weekly drug cards

8/9/2019 Weekly Drug Cards

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Morphine – High Alert Medication – opioid analgesics- Pregnancy

Category C – Schedule II

Indications: Severe Pain, Mgmt of moderate to severe chronic pain requiring use of a

continuous around-the-cloc opioid analgesic for an e!tended period of time

"e!tended#sustained-release$

Action: %inds to opiate receptors in the C&S' Alters the perception of and response to pain

stimuli (hile producing generali)ed C&S depression'

Contraindicated in: hypersensitivity, signi*cant respiratory depression, acute or severe

+ronichal asthma, paralytic ileus

Use cautiously in: &eonates and infants mo "more suscepti+le to respiratory

depression$. &eonates "oral solution contains sodium +en)oate (hich can cause potentially

fatal gasping syndrome$'

Adverse Reactions/Side Efects: confusion, sedation, hypotension, constipation,

/0SPI/A12/3 40P/0SSI2&

Drug Drug Interactions: 5se (ith e!treme caution in patients receiving MA2 inhi+itors

(ithin 67 days prior "may result in unpredicta+le, severe reactions–8 initial dose of morphi

to 9:; of usual dose$, < C&S depression (ith alcohol, sedative#hypnotics, clomipramine,

+ar+iturates, tricyclic antidepressants, and antihistamines' Administration of partial-

antagonist opioid analgesics may precipitate opioid (ithdra(al in physically dependent


2/43

patients' %uprenorphine, nal+uphine, +utorphanol, or penta)ocine may 8 analgesia, May <

the anticoagulant e=ect of (arfarin, Cimetidine 8 meta+olism and may < e=ects

Morphine Route/Dosage:

P: Rect: !Adults and Children "#$ %g&: Usual starting dose for moderate to sever

pain in opioid-naive patients–>' mg#g q –7 hr initially'

P: !Children '( )o&: Prompt-release tablets and solution–>'9–>': mg#g#dose q 7–?

as needed' Controlled-release tablet–>'–>'? mg#g#dose q 69 hr'

IM: I*: SC: !Adults and Children "#$ %g&: Usual starting dose for moderate to seve pain in opioid-naive patients–>'>:–>'9 mg#g q –7 hr, ma!imum@ 6: mg#dose'

IM: I*: SC: +eonates >'>: mg#g q 7– hr, ma!imum dose@ >'6 mg#g' 5se preservatfree formulation'

I*: SC: !Children '( )o&: Continuous infusion, postoperative pain–>'>6–>'>7 mg#g#Continuous infusion, sickle cell or cancer pain–>'>9–9'? mg#g#hr'

I*: +eonates Continuous infusion–>'>6–>'> mg#g#hr'

Epidural: !Children '( )o&: >'>–>'>: mg#g, ma!imum dose@ >'6 mg#g or : mg#97hr' 5se preservative-free formulation'


3/43

,o-icity verdose:nalo!one, Bor children and adults (eighing 7> g, dilute>'6 mg of nalo!one in 6> m of >'D; &aCl for a concentration of 6> mcg#m aadminister >': mcg#g every 9 min'

Aceta)inophen – antipyretics#nonopioid analgesics - Pregnan

Cat' % E C

Indications: P: Rect: Mild pain, fever – I*: Mild to Mod' Pain, Mild to Mod' Pain (ith2pioids, Bever

Action: Inhi+its the synthesis of prostaglandins that may serve as mediators of pain anfever, primarily in the C&S, Has no signi*cant anti-inFammatory properties or GI to!icit

Contraindicated in: Previous hypersensitivity. Products containing alcohol, aspartamesaccharin, sugar, or tartra)ine "B4C yello( dye :$ should +e avoided in patients (hohave hypersensitivity or intolerance to these compounds. Severe hepaticimpairment#active liver disease'

Use Cautiously in: Hepatic disease, /enal disease, malnutrition, &eonates "safety and

e=ectiveness not esta+lished$ "for I$'

Adverse Reactions Side Efects: agitation "< in children$ "I$,atelectasis "< in childr"I$, constipation "< in children$ "I$, H0PA1212JICI13 "< 42S0S$, AC510 G0&0/AIK04


4/43

0JA&1H0MA125S P5S152SIS, S100&S-L2H&S2& S3&4/2M0, 12JIC 0PI40/MA&0C/23SIS

Drug Drug Interactions: Chronic high-dose acetaminophen "9 g#day$ may < ris of+leeding (ith (arfarin "I&/ should not e!ceed 7$, Hepatoto!icity is additive (ith otherhepatoto!ic su+stances, Concurrent use of isonia)id, rifampin, rifa+utin, phenytoin,

+ar+iturates, and car+ama)epine may < the ris of acetaminophen-induced liver dama"limit self-medication$. these agents (ill also 8 therapeutic e=ects of acetaminophen,Concurrent use of &SAI4s may < the ris of adverse renal e=ects "avoid chronicconcurrent use$, Propranolol 8 meta+olism and may < e=ects, May 8 e=ects oflamotrigine and )idovudine'

Aceta)inophen Route/Dosage: Children N69 yr should not receive :

or rectal doses#97 hr (ithout notifying physician or other health care professional' &odosage adOustment needed (hen converting +et(een I and P2 acetaminophen in adu

and children :> g

P: !Adults and Children '(. yr&: 9:–?:> mg q ? hr or 6 g –7 times daior 6>> mg q hr "not to e!ceed g or 9 g#97 hr in patients (ith hepatic#renimpairment$'

P: !Children ((. yr&: 6>–6: mg#g#dose q ? hr as needed "not to e!ceed doses#97 hr$'P: In0ants 6>–6: mg#g#dose q ? hr as needed "not to e!ceed : doses#97 hP: +eonates 6>–6: mg#g#dose q ?– hr as needed'


5/43

I*: !Adults and Children 1(2 yr and 1#$ %g&: 6>>> mg q ? hr or ?:> mg 7 hr "not to e!ceed 6>>> mg#dose, 7 g#day, and less than 7 hr dosing intervalI*: !Adults and Children 1(2 yr and "#$ %g&: 6: mg#g q ? hr or 69':mg#g q 7 hr "not to e!ceed 6: mg#g#dose, Q: mg#g#day, and less than 7 hrdosing interval$'I*: !Children .(. yr&: 6: mg#g q ? hr or 69': mg#g q 7 hr "not to e!ceed

mg#g#dose, Q: mg#g#day, and less than 7 hr dosing interval$'I*: !In0ants and Children ".yr&: Q':–6: mg#g#dose q ? hr "not to e!ceed mg#g#day$'Rect: !Adults and Children '(. yr&: 9:–?:> mg q 7–? hr as needed or 6 –7 times#day "not to e!ceed 7 g#97 hr$'Rect: !Children ((. yr&: 6>–9> mg#g#dose q 7–? hr as needed'Rect: In0ants 6>–9> mg#g#dose q 7–? hr as needed'

Rect: +eonates 6>–6: mg#g#dose q ?– hr as needed',o-icity verdose: If overdose occurs, acetylcysteine "Acetadote$ is theantidote'

I3upro0en – antipyretics#nonopioid analgesics#&SAI4 -Pregnancy Ca

C E 4

Indications: P4 I*: Mild to Mod' Pain, Bever, P: 1reatment of inFammatory disorders"incl' Luvenile /A$, dysmenorrhea, I*: Moderate to severe pain (ith opioid analgesics'


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Closure of a clinically signi*cant P4A in neonates (eighing :>>–6:>> g and N9 (eesgestational age "i+uprofen lysine only$Action: Inhi+its prostaglandin synthesis'

Contraindicated In: Hypersensitivity, Active GI#ulcer +leed, Che(a+le ta+lets contain

aspartame and should not +e used in patients (ith phenyletonuria, Preterm neonates

(ith untreated infection, congenital heart disease (here patency of P4A is necessary fo

pulmonary or systemic +lood Fo(, +leeding, throm+ocytopenia, coagulation defects,

necroti)ing enterocolitis, signi*cant renal dysfunction

Use Cautiously in: /enal or hepatic disease, dehydration, or patients on nephroto!ic

drugs "may < ris of renal to!icity$, Aspirin triad patients "asthma, nasal polyps, and

aspirin intolerance$. can cause fatal anaphylactoid reactions, Coagulation disorders,

Safety not esta+lished for infants ? mo "oral$ and children 6Q yr "I Caldolor$.

I+uprofen lysine@ Hyper+iliru+inemia in neonates "may displace +iliru+in from al+umin-

+inding sites$

Adverse Reactions/Side Efects: Headache, dyspepsia, nausea, constipation, vomiti

GI %004I&G, H0PA1I1IS, 0JB2IA1I0 40/MA1I1IS, S100&S-L2H&S2& S3&4/2M0, 12

0PI40/MA &0C/23SIS, A&APH3AJIS

Drug Drug Interactions:< ris of nephroto!icity (ith cyclosporine, < ris of adverse

hematologic reactions (ith antineoplastics or radiation therapy, < ris of +leeding (ith

cefotetan, cefopera)one, corticosteroids, valproic acid, throm+olytics, (arfarin, and dru


7/43

a=ecting platelet function including clopidogrel, ticlopidine, a+ci!ima+, epti*+atide, or

tiro*+an'

I3upro0en Route/Dosage:

P: !Children 5 )o(. yr&: Anti-inFammatory–>–:>mg#g#day in –7 divided doses "ma!imum dose@ 9'7 g#day$'

Antipyretic–: mg#g for temperature 6>9':RB "D'6QRC$ or 6>

mg#g for higher temperatures "not to e!ceed 7> mg#g#day$.

may +e repeated q 7–? hr' Cystic *+rosis "unla+eled$–9>–>

mg#g#day divided t(ice daily'

P: !In0ants and Children&: Analgesic–7–6> mg#g#dose q ?–hr'P: !Children (( yr/6.7# l3&: >> mg q ?– hr'P: !Children 7($ yr/5$6( l3&: 9:> mg q ?– hr'P: !Children 58 yr/98#7 l3$@ 9>> mg q ?– hr'P: !Children 9# yr/2596 l3&: 6:> mg q ?– hr'P: !Children .2 yr/.92# l3&: 6>> mg q ?– hr'P: !Children (..2 )o/(8.2 l3&: Q: mg q ?– hr'P: !In0ants 5(( )o/(.(6 l3&: :> mg q ?– hr'


8/43

I*: !+eonates estational age ;2.

mg#g follo(ed +y t(o doses of : mg#g at 97 and 7 hr after initial

dose

Al3uterol – +ronchodilator#andrenergic - Pregnancy Category C

Indications: 5sed as a +ronchodilator to control and prevent reversi+le air(ay

o+struction caused +y asthma or C2P4, Inhaln: 5sed as a quic-relief agent for acute

+ronchospasm and for prevention of e!ercise-induced +ronchospasm, P: 5sed as a lo

term control agent in patients (ith chronic#persistent +ronchospasm'

Action: %inds to +eta9-adrenergic receptors in air(ay smooth muscle, /ela!ation of

air(ay smooth muscle (ith su+sequent +ronchodilation'

Contraindicated In: Hypersensitivity to adrenergic amines'

Use Cautiously In: Cardiac disease, Hypertension, Hyperthyroidism, 4ia+etes, Sei)ure

disorders, Safety not esta+lished for children 9 yr'

Adverse Reactions/Side Efects: nervousness, restlessness, tremor, insomnia "Pedi@occurs more frequently in young children than adults$, hyperactivity in children, chest

pain, palpitations


9/43

Drug Drug Interactions: Concurrent use (ith other adrenergic agents (ill have <

adrenergic side e=ects, use (ith MA2 inhi+itors may lead to hypertensive crisis,

Cardiovascular e=ects are potentiated in patients receiving tricyclic antidepressants

5se spacer for children yr of age, Caution adolescents and their parents a+out

overuse of inhalers, (hich can cause heart damage and life-threatening arrhythmias'

Al3uterol Route/Dosage:P: !Adults and Children 1(. yr&: 9–7 mg –7 times daily "not to e!ceed 9 mg#dayor 7– mg of e!tended-release ta+lets t(ice daily'

P: !Children 5(. yr&: 9 mg –7 times daily or >'–>'? mg#g#day as e!tended-relea

ta+lets divided t(ice daily. may +e carefully < as needed "not to e!ceed mg#day$'

P: !Children .5 yr&: >'6 mg#g times daily "not to e!ceed 9 mg times daily

initially$. may +e carefully < to >'9 mg#g times daily "not to e!ceed 7 mg times

daily$'

Inhaln: !Adults and Children 19 yr&: ia metered-dose inhaler–9 inhalations q 7–? h

or 9 inhalations 6: min +efore e!ercise "D> mcg#spray$. some patients may respond to

inhalation' &IH Guidelines for acute asthma e!acer+ation@ Children–7– pu=s q 9> min

doses then q 6–7 hr. Adults–7– pu=s q 9> min for up to 7 hr then q 6–7 hr prn'


10/43

Inhaln: !Adults and Children '(. yr&: &IH Guidelines for acute asthma e!acer+atio

via ne+uli)ation or IPP%–9':–: mg q 9> min for doses then 9':–6> mg q 6–7 hr prn.

Continuous ne+uli)ation–6>–6: mg#hr'

Inhaln: !Children .(. yr&: &IH Guidelines for acute asthma e!acer+ation via

ne+uli)ation or IPP%–>'6: mg#g#dose "minimum dose 9': mg$ q 9> min for doses the

>'6:–>' mg#g "not to e!ceed 6> mg$ q 6–7 hr prn or 6'9: mg –7 times daily for child6>–6: g or 9': mg –7 times daily for children 6: g. Continuous ne+uli)ation–>':–

mg#g#hr'

Inhaln: +eonates 6'9: mg#dose q hr via ne+uli)ation or 6–9 pu=s via M4I into the

ventilator circuit q ? hrs'

Prelone/rapred/prednisolone - anti-inFammatories"steroidal$ "intermediate-acting$- Pregnancy Category C

Indications: 5sed systemically and locally in a (ide variety of chronic diseas

including@ InFammatory, Allergic, Hematologic, &eoplastic, Autoimmune

disorders. Suita+le for alternate-day dosing in the management of chronic

illness. /eplacement therapy in adrenal insuciency

Action: In pharmacologic doses, suppresses inFammation and the normal

immune response, has numerous intense meta+olic e=ects, Suppresses adren

function at chronic doses of : mg#day, Has minimal mineralocorticoid activity


11/43

Contraindicated In: Active untreated infections "may +e used in patients

+eing treated for tu+erculous meningitis$

Use Cautiously In: Chronic use (ill result in 8 gro(th. use lo(est possi+le

dose for shortest period of time, &eonates "oral solution and syrup contains

+en)oic acid, a meta+olite of +en)yl alcohol, (hich can cause potentially fata

gasping syndrome$

Adverse Reactions/Side Efects: depression, euphoria,< intracranial

pressure "children only$, hypertension, acne, 8 (ound healing, ecchymoses,

fragility, hirsutism, petechiae, adrenal suppression, muscle (asting,

osteoporosis,cushingoid appearance, 1H/2M%20M%2ISM

Prelone/rapred/prednisolone

Drug Drug Interactions: Additive hypoalemia (ith thia)ide and loop

diuretics, amphotericin %, piperacillin, or ticarcillin, May < requirement for

insulin or oral hypoglycemic agents, Phenytoin, pheno+ar+ital, and rifampin

stimulate meta+olism. may 8 e=ectiveness, 2ral contraceptives may 8meta+olism, < ris of adverse GI e=ects (ith &SAI4s "including aspirin $, At

chronic doses that suppress adrenal function, may 8 anti+ody response to an

< ris of adverse reactions from live-virus vaccines, May < ris of tendon

rupture from Fuoroquinolones'


12/43

Route/Dosage:

P: Children Antiin=a))atory/I))unosuppressive–>'6–

mg#g#day in 6–7 divided doses' +ephrotic syndro)e–9

mg#g#day "?> mg#m9#day$ in 6– divided doses daily "ma!imu

dose@ > mg#day$ until urine is protein free for 7–? (ees,

follo(ed +y 9 mg#g#dose "7> mg#m9#dose$ every other day in

the morning, gradually taper o= over 7–? (ees' Asth)a

e-acer3ations–6 mg#g q ? hr for 7 hr, then 6–9 mg#g#day

"ma!imum@ ?> mg#day$ divided t(ice daily'

Children should have periodic evaluations of gro(th'

Atrovent/ipratropiu) – %ronchodilator – Pregnancy Category

Indications:Inhaln: Maintenance therapy of reversi+le air(ay o+struction du

to C2P4, including chronic +ronchitis and emphysema. Intranasal: /hinorrheassociated (ith allergic and nonallergic perennial rhinitis ">'>; solution$ or t

common cold ">'>?; solution$'


13/43

Action: Inhaln: Inhi+its cholinergic receptors in +ronchial smooth muscle,

resulting in decreased concentrations of cyclic guanosine monophosphate

"cGMP$' 4ecreased levels of cGMP produce local +ronchodilation. Intranasal

ocal application inhi+its secretions from glands lining the nasal mucosa'

Contraindicated In: Hypersensitivity to ipratropium, atropine, +elladonna

alaloids, or +romide. Avoid use during acute +ronchospasm.

Use Cautiously In: Patients (ith +ladder nec o+struction, prostatic

hyperplasia, glaucoma, or urinary retention

Adverse Reactions/Side Efects: di))iness, cough, GI irritation, nausea

Drug Drug Interactions: < anticholinergic e=ects (ith other drugs having

anticholinergic properties "antihistamines, phenothia)ines, disopyramide$

Atrovent/ipratropiu) Route/Dosage:

Inhaln: !Adults and Children '(. yr&: Metered-dose inhaler "nonacute$–9

inhalations 7 times daily "not to e!ceed 69 inhalations#97 hr or more frequent

than q 7 hr$' Acute e!acer+ations–7– pu=s using a spacer device as needed'

ia ne+uli)ation "nonacute$–:>> mcg –7 times daily' ia ne+uli)ation "acute

e!acer+ations$–:>> mcg q > min for doses then q 9–7 hr as needed'


14/43

Inhaln: !Children #(. yr&: Metered-dose inhaler "nonacute$–6–9 inhalation

q ? hr as needed "not to e!ceed 69 inhalations#97 hr$' Acute e!acer+ations–7

pu=s as needed ia ne+uli)ation "nonacute$–9:>–:>> mcg 7 times daily given

? hr' Acute e!acer+ations–9:> mcg q 9> min for doses then q 9–7 hr as

needed'

Inhaln: In0ants &e+uli)ation–69:–9:> mcg times a day'

Inhaln: +eonates &e+uli)ation–9: mcg#g#dose times a day'

Intranasal: !Adults and Children ' 5 yr&: >'>; solution–9 sprays in each

nostril 9– times daily "96 mcg#spray$'

Inhaln: !Adults and Children ' # yr&: >'>?; solution–9 sprays in each nos

–7 times daily "79 mcg#spray$'

Solu)edrol/)ethylprednisolone - anti-inFammatories

"steroidal$, immunosuppressants– Pregnancy Category C

Indications: 5sed systemically and locally in a (ide variety of chronic diseases includi

InFammatory, Allergic, Hematologic, &eoplastic, Autoimmune disorders,

Immunosuppresant. May +e suita+le for alternate-day dosing in the management of

chronic illness. /eplacement therapy in adrenal insuciency


15/43

Action: Suppresses inFammation and the normal immune response, has numerous

intense meta+olic e=ects. Suppresses adrenal function at chronic doses of 7 mg#day. H

negligi+le mineralocorticoid activity'

Contraindicated In: Active untreated infections "may +e used in patients +eing treate

for tu+erculous meningitis$. Tno(n alcohol, +isul*te, or tartra)ine hypersensitivity or

intolerance "some products contain these and should +e avoided in suscepti+le patientsAdministration of live virus vaccines

Use Cautiously In: Chronic use (ill result in 8 gro(th. use lo(est possi+le dose for

shortest period of time. &eonates "avoid use of +en)yl alcohol containing inOecta+le

preparations, use preservative-free formulations$'

Adverse Reactions/Side Efects: depression, euphoria, < intracranial pressure"children only$, hypertension, anore!ia, nausea, acne, 8 (ound healing, ecchymoses,

fragility, hirsutism, petechiae, adrenal suppression, muscle (asting, osteoporosis,

cushingoid appearance, 1H/2M%20M%2ISM

Solu)edrol/)ethylprednisolone

Drug Drug Interactions: Additive hypoalemia (ith thia)ide and loo

diuretics, amphotericin %, piperacillin, or ticarcillin, May < requiremen


16/43

for insulin or oral hypoglycemic agents, Phenytoin, pheno+ar+ital, and

rifampin stimulate meta+olism. may 8 e=ectiveness, 2ral

contraceptives may 8 meta+olism, < ris of adverse GI e=ects (ith

&SAI4s "including aspirin $, At chronic doses that suppress adrenal

function, may 8 anti+ody response to and < ris of adverse reactions

from live-virus vaccines, May < ris of tendon rupture fromFuoroquinolones'

Route/Dosage:Children should have periodic evaluations of gro(th'

P: Children Anti>in=a))atory/I))unosuppressive– >':–6'Q mg#g#da

or :–9: mg#m9#day in divided doses q ?–69 hr' Asth)a e-acer3ations–6mg#g q ? hr for 7 hr, then 6–9 mg#g#day "ma!imum@ ?> mg#day$ divided

t(ice daily'

IM: I*: Children Anti>in=a))atory/I))unosuppressive– >':–6'Q

mg#g#day or :–9: mg#m9#day in divided doses q ?–69 hrAcute spinal cord

in?ury: methylprednisolone sodium succinate–> mg#g over 6: min initially,

then 7: min later initiate continuous infusion of :'7 mg#g#hr for 9 hr

"unla+eled$' Stausasth)aticus–9 mg#g#dose, then >':–6 mg#g#dose q ? h

@upus nephritis–> mg#g I every other day for ? doses'

i idi / i l P C %


17/43

ranitidine/antac – antiulcer agent – Pregnancy Cat' %

Indications: 1reatment of#maintenance therapy for erosive esophagit

1reatment of "G0/4$. Heart+urn, acid indigestion, and sour stomach

"21C use$. I*: Prevention and treatment of stress-induced upper GI

+leeding in critically ill patients

Action: Inhi+its the action of histamine at the H9-receptor site locate

primarily in gastric parietal cells, resulting in inhi+ition of gastric acid

secretion'

Contraindicated In: Hypersensitivity. syrup contains alcohol andshould +e avoided in patients (ith no(n intolerance

Use Cautiously In:Phenyletonuric patients. renal E hepatic

impairment. Acute porphyria

Adverse Reactions/Side Efects: confusion, A//H31HMIAS,AG/A&52C312SIS, APAS1IC A&0MIA

D D I t ti M 8 + ti f t l


18/43

Drug Drug Interactions: May 8 a+sorption of etocona)ole,

itracona)ole, ata)anavir, delavirdine, and geftini+. May < a+sorption o

tria)olam and glipi)ide. May < procainamide levels. May < the e=ects

(arfarin'

rantidine/antac > Route/Dosage:

P: !Children ( )o>(5 yr&: ,reat)ent o0 active ulcers–9–7

mg#g#day divided t(ice daily, ma!imum >> mg#day' ERD and

Erosive esophagitis–7–6> mg#g#day divided t(ice daily, ma!imum

>> mg#day for G0/4, ?>> mg#day for erosive esophagitis'

P: +eonates 9 mg#g#day divided q 69 hr'

I*: IM: !Children ( )o(5 yr&: ,reat)ent o0 active ulcers–

9–7 mg#g#day divided q ?– hr, ma!imum 9>> mg#day'

Continuous in0usion–6 mg#g#dose follo(ed +y >'>–>'6Q

mg#g#hr'

I* + t 6 : # #d l d th i 69 h t t


19/43

I*: +eonates 6': mg#g#dose load, then in 69 hr start

maintenance of 6':–9 mg#g#day divided q 69 hrContinuous I*

in0usion–6': mg#g#dose load follo(ed +y >'>7–>'> mg#g#hr

infusion'

Prostaglandin E(/alprostadil - ductusarteriosus patency adOunc

– Pregnancy Category@ 5&T

Indications:I@ 1emporary maintenance of patentductusarteriosus in neonates (ho depend on patency untilsurgery can +e performed'

Action:I@ 4irectly rela!es smooth muscle of theductusarteriosus'

Contraindicated In:/espiratory distress syndrome'

Use Cautiously In:&eonates (ith +leeding tendencies


20/43

Use Cautiously In:&eonates (ith +leeding tendencies'

Adverse Reactions/Side Efects: Fushing, fever, S0IK5/0S,

AP&0A

Drug Drug Interactions: /is of +leeding may +e < +yconcurrent use of anticoagulants, some cephalosporins, orantiplatelet agents' Concurrent use of epinephrine, orphenylephrine may 8 e=ectiveness of alprostadil' Concurrentuse (ith other vasodilators < ris of hypotension'

Prostaglandin E(/alprostadil Route/Dosage:

I*: IA: +eonates >'>:–>'6 mcg#g#min initially. may +eincreased up to >'7 mcg#g#min until satisfactory response, the

decrease to maintenance dose +y halving infusion rate' In somepatients lo(er doses ">'>6 mcg#g#min$ may +e sucient'

,o-icity verdose:


21/43

,o-icity verdose:Symptoms of overdose include Fushing, hypotension, +radycardia,

fever,and decreased respiratory rate or apnea' Infusion should +ediscontinued ifapnea or +radycardia occurs'

Digo-in – antiarrhythmics, inotropics # digitalis glycosides – PregnancCat' CIndications: Heart failure, Atrial *+rillation and atrial Futter "slo(s ventricular rate$,Paro!ysmal atrial tachycardia'

Action: Increases the force of myocardial contraction, Prolongs refractory period of thenode, 4ecreases conduction through the SA and A nodes'Contraindicated In: Hypersensitivity. 5ncontrolled ventricular arrhythmias. A +loc"in a+sence of pacemaer$. Idiopathic hypertrophic su+aortic stenosis. Constrictivepericarditis. Tno(n alcohol intolerance "eli!ir only$'

Use Cautiously In: Hypoalemia "< ris of digo!in to!icity$. Hypercalcemia "< ris of


22/43

Use Cautiously In: Hypoalemia "< ris of digo!in to!icity$. Hypercalcemia "< ris ofto!icity, especially (ith mild hypoalemia$. Hypomagnesemia "< ris of digo!in to!icity4iuretic use "may cause electrolyte a+normalities including hypoalemia andhypomagnesemia$. Hypothyroidism. MI. /enal impairment "dose 8 required$. 2+esity"dose should +e +ased on ideal +ody (eight$Adverse Reactions/Side Efects: Batigue, +radycardia, anore!ia, nausea, vomiting,A//H31HMIAS

Drug Drug Interactions@ 1hia)ide and loop diuretics, piperacillin, ticarcillin,amphotericin %, corticosteroids, and e!cessive use of la!atives may cause hypoalemia(hich may < ris of to!icity. Amiodarone, some +en)odia)epines, cyclosporine,dipheno!ylate, indomethacin, itracona)ole, propafenone, quinidine, quinine,spironolactone, and verapamil may < levels and lead to to!icity "serum levelmonitoring#dose 8 may +e required$. evels may +e 8 +y some antineoplastics"+leomycin, carmustine, cyclophosphamide, cytara+ine, do!oru+icin, methotre!ate,procar+a)ine, vincristine$, activated charcoal, cholestyramine, colestipol, aolin#pectin,

metoclopramide, penicillamine, rifampin, or sulfasala)ine'Route/Dosage:I*: !Children '($ yr&: 4igitali)ing dose––69 mcg#g given as :>; of the dose initialland one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hr intervals'I*: !Children #($ yr&: 4igitali)ing dose–6:–> mcg#g given as :>; of the dose initiand one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hr intervals'

Digo-in

I*: !Children .# yr&: 4igitali)ing dose–9:–: mcg#g given as :>; of the dose initiaand one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hr intervals'I*: !Children (.9 )o&: 4igitali)ing dose–>–:> mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals'

I*: !In0ants 0ull ter)&: 9>–> mcg#g given as :>; of the dose initially and one


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I*: !In0ants 0ull ter)&: 9> > mcg#g given as :>; of the dose initially and onequarter of the initial dose in each of 9 su+sequent doses at ?-69 hr intervals'I*: !In0ants pre)ature&: 4igitali)ing dose–6:–9: mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals'P: !Children '($ yr&: 4igitali)ing dose–6>–6: mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hr

intervals' Maintenance dose–9':–: mcg#g given daily as a single dose'P: !Children #($ yr&: 4igitali)ing dose–9>–: mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals' Maintenance dose–:–6> mcg#g given daily in 9 divided doses'P: !Children .# yr&: 4igitali)ing dose–>–7> mcg#g given as :>; of the dose initiaand one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hr intervals'Maintenance dose–Q':–6> mcg#g given daily in 9 divided doses'P: !Children (.9 )o&: 4igitali)ing dose–:–?> mcg#g given as :>; of the dose

initially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals' Maintenance dose–6>–6: mcg#g given daily in 9 divided doses'P: !In0ants 0ull ter)&: 4igitali)ing dose–9:–: mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals' Maintenance dose–?–6> mcg#g given daily in 9 divided doses'P: !In0ants pre)ature&: 4igitali)ing dose–9>–> mcg#g given as :>; of the doseinitially and one quarter of the initial dose in each of 9 su+sequent doses at ?-69 hrintervals' Maintenance dose–:–Q': mcg#g given daily in 9 divided doses'

Regular Insulin/Bu)u@I+ R4 +ovo@I+ R–antidia+etic, hormone –Pregnancy Cat' %

Indications:Control of hyperglycemia in patients (ith dia+etes


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Indications:Control of hyperglycemia in patients (ith dia+etesmellitus, Concentrated regular insulin U>#$$@ 2nly for use inpatients (ith insulin requirements 9>> units#day

Action: o(ers +lood glucose +y@ stimulating glucose uptae inseletal muscle and fat, inhi+iting hepatic glucose production' theractions o0 insulin:inhi+ition of lipolysis and proteolysis, enhancedprotein synthesis'

Contraindicated In: Hypoglycemia. Allergy or hypersensitivity to aparticular type of insulin, preservatives, or other additives'

Use Cautiously In:Stress or infection–may temporarily < insulinrequirements. /enal#hepatic impairment–may 8 insulin requirementsConcomitant use (ith pioglita)one or rosiglita)one "< ris of Fuidretention and (orsening HB$

Adverse Reactions/Side Efects:H3P2G3C0MIA, A&APH3AJIS

Drug Drug Interactions: %eta +locers, clonidine, and reserpine may mas some of tsigns and symptoms of hypoglycemia. Corticosteroids, thyroid supplements, estrogensisonia)id, niacin, phenothia)ines, and rifampin may < insulin requirements. Alcohol, ACinhi+itors, MA2 inhi+itors, octreotide, oral hypoglycemic agents, and salicylates, may 8

insulin requirements. Concurrent use (ith pioglita)one or rosiglita)one may < ris of F


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q . p g g yretention and (orsening HB

Regular Insulin/Bu)u@I+ R4 +ovo@I+ R Route/Dosage:

4ose depends on +lood glucose, response, and many other factors

I*: Children @oading dose->'6 unit#g, then maintenance continuouinfusion >'>:–>'9 unit#g#hr, titrate to optimal rate of decrease of seruglucose of >–6>> mg#d#hr'

Maintenance ,herapy

SC: !Adults and Children& >':–6 unit#g#day in divided doses'Adolescents during rapid gro(th–>'–6'9 unit#g#day in divided doses

,reat)ent o0 Byper%ale)ia

SC: I*: !Adults and Children& de!trose >':–6 g#g com+ined (ithinsulin 6 unit for every 7–: g de!trose given'


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urose)ide/@asi- – diuretic#loop diuretic – Pregnancy Category C

Indications: 0dema due to heart failure, hepatic impairment or renaldisease. Hypertension'

Action: Inhi+its the rea+sorption of sodium and chloride from the loopof Henle and distal renal tu+ule. Increases renal e!cretion of (ater,sodium, chloride, magnesium, potassium, and calcium. 0=ectivenesspersists in impaired renal function'

Contraindicated In: Hypersensitivity. Cross-sensitivity (ith thia)ideand sulfonamides may occur. Hepatic coma or anuria. Some liquidproducts may contain alcohol, avoid in patients (ith alcohol intoleran

Use Cautiously In: Severe liver disease "may precipitate hepaticcoma. concurrent use (ith potassium-sparing diuretics may +enecessary$. 0lectrolyte depletion. 4ia+etes mellitus. Hypoproteinemia"< ris of ototo!icity$. Severe renal impairment "< ris of ototo!icity$. ris for renal calculi and patent ductusarteriosis in premature neonate

Adverse Reactions/Side Efects: dehydration, hypocalcemia,


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/ y , yp ,hypochloremia, hypoalemia, hypomagnesemia, hyponatremia,hypovolemia, meta+olic alalosis, 0/31H0MA M51IB2/M0, S100&S- L2H&S2& S3&4/2M0, 12JIC 0PI40/MA &0C/23SIS, APAS1ICA&0MIA, AG/A&52C312SISurose)ide/@asi-

Drug Drug Interactions: < ris of hypotension (ithantihypertensives, nitrates, or acute ingestion of alcohol. < ris ofhypoalemia (ith other diuretics, amphotericin %, stimulant la!atives,and corticosteroids. Hypoalemia may < ris of digo!in to!icity and <ris of arrhythmia in patients taing drugs that prolong the U1 interva

8 lithium e!cretion, may cause lithium to!icity, < ris of ototo!icity (aminoglycosides or cisplatin, < ris of nephroto!icity (ith cisplatin,&SAI4S8 e=ects of furosemide'

Route/Dosage:

P: !Children ' ( )o&: 9 mg#g as a single dose. may +e < +y 6–9

mg#g q ?– hr "ma!imum dose V ? mg#g$'

P: +eonates 6–7 mg#g#dose 6–9 times#day'


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IM: I*: Children 6–9 mg#g#dose q ?–69 hr Continuous infusion–>'>:mg#g#hr, titrate to clinical e=ect'

IM: I*: +eonates 6–9 mg#g#dose q 69–97 hr'

Dilantin/phenytoin – antiarrhythmics#anticonvulsants –

Pregnancy Category 4

Indications: 1reatment#prevention of tonic-clonic "grand mal$ sei)ures andcomple! partial sei)ures'

Action: imits sei)ure propagation +y altering ion transport. May also decreasynaptic transmission. Antiarrhythmic properties as a result of shortening theaction potential and decreasing automaticity'

Contraindicated In: Hypersensitivity. Hypersensitivity to propylene glycol"phenytoin inOection only$. Alcohol intolerance "phenytoin inOection and liquid

only$. Sinus +radycardia, sinoatrial +loc, 9nd- or rd-degree heart +loc, orStoes-Adams syndrome "phenytoin inOection only$. Concurrent use ofdelavirdine

Use Cautiously In: All patients "may < ris of suicidal thoughts#+ehaviors$.

Hepatic or renal disease "< ris of adverse reactions. dose reduction


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recommended for hepatic impairment$. Patients (ith severe cardiac orrespiratory disease "use of I phenytoin may result in an < ris of seriousadverse reactions$. Suspension contains sodium +en)oate, a meta+olite of+en)yl alcohol that can cause potentially fatal gasping syndrome in neonates

Adverse Reactions/Side Efects: ata!ia, diplopia, nystagmus, hypotensiongingival hyperplasia, nausea, rash, S5ICI4A 1H25GH1S, S100&S-L2H&S2&S3&4/2M0, 12JIC 0PI40/MA &0C/23SIS, AG/A&52C312SIS, APAS1ICA&0MIA

Dilantin/phenytoin

Drug Drug Interactions: May 8 the e=ects of amiodarone, atorvastatin,+en)odia)epines, car+ama)epine, corticosteroids, cyclosporine, digo!in,do!ycycline, efaviren), estrogens, Fuvastatin, indinavir, lopinavir#ritonavir,methadone, me!iletine, nel*navir, nisoldipine, oral contraceptives, paro!etinequinidine, rifampin, ritonavir, saquinavir, simvastatin, tacrolimus, theophyllinetopiramate, and (arfarin. I phenytoin and dopamine may cause additivehypotension. Additive C&S depression (ith other C&S depressants, including

alcohol, antihistamines, antidepressants, opioids, and sedative#hypnotics'

/oute#4osage@P: !Children ($(5 yr&: ?–Q mg#g#day in 9– divided doses'P: !Children 67 yr&: Q– mg#g#day in 9– divided doses'

P: !Children 95 yr&: Q':–D mg#g#day in 9– divided doses'


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P: !Children $#2 yr&: –6> mg#g#day in 9– divided doses'P: !+eonates up to 5 )o&: :– mg#g#day in 9 divided doses, may require

hr dosing'I*: Children Status epilepticus loading dose–6:–9> mg#g at 6–mg#g#min' Maintenance dose–same as P2 dosing a+ove'

Antiarrhyth)icI*: Children 6'9: mg#g q : min, may repeat up to total loading dose of 6:mg#g' Maintenance dose:–6> mg#g#day in 9– divided doses I or P2'

DDA*P/des)opressin – hormones – Pregnancy Category %

Indications:P: SC: I*: Intranasal: 1reatment of central dia+etesinsipidus caused +y a de*ciency of vasopressin'I*: Intranasal:Controls +leeding in certain types of hemophilia and von Wille+randXsdisease'P: Primary nocturnal enuresis'

Action:An analogue of naturally occurring vasopressin "antidiuretic

hormone$' Primary action is enhanced rea+sorption of (ater in theidneys'

Contraindicated In: Hypersensitivity. Hypersensitivity to


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chloro+utanol. Patients (ith severe type I, type II% or platelet-type"pseudo$ von Wille+randXs disease, hemophilia A (ith factor III levels:; or hemophilia %. /enal impairment "CCr :> m#min$.Hyponatremia'

Use Cautiously In: Angina pectoris. Hypertension. Patients at ris fohyponatremia

Adverse Reactions/Side Efects: dro(siness, headache, S0IK5/0S

Drug Drug Interactions:Chlorpropamide, clo*+rate, chlorproma)ine

lamotrigine, SS/Is or car+ama)epine may enhance the antidiureticresponse to desmopressin. 4emeclocycline, lithium, or norepinephrinemay diminish the antidiuretic response to desmopressin. arge dosesmay enhance the e=ects of vasopressors'DDA*P/des)opressin Route/Dosage:

Pri)ary +octurnal Enuresis

P: !Adults and Children 15 yr&: >'9 mg at +edtime. may +e titratup to >'? mg at +edtime to achieve desired response'

Dia3etes Insipidus

P: !Adults and Children& >'>: mg t(ice daily. adOusted as needed


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"usual range@ >'6–6'9 mg#day for adults or >'6–>' mg#day for childrenin 9– divided doses$'Intranasal: !Adults and Children 1 (. yr&: 44AP–:–7> mcg">'>'>:–>'7 m$in 6– divided doses'Intranasal: !Children 2 )o(. yr&: 44AP–:–> mcg ">'>:–>' m

in 6–9 divided doses'SC: I*: !Adults and Children1(. yr&:9–7 mcg#day in 9 divided dosSC: I*: !Children " (. yr&: >'6–6 mcg#day in 6–9 divided doses'

Be)ophilia A/von ille3randFs diseaseIntranasal: !Adults and Children '#$ %g&:Stimate–6 spray "6:>

mcg$ in each nostril'Intranasal: !Adults and Children ;#$ %g&:Stimate–6 spray "6:>mcg$ in one nostril'I*: !Adults and Children '2 )o&: >' mcg#g, repeated as needed

So)atotropin– hormones "gro(th$ – Pregnancy Category % E C

Indications: Gro(th failure in children due to de*ciency of gro(th hormone.

Children (ith gro(th failure associated (ith Prader-Willi syndrome or 1urnersyndrome Children (ith short stature +orn small for gestational age (ith no


33/43

syndrome. Children (ith short stature +orn small for gestational age (ith nocatch-up gro(th +y age 9 yr'. Children (ith idiopathic short stature'

Action: Produce gro(th "seletal and cellular$. Meta+olic actions include@Increased protein synthesis, Increased car+ohydrate meta+olism, ipidmo+ili)ation, /etention of sodium, phosphorus, and potassium. Gro(th hormoenhances GI tract mucosal transport of (ater, electrolytes and nutrients'

Contraindicated In: Closure of epiphyses. Active malignancy. Hypersensitivto gro(th hormone or any of the e!cipients. Acute critical illness "therapyshould not +e initiated$ or respiratory failure. 4ia+etic retinopathy. Prader-Wilsyndrome (ith severe o+esity, upper air(ay o+struction, sleep apnea, or severespiratory impairment "< ris of fatal complications$'

Use Cautiously In: Gro(th hormone de*ciency due to intracranial lesion.Coe!isting adrenocorticotropic hormone "AC1H$ de*ciency. 4ia+etes "maycause insulin resistance$. Scoliosis "may cause progression$. 1urner syndrome(ith otitis media or cardiovascular disorders "may cause progression$

Adverse Reactions/Side Efects: hypothyroidism, eosinophilia, PA&C/0A1I1

So)atotropin

Drug Drug Interactions:In patients requiringl ti id# ti t id l t l t ti f l


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glucocorticoid#corticosteroid replacement or supplementation carefultitration is required as some meta+olic path(ays are inhi+ited +ysomatropin. May alter clearance of compounds no(n to +emeta+oli)ed +y C3P7:> liver en)ymes including corticosteroids,steroidal hormones, anticonvulsants and cyclosporine. 0strogen may

requirements for somatropin. May alter response to insulin and#or orahypoglycemic agents, dose adOustment may +e necessary'

Route/Dosage:Pediatric ro'6?–>'97 mg#g#( divided into equal doses given ?–Q times p('

roilli syndro)e–>'97 mg#g#( divided into equal dosgiven ?–Q times per (. ,urner syndro)e–>' mg#g#( divided into equadoses given ?–Q times per ('

Short Stature Horn S)all 0or estational Age

SC: Children up to >'7 mg#g#( divided into equal doses given ?–Q times p('

Idiopathic Short Stature

SC: Children 5p to >'7Q mg#g#( divided into equal doses given ?–Q times (


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('

succi)er/Che)et – antidote#chelating agent – PregnancyCategory C

Indications: 1reatment of lead poisoning in children (ith +loodlead levels 7: mcg#d'

Action: Borms a (ater-solu+le compound (ith lead, allo(ingurinary elimination of e!cessive amounts of lead'

Contraindicated In: Hypersensitivity or allergy to succimer.actation "should +e discouraged during succimer therapy$'

Use Cautiously In: /enal failure "chelates are not dialy)a+le$.Children "increased ris of +radyarrhythmias$. Children (ithseletal muscle myopathy "more prone to rare, +ut serious,adverse reactions$. Pregnancy or children 6 yr "safety notesta+lished$'

Adverse Reactions/Side Efects: nausea, vomiting


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Drug Drug Interactions: &ot recommended for use (ith othechelating agents'

succi)er/Che)et

Route/Dosage:

P: !Adults and Children& 6> mg#g ":> mg#m9$ q hr for : daysthen reduce to 6> mg#g ":> mg#m9$ q 69 hr for 9 more (' /epeatecourses should follo( a 9-( rest period'

If patient is una+le to s(allo( the capsule, open capsule and sprinlemedicated +eads on a small amount of soft food or place in a spoon afollo( (ith a fruit drin'


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diaepa) Rectal el/*aliu)–antian!iety

agents#anticonvulsants#sedative#hypnotics#seletal muscle rela!ants"centrally acting$ – +en)odia)epine – Pregnancy Category 4

Indications 0or Rectal el: AdOunct in the management of@ 1reatment ofstatus epilepticus#uncontrolled sei)ures "inOection$. Seletal muscle rela!ant

Action: 4epresses the C&S, pro+a+ly +y potentiating GA%A, an inhi+itory

neurotransmitter. Produces seletal muscle rela!ation +y inhi+iting spinalpolysynaptic a=erent path(ays. Has anticonvulsant properties due to enhancpresynaptic inhi+ition' A3sorption: Well a+sor+ed "D>;$ from rectal mucosa

Contraindicated In: Hypersensitivity. Cross-sensitivity (ith other+en)odia)epines may occur. Comatose patients. Myasthenia gravis. Severepulmonary impairment. Sleep apnea. Severe hepatic dysfunction. 5ncontrolle

severe pain. Children ? mo "for oral. safety not esta+lished$

Use Cautiously In: Severe renal impairment. History of suicide attempt ordrug dependence. 4e+ilitated patients "dose 8 required$. Patients (ith lo(


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drug dependence. 4e+ilitated patients "dose 8 required$. Patients (ith lo(al+umin.Meta+olites can accumulate in neonates' InOection contains +en)yl alcohol (hcan cause potentially fatal gasping syndrome in neonates.

Adverse Reactions/Side Efects: di))iness, dro(siness, lethargy,/0SPI/A12/3 40P/0SSI2&

diaepa) Rectal el/*aliu)Drug Drug Interactions: Alcohol, antidepressants, antihistamines, and opianalgesics–concurrent use results in additive C&S depression. Cimetidine,hormonal contraceptives, disul*ram, Fuo!etine, isonia)id, etocona)ole,metoprolol, propranolol, or valproic acid may 8 the meta+olism of dia)epam,enhancing its actions. May 8 the ecacy of levodopa. /ifampin or +ar+ituratemay < the meta+olism and 8 e=ectiveness of dia)epam. Sedative e=ects ma+e 8 +y theophylline. Concurrent use of ritonavir is not recommended'

Route/Dosage:Status Epilepticus/Acute Seiure Activity

Rect: !Adults and Children '(. yr&: >'9 mg#g. may repeat 7–69 hr later'

Rect: !Children 5(( yr&: >' mg#g. may repeat 7–69 hr later'

Rect: !Children .# yr&: >': mg#g. may repeat 7–69 hr later'


39/43

Rect: 4o not repeat 4iastat rectal dose more than : times#mo or 6 episodeevery : days' /ound dose up to ne!t availa+le dose unit'

4ia)epam inOection has +een used for rectal administration' Instill via catheteor cannula *tted to the syringe or directly from a 6-m syringe inserted 7–: cinto the rectum' A dilution of dia)epam inOection (ith propylene glycolcontaining 6 mg#m has also +een used'

4o not dilute (ith other solutions, I Fuids, or medications'

hydro-yurea/Dro-ia/Bydrea – antineoplastic – Pregnancy Category

Indications: Head and nec carcinoma. 2varian carcinoma. /esistanchronic myelogenous leuemia. Melanoma. Reduction o0 pain0ulcrises in sic%le cell ane)ia and decreased need for transfusions inadult patients (ith a history of recurrent moderate to severe crises "aleast in the preceding yr$'

Action:Interferes (ith 4&A synthesis "cell-cycle S-phase–speci*c$. Ma

alter characteristics of /%Cs'

Contraindicated In: Hypersensitivity. Some products containtartra)ine "B4C yello( dye :$ and should +e avoided in patients (ith


40/43

tartra)ine "B4C yello( dye :$ and should +e avoided in patients (ithno(n hypersensitivity'

Use Cautiously In:/enal impairment. Hepatic impairment.Myeloproliferative disorders. Active infections. 8 +one marro( reserve

2ther chronic de+ilitating illness. HI patients receiving didanosine anstavudine "< ris of pancreatitis and hepatoto!icity$

Adverse Reactions/Side Efects:anore!ia, diarrhea, nausea,vomiting, leuopenia

hydro-yurea/Dro-ia/Bydrea

Drug Drug Interactions:Additive +one marro( depression (ith agenthat depress +one marro(, including radiation therapy. May 8 the

anti+ody response to and increase the ris of adverse reactions to livevirus vaccines. < ris of pancreatitis and hepatoto!icity (hen used (ididanosine and stavudine. avoid concurrent use'

Route/Dosage:


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Sic%le Cell Ane)ia

P: !Adults and Children& 6: mg#g#day as a single dose, may < +: mg#g#day q 69 ( up to : mg#g#day'

P: Capsules may +e opened and contents mi!ed into a glass of (ateand taen immediately if patient has diculty s(allo(ing' Some inertpo(der may Foat on the surface' If po(der from capsule is spilled, (i(ith a damp, disposa+le cloth immediately'

de0ero-a)ine/Des0eral – antidote – Pregnancy Category C

Indications: Acute to!ic iron ingestion. Secondary iron overloasyndromes associated (ith multiple transfusion therapy'

Action: Chelates un+ound iron, forming a (ater-solu+le comple"ferrio!amine$ in plasma that is easily e!creted +y the idneys'

Contraindicated In: Severe renal disease. Anuria


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Contraindicated In: Severe renal disease. Anuria

Use Cautiously In: Children yr "safety not esta+lished$

Adverse Reactions/Side Efects: red urine

Drug Drug Interactions: Ascor+ic acid may < e=ectiveness odefero!amine +ut may also < cardiac iron to!icity'

de0ero-a)ine/Des0eral Route/Dosage:

Acute Iron Ingestion

IM: I*: !Adults and Children 12 yr&: 6 g, then :>> mg q 7 hrfor 9 doses' Additional doses of :>> mg q 7–69 hr may +e need"not to e!ceed ? g#97 hr$'

Chronic Iron verload


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IM: I*: !Adults and Children 12 yr&: :>> mg–6 g daily IM.additional doses of 9 g should +e given I for each unit of +loodtransfused "not to e!ceed 6 g#day in a+sence of transfusions. ?

g#day if patient receives transfusions$'

SC: !Adults and Children 12 yr&: 6–9 g#day "9>–7> mg#g#dainfused over –97 hr'

weekly drug cards

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