Dosing guidelines

Fondaparinux has been used for the treatment of DVT and PE in two large Phase III trials and is approved by the FDA for these indications. Fondaparinux is as safe and effective as IV UFH for the treatment of PE and SC LMWH for DVT treatment.36,40 The recommended dose for fondaparinux in the treatment of VTE is based on the patient s weight (Table 7-3). Fondaparinux is renally eliminated and accumulation can occur in patients with renal dysfunction. Due to the lack of specific dosing guidelines, fondaparinux is contraindicated in patients with severe renal impairment (CrCl less than 30 mL/minute). Baseline renal function should be measured and monitored closely during the course... 

Initiate unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) or fondaparinux by injection (see Table 7-3 for dosing guidelines)... 

Drug and dosing guidelines based on disease severity and location are presented in Table 16-4. 

TABLE 60-2. Bacterial Conjunctivitis Dosing Guidelines for Topical Ophthalmic Antibiotics32... 

Although tetracycline, doxycycline, and minocycline are the most commonly prescribed oral antibiotics for acne, erythromycin and clindamycin are appropriate second-line agents for use when patients cannot tolerate or have developed resistance to tetracycline or its derivatives.3 See Table 62-3 for antibiotic dosing guidelines. 

Pediatric dosec nafcillin Table 71-3 for dosing guidelines) ... 

TABLE 96-5. Dosing Guidelines for Empirical Antimicrobial Agents in Febrile Neutropenia... 

Dosing guidelines and adverse effects of parenteral agents for treating hypertensive emergency are listed in Table 10-4. 

Dosing guidelines range from 0.5 to 1 mg/kg/day, but the cumulative dose taken during a treatment course may be the major factor influencing longterm outcome. Optimal results are usually attained with cumulative doses of 120 to 150 mg/kg. 

Penicillin G 24 million units/24 h IV in four to six equally divided doses may be used in place of nafcillin or oxacillin if strain is penicillin susceptible (minimum inhibitory concentration 0,1 mcg/mL) and does not produce /5-lactamase vancomycin should be used in patients with immediate-type hypersensitivity reactions to beta-lactam antibiotics (see Table 37-3 for dosing guidelines) cefazolin may be substituted for nafcillin or oxacillin in patients with non-immediate-type hypersensitivity reactions to penicillins... 

TABLE 44-10 Dosing Guidelines for Acute Bacterial Sinusitis ... 

Amoxicillin is first-line treatment for acute bacterial sinusitis. It is cost effective in acute uncomplicated disease, and initial use of newer broad-spectrum agents is not justified. The approach to treating acute bacterial sinusitis is given in Table 44-9. Dosing guidelines are given in Table 44-10. 

Equianalgesic doses, dosing guidelines, histamine-releasing characteristics, major adverse effects, and pharmacokinetics of opioids are shown in Tables 54-2, 54-3, and 54-4. The equianalgesic doses are only a guide, and doses must be individualized. 

Adult Dosing Guidelines for Opioids and Nonopioids (Continued)... 

Refer to Table 56-3 for dosing guidelines for adults and children. The manufacturer recommends that IV valproate be given no faster than 3 mg/ kg/min. 

Lidocaine is not recommended unless other agents have failed. Table 56-3 shows the recommended dosing guidelines. It has a rapid onset of action. Fasciculations, visual disturbances, and tinnitus may occur at serum concentrations between 6 and 8 mg/L. Seizures and obtundation may develop when serum concentrations exceed 8 mg/L. 

Volume of distribution for water-soluble drugs is significantly increased due to edema. Use of dosing guidelines for CKD does not reflect the clearance and volume of distribution in critically ill ARF patients. 

The TCAs are the only antidepressant class in which effectiveness is dependent on serum level. Attainment of the minimal therapeutic level is typically required for effectiveness. Exceeding the maximum treatment level usually provides no additional benefit and risks toxicity. Unique in this regard is nortriptyline, which is the only TCA with a therapeutic window. This means that beyond the maximum therapeutic level of 150ng/mL nortriptyline not only risks toxicity but is actually less effective at treating depression. Please refer to Table 3.9 for a summary of dosing guidelines and therapeutic levels. 

Remifentanil Dosing Guidelines - General Anesthesia and Continuing as an Analgesic into the Postoperative Care Unit or... 

Maintenance of anesthesia - After endotracheal intubation, decrease the infusion rate of remifentanil in accordance with the dosing guidelines in the table above. Because of the rapid onset and short duration of action of remifentanil, the rate of administration during anesthesia can be titrated upward in 25% to 100% increments or downward in 25% to 50% decrements every 2 to 5 minutes to attain the desired level of p-opioid effect. In response to light anesthesia or transient episodes of intense surgical stress, supplemental bolus doses of 1 mcg/kg may be administered every 2 to 5 minutes. At infusion rates more than 1 mcg/kg/min, consider increases in the concomitant anesthetic agents to increase the depth of anesthesia. 

Adjunctive therapy For dosing guidelines below, enzyme-inducing antiepileptic drugs (ElAEDs) include phenytoin, carbamazepine, phenobarbital, and primidone. Patients 2 to 12 years of age ... 

Conversion from adjunctive therapy with AEDs other than carbamazepine, phenytoin, phenobarbital, primidone, or valproate to monotherapy with lamothgine No specific dosing guidelines can be provided for conversion to monotherapy with lamothgine with AEDs other than carbamazepine, phenobarbital, phenytoin, primidone, or valproate. 

Dosing guidelines Alert patients that frequently observed adverse events, such as mild to moderate Gl disturbances and paresthesias, may diminish as therapy is continued. In addition, patients initiating combination regimens with ritonavir and nucleosides may improve Gl tolerance by initiating ritonavir alone and subsequently adding nucleosides before completing 2 weeks of ritonavir monotherapy. 

The following dose guidelines are for healthy adults with minimal anxiety. Patients with significant anxiety, panic, or a tendency to be sensitive to side effects should receive initial doses that are 50% lower. Similarly, elderly patients and patients with cardiovascular or hepatic disease should receive lower initial doses. 

Drug Trade name Dosing guidelines Formulations... 

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