Increased dosage

Benzodiazepines are excreted more slowly in older adults causing a prolonged drug effect. The drugs may accumulate in the blood, resulting in an increase in adverse reactions or toxicity. For this reason, the initial dose should be small, and the nurse should increase dosages gradually until a therapeutic response is obtained. 

Fig. 2 UV-Vis DRS spectra of reduced Cr(II)/Si02 sample (0.5 wt% by Cr loading) upon increasing dosages of CO at RT. Curve 1 Cr(ll)/Si02 reduced in CO at 623 K. Curves 2-4 increasing dosages of CO from 0.1 mbar to 50 mbar (unpublished spectra)...

Starting from a stoichiometric, well-ordered MgCl2 film, an increasing dosage of sputtered ions leads to increasing background intensity of the LEED picture, which finally results in a complete loss of all diffraction spots [108]. Even though the process removes material from the surface, the surface... 

The phase of the cell cycle that is resistant to most chemotherapeutic agents and requires increased dosage to obtain a response is the... 

Thibeault L, Hengartner M, Lagueux J, Poirier G, Muller S (1992) Rearrangements of the nucleosome structure in chromatin by poly (ADP-ribose). Biochim Biophys Acta 1121 317-324 Tissenbaum HA, Guarente L (2001) Increased dosage of a sir-2 gene extends lifespan in Caenorhabditis elegans. Nature 410 227—230... 

Physiological effects of Rohypnol are similar to those experienced with other sedatives and anesthetics and include drowsiness, dizziness, lack of coordination, confusion, decreased blood pressure, respiratory depression, nausea, and vomiting. Increased dosages can result in blackouts that may include partial amnesia. 

Tissenbaum, H.A. and Guarente, L. (2001) Increased dosage of a sir-2 gene extends lifespan in Caenorhabditis elegans. Nature, 410, 227-230. 

Moynihan, K.A., Grimm, A.A., Plueger, M.M., Bernal-Mizrachi, E., Ford, F., Cras-Meneur, C., Permutt, M.A. and Imai, S. (2005) Increased dosage of mammalian Sir2 in pancreatic beta cells enhances glucose-stimulated insulin secretion in mice. Cell Metabolism, 2, 105-117. 

Elevated blood pressure Elevated blood pressure and hypertension may occur within a few months of beginning use. The prevalence increases with the duration of use and age. Incidence of hypertension may directly correlate with increasing dosages of progestin. Discontinue use if elevated blood pressure occurs. Encourage women with a history of hypertension or hypertension-related diseases during pregnancy, or renal disease to use another method of contraception. 

Stress In patients receiving or recently withdrawn from corticosteroid therapy subjected to unusual stress, increased dosage of rapidly acting corticosteroids is indicated before, during, and after stressful situations, except in patients on high-dose therapy. 

Paget disease (etidronate) Response may be slow and may continue for months after treatment discontinuation. Do not increase dosage prematurely or initiate retreatment until after at least a 90-day drug-free interval. 

Half-life increases with increasing dosage. 

Do not increase dosage more frequently than once every 4 days, because optimal effect may not be achieved during the first 2 to 3 days of therapy. 

Keep patient supine during therapy or closely observe for postural hypotension. The optimal dose has not been determined. Dosages greater than 40 mg/kg/day have been used without apparent adverse effect. As soon as possible, and when indicated, change patient to an oral antiarrhythmic agent for maintenance therapy. Immediate life-threatening ventricular arrhythmias (eg, ventricular fibrillation, hemodynamically unstable ventricular tachycardia) Administer undiluted, 5 mg/kg by rapid IV injection. If ventricular fibrillation persists, increase dosage to 10 mg/kg and repeat as necessary. 

Tabiets, immediate-reiease Start with 30 mg 4 times/day before meals and at bedtime gradually increase dosage to 180 to 360 mg (given in divided doses 3 or 4 times/day) at 1- to 2-day intervals until optimum response is... 

Angina Usual initial dose is 80 to 120 mg 3 times/day 40 mg 3 times/day may be warranted if patients may have increased response to verapamil (eg, decreased hepatic function, elderly). Base upward titration of safety and efficacy evaluated about 8 hours after dosing. Increase dosage daily (eg, unstable angina) or weekly until optimum clinical response is obtained. 

Initial dose 400 mg (200 mg twice/day). Increase dosage gradually until optimal response is obtained, usually 600 to 1200 mg/day. 

Initial dose 40 mg once daily, alone or in addition to diuretic therapy. Gradually increase dosage in 40 to 80 mg increments until optimum blood pressure reduction is achieved. 

Initial therapy 250 mg, 2 or 3 times/day in the first 48 hours. Adjust dosage at intervals of not less than 2 days until adequate response is achieved. To minimize sedation, increase dosage in the evening. By adjustment of dosage, morning hypotension may be prevented without sacrificing control of afternoon blood pressure. 

Initial dose 1 mg 2 or 3 times daily. When increasing dosages, give the first dose of each increment at bedtime to reduce syncopal episodes. 

Bioavailability of hydralazine tablets is enhanced by the concurrent ingestion of food. Initiate therapy Initiate therapy in gradually increasing dosages individualize dosage. Start with 10 mg 4 times daily for the first 2 to 4 days, increase to 25 mg 4 times daily for the balance of the first week. 

Second and subsequent weeks Increase dosage to 50 mg 4 times daily. Maintenance Adjust dosage to lowest effective level. Twice daily dosage may be adequate. In a few resistant patients, up to 300 mg/day may be required for a significant antihypertensive effect. In such cases, consider a lower dosage of hydralazine combined with a thiazide or reserpine or a beta-blocker. However, when combining therapy, individual titration is essential to ensure the lowest possible therapeutic dose of each drug. 

Hypertension - Initiate therapy with a single dose of 25 mg/day Thalitone, 15 mg). If response is insufficient after a suitable trial, increase to 50 mg Thalitone, increase from 30 to 50 mg). For additional control, increase dosage to 100 mg once daily (except Thalitone), or add a second antihypertensive. 

Mild to moderate hypertension 0.5 mg as a single daily dose taken in the morning. If response is inadequate, increase the dose to 1 mg daily. Do not increase dosage if blood pressure is not controlled with 1 mg. Rather, add another antihypertensive agent with a different mechanism of action. 

Concomitant therapy Add amiloride 5 mg/day to the usual antihypertensive or diuretic dosage of a kaliuretic diuretic. Increase dosage to 10 mg/day, if necessary doses greater than 10 mg are usually not needed. If persistent hypokalemia is documented with 10 mg, increase the dose to 15 mg, then 20 mg, with careful titration of the dose and careful monitoring of electrolytes. 

Elderly patients and those sensitive to -adrenergic stimulants Start with 2 mg 3 or 4 times/day. If adequate bronchodilation is not obtained, increase dosage gradually to as much as 8 mg 3 or 4 times/day. 

Usual effective dose range is 200 to 300 mg/day. If no response is seen at 300 mg, increase dosage, depending upon tolerance, to 400 mg/day. Hospitalized patients refractory to antidepressant therapy and who have no history of convulsive seizures may have dosage cautiously increased up to 600 mg/day in divided doses. 

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