage: Tablets: 25 mg b.i.d. to q.i.d., up to 150 mg/d (outpatients) or 300 mg/d (hospitalized patients); injection: IM, 20–{endash}30 mg q.i.d.
Elderly Dosage: Tablets: initially 25 mg at bedtime, dosage adjusted as tolerated, up to 10 mg t.i.d. and 20 mg at bedtime; IM: lower dosage may be required
Child Dosage: Tablets, 6–{endash}12 y: 10–{endash}30 mg b.i.d.; 12 y and over: 10 mg t.i.d. and 20 mg at bedtime, up to a maximum of 100 mg/d. Injection, up to 12 y: not established
Infant Dosage: Not established
Dosage Forms: Tablets: 10 mg, 25 mg, 50 mg, 75 mg, 100 mg, and 150 mg. Injection: 10 mg/mL
Frequent Side Effects: Dizziness, drowsiness, dry mouth, headache, increased appetite, nausea, fatigue, weight gain
Occasional Side Effects: Anticholinergic effects, sexual function impairment, arrhythmia, tremors, hypotension, Parkinsonian syndrome, diarrhea, vomiting, heartburn, excessive sweating
Rare Side Effects: Agranulocytosis, tinnitus, alopecia, breast enlargement, seizures, allergic reaction, jaundice, galactorrhea, testicular swelling
Contraindications: Alcoholism, bipolar disorders, schizophrenia
Overdosage: Confusion, arrhythmia, convulsions, hallucinations, vomiting
Antidotal Therapy: May include gastric lavage, EKG, activated charcoal
Disease States: Blood disorders, hepatic and renal impairment, seizure disorders, asthma, cardiovascular disorders, GI disorders, glaucoma, urinary retention, hyperthyroidism
Other Drugs: Clonidine, alcohol, CNS depressants, antithyroid agents, cimetidine, guanadrel, guanethidine, extrapyramidal reaction–{endash}causing medications, metrizamide, MAO inhibitors, sympathomimetics
Lab Tests: Blood pressure, glaucoma
Amitriptyline Hydrochloride/Chlordiazepoxide
Trade Name(s): Limbitrol DS
Pregnancy Category: C
Medical Category: Antidepressant/antianxiety
Accepted Indications: Depression and anxiety
Mechanism of Action: Acts on subcortical nuclei
Adult Dosage: 1 tablet t.i.d. or q.i.d. initially; dosage adjusted as needed
Child Dosage: Up to 12 y: not established; 12 y and over: same as adult dose
Dosage Forms: Tablets: 12.5 mg/5 mg and 25 mg/10 mg
Amitriptyline Hydrochloride/Perphenazine
Trade Name(s): Etrafon, Etrafon-Forte, Per-Trip, Talazil, Triavil 2-10, 2-25, 4-10, 4-25, 4-50
Pregnancy Category: D
Medical Category: Antianxiety/antidepressant
Accepted Indications: Depression/anxiety with emesis
Adult Dosage: 25 mg/2 mg to 25 mg/4 mg t.i.d. or q.i.d. initially; dosage adjusted as needed
Elderly Dosage: 10 mg/4 mg t.i.d. or q.i.d. initially; dosage adjusted as needed
Child Dosage: Up to 12 y: safety not established; over 12 y: dosage must be individualized
Dosage Forms: Tablets: 10 mg/2 mg, 25 mg/2 mg, 10 mg/4 mg, 25 mg/4 mg, and 50 mg/4 mg
Amlodipine Besylate
Trade Name(s): Norvasc
Chemically Related To: Calcium channel blockers
Pregnancy Category: C
Medical Category: Antianginal, antihypertensive
Accepted Indications: Chronic stable and vasospastic angina, hypertension
Mechanism of Action: Inhibits calcium influx across membranes
Absorption/Distribution: Slowly and completely absorbed from GI tract; bioavailability 60%–{endash}65%, very high protein binding
Half life: 35 h in healthy patients
Peak activity: 6–{endash}9 h
Metabolism: Hepatic
Elimination: Renal, fecal
Research Notes: Problems may occur with highly protein-bound medications
Adult Dosage: 5–{endash}10 mg once daily
Elderly Dosage: Initial 2.5 mg dose recommended
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Tablets: 2.5 mg, 5 mg, and 10 mg
Frequent Side Effects: Peripheral edema, flushing, headache
Occasional Side Effects: Dizziness, palpitations, fatigue, nausea
Rare Side Effects: Angina, bradycardia, hypotension, orthostatic hypotension
Contraindications: Severe hypotension
Overdosage: Hypotension, tachycardia, bradycardia
Antidotal Therapy: May include IV fluids, dopamine or dobutamine, calcium chloride, isoproterenol, metaraminol, norepinephrine, IV lidocaine or procainamide, IV atropine
Disease States: Aortic stenosis, CHF, liver function impairment
Other Drugs: NSAIDs, beta blockers, estrogens, anticoagulants, hydrocarbon inhalation anesthetics, quinine, salicylates, sulfinpyrazone, hypotension–{endash}producing medications, lithium, sympathomimetics
Lab Tests: EKG, heart rate
Amobarbital Sodium
Trade Name(s): Amytal
Scheduled Class: II
Abuse Potential: High
Pregnancy Category: D
Medical Category: Sedative-hypnotic, anticonvulsant
Accepted Indications: Narcoanalysis, epilepsy, convulsions, tetanus, anxiety (pre-operative)
Unaccepted Indications: Schizophrenia (diagnostic aid), catatonic reactions (management)
Mechanism of Action: Interferes with impulses from the thalamus to the cortex in the brain
Absorption/Distribution: Varying degrees of absorption; rapidly distributed
Half life: 16–{endash}40 h
Metabolism: Hepatic
Elimination: Renal
Research Notes: Intermediate-acting barbiturate
Adult Dosage: 50–{endash}300 mg/d
Elderly Dosage: Possible increased effects of excitement and confusion
Child Dosage: 2 mg/kg t.i.d.
Infant Dosage: 2 mg/kg t.i.d.
Dosage Forms: Tablets: 30 mg and 100 mg; capsules: 200 mg; parenteral sterile solution: 500 mg
By System: CNS
Warnings: Avoid alcohol; may cause drowsiness
Precautions: Make regular visits to physician
Frequent Side Effects: Clumsiness, dizziness, drowsiness
Occasional Side Effects: Mental depression, paradoxical reaction, anxiety, constipation, headache, nausea/vomiting, dependence
Rare Side Effects: Agranulocytosis, Stevens-Johnson syndrome, hallucinations, thrombocytopenia, osteomalacia
Contraindications: Porphyria
Overdosage: Confusion, decrease in reflexes, drowsiness, hypothermia, bradycardia, staggering
Antidotal Therapy: May include supportive treatment: ensure adequate airway; maintain blood pressure and body temperature; emesis/gastric lavage
Disease States: Anemia, asthma, pain, hyperthyroidism, mental depression, kidney problems, diabetes mellitus
Other Drugs: Valproic acid, estrogen–{endash}containing contraceptives, anticoagulants, CNS depressants, adrenocorticoids, carbamazepine, warfarin
Lab Tests: Metyrapone test, bilirubin, phentolamine, cyanocobalamin
Administrative Notes: Solution should be used within 30 min of being reconstituted
Amobarbital Sodium/Secobarbital Sodium
Trade Name(s): Tuinal
Chemically Related To: Barbiturates
Scheduled Class: II
Abuse Potential: High
Pregnancy Category: C
Medical Category: Hypnotic
Accepted Indications: Induce sleep
Mechanism of Action: Suppresses subcortical nuclei
Adult Dosage: 1 capsule at bedtime
Child Dosage: Not established
Dosage Forms: Capsules: 50 mg/50 mg and 100 mg/100 mg
Warnings: Lower doses may be required for elderly patients
Amoxapine
Trade Name(s): Asendin
Chemically Related To: Tricyclic antidepressants
Pregnancy Category: C
Medical Category: Antidepressant
Accepted Indications: Mental depression
Mechanism of Action: Increases the synaptic concentration of central amines in the CNS through inhibition of their reuptake at the synapse
Absorption/Distribution: Very high protein-binding in plasma and tissues; rapidly and well absorbed
Half life: 8–{endash}30 h
Peak activity: Onset of action 1–{endash}2 w
Metabolism: Hepatic
Elimination: Renal
Research Notes: Has marked anticholinergic activity
Adult Dosage: 25–{endash}300 mg/d
Elderly Dosage: 25–{endash}100 mg/d as tolerated
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Tablets: 25 mg, 50 mg, 100 mg, and 150 mg
By System: Acts at CNS subcortical nuclei
Frequent Side Effects: Dizziness, drowsiness, dry mouth, headache, nausea, tiredness, weight gain
Occasional Side Effects: Anticholinergic effects, arrhythmia, fine-muscle tremor, parkinsonism, impairment of sexual function
Rare Side Effects: Agranulocytosis, alopecia, tinnitus, trouble with teeth or gums, neuroleptic malignant syndrome
Contraindications: Should not be used during the acute recovery period after myocardial infarction
Overdosage: Confusion, convulsions, drowsiness, arrhythmia, hallucinations, shortness of breath
Antidotal Therapy: May include essentially symptomatic and supportive treatment, including gastric lavage, maintaining respiratory and cardiac function, maintaining body temperature
Disease States: Active alcoholism, asthma, blood disorders, GI disorders, impairment of hepatic function, hyperthyroidism, seizure disorders, urinary retention
Other Drugs: Antihistamines, anticonvulsants, phenothiazines, antithyroid agents, estrogens, cocaine, sympathomimetics, MAO inhibitors
Lab Tests: EKG changes, blood glucose concentration
Administrative Notes: May be taken with or immediately after food to lessen gastric irritation
Amoxicillin
Trade Name(s): Amoxil, Polymox, Trimox, Wymox
Chemically Related To: Penicillin
Pregnancy Category: B
Medical Category: Antibacterial
Accepted Indications: Genitourinary infections, gonorrhea, otitis media, sinusitis, bacterial pneumonia, bacterial pharyngitis, bacterial bronchitis, endocarditis prophylaxis
Unaccepted Indications: Meningitis
Mechanism of Action: Bactericidal, cell division and growth inhibitor
Absorption/Distribution: Widely distributed to most body tissues and fluids
Half life: 15–{endash}20 h
Peak activity: 1–{endash}2 h
Elimination: Small amount excreted in bile, 90% renal
Adult Dosage: Capsules, oral suspension and tablets, antibacterial: 250–{endash}500 mg t.i.d.; endocarditis prophylaxis: 3 g 1 h before procedure and then 1.5 g 6 h after initial dose
Elderly Dosage: Lower dosage may be required
Child Dosage: Oral suspension, up to 6 kg: 25–{endash}50 mg/t.i.d.; 6–{endash}8 kg: 50–{endash}100 mg/t.i.d.; 8–{endash}20 kg: 6.7–{endash}13.3 mg/kg t.i.d.; 20 kg and over: same as adult dose
Infant Dosage: Same as child dose
Dosage Forms: Capsules: 250 mg and 500 mg; chewable tablets: 125 mg and 250 mg; for oral suspension: 50 mg/mL, 125 mg/mL, and 250 mg/5 mL
Occasional Side Effects: Mild diarrhea, nausea and vomiting, oral candidiasis, allergy
Rare Side Effects: Abdominal cramps, severe diarrhea, blood in stool, seizures, rash
Contraindications: Hypersensitivity
Other Drugs: Anticoagulants, NSAIDs, diuretics
Administrative Notes: Excreted in breast milk
Amoxicillin/Clavulanate Potassium
Trade Name(s): Augmentin
Chemically Related To: Penicillin
Pregnancy Category: B
Medical Category: Systemic antibacterial
Accepted Indications: Otitis media, bacterial pneumonia, urinary tract infections, bronchitis, chancroid, sinusitis, skin and soft tissue infections
Mechanism of Action: Clavulanic acid inhibits beta-lactamase activity from microbes and protects penicillin action; penicillin inhibits cell wall formation in bacteria
Adult Dosage: Oral suspension and chewable tablets: severe infections, 500 mg/125 mg t.i.d., other infections, 250 mg/62.5 mg t.i.d. for 7–{endash}10 d; tablets: severe infections, 500 mg/125 mg t.i.d. for 7–{endash}10 d, other infections, 250 mg/125 mg t.i.d. for 7–{endash}10 d
Elderly Dosage: Same as adult dose
Child Dosage: Oral suspension and chewable tablets: severe infections, under 40 kg: 13.3 mg/3.3 mg/kg t.i.d. for 7–{endash}10 d; other infections, 6.7 mg/1.7 mg/kg t.i.d. for 7–{endash}10 d, over 40 kg: same as adult dose; tablets: severe infections, under 40 kg: 13.3 mg/3.3 mg/kg t.i.d. for 7–{endash}10 d, other infections, 6.7 mg/1.7 mg/kg t.i.d. for 7–{endash}10 d; over 40 kg: same as adult dose
Infant Dosage: 20 mg/kg/d
Dosage Forms: Tablets: 250 mg/125 mg and 500 mg/125 mg; oral suspension: 125 mg/31.25 mg/5mL and 250 mg/62.5 mg/5mL; chewable tablets: 125 mg/31.25 mg and 250 mg/62.5 mg
By System: Antibacterial effects only
Amphetamine Sulfate
Scheduled Class: II
Abuse Potential: High
Pregnancy Category: C
Medical Category: CNS stimulant
Accepted Indications: Attention deficit disorder (ADD), narcolepsy
Unaccepted Indications: Fatigue, rest replacement, appetite suppression
Mechanism of Action: Sympathomimetic amine that increases motor activity and alertness
Half life: 10–{endash}30 h
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: 5–{endash}20 mg once daily to t.i.d.
Elderly Dosage: Same as adult dose
Child Dosage: ADD: under 3 y: not recommended; 3–{endash}6 y: 2.5 mg once daily, dose increased as needed; 6 y and over: 5 mg once daily or b.i.d., dose increased as needed. Narcolepsy: under 6 y: not established; 6–{endash}12 y: 2.5 mg b.i.d., dose increased as needed; 12 y and over: 5 mg b.i.d., dose increased as needed.
Infant Dosage: Not recommended
Dosage Forms: Tablets: 5 mg and 10 mg
Frequent Side Effects: Arrhythmia, CNS stimulation, irritability, nervousness
Occasional Side Effects: Blurred vision, diarrhea, constipation, anorexia, stomach cramps, nausea, dizziness, headache, dry mouth, increased sweating, unpleasant taste
Rare Side Effects: Chest pain, changes in libido, tachycardia, allergic reaction, Tourette's syndrome, hyperthermia
Contraindications: Arteriosclerosis, drug abuse, hypertension, Tourette's syndrome
Antidotal Therapy: May include emesis, barbiturates, acidification of urine
Disease States: Agitation, glaucoma, cardiovascular disease, hyperthyroidism
Other Drugs: MAO inhibitors, CNS stimulants, beta-blockers, thyroid hormones, tricyclic antidepressants, digitalis glycosides, meperidine, sympathomimetics
Lab Tests: Urinary steroid determinations
Administrative Notes: Withdrawal symptoms possible
Amphetamine/Dextroamphetamine
Trade Name(s): Generic only
Chemically Related To: Amphetamines
Scheduled Class: II
Abuse Potential: Very high
Pregnancy Category: C
Medical Category: CNS stimulant
Accepted Indications: Attention-deficit hyperactivity disorder, narcolepsy, exogenous obesity
Unaccepted Indications: Fatigue
Mechanism of Action: Facilitates the action of dopamine and norepinephrine by blocking reuptake from the synapse; inhibits action of MAO and facilitates release of catecholamines
Absorption/Distribution: Completely absorbed in 3 h, widely distributed in the body, with high concentrations in the brain
Half life: Amphetamine: 10–{endash}30 h, depending on urinary pH; dextroamphetamine: 10–{endash}12 h in adults and 6–{endash}8 h in children
Peak activity: 30–{endash}60 min
Metabolism: Hepatic
Elimination: Renal
Research Notes: Dosage reduction or interruption of therapy may be possible during summer months and at other times when the child is under less stress ("drug holidays")
Adult Dosage: 1 capsule once daily, 10–{endash}14 h before retiring
Elderly Dosage: Same as adult dose
Child Dosage: 3–{endash}5 y: 2.5 mg/d initially, dosage may be increased in increments of 2.5 mg at weekly intervals; 6 y and over: 5 mg once daily or b.i.d., dosage may be increased in increments of 5 mg at weekly intervals up to 40 mg once daily
Infant Dosage: Up to 3 y: not recommended
Dosage Forms: Capsules: 6.25 mg/6.25 mg and 10 mg/10 mg
By System: CNS
Warnings: Swallow capsules whole; possibility of psychological or physical dependence
Precautions: Gradual dosage reduction may be necessary to avoid possibility of withdrawal symptoms
Frequent Side Effects: Arrhythmia, false sense of well-being, irritability, nervousness, restless, insomnia
Occasional Side Effects: Changes in sexual function, constipation, diarrhea, dizziness, dry mouth
Overdosage: Insomnia, CNS excitement, hallucinations, tachycardia, hypertension, convulsions, coma
Antidotal Therapy: May include symptomatic and supportive treatment
Disease States: Agitated states, advanced arteriosclerosis, symptomatic cardiovascular disease, history of drug abuse, glaucoma, hypertension, hyperthyroidism, Tourette's syndrome
Other Drugs: Urinary acidifiers, urinary alkalizers, inhalation anesthetics, tricyclic antidepressants, oral antidiabetic agents, insulin, beta-adrenergic blockers, antihypertensives, digitalis glycosides, lithium, guanethedine, MAO inhibitors
Lab Tests: Urinary steroid determinations, plasma corticosteroid concentrations
Amphotericin B
Trade Name(s): Fungizone
Chemically Related To: Polyene antibiotics
Pregnancy Category: B
Medical Category: Antifungal, antiprotozoal
Accepted Indications: Systemic fungal infections, fungal urinary tract infections
Mechanism of Action: Fungistatic; in higher concentrations, fungicidal; binds fungus cell membrane sterols, causing potassium loss
Absorption/Distribution: Distributed in all body tissues
Half life: Elimination, adults: approximately 24 h; terminal half-life: 15 d
Metabolism: Metabolic pathways unknown
Elimination: Renal: very slow (approximately 40% over a 7 d period)
Research Notes: Poorly dialyzable
Adult Dosage: (Including adolescent) IV: initially l mg as a test dose, increased in 5–{endash}10 mg increments up to a maximum of 50 mg/d and administered over a period of 6 h
Elderly Dosage: Minimal effective doses because of renal impairment
Child Dosage: Antifungal, IV infusion; initially 0.25 mg/kg/d, maximum of 1 mg/kg/d
Infant Dosage: Same as child dose
Dosage Forms: Parenteral: 50 mg/15 mL (base)
Warnings: Extravasation of the drug may cause severe local irritation
Precautions: A total dosage exceeding 4 g may result in permanent impairment of renal function
Frequent Side Effects: Anemia, hypokalemia, infusion-related reactions, renal function impairment, thrombophlebitis, GI disturbances, headache
Occasional Side Effects: Blurred vision, arrhythmias, leukopenia, polyneuropathy, seizures, thrombocytopenia
Rare Side Effects: With intrathecal injection: blurred vision, difficulty in urination, polyneuropathy
Disease States: Renal function impairment
Other Drugs: Adrenocorticoids, bone marrow depressants, digitalis glycosides, potassium-depleting diuretics; nephrotoxic drugs
Administrative Notes: Therapy should be continued for a period of time sufficient to minimize the possibility of relapse
Amphotericin B/Tetracycline
Trade Name(s): Generic only
Pregnancy Category: B
Medical Category: Antibiotic
Accepted Indications: Systemic infections
Dosage Forms: Capsules: 50 mg/250 mg; syrup: 25 mg/125 mg/5 mL
Ampicillin Sodium/Sulbactam Sodium
Trade Name(s): Unasyn
Pregnancy Category: B
Medical Category: Antibiotic
Accepted Indications: Systemic infections
Adult Dosage: 1.5–{endash}3 g q.i.d.
Elderly Dosage: May require lower dose
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Sterile injection: 1.5 g (1 g/500 mg) and 3 g (2 g/1 g)
Ampicillin Trihydrate/Probenecid
Trade Name(s): Polycillin-PRB, Principen with Probenecid, Probampacin
Pregnancy Category: C
Medical Category: Antibiotic
Accepted Indications: Uncomplicated infections (urethral, endocervical, rectal) caused by Neisseria gonorrhoeae in adults
Adult Dosage: 3.5 g/1 g as a single dose
Dosage Forms: Capsules: 3.5 g/1 g; oral suspension: 3.5 g/1 g; powder for oral suspension: 3.5 g/1 g
Amrinone Lactate
Trade Name(s): Inocor
Pregnancy Category: C
Medical Category: Cardiotonic
Accepted Indications: Short term treatment CHF
Mechanism of Action: Peripheral vasodilatation
Half life: 3.6 h
IV: Within 10 min
Metabolism: Hepatic
Elimination: Renal: about 63%; fecal: about 18%
Adult Dosage: Initial: IV, 750 m{mu}g/kg over 2–{endash}3 min, may be repeated after 30 min; maintenance: IV, 5–{endash}10 m{mu}g/kg/min, dosage adjusted according to response. Total daily dose should not exceed 10 mg/kg/d
Elderly Dosage: Same as adult dose
Infant Dosage: Safety and efficacy not established
Dosage Forms: Injection: 5 mg/mL
Occasional Side Effects: Arrhythmias, hypotension, abdominal pain, fever, nausea, vomiting
Rare Side Effects: Chest pain, thrombocytopenia, burning at site of injection, hepatotoxicity
Contraindications: Aortic disease, hypertrophic cardiomyopathy
Antidotal Therapy: May include circulatory support
Disease States: Liver or kidney impairment
Lab Tests: Platelet counts, heart rate
Administrative Notes: Should not be diluted in solution that contains dextrose (glucose) prior to injection
Amyl Nitrite
Trade Name(s): Generic only
Chemically Related To: Unique compound
Pregnancy Category: X
Medical Category: Antianginal, antidote to cyanide poisoning, diagnostic aid (cardiac function)
Accepted Indications: Acute angina pectoris, cyanide toxicity, cardiac function studies
Unaccepted Indications: Production of euphoria, sexual stimulant
Mechanism of Action: Peripheral vasodilation; formation of methemoglobin for cyanide poisoning
Metabolism: Hepatic
Elimination: Renal
Research Notes: Onset of action 30 sec; duration of action 3–{endash}5 min
Adult Dosage: Inhalation: 0.18 mL or 0.3 mL, repeated in 3–{endash}5 min
Elderly Dosage: Lower dosage may be required
Child Dosage: Safety and efficacy not established
Infant Dosage: Safety and efficacy not established
Dosage Forms: Inhalant: 0.18 mL and 0.3 mL
By System: Cardiovascular
Warnings: Very flammable; avoid alcohol; orthostatic hypotension effects more likely in elderly
Precautions: Do not arise suddenly
Frequent Side Effects:
Rare Side Effects: Rash, hemolytic anemia
Overdosage: Bluish lips, fingernails, and palms of hands; dizziness; respiratory distress; tachycardia; tiredness; fainting
Antidotal Therapy: May include monitoring of methemoglobin concentration; administration of high-flow oxygen, IV methylene blue; avoiding use of epinephrine
Disease States: Anemia, cerebral hemorrhage, glaucoma, hyperthyroidism, recent myocardial infarction
Other Drugs: Acetylcholine, histamine, norepinephrine, antihypertensives, sympathomimetics
Lab Tests: Methemoglobin concentrations
Amylase/Cellulase/Lipase/Protease
Trade Name(s): Ku-Zyme
Pregnancy Category: C
Medical Category: Digestive aid
Accepted Indications: Functional indigestion caused by enzyme deficiency or imbalance
Research Notes: Does not attack living tissue; no danger to patient with ulceration
Adult Dosage: 1–{endash}2 capsules with or after meals/snacks
Dosage Forms: Capsules: 30 mg/2 mg/75 mg/6 mg
By System: GI tract
Overdosage: Excessive dosage may cause laxative effect
Disease States: Allergy to pork products
Administrative Notes: For patients with difficulty swallowing the capsule, the capsule contents may be sprinkled on the food
Anisotropine
Trade Name(s): Valpin 50
Chemically Related To: Atropine
Pregnancy Category: C
Medical Category: Anticholinergic
Accepted Indications: Peptic ulcer
Mechanism of Action: Antimuscarinic
Absorption/Distribution: Incompletely absorbed from the GI tract
Half life: 4 h
Metabolism: Hepatic
Elimination: Renal/fecal
Research Notes: Synthetic quaternary ammonium compound
Adult Dosage: 50 mg t.i.d.
Elderly Dosage: Over 70 y: decrease by 50%
Dosage Forms: Tablets: 50 mg
By System: Parasympathetic nervous system
Warnings: May cause blurred vision, photosensitivity
Precautions: Caution during exercise; caution getting up suddenly
Frequent Side Effects: Constipation, decreased sweating, dry mouth
Occasional Side Effects: Difficulty in swallowing, urinary retention
Rare Side Effects: Confusion, headache, tiredness
Overdosage: Blurred vision, clumsiness, confusion, drowsiness, fever, hallucinations, convulsions, dry skin, slurred speech
Antidotal Therapy: May include emesis/gastric lavage, activated charcoal, physostigmine, barbiturates, norepinephrine, oxygen
Disease States: Brain damage in children, heart trouble, glaucoma, myasthenia gravis, kidney or liver problems, ulcerative colitis, prostatic hypertrophy
Nutrition: Take 30 min–{endash}1 h before meals
Other Drugs: Other anticholinergics, potassium chloride, antimyasthenics, antacids, cyclopropane, ketoconazole
Lab Tests: Gastric acid secretion, gastric emptying studies
Administrative Notes: Do not stop abruptly
Antazoline Phosphate/Naphazoline Hydrochloride
Trade Name(s): Albalon-A, Antazoline-V, Naphazoline HCl with Antazoline, Vasocon-A
Pregnancy Category: C
Medical Category: Ophthalmic decongestant and antihistamine
Accepted Indications: Conjunctivitis, congestion, itching, minor irritation
Adult Dosage: 1–{endash}2 drops to the conjunctiva q.i.d.
Dosage Forms: Solution: 0.5 mg/0.05 mg
Anthralin
Trade Name(s): Anthra-Derm, Drithocreme, Dritho-Scalp, Lasan
Chemically Related To: Anthracene dyes
Pregnancy Category: C
Medical Category: Antipsoriatic, hair growth stimulant
Accepted Indications: Psoriasis, alopecia areata
Unaccepted Indications: Acute or actively inflamed psoriatic eruptions
Mechanism of Action: Reduces mitotic activity of hyperplastic epidermis
Absorption/Distribution: Low absorption via skin
Elimination: Renal
Research Notes: Has been shown to cause tumors in animals, but none reported in humans
Adult Dosage: Topical to skin once daily or b.i.d.
Elderly Dosage: Same as adult dose
Child Dosage: Safety and efficacy not established
Infant Dosage: Safety and efficacy not established
Dosage Forms: Cream: 0.1%, 0.2%, 0.25%, 0.4%, 0.5%, and 1%; ointment: 0.1%, 0.25%, 0.4%, 0.5%, 1%
By System: Dermal
Warnings: Avoid contact with eyes or other mucous membranes; do not apply to blistered or raw areas of skin and scalp
Precautions: Avoid contact with clothing or bedding; wear plastic gloves when applying medication
Frequent Side Effects: Redness of skin
Rare Side Effects: Rash
Overdosage: No evidence of systemic toxicity
Disease States: Acute inflammation of skin
Other Drugs: Photosensitizing medications
Administrative Notes: Protect from freezing
Antihemophilic Factor
Trade Name(s): Hemofil M, Humate-P, Hyate:C Koate-HP, KoGENate, MelATE, Monoclate P, Profilate HP, Profilate OSD, Recombinate
Chemically Related To: Biologic product
Pregnancy Category: C
Medical Category: Coagulant
Accepted Indications: Hemophilia, von Willebrand's disease, factor XIII deficiency, hypofibrinogenemia
Mechanism of Action: Endogenous glycoprotein necessary for blood clotting and hemostasis
Half life: Distribution 2.4–{endash}8 h, elimination 8.4–{endash}19.3 h
IV: 1–{endash}2 h
Adult Dosage: Various
Elderly Dosage: Same as adult dose
Dosage Forms: Numerous dosages and forms
Occasional Side Effects: Allergic reaction to AHF, or to mouse, hamster, or bovine protein, hemolytic anemia, thrombosis, inflammation at injection site, dry mouth, dizziness, headache, flushing
Rare Side Effects: Allergic reaction to albumin; hyperfibrinogenemia
Contraindications: Sensitivity to mouse, hamster, or bovine protein
Antipyrine
Pregnancy Category: Safety not established
Medical Category: Analgesic, antipyretic, hepatic function indicator
Accepted Indications: Test as an of hepatic drug-metabolizing capacity (orphan drug)
Absorption/Distribution: Readily absorbed from GI tract; distributed throughout body
Half life: 12 h (elimination)
Metabolism: Hepatic
Elimination: Renal
Dosage Forms: Tablets: 1200 mg in investigational studies
Antipyrine/Benzocaine
Trade Name(s): A/B Otic, Allergen, Antiben, Aurafair, Auralgan, AuroDex, Auroto, Benzotic, Dolotic, Earocol, Otipyrin, Otocalm
Pregnancy Category: C
Medical Category: Otologic analgesic/anesthetic, cerumen removal adjunct
Unaccepted Indications: No longer recommended because of questionable effectiveness and because benzocaine often causes contact dermatitis
Adult Dosage: Otic analgesic/anesthetic: fill ear canal q1–{endash}2h until relief obtained; cerumen removal adjunct: fill ear canal t.i.d. for 2–{endash}3 d, irrigate ear canal with warm water after 2–{endash}3 d
Elderly Dosage: Same as adult dose
Child Dosage: Same as adult dose
Dosage Forms: Otic solution: 54 mg/14 mg/1 mL
Antipyrine/Benzocaine/Phenylephrine Hydrochloride
Trade Name(s): Tympagesic
Pregnancy Category: C
Medical Category: Otologic analgesic and decongestant
Accepted Indications: Otitis media
Adult Dosage: Fill the ear canal, plug with saturated cotton, repeat q2–{endash}4h
Dosage Forms: Solution, otic 5%/5%/0.25%
Apraclonidine Hydrochloride
Trade Name(s): Iopidine
Chemically Related To: Clonidine
Pregnancy Category: C
Medical Category: Antiglaucoma agent, ocular antihypertensive
Accepted Indications: Elevated intraocular pressure
Mechanism of Action: Relatively selective alpha2-adrenergic agonist; reduces intraocular pressure by affecting aqueous humor action
Half life: Onset of action usually within 1 h
Peak activity: Usually 3–{endash}5 h after application of a single dose
Adult Dosage: For ocular hypertension, 1 drop of 1.0% ophthalmic solution into affected eye; for open-angle glaucoma, 1 drop of 0.5% solution in each eye t.i.d.
Dosage Forms: Ophthalmic solution: 0.5% or 1%
By System: Ophthalmic
Warnings: It may be necessary to avoid breastfeeding while taking this drug
Frequent Side Effects: Conjunctival blanching, mydriasis, raising of upper eyelid
Occasional Side Effects: Arrhythmia
Rare Side Effects: Ocular inflammation
Antidotal Therapy: No information is available regarding overdosage in humans
Disease States: Severe cardiovascular disease, including hypertension
Other Drugs: MAO inhibitors
Administrative Notes: There is 0.25 mL apraclonidine HCl in each single-dose dispenser
Aprobarbital
Trade Name(s): Alurate
Chemically Related To: Phenobarbital
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: D
Medical Category: Sedative-hypnotic
Accepted Indications: Treatment of insomnia, anxiety (short-term); barbiturates have generally been replaced by benzodiazepines
Mechanism of Action: Depresses the sensory cortex; inhibits ascending conduction in the reticular formation
Absorption/Distribution: Rapidly distributed to all tissues and fluids, with high concentration in brain, liver, and kidneys
Half life: 14–{endash}34 h (mean, 24 h)
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: Hypnotic: oral, 40–{endash}160 mg at bedtime; sedative: oral, 40 mg t.i.d. during daytime
Elderly Dosage: Lower doses required
Dosage Forms: Elixir 40 mg/5 mL
By System: CNS depressant
Warnings: Barbiturates readily cross placenta; children may react to barbiturates with paradoxical excitement
Frequent Side Effects: Clumsiness, dizziness, drowsiness
Occasional Side Effects: Sensitivity to barbiturates, mental depression
Rare Side Effects: Agranulocytosis, hallucinations, thrombocytopenia, thrombophlebitis, osteomalacia, Stevens-Johnson syndrome
Contraindications: Porphyria
Overdosage: Confusion, decrease or loss of reflexes, drowsiness, high fever, hypothermia, shortness of breath, bradycardia, slurred speech, staggering
Antidotal Therapy: May include primarily supportive treatment; adequate airway should be ensured, blood pressure and body temperature maintained, fluid balance monitored
Disease States: Severe anemia, diabetes mellitus, mental depression, suicidal tendencies, acute or chronic pain
Other Drugs: Acetaminophen, adrenocorticoids, quinidine, CNS-depressants, coumarin anticoagulants, hydantoin anticonvulsants
Lab Tests: Metyrapone tests, bilirubin
Ascorbic Acid
Trade Name(s): Apo-C, Ascorbicap, Cebid, Cecon, Cee-500, Cemill, Cevalin, Ce-Vi-Sol, Sunkist
Chemically Related To: Vitamin C
Pregnancy Category: C
Medical Category: Nutritional supplement, red blood cell disease diagnostic aid adjunct, chronic iron overdose adjunct, idiopathic methemoglobinemia therapy adjunct
Accepted Indications: Vitamin C deficiency, labelling of red blood cells, chronic iron toxicity, idiopathic methemoglobinemia
Unaccepted Indications: Cancer, asthma, aging, hay fever, pyorrhea, gingival infections, hemorrhagic states, hematuria, retinal hemorrhages, immune system dysfunction, mental depression, dental caries, anemia, acne, infertility, atherosclerosis, peptic ulcer, tuberculosis, schizophrenia, dysentery, collagen disorders, fractures, skin ulcers, drug toxicity, prevention of vascular thrombosis or common cold
Mechanism of Action: Necessary for collagen formation
Absorption/Distribution: Readily absorbed from GI tract
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: Up to 750 mg/d
Elderly Dosage: Same as adult dose
Child Dosage: Up to 300 mg/d
Infant Dosage: Varies
Dosage Forms: Tablets: 50 mg, 100 mg, 250 mg, 500 mg, 1 g, and 1.5 g; syrup: 500 mg/5 mL; chewable tablets: 50 mg, 100 mg, 250 mg, 500 mg, and 1 g; injection: 100 mg/mL, 250 mg/mL, and 500 mg/mL; extended-release capsules: 500 mg; oral solution: 35 mg/0.6 mL and 100 mg/mL; effervescent tablets: 1 g; extended-release tablets: 500 mg, 1 g, and 1.5 g
Warnings: Protect from light
Precautions: Effectiveness of megadoses remains unproven
Occasional Side Effects: Kidney stones, oxalate (dose-related), dizziness, faintness, diarrhea, flushing, headache, urination increase, nausea, vomiting, stomach cramps
Contraindications: Diabetes, hemochromatosis, kidney stones
Overdosage: Dizziness, faintness
Disease States: Sideroblastic anemia, thalassemia, sickle cell anemia, G6PD deficiency
Other Drugs: Disulfiram, mexiletine, deferoxamine, vitamin B12, anticoagulants
Lab Tests: Occult blood in stool, bilirubin, urinary pH
Administrative Notes: Withdrawal scurvy may occur at high doses
Aspirin
Trade Name(s): Aspergum, Bayer Aspirin, Ecotrin, Empirin, Halfprin,
Chemically Related To: Salicylates
Pregnancy Category: D
Medical Category: Analgesic, anti-inflammatory, antipyretic, antirheumatic, platelet aggregation inhibitor, antithrombotic, myocardial infarction prophylactic
Accepted Indications: Pain and fever, inflammation, juvenile and rheumatoid arthritis, osteoarthritis, rheumatic fever, platelet aggregation (prophylaxis), myocardial infarction (prophylaxis)
Mechanism of Action: Inhibits prostaglandin synthesis
Absorption/Distribution: Generally rapid and complete absorption
Half life: 15–{endash}20 min
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: Varies by form and indication
Elderly Dosage: Lower dose may be required
Child Dosage: Varies by form and indication
Infant Dosage: Varies by form and indication
Dosage Forms: Tablets: 325 mg, 500 mg, and 650 mg; chewable tablets: 81 mg; chewing gum tablets: 227 mg; delayed-release tablets: 80 mg, 165 mg, 325 mg, 500 mg, 650 mg, and 975 mg; extended-release tablets: 650 mg and 800 mg; suppositories: 60 mg, 120 mg, 125 mg, 130 mg, 195 mg, 200 mg, 300 mg, 325 mg, 600 mg, 650 mg, and 1.2 g
By System: CNS and peripheral pain receptors
Warnings: GI ulceration for bleeding; do not use in viral infections; prolongs bleeding time
Frequent Side Effects: GI irritation, with mild stomach pain, heartburn, indigestion, nausea with or without vomiting
Occasional Side Effects: Anemia, dermatitis, GI ulcerations
Rare Side Effects: Bloody or black, tarry stools; headache; extreme tiredness; renal impairment; allergy
Contraindications: Bleeding ulcers; hemorrhagic states; hemophilia; angioedema; nasal polyps associated with asthma; thrombocytopenia
Overdosage: Severe overdose: bloody urine; convulsions; hallucinations; severe nervousness, excitement or confusion; shortness of breath
Antidotal Therapy: May include empty stomach via induction of emesis, gastric lavage, activated charcoal; monitor and support vital functions; correct hyperthermia; use supportive measures
Disease States: Anemia, conditions predisposing to fluid retention, erosive gastritis, peptic ulcer, gout, vitamin K deficiency, thyrotoxicosis, nasal polyps, asthma, thrombocytopenia, G6PD deficiency
Nutrition: May increase ascorbic acid requirement; most combinations are to be taken with or after food
Other Drugs: Acetaminophen, urinary acidifiers, NSAIDs, adrenocorticoids, antacids, anticoagulants, insulin, valproic acid, ototoxic medications
Lab Tests: Urine 5-hydroxyindoleacetic acid determination, protirelin-induced thyroid-stimulating hormone release determinations, bleeding time
Administrative Notes: Risk of complications from this action appears minimal in patients with normal renal function
Aspirin/Butalbital/Caffeine
Trade Name(s): Butalgen, Fiorex, Fiorgen, Fiorinal, Fiormor, Fortabs, Idenal, Isobutal, Isobutyl, Isolin, Isollyl, Laniroif, Lanorinal, Marnal, Vibutal
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1–{endash}2 capsules or tablets q4h, not to exceed 6 capsules or tablets/d
Child Dosage: Not established
Dosage Forms: Capsules: 325 mg/50 mg/40 mg; tablets: 325 mg/50 mg/40 mg
Aspirin/Butalbital/Caffeine/Codeine Phosphate
Trade Name(s): Ascomp with Codeine, B-A-C #3, Farbital with Codeine, Fiorinal with Codeine
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1–{endash}2 capsules q4h, not to exceed 6 capsules/d
Dosage Forms: Capsules: 325 mg/50 mg/40 mg/30 mg
Aspirin/Caffeine/Dihydrocodeine Bitartrate
Trade Name(s): Dihydrocodeine Compound, Synalgos-DC
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 2 capsules q4h
Child Dosage: Not established
Dosage Forms: Capsules: 356.4 mg/30 mg/16 mg
Aspirin/Caffeine/Orphenadrine Citrate
Trade Name(s): N3 Gesic, Norgesic, Orphenadrine Citrate Compound, Orphengesic
Pregnancy Category: C
Medical Category: Analgesic, muscle relaxant
Adult Dosage: 1–{endash}2 tablets containing 25 mg of orphenadrine citrate t.i.d. or q.i.d.; ½–{endash}1 tablet containing 50 mg of orphenadrine citrate t.i.d. or q.i.d.
Child Dosage: Not established
Dosage Forms: Tablets: 385 mg/30 mg/25 mg and 770 mg/60 mg/50 mg
Aspirin/Caffeine/Propoxyphene Hydrochloride
Trade Name(s): Bexophene, Cotanal-65, Darvon Compound, Doraphen Compound, Doxaphene Compound, Margesic Compound, Propoxyphene HCl Compound
Scheduled Class: IV
Abuse Potential: Mild
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1 capsule q4h
Child Dosage: Not established
Dosage Forms: Capsules: 389 mg/32.4 mg/32 mg and 389 mg/32.4 mg/65 mg
Aspirin/Carisoprodol
Trade Name(s): Carisoprodol Compound, Soma Compound
Pregnancy Category: C
Medical Category: Analgesic, muscle relaxant
Adult Dosage: 1–{endash}2 tablets q.i.d.
Dosage Forms: Tablets: 325 mg/200 mg
Aspirin/Carisoprodol/Codeine Phosphate
Trade Name(s): Soma Compound with Codeine
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic, muscle relaxant
Adult Dosage: 1–{endash}2 tablets q.i.d.
Dosage Forms: Tablets: 325 mg/200 mg/16 mg
Aspirin/Codeine Phosphate
Trade Name(s): Emcodeine, Empirin with Codeine
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1–{endash}2 tablets q4h
Child Dosage: Not established
Dosage Forms: Tablets: 325 mg/15 mg; various other combinations available
Aspirin/Hydrocodone Bitartrate
Trade Name(s): Azdone, Damason-P, Lortab ASA
Scheduled Class: III
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1–{endash}2 tablets q4h
Child Dosage: Not established
Dosage Forms: Tablets: 500 mg/5 mg
Aspirin/Meprobamate
Trade Name(s): Epromate-M, Equazine-M, Heptogesic, Meprogesic, Micrainin
Scheduled Class: IV
Abuse Potential: Mild
Pregnancy Category: C
Medical Category: Analgesic, muscle relaxant
Accepted Indications: Tension headaches
Adult Dosage: 1–{endash}2 tablets t.i.d. or q.i.d.
Child Dosage: Not recommended
Dosage Forms: Tablets: 325 mg/200 mg
Warnings: Elderly may be more sensitive to the drug's effects
Aspirin/Methocarbamol
Trade Name(s): Methocarbamol with Aspirin, Robaxisal
Scheduled Class: IV
Abuse Potential: Mild
Medical Category: Analgesic, muscle relaxant
Adult Dosage: 2 tablets q.i.d.
Dosage Forms: Tablets: 325 mg/400 mg
Aspirin/Oxycodone Hydrochloride
Trade Name(s): Percodan, Percodan-Demi, Roxiprin
Chemically Related To: Opioids
Scheduled Class: II
Abuse Potential: High
Pregnancy Category: Adequate studies have not been done
Medical Category: Analgesic
Accepted Indications: Moderate to moderately severe pain
Mechanism of Action: Binds with opioid receptors (mu) in the CNS to modify the process of perceiving pain
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: 1–{endash}2 half-strength tablets or 1 full-strength tablet q4–{endash}6h
Elderly Dosage: Same as adult dose
Child Dosage: Under 6 y: not recommended; over 6–{endash}12 y: ¼ half-strength tablet q.i.d.; over 12 y: ½ half-strength tablet q.i.d
Dosage Forms: Tablets: half-strength, 325 mg/2.25 mg oxycodone HCl and 190 m{mu}g oxycodone terephthalate; full-strength 325 mg/4.5 mg oxycodone HCl and 380 m{mu}g oxycodone terephthalate
By System: CNS
Warnings: May be habit forming; may prolong labor and should not be used during labor/delivery
Frequent Side Effects: Dizziness, drowsiness, hypotension, nausea, tiredness
Occasional Side Effects: Histamine release, antidiuretic effect, anticholinergic effects, ureteral spasm
Rare Side Effects: Respiratory depression, mental depression, toxic megacolon, trouble sleeping
Overdosage: Clammy skin, confusion, convulsions, dizziness, drowsiness, hypotension, bradycardia, slow breathing, unconsciousness, restlessness
Disease States: Asthma, respiratory impairment, inflammatory bowel disease, myocardial infarction, respiratory function
Other Drugs: Alcohol, other CNS depressants, anticholinergics, MAO inhibitors, naltrexone
Lab Tests: Gastric emptying; CSF pressure; plasma amylase or lipase activity; serum SGPT, SGOT, bilirubin, and lactate dehydrogenase
Administrative Notes: Controlled drug substance; may cause drowsiness; avoid alcohol; may be habit forming
Aspirin/Oxycodone Hydrochloride/Oxycodone Terephthalate
Trade Name(s): Oxycodone with Aspirin, Percodan, Percodan-Demi, Roxiprin
Scheduled Class: II
Abuse Potential: Moderate
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 1–{endash}2 half-strength tablets or 1 full-strength tablet q4–{endash}6h
Child Dosage: Up to 6 y: not recommended; 6–{endash}12 y: ¼ half-strength tablet q.i.d.; 12 y and over: ½ half-strength tablet q.i.d.
Dosage Forms: Tablets: 325 mg/2.25 mg/0.19 mg (half-strength) and 325 mg/4.5 mg/0.38 mg (full-strength)
Aspirin/Pentazocine Hydrochloride
Trade Name(s): Talwin Compound
Scheduled Class: IV
Abuse Potential: Mild
Pregnancy Category: C
Medical Category: Analgesic
Adult Dosage: 2 tablets t.i.d. or q.i.d.
Child Dosage: Not established
Dosage Forms: Tablets
Astemizole
Trade Name(s): Hismanal
Chemically Related To: Antihistamines
Pregnancy Category: C
Medical Category: Antihistamine, antiasthmatic
Accepted Indications: Rhinitis, conjunctivitis (allergic), pruritus, urticaria, sneezing, rhinorrhea, bronchial asthma
Mechanism of Action: Competitive inhibitor of H1 receptor site
Absorption/Distribution: Well-absorbed
Half life: 1.6 d
Metabolism: Hepatic
Elimination: Fecal
Research Notes: 2–{endash}3 d onset of action; drug will continue activity several w after discontinuation
Adult Dosage: 10 mg once daily
Elderly Dosage: May have increased occurrence of nightmares, nervousness, irritability
Child Dosage: Up to 6 y: 2 mg/10 kg once daily; 6–{endash}12 y: 5 mg once daily; over 12 y: see adult dose
Infant Dosage: Not recommended for newborn or premature infants
Dosage Forms: Tablets: 10 mg
By System: Respiratory system
Warnings: Avoid alcohol; note potentially fatal interactions may occur with other medications
Precautions: Drowsiness; possible dry mouth
Frequent Side Effects: Drowsiness, thick mucus
Occasional Side Effects: Blood dyscrasias, cardiac arrhythmias, blurred vision, painful voiding, tachycardia, GI distress, prolonged QT interval
Contraindications: Liver problems
Overdosage: Anticholinergic effects, cardiac arrhythmias, CNS depression, hypotension
Antidotal Therapy: May include symptomatic and supportive treatment: possible emesis/gastric lavage, saline cathartics, vasopressors, oxygen
Disease States: Prostatic problems, bladder neck obstruction, urinary retention, glaucoma
Other Drugs: CNS depressants, anticholinergics, apomorphine, erythromycin, MAO inhibitors, ketoconazole, itraconazole
Lab Tests: Skin tests with allergen extracts
Administrative Notes: Prolonged QT intervals may occur with high doses
Atenolol
Trade Name(s): Tenormin
Chemically Related To: Propranolol
Pregnancy Category: D
Medical Category: Beta-adrenergic blocking agent
Accepted Indications: Angina pectoris, cardiac arrhythmias, hypertension, cardiomyopathy, myocardial reinfarction, pheochromocytoma, vascular headache (prophylaxis), tremors
Mechanism of Action: Beta blocker
Absorption/Distribution: Low lipid solubility; 50% absorption
Half life: 6–{endash}7 h
Elimination: Renal
Research Notes: Half-life can increase to nearly 150 h if renal disorder is severe
Adult Dosage: 50 mg once daily up to 200 mg/d
Elderly Dosage: Dosage reduction required
Dosage Forms: Tablets: 25 mg, 50 mg, and 100 mg; injection: 5 mg/10 mL
By System: Cardiovascular
Precautions: Use with caution if surgery required
Frequent Side Effects: Decreased sexual ability
Occasional Side Effects: Bradycardia, chest pain, mental depression, diarrhea, dizziness, nausea and vomiting, tiredness
Rare Side Effects: Rash, confusion, drowsiness, nightmares
Contraindications: Cardiac failure, cardiogenic shock, heart block, sinus bradycardia
Antidotal Therapy: May include gastric lavage, atropine sulfate, IV lidocaine, oxygen, IV fluids, IV diazepam
Disease States: Allergy, emphysema, CHF, diabetes mellitus, mental depression, psoriasis, kidney and liver problems
Other Drugs: Cocaine, MAO inhibitors, sympathomimetics, xanthines, estrogens, calcium channel blockers
Lab Tests: Glaucoma screening tests, urinary amphetamine determinations, BUN, uric acid test, blood glucose concentrations
Atenolol/Chlorthalidone
Trade Name(s): Atenolol with Chlorthalidone, Tenoretic 50, Tenoretic 100
Pregnancy Category: C
Medical Category: Antihypertensive
Research Notes: Elderly patients may have increased or decreased sensitivity to the drug's effects
Adult Dosage: 1–{endash}2 tablets once daily, determined by individual titration
Child Dosage: Not established
Dosage Forms: Tablets: 50 mg/25 mg and 100 mg/25 mg
Warnings: Elderly patients may have increased or decreased sensitivity to the drug's effects
Atovaquone
Trade Name(s): Mepron
Chemically Related To: Hydroxynaphthoquinones
Pregnancy Category: C
Medical Category: Antiprotozoal
Accepted Indications: Pneumocystis carinii pneumonia
Unaccepted Indications: Other pneumonias (bacterial, viral, fungal)
Mechanism of Action: Possible cidal activity against organisms through poorly understood mechanism
Half life: 2.2–{endash}2.9 d
Metabolism: Probably not metabolized
Elimination: Fecal
Adult Dosage: 750 mg t.i.d. for 21 d
Elderly Dosage: Not established
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Tablets: 250 mg
Precautions: Continue with full treatment
Frequent Side Effects: Fever, rash, diarrhea, vomiting, nausea, headache, insomnia
Contraindications: GI disorders that inhibit digestion
Disease States: Highly plasma protein-bound medications
Lab Tests: Serum hemoglobin, serum sodium, white blood cell count
Administrative Notes: Take with a high-fat meal
Atracurium Besylate
Trade Name(s): Tracrium
Pregnancy Category: C
Medical Category: Neuromuscular blocking agent
Accepted Indications: Muscle relaxation for surgery, convulsions
Mechanism of Action: Blocks neural transmission at myoneural junction
Half life: 2–{endash}3.4 min (distribution), 20 min (elimination)
IV: 3–{endash}5 min
Metabolism: In plasma
Elimination: Renal and biliary
Research Notes: Onset of action: 2 min
Adult Dosage: Initial: 400–{endash}500 m{mu}g/kg; supplemental: IV, 80–{endash}100 m{mu}g/kg 20–{endash}45 min after initial dose, then every 15–{endash}25 min
Elderly Dosage: May require lower dose
Child Dosage: 2 y and over: 300–{endash}400 m{mu}g/kg initially
Infant Dosage: Under 1 m: not established. 1 m–{endash}2y: IV, 300–{endash}400 m{mu}g/kg.
Dosage Forms: Injection: 10 mg/mL
Precautions: Should be used within 14 d if not refrigerated
Frequent Side Effects:
Occasional Side Effects: Increased blood pressure, decreased blood pressure, tachycardia
Rare Side Effects: Edema, hives, bradycardia, hypersensitivity reaction, bronchospasm, circulatory depression, erythema, laryngospasm, itching, rash
Contraindications: Dehydration, hypotension, respiratory depression, myasthenia gravis
Overdosage: Respiratory depression, apnea, cardiovascular collapse
Antidotal Therapy: May include peripheral nerve stimulator, mechanical ventilation, anticholinesterase agents, fluids, vasopressors
Disease States: Hypothermia, myasthenia gravis
Other Drugs: Quinidine, procainamide, lithium, aminoglycosides, anesthetics, capreomycin, lincomycin, polymyxins, clindamycin, citrate-anticoagulated blood, opioid analgesics, edrophonium, antimyasthenics, calcium salts, doxapram, neuromuscular blocking agents, potassium-depleting medications
Atropine Sulfate
Trade Name(s): Atropen, Sal-Tropine
Chemically Related To: Belladonna
Pregnancy Category: C
Medical Category: Anticholinergic, antiarrhythmic, antidote, urinary antispasmodic
Accepted Indications: Peptic ulcer, irritable bowel syndrome, urologic disorders, urinary incontinence, preanesthesia antisialagogue, arrhythmias, bradycardia, cholinesterase toxicity
Mechanism of Action: Inhibits the muscarinic actions of acetylcholine
Absorption/Distribution: Rapidly absorbed from the GI tract
Half life: 2.5 h
Metabolism: Hepatic
Elimination: Renal, 30%–{endash}50% excreted unchanged
Research Notes: Duration of action of oral atropine, 4–{endash}6 h
Adult Dosage: (And adolescent) soluble tablets and tablets: anticholinergic: 300 m{mu}g–{endash}1.2 mg q4–{endash}6h; preanesthesia: 2 mg; injection: anticholinergic: 400–{endash}600 m{mu}g q4–{endash}6h; antiarrhythmic: 400 m{mu}g–{endash}1 mg q1–{endash}2h up to 2 mg; cholinergic adjunct: IV, 600 m{mu}g–{endash}1.2 mg administered with 500 m{mu}g–{endash}2 mg of neostigmine methylsulfate; antidote: IM or IV, 2–{endash}4 mg initially, follow-up dose depends on toxic substance
Elderly Dosage: May be more sensitive to drug's effects
Child Dosage: Soluble tablets and tablets, anticholinergic: 0.01 mg/kg, not to exceed 0.4 mg q4–{endash}6h; injection: SQ, anticholinergic: 0.01 mg/kg, not to exceed 0.4 mg q4–{endash}6h
Infant Dosage: Same as child dose
Dosage Forms: Soluble tablets: 400 m{mu}g and 600 m{mu}g; tablets: 400 m{mu}g; injection: 50 m{mu}g/mL, 100 m{mu}g/mL, 300 m{mu}g/mL, 400 m{mu}g/mL, 500 m{mu}g/mL, and 1 mg/mL
By System: Parasympathetic nervous system
Warnings: May cause blurred vision; possible increased sensitivity to light
Precautions: IV administration may produce tachycardia in fetus
Frequent Side Effects: Constipation, decreased sweating, redness at injection site
Occasional Side Effects: Decreased flow of breast milk, decreased salivary secretion, blurred vision
Rare Side Effects: Confusion, increased intraocular pressure, orthostatic hypotension, sensation of bloating, difficulty in urination, drowsiness, headache, extreme tiredness
Overdosage: Blurred vision; confusion; dizziness; dry, hot, flushed skin; tachycardia
Antidotal Therapy: May include emesis or gastric lavage, slow IV physostigmine
Disease States: Brain damage in children, cardiac disease, fever, GI tract obstructive disease, acute hemorrhage, ulcerative colitis
Other Drugs: Citrates, antacids, antidiarrheals, haloperidol, ketoconazole, metoclopramide
Lab Tests: Gastric acid secretion test, radionuclide gastric emptying studies
Administrative Notes: Fatal dose of atropine in children may be as low as 10 mg
Atropine Sulfate/Benzoic Acid/Hyoscyamine/Methenamine/Methylene Blue/Phenyl Salicylate
Trade Name(s): Urinary Antiseptic No. 2, Urised, Urisep, Uritab
Chemically Related To: Atropine
Pregnancy Category: C
Medical Category: Anticholinergic-antibacterial-analgesic (urinary tract)
Accepted Indications: Irritative voiding, diagnostic procedure–{endash}induced urinary symptoms
Unaccepted Indications: Cystitis, urethritis, and trigonitis
Mechanism of Action: Relaxes smooth muscle spasm; bacteriostatic or bactericidal; blocks pain impulse generation
Absorption/Distribution: Well absorbed from GI tract
Metabolism: Hepatic
Elimination: Renal
Adult Dosage: 1–{endash}2 tablets q.i.d.
Elderly Dosage: Same as adult dose
Child Dosage: Not recommended
Infant Dosage: Not recommended
Dosage Forms: Tablets: 0.03 mg/4.5 mg/0.03 mg/40.8 mg/5.4 mg/18.1 mg and 0.06 mg/7.5 mg/0.03 mg/120 mg/6 mg/30 mg
By System: Urinary tract
Warnings: It is important to maintain acidic urine (pH£{less than or equal}5.5)
Precautions: Caution if blurred vision occurs; there may be dryness of mouth, nose, or throat (use sugarless gum, candy, ice or saliva substitute for relief)
Frequent Side Effects: Blue or blue-green urine and/or stools
Occasional Side Effects: Difficulty in urination; dry mouth, nose, or throat; nausea or vomiting; GI distress or pain
Rare Side Effects: Allergic reaction, blurred vision, increased intraocular pressure
Overdosage: Anticholinergic effects (severe drowsiness, dizziness, tachycardia, flushing, shortness of breath), hematuria, crystalluria, bloody stools, diarrhea, severe headache
Antidotal Therapy: May include emesis or gastric lavage, slow IV physostigmine, small doses of diazepam, artificial respiration with oxygen, adequate hydration
Disease States: Brain damage in children, cardiac disease, severe dehydration, GI tract obstructive disease, open-angle glaucoma, impairment of hepatic function, hyperthyroidism, myasthenia gravis, urinary retention
Other Drugs: Alkalizers, citrates, thiazide diuretics, anticholinergics, antidiarrheals, opioid narcotics, sulfonamides, metoclopramide
Lab Tests: Urine pH, urinary estriol determination, urinary catecholamine determination
Administrative Notes: Urea-splitting organisms may cause an increase in urine pH and decrease the effectiveness of methenamine. Instruct patient to take adequate amounts of fluid with each dose and during therapy
Atropine Sulfate/Chlorpheniramine Maleate/Hyoscyamine Sulfate/Phenylephrine Hydrochloride/Phenylpropanolamine Hydrochloride/Scopolamine Hydrobromide
Trade Name(s): Atrohist Plus, Phenahist-TR, PhenchlorSHA, RuTuss, Stahist
Pregnancy Category: C
Medical Category: Decongestant, antihistamine
Accepted Indications: Common cold symptoms
Adult Dosage: 1 tablet b.i.d.
Dosage Forms: Tablets 0.4 mg/8 mg/0.19 mg/25 mg/50 mg/0.01 mg
Atropine Sulfate/Difenoxin Hydrochloride
Trade Name(s): Motofen
Scheduled Class: V
Abuse Potential: Low
Pregnancy Category: C
Medical Category: Antidiarrheal
Adult Dosage: 2 tablets initially, followed by 1 tablet after each loose stool or q3–{endash}4h up to 8 tablets/d
Child Dosage: Not recommended
Dosage Forms: Tablets: 0.025 mg/1 mg
Atropine Sulfate/Diphenoxylate Hydrochloride
Trade Name(s): Lofene, Logen, Lomocot, Lomotil, Lonox, Vi-Atro
Chemically Related To: Meperidine HCl
Scheduled Class: V
Abuse Potential: Low
Pregnancy Category: C
Medical Category: Antidiarrheal
Accepted Indications: Diarrhea
Mechanism of Action: Reduces intestinal motility
Half life: Atropine sulfate: 2–{endash}5 h; diphenoxylate: 2.5 h
Peak activity: Onset of effect, 45–{endash}60 min; duration of effect, 3–{endash}4 h
Metabolism: Hepatic
Elimination: Fecal, renal
Adult Dosage: Initial: 0.05 mg/5 mg t.i.d. or q.i.d.; maintenance: 0.05 mg/5 mg once daily
Elderly Dosage: Same as adult dose
Child Dosage: Under 12 y: not recommended; 12 y and over: same as adult dose
Dosage Forms: Solution: 0.025 mg/2.5 mg/5 mL; tablets: 0.025 mg/2.5 mg
By System: Affects intestinal motility
Warnings: Controlled drug substance; excreted in breast milk
Occasional Side Effects: Anticholinergic effects, CNS depression, headache, swelling of gums, confusion, numbness of hands or feet, rash
Rare Side Effects: Paralytic ileus, toxic megacolon
Contraindications: Colitis; diarrhea associated with pseudomembranous colitis; dehydration; diarrhea caused by poisoning; dysentery; jaundice
Overdosage: Respiratory depression, severe anticholinergic effects, extreme nervousness, coma
Antidotal Therapy: May include naloxone, gastric lavage, activated charcoal, support of respiration
Other Drugs: Addictive medications, alcohol, CNS depressants, anticholinergics, MAO inhibitors, naltrexone, opioid analgesics
Lab Tests: Phenolsulfonphthalein excretion test
Administrative Notes: May be habit forming
Atropine Sulfate/Hyoscyamine/Methenamine/Methylene Blue/Phenyl Salicylate
Trade Name(s): Atrosept, Dolsed, Lanased, Uretron, Uridon, Urisep, Urstat
Pregnancy Category: C
Medical Category: Urinary tract antiseptic
Dosage Forms: Tablets: 0.03 mg/4.5 mg/0.03 mg/40.8 mg/5.4 mg/18.1 mg and 0.06 mg/7.5 mg/0.03 mg/120 mg/6 mg/30 mg
Attapulgite
Trade Name(s): Diar-Aid, Diasorb, Donnagel, Kaopectate, K-Pek, Parepectolin, Rheaban
Pregnancy Category: Problems in humans not documented
Medical Category: Adsorbent antidiarrheal
Accepted Indications: Diarrhea
Mechanism of Action: Adsorbs bacteria and toxins, reduces water loss
Absorption/Distribution: Not absorbed
Adult Dosage: 1.2–{endash}1.5 g after each loose bowel movement, 9 g/d maximum
Elderly Dosage: Use with caution
Child Dosage: 3–{endash}6 y: 300 mg after each loose bowel movement, not to exceed 2.1 g/d; 6–{endash}12 y: 600 mg after each loose bowel movement, not to exceed 4.2 g/d; 12 y and over: same as adult dose
Infant Dosage: Up to 3 y: not recommended
Dosage Forms: Oral suspension: 600 mg/15 mL and 750 mg/5mL; tablets: 750 mg; chewable tablets: 300 mg and 600 mg
Warnings: Do not chew regular tablets
Precautions: Shake suspension well
Frequent Side Effects: Constipation (dose related)
Contraindications: Dehydration, acute dysentery
Disease States: Bowel obstruction
Other Drugs: Xanthines, loxapine, digitalis glycosides, anticholinergics, antidyskinetics, lincomycins, phenothiazines, thioxanthenes
Administrative Notes: Maintain adequate hydration
Auranofin
Trade Name(s): Ridaura
Chemically Related To: Gold
Pregnancy Category: C
Medical Category: Antirheumatic
Accepted Indications: Rheumatoid arthritis, juvenile rheumatoid arthritis
Mechanism of Action: Suppression of the inflammatory mechanisms of rheumatoid disease
Absorption/Distribution: Approximately 25% of gold in a dose is absorbed from GI tract
Half life: 26 d in blood; 80 d in body tissue
Metabolism: Hepatic
Elimination: 60% renal; 40% fecal
Research Notes: Onset of action is usually 3–{endash}4 m but can take up to 6 m
Adult Dosage:
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Capsules: 3 mg
By System: Acts on connective tissue
Precautions: Possibility of phototoxicity; use blood and urine tests to detect possible adverse effects
Frequent Side Effects: Abdominal or stomach cramps; sensation of bloating; gas or indigestion; decrease or loss of appetite; diarrhea
Occasional Side Effects: Constipation, bloody or cloudy urine, hives, metallic taste, hypersensitivity, proteinuria
Rare Side Effects: Convulsions, shortness of breath, hallucinations, lower abdominal cramps, fever, coughing
Contraindications: Bone marrow aplasia, necrotizing enterocolitis, pulmonary fibrosis, exfoliative dermatitis
Disease States: Blood dyscrasias; history of agranulocytosis or hemorrhagic diathesis; colitis; systemic lupus erythematosus; urticaria
Other Drugs: Bone marrow depressants, hepatotoxic medications, nephrotoxic medications, penicillamine, dermatitis–{endash}causing medications
Lab Tests: Hemoglobin concentration, white blood cell count, liver function tests, urine protein concentrations
Administrative Notes: Possibility of side effects up to many m after discontinuation of medication
Azatadine Maleate
Trade Name(s): Optimine
Chemically Related To: Cyproheptadine
Pregnancy Category: B
Medical Category: Antihistamine
Accepted Indications: Rhinitis, allergic conjunctivitis, pruritus, urticaria, angioedema
Mechanism of Action: Antihistaminic; competes with histamine for H1-receptor sites on effector cells
Absorption/Distribution: Well absorbed
Half life: 12 h
Metabolism: Hepatic
Elimination: Renal
Research Notes: Prolonged use may decrease or inhibit salivary flow, contributing to development of caries, periodontal disease, and oral candidiasis
Adult Dosage: 1–{endash}2 mg b.i.d. or t.i.d.
Elderly Dosage: Elderly patients may be more sensitive to adult dose
Child Dosage: 12 y and over: 0.5–{endash}1 mg b.i.d.; under 12 y: not recommended
Infant Dosage: Not recommended
Dosage Forms: Tablets: 1 mg
By System: Blocks histamine receptors
Precautions: Avoid alcohol
Frequent Side Effects: Drowsiness, dry mouth
Occasional Side Effects: Blood dyscrasias, cardiac arrhythmias
Rare Side Effects: Blurred vision, confusion, dizziness, tinnitus, rash, GI distress
Overdosage: Anticholinergic effects, cardiac arrhythmias, CNS depression or stimulation, hypotension
Antidotal Therapy: No specific antidote
Disease States: Bladder neck obstruction, prostatic hypertrophy, urinary retention, glaucoma
Other Drugs: Alcohol, CNS depressants, anticholinergics, ototoxic medications, MAO inhibitor
Lab Tests: Skin tests with allergen extracts
Administrative Notes: A paradoxical reaction characterized by excitability may occur in older children
Azatadine Maleate/Pseudoephedrine Sulfate
Trade Name(s): Trinalin
Pregnancy Category: C
Medical Category: Antihistamine, decongestant
Accepted Indications: Allergic rhinitis, nasal congestion, eustachian tube congestion
Adult Dosage: 1 tablet b.i.d.
Child Dosage: Under 12 y: not recommended
Dosage Forms: Tablets: 1 mg/120 mg
Azathioprine
Trade Name(s): Imuran
Chemically Related To: Modified nucleic acid
Pregnancy Category: D
Medical Category: Immunosuppressant; antirheumatic
Accepted Indications: Organ transplant rejection; rheumatoid arthritis
Mechanism of Action: Suppresses immune response, antagonizes purine metabolism
Absorption/Distribution: Well absorbed from GI tract
Half life: Approximately 5 h
Peak activity: 1–{endash}2 h
Metabolism: Hepatic
Elimination: Hepatic, renal
Research Notes: Onset of action in rheumatoid arthritis is 6–{endash}8 w; in other inflammatory disorders, 4–{endash}8 w
Adult Dosage: (And adolescent), up to 5 mg/kg
Elderly Dosage: May require lower dose
Child Dosage: Same as adult dose
Dosage Forms: Tablets: 50 mg; for injection: 100 mg (base)
By System: Immune system
Warnings: If infection develops, it must be treated promptly
Precautions: Avoid immunizations
Frequent Side Effects: Leukopenia or infection, megaloblastic anemia, loss of appetite, nausea or vomiting
Occasional Side Effects: Hepatitis or biliary stasis; thrombocytopenia; rash
Rare Side Effects: Hepatic veno-occlusive disease, hypersensitivity, pancreatitis, pneumonitis, sores in mouth and on lips
Disease States: Sensitivity to azathioprine, chickenpox, herpes zoster, gout, hepatic function impairment, infection, pancreatitis
Other Drugs: Allopurinol, blood dyscrasia–{endash}causing medications, bone marrow depressants, radiation therapy, vaccines (live virus)
Lab Tests: Hemoglobin, plasma albumin, uric acid, serum alkaline phosphatase, serum bilirubin
Administrative Notes: GI distress may be reduced by giving oral drug in divided doses or after meals
Azithromycin Dihydrate
Trade Name(s): Zithromax
Chemically Related To: Erythromycin
Pregnancy Category: B
Medical Category: Antibacterial
Accepted Indications: Bronchitis, pharyngitis, skin and soft tissue infections, urethritis, cervicitis, pneumonia
Mechanism of Action: Interferes with protein synthesis in bacterial cell
Absorption/Distribution: Rapidly absorbed, widely distributed
Half life: 2–{endash}4 d
Metabolism: Hepatic
Elimination: Hepatic, renal
Adult Dosage: 500 mg on day 1; 250 mg on days 2–{endash}5
Elderly Dosage: Same as adult dose
Child Dosage: Safety and efficacy not established
Infant Dosage: Safety and efficacy not established
Dosage Forms: Capsules: 250 mg
Occasional Side Effects: GI disturbances
Rare Side Effects: Headache, dizziness, acute intestinal nephritis, allergic reaction
Disease States: Liver problems
Other Drugs: Aluminum and magnesium–{endash}containing antacids, astemizole, terfenadine
Aztreonam
Trade Name(s): Azactam
Chemically Related To: Monocyclic beta lactams
Pregnancy Category: B
Medical Category: Systemic antibacterial
Accepted Indications: Bronchitis, pneumonia (gram negative), skin and soft tissue infections, cystitis, urinary tract infection, gynecologic infections, septicemia
Unaccepted Indications: Gram-positive organisms and anaerobes
Mechanism of Action: Bactericidal: inhibits cell wall synthesis
Absorption/Distribution: Complete absorption after injection; wide distribution
Half life: 1.4–{endash}2.2 h
IM: 0.6–{endash}1.3 h
Metabolism: Hepatic
Elimination: Renal, biliary/fecal
Research Notes: Creatinine clearance calculation helps determine any needed adjustments in dosage
Adult Dosage: 1–{endash}2 g b.i.d. to q.i.d. up to 8 g/d
Elderly Dosage: May require decrease in dosage
Child Dosage: Not established
Infant Dosage: Not established
Dosage Forms: Injection: 1 g/50 mL and 2 g/50 mL; for injection: 500 mg, 1 g, and 2 g
Frequent Side Effects: Eosinophilia
Occasional Side Effects: Hypersensitivity, thrombophlebitis
Rare Side Effects: Dizziness, tinnitus, hypotension
Antidotal Therapy: May include supportive treatment, hemodialysis
Disease States: Cirrhosis, kidney problems
Lab Tests: Coombs' test, prothrombin time, creatinine
Administrative Notes: Must be given slowly over 3–{endash}5 min period
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