Recommended dose

Classification of the anabolic steroids is based on chemical stmctures and associated actions. A review of the biosynthesis and metabolism of the naturally occurring estrogens and androgens is available (1). Names, descriptions, approval dates, and recommended doses of the commercial products are found in References 1, 8, and 9. Although steroids may be orally active, the FDA approved mode of adrninistration is the subcutaneous implant. Effective dose is lower with implant rather than oral adrninistration. 

Florfenicol (2) has been approved in Japan for the treatment of pseudo-tuberculosis caused by Pasteurellapiscicida and streptococcosis m. yeUowtail fish. The recommended dose is 10 mg/kg for up to one week and the drug withdrawal time is five days after cessation of treatment. Florfenicol is active in bovine respiratory disease caused by Pasteurella species and mastitis caused by Staphylococci and Streptococci. It is also effective in neonatal cohbacillosis caused by E. coli. The drug is being developed worldwide by Schering-Plough Animal Health for the treatment of aquatic and bovine diseases. 

Go to the Web and develop a list of suppliers along with unit costs for some of the various types of flocculants described in this chapter. Also obtain the MSDS (Material Safety Data Sheets) for these chemicals. Once you have collected the information, develop a relative ranking of unit cost and health risk associated with each. For question 2 you will need information of recommended doses. 

The recommended dose of pemetrexed is 500 mg/m2 administered as an intravenous infusion over 10 min on Day 1 of each 21-day cycle. Pemetrexed is not metabolized to an appreciable extent and is primarily eliminated in the urine, with 70-90% of the dose recovered unchanged within the first 24 h following administration. Pemetrexed has a steady-state volume of distribution of 16.1 L. Pemetrexed is highly bound (approximately 81%) to plasma proteins. Binding is not affected by the degree of renal impairment. Plasma... 

Anastrazole is a nonsteroidal, type H, aromatase inhibitor that is 200 times more potent than aminoglutethimide. It is eliminated primarily via hqDatic metabolism, has a terminal half life of 50 h with steady state concentrations achieved approximately 10 days with once daily dosing regimens. It is administered orally at a dose of 1 mg/day that achieves near maximal aromatase inhibition and hence estrogen suppression in breast cancer patients. No effect on adrenal steroidogenesis has been observed at up to ten times the daily recommended dose. When used in the metastatic setting, anastrozole has been shown... 

Kunin CM (1967) A guide to use of antibiotics in patients with renal disease. A table of recommended doses and factors governing serum levels. Ann Intern Med 67 (1 ) 151—158... 

Nurses must carefully monitor the patient s blood levels of drugs to ensure that they remain within the therapeutic range Any deviation should be reported to the primary health care provider. Because some dragp can cause toxic reactions even in recommended doses, the nurse should be aware of the signs and symptoms of toxicity of commonly prescribed drugs. 

B. adverse reactions are usually mild when recommended doses are used... 

In elderly or debilitated patients doses may be instituted at 1A> to Vs the recommended dose for younger adults and increased more gradually than dose increases in younger adults... 

Control of blood pressure in perioperative hypertension and in immediate postoperative period, CHF associated with acute Ml, angina pectoris unresponsive to recommended doses of nitrates or beta blockers... 

If chest pain persists, changes character, increases in severity, or is not relieved by following the recommended dosing regimen, seek prompt medical attention. 

Take the dragp as directed by the primary health care provider. Do not exceed the recommended dose... 

Ipecac is available without a prescription for use in the home. The instructions for use and the recommended dose are printed on the label. 

Administered IM in single-dose vial and single-dose prefilled syringes, fee package insert for recommended dose. Children 1-12 years one dose 0.5 mL9C Adults 0.5 mL 9C two doses... 

Significant changes in the Summary of Product Characteristics (SPC) such as, the introduction of new contraindications, the introduction of new warnings, the reduction in the recommended dose, the restriction in the indications, the restriction in the availability of the medicinal product. 

LAAM usually has been prescribed in doses of 20—140 mg (Ling et al. 1978 Tennant et al. 1986). The typical Monday-Wednesday-Friday dosing schedule is 100 mg—100 mg—140 mg. The maximum recommended doses are 140 mg—140 mg—140 mg or 130 mg—130 mg—180 mg (thrice-weekly schedule) or 140 mg every other day. For some patients LAAM holds better than methadone. There is evidence that LAAM may be particularly helpful for patients who do not respond to high-dose methadone because of low plasma levels (Tennant 1988). Others patients prefer LAAM to methadone because they can attend the clinic less often (Tennant et al. 1986 Trueblood et al. 1978). However, a few experience nervousness and stimulation while taking this drug. 

Epinephrine has a narrow benefit-to-risk ratio. Along with its therapeutic effects, when administered in recommended doses by any route, it potentially causes transient anxiety, fear, restlessness, palpitations, pallor, tremor, and headache. Although usually perceived as adverse effects, such symptoms indicate that a pharmacologically active dose of the medication has been absorbed. The desirable pharmacologic effects of epinephrine cannot be separated from the undesirable pharmacologic effects [10]. 

Doses are estimated based on recommended dosing ranges and TOF... 

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... 

There is no evidence that intravenous corticosteroid administration is more effective than oral administration, and the oral route is preferred in acute severe asthma.3 There are also few data to guide selection of initial corticosteroid doses. Recommended doses for acute severe asthma are shown in Table 11-5, page 227 however, recent data indicate that... 

The recommended dose of lubiprostone is 24 meg orally twice daily with food. Early studies evaluated lubiprostone use for no longer than 4 weeks. Patients should be assessed periodically for the need to continue therapy. 

Antihistamines such as diphenhydramine are known for their sedating properties and are frequently used over-the-counter medications (usual doses 25-50 mg) for difficulty sleeping. Diphenhydramine is approved by the FDA for the treatment of insomnia and can be effective at reducing sleep latency and increasing sleep time.43 However, diphenhydramine produces undesirable anticholinergic effects and carryover sedation that limit its use. As with TCAs and BZDRAs, diphenhydramine should be used with caution in the elderly. Valerian root is an herbal sleep remedy that has inconsistent effects on sleep but may reduce sleep latency and efficiency at commonly used doses of 400 to 900 mg valerian extract. Ramelteon, a new melatonin receptor agonist, is indicated for insomnia characterized by difficulty with sleep onset. The recommended dose is 8 mg at bedtime. Ramelteon is not a controlled substance and thus may be a viable option for patients with a history of substance abuse. 

Reductions in HbAlc of 0.7%-0.8% were found in clinical trials verses placebo in both monotherapy and combination therapy using the recommended dose of sitagliptin 100 mg daily taken with or without food. Dosage adjustments to 50 mg and 25 mg daily are recommended for patients with moderate... 

The medical management of dysmenorrhea should relieve the related pelvic pain. Effective management of dysmenorrhea also results in a reduction in lost school and work days. Table 46-2 identifies the agents used in the management of dysmenorrhea, their recommended doses, and their common side effects. Figure 46-5 is a treatment algorithm for the management of dysmenorrhea. 

It has been suggested that a loading dose (twice the usual single dose) of the NSAID be taken, followed by the usually recommended dose until symptoms resolve.28 An alternate recommendation is to begin the NSAID at the onset of menses or perhaps even the day prior and to continue treatment around the clock instead of waiting until the onset of symptoms. For patients in whom NSAID use is contraindicated, the agents discussed below should be considered. The use of acetaminophen has been proven inferior to the use of NSAIDs for the treatment of this disorder.17... 

Interventions for managing PMS and PMDD focus on alleviation of the presenting symptoms and subsequent improvement in quality of life. See Table 46-2 for a listing of the various agents used in the management of this disorder, their recommended dosing, and common side effects. 

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