Davis's Pocket Clinical Drug Reference by Shamim Tejani PharmD, Cynthia A. Sanoski BS PharmD FCCP

By Shamim Tejani PharmD, Cynthia A. Sanoski BS PharmD FCCP BCPS

Davis's Pocket medical Drug Reference is a short source for the main standard medicines in medical perform. The monographs are designed to focus on pertinent details; particularly, each one monograph features a drug's widely used identify, model identify, therapeuticindication, pharmacologic type, being pregnant classification, contraindications, antagonistic drug reactions, drug interactions, dose, availability, and tracking parameters.

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Amitriptyline (Elavil) Uses: Depression; Class: tricyclic antidepressants; Preg: C; CIs: Hypersensitivity, Concurrent use with MAOIs, Post-MI, May risk of suicidal thoughts/behaviors esp. , phenothiazines, quinidine, cimetidine, and class Ic antiarrhythmics) may levels, risk of hypertensive crises, seizures, or death with MAOIs CAPITALS indicates life-threatening; underlines indicate most frequent A → → → → (discontinue for ≥2 wk), risk of toxicity with SSRIs (discontinue fluoxetine for ≥5 wk), risk of arrhythmias with other drugs that prolong QT interval, CNS depression with other CNS depressants including alcohol, antihistamines, opioids, and sedative/hypnotics, risk of anticholinergic effects with other anticholinergic agents; Dose: PO: Adults: 75 mg/day in divided doses; may be up to 300 mg/day or 50–100 mg at bedtime, may by 25–50 mg/day up to 300 mg at bedtime; PO: Geri and Adolescents: 10 mg tid and 20 mg/day at bedtime or 25 mg at bedtime initially, slowly to 100 mg/day as a single bedtime dose or in divided doses; Availability (G): Tabs: 10, 25, 50, 75, 100, 150 mg; Monitor: BP, HR, ECG, mental status, suicidal thoughts/behaviors; Notes: May take 4–6 wk to see effect.

ER (for 6–12 yr): 10 mg daily; by 5–10 mg/day at weekly intervals (max: 30 mg/day). 5, 15, 20, 30 mg; ER caps: 5, 10, 15, 20, 25, 30 mg; Monitor: BP, HR, ECG, mental status, ht/wt; Notes: Schedule II controlled substance. For IR tabs, give first dose upon awakening, and then subsequent doses at 4–6 hr intervals. Take last dose ≥6 hr before bedtime to minimize insomnia. If switching from IR to ER, give same total daily dose once daily. All children should have CV assessment prior to initiation. Potential for dependence/abuse with long-term use.

Meningitis—150–250 mg/ kg/day divided q 3–4 hr (max: 12 g/day); IM: IV: Peds: <40 kg 100–150 mg/ kg/day divided q 6 hr (max: 4 g/day). IE prophylaxis—50 mg/kg (not to exceed 2 g) 30–60 min before procedure. Meningitis—200–400 mg/kg/ day divided q 6 hr (max: 12 g/day); PO: IM: IV: Adults and Peds: dose if CrCl ≤50 ml/min; Availability (G): Caps: 250, 500 mg; Oral susp: 125 mg/5 ml, 250 mg/5 ml; Inject: 125, 250, 500 mg, 1, 2, 10 g; Monitor: HR, BP, temp, sputum, U/A, CBC, LFTs, BUN/SCr; Notes: Give on empty stomach ≥1 hr before or 2 hr after meals with full → → → → A → CAPITALS indicates life-threatening; underlines indicate most frequent anastrazole 17 glass of water.

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