Clinician's Pocket Drug Reference 2008

Phenylephrin, oral 169mia, constipation, urinary retention Notes: 2–4 wk for effect; avoid tyramine-containingfoods (eg, cheeses)Phenobarbital [C-IV] Uses: *Sz disorders,* insomnia, anxiety Action:Barbiturate Dose: Adults. Sedative–hypnotic: 30–120 mg/d PO or IM PRN. Anticonvulsant:Load 10–12 mg/kg in 3 ÷ doses, then 1–3 mg/kg/24 h PO, IM, or IV.Peds. Sedative–hypnotic: 2–3 mg/kg/24 h PO or IM hs PRN. Anticonvulsant: Load15–20 mg/kg ÷ in 2 equal doses 4 h apart, then 3–5 mg/kg/24h PO ÷ in 2–3 doses;↓ w/CrCl < 10 Caution: [D, M] Contra: Porphyria, hepatic impair, dyspnea, airwayobst Disp: Tabs 15, 16, 30, 32, 60, 65, 100 mg; elixir 15, 20 mg/5 mL; inj 30,60, 65, 130 mg/mL SE: Bradycardia, ↓ BP, hangover, Stevens–Johnson synd,blood dyscrasias, resp depression Notes: Tolerance develops to sedation; paradoxichyperactivity seen in ped pts; long half-life allows single daily dosing; Levels:Trough: just before next dose; Therapeutic: Peak 15–40 mcg/mL; Toxic Trough> 40 mcg/mL; 1 ⁄2 life: 40–120hPhenylephrine, nasal (Neo-Synephrine Nasal) (OTC) Uses:*Nasal congestion* Action: α-adrenergic agonist Dose: Adults. 1–2 sprays/nostrilq4h (usual 0.25%) PRN. Peds. 6 mo–2 yr: 0.125% 1–2 drops/nostril q3-4h, 2–6 yr:0.125% 2–3 drops/nostril q3–4h 6-12 yr: 1–2 sprays/nostril q4h 0.25% 2–3 dropsCaution: [C, +/–] HTN, acute pancreatitis, hepatitis, coronary Dz, NAG, hyperthyroidismContra: Bradycardia, arrhythmias Disp: Nasal soln 0.125, 0.25, 0.5, 1%;Liquid 7.5 mg/5 mL; drops 2.5 mg/mL SE: Arrhythmias, HTN, nasal irritation,dryness, sneezing, rebound congestion w/ prolonged use, HA Notes: Do not use >3 daysPhenylephrine, ophthalmic (Neo-Synephrine Ophthalmic,AK-Dilate, Zincfrin [OTC]) Uses: * Mydriasis, ocular redness [OTC], periopmydriasis, posterior synechiae, uveitis w/posterior synechiae* Action: α-adrenergic agonist Dose: Adults. Redness: 1 gtt 0.12% Q 3–4h PRN; Exammydriasis: 1 gtt 2.5% (15 min–1 h for effect); Preop 1 gtt 2.5–10% 30–60 minpreop; Ocular disorders: 1 gtt 2.5–10% daily-TID Peds. As adult, only use 2.5%for exam, preop and ocular conditions Caution: [C] may cause late-term fetalanoxia/bradycardia, +/–] HTN, w/ elderly w/ CAD, Contra: NAG Disp: Ophthsoln 0.12% (Zincfrin OTC), 2.5, 10%; SE: Tearing, HA, irritation, eye pain, photophobia,arrhythmia, tremorPhenylephrine, oral (Sudafed PE, SudoGest PE, Nasop, Lusonal,AH-chew D, Sudafed PE quick dissolve)(OTC) WARN-ING: Prescribers should be aware of full prescribing info before use Uses:*Nasal congestion* Action: α-adrenergic agonist Dose: Adults. 10–20 mg PO q4hPRN, Max 60 mg/d Peds. 5 mg PO q4h prn, max 60 mg/day Caution: [C, +/–]HTN, acute pancreatitis, hepatitis, coronary Dz, NAG, hyperthyroidism Contra:MAOI w/in 14 d, NAG, severe ↑ (BP or CAD, urinary retention Disp: Liquid 7.5mg/5 mL; drops 2.5 mg/mL; tabs 5, 10 mg; chew tabs 10 mg; tabs OD 10 mg;strips 10 mg. SE: Arrhythmias, HTN, HA, agitation, anxiety, tremor, palpitations