tailieunhanh - CLINICIAN’S POCKET DRUG REFERENCE 2008 - part 7

Phenylephrine, hệ thống (Neo-Synephrine) Chú ý: sĩ nên lưu ý về Trước khi sử dụng Sử dụng thông tin đầy đủ Quy định: * Mạch thất bại trong dị ứng, sốc, hoặc do thuốc ↓ BP * Hành động: α-adrenergic chủ vận Liều lượng: Người lớn. Nhẹ trung bình ↓ BP: 2-5 mg IM hay SQ ↑ BP trong 2 h, 0,1-0,5 mg IV nâng BP trong 15 phút. | 170 Phenylephrine systemic Phenylephrine systemic Neo-Synephrine I WARNING Prescribers should be aware of full prescribing info before use Uses Vascular failure in shock allergy or drug-induced ị BP Action a-adrenergic agonist Dose Adults. Mild-moderate ị BP 2-5 mg IM or SQ T BP for 2 h mg IV elevates BP for 15 min. Severe ị BP shock Cont inf at 100-180 mcg min after BP stable maint 40-60 mcg min Peds. ị BP 5-20 mcg kg dose IV q10-15 min or mcg kg min IV inf titrate to effect. Caution C - HTN acute pancreatitis hepatitis coronary Dz NAG hyperthyroidism Contra Bradycardia arrhythmias Disp Inj 10 mg mL SE Arrhythmias HTN peripheral vasoconstriction T w oxytocin MAOIs TCAs HA weakness necrosis ị renal perfusion Notes Restore blood volume if loss has occurred use large veins to avoid extrav phentolamine 10 mg in 10-15 mL of NS for local inj to Rx extrav Phenytoin Dilantin Uses Sz disorders Action ị Sz spread in the motor cortex Dose Load Adults Peds. 15-20 mg kg IV 25 mg min max or PO in 400-mg doses at 4-h intervals. Maint Adults. Initial 200 mg PO or IV bid or 300 mg hs then follow levels. Peds. 4-7 mg kg 24h PO or IV daily-bid avoid PO susp erratic absorption Caution D Contra Heart block sinus bradycardia Disp Dilatin Infatab chew 50 mg Dilantin Phenytek capsules 100 mg capsules ER 30 100 200 300 mg susp 125 mg 5 mL inj 50 mg mL SE Nystagmus ataxia early signs of tox gum hyperplasia w long-term use. IV ị BP bradycardia arrhythmias phlebitis peripheral neuropathy rash blood dyscrasias Stevens-Johnson synd Notes Levels Trough just before next dose Therapeutic Peak 10-20 mcg mL Toxic 20 mcg mL Phenytoin albumin bound levels bound free phenytoin w ị albumin azotemia low levels may be therapeutic nl free levels do not change dosage at intervals 7-10 d hold tube feeds 1 hr before and after dose if using oral susp Physostigmine Antilirium Uses Antidote for TCA atropine scopolamine OD glaucoma Action Reversible cholinesterase inhibitor Dose Adults. mg