drug study (romel cruz hospital)

Name of the Drug Action Indications Dosages Contraindications Adverse Reactions

Generic Name:Acetazolamide

Brand Name: (Philippines) Diamox

Inhibits carbonic anhydrase activity. As an anticonvulsant, inhibition of carbonic anhydrase in the CNS increases carbon dioxide tension resulting to decrease neuronal conduction. As a diuretic, inhibition of carbonic anhydrase in the kidney decreases formation of bicarbonate and hydrogen ions for active transport. Inhibition of carbonic anhydrase in the eye decreases aqueous humor which lowers intraocular pressure.

Adjunctive treatment of chronic simple (open angle) glaucoma and secondary glaucoma.

Preoperative treatment of acute congestive (closed-angle) glaucoma.

Prevention or lessening of symptoms associated with acute mountain sickness.

Adjunctive treatment of (1) edema caused by CHF or drug-induced edema and (2) centrencephalic epilepsies (e.g. petit mal, generalized seizures)

Take with food. Do not crush sustained-release capsules. Glaucoma: 250mg to 1g/day in divided doses.Epilepsy: 8-30 mg/kg BW in divided doses. Range: 375mg to 1 g daily.CHF: 250-375 mg once a day.Drug-induced edema: 250-375 mg once a day for 1-2 days.

Hypersensitivity to sulfonamides, severe renal or hepatic disease, electrolyte imbalances (hyponatremia, hypokalemia), hyperchloremic acidosis, Addison’s disease, long term use in narrow-angle glaucoma.

CNS: drowsiness, anxiety, depression, headache, dizziness, confusion, stimulation, fatigue, seizure, sedation, nervousnessEndocrine: hyperglycemia, hypokalemia, hypocalcemia, hypomagnesia, hyponatremia, hyperchloremiaEENT: myopia, tinnitus, photosensitivitySkin: paresthesia, purpura, rash, pruritis, urticariaGI: nausea, vomiting, anorexia, constipation, diarrhea, melena, weight loss, hepatic insufficiency, taste alterationsGU: polyuria, uremia, glucosuria, hematuria, dysuria, crystalluria, renal calculiHematologic: Aplastic anemia,

hemolytic anemia, leucopenia, agranulocytosis, thrombocytopenia, pancytopeniaOther: fever, Stevens-Johnson syndrome

Name of the Drug

Action Indications Dosages Contraindications Adverse Reactions

Generic Name:Amikacin

Brand Name: (Philippines) Amikacide, Amikin, Cidacid, Kormakin, Nica

Binds to bacterial ribosomal subunit to cause misreading of the genetic code which leads to inaccurate peptide sequence of protein synthesis and bacteria death.

Route Onset Peak

IM Rapid15-30 mins

IV Rapid1-2 hrs

Treatment of infections caused by susceptible strains of microorganisms, especially gram-negative bacteria.

Adults, Children, and Infants: IV/IM 15mg/kg(ideal body weight)/day in 2 or 3 divided doses. Treatment in heavier patients should not exceed 1.5g/dayUncomplicated UTIs: IV/IM 250 mg BID.Newborns: IV/IM Loading dose of 10 mg/kg is recommended followed by 7.5 mg/kg every 12hrs. Lower doses may be needed in first 2 weeks of life.

Hypersensitivity to amikacin. History of hypersensitivity or serious toxic reactions to aminoglycosides.

CNS: loss of balanceEENT: hearing loss, deafnessGU: oliguria, proteinuria, increase serum creatinine, urinary casts, red and white blood cells in urine, azotemia, decreased serum magnesium

Name of the Drug

Action Indications DosagesContraindication

sAdverse Reactions

Generic Name:Aminophylline

Brand Name: Corophyllin , Paladron , Phyllocontin, Somophyllin, Somophyllin-DF, Truphylline

Aminophylline is a combination of theophylline and ethylenediamine. Ethylenediamine is inactive; it increases the solubility of theophylline in water. Theophylline relaxes bronchial smooth muscle. Suggested mechanisms are an increase in intracellular cAMP through inhibition of phosphodiesterase; adenosine receptor antagonism, prostaglandin antagonism and effects on intracellular calcium.

Management of bronchospasm

Relieve apnea in neonates

Bronchospasm: Adult: IV Loading Dose 6 mg/kg over 30 min. IV Maintenance Dose nonsmoker, 0.5 mg/kg/h; smoker, 0.75 mg/kg/h; CHF or cirrhosis, 0.25 mg/kg/h. PO nonsmoker, 0.5 mg/kg/h times 24 h in 4 divided doses; smoker, 0.75 mg/kg/h times 24 h in 4 divided doses; CHF or cirrhosis, 0.25 mg/kg/h times 24 h in 4 divided dosesChild: IV Loading Dose 6 mg/kg IV over 30 min. IV Maintenance Dose 1–9 y, 1 mg/kg/h; >9 y, 0.75 mg/kg/h. PO 1–9 y, 1 mg/kg/h times 24 h in 4 divided doses; >9 y, 0.75 mg/kg/h times 24 h in 4 divided doses

Hypersensitivity to xanthine derivatives or to ethylenediamine component; cardiac arrhythmias.

.

CNS: Nervousness, restlessness, depression, insomnia, irritability, headache, dizziness, muscle hyperactivity, convulsions. CV: Cardiac arrhythmias, tachycardia (with rapid IV), hyperventilation, chest pain, severe hypotension, cardiac arrest. GI: Nausea, vomiting, anorexia, hematemesis, diarrhea, epigastric pain.

Infant: PO/IV 6–11 mo, 0.87 g/kg/h; 2–6 mo, 0.5 mg/kg/hNeonate: PO/IV 0.16 mg/kg/hNeonatal Apnea: PO/IV Loading Dose:5 mg/kg. PO /IV Maintenance Dose 5 mg/kg/d divided q12h

Name of the Drug

Action Indications Dosages ContraindicationsAdverse

ReactionsGeneric Name:Amphotericin B

Brand Name: (Philippines) Fungizone

Binds to sterol in the fungal cell membrane causing alteration in membrane permeability, leading to leakage of intracellular components.

Route Onset Peak

IVImmedi

ate1-2 hrs

Treatment of progressive, potentially fatal infections caused by certain fungal species.

Amphotericin B desoxycholate: Treatment of Maerican mucocutaneous leishmaniasis.

Amphotericin lipid- based: treatment of invasive fungal infections in patients refractory to conventional amphotericin B desoxylate or when renal impairment or

Amphotericin B desoxycholate: Adults: IV test dose of 0.05 mg/ml infused slowly over 20 to 30 mins. Systemic Fungal Infections: Adults: IV initial recommended dose 0.25 to 0.3 mg/kg/day infused slowly over 2 to 6 hrs. Dose increased gradually up to 0.5 to 0.7 mg/kg/day and up to 1.5 mg/kg/day for some mycoses (maximum daily dose 1.5 mg/kg/day). Daily dose varies

Hypersensitivity, severe bone marrow depression.

CNS: headacheGI: anorexia, weight loss, nausea, vomiting dyspepsia, diarrheOther: fever, malaise

unacceptable toxicity precludes use of the desoxycholate formulation (lipoid complex)

Treatment of infections caused by Aspergillus, Candida, or Cryptococcus species (liposomal)

Empirical treatment of febrile, neutropenic patients with presumed fungal infections

Treatment of visceral leishmaniasis.

Amphotericin B cholestryl: treatment of invasive aspergillosis.

Amphotericin B (topical): treatment of cutaneous mycotic infections caused by Candida sp.

with type of infection, ranging from 0.5 to 1.5 mg/kg/day for 4 to 12 wks. However, aspergillosis regimen is 1 to 1.5 mg/kg/day up to a total treatment dose of 3.6 gRhinocerebral phycomysis regimen: 0.25 to 1.5 mg/kg/day to a total treatment dose of 3 to 4 g.Sporotrichosis regimen: 0.5 mg/kg/day up to a total treatment dose of 2.5g.

Name of the Drug Action Indications DosagesContraindicatio

nsAdverse Reactions

Generic Name:Ampicillin (Ampicillin Trihydrate)

Brand Name: (Philippines)

Interferes with cell wall synthesis of susceptible organisms, preventing bacterial multiplication, it also renders the cell wall osmotically unstable and burst due to osmotic pressure.

Treatment of respiratory tract and soft tissue infections, bacterial

Administer 1 hr before or 2 hrs after a meal.Adults: Orally/IV/IM 50 to 200 mg/kg/day in divided doses

Hypersensitivity to penicillins, cephalosporins or imipenem. Oral form not used to treat severe pneumonia,

CNS: dizziness, neurotoxicity, Endocrine: EENT: itchy eyes, laryngospasms, laryngeal edemaSkin: urticaria,

Ampicin, Amplivacil, Bactimed, Celidam, DLI Ampicillin, Drugmaker’s Biotech Ampicillin, Eurocin, Genaxcin, Panacta, Penbritin, Pentrexyl, Picaplin, Saloxin, Shinapen, Vatacil

Deactivated by beta-lactamase, an enzyme by resistant bacteria.

Route Onset PeakPO Rapid 2 hrsIM Rapid 1 hr

IV RapidInfusions

meningitis, septicemia and gonoccocal infections caused by susceptible microorganisms.

Prophylaxis in rape victims and for bacterial endocarditis.

every 4 to 6 hours.Infants >7 days and >2000g: IV/IM 100mg/kg/day in divided doses every 6 hrs.Infants >7 days and <2000g: IV/IM 75 mg/kg/day in divided doses every 8 hrs.Infants <7 days and >2000g: IV/IM 7 mg/kg/day in divided doses every 8 hours.Infants <7 days and <2000g: IV/IM 50 mg/kg/day in divided doses every 12 hrs.

emphysema, bacteremia, pericarditis and purulent or septic arthritis during acute stage.

maculopapular to exfoliative dermatitis, vesicular eruptions, erythema multiforme, skin rashesGI: diarrhea, pseudomembranous colitisGU: interstitial nephritis, nephropathy, increased BUN and creatinine, vaginitis,Hematologic: thrombophlebitis at injection site, dcreased Hgb, Hct, RBC, WBC, neutrophils, eosinophils and platelets elevated serum alkaline phosphatase, glutamic oxaloacetic transaminase, ALT, AST, and LDH, reduced serum albumin, and total proteinsOther: fatigue, insomnia, reversible hyperactivity, pain at injection site, hyperthermia


Generic Name:Cloxacillin


Interferes with cell wall replication of susceptible organisms, the cell wall, rendered osmotically unstable, swell, bursts from

Treatment of infections caused by pneumococci, Group A beta-hemolytic streptococci, and

Give on an empty stomach atleast 1 hr before or 2 hrs after meals unless otherwise advised by

History of hypersensitivity to penicillins and cephallosporins. Sever pneumonia,

CNS: Endocrine: EENT: occasionally, laryngeal edema,

Avastoph, Cibacter, Drugmaker’s Biotech Cloxacillin, Encloxil, Lewinex, Medix, Myrex Cloxacillin, Orbenin, Oxaclen, Pannox, Patriflex, Pharex Cloxacillin, Prostaphlin-A, Ritemed Cloxacillin, Secloxin

osmotic pressure; resists the penicillinase action that inactivates penicillins.

Route Onset PeakPO ½ hr 1/2

penicillin G sensitive staphylococci.

Sinusitis, skin and soft tissue infections, bones and joint infections, respiratory and urinary tract infections, genitourinary infections, ear, nose and throat infections.

Otitis media, endocarditis, septicemia, meningitis

Prophylaxis: Staphylococcal infection during major cardiovascular and orthopedic surgery.

physician.Mild to moderate upper respiratory and localized skin and soft tissue infections: Adult and Pedia more than 12 y/o: 250 mg every 6 hrs. Pedia less than 20 kg: 50 mg/kg/day in equally divided doses every 6 hours or as prescribed.Severe infections: Adult and Pedia more than 12 y/o: 50Omg-1g every 6 hrs. Pedia less than 20 kg: 100 mg/kg/day or more in equally divided doses every 6 hours or as prescribed.Vial: Usual dose 250mg by IM every 4 to 6 hrs or 500mg may be given by slow IV inj over 3 to 4 mins every 4 to 6 hrs or by IV infusion. Children aged 2 to 10 yrs: ½ the adult dose.Children up to 2y/o:1/4 the adult dose or as prescribed.

emphysema, bacteremia, pericarditis, meningitis and purulent and septic arthritis during the acute the stage. Sub-conjunctival infections.

Skin: urticaria, skin rashes, exfoliative dermatitis, rashGI: GI disturbances, nausea, vomiting, epigastric distress, diarrhea and flatulence, antibiotic-associated pseudomembranous colitisGU: interstitial nephritis and vasculitisHematologic: eosinophilia, agranulocytosis, anemia, thrombocytopenia, transient rise in transminases and alkaline phophataseOther: hypersensitivity reactions, serum sickness-like reactions, fever,

Name of the Drug


ReactionsGeneric Name:Cefazolin

Brand Name: (Philippines) Fonvicol, Ilozef, Lupex, Stancef

Inhibits bacterial cell wall synthesis, thus promoting osmotic instability which eventually leads to bacterial cell death.

Route

Onset Peak Duration

IM Rapid 1-2 hrs 6-12 hrs

IV10

minsInfusion

s end

Infections caused by staphylococcus, streptococcus, E.Coli, D. pneumonia, Proteus spp. And other susceptible microorganisms. Respiratory tract infections, genitourinary tract infections, gynecological infections, skin and skin structure infections, pre- and post-operative wound and trauma, biliary tract infections bone and joint infections, perioperative prophylaxis.

Adult IM or IV: 500mg to 1g very 8 to 12 hrs. usual maximum daily dose: 6 g, up to 126 in severe life-threatening infections. Children over 1 month: 25-50 mg/kg BW daily in 3 or 4 divided doses, increased in severe infections to a maximum of 100 mg/kg daily. Surgical Prophylaxis: 1g 3o minto 1 hr before the operation, followed by 500 mg to 1g during surgery for lengthy procedure. A dose of 0.5 to 1g is given every 6-8 hrs post-operative for 24 hrs or up to 5 days in certain cases.For patients with renal impairment: initial dose of 500mg through IV route – severe and very severe infections Creatinine clearance

Allergy to penicillins and cephalosporins.

Skin: skin rashGI: nausea, vomiting, anorexia, diarrhea, oral thrushHematologic: eosinophilia, leucopenia, reversible thrombopenia, transient rise in SGOT, SGPT and alkaline phosphatesOther: allergy, fever, shock, Vit B group deficiencies

Treatment of septicemia and endocarditis.

50-20mL/min: 500mg every 12 hrs; 20-10mL/min: 500mg every 24hrs; 10-5 mL/min: 500mg every 48-72 hrs; less than 5mL/min in patients undergoing hemodialysis: 500mg every 72 hrs. Less severe infections Creatinine clearance 50-20mL/min:120-250mg every 12 hrs; 20-10mL/min:120-250 mg every 24 hrs; 10-15 mL/min: 75-125 mf every 24 hrs; less than 5 mL/min in patients undergoing dialysis: 50-75mg every 72hrs.

Name of the Drug


ReactionsGeneric Name:Cefoperazone

Brand Name: (Philippines) Bactizon, Endure Medical Cefoperazone

Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death.

Route Onset Peak Duration

IMunknow

n1-2 hrs

unknown

IVimmedia

teimmediat

eunknow

n

RTI, UTI, peritonitis, cholesystitis, cholangitis, and other intraabdominal infections.

Septicemia, menigitits, skin and soft tissue infections, bone

Adult 1:1 ratio: 2-4g or 1:2 ratio: 1.5-3g. Administer 12 hrly in equally divided doses. Severe or refractory infections: dose may be increased up to

Allergy to penicillins sulbactam or cephalosporins.

CNS: headacheCV: hypotensionSkin: mucopapular rash, urticaria, pruritusGI: diarrhea, nausea, vomiting, pseudomembranous colitis

and joint infections

PID, endometriosis, gonorrhea, and other genital tract infections.

8 g of the 1:1 ratio or 12g of the 1:2 ratio. Patients receiving the 1:1 ratio may require additional cefoperazone administered separately.Pedia 1:1 ratio: 40-80 mg/kg/day or 1:2 ratio: 30-60 mg/kg/day. Doses should be administered 6-12 hrly in equally divided doses. In serious or refractory infections, dose may be increased up to 160 mg/kg/day of the ratio 1:1 or 240 mg/kg/day of the 1:2 ratio. Doses should be admin in 2-4 equally divided doses. Neonates 1st week of life: should be given

GU: hematuria, vasculitisHematologic: leucopeniaOther: Anaphylacoidal reactions, Steven Johnson syndrome

12 hrly

Name of the Drug


ReactionsGeneric Name:Cefotaxime

Brand Name: (Philippines) Ceptax, Cladex, Claforan, Pantaxin

Inhibits bacterial cell wall synthesis, rendering cell wall osmotically unstable, leading to cell death.


IMunknow

n1-2 hrs

unknown

IVimmedia

teimmediat

eunknow

n

Treatment of infections caused by susceptible microorganisms, especially serious and life-threatening infections.

Brain abscess, gonorrhea, intensive care, Lyme disease, meningitis, peritonitis, pneumonia, septicemia, surgical infection, and typhoid fever.

Unless otherwise stated, dosage for asultsand children greater than 12 yrs is 1g every 12 hrs.Moderate to severe infections: 1-2g IV every 6-8 hrsSevere life-threatening infections: 2g IV every 4 hrs. Maximum daily dose is 12g.Prevention of post-operative infxns: 1g by IM or UV 30-90 mins before surgery. Cesarean Surgery: 1g IV immediately after the umbilical cord is clamped, and then followed by 1g IM or IV 6-12 hrs after the 1st dose.

Hypersensitivity to cephalosporins. Possibility of cross-sensitivity in patients who have shown allergy to penicillin. Intramuscular administration in conditions with impaired hemostasis and severe sepsis.

CNS: headache, confusion, fatigueGI: anorexia, diarrhea, nausea, vomiting, abdominal cramps, colitisHematologic: transient neutropenia, granulocytopenia, leucopenia, eosinophilia, thrombocytopenia, agranulocytopeniaOther: hypersensitivity reactions

Gonorrhea: 1g IM as single dose.Uncomplicated infxns: 2g or 1g as single dose given IMPatients undergoing hemodialysis: 0.5-2 daily given daily as a single dose and additional dose given after each dialysis period.

Name of the Drug


ReactionsGeneric Name:Cefoxitin

Brand Name: (Philippines) Monowel, Panafox


Route

Onset Peak Duration

IM Rapid ½ hr <6 hrs

IV immediateimmediat

eunknown

Peritonitis and other intra-abdominal and intrapelvic infections, gynecological, septicemia, endocarditis, UTI, uncomplicated gonorrhea, respiratory tract infection,

Administer through IV/IMAdult usual dose: 1g or 2g 3x/day.Renal insufficiency and undergoing hemodialysis: Loading dose: 1-2g. Maintenance dose: mild impairment: 1-2g 2x-3x per day. Moderate impairment: 1-2g once to twice a day. Severe

Allergy to penicillins and cephalosporins and people with allergic drug backgrounds.

CV: phlebitis, GI: nausea, vomitingGU: renal impairmentHematologic: Other: allergy,

bone and joint infection, skin and soft tissue infections

Endometritis, PID, and surgical infections

impairment: 0.5-1g once to 2x per day. Essentially no function: 0.5-1g once a day to every 48hrs.Uncomplicated UTI: 1g IM 2x/dayUncomplicated gonorrhea: single dose of 2g IM given with 1g of probenecid by mouth at the same time up to 1 hr before. Prophylactic dose: 2g IM/IV ½-1hr before initial incision then 2g 4x/day.CS: administer a single dose of 2g IV as soon as the umbilical cord is clamped.

Name of the Drug


ReactionsGeneric Name:Ceftazidime




IMunknow

n<1hr

unknown

Severe infections, e.g. septicemia, bacterimia, RTI, complicated

Adult: infections caused by susceptible organisms: 1g IV or IM every 8-12 hrs. Maximum

Lactation and pregnancy. Hypersensitivity to cephalosporins.

CNS: headache, dizziness, tremor, convulsionSkin: skin

Ceftavex, Fortum, Fortum, Ritemed Ceftazidime,Tazidem, Zeptrigen

IVimmedi

ateimmediat

eunknow

nand uncomplicated UTI, infxns of ENT, skin and soft tissues, GI, gynecological infxns, intra-abdominal infxns, peritonitis, meningitis infxns

Infxns associated with hemo and peritoneal dialysis.

Prostatic surgery prophylaxis

dose: 6g daily.Uncomplicated UTI: 250mg IV/IM every 12 hrsComplicated UTI: 500mg IV/IM every 8-12 hrs.Uncomplicated pneumonia or mild skin and skin structure infxns: 0.5-1g IV/IM every 8hrs.Bone&joint infxns: 2g IV every 12hrs.Meningitis: 2g IV every 8hrs.Fibrocystic patients w/pseudomonal lung infxns: 100-150mg/kg/day in 3 divided doses.Prophylactic agent in prostatic surgery: 1g at the induction of anesthetics. A 2nd

dose should be considered at the time of catheter removal.Elderly: should not exceed 3g daily

rash, maculopapular or urticarial rash, pruritusGI: diarrhea, vomiting, abdominal pain, oral thrush, colitisGU: candidiasis, vaginitisHematologic: transient hematologic changesOther: fever, anaphylaxis

Name of the Drug


Generic Name:Ceftriaxone

Brand Name: (Philippines) Forgram, Keptrix, Megion, Pantrixon, Retrokor, Ritemed Deftriaxone, Rocephin, Sergimax, Xtenda


Route

Onset Peak

IM Rapid 1 hr

IVimmediat

eInfusion’

s end

Treatment of susceptible infxns including chancroid, gastroenteritis, Lyme disease, meningitis, syphilis, typhoid fever.

Delayed stage with neurological and articular systemic manifestations.

Treatment of LRTI, skin and soft tissue infections, complicated and uncomplicated UTI, uncomplicated gonorrhea, PID, bacterial septicemia, intra-abdominal infxns, meningitis

Pre-operative prophylaxis to

Adult usual dose: 1 g/day in a single injection and up to 2g/day once daily according to the infxn severity and the patient’s bodt wt.Lyme disease: 2 g/day in a single inj. Usual therapy is 14 days long anc be up to 21 days in severe or delayed forms of disease.Prophylaxis of post-operative surgical infxns: 1g in a single dose IV/IM inj when inducing ansthesia, over 24 hrs, not exceeding 48 hrs.Susceptibility to Purpura fulminans: 1-2g or as prescribed.Pedia usual dose: 50 mg/kg/day in a

Hypersensitivity to cephalosporins and penicillin, lidocaine, or any other anaesthethic product of the amide type. Porphyria, unapplied auricular-ventricular block, cardiogenic shock.

CNS: headache, dizzinessSkin: rash, exanthema, allergic dermatitis, pruritus, urticaria, edema, erythema multiforme.GI: diarrhea, nausea, vomiting, stomatitis, glossitisGU: oliguria, crytalluria, increase in serum creatinine, mycosis of genital tractHematologic: eosinophiliam thrombocytosis, leucopenia, granulocytopenia, hemolytic anemia, thrombocytopenia

reduce chance of post-operative surgical infxns.

single inj. Lyme disease: 50-100 mg/day in a single inj for 14-21 daysMeningitis: 50-100 mg/kg/day in a single inj, 100 mg/kg is only justified as attack treatment

Name of the Drug


Generic Name:Cefradine

Brand Name: (Philippines) Altozef, Drugmaker’s Biotech Cefradine, Sedinef, Velodyne, Tolzep, Zedril

Inhibits mucopeptide synthesis in bacterial cell wall.

Route

Onset

Peak

Duration

Oral Rapid 1 hr 6hrs

IM Rapid 1-2 hrs

6 hrs

Infections caused by susceptible strains of Staphylococci, Streptopneumonia, Haemophilus Influenzae, E.Coli, Proteus mirabilis, Klebsiella sp., Streptococci, tonsillitis, phrayngitis, lobas pneumonia, bronchitis

UTI, protatitis, cystitis,

Capsule Adult: RTI and skin structure infxns: 250 mg every 6 hrs or 500mg every 12 hrs.Lobar pneumonia: 500mg every 6 hrsUncomplicated UTI: 500mg every 12hrs.Skin and skin structure infxns: 1g/day in single or divided dosesPharyngitis and tonsillitis: 1g/day in single or divided doses for 10 days.Pedia over 9mos. Age usual dose:

History of shock to this drug, hypersensitivity to cephalosporinsm and patients with known history of allergy

CNS: headache, dizziness, GI: colitis, stomatitis, glossitis, pseudomembranous colitisGU: candidiasisHematologic: eosinophilia, leucopenia, neutropenia, Other: hypersensitivity reactions

pyelonephritis, urethritis, abscess, cellulitis, impetigo, otitis media, GIT infxns.

Bones and joint infxns

CV infxns caused by Staph. Aureus, Streptococci, H. influenza, E.Coli and Klebsiella spp.

Prophylaxis of infxns during surgical operations

Treatment of post-operative infxn including vaginal hysterectomy, CS, and prosthetic arthroplasty.

25-50 mg/kg/day administered in equally divided doses every 6 or 12 hrsOtitis Media: 75-100 mg/kg/day in equally divided doses every 6 or 12 hrs, but should not exceed 4g/dayIM/IV Adults usual dose: 2-4g daily in 4 divided doses. Doses can be increased up 8 g/day for severe or chronic infxnsTreatment of infxns: 500mg 4x a day. Doses can be increased for severe or chronic infxns


Generic Name:Chloramphenicol

Brand Name: (Philippines) Alphagram, Biomycetin, Celsus Chloramphenicol Eye-Ear Drops, Chloromycetin, C-Phenicol, DLI-Chloramphenicol, Drugmaker’s Bioatech Chloramphenicol, Medimycetin, Micromycetin, Pediachlor Suspension, Penachlor, Pharex Chloramphenicol, Vamcetin

Inhibits protein synthesis in bacteria. Acts primarily by binding reversibly to the 50s ribosomal subunit.

Route Onset Peak

PO15

mins2-3 hrs

IV rapidInfusion’s

end

Typhoid fever, meningeal infection, bacteremia, meningitis or other serious infxns caused by7 susceotible strains of salmonella, Rickettsia or Chlamydia, aerobic and anaerobic bacteria, cystic fibrosis, anti-infective regimens, brain abscess, and other diseases which do not respond to other standard antimicrobial agents.

Give preferably with a full glass of water on an empty stomach, or at least 1hr before or 2 hr after a meal, to achieve blood levels.Adult: Capsule 250-500mg or 2 tsp suspension every 6 hrs or as prescribed.Pedia: Capsule 125-250mg every 6 hours or as prescribed.2-6yrs: ½ tsp; infants: ¼-1/2 tso every 6 hrs daily preferably after feeding time or as prescribed.Impaired hepatic fxn or severe renal failure: reduce the dose of chloramphenicol

History of hypersensitivity and toxic reactions. Infants <1 month and in pregnant women prior to delivery due to risk of Gray syndrome. Blood diseases, esp., aplastic anemia, and thrombocytopenia. Lactation, trivial infxn. Concurrent therapy with other bone marrow depression, TB affections.

CNS: headache, mild depression,EENT: blurring of visions, optic neuritis in some children in mucoviscodosisSkin: paresthesia, GI: diarrhea, stomatitis, glossitis, nausea, vomitingHematologic: serious and fatal blood dyscrasiasOther: allergic reactions

Name of the Drug


ReactionsGeneric Name:Cimetidine

Brand Name:

Competitively inhibits histamine H2-receptor site of gastritis parietal cells, resulting to decreased gastric acid secretion by about 50-80%.


Duodenal and gastric ulcers, esophageal reflux, Zollinger-

Take with food. Adult: Active ulver and gastroesophageal reflux disease:

Patients with impaired renal function, hypersensitivity to Cimetidine.

CNS: tiredness, dizzinessSkin: skin rashesGI: mild transient diarrhea

(Philippines) Antag, Biogenerics Cimetidine, Drugmaker’s Biotech Cimetidine, Dugastril, Mestulcer, Tagamet

POunknow

n45-90 mins

4-5hrs

IM/IVunknow

nimmediate unknown

Ellison syndrome.

Prophylaxis: GI hemorrhage, malabsorption and fluid loss reduction in patients with short bowel syndrome, systematic mastocytosis and multiple endocrine adenomas

Treatment of duodenla and benign gastric ulceration.

Prevention of stress ulcer critically ill patients at risk of hemorrhage

Reduction of gastric acidity secretory volume.

single bedtime dose of 800mg or 400mg twice a day in the morning and at bedtime. Duration of therapy: 4 wks for active ulcer, 12 wks for gastroesophageal refluxGastritis: 200mg after breakfast and 200mg at bedtimePrevention of recurrent ulcer: maintenance dose: 400mg at bedtimeZollinger-Ellison syndrome: doses up to 12g/day have been used.NSAID-induced lesions: 800mg at bedtime or 400mg twice a day for 8 weeks. Pancreatic insufficiency: 0.8-1.6 g/day in 4 divided doses, 1-1 ½ hrs before meals.

Hematologic: decreased white cell counts, agranulocytosis, thrombocytopeniaOther: gynecomasia, alopecia

Name of the Drug


ReactionsGeneric Name:Dexamethasone

Brand Name: (Philippines) Cordex 5, Decilone, Drenex, Inflam, Isodexam, Maxidez, Oradexon, Oradexon Forte, Santeson 0.1%, Scancortin 4, Scancortin 5

Synthetic glucocorticoid with marked anti –inflammatory effect because of its abilty to inhibit prostaglandin synthesis, inhibit migration of macrophages, leukocytes and fibroblasts at site of inflammation, phagocytosis and lysosomal enzyme release. It can also cause the reversal of increased capillary permeability.


PO 1-2 hrs 1-2 hrs 2 ½ days

IM/IV <1 hr 1hr2days-3wks

Testing adrenal cortical hyperfunction, management of primary or secondary adrenal cortex insufficiency, rheumatic disorders, collagen diseases, dermatologic diseases, allergic states, allergic and inflammatory ophthalmic processes, respiratory diseases, cerebral edema, associated w/

Take with food. Dexamethasone: Initial dose: given by mouth 0.75-9 mg/day. Cushing syndrome: given by motuh , 1mg at 11pm. Alternate: Given by mouth, 0.5mg every 6 hrs for 48 hrsAcute mountain sickness: given by mouth, 4mg every 6 hrs.Antiemetic: given by mouth,16-20 mgDiagnosis of depression: given by mouth, 1mg.Dexamethasone sodium

Systemic fungal infxns. IM inj use in idiopathic thrombocytopenia purpura, administration of live virus vaccines, topical monotherapy in primary bacterial infxns

CNS: convulsion, increased ICP w/ papilledema, psychosis, vertigo, headacheCV: cardiac arrhythmias or ECG changes, hypertension, myocardial rupture, CHFMusculoskeletal: weakness, myopathy, muscle mass loss, osteoporosisSkin: paresthesia, petechiae, ecchymoses, erythema, acneiform eruptions,

primary or metastatic brain tumor, craniotomy or head injury, edematous states, GI diseases, multiple sclerosis, TB meningitis, trichinosis w/ neurologic or myocardial involvement.

phosphate – systemic: given IV/IM, 0.5-9mg/day.Cerebral edema: IV, 10mg, then IM 4mg every 6hrs until maximum response.Brain tumors: IM/IV,2mg 2-3x a dayUnresponsive shock: IV, 1-6mg/kg as single inj or 40mg followed by repeated IV inj every 2-6 hrs.Bacterial meningitis: IV, 0.15 mg/kg every 6 hrs.

allergic dermatitis, urticaria, burining, itching, dryness, pruritus GI: pancreatitis, nauseas, vomiting, increased appetite and weight gain, peptic ulcer w/ perforation and hemorrhage, bowel perforationGU: glycosuriaHematologic: thrombophlebitisOther:

Name of the Drug


Generic Name:Dopamine

Brand Name: (Philippines) Docard, Hospira Dopamine HCl

Immediate precursor of epinephrine in the body, exogenous administration produce direct stimulation of beta-1 receptors variable stimulation of alpha receptors, will cause release of norepinephrine from storage sites. These actions result in increased myocardial contraction and cardiac output, systemic vasoconstriction as well as increase renal blood flow and

Correction of hemodynamic imbalances present in shock after MI

Trauma, endotoxic septicemia,

Adults: IV initial dose: 2-5mcg/kg/min at 10-15 mins intervals until adequate response is noted. Most patients are

Should not be used in patients with phaechromocytoma, or hyperthyroidism, nor in the presence of uncorrected tachyarrhythmia or ventricular fibrillation.

CNS: headache, anxietyCV: Ectopic beats, tachycardia, angina pain, palpitation, hypotension, vasoconstriction, ventricular arrhythmia,

sodium excretion.Route Onset Peak Duration

IV2-5

minsunknown <10mins

surgery and renal failure or imbalances in conditions of chronic refractory cardiac decompensation

maintained at <20 mcg/kg/min. if dosage exceeds 50 mcg/kg/min, assess renal fxn frequently.

hypertensionEENT: dilated pupilGI: nausea, vomitingGU: decreased urine ouputRespiratory: dyspnea

Name of the Drug


Generic Name:Erythromycin

Brand Name: (Philippines) AM-Europharma Eryhtromycin, Celsus Eryhthromycin Eye Ointment, Drugmaker’s Biotech Erythromycin, Elicocin, Erasymin, Erosuccin, Erycar, Eryhthrocin/Eryhthrocin DS, Ery-V, Ilosone/Ilosone

Macrolide antibiotic produced by a strain of Streptomyces erythreus. Bacteriostatic or bactericidal, depending on nature of organism and drug concentration used.


PO 1 hr 4hrs unknown

IVimmediate

immediate

unknown

Pneumococcal pneumonia, Mycoplasma pneumoniae (primary atypical pneumonia), acute PID caused by Neisseria gonorrhoeae in females sensitive to penicillin, infections caused by susceptible strains of staphylococci, streptococci, and certain strains of Haemophilus influenzae.

Also used in intestinal amebiasis, Legionnaires' disease, uncomplicated

Give on an empty stomach 1hr before or 3 hrs after meals.Systemic Use: given by mouth, 250-500mg of baseevery 6 hrs or 500mg every 12 hrs or 333mg every 8 hrs.IV: 15-20mg/kg/day; up to 4g/day in very severe infxns.Children:

Hypersensitivity to erythromycin or any amcrolide antibiotic; pre-existing liver disease. Epithelial herpes simplex keratitis, fungal disease of eye, vaccinia or varicella. Lactation, Excreted in breastmilk.

EENT: photosensitivitySkin: rash, erythema and peelingGI: diarrhea, nausea, vomiting, abdominal pain, crampingGU: vaginitisOther: venous irritationor phlebitis with IV administration.

DS, Pharex Erythromycin, RiteMed Erythromycin, Romaxin, Sansacne, Sefavex, Stiemycin, Upperzin

urethral, endocervical, and rectal infections caused by Chlamydia trachomatis, for prophylaxis of ophthalmia neonatorum caused by N. gonorrhoeae, C. trachomatis, and for chlamydial conjunctivitis in neonates.

Considered an acceptable alternative to penicillin for treatment of streptococcal pharyngitis, for prophylaxis of rheumatic fever and bacterial endocarditis, for treatment of diphtheria as adjunct to antitoxin and for carrier state, and as alternate choice in treatment of primary syphilis in patients allergic to penicillins.

Topical applications: Pyodermas, acne vulgaris, and external ocular infections,

given by mouth, 30-50 mg/kg/day in divided doses.

including neonatal chlamydial conjunctivitis and gonococcal ophthalmia.

Name of the Drug


Generic Name:Gentamicin

Brand Name: (Philippines) Adelanin, Garamycin, Garamycin 0.1% Cream/Oint, Gentamytrex, Opthagen, Servigenta, Topigen, Topigen Eye drops, Sannogen

Interferes with protein synthesis in bacterial cell by binding to ribosomal subunit, causing misreading of genetic code; inaccurate peptide sequence forms in protein chain, causing bacterial death.

Route Onset PeakIM Rapid rapid

IV½-1 ½

hrInfusion’s

end

Short-term treatment of serious infxns caused by susceptible strains of microorganisms, esp.,gram-neagative bacteria

Adjunct to systemic gentamicin in serious CNS infxns

Treatment of superficial ocular and skin infxns

Infxn prophylaxis and aid to healing.

Adults IM/IV: 3-5 mg/kg/day in divided dosesObese patients: base dose on estimate of lean body weightChildren IM/IV: 6-7.5mg/kg/dayInfants/Newborn: IM/IV 7.5 mg/kg/dayPremature and term newborns: IM/IV 5mg/kg/day or 2.5mg/kg every 18 hrs or 3mg/kg every 24hrs.

History of hypersensitivity to or toxic reaction with any aminoglycoside antibiotic. Safe use during pregnancy or lactation is not established.

CNS: neuromuscular blockade: weakness, arachnoiditis CV: hypotension, hypertension. GI: Nausea, vomiting, transient increase in AST, ALT, and serum LDH and bilirubin; hepatomegaly, splenomegaly. Hematologic: Increased or decreased reticulocyte counts; granulocytopenia, thrombocytopenia (fever, bleeding tendency), thrombocytopenic purpura, anemia. GU: Nephrotoxicity: proteinuria, hematuria, rising BUN, nonprotein

nitrogen, serum creatinine; decreased creatinine clearance. Other: Local irritation and pain following IM use; hypersensitivity, fever

Name of the Drug


Generic Name:Heparin

Brand Name: (Philippines) Contractubex, Heparin Leo

Accelerates formation of antithrombin III-thrombin complex and deactivates thrombin to prevent conversion of fibrinogen to fibrin. Anticoagulant. Decreases the ability of blood to clot.

Route Onset Peak DurationSC ½-1hr 2-4hrs unknown

IVimmediate

unknown

unknown

Prophylaxis and treatment of thromboembolic disorders such as thrombophlebitis, pulmonary embolism, coronary or venous thrombosis, and occlusive vascular disease.

Prevention of thromboembolic complications arising as a result of cardiac and vascular

By intermittent IV inj, IV infusion or deep SC inj. Adult low dose prophylaxis against venous thromboembolism in patients undergoing surgery: initiated about 2 hrs prior to surgery. Usual dose: 5000IU by deep SC inj, repeated every 8-12hrsfor 7days following surgery or until patient is ambulatoryContinuous IV infusion: bolus dose of 5000IU may be given initially followed by an infusion of

Aspirin should be avoided by patients receiving heparin therapy. If an analgesic is required, acetaminophen would be acceptable substitute. Hypersensitivity to heparin. Actual or potential hemorrhagic states. Threatened abortion, subacute bacterial endocarditis, severe hypertension, gastric or duodenal ulcers, advanced hepatic or renal disease.

GI: diarrheaHematologic: hemorrhageOther: allergy, anaphylactic reaction

surgery , frostbite

Anticoagulant during blood transfusions

20,000-40,000IU in 1L NSS or glucose infusion over 24hrs.Intermittent IV inj: initial dose of 10,000 IU followed by 5,000-10,000 IU every4-6 hrs.

Name of the Drug


Generic Name:Hydrocortisione

Brand Name: (Philippines) Cortizan, Drugmaker’s Biotech Hydrocortisone, Efficort, Hydrotopic, Hydrotopic Injection, Lacticare-HC Lotion, Pharex Hydrocortisone, Pharmacort, Phoenix Hydrocortisone Sodium Succinate, Solu-Cortef

Glucocorticoid w/ anti-inflammatory effect because of its ability to inhibit prostaglandins synthesis inhibit migration of macrophages, leucocytes, and fibroblasts at sites of inflammation, phagocytosis and lysosomal enzyme release. It can also cause the reversal of increased capillary permeability.

Route Onset Peak DurationPO 1-2hrs 1hr 1 ½ days

IM20min

s4-8hrs

1 ½ days

IV Rapiduknow

n1 ½ days

Replacement therapy in adrenocortical insufficiency

Treatment of rhemumatic disorders, collagen diseases, dermatologic disease, allergic states, respiratory disease, hematologic disease, neoplastic disease, multiple sclerosis, tuberculous

Give medication with food. With large doses, administer antacids between meals.Adrenal insufficiency/inflammation: Adult: PO 5-30 mg 2x/4x a day. IM/IV 100-250mg, then 50-100 mg IM as needed. IM.IV 15-240mg every 12 hrs.Shock: Adult: 500mg-2g every 2-6 hrs

Sytemic fungal infections. IM use in idiopathic thrombocytopenic purpura. Psychosis, acute glomerulonephritis, amebiasis, noanasthmatic nronchial disease, children <2yrs, AIDS, TB

CNS: depressionCV: hypertension, circulatory collapse, tachycardia, EENT: blurred vision, GI: diarrhea, nausea, abdominal distenstion, increased appetite, pancreatitisHematologic: hemorrhage, thrombocytopeniaSkin: petechiae, ecchymosis

meningitis Treatment of

synovitis of osteoarthritis ans symptoms of rheumatoid arthritis, bursitis, acute gouty arthritis, ericondylitis

Name of the Drug


Generic Name:Insulin

Brand Name: (Philippines) Novomix 30 FlexPen, Levemir, Actrapid HM, Humulin R, Humulin N, Insulatard HM, Scilin N

Decreases blood glucose; by transport of glucose into cells and the conversion of glucose to glycogen indirectly increases blood pyruvate and lactate, decreases phosphate and potassium

Management of type1 DM and type2 DM which cannot be controlled by diet, exercise or weight reduction alone

Maintenance dose: given SC, dose determined by the physician depending on the requirement of the individual patient. Administer before meals and after soon after meal when necessary. Regular Insulin: given IV/Im for severe ketoacidosis or diabetic coma

Hypoglycemia, insulinoma, hypersensitivity reactions, IV administration of insulin suspension , diabetic coma.

Skin: redness, itching, hives, selling, inflammation,


Generic Name:Methylprednisolone

As a glucocorticoid, it has marked anti-inflammatory action due to its ability to inhibit prostaglandin

Suppression of inflammatory and allergic

Take with food.Vial: adjuvant treatment of life-

Systemic fungal infections. Septic shock.

Musculoskeletal effects, GI effects, skin reactions,

Brand Name: (Philippines) Adrena, Advantan, Depo-Medrol, Medixon, Medrol, Solu-Medrol

synthesis. As an immunosuppressant, it inhibitsphagocytosis, and migration of macrophrages and leukocytes to the site of inflammation as well as stabilizes lysosomes to prevent release of enzymes and reverses increases capillary permeability.

Route Onset Peak DurationPO rapid 1-2hrs 30-36hrs

IM6-

48hrsunkno

wn4-8days

IVimmediate

immediate

unknown

disorders, cerebral edema, rheumatic disease, immunosuppressant in spinal cord injury.

Atopic dermatitis, contact eczema, degenerative, dyshidrotic, vulgar eczema, and eczema in children.

Osteoarthritis, bursitis, rheumatoid arthritis, tendinitis, epicondylitis, ulcerative colitis, acute gastroenteritis, or in pre- or post-operative

Neoplastic diseases

Allergic and edematous states

threatening states: 30mg.kg BW given in 30 mins IV infusion, can be repeated in the 1st 48-72hrs in 4-6hrs intervals.RA: 0.5-1g/day for 1-4 days or 1g/mo for 6mosSLE: 0.5-1g/day for 3 days.Multiple Sclerosis: 1g/day for 5 daysEdemic States: 30mg/kg BW every 2nd day for 4 days or 0.2-1g/day for 3-5 daysTerminal Stage of Malignant disease: 125mg/day for 8weeks

Hypersensitivity, administration of live/live attenuated vaccine. Lactation. Premature infants. Tuberculous or syphilitic processes in the area to be treated. Viral disease.

negative nitrogen due to protein catabolism, nervous system effects, seizures, psychic disorders.


Generic Name:Netilmicin

Brand Name: (Philippines) Netromycin

Broad spectrum antibiotic, believed to inhibit protein synthesis by binding irreversibly to the 30S subunit of bacterial ribosome thereby interfering with the initiation complex between messenger RNA and 30S subunit. Polyribosomes are split apart and are unable to synthesize protein. It also causes disruption of the bacterial cytoplasmic membrane leading to cell death.


IV/IMimmediate

30-60 mins

12-24 hrs

Bacteremia, Septicemia, neonatal sepsis

Skin and soft tissue, bone and joints infections.

BuRns, wounds, and peri-op infxns.

Normal Renal Function: adult 50-90 kg: 150mg 12 hrly; 40-60kg: 100mg 12 hrly.Pedia: 2-2.5mg/kg every 8hrsInfants/Neonates: >1wk: 2.5-3.0 mg/kg every 8 hrs.

Pregnancy. Hypersensitivity.

Nephrotoxicity, neurotoxicity, local reactions, GI effects and fever.


Generic Name:Penicillin G, Benzyl Penicillin

Brand Name: (Philippines) YSS Benzylpenicillin Sodium

Inhibits bacterial cell wall synthesis during bacterial multiplication.


IVimmediate

Immediate

unknown

IMimmediate

15-30 mins

unknown

POimmediate

1hrunknown

Treatment of respiratory tract infection, skin and soft tissue infxns, dental and surgical infxns.

Some types of sub-acute bacterial endocarditis, meningitis, otitis media, and osteomyelitis

Adult: 400,000-800,000 units every 6hrsPedia 7-12 yrs: 40,000-800,000 units/kg BW/day in divided doses every 6 hrsIntermittent IM inj. Or IV infusion: Serious acute infxns with or without bacteremia: 300,000-600,000 units 4 hrly.

Hypersensitivity. Hypersensitivity reactions, sensitizations, mild GI irritation.

Pneumococcic pneumonia: IM 500,000 units 12hrlyGonorrhea: IM 300,000-600,000 units 4 hrly.


Generic Name:Streptomycin

Brand Name: (Philippines) Biolab Streptomycin Sulfate

Inhibits protein synthesis in bacterial cell by binding directly to 30S ribosomal subunit, causing inaccurate peptide sequence to form in protein chain, resulting in bacterial death.

Route Onset PeakIM rapid 1-2hrs

Part of the combination therapy of active TB, used in combination with other agents for treatment of streptococcal or enterococcal endocarditis, mycobacterial infxns, plague, tularemia, and brucellosis.

TB: 1g IM 2 or 3 times wk or daily. Gonorrhea: 1 IM inj of 0.3-0.5gSubacute bacterial endocarditis: at least 2g IMdaily divided doses for a minimum of 6 weeks Brucellosis w/ bacteremia: 1g IM twice daily for 1 wk, then 1 g/day for 2nd

wk.UTI: 1-2.5g

Hypersensitivity. Pregnancy

Allergic reactions, disturbances of vestibular fxns, paresthesia.

drug study (romel cruz hospital)

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