Counseling Rx

Ibuprofen

(Advil, Motrin)

MoA: Inhibits PG synthesis, also inh platelet agg

Uses: Inflammatory conditions, rheumatoid arthritis, osteoarthritis, dysmenorrhea, fever, HA, migraine, pain

OTC dosing: 200-400mg Q4-6H MAX 1.2g/day NTE 10days

Dosing: 200-400 Q4-6H NTE 16/8tab, 600mg Q6-8H, 800mg Q6-8H

Pediatric Dosing: 10mg/kg/dose Q4-6H NTE 400mg/dose and 40mg/kg/day or 1600/2400mg/day

O/L: Abn uterine bleeding, acute gout, pericarditis

OTC: HA, migraine, sprains/strains, minor muscle/bone/joint pain

Administration: YES- food or milk to decrease GI upset

AE: Constip/Diarrhea, stomach pain, upset stomach, vomiting, heartburn, gas, dizz/drows,  Hyperkalemia

Watch for: lower back pain (kidney pain), GI bleeding

Risks: PUD/IBD, GI bleeding, CrCl <30mL/min, 3^rd trim, breastfeeding, <18 IV, <12 oral

Naproxen

(Aleve)

Dosage: naproxen sodium is faster onset; 200mg naproxen base=220mg naproxen sodium

-IR: 250-500mg Q12H max 1.5g/day

-DR: 375-500mg Q12H

-ER: 750mg-1g QD

OTC dosing: 200-400mg once, then 200mg Q8-12H prn, NTE 400mg in 8-12hr or 600mg in 24h

CONTRA: <30mL/min (or lowest eff dose)

Pediatric Dosage:; 5-7mg/kg/dose Q8-12H

-ped OTC >12yr: IR: 200mg Q8-12H NTE 600mg or 1g/d

Uses: Anti-inflammatory (gout, ankulosing spondylitis, bursitis, juvenile idio arthritis, osteo/rheumatoid arthritis, Dysmenorrhea, Pain, Fever,

O/L: acu migraine, abn uterine bleeding

-DR NOT FOR acute pain

Administration: WITH food/milk/antacids for GI, CONTAINS sodium (50mg/500mg)

AE: Diarrhea, Abd pain, gas, HA, Edema, Chest pain, rash, bruising, UTI, diz/drowz, ULCERS-bleeding

Risks: Gi bleeding/ulcer/perforation (PUD/GI bleeding), BEERS, inh platelet aggr, NO PREG

Meloxicam

(Mobic)

Dosage, 7.5, 15mg QD

Pediatric Dosing >2yrs under 60kg: 0.125mg/kg/day nTE 7.5mg/d

Uses: Pain, acute gout, osteoarthritis, rheumatoid arthritis

Administration: can be taken WITH food/milk for GI irritation

CONTRA: concurrent corticosteroids/anticoag/ antiplatelet, Renal impairment (<30mL/min po or <60mL/min IV), PREG >/=30wk, avoid taking other NSAIDS/aspirin

AE: Constipation, Diarrhea, stomach pain, V, loss of appetite, Dizz/HA, Heartburn, gas, flu-like, CV, GI bleeding

Acetaminophen

(Tylenol)

MoA: unk- inh central PG synthesis (specifically COX-2)

Dosing: 325, 500 Q4-6H or 1g Q6H , 600mg ER 2TabQ8H NTE 4g/d

Pediatric Dosing: 10-15mg/kg/dose NTE 75mg/kg/day or 4g/day

Uses: Fever, Pain

O/L: acute Migraine, Patent ductus arteriosus,

Administration: w/wo food, Can with food for GI upset, Take with full glass of water, NO Alcohol

AE: Nausea, Vomiting, HA, Insomnia

Risks: Liver failure

Sulfamethoxazole and Trimethoprim

(Bactrim)

MoA: inh bacterial synth of dihydrofolic acid by competing with PABA/irrev inh DHFreductase

Dosage: 400/80- 800/160mg  1-2ds tab Q12-24H

Prophylaxis dosage: 0.5-1t ss qd

Pediatric dosing: 8-12mg TMP/kg/day in divided doses Q12 H

PK: renally cleared, Inh/substr of CYP2C9

Uses: UTI (E. coli, Klebsiella, Enterobacter), Skin infection (s. aureus), PCP Pneumonia (Shigella flexerni/sonnei), GI infections (travellers diarrhea, dysentery-E. coli), Respiratory Infections (chronic bronchitis- H. influenzae), Otitis media

AE: N/V, Loss of appetite, Photosensitivity, Allergy (rash, flu-like symptoms, anaphylaxis – usually within 1^st day, but can appear anytime in therapy)

Risks: SULFA allergy

Administration: W/Wo food, WITH full glass of water (protects kidney)

Nitrofurantoin Monohydrate/Macrocrystals

(Macrobid / Macrodantin (IR))

Administration: WITH food for abs + GI eff, CAN be administered with water, milk, or fruit juice

Open? Macrodantin May be opened and mixed w/ food or juice for immediate use

Dosage: 100mg BID (Macrobid)- QID(Macrodantin) for 5 (F) or 7(M) days

Suspension dosage: 50-100mg Q6H

Prophylaxis doage: 100mg QHS or within 2hr of sexual intercourse (PO) or 50-100mg QHS (susp)

PK: contra/only short term for CrCl 30-60mL/min

Pediatric Dosage: 5-7mg/kg/dose NTE 100mg/dose Q6H for 7 days

Uses: Uncomplicated Cystitis (UTI) E.coli, staph saprophyticus in pt >12yr, suspension in >1mo (hemolytic anemia)

AE: N, HA, upset stomach, V, v appetite, urine brown, hemolytic anemia

Risks: may decrease sperm count (lasting 13-32 wks), Renal impairment (<60mL/min), Pregnancy 38wks-delivery

CONTRA: fluconazole, sys lidocaine, mercaptopurine, live cholera vaccine, articaine, levoketoconazole, methotrexate

Doxycycline

(Doryx, Vibramycin, Doxy 100)

Forms: Hyclate, monojudrate, calcium salts (all expressed as doxy base) 60mg modified polymer-coated tab (Doryx MPC) = 50mg normal DR

Dosage: 100mg BID or 200mg QD x 5-7 or 10d for sev

Uses: acne, malaria prevention, rosacea, COPD acute exacerbation, malaria, lyme, otitis media, STI (Chlamydia Syphilis alt), skin infec, anthrax, cholera, clostridium, G- infec (Ecoli, kleb, shigella, Neisseria (UTI))<G+ strep

Administration: IV=PO bioav, may take WITH meals for GI upset, CAP WITH full glass water, SIT UP for 30min-2hr after taking (for irritation/ulceration of esophagus), NO CHEWING/CRUSHING, take in the morning

-Separate Ca/Fe/Al/Mg/Bismuth Subsalicylate by 2-2 hrs

Watch for : ch tooth color, liver tox, throat irrit

AE: Diarrhea, abd pain, esophageal injury, photosensitivity, skin pigmentation/dental discolor, bone growth suppr in infants

Cefazolin

(Ancef, Kefzol)

2g Q8H x 7-14d

Ped Dosing: 25-100mg/kg/d (div Q8H) MAX 12g/d

Uses: MRSA, compl UTI, TSS, skin/soft tiss infection, peunomia, endocarditis, sepsis

Administration:

AE: Diarrhea, upset stomach, V, v appetite, Stomach pain/heartburn, Gas, HA, thrombocytopenia

Warnings: renal functions