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Pharm Final Doses
olol pa program
| Question | Answer |
|---|---|
| Chloramphenicol | 50-100 mg/kg/day in 4 divided doses |
| tetracycline, Oxytetracycline | 250-500mg PO qid |
| Doxycycline | 100mg PO/IV qd or bid |
| Tetracycline - children | 20-40mg/kg/day in 4 divided doses |
| Methacycline | 100mg po qd or bid |
| Minocycline | 100mg po bid |
| Demeclocyline | 300 mg PO bid |
| Erythromycin base, stearate or estolate | 250-500mg PO q6hr |
| Erythromycin base, stearate or estolate - children | 40mg/kg/day PO |
| Erythro Ethylsuccinate | 400-600mg PO Q6hrs |
| Erythromycin base - colon surgery | 1gm PO + Neomycin |
| Erythromycin Lactobioate | 0.5-1gm IV q6hrs |
| CLARITHROMYCIN | 500 mg PO bid |
| CLARITHROMYCIN XL | 1 gm PO qd |
| CLARITHROMYCIN - CrCl < 50ml/min | 500mg x1, then 250mg q24hrs |
| AZITHROMYCIN - CAP | 500mg, then 250mg IV/PO q24hrs x 4days |
| AZITHROMYCIN - Chlamydia | 1gm PO x1 dose |
| TELITHROMYCIN - CAP, pharyngitis | 800mg PO qd |
| CLINDAMYCIN | 150-300mg PO q6hrs |
| CLINDAMYCIN | 600-900mg IV q8hrs |
| CLINDAMYCIN - PID | 900 mg IV q8hrs |
| CLINDAMYCIN - abscess | 600 mg IV q8hrs then PO |
| Synercid | 7.5mg/kg IV Q8-12hrs |
| Mucomyst | 140 mg/kg PO then 70 mg/kg q4hr for 17 doses |
| Acetadote | 150 mg/kg over 1 hr then 50 mg/kg over 4 hrs then 100 mg/kg over 16 hrs |
| Mucomyst - COPD, CF | 6-10 mL of 10% solution OR 3-5 of 20% solution |
| Mucomyst - radio contrast toxicity prevention | 600 mg PO bid x2 days |
| Ethanol LD | 600-700 mg/kg IV/NG/PO |
| Ethanol MD - non drinkers | 66-154 mg/kg/hr |
| Ethanol MD - dialysis pts | 169 mg/kg/hr |
| Ethanol MD - alcoholics | start at 154 mg/kg/hr |
| Ethanol MD - alcoholics on dialysis | 257 mg/kg/hr |
| Fomepizole (Antizol) | 15 mg/kg IV then 10 mg/kg q12hr x 4 doses then 15 mg/kg q12hr |
| Fomepizole (Antizol) | 15 mg/kg PO q12hr then 5 mg/kg q12hr x 1 dose then 10 mg/kg q12hr |
| Fomepizole (Antizol) | 10 mg/kg PO then 5 mg/kg bid up to 36 hrs then 10 mg/kg bid up to 96 hrs |
| Crofab | 4-6 vials over 1 hr then 2 vials q6hrs for 18 hrs (3 more doses) |
| Digoxin Antidote - life threatening | 20 vials IV |
| Digoxin Antidote - acute ingestion | 10 vials IV |
| Digoxin Antidote - peds chronic toxicity | 1 vials initially IV |
| Melatonin - sleep | .3-10 mg (max 20 mg) |
| Melatonin - jet lag | 5-8 mg |
| Gingko Biloba | 120-240 mg given 2-3 divided doses |
| atropine sulfate | 1-2 mg IV, repeat q15-30min prn |
| deferoxamine mesylate (Desferal) | 15 mg/kg/hr IV |
| flumazenil (Romazicon) | 0.2 mg IV over 30 secs |
| naloxone (Narcan) | 0.4-2mg IV, may repeat at 2-3min intervals up to 10 mins |
| phytonadione (vitamin K) | 2.5-10mg SC/PO/IM |
| Fungizone - test dose | 1mg in 20ml D5 over 20-30min |
| Fungizone - general | 0.25–1 mg/kg/day IV |
| Fungizone - Aspergillosis | up to 3.6g over 11 months |
| Sulfisoxazole UTI | 1 gm qid |
| Sulfamethoxazole UTI | 1 gm qid |
| Sulfadiazine + pyrimethamine (+ folic acid) | 1gm po qid plus; 75mg po x one dose, then 25mg po qd |
| Sulfasalazine (Azulfidine): UC,IBD | Initial dose: 3-4gm/day initMaintenance dose: 2gm/day in 2 divided dosesially in 3-4 divided doses, |
| Fansidar: ACUTE MALARIA | 2-3tabs x one dose |
| Fansidar: malaria prophylaxis | Sulfadoxine 500mg +Pyrimethamine 25mg, one tablet weekly or 2 tabs Q 2weeks |
| Bactrim DS : UTI, salmonella/ shigella | Trimethoprim 160mg /sulfamethoxazole 800mg given Q12hrs |
| Bactrim SS: PCP | 80mg trimethoprim/400mg sulfamethoxazole per 5ml in 125ml D5W over 60-90mins |
| Bactrim DS :proph.UTI | .5 ta 3x/wk x months |
| Bactrim : PCP | Dose 5mg/kg 3-4x/day based on Trimethoprim portion of agent; Typical dose: 15-20ml IV Q 6 or 8hrs |
| Fungizone - CNS fungal infection (severe) | 0.01-0.1 mg IT Q 48-72 hrs |
| Fungizone - lung fungal infection (severe) | 5mg intracavitary injection then 50mg daily |
| Fungizone - Urinary Tract Mycosis | 30-50mg diluted in 20-100ml sterile H2O by bladder irrigation |
| Abelcet - Aspergillosis, Bastomycosis, Candidiasis, Cryptococcal meningitis, Leishmaniasis, systemic mycosis | 5 mg/kg IV qd |
| Amphotec - Aspergillosis | 3-4 mg/kg/day, MAX: 7.5 mg/kg/day |
| Amphotec - Candidiasis (non-FDA) | 3.9 – 6 mg/kg IV qd |
| Ambisome - Cryptococcal meningitis (HIV) | 6 mg/kg IV qd |
| Ambisome - Mycosis, febrile neutropenia | 3 mg/kg IV qd |
| Ambisome - Systemic mycosis (Aspergillus, candida, or Cryptococcus) | 3-5 mg/kg IV qd |
| Ambisome - Visceral leishmaniasis | 3 mg/kg IV qd |
| Ambisome - Visceral leishmaniasis (immunocompromised pts) | 4mg/kg IV qd |
| Nystatin (Mycostatin) - Candida Vaginitis | 100,000 units VAGINALLY qd |
| Nystatin (Mycostatin) - mucocutaneous & skin Candidiasis | Apply powder 2-3 x daily to affected area |
| Nystatin (Mycostatin) - GI Candidiasis (non-esophageal) | 500,000 U (5ml) – 1,000,000 U (10ml) tid SWISH & Swallow |
| Nystatin (Mycostatin) - Oral Candidiasis | 300,000 – 400,000 units suspension qid OR 200,000-400,000 U troche units 4-5 x daily |
| Caspofungin (Cancidas) - refractory invasive Aspergillosis, Candidal septicemia, intra-abdominal abscesses Candidiasis, febrile neutropenia | 70mg IV (day 1) then 50 mg qd |
| Caspofungin (Cancidas) - Esophageal Candidiasis | 50mg IV qd |
| Micafungin (Mycamine) - Candidiasis prophylaxis in stem cell transplant | 50 mg IV qd |
| Micafungin (Mycamine) - Esophageal Candidiasis | 150 mg IV qd |
| Anidulafungin (Eraxis) - Candidemia, Intra-abdominal and peritoneal disseminated candidiasis | 200 mg (day 1) IV then 100 mg IV qd |
| Anidulafungin (Eraxis) - Esophageal Candidiasis | 100mg (day 1) IV then 50 mg IV qd |
| Flucytosine (Ancobon) - Candidiasis (meningitis or pulmonary) | 50 – 150 mg/kg/day PO given in 6hr intervals |
| Flucytosine (Ancobon) - Cryptococcosis (septicemia, endocarditis, UTI, pulmonary) | 50 – 150 mg/kg/day PO in 4 equal doses @ 6hr intervals |
| Fluconazole (Diflucan) - Candida Vaginitis | 150 mg PO 1 x dose |
| Fluconazole (Diflucan) - Esophageal or Oral Candidiasis | 200 mg IV/PO then 100 mg qd |
| Fluconazole (Diflucan) - Candiduria | 50-200 mg IV/PO qd |
| Fluconazole (Diflucan) - Prophylaxis for Candidiasis (bone marrow transplant) | 400 mg IV/PO qd |
| Fluconazole (Diflucan) - Cryptococcal Meningitis | 400 mg IV/PO then 200 mg qd |
| Fluconazole (Diflucan) - Disseminated Candidiasis | 400 mg IV/PO qd |
| Itraconazole (Sporanox) - Aspergillosis, Blastomycosis, Histoplasmosis | PO: 200 mg qd or bid, IV: 200 mg bid for 4 doses; then 200 mg qd |
| Itraconazole (Sporanox) - Febrile Neutopenia | 200 mg bid for 4 doses; then 200 mg qd |
| Itraconazole (Sporanox) - Onychomycosis (fingernail) | 200 mg BID x 1 wk, 3 wks off, then 200 mg BID x 1 wk |
| Itraconazole (Sporanox) - Onychomycosis (toenail) | 200 mg qd x 12wks |
| Itraconazole (Sporanox) - Tinea | 200 mg qd |
| Itraconazole (Sporanox) - Oral Candidiasis | 200 mg solution swish/swallow qd |
| Itraconazole (Sporanox) - Esophageal Candidiasis | 100-200 mg swish/swallow qd |
| Voriconazole (Vfend) - Invasive Aspergillosis, Disseminated Candidiasis, Fusarium infection, Monosporium apiospermum infection | 6 mg/kg IV q 12hrs for 2 doses; then 4 mg/kg IV Q 12hrs |
| Voriconazole (Vfend) - Candidal Septicemia | 6 mg/kg IV q 12hrs for 2 doses; then 3 mg/kg IV Q 12hrs |
| Voriconazole (Vfend) - Esophageal Candidiasis | 200 mg PO q 12hrs (pt >40kg); 100 mg PO q 12hrs (pt <40kg) |
| Voriconazole (Vfend) - IV to PO step-down | 200-300 mg PO q 12hrs (>40kg); 100-150 mg PO q 12hrs (<40kg) |
| Ketoconazole (Nizoral) | 200-400 mg PO qd |
| Ketoconazole (Nizoral) - Candidiasis of the skin | 2% cream topically qd |
| Ketoconazole (Nizoral) - Dandruff | 2% shampoo qd to wet hair |
| Ketoconazole (Nizoral) - Pityriasis Versicolor | 2% shampoo qd to damp skin |
| Ketoconazole (Nizoral) - Seborrheic Dermatitis | 2% cream or gel qd |
| Ketoconazole (Nizoral) - Tinea | 2% cream daily OR 200-400 mg PO qd |
| Posaconazole (Noxafil) - disseminated Candidiasis (immunocompromised prophylaxis), Aspergillus (prophylaxis) | 200 mg (5ml) orally tid |
| Aspergillosis - DOC | Conventional Ampho B (Fungizone) 1-1.5 mg/kg/day IV (increase to 1.5 if low dose not working) |
| Aspergillosis - DOC | Voriconazole (Vfend) 6 mg/kg IV q 12hrs x 2; then 4 mg/kg IV q12hrs; Switch to PO with sx improvement (200 mg PO bid) |
| Aspergillosis - alt | Itraconazole (Sporanox) 200 mg IV q 12hrs x 2; then 200 mg IV qd OR 200mg PO tid |
| Aspergillosis - alt | Caspofungin (Cancidas) 70mg IV x 1; then 50 mg IV qd |
| Cryptococcosis - DOC | Conventional Ampho B (Fungizone) 0.5-1 mg/kg/day IV |
| Cryptococcosis - DOC | Flucytosine (Ancobon) 100 mg/kg/day PO for 2 weeks THEN Fluconazole (Diflucan) 400 mg PO pd for 8wks |
| Cryptococcosis - alt | Flucytosine (Ancobon) 100 mg/kg/day PO for 2 weeks THEN Itraconazole (Sporanox) 200 mg PO bid |
| Blastomyces - DOC | Itraconazole (Sporanox) 200 mg PO bid for 6-12 months |
| Blastomyces - DOC | Ampho B (Fungizone) 0.5 -1 mg/kg/day IV for 6-12 wks |
| Blastomyces - alt | Fluconazole (Diflucan) 400-800 mg PO qd |
| Histoplasmosis - DOC | Itraconazole (Sporanox) 200 mg PO bid for 6-18 months |
| Histoplasmosis - DOC | Ampho B (Fungizone) 0.5 – 1 mg/kg/day IV for 10-12 wks |
| Histoplasmosis - alt | Fluconazole (Diflucan) 400-800 mg PO qd |
Created by:
lisaschavrien
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