Term
| Amitriplyline (endep) C ( congential malformations). |
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Definition
Mode of Action: TCA inhibit reuptake of noradrenaline and serotonin into presynaptic terminals
Indication: Major Depression, Insomnia or Neuropathic pain, urinary urge.
Dose: Major Depression: start 25-75mg, can increase by 25-50 every 3 days (300mg max), pain: 10-25mg daily (150mg max)
Adverse Reactions: Anticholingeric like dry mouth, urinary retention, dry eyes, constipation, weight gain, palpitations, orthostatic hypo
Refer: increase S/E, no effect, skin reactions, palpitations.
Lifestyle: Counselling.
Interactions: SSRI, SNRI, Tramadol (serotonin syndrome).
Counselling: Don’t drive until you know the effects, limit alcohol, don’t stop taking abruptly. Avoid in prolonged QT intervals. |
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Term
| Amoxycillin/Clav acid (augmentin duo) B1. |
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Definition
Mode of Action: Amoxycillin (attacks the bacteria cell wall peptidoglycan and causing cell lysis, Clav acid extends the spectrum by inhibiting beta lactamase).
Indication: Hospital acquired pneumonia, UTI, Otitis media, Acute bacterial sinusitis, PID.
Dose: 500-875mg bd plus 125mg of CA for 5-10 days, >1 month 7.5-15mg/kg Q8h max 20mg/kg, >2 months 22.5mg/kg bd. (can be up to 50mg/kg for severe infections).
Adverse Reactions: Diarrhoea, nausea, allergic reactions.
Refer: If signs of allergic reaction, or improvement in infection.
Lifestyle: Probiotics.
Interactions: none.
Counselling: Take for the recommended time, and better with food. |
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Term
| Buprenorphine (Norspan Patch, Temgesic tabs or inj) C. |
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Definition
Mode of Action: Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia. Is also a partial agonist, so may block other opioids effects and increase withdrawal for addicts.
Indication: Moderate to Severe pain relief.
Dose: Acute: IM/IV, 300–600 micrograms every 6–8 hours. Sublingual, 200–400 micrograms every 6–8 hours.
Chronic: 5 microgram/hour patch in opioid-naive people, Do not increase dose at intervals of <3 days; do not apply >2 patches concurrently; maximum dose 2 x 20 microgram/hour patches. Each patch must be changed every 7 days.
Adverse Reactions: nausea and vomiting (below), dyspepsia, drowsiness, dizziness, headache, orthostatic hypotension, itch, dry mouth, miosis, urinary retention, constipation, respiratory depression.
Refer: Pain not adequately controlled.
Interactions: other opioids.
Counselling: about sublingual tablets, and patches (7 days). |
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Term
| Carbamazapine (tegretol) D. |
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Definition
Mode of Action: Prevents repetitive neuronal discharges by blocking voltage-dependent and use-dependent sodium channels.
Indication: Neuropathic pain, Antiepileptic, Bipolar.
Dose: Epilespy : initially 100 mg twice daily; increase daily dose gradually by 100–200 mg every 2–4 weeks according to response. Usual range, 400 mg – 1.2 g daily in 2 or more doses; up to 2 g daily may be required. Child: 5-8mg/kg, increase to 10-20mg/kg.
Trigeminal neuralgia: Adult, initially 50–100 mg once or twice daily; increase gradually to 400–800 mg daily in 2–4 doses. Up to 1.6 g daily may be required.
Bipolar: Adult, initially 400 mg daily in divided doses; increase gradually according to response, up to 1.6 g daily.
Neurological pain: Adult, initially 100 mg twice daily; increase gradually until pain relieved. Maintenance, 200–600 mg daily, do not exceed 1.2 g daily.
Adverse Reactions: drowsiness, ataxia, dizziness, blurred vision, diplopia, headache (all dose-related), rash, dry mouth, abdominal pain, nausea, vomiting, anorexia, diarrhoea, constipation.
Refer: SJS, no effect, increased side effects.
Interactions: Clarithromycin, Diltiazem, Fluoxetine, macrolides, Valproate and Verapamil increase carba, Phenytoin decrease it. Decreases warfarin and levonorgestrels effects.
Counselling: Take with food, may cause drowsiness, limit alcohol and do not stop taking abruptly. |
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Term
| Ceftriaxone (injection only) A. |
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Definition
Mode of Action: Interfere with bacterial cell wall peptidoglycan synthesis by binding to penicillin-binding proteins, eventually leading to cell lysis and death; bactericidal.
Indication: Empirical treatment for Infections like pneumonia, bacterial meningitis, orbital cellulitis, PID and septicaemia.
Dose: 1-2g daily (max 4g), Child: 50-75mg/kg daily (max 2g).
Adverse Reactions: NVD, CDAD, pancreatitis, dizziness, pain at site, allergic reaction.
Refer: allergic, CDAD, no improvement.
Lifestyle: Probiotics.
Counselling: Monitor renal function and FBC. |
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Term
| Diazepam (Valium, Antenex) C (avoid if possible). |
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Definition
Mode of Action: Potentiate the inhibitory effects of GABA throughout the CNS, resulting in anxiolytic, sedative, hypnotic, muscle relaxant and antiepileptic effects.
Indication: Anxiolytic, Sleep, Epilepsy.
Dose: Seizures: IV and rectal 10mg repeat in 10-15 mins if needed. Child: 0.2 to 0.3mg/kg (max 10mg).
Spasms: IV 10mg repeat in 4 hours if needed, oral: 2-15mg (max 60mg). Child IV and oral: 0.1-0.3mg/kg.
Adverse Reactions: Drowsiness, sedation.
Refer: no improvement.
Lifestyle: Sleep hygiene, plenty of water
Interactions: phenytoin.
Counselling: Avoid alcohol, may cause drowsiness, if long term do not stop taking abruptly. |
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Term
| Dicloxacillin/Flucoxacillin (Diclo: Distaph, Flucox: Staphex) B2, B1. |
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Definition
Mode of Action: Interfere with bacterial cell wall peptidoglycan synthesis by binding to penicillin-binding proteins, eventually leading to cell lysis and death; bactericidal.
Indication: Severe skin infection (staph) like folliculitis, boils, stab wounds , impetigo, septicaemia
Dose: Dicloxacillin: PO: 250-500mg q6h, Max 4g, child 12.5-25mg/kg q6h (max 1g). Flucloxacillin: orally the same, IV: 1-2g every q6h (max 12g), child IV 25mg/kg (max 1g).
Adverse Reactions: NVD, pain at site, superinfections, allergy, electrolyte disturbances, increased liver enzymes.
Refer: allergy, no improvement.
Lifestyle: Probiotics. Monitor: hepatic functions, renal functions and blood count for prolonged treatment.
Interactions: increases warfarin’s effect.
Counselling: best on an empty stomach (30 minutes before or 2 hours after). |
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Term
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Definition
Mode of Action: Bind to TNF alpha and inhibit its activity, which is a cytokine involved in the inflammatory/immune response.
Indication: Psoriasis, RA, anklosing spondylitis.
Dose: SC: 50mg weekly or 25mg twice weekly (3-4 days apart). Child: 0.8mg/kg (max 50mg).
Adverse Reactions: injection site reaction, allergic reaction abdominal pain, dyspepsia, headache.
Refer: allergic reaction, or no improvement.
Monitor: FBC, LFTs, creatinine before treatment, check for infections like TB, Hep B, skin cancers, and adverse effects.
Counselling: contact doctor if bruising, breeding or fever occurs. See doctor before getting vaccinations while on this medication before of immunosuppression. |
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Term
| Gentamicin (injection or eye drops Genoptic) D. |
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Definition
Mode of Action: Aminoglycoside that Inhibits protein synthesis by irreversibly binding to the 30S ribosomal subunit and causing cell membrane damage. Concentration-dependent bactericidal effect.
Indication: Severe infections. Empirical treatment of gram negative infections, P aeruginosa, surgical prophylaxis. Enterococcal infections.
Dose: use ideal weight to calculate dose, CrCl: >60ml/min, IM/IV 5-7mg/kg daily, CrCl 30-60: 4-5mg/kg, <30: seek specialist advice. Prophylaxis: 2-5mg/kg. Child: 7.5mg/kg (max 320mg), >10 years 6-7mg/kg.
Adverse Reactions: Nephrotoxicity, Ototoxicity, Neuromuscular blockade, anaphylaxis.
Refer: adverse effects, no improvement.
Monitor: >48 hours monitor concentrations and calculate CrCl every 3-5 days. Infusion over 15-30 minutes with <120mg IV over 3-5 minutes. Hearing and kidneys. |
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Term
| Haloperidol (Serenace) C. |
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Definition
Mode of Action: by blockade of dopaminergic transmission in various parts of the brain, block d2 receptors
Indication: Antipsychotic, anxiety, terminal agitation, intractable nausea and vomiting.
Dose: N&V: 1-2mg tds oral, agitation: oral 1-5mg tds or IM/IV: 2-10mg every 2-6 hours (max 15g). Child>5: 0.25mg daily, increase to 0.15mg/kg daily (max 5g).
Adverse Reactions: Sedation, EPSE (dystonias, Akathisia, Parkinsonism, Tardive dyskinesia), orthostatic hypotension, blurred vision, anxiety, dry mouth, urinary retention. Rare is neurolepic malignant syndrome.
Refer: increased side effects, no improvement.
Lifestyle: limit alcohol, montior effect, weight, blood glucose, BP, lipids at baseline, routine FBP and LFTs
Interactions: Carbamazepine decreases it, Fluoxetine, Fluvoxamine, venlafaxine increase it.
Counselling: Take regularly, consider if injection is better, understand what the EPSE are, may cause drowsiness and dizziness. |
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Term
| Hormonal Contraception (Too Many) (levlen ED 150mcg levonorgestrel/ 30mcg ethinyloestradiol) B3. |
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Definition
Mode of Action: All COCs contain an oestrogen and progestogen. They inhibit ovulation, reduce receptivity of endometrium to implantation and thicken cervical mucus to form a barrier to sperm.
Indication: Contraception control, Endometriosis, menstrual disorders, acne.
Precautions: Increase stroke risk: smoking, >35, >30, breast cancer, frequent migraine with aura, antiphospholipid syndrome.
Adverse Reactions: Breakthru bleeding (change to higher dose ethinyloestradiol 50mcg or change progesterone), amenorrhoea, NV, breast tenderness, changed libido, acne, thrush, fluid retention. VTE risk for desogestrel and cyproterone.
Refer: increase side effects.
Lifestyle: tell your doctor or pharmacist if you are on any other medications.
Interactions: carbamazepine, phenytoin, SJW reduce its affect, COC decrease lamotrigine effect.
Counselling: seek medical advice if increased side effects, know active pills and sugar pills, what to do if missed pill, vomiting or diarrhoea (within 2 hours), take another active pill asap. Less than 24 hours late take active asap, if more the pill will not be effective, take 2 the next time, and use alternative contraception for 7 days of continuous tablets. If the pill missed was in the 1st after the sugar pills, seek emergency contraception if had sex during or after that time. |
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Term
| Lamotrigine (Lamitcal) D. |
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Definition
Mode of Action: Stabilises presynaptic neuronal membranes by blocking voltage-dependent and use-dependent sodium channels.
Indication: Partial and generalised seizures, Bipolar.
Dose: 25mg daily for 2 weeks, then 50mg for 2 weeks, then increase by 50-100mg every 1-2 weeks according to response, Maintenance: 100-200mg daily. Reduce if on valproate by half (every second day). Child: 0.3mg/kg daily, then the same ratio as adults. Double if on inducers like carbamazepine or phenytoin.
Adverse Reactions: blurred vision, ataxia, dizziness, alopecia, NV, SJS, and multi-organ hypersensitivity.
Refer: allergic reaction, no improvement.
Interactions: COC, Carbamazepine and phenytoin decreased it, Valproate increases it.
Counselling: may cause dizziness, increases alcohols effect, do not stop abruptly. Monitor LFTs. |
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Term
| Levodopa/Carbidopa (Madopar) B3. |
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Definition
Mode of Action: Levodopa is converted to dopamine in the brain and peripheral tissues, and replenishes depleted striatal dopamine. It is given with a peripheral dopa decarboxylase inhibitor (benserazide or carbidopa) to reduce peripheral dopamine production and also reduce adverse effects (eg nausea, vomiting, hypotension).
Indication: Parkinson.
Dose: Initially: 50-100mg 2 to 3 times, adjust gradually if needed, can give up to 2g in 3 divided doses, or 6 doses. CR formulation is available too (release over 4-6 hours).
Adverse Reactions: Anorexia, NV, orthostatic hypotension, agitation, insomnia, depression, confusion, dyskinesia, discolouration of urine and sweat.
Refer: no improvement or increased adverse effect.
Interactions: Methyldopa increases levodopa effect, phenytoin decreases it. Dopamine antagonist are bad for people with parkinsons.
Counselling: Take at the same time each day, be careful standing up, do not stop taking abruptly, may cause drowsiness. Protein in food reduces absorption (better on empty stomach) |
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Term
| Lithium (Lithicarb, Quilonum) D. |
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Definition
Mode of Action: its actions include inhibition of dopamine release, enhancement of serotonin release and decreased formation of intracellular second messengers.
Indication: Manic bipolar, schizophrenia.
Dose: Acute: 750-1000mg in divided doses, increase by 250-500mg depending on concentration (max 2500mg). prophylaxis: 250-1000mg daily.
Adverse Reactions: metallic taste, nausea, diarrhoea, epigastric discomfort, weight gain, tremor, T wave changes, hypothyroidism, polyuria, nephrotoxicity. Toxicity: blurred vision, NVD, ataxia. Severe: increased muscle tone, hyper-reflexia, seizures, comas.
Refer: toxicity signs, increased side effects.
Monitor: TR (0.5-1.2).
Interactions: Ural increases it, ACEi, NSAIDs, sartans, thiazides increase it, carbamazepine and lithium can result in neurotoxicity.
Counselling: take with food, maintain normal diet. |
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Term
| Metoclopramide (Maxolon, Pramin) A. |
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Definition
Mode of Action: Dopamine Antagonist
Indication: Anti-emetic (nausea and vomiting), gastric stasis (like gastric surgery) .
Dose: 10mg tds >60kg (max 0.5mg/kg daily), 30-59mg half the dose, 20-29: half again, 15-19kg: 2mg tds, 10-14: 1mg tds, <10kg: 0.1mg/kg bd (max 1mg). Chemo: 10-20mg then every 4-6 hours if required.
Adverse Reactions: akathisia, depression, EPSE.
Refer: increase EPSE, no improvement.
Interactions: Dopamine agonist in parkinsons (apomorhine, bromocriptine, pramipexole, rotigotine).
Counselling: may cause dizziness and drowsiness. |
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Term
| Metronidazole (Flagyl) B2. |
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Definition
Mode of Action: Metronidazole and tinidazole are metabolised to active metabolites that are thought to interfere with DNA synthesis.
Indication: gram positive and negative anaerobic bacterial infections, protozoal infections (giardiasis) bacterial vaginosis, PID, dental infections
Dose: 200-400mg 8-12 hours (max 4g), severe IV: 500mg 8-12 hours. Child: 7.5mg/kg every 8 hours or 10mg/kg every 12 hours (max 400mg). IV (max 500mg). give with amoxicillin tds for H pylori 14 days, bacterial vaginosis 400 bd for 7 days, trichomoniasis give 2g as a single dose.
Adverse Reactions: Thrombophlebitis (IV), pancreatitis, hepatitis, NVD, metallic taste.
Refer: no effect or increased side effects.
Lifestyle: no alcohol while on this medication.
Interactions: Alcohol, disulfram (increase alcohol effect), increases warfarin and fluorouracil.
Counselling: avoid alcohol, with food, may cause dizziness initially. |
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Term
| Oxycodone (Endone, Oxycontin, Oxynorm, Targin with naloxone) C. |
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Definition
Mode of Action: Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia.
Indication: Moderate to severe pain relief.
Dose: initially: 2.5-5mg every 4 hours, titrate dose until stable, then can calculate CR dose (breakthrough is one 6th of the daily dose). 15-20mg oral is equivalent to 10mg of IM/SC morphine. Child: 0.1-0.2mg/kg (max 5mg).
Adverse Reactions: NV, sedation, constipation, dizziness, orthostatic hypotension, dry mouth, respiratory depression.
Refer: no improvement, constipation, increased sedation, trouble breathing.
Lifestyle:
Interactions: Clarthromycin increases it, SJW decreases it.
Counselling: stick to recommended dose. |
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Term
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Definition
Mode of Action: Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain.
Indication: Antipsychotic for schizophrenia, bipolar.
Dose: 10mg daily, increase by 2.5-5mg to 20mg daily. IM 210-300mg every 2 weeks.
Adverse Reactions: Hyperglycaemia, peripheral oedema, increased weight, EPSE (rare)
Refer: increased androgenic effects, no effect.
Lifestyle: Stop smoking (reduces olanzapine effect), monitor signs of schizophrenia or bipolar, BSL, weight, lipids.
Interactions: Carbamazepine, valproate decrease it, fluvoxamine increases it.
Counselling: Do not stop taking abruptly, limit alcohol and cannabis (illicit drugs), may cause drowsiness or dizziness. |
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Term
| Omeprazole (Acimax, Losec) B3. |
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Definition
Mode of Action: Irreversibly inactivate the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated and basal acid secretion.
Indication: GORD, peptic ulcers.
Dose: 20mg daily (IV 40mg), Child: <10kg: 5mg daily, >10kg: 10mg daily.
Adverse Reactions: B12 anaemia, alopecia.
Refer: no improvement.
Lifestyle: decrease alcohol, caffeine, spicy foods.
Interactions: reduces clopidogrel effect, fluconazole increases it, SJW decreases it.
Counselling: do not crush, can have disperse. |
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Term
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Definition
Mode of Action: Central and peripheral 5HT3 receptor blockade.
Indication: Anti-emetic (nausea and vomiting), for chemo, radiotherapy and post op related.
Dose: Severe and moderate cancer chemo treatment: IV: 8-12mg, oral 16-24mg. Child: 0.15mg/kg every 4 hours or 4mg orally. Radio: 8mg bd, post op: 4mg.
Adverse Reactions: constipation, headache, high LFTs, hypersensitivity (rare).
Refer: no improvement.
Interactions: Apomorphine (severe hypotension). Increases tramadols effect. |
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Term
| Pipercillin/Tazobactam (Tazocin) B1. |
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Definition
Mode of Action: Same as Amoxycillin, Tazobactam: Beta Lactams inhibitor,
Indication: Severe Infections, P aeruginosa, mixed infections (anaerobes and aerobes), febrile neutropenia.
Dose: 2-4g every 6-8 hours (max 24g), decrease slight for renal impairment. Child: 1-6 months: 80-100mg/kg every 8 hours, >6 months give 100mg/kg every 8 hours (max 4g).
Adverse Reactions: jaundice, high LFTs, rash, NVD, superinfection (candiasis), allergy.
Refer: CDAD, allergy, jaundice, no improvement.
Lifestyle: probiotics.
Interactions: Increases warfarins effect.
Counselling: Monitor: FBP, hepatic function when >10 days treatment. |
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Term
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Definition
Mode of Action: An analogue of the neurotransmitter GABA with analgesic, anxiolytic and anticonvulsant activity; reduces calcium influx at nerve terminals and decreases the release of several neurotransmitters including glutamate, noradrenaline and substance P.
Indication: Neuropathic pain, partial seizures.
Dose: 75mg bd initially, increase if needed after 3-7 days to 150mg bd, max 300mg bd. Reduce if renally impaired (30-60: 75mg daily, 15-30: 25-50 daily, <15: 25mg daily.
Adverse Reactions: dizziness, drowsiness, weight gain, visual disturbance, ataxia, constipation, peripheral oedema, dry mouth.
Refer: peripheral oedema, no improvement.
Counselling: limit alcohol, do not stop taking abruptly, may cause drowsiness. |
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Term
| Risperidone (Risperdal) C. |
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Definition
Mode of Action: Antipsychotic actions are thought to be mediated (at least in part) by blockade of dopaminergic transmission in various parts of the brain.
Indication: Antipsychotic for schizophrenia, bipolar, dementia behavioural problems.
Dose: 1mg bd, (usual is 4-6mg), long acting IM: 25mg every 2 weeks (max 37.5-50mg). Dementia: 0.25mg bd (usual range 0.5-1mg), Child: >50kg 0.5mg daily (range 0.5-1.5mg), <50kg: 0.25mg daily (range 0.25-0.75mg).
Adverse Reactions: insomnia, akathasia, headache, rhinitis, EPSE, sexual adverse effects, SIADH.
Refer: increased EPSE, no improvement.
Interactions: Carbamazepine and Paroxetine decrease it, Fluoxetine increases it.
Counselling: treatment response in about 1-2 weeks, do not stop taking abruptly. |
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Term
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Definition
Mode of Action: Blocks the reuptake of Serotonin, therefore stopping the breakdown of serotonin.
Indication: Major Depression, panic disorder, PDMS.
Dose: 50mg starting, (max 200mg), child: 25mg.
Adverse Reactions: Agitation, dizziness, tremor, impotence, sweating, weight gain, high LFTs, hyponatraemia.
Refer: no improvement.
Lifestyle: seek counselling if needed.
Interactions: MAO-B, MAOIs, pethidine, tramadol, TCA, SNRIs, Triptans (serotonin toxicity), increases warfarins effect.
Counselling: do not stop talking abruptly, may cause dizziness. This SSRI of choice for breast feeding. |
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Term
| Sumatriptan (Imigran) B3. |
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Definition
Mode of Action: Constrict cranial vessels by acting selectively at 5HT1B/1D receptors; also thought to inhibit the abnormal activation of trigeminal nociceptors.
Indication: Acute relief from Migraines.
Dose: 50-100mg, repeat in 2 hours if reoccurs (max 300mg).
Adverse Reactions: tingling, heat, pain, tightness, flushing, dizziness, myalgia.
Refer: no relief, tightness around chest, angina, rash.
Lifestyle: drink plenty of water, dark room when occurs, ID possible cause.
Interactions: MAOIs, moclobemide (increase ischaemia risk), SSRIs (serotonin toxicity). |
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Term
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Definition
Mode of Action: T4 endogenous thyroid hormone,
Indication: hypothyroidism, thyroid cancer.
Dose: 1.6mcg/kg, 50-200mcg daily, adjust dose every 6-8 weeks if needed. Child and elderly adjust by 25mcg, 25mcg
Adverse Reactions: palpitations, flushing, sweating, weight loss, insomnia.
Refer: increased palpitations, flushing, sweating, weight loss, insomnia (signs of hyperthyroidism).
Lifestyle: maintain a healthy diet.
Interactions: increases warfarins effect, calcium carbonate, iron, orlistat decrease its absorption.
Counselling: take on empty stomach. Keep in the fridge. Monitor TSH and free T4. |
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Term
| Tramadol (Tramal, Zydol) C. |
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Definition
Mode of Action: Opioid analgesics mimic endogenous opioids by activating opioid receptors in the central and peripheral nervous systems to produce analgesia.
Indication: Moderate to severe Pain Relief.
Dose: max 400mg daily, avoid in CrCl <10 and no Slow release for under <30.
Adverse Reactions: weakness, sweating, confusion, drowsiness, sleep disorder, SJS, respiratory depression, dry mouth, urinary retention.
Refer: no improvement, signs of serotonin toxicity.
Interactions: SSRI, SNRI, MAOIs (serotonin toxicity).
Counselling: may cause drowsiness, be careful standing, limit alcohol, long term dental check ups (dry mouth). |
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Term
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Definition
Mode of Action: Prevents repetitive neuronal discharge by blocking voltage-dependent and use-dependent sodium channels.
Indication: Primary generalised epilepsy, Bipolar.
Dose: Epilepsy: Initially: 600mg or child 10mg/kg in 2 doses, increase 3 days by 200mg or child 5-10mg/kg according to response. Maintenance: 1-2g or child 20-40mg/kg daily in 2 doses (max 2.5g). Bipolar dose is the same. Migraine: oral 200-400mg bd.
Adverse Reactions: nausea, dizziness, vomiting, increased appetite, weight gain, tremor, ataxia, drowsiness, elevated aminotransferase.
Refer: increased side effects or no effect.
Interactions: Aspirin increases valproate, Lamotrigine, olanzipine and phenytoin decrease it.
Counselling: Take with food, see doctor if jaundice occurs, may increase drowsiness and weight, limit alcohol.
Monitor: bloods, BMD, Liver function. |
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Term
| Vancomycin (Vancocin) B2. |
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Definition
Mode of Action: Bactericidal; inhibit bacterial cell wall synthesis by preventing formation of peptidoglycan polymers.
Indication: Severe infections, MRSA, CDAD, surgical prophylaxis, penicillin resistant infections.
Dose: IV: 1-1.5g bd, consider loading dose (25-30mg/kg), followed by 15-20mg/kg every 8-12 hours. Child: > 1month, IV 15mg/kg (max 750mg) q6h or 15-20mg/kg tds (max 1g). CDAD: oral: 125mg q6h for 10 days, child 5mg/kg.
Adverse Reactions: Nausea, allergic reactions, Nephrotoxicity, Ototoxicity, red man syndrome.
Refer: Allergic reactions, red man syndrome, nephro or oto toxicity.
Counselling: Monitor: renal function, hearing if on for long periods, concentration trough levels (10-20mg/L). |
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Term
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Definition
Mode of Action: Inhibit serotonin and noradrenaline reuptake.
Indication: Major depression, general anxiety.
Dose: 75-150mg daily (225mg).
Adverse Reactions: Nausea, dry mouth, constipation, orthostatic hypotension, hypertension, impotence, decreased appetite, hyponatraemia.
Refer: high BP, no effect, increase in seizures.
Lifestyle: seek counselling for help also, get enough sleep.
Interactions: Mao-B, MOAIs, SSRI, TCA (serotonin toxicity).
Counselling: Take with food, do not stop taking abruptly, be careful when you first start taking it. Monitor effect, BP and sodium. |
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