Temazepam

Restoril®

Uses: *Insomnia*, anxiety, depression, panic attacks

MOA: Benzodiazepine

Dose: 15-30 mg po HS PRN, ↓ in elderly

Caution: X, ?/-, Potentiates CNS depressive effects of opioids, barbs, EtOH, antihistamines, MAOIs, TCAs

CI: NAG

Disp: Caps 7.5, 15, 22.5, 30 mg

SE: Confusion, dizziness, drowsiness, hangover

Notes: Abrupt DC after >10 days use may cause withdrawal

Schedule: C-IV

Promethazine

Phenergan®

BBW: Do not use in pts <2 yrs; resp depression risk; tissue damage, including gangrene w/ extravasation

Uses: *N/V, motion sickness, adjunct to post op analgesics, sedation, rhinitis*

MOA: Phenothiazine, blocks CNS postsynaptic mesolimbic dopaminergic receptors

Dose: Adults: 12.5-50 mg PO, PR, or IM BID-QID PRN Peds >2: 0.1-0.5 mg/kg/dose PO/IM q2-6h PRN

Caution: C, +/-, Use w/ agents w/ resp depressant effects

CI: Component allergy, NAG, age <2 yrs

Disp: Tabs 12.5, 25, 50 mg; Syrup 6.25 mg/5 mL, 25 mg/5 mL; Supp 12.5, 25, 50 mg; Inj., 25, 50 mg/mL

SE: Drowsiness, tardive dyskinesia, EPS, lowered Sz threshold, ↓ BP, GI upset, blood dyscrasias, photosens, resp depression in children

Notes: IM/PO preferred route, not SQ or intra-arterial

Glimepiride

Amaryl®

Uses: *Type 2 DM*

MOA: Sulfonylurea, ↑ pancreatic insulin release; ↑ peripheral insulin sensitivity; ↓ hepatic glucose output/production

Dose: 1-4 mg/d, max 8 mg

Caution: C, -

CI: DKA

Disp: Tabs 1, 2, 4 mg

SE: HA, N, hypoglycemia

Notes: Give w/ 1st meal of day

Albuterol nebulizing soln

Ventolin®

Uses: *Asthma, COPD, prevent exercise-induced bronchospasm*

MOA: Beta adrenergic sympathomymetic bronchodilator; relaxes bronchial smooth muscle

Dose: Adults: 1.25-5 mg (0.25-1 mL of 0.5% soln in 2-3 mL of NS) TID-QID. Peds: 0.05 mg/kg (max 2.5 mg) in 2-3 mL of NS TID-QID. 2-6 yr: 12 mg/d, 6-12 yr: 24 mg/d

Caution: C, +

Disp: 0.083%, 0.5%

SE: Palpitations, tachycardia, nervousness, GI upset

Tamsulosin HCl

Flomax®

Uses: *BPH*

MOA: Antagonist of prostatic alpha receptors

Dose: 0.4 mg/d, may ↑ to 0.8 mg/d

Caution: B, ?

CI: Female gender

Disp: Caps 0.4 mg

SE: HA, dizziness, syncope, somnolence, ↓ libido, GI upset, retrograde ejaculation, rhinitis, rash, angioedema, IFIS

Notes: Not for use as antihypertensive; do not open/crush/chew; approved for use/ dutasteride for BPH

Folic Acid

No Brand Name

Uses: *Megaloblastic anemia; folate deficiency*

MOA: Dietary supl

Dose: Adults: Supl: 0.4 mg/d PO; PRG: 0.8 mg/d PO. Folate Def: 1 mg PO daily-TID. Peds: Supl: 0.04-0.4 mg/24 hr PO/IM/IV/SQ

Caution: A, +

CI: Pernicious, apastic, normocytic anemias

Disp: Tabs, 0.4, 0.8, 1 mg; Inj 5 mg/mL

SE: Well tolerated

Notes: OK for all women of child-bearing age, ↓ fetal neural tube defects by 50%, no effect on normocytic anemias 

Spironolactone

Aldactone®

BBW: Tumorogenic in animal studies, avoid unneccesary use

Uses: *Hyperaldosteronism, HTN, Class III/IV CHF, ascites from cirrhosis*

MOA: Aldosterone antagonist; K+ sparing diuretic

Dose: Adults: CHF (NYHA class III-IV): 12.5-25 mg/d (w/ ACE and loop diuretic); HTN: 25-50 mg/d; Ascites: 100-400 mg QAM w/ 40-160 mg of furosemide, start w/ 100 mg/40 mg, wait at least 3 d before ↑ dose. Peds: 1-3.3 mg/kg/24 h PO ÷ BID-QID. Neonates: 0.5-1 mg/kg/dose q8h; take w/ food

Caution: D, +

CI: ↑ K+, acute renal failure, anuria

Disp: Tabs, 25, 50, 100 mg

SE: ↑ K+ & gynecomastia, arrhythmia, sexual dysfunction, confusion, dizziness, D/N/V, abnormal menstruation

Amlodipine besylate & Benazepril

Lotrel®

BBW: Fetal/neonatal morbidity/mortality may occur when drugs that act directly on the renin-angiotensin system are used in pregnancy; DC drug as soon as possibly once pregnancy detected

Uses: *HTN*

MOA: Dihydropyridine calcium channel blocker, ACE inhibitor

Caution: D, ?, Renal artery stenosis, renal impairment, hepatic impairment, volume depletion, hyponatremia, hypotension, elderly, CHF, aortic stenosis, severe CAD

CI: Hypersensitivity, history of angioedema, pregnancy

Disp: Caps, 2.5/10, 5/10, 5/20, 5/40, 10/20, 10/40 mg

SE: Cough, HA, edema, dizziness, flushing, fatigue, somnolence, elevated BUN, Cr

Amphetamine salt combo

Adderall®

BBW: High abuse potential, dependency

Uses: *ADHD, Narcolepsy*

MOA: Stimulates CNS activity; blocks reuptake and increases release of norepinephrine and dopamine in extraneuronal space

Dose: ADHD: 5-40 mg/day divided QD-TID. Narcolepsy: 5-60 mg divided QD-TID

Caution: C, -,elderly, psychosis, bipolar disorder, history of seizures

CI: Hypersensitivity, cardiovascular disease, arrhythmias, HTN, glucoma, drug abuse history

Disp: Tabs, 5, 7.5, 10, 12.5, 15, 20, 30

SE: Anorexia, insomnia, abdominal pain, HA, emotional lability, weight loss, nervousness, dry mouth, N/V, asthenia, D, dyspepsia, dizziness, palpitations, elevated BP, tachycardia, tremor, dyskinesia, constipation, libido changes, impotence, visual disturbances, tics 

Metformin HCl ER

Glucophage® XR

BBW: Associated w/ lactic acidosis

Uses: *Type 2 DM*, polycystic ovary synd (PCOS), HIV lipodystrophy

MOA: Biguanide, ↓ hepatic glucose production & intestinal absorption of glucose; ↑ insulin sensitivity

Dose: Adults: Initial: 500 mg PO BID, or 850 mg daily, titrate 1-2 wk intervals may ↑ to 2550 mg/d max; take w/ AM & PM meals; XR dose is total daily dose of IR. Peds 10-16 yrs: Do not use XR

Caution: B, +/-, Avoid EtOH; hold dose before & 48 hrs after ionic imaging contrast; hepatic impair, elderly

CI: SCr> 1.4 mg/dL in females or >1.5 mg/dL in males; hypoxemic conditions (e.g acute CHF/sepsis); metabolic acidosis

Disp: Tabs, 500, 850, 1000 mg; XR tabs, 500, 750, 1000 mg; Soln, 100 mg/mL

SE: Anorexia, N/V/D, flatulence, weakness, myalgia, rash