Drugs

Acetaminophen-500/Hydrocodone-5 (Vicodin)

  • PO: 1-2 tabs q4-6hrs PRN

Acetazolamide (Diamox)

  • Carbonic anhydrase inhibitor -> increases renal bicarb excretion
  • PO: 125-250 mg qday
  • IV: 125-250 mg qday
  • SE: non-AG metabolic acidosis
  • Contraindications: sulfa allergy

Adenosine

  • IV Push: 6 mg, followed by 12 mg
  • Contraindications: theo (blocks effect)
  • SE: bronchospasm

Advair

  • INH (250/50): 1 puff BID
  • INH (500/50): 1 puff BID

Albumin

  • Pooled from human plasma -> heat pasteurization
  • IV: 5% (plasmanate) -> 250-500 ml
  • IV: 25% -> 50 ml (contains 12.5 g albumin)
    • Draws approximately an additional 175 ml of fluid intravascularly within 15 min
  • IV: 25% -> 100 ml (contains 25g of albumin)

Allopurinol

  • PO: 200-600 mg qday divided qday-QID

Alprazolam (Xanax)

  • PO: 0.25-0.5 mg TID

Aminocaproic Acid (Amicar)

  • IV:
  • Indications:

Amiodarone

  • PO Maint: 200 mg BID
  • IV Load: 150 mg over 10 min, then 360 mg over 6 hrs, then 540 mg over 18 hrs
  • IV Maint: 0.5 mg/min
  • SE:

Amlodipine (Norvasc)

  • PO: 2.5-10 qday

Amphotericin

  • IV:
  • BLADDER: via 3-way Foley, 50 mg/1L sterile water -> run at 42 ml/hr (gives 1L per day)

Apidra (Insulin Glulisine)

  • Onset <30 min, peak 30-90 min, duration <6hrs
  • Give <15 min before or <20 min after meal
  • SQ:

Argatroban

  • IV: 2-10 ug/kg/min (adjust to PTT of X)
  • Half-life: 30-50 min
  • SE:

Atenolol (Tenormin)

  • PO: 50-100 mg qday

Atorvastatin (Lipitor)

  • PO: 10-80 mg qday
  • SE:

Atracurium

  • IV:

Atropine

  • IV: 1 mg PRN bradycardia

Azathioprine (Imuran)

  • PO: 1-5 mg/kg qday
  • SE:

Azithromycin

  • PO:
  • IV:
  • SE:
  • Penetration:
  • Coverage: Pneumococci, Atypicals (Moraxella/ Chlamydia Pneumoniae/ Legionella/ Mycoplasma Pneumonia)

Banana Bag

  • IV: 100 mg thiamine/1 mg folate/1 amp MVI to first liter of IVF qday

Benazepril (Lotensin)

  • PO: 10-40 mg qday

Bosentan (Tracleer)

  • PO: 125 mg BID
  • SE:

Bumetanide (Bumex)

  • PO: 1-2 mg qday (1 mg=40 mg lasix)
  • IV: 1-2 mg
  • IV Drip: 0.5-1 mg/hr
  • Contraindications: sulfa allergy

Bupropion (Welbutrin)

  • PO: 100 mg TID

Candesartan ()

  • PO:

Captopril (Capoten)

  • PO: 6.25-100 mg TID-q6hrs
  • IV: 6.25-100 mg TID-q6hrs

Carbamazepine (Tegretol)

  • PO: 100-200 mg BID-QID

Carbidopa/Levodopa (Sinemet)

  • PO (10/100, 25/100, 25/250): 1 TID-QID
  • SE: dyskinesia/dystonia, orthostatic hypotension, syncope, severe HTN (rare), arrhythmias, altered MS, N/V

Carvedilol (Coreg)

  • PO: 6.25-25 mg BID

Caspofungin ()

  • IV:
  • SE:
  • Coverage: Candida krusei (high Flucon resistance),

Ceftriaxone (Rocephin)

  • IV:
  • SE:
  • Penetration:
  • Coverage: Pneumococci

Cetirizine (Zyrtec)

  • PO: 5-10 mg qday

Charcoal

  • PO: 50-100 g within 1hr of ingestion
    (use Sorbitol prep only once, if giving multiple doses)

Cisatracurium ()

  • IV:

Citalopram (Celexa)

  • PO:
  • SE:

Clevidipine (Cleviprex)

  • IV Drip: start 1-2 mg/hr (max: 32 mg/hr)
  • SE: AF, ARF, MI

Clopidogrel (Plavix)

  • PO: 75 mg qday
  • Mechanism: IIb/IIIa inhibition (IIb/IIIa normally acts as receptor for fibrinogen, vitronectin, fibronectin, and vWF) -> prevents cross-linking of platelets by fibrin -> inhibits platelet aggregation
  • SE: bleeding, neutropenia, TTP, rash

Clonazepam (Klonopin)

  • PO: 0.25-0.5 BID-TID

Clonidine ()

  • PO: 0.1
  • Patch:

Colace

  • PO: 100 mg BID

Conjugated Estrogens

  • IV (plt dysfunction):

Conivaptan (Vaprisol)

  • IV (euvolemic hyponatremia): 20 mg bolus, then 20 mg over 24hrs
  • SE:

Cyclosporin A (Sandimmune, Neoral)

  • PO: 7-9 mg/kg/day given q12hrs

Dabigatran (Pradaxa)

  • PO:
  • Renal Dose-Adjustment:

Daptomycin (Cubicin)

  • Cyclic lipopeptide (inserts lipophilic tail into bacterial cell membrane causing cell wall depolarization/unlike Vanco+beta lactams, does not cause endotoxin release) -> bactericidal
  • Synergy with: aminoglycosides, rifampin
  • IV: 4-6 mg/kg q24hrs
  • Renal: requires dose reduction
  • SE: ARF, arrhythmias, hypersensitivity, anaphylaxis, anemia/thrombocytopenia, rhabdo, N/V/D, rash, elevated LFT’s, hypotension
  • Penetration: not into CNS or lung (inactivated by surfactant)
  • Coverage: MSSA+MRSA, Strep, VRE (complicated SSSI, bacteremia)
  • FDA-Approved: complicated SSSI, Staph bacteremia with/without right-sided or native valve endocarditis

DDAVP

  • IV (Pre-Procedure): 0.3 ug/kg x 1
  • SE:

Dexamethasone (Decadron)

  • PO: 4-6 mg q6hrs
  • IV: 4-6 mg q6hrs

Dexmedetomidine (Precedex)

  • IV: 0.2-0.7 ug/kg/hr
  • Mechanism: alpha-2 adrenergic receptor agonist -> sedative sympatholytic analgesic properties
  • Half-Life: 2 hrs
  • SE: bradycardia, hypotension, no resp depression
  • Renal: none
  • Hepatic: ?

Digoxin (Lanoxin)

  • PO or IV Maint: 0.125-0.25 mg qday
  • IV Load: 0.25 mg q2hrs x 4

Diltiazem (Cardizem)

  • PO:
    • Dilt: 30-90 mg q6hrs
    • Dilt-CD: 180-360 mg qday
  • IV Push: 5-10 mg
  • IV Drip: 5-15 mg/hr

Diphenhydramine (Benadryl)

  • PO/IV: 25-50 mg q6hrs PRN (max: 400 mg qday)

Divalproex (Depakote)

  • PO (Ext Rel=ER): 10-15 mg/kg/day divided qday-TID
  • Follow valproic acid levels

Dobutamine (Dobutrex)

  • IV: 2-20 ug/kg/min

Dopamine ()

  • IV: 1-20 ug/kg/min

Doxazosin (Cardura)

  • PO: 1-4 mg qday

Drotrecogin Alfa (Xigris)

  • IV: 24 ug/kg/h x 96hrs
  • Contraindications:

Duloxetine (Cymbalta)

  • PO: 40-60 mg qday divided qday-BID
  • SE:
  • Indications: depression/diabetic neuropathy

Edrophonium (Tensilon)

  • IV: 2 mg over 15-30 sec (if no response in 45 sec, give additional 8 mg)
  • May repeat test in 30 min

Enalapril (Vasotec)

  • PO: 2.5-20 mg BID
  • IV: 0.625 mg initially, then 1.25 mg q6hrs

Enoxaparin (Lovenox)

  • SQ-Proph: 40 mg qday or 30 mg BID
  • SQ-Ther: 1 mg/kg q12hrs
    (max: 160 mg q12 hrs)
  • Renal: dose-adjust in renal insufficiency
  • Reversal: none (not neutralized by protamine)

Epinephrine

  • IV Drip: 2-10 ug/min
  • IV-Code (1:10,000): 1 mg
  • ETT-Code (1:10,000): 2 mg
  • Anaphylaxis (1:1000): 0.3 mg SQ or IM or IV
    • Dosage range = 0.3 mg (same as epi-pen) – 1 mg (max single dose)
    • Route: IM into thigh is preferred over SQ route in non-code situation, IV route is preferred in code situation

Epoprostenol (Flolan)

  • IV: start at 2 ng/kg/min
  • SE:

Erlotinib (Tarceva)

  • PO (NSC Lung Ca): 150 mg qday

Ertapenem (Invanz)

  • IV:
  • SE:
  • Coverage:

Escitalopram (Lexapro)

  • PO: 10-20 mg qday

Esmolol (Brevibloc)

  • IV Load: 500 ug/kg
  • IV Drip: 50-300 ug/kg/min

Ethacrynic Acid

  • IV: 50-100 mg qday-BID

Ethambutol

  • PO: 15 mg/kg qday (max: 1600 mg/day)

Etomidate

  • IV (over 30-60 sec): 0.3 mg/kg
  • SE: 11-beta-hydroxylase inhibition -> adrenal suppression for up to 24 hrs (usually only 4-8 hrs in healthy pts)

Ezetimibe (Zetia)

  • PO: 10 mg qday

Ezetimibe/Simvastatin (Vytorin)

  • PO (10/20, 10/40, 10/80): 1 tab qPM

Factor 9 Concentrate

  • IV: 30 IU/kg IV -> check INR q6hrs x 24hrs
    • May need to give concomitant vitamin K, as factor 9 half-life is short
  • Physiology: vitamin K-dependent clotting factor
  • Half-Life: 18-24hrs
  • Indications: acute hemorrhage in setting of anticoagulation

Famotidine (Pepcid)

  • PO: 20 mg BID
  • IV: 20 mg q12hrs

Felodipine (Plendil)

  • PO: 2.5-10 mg qday

Fenofibrate (Tricor)

  • PO: 48-145 mg qday

Fentanyl

  • IV: 25 ug PRN
  • IV Drip: 25-100 ug/hr
  • TRANSDERMAL: 25-100 ug/hr

FeSO4

  • PO: 325 mg BID

Filgastrim (GCSF)

  • SQ: 300 ug qday

Finasteride (Proscar)

  • P0: 5 mg qday
  • SE: orthostatic hypotension, hypersensitivity rxn

Fluconazole (Flucon)

  • PO: 100 mg qday
  • IV: 100 mg qday

Fludrocortisone (Florinef)

  • PO: 0.1-0.2 mg qday

Flumazenil (Romazicon)

  • IV Push: 0.2 mg, 0.3 mg in 30 sec, 0.5 mg in 30 sec (max: 5 mg total dose)
  • IV Drip (after initial response): max of 3 mg/hr

Fluticasone (Flonase)

  • NASAL: 1 puff BID

Fluticasone (Flovent)

  • INH (110): 1 puff BID
  • INH (220): 1 puff BID

Fondaparinux (Arixtra)

  • SQ:
  • Renal: contraindicated with CrCl <30, use cautiously and dose-adjust in renal insuff
  • Reversal: none (not neutralized by protamine)

Formoterol (Foradil)

  • INH: 1 (12 ug) cap BID

Fosphenytoin (Cerebyx)

  • IV Load: 15-20 mg phenytoin equivalents/kg

Furosemide (Lasix)

  • Contraindication: sulfa allergy
  • PO: 20-40 mg
  • IV: 20-40 mg
  • IV Drip: 5-10 mg/hr

Gabapentin (Neurontin)

  • PO: 300-1200 mg TID
  • Indications: chronic pain, fibromyalgia

Glipizide (Glucotrol)

  • PO: 2.5-20 mg qday-BID

Glucagon

  • IV Push: 5-10 mg IV
  • IV Drip (for responders): 1-5 mg/hr

Glyburide (Diabeta/Micronase)

  • PO: 1.25-20 mg qday
  • SE:
  • Renal:

Haloperidol (Haldol)

  • PO: 1-5 mg q6hrs PRN
  • IV: 1-5 mg q6hrs PRN

Heparin

  • SQ-Proph: 5000 U q8hrs
  • IV-Bolus: 80 U/kg
  • IV-Drip: 18 U/kg/hr
  • Half-life: X min

Hydralazine (Apresoline)

  • PO: 10-50 mg QID
  • IV: 10-40 q6hrs

Hydrochlorothiazide

  • PO: 12.5-50 mg qday

Hydrocortisone

  • IV (Adrenal Insuff): 100 mg q8hrs

Hydromorphone (Dilaudid)

  • PO:
  • IV: 0.1-0.2 mg q1-2hrs
  • IV Equivalence: use about 1/6th dose of MS
  • PO Equivalence: use about 1/4th dose of MS

Hypertonic Saline:

  • IV:
  • SE:

Iloprost Inhaled (Ventavis)

  • NEB: 2.5-5 ug q2-4 hrs

Inhaled Insulin (Exubera)

  • INH:

Irbesartan (Avapro)

  • PO: 75-300 mg qday

Isoniazid (INH)

  • PO: 5 mg/kg/day (max: 300 mg/day)
  • Always use with pyridoxine supp

Isoproterenol (Isuprel)

  • IV Drip:

Itraconazole (Sporanox)

  • PO: 200 mg qday-BID

Kayexelate

  • PO: 15 g PRN
  • Enema: 30-50 g PR PRN

Ketorolac (Toradol)

  • IV: 15-30 mg q6hrs PRN

Labetalol (Trandate, Normodyne)

  • Physiology: selective α1-adrenergic + nonselective ß-adrenergic receptor blockade -> AV nodal blockade + vasodilation
  • PO: 100-200 mg BID
  • IV: 20-80 mg q6hrs
  • IV Drip: 1-2 mg/min

Lactulose

  • PO: 30 cc q1hr until BM, then titrate to 2-3 soft BM qday
  • Enema: 300 ml PR q4-6hrs

Lamotrigine (Lamictal)

  • PO:

Lantus (Insulin Glargine)

  • Onset 1 hr, no true peak, duration 24 hrs
  • SQ: usually 0.5-1 U/kg/day

Levalbuterol (Xopenex)

  • NEB (not mixed with other nebs): 0.63-1.25 mg q6hrs
  • INH (HFA): 2 puffs q4-6hrs PRN

Levatiracetam (Keppra)

  • PO: 500-1500 mg q12hrs
  • IV: 500-1500 mg q12hrs

Lepirudin ()

  • IV Bolus: 0.4 mg/kg (max: 44 mg)
  • IV Maint: 16.5 mg/hr (adjust to PTT of 1.5-2.5x control)
  • Cautious use in renal insufficiency

Levofloxacin (Levaquin):

  • PO:
  • IV:
  • SE: Q-T prolongation
  • Penetration:
  • Coverage: Pneumococcus, H flu, Pseudomonas, Atypicals (Moraxella, Chlamydia Pneumoniae/Legionella/Mycoplasma Pneumoniae)

Levothyroxine (Synthroid)

  • PO: start 25 ug qday, adjust by 12.5-25 ug q4-8 wks based on TSH
  • IV: give half of PO dose

Lidocaine

  • IV-VT: 100 mg bolus (may repeat 50 mg), then 1-2 mg/min drip
  • ETT-VT:

Linezolid (Zyvox)

  • Oxazolidinone antibiotic (binds to 50s ribosomal subunit)
  • PO: 600 mg q12hrs
  • IV: 600 mg q12hrs
  • Renal: no dose adjustment needed
  • Hepatic: no dose adjustment needed
  • SE: thrombocytopenia/cytopenias, lactic acidosis (case reports), neuropathy, optic neuropathy/vision loss, serotonin syndrome, N/V/D, headache, fever
  • Penetration:
  • Coverage: MSSA+MRSA (pneumonia, skin), VRE, Strep
  • FDA-Approved: VRE, HAP/CAP, complicated and uncomplicated SSSI

Lisinopril ()

  • PO: 10-40 mg qday
  • SE: hyperkalemia, cough

Lithium ()

  • PO: 900-1200 mg qday divided TID-QID
  • SE:

Lorazepam (Ativan)

  • IV: 1-2 mg PRN

Losartan (Cozaar)

  • PO: 25-100 mg qday

Lovastatin (Mevacor)

  • PO: 10-80 qday

Mannitol

  • IV: 25 g q8hrs
  • Indications:
  • Removed with CVVHD

Magnesium Sulfate

  • IV: 1-2 g over 2 hrs

Meperidine (Demerol)

  • IV: 12.5-25 mg IV PRN

Metformin (Glucophage)

  • PO: 500-850 mg BID
  • SE: lactic acidosis, megaloblastic anemia, N/V/D, headache, rash
  • Renal: contraindicated
  • Hepatic: avoid use

Methadone

  • PO: start 2.5-10 mg q12hrs
  • IV:

Methimazole (Tapazole)

  • PO: 5-15 mg qday
  • SE: cytopenias, hepatitis, nephritis, rash, N/V, myalgias/arthralgias
  • Renal: no adjustment
  • Hepatic: avoid use in hepatitis

Methylene Blue (see [[Methylene Blue]])

  • Indications: [[Methemoglobinemia]]
  • Dosing: 1-2 mL/kg (of 1% soln) IV over 5 min
  • Side Effects
    • Hemolysis (with higher doses)
    • Methylene blue is less effective and may exacerbate hemolysis in patients with G6PD deficiency (G6PD deficient cells clear /MetHb slowly in response to methylene blue) -> use cautiously in these patients

Methylprednisolone (Solumedrol)

  • IV: 125 mg, then 60 mg q6hrs

Metoclopramide (Reglan)

  • IV: 5-10 mg q6-8hrs
  • PO: 5-10 mg QID

Metolazone (Zaroxylyn)

  • PO: 5 mg qday-BID

Metoprolol (Lopressor)

(PO Dose = 2.5 x IV Dose)
– PO (XL): 25-400 mg qday
– IV: 5 mg IV q6hrs (equivalent to PO: 25 mg BID)
– IV: 10 mg IV q6hrs (equivalent to PO: 50 mg BID)


Metronidazole (Flagyl)

  • PO:
  • IV:
  • SE:

Micafungin ()

  • IV:
  • Coverage:

Midazolam (Versed)

  • IV: 1-2 mg PRN

Midodrine ()

  • PO: 10 mg TID

Milrinone (Primacor)

  • Physiology: phosphodiesterase inhibitor -> positive inotrope and vasodilator
  • IV Load: 50 ug/kg
  • IV Drip: 0.375 ug/kg/min (max: 0.75 ug/kg/min)
  • SE: ventricular arrhythmias, hypotension, torsade (rare), headache

Miralax

  • PO: 17 g qday

Montelukast (Singulair)

  • PO: 10 mg qday

Morphine

  • PO:
  • IV: 2-4 mg q2-4 hrs

Moxifloxacin (Avelox)

  • PO:

Mycophenolate (Cellcept)

  • PO (Liver Transplant Proph): 1.5 g BID
  • PO (Kidney Transplant Proph): 1g BID
  • SE:
  • Levels available

Narcan

  • IV: 1 amp PRN
  • IV Drip:
  • PO: 4.5 mg q6hrs (hold for diarrhea)
  • SE: antagonism of opiates

Nesiritide (Natrecor)

  • Physiology: recomb human BNP -> venous and arterial vasodilation
  • IV:
  • SE: hypotension, bradycardia, N/V

Nicardipine (Cardene)

  • IV Drip: start 5 mg/hr, increase in increments of 2.5 mg/hr to max 15 mg/hr (at goal BP, decrease to 3 mg/hr)
  • PO: 20-40 TID
  • SE: angina exacerbation, AV block (rare), headache, edema, dizziness, flushing, hypotension, tachycardia, N/V, palpitations

Nifedipine (Procardia)

  • PO: 10 mg TID

Nitroglycerine

  • IV Drip: 20-200 ug/min

Nitropaste

  • TOP: 1/2-1 inch q6hrs

Nitropatch (Nitrodur)

  • TOP: 0.2-0.4 mg/hr (remove at night)

Nitroprusside (Nipride)

  • IV Drip: X ug/kg/min

Norepinephrine (Levophed)

  • IV Drip: 1-X ug/min

Normal Saline

  • IV (contains 154 mEq Na per L):

Nortriptyline (Pamelor)

  • PO: 50-150 mg qHS

NPH Insulin

  • Onset 1-2 hrs, peak 4-14 hrs, duration 10 to >24 hrs

Nystatin

  • ORAL: 5 ml QID S+S

Octreotide

  • IV Drip: 50 ug/hr

Olanzapine (Zyprexa)

  • Indication: schizophrenia, bipolar
  • PO: 5-20 mg qday

Olmesartan (Benicar)

  • PO: 20-40 mg qday

Omalizumab (Xolair)

  • SQ: 150-375 mg q2-4 wks

Ondansetron (Zofran)

  • IV: 4-8 mg q8hrs PRN

Oseltamivir (Tamiflu)

  • PO: 75 mg BID x 5 days

Oxcarbazepine (Trileptal)

  • PO: 300-600 mg BID (max: 1200 mg BID)

Oxubutynin (Ditropan)

  • PO (Regular): 5 mg BID-TID
  • PO (Ext Release): 5-15 mg qday

Oxycodone (Oxycontin)

  • PO: 10-160 mg q12hrs

Pancuronium (Pavulon)

  • IV:

Pantoprazole (Protonix)

  • PO: 40 mg qday
  • IV: 40 mg qday
  • IV Drip: load with 40-80 mg bolus, then 8 mg/hr drip

Paroxetine (Paxil)

  • PO: 20-50 mg qday

Phenylephrine (Neosynephrine)

  • IV Drip: 20-200

Phenytoin (Dilantin)

  • PO: 100 mg TID
  • IV Load: 15-20 mg/kg (usually 1 g) over 1 hr
  • IV Maint:

Physostigmine ()

  • IV: 0.5-2 mg PRN
  • Indications: anticholinergic intoxication
  • Have atropine available

Piperacillin/Tazobactam (Zosyn)

  • IV:
  • SE:
  • Penetration:
  • Coverage: anaerobes, GNR, Pseudomonas

Posaconazole ()

  • PO (invasive fungal infections): 200 mg TID
  • SE:
  • Coverage: Aspergillus

Potassium Phosphate

  • IV: 16 mEq (12 mmol) over 2 hrs

Pralidoxime (2-PAM)

  • IV: 1-2 g
  • Indications: organophosphate intoxication

Prasugrel (X)

  • PO:

Pravastatin (Pravachol)

  • PO: 10-80 mg qday

Prednisone

  • PO: 60 mg qday, then taper

Pregabalin (Lyrica)

  • PO: 50-100 mg TID
  • Indications: fibromyalgia

Procainamide ()

  • IV Load:
  • SE: procainamide-induced positive ANA (occurs in 60-70% of chronically treated cases), procainamide induced SLE (occurs in 20% of cases) -> reverses with discontinuation of drug, granulocytosis

Prochlorperazine Maleate (Compazine):

  • PO: 10 mg q6-8hrs
  • IV: 10 mg q6-8hrs
  • SE: NMS, dystonia, blood dyscrasias, hypotension, QT prolongation

Promethazine (Phenergan)

  • IV: 12.5-25 mg q6hrs PRN

Propafenone (Rhythmol)

  • PO: 150 mg q8hrs

Propofol (Diprivan)

  • IV Drip: 10-60 ug/kg/min

Propanolol ()

  • PO: 40-240 mg BID

Prostacyclin (Flolan): aka Epoprostanol

  • IV Drip: start at 2 ng/kg/min, increase by 1-2 ng/kg/min q15 min based on response
  • SE: headache, thrombocytopenia, pulm edema, N/V, hypotension, jaw pain

Protamine Sulfate

  • IV: 1-1.5 mg per 100 U heparin (max: 50 mg per dose)

Pyrazinamide (PZA)

  • PO: 20-25 mg/kg/day (max: 2 g/day)

Pyridostigmine (Mestinon)

  • PO: start 60 mg q8hrs, then 60-120 mg q3-8 hrs (max: 1500 mg qday)

Pyridoxine (Vitamin )

  • PO (with INH): 25-50 qday

Quetiapine (Seroquel)

  • PO: 50-250 mg TID

Ramipril (Altace)

  • PO: 2.5-20 mg qday

Regular (Humulin) Insulin

  • Onset: X, peak: X hrs, duration: X hrs
  • SQ:

Rifampin ()

  • PO/IV: 10 mg/kg qday (max: 600 mg qday)
  • SE:

Rifaximin

  • PO: 400 mg TID ????
  • Indications: hepatic encephalopathy

Risperidone (Risperdal)

  • PO (schizo/mania): 1-4 mg qday (in elderly, start 0.5 mg BID)

Rosuvastatin (Crestor)

  • PO: 5-40 mg qday

Salmeterol (Serevent)

  • INH: 1 (50 ug) cap BID

Selegiline (Eldepryl)

  • PO: 5 mg BID
  • Indications: Parkinson’s

Sertraline (Zoloft)

  • PO: 50-200 mg qday

Sildenafil (Revatio, Viagra)

  • PO: 20 mg TID

Simvastatin (Zocor)

  • PO: 5-80 mg qHS

Sirolimus (Rapamune)

  • PO: 1 mg/m2 qday (max: 40 qday)

Sodium Bicarbonate Drip

  • IV: 3 amps in 1 L D5W (contains 150 mEq Na per L, similar to NS), run at 50-100 ml/hr

Sodium Chloride

  • PO: 2 g TID

Sodium Colistimethate (aka Colistin, Polymyxin E)

  • IV:
  • Inh:

Sodium Phosphate

  • IV: 10-20 mEq (7.5-15 mmol) over 3 hrs

Sotalol (Betapace)

  • PO: 80-160 mg q12hrs

Spironolactone (Aldactone)

  • Potassium-sparing diureti
  • PO:

Tacrolimus (Prograf)

  • PO (Liver Transplant): 0.1-0.15 mg/kg/day given q12hrs
  • IV:
  • SE:

Tamsulosin (Flomax)

  • PO: 0.4 mg qday

Televancin (Vibativ)

  • Lipoglycopeptide antibiotic (inhibits bacterial cell wall synthesis and disrupts bacterial cell membrane function)
  • IV:
  • SE:
  • Penetration:
  • Coverage: MSSA MRSA

Telmisartan (Micardis)

  • PO:

Tigecycline (Tygacil)

  • Glycylcycline derived from tetracylines (binds to 30s ribosomal subunit) -> bacteriostatic
  • IV: 100 mg load, then 50 mg q12hrs
  • Metabolism: hepatic metabolism
  • SE: N/V, headache, pruritus
  • Penetration: not into CNS or kidneys
  • Coverage: Skin (MSSA+MRSA, Strep, Enterococcus+VRE, Anaerobes), Abdominal (Klebsiella, E coli, Acinetobacter, Stenotrophomonas, Citrobacter, Serratia, Anaerobes), in vitro against Mycobacteria
  • Lack of Coverage: Pseudomonas, limited against Proteus+Providencia
  • FDA-Aproved: complicated SSSI, abdominal infections
  • FDA-Pending?: HAP/VAP

Tiotropium (Spiriva)

  • INH: 1 cap qday
  • SE:

Topiramate (Topamax)

  • PO: start 25 mg qHS, increase q2wks to max 100 mg BID

Torsemide (Demadex)

  • PO: 10-200 mg qday

Tramadol (Ultram)

  • PO: start 25 mg qAM, then increase slowly to 50-100 mg q4-6 hrs

Treprostinil

  • IV (Remodulin): start 1.25 ng/kg/min, increase q4wks
  • Inh (Tyvaso):

Ursodiol (Actigall)

  • PO: 8-10 mg/kg qday divided qday-TID

Valacyclovir (Valtrex)

  • PO (suppression): 1000 mg qday

Valganciclovir (Valcyte)

  • PO: 900 mg qday x 100 days

Valproic Acid (Depacon)

  • IV: typical dose 500 mg IV over 30 min
  • Follow valproic acid levels

Valsartan (Diovan)

  • PO: 80-320 mg qday
  • SE:
  • Interaction: avoid use with ACE-I (increased risk of hyperkalemia)

Vancomycin ()

  • Glycopeptide antibiotic (inhibits cell wall synthesis) ->
  • PO:
  • IV:
  • SE: “red man” syndrome (histamine-related pruritic erythematous rash/hypotension) due to high dose rapid infusion (treatment is to slow infusion rate and use H1/H2 antihistamines and vasopressors), local pain/thrombophlebitis, thrombocytopenia
  • Interaction: high heparin concentrations may inactivate Vanco
  • Coverage: MSSA MRSA

Vardenafil (Levitra)

  • PO: 5-10 mg x 1

Varenicicline (Chantix)

  • PO: 1 mg BID x 12 wks

Vasopressin

  • IV Drip (Sepsis, Pressor-Low Dose): 0.04 U/min

Vecuronium

  • IV: x ug/kg/min

Venlafaxine (Effexor)

  • PO: 37.5-75 mg BID-TID

Verapamil (Calan)

  • PO: 80-120 mg TID
  • PO (SR): 180-480 qday

Vitamin K

  • SQ: 10 mg qday x 3
  • IV: 10 mg slow IV push

Voriconazole (Vfend)

  • PO: 300-600 mg qday (or 200 mg q12hrs following IV loading dose)
  • IV: 4 mg/kg q12 hrs
  • SE: transient visual disturbance
  • Coverage: Aspergillus

Zafirlukast (Accolate)

  • PO:
  • SE:

Zileuton (Zyflo)

  • PO: 600 mg QID

Zolpidem (Ambien)

  • PO: 5-10 mg qHS
  • No significant respiratory depression