Clinician's Pocket Drug Reference 2008

38 AmoxicillinEncephalopathy possible; aluminum levels, especially in renal insuff; can precipitate& occlude catheters Notes: Safe w/o anesthesia & w/vesicoureteral refluxAmoxicillin (Amoxil, Polymox) Uses: *Ear, nose, & throat, lowerresp, skin, urinary tract Infxns from susceptible gram(+) bacteria* endocarditisprophylaxis Action: β-Lactam antibiotic; ↓ cell wall synth Spectrum: Gram(+)(Strep sp, Enterococcus sp); some gram(–) (H. influenzae, E. coli, N. gonorrhoeae,H. pylori, & P. mirabilis) Dose: Adults. 250–500 mg PO tid or 500–875 mg bid.Peds. 25–100 mg/kg/24 h PO ÷ q8h. 200–400 mg PO bid (equivalent to 125–250mg tid); ↓ in renal impair Caution: [B, +] Disp: Caps 250, 500 mg; chew tabs 125,200, 250, 400 mg; susp 50 mg/mL, 125, 200, 250 & 400 mg/5 mL; tabs 500, 875mg SE: D; skin rash Notes: Cross hypersensitivity w/PCN; many E. coli strains resistant;chew tabs contain pheylalanineAmoxicillin & Clavulanic Acid (Augmentin, Augmentin 600ES, Augmentin XR) Uses: *Ear, lower resp, sinus, urinary tract, skin Infxnscaused by β-lactamase-producing H. influenzae, S. aureus, & E. coli* Action:Combo β-lactam antibiotic & β-lactamase inhibitor. Spectrum: Gram(+) same asamox alone, MSSA; gram(–) as w/ amox alone, β-lactamase-producing H. influenzae,Klebsiella sp, M. catarrhalis Dose: Adults. 250–500 mg PO q8h or 875 mgq12h; XR 2000 mg PO Q12H. Peds. 20–40 mg/kg/d as amoxicillin PO ÷ q8h or 45mg/kg/d ÷ q12h; ↓ in renal impair; take w/ food Caution: [B, enters breast milk]Disp: Supplied (as amox/clav): Tabs 250/125, 500/125, 875/125 mg; chew tabs125/31.25, 200/28.5, 250/62.5, 400/57 mg; susp 125/31.25, 250/62.5, 200/28.5,400/57 mg/5 mL; susp: ES 600/42.9 mg/5 mL; XR tab 1000/62.5 mg SE: Abd discomfort,N/V/D, allergic Rxn, vaginitis Notes: Do not substitute two 250-mg tabsfor one 500-mg tab (OD of clavulanic acid); max clavulanic acid 125 mg/doseAmphotericin B (Amphocin) Uses: *Severe, systemic fungal Infxns; oral& cutaneous candidiasis* Action: Binds ergosterol in the fungal membrane to alterpermeability Dose: Adults & Peds. Test dose: 1 mg IV adults or 0.1 mg/kg to 1 mgIV in children; then 0.25–1.5 mg/kg/24 h IV over 2–6 h (range 25–50 mg/d or qod).Total dose varies w/ indication. PO: 1 mL qid Caution: [B, ?] Disp: Powder for inj50 mg/vial SE: ↓ K + /Mg 2+ from renal wasting; anaphylaxis reported, HA, fever,chills, nephrotoxicity, ↓ BP, anemia, rigors Notes: Monitor Cr/LFTs/K/Mg; ? ↓ inrenal impair; pretreatment w/ APAP & antihistamines (Benadryl) ↓ SEAmphotericin B Cholesteryl (Amphotec) Uses: *Aspergillosis ifintolerant/refractory to conventional amphotericin B,* systemic candidiasis Action:Binds cell membrane sterols, alters permeability Dose: Adults & Peds. Testdose 1.6–8.3 mg, over 15–20 min, then 3–4 mg/kg/d; 1 mg/kg/h inf; ↓ w/renal insuffCaution: [B, ?] Disp: Powder for inj 50 mg, 100 mg/vial SE: Anaphylaxis;fever, chills, HA, ↓ K + , ↓ Mg 2+ , nephrotox, ↓ BP, anemia Notes: Do not use in-linefilter; LFT/lytesAmphotericin B Lipid Complex (Abelcet) Uses: *Refractory invasivefungal Infxn in pts intolerant to conventional ampho B* Action: Binds cell