Top 100 - doses

250-500mg TDS or 1g BD

• (MIMS)
• Adult, children >20kg: 250-500 mg q8h
• children <20kg: 20-40mg/kg/day in 3 divided doses

• (AMH)
• Adult: orally: 250-500mg tds OR 1g BD
• 1g TDS (severe infections)
• IM/IV: 1g q6h (max 12g d (severe infections))

• Child: orally: 7.5-25 mg/kg q8h (80-90mg/kg in severe infections)
• IM/IV: 10-25mg/kg q8h (max 50mg/kg q4h)

1 BD for 5-10 days

• AMH:
• Adult: 500-875mg q12h for 5-10 days or longer depending on infection

• Children: 7.5-15mg/kg q8h for 5-10 days, max 22.5mg/kg q8h in severe infections
• Duo product: 12.5-22.5mg/kg q12h

• acute bacterial sinusitis: tds for 7-14 days
• UTI: bd for 5 days
• max 14 days without r/v

• 250-500mg QID or 500mg-1g QID-BD
• UTI Px: 250mg n
• UTI Tx: 500mg BD

• 1 BD (150)
• 1 D (300)

• 2 stat then 1 d (100) (max 200mg d)
• Acne: 50mg d
• Malaria: 1d (100) for 2d before, during and 2-4 weeks after

• mane preferred
• DEET

1 BD (375mg CD)

• AMH:
• Adult: CD: 375-750mg BD (max 4g d) OR 250-500mg q8h
• Child: 10-15mg/kg q8h OR 20mg/kg q12h (max 1g/dose)

With food

250-500mg q6h (max 4g d)

• AMH:
• po: 250-500mg q6h (max 4g d)
• IV: 1-2g q6h, max 12g d

empty stomach

200-400mg TDS (max 4g d)

• child: 7.5mg/kg q8h
• tabs with food, liquid 1hr before food
• EtOH (during + 24 hrs after)

1 d (10/20/40/80)

1 n (10/20/40/80)

• 1 D
• usually 150mg d; 300mg if req
• start at 75mg

1 d (4/8/16/32 - usu 8; 16 if req)

1d (usu 20-40; 80 if req)

• 10-20mg BD
• initially 5mg BD

painful ulcers (any region of GI tract - mouth, perianal region most common)

• 100mg d
• Load: 200-300mg for 5-7d
• TDM drug - slow metabolisers = very low doses, test after 3-5 days, MM kinetics
• diabetes - hypos risk
• P neuropathy
• monitoring: weight, BSLs, hepatotoxicity, p neuropathy, levels

5-10mg d

• reduce dose in elderly/renal imp - 2.5mg
• 30-60mL/min = 1d
• 15-30mL/min = alt days

1 d (2.5-10) in 1-2 doses (BD for HF)

2.5-5mg d (max 10)

• IR: 180-240mg d (3-4 divided doses)
• CR: 180-360 d

10-20 d

• IR: 20-40mg BD
• CR: 20-30 D, max 90 D (angina) OR 120mg d (HTN)

• Med box:
• IR: 1 D (10/20)
• CR: 1 BD (20/30/60)

• IR: 160 BD-TDS
• CR: 120-240 D-BD

25-100mg d

10mg d (initially 1.25mg d and gradually titrate up)

1 D (3.125/6.25/12.5/25)

• Maintenance:
• 25mg bd (max if <85 kg)
• 50mg bd (max if >85kg)
• initially 3.125mg BD and titrating up at intervals of at least 2 weeks

• 50-100mg D-BD (HTN, migraine)
• 50-100mg BD-TDS (Angina)
• CR: 23.75mg-190mg D (maintenance)

• 120-320mg d (in 3 divided doses) (HTN, angina, tremor)
• initially 20-40mg bd - tds

• 3-20mg D (in 2-3 divided doses)
• initially 0.5mg BD

• po: 150-300mg BD (MD) (HTN)
• 25mg BD, max 75mg BD (menopausal flushing)

• withdrawal syndrome - risk of rebound hypertension, withdraw gradually over at least 7 days
• withdrawal may worsen wtih BB. Stop BB days before removing clonidine
• depression - may exacerbate, avoid
• Common: sedation, depression, constipation, othostatin

• 50-200mg D
• initially 25mg BD, caution with doses > 100mg D

• arterial vasodilator
• give 300mg D in 4 divided doses with ISDN (HF)
• usually add BBS and thiazides to prevent tachycardia and fluid retention
• Common sfx: oedema, flushing, tachycardia

• 100-400mg D
• use lowest MD to control arrhythmia
• Loading required: po schedule: 200-400mg tds for 1 week, then 200-400 BD for 1 week

• iodine allergy = C/I
• monitor q6m: Thyroid fn, Lung fn (CXR), EUC (hypo/hyperK, hypoMg)
• eye exam anually
• counselling: sun exposure, regular tests, tell dr if dyspnoea, dry cough, problems with vision, wt loss, muscle weakness, worsening of heart symptoms

• 62.5-250mcg D
• tailor dose according to renal fn, clinical resp, and levels

• SS after 5 days
• Rnage: 0.6-2.6nmol/L
• toxicity: a --> n --> v
• Common sfx: a, n, v, d, blurred VISION, confusion,

50-100mg po BD, max 400mg D

20-80mg D

5-20mg D

max 40mg D (specialist supervision)

10-80mg D (usually 40mg - existing/risk CAD)

• 145mg D
• (Lipidil)

• lower dose in renal imp:
• 20-60mL/min = 96 mg D

• TRIGLYCERIDES
• MOA: PPAR-g activators - lower TG, inc HDL ( mod), variable LDL effects
• Common ADR: GI (dyspepsia, abdo pain)
• infrequent: photosensitivity
• monitor LFTs

10mg D

• Reduces absorption of cholesterol (dietary and biliary) by inhibiting its transport across the intestinal wall = inc. LDL uptake
• Tell GP if muscle pain, tenderness or weakness
• Fibrate tx - increase risk of GALL BLADDER disease
• Common ADR: headache, diarrhoea

1 D (2.5/5/10)

• Plendil ER
• Felodur ER

1 D (mane) (2.5/5/10/20)

• AMH:
• usu 10-40mg D (HTN) as 1-2 doses
• 10-20mg D (HF) as 1-2 doses

Renitec

25-50mg TWICE daily

Capoten

1 D (mane) (5/10/20)

Prinivil

1 D (F: 10/20, HCT: 12.5)

Monoplus, Fosetic

1 D (5/10/20)

• Maintenance:
• 10-40 D (mane) (in 1-2 doses) (HTN)
• 5-10 D (HF)
• 2.5-5 D (elderly/renal imp/taking diruretic)

Accuretic, Accupril, Acquin

• IR: 1.25-2.5 D (mane)
• CR: 1.5 D

Risk of hypoK lower with CR tablet

1 D (usu 1-2mg D, max 4mg D)

Gopten

100-150mg D (anti-platelet)

300-900mg D (analgesic)

10mg D (2 weeks TKR, 5 weeks THR)

• Factor Xa inhibitor (selective) - blocks thrombin production, conversion of fibrinogen to fibrin, and thrombus development
• No antidote
• Common ADR: bleeding, signs of bleeding (e.g. anaemia)
• Oral (fondaparinux = sc)

• 110mg BD
• 150mg D (CrCl 30-50mL/min)

• Direct thrombin inhibitor
• 10 days after TKR, 4-5 weeks (28-35 days) after THR
• lower dose (150mg) with amiodarone and conventional verapamil (or 2 hrs before Verapamil to avoid interaction)

• 1mg elemental iron =
• ferrous fumarate 3mg
• ferrous sulphate (dried) = 3mg
• ferrous sulphate (non-dried, heptahydrate) = 5mg

• EMPTY STOMACH (1 hr b4/2 hrs after)
• Shortly after food if upset stomach
• Minimise GI sfx by: slowly inc dose, use CR (may have lower F)
• accidental overdose serious - v, d, hypotension, tacchycardia, acidosis, CNS depression.

• amiodarone
• griseofulvin
• NSAIDs
• phenothiazines (chlorpromazine, pimozide, clozapine, promethazine, etc. - 'z-drugs')
• methoxsalen (for psoriasis)
• quinolones (ciprofloxacin, moxifloxacin, norfloxacin, ofloxacin)
• retinoids (acitretin, adapalene, isotretinoin, tazarotene, tretinoin)
• SJW
• tetracyclines (doxycycline, minocycline, tetracycline)
• thiazides (rare)

• triclosan
• coal tar derivatives
• fragrances
• methoxsalen
• retinoids (adalaplene, isotretinoin, tazarotene, tretinoin)
• sulfonamides

• BD except for mometasone and methylprednisolone, which are applied ONCE a day
• no benefit from more frequent application, some cases less may be adequate (e.g. eczema)
• Dose = finger tip unit; tip of index to first crease: area twice size of adult hand with fingers together
• Apply enough to cover affected areas. Smooth gently into skin, preferably after bathing

• 0.5-1%
• mild
• DermAid, Cortic-DS, Cortef, Sigmacort

• 0.02%, 0.05%
• moderate
• 0.02% Betnovate 1/5, Cortival 1/5, Celestone-M

• 0.05%
• moderate

• 0.02%
• moderate
• Aristocort, Tricortone

• 0.05%
• potent
• Diprosone, Eleuphrat

very potent = diprosone OV

• 0.1%
• potent (vs. 0.05% and less = moderate)
• Betnovate, Cortival

• 0.1%
• potent
• Elocon, Novasone

• 0.1%
• potent
• Advantan

• 0.5mg/kg d (as 1-2 doses)
• treatment continued until total cumulative dose is 120-150mg/kg (usually 4-5 months)
• Roaccutane, Oratane

• PPs:
• with food
• promptly report n, headaches, visual changes (poor night vision or blurring)
• dry lips, mouth, eyes - vaseline, lubricating eye drops. tell dr if not mgeable
• avoid vit A supplements
• photosensitivity - physical barrier sunscreen
• Cat X - contraception during and for 1 month after
• monitor BSLs in pts predisposed to diabetes

ADRs: hyperlipidaemia, tetracyclines - inc risk of benign intracranial HTN, photosensitising meds, topical retinoids

• 1% - head lice
• 5% - scabies: adult - 1 tube/application, 5-12 yrs - 0.5 tube, 1-5 yrs - 0.25 tube

• scabies - apply chin-down and wash off with warm soapy water 8-14 hours later. rinse thoroughly. rpt after 7 days.
• also apply to neck, face, scalp and ears in children <2 yrs, elderly or immunocompromised ppl, tx failure

head lice: apply to damp hair after washing with usual shampoo, leave in for 10 mins, rinse with warm water, rpt after 7/7. Use fine tooth comb to remove dead lice/nits.

• 2 sprays D - acute phase
• 1 spray D - MD

• Beclomethasone 50mcg/dose - Beconase Allergy & Hayfever (use BD)
• Budesonide 32mcg/dose - Rhinocort Hayfever; 64mcg/dose - Budamax, Rhinocort
• Fluticasone 27.5mcg/dose - Avamys, 50mcg/dose - Beconase Allergy & Hayfever 24 hour
• Mometasone 50mcg/dose - Nasonex
• Triamcinolone 55mcg/dose - Telnase

2.5-20mg D (1-2 divided doses)

Daonil, Glimel

• IR: 40-320mg D (1-2 divided doses, max 160mg/dose)
• CR: 30-120mg D

NB: 30mg CR = 80mg IR

Diamicron, Glyade

1-4mg D

Amaryl, Aylide

2.5-40mg D (1-2 doses - divide doses > 15mg)

Minidiab

15-30mg D (max 45mg D)

Actos

4mg D (max 8mg D in 1-2 doses)

Avandia

• 100mg D
• reduce dose in renal imp
• 25mg, 50mg, 100mg tabs av

Januvia

DPP-1 inhibitor (gliptin)

50mg D-TDS swallowed whole with liquid immeidately before a meal or chew with first few mouthfuls of food

Glucobay

5mcg BD (10mcg BD if tolerated) - 60 mins before breakfast and dinner

• GLP-1 analogue
• Byetta

• IR: 500-850mg D-TDS according to response (Max 3g D)
• CR: 500mg-2g D (with evening meal)
• Reduce dose in renal imp:
• 60-90mL/min - 2g D
• 30-60mL/min - 1g D

• usual: 100-200mcg D
• start at 25-50mcg, increase according to TSH

• initially 20-40mg D (up to 60mg in severe cases) for 3-4 weeks
• MD: 5-15 mg D

• Neo-Mercazole
• common: itching & mild rash --> antihistamines
• rare: agranulocytosis - rapid onset in 1st 3 months -->tell dr stat: fever, mouth ulcers, sore throat, rash, severe fatigue, abdominal pain, jaundice

1200-1300mg (including diet)

• Dietary intake (Australian recommendations):
• 1300mg - men >70, post-menopausal women, adolescents 12-18 yrs
• 1000mg for all other adults

• Fosamax Plus Once weekly 70/70 OR 140: alendronate 70mg, cholecalciferol 70mcg OR 140mcg
• Fosamax Plus D-Cal: alendronate 70mg, cholecalciferol 140mcg (4), calcium 500mg (48)

• 70mg once weekly OR
• 10mg D
• avoid use if CrCl <35mL/min
• combination pack with:
• cholecalciferol 70mcg OR 140mcg - 1/week (Fosamax plus 70/70 OR 70/140)
• cholecalciferol 140mcg (w/ alendronate) & calcium 500mg (Fosamax plus D Cal)

• Actonel Combi: risedronate 35mg (4), calcium 500mg (24)
• Actonel Combi D: risedronate 35mg (4), calcium 1000mg, cholecalciferol 22mcg (24)

• 5mg D OR
• 35mg weekly OR
• 150mg monthly
• not recommended if CrCl < 30mL/min
• Actonel

0.25mcg BD

(0.75mcg D when for OP prev'n w/ oral pred dose >10mg D)

Rocaltrol

• 25mcg D
• 75-125 (3-5) daily for 6-12 weeks as loading dose

60mg D

• Evista
• SERM - oestrogen agonist effects on bone, antagonistic effects at other oestrogen-responsive tissue (e.g. breast, endometrium)

2g D (bedtime, at least 2 hrs after food) - sachet, mix with water

Rare ADR: VTE, DRESS (drug rash with eosinophilia) --> rash = seek advice promptly

Protos

• Bacterial conjunctivitis:
• 0.5% eye drop: 1 drp q2-4h for 2 days, then if there is improvement, 1 drop qid for 5 days
• 1% ointment: use n as adjunct to eye drop, or as single agent TDS, e.g. in children

• Prevention of infection after sx/superficial trauma:
• 0.5% drop: 1 drop qid until epithelium healed (rarely > 4 days)
• do not supply OTC if eye is red and painful (esp. if contact lens wearer) - further investigation req'd

• BB (e.g. timolol) --> 1-2
• PG analogue (e.g. latanoprost) --> 1
• Carbonic anhydrase inhibitor --> 2 (except dorzolamide when single agent --> 3)
• A2 agonist (e.g. brimonidine) --> 2
• cholinergic (e.g. pilocarpine) --> 2-4

• BBs - dec aqueous humor formation
• PG analogues - inc UV scleral outflow
• A2 agonist - dec aq humor formation and inc UV scleral outflow
• CA-i - dec aq humor formation
• ie. dec aq humor formation - all classes except PG analogues, A2 agonists - do both (2 for both!)

• PPI - standard dose BD
• clarithromycin 500mg BD
• amoxycillin - 1g BD
• duration: 7 days

• PPI - standard dose BD
• clarithromycin - 500mg BD
• metronidazole - 400mg BD
• duration: 7 days

• PPI - standard dose BD
• amoxycillin - 500mg TDS
• metronidazole - 400mg TDS
• duration: 14 days

300mg daily (1-2 divided doses)

Usually 20mg D-BD (range: 20-40mg D-BD)

• tablet - swallow whole or dispserse in water and drink within 30 mins
• oral liquid/sachet av

Nexium

15-30mg D

• capsule - open and mix with juice/yogurt
• tablet - suck, swallow whole with water, disperse and drink stat

Zoton

MD: 10-20mg D

Losec, Acimax

20-40mg D

somac

10-20mg D

Pariet

• 10-20mg TDS-QID
• doses can be repeated after 30 mins prn

• MOA - SM relaxant, dec GI motility
• Indications: GI spasm, aid in endoscopy, IBS

buscopan, setacol

135mg TDS

• MOA: SM relaxant, reduces GI motility and spasm
• indications: IBS

Colese, Colofac

10-20mg TDS -QID

• n+v, gastroparesis: 10-20mg q6-8h (TDS-QID) (max 80mg D) (12 weeks - n+v, 6 months - gastroparesis)
• stimulation of lactation: 10mg TDS for 5 days, then taper down

• prolongs QT interval - C/I with ketoconazole, erythromycin and other potent inhibitors of CYP3A4 (e.g. fluconazole, clarithromycin)
• ADRs: dry mouth (common), hyperprolactinaemia --> boobs, leaking (infrequent), EPSE (rare)

Motilium

10mg TDS

• n+v, gastric stimulation, lactation stimulation
• caution - PD (prefer domperidone) - EPSE, depression + elderly - avoid LT use

dopamine ANTagonist

• n+v: initially 20mg, then 10mg 2 hrs later
• if still needed, 5-10mg TDS PRN

potentiates CNS dep - C/I

• ADR: common: constipation, dry mouth, drowsiness, parkinsonism, EPSE (esp children), hyperprolactinaemia
• rare: prolong QT

counselling - L1: drowsy, EtOH

• Nausetil, Stemetil, Stemzine
• 5mg tabs, 25mg suppositories

1-2 tabs, max 4/24 hrs (halve dose in children)

• 1 tab = 0.3mg = 300mcg
• take 1st dose 30 mins before travel, repeat in 4-6 hrs prn
• indication: motion sickness
• Kwells, Travacalm HO
• combination: Travacalm original (hyoscine butylBr 0.2mg. dimenhydrinate 50mg, caffeine 20mg)

100-150mg D-BD (max 480mg D)

onset 1-3 days (po)

2 TDS-QID PRN

diphenoxylate 2.5mg (+ atropine 25mcg)

L1 - drowsiness, alcohol

acute diarrhoea, SHORT TERM: initially 4mg, then 2mg after each loose bowel motion (max 16 mg D)

loperamide 2mg

loperamide 2mg, simethicone 125mg

diarrhoea associated with gas-related abdominal discomfort, SHORT TERM

• 2 tabs or 1 sachet into 200mL fresh drinking water/freshly boiled and cooled water
• Age determines dose:
• 6-24 months: 1 sachet/q3-4h
• 2-5 yrs: 1-2 sachet/q3-4h
• 5-8 yrs: 2 sachet/q3-4h
• 8-10 yrs: 1 sachet/q1-2h
• 10-12 yrs: 1 sachet/q1h (up to 6-12 sachets in 24h)
• adults, children >12y: 1-2 sachets after every loose bowel motion (up to 8-12 sachets in 24 hrs)

• seek medical advice if diarrhoea persists:
• <6 months: >6 hrs
• <3 yrs: >12 hrs
• 3-6 yrs: > 24 hrs
• 6+ yrs: >48 hrs

• Reconstituted soln can be stored for up to 24 hrs in FRIDGE, otherwise d/c w/in 1 hr
• If vomitting - drink in small amounts at first

1 applicatorful D-BD for 2-3 weeks, then every second day until remission achieved

• indications: UC, CD; mild rectal/rectosigmoidal disease
• hydrocortisone 10% - rectal foam

• balsalazide - Colazide
• mesalazine - mesasal, salofalk, pentasa
• olsalazine
• sulfasalazine - salazopyrin (contains sulfonamide moiety)
• monitoring: renal and liver fn - baseline, q3m for 1 yr, then q6m

• Acute: 2-4g D in 3-4 doses (UC), 3-6g D (CD)
• MD: 500mg QID
• RA: initially 500mg D (max 3g), MD: 2-3g D
• C/I - allergy to sulphonamides, blood dyscrasias
• common sfx: reversible male infertility, haemolysis (usu not severe)
• take WITH FOOD
• STAINS - urine - dark orange, skin & tears - yellow, soft contacts - stained
• impairs absorption of FOLIC ACID (NB: sulfonamide moiety)- consider supplements

• 120mg TDS with main meals
• Do not take dose if you miss a meal/meal dose not contain fat
• likely to cause fatty or oily stools, esp when diet too high in fat
• efficacy for up to 4 yrs
• mean wt loss of approx 2-4 kg in 1st yr
• may decrease abs of fat-sol vitamins (ADEK) - supplement if necessary at least 2 hrs from orlistat dose
• orlistat

• oral: 2.5-5mg BD-TDS (max 20mg D) (Ditropan)
• patch: 1 patch TWICE weekly (q3-4 days) - apply to abdomen, hip or buttock; patch = 3.9mg/24hrs (Oxytrol)
• anticholinergic
• urinary urge incontince

• 5-10mg D
• anticholinergic
• urinary urge incontinence
• Vesicare

• alfuzosin
• prazosin
• tamsulosin
• terazosin

MOA: block A1 receptors, relaxing SM in bladder neck, decreasing resistance to urinary flow

• tamsulosin most selective
• less effect on BP: tamsulosin, alfuzosin - better tol
• prazosin - short duration of action - BD

• precautions:
• intra-operative floppy iris syndrome during cataract sx (esp tamsulosin)
• first dose hypotension

0.5-2mg BD

Minipress

400mcg D

flomaxtra

5mg D

indications: BPH, alopecia in men

Proscar

• 100mg D-BD, max 400mg D
• Do not use >200mg D LT - risk of CV ADR dose-related

Celebrex

• 75-150mg D in 2-3 divided doses (max 200mg D) (po)
• 1-2 TDS PRN (25)

1% gel - rub into affected area BD - TDS PRN

200-400mg TDS-QID PRN (max 2400mg D)

Nurofen, Panafen, brufen, advil

NB: ibuprofen can reduce the antiplatelet activity of low-dose aspirin, possibly reducing or negating its cardioprotective effect - consider if using LT

• po: 25-50mg BD-QID
• pr: 100mg D-BD

Indocid, Arthrexin

7.5-15mg 1 D PRN

Mobic, Movalis

• IR: 250-500mg BD
• CR: 750-1000mg D
• max, 1250mg D

period pain: 500mg initially, then 250mg q6-8h prn

NB: naproxen may reduce/negate cardioprotective effects of low-dose aspirin

CR products - take nocte to reduce nocturnal and morning sx

Inza, Naprosyn, Naproxyn SR

• 1mg/kg D (usually 50-100mg D in 1-2 doses)
• MD: 50-150mg D (1-2 doses)

Allopurinol reduces AZA metabolism = inc risk of severe BM toxicity. Redue AZA dose to a QUARTER or a THIRD of normal dose.

Referal: persistent fever, sore throat, bruising, bleeding, paleness

Imuran

5-25mg once weekly, depending on response

referal: cough, difficulty breathing, signs of infection

photosensitivity

• monitor: FBC, Hep B + C serology, pulmonary fn tests + CXR
• GI ADRs:
• folic acid supplements - 1mg D to reduce GI ADRs (stomatitis, nausea, diarrhoea)
• divide oral dose into 3 - take at 0, 12, 24 hrs
• may be 1-2 months before effect seen

• RA: 2-3 (200mg) D for 1-3 months
• MD: 1-2 D (if desired/responsive)

malaria p'laxis: 400mg once weekly (start 1 week before leaving and 4 weeks after leaving endemic area)

• MOA: anti-inflammatory + immunosuppressive effects
• Indications: mild RA, malaria prophylaxis of chloroquine not available (reasonable 1st choice in mild disease)

ADRs: retinopathy (rare) - tell dr if any changes in sight, wear sunglasses - VISION!

• 500mg D (inc to max of 3g D)
• MD: 2-3 g D

• with food
• monitor: FBC, renal and liver fn tests
• 1-3 months for effect

• 100-300mg D
• prevention of hyperuricaemia due to tumour lysis syndrome: 600-800mg D

• MOA: inhibits xanthine oxidase = dec uric acid production
• after food
• stop + see Dr: rash, swollen lips or mouth, persistent fever, sore throat
• drink lots of fluids - prevent kidney stones
• L1 - drowsy
• interaction with azathioprine/mercaptopurine - reduce their dose to a QUARTER to a THIRD normal dose
• consider low-dose NSAID/low-dose colchicine to prevent gout during 1st 3 months of tx

• Progout
• zyloprim

• tx: 1mg ASAP, then 500mcg 1hr later (max 1.5mg/course)
• prophylaxis: 500mcg D-BD

MOA: inhibits neutrophil activity - reduces inflammatory reaction to urate crystals (no effect on uric acid)

common ADR: GI (n, v, d, abdominalk discomfort)

Dr: severe v/d, myalgia, peripheral neuropathy, unusual bleeding, infection

accumulation and toxicity if used with CYP3A4 inhibitor (e.g. clarithromycin), or course repeated too quickly

Colgout, Lengout (500mcg tabs)

• Apply BD - QID PRN for up to 14 days, r/v use afterwards
• may stain skin and discolour skin - rub in properly
• photosensitivity
• rice for days 1-2

• Epilepsy:
• usual range = 400-1.2g D (in 2 + doses) (max 3g D)
• initially 100mg BD and titrate up

• neuropathic pain: 200-600mg BD
• mania/bipolar: 400mg D (divided doses), titrate up to effect

th range: 4-12mg/L

• MOA: prevents repetitive neuronal discharge by blocking
• voltage and use-dependent Na channels

• Indications:
• - partial seizures (simple and complex), generalised tonic-clonic
• - bipolar - acute mania and prevention
• - neuropathic pain

• Increase dose slowly - auto-induces own metabolism monitor for life-threatening skin reactions
• risk of osteomalacia - vit D + cal supp's

Tegretol

400mg - 1.2g D (in 2-4 divided doses) (max 2g D)

Tegretol

• In 2-4 doses:
• 400mg - 1.2g D, max 2g (epilepsy)
• 400-800mg D, max 1.6g (trigeminal neuralgia)
• 200-600mg D, max 1.2g (neuropathic)
• 400mg D, max 1.6g (mania/bipolar)
• Tegretol

• partial seizures: usually 0.9-1.8g D (in 3 divided doses)
• neuropathic pain: 1.8-3.6g D (in 3 divided doses), but initially 100-300mg nocte

• L1 - drowsiness, EtOH
• L9 - do not stop abruptly

Neurontin

• 100-200mg D (in 1-2 doses)
• (OR 200-400mg D (in 2 doses, up to 500-700mg D) in pts taking enzyme inducers and not taking valproate)

ADR: common: VISION (diplopia, blurred vision), dizziness, somnolescence; SEVERE SKIN REACTIONS - occur with rapid dose inc/valproate tx

Lamictal, Seaze

500mg BD, up to 1.5g BD (adults, children > 50kg)

Keppra

usually 200-500mg D (in 1-2 doses)

not effective in absence and myoclonic seizures

• ADRs: VISION (diplopia, blurriness), gingival hypertrophy - visit dentist regularly
• TDM - total PHY = 40-80mmol/L
• saturable metabolism/MM kinetics

Dilantin

75-150mg BD (max 300mg BD) (partial seizures + neuropathic pain)

Lyrica

epilepsy: 600mg D (in 2 doses) titrate to response, max 2.5g D

• common ADR: increased appetite, wt gain, elevated ALT/AST, blood dyscrasias --> fever, rash, abdo pain, bruising, bleeding (inc INR/thrombocytopaenia)
• BMD - monitor/supplement vit D/Ca

indications: epilepsy, migraine, bipolar

Epilim (100, 200, 500mg)

• Levodopa
• DOPA-decarboxylase - carbidopa, benserazide (given with levo) - decreases peripheral metabolism of levo (= less n, v, hypotension)
• MAO-B inhibitor - selegeline (levo adjunct)
• COMT-i - entecapone (levo adjunct)
• dopamine agonists - pramipexole (non-ergot), carbergoline
• apomorphine - stimulates dopa Rs, use with domperidone (highly emetogenic)
• Amantadine - dopaminergic and anticholinergic activity
• anticholinergics - benzhexol, benztropine, etc. - used infrequently

200mg with each levodopa/carbidopa or benserazide dose (max 2 g D)

• COMT-I
• indications: adjunct to levo with motor fluctuation

Comtan (200mg)

dosage expressed as levo: 50-100mg TDS, titrate to response (max 2g D)

levodopa : benserazide/carbidopa = 4:1, 10:1 ratio also av with carbidopa

do not stop suddenly, take at same time daily and same way (with/without food - food reduces abs of levo, but minimised GI fx)

• w/ Benserazide
• Madopar (50-200mg levo) rapid (tab)
• Madopar (50-200mg levo) (cap)

• w/ Carbidopa
• Sinemet, Kinson (100-250mg levo)
• Sinemet CR (200mg levo)

• w/ Carbidopa + Entecapone
• Stalevo (50-200mg levo) + 200mg entecapone

• 50-100mg ASAP after headache onset
• MOA: constrict cranial vessels (selective 5HT1B/D) - C/I in IHD, TIA
• indications: acute relief of migraine
• take as headache beginning to develop; if no improvement with first dose, do not repeat; repeat after at least 2 hrs if migraine recurs
• Imigran, Sumagran

• 5-10mg D (bedtime)
• Anticholinesterase
• Aricept

• 8-16mg D (mane, max 24mg)
• anticholinesterase
• Reminyl, Galantyl

• 100mcg levo, 20mcg ED - microgynon, loette, microlevlen
• 150mcg levo, 30mcg - microgynon, levlen, monofeme, nordette

monorest, femtran, estraderm, climara

• 10mg escitalopram
• 20mg citalopram, fluoxetine, paroxetine
• 50mg sertraline
• 50-100mg fluvoxamine

dose may be higher in OCD or eating disorders (vs. for depression or anxiety)

20mg D (max 60mg)

Cipramil

10mg D (max 20mg D)

Lexapro

20mg D (max 60mg D)

longer t1/2

Lovan, Prozac

50mg D, titrate to effect (max 100-300mg D)

nocte of somnolence exp'd

Luvox, Movox

20mg D (max 50mg D)

short t1/2 - more likely to exp withdrawal fx

Aropax

50mg D (max 200mg D)

Zoloft, Eleva

• depression: 75-150mg D (max 300mg D)
• pain mgt, migraine p'laxis: 10-25mg N (max 75 in migraine, 150mg pain)
• Urge incontinence: 10-25mg D-TDS
• Endep

75-150mg D (max 300mg D, except nortriptyline - max 150mg D)

• amitriptyline, nortriptyline, imipramine - nocturnal enuresis, urge incontinence
• (amitriptyline also indicated for pain mgt, migraine p'laxis)

75-150mg D (max 300mg)

Prothiaden, Dothep

• maj depression: 75-150mg D (max 150mg)
• nocturnal enuresis: 10-20mg nocte
• urge incontinence: 10-25mg D-TDS
• Allegron

50mg D (max 200mg D)

• major metabolite of venlefaxine
• SNRI

Pristiq

30-60mg D

• SNRI
• indications: major depression, GAD, painful diabetic peripheral neuropathy

Cymbalta

15-45mg nocte (max 60mg)

• tetracyclic antidepressant
• post-synaptic blockade of 5HT2 & 3 Rs, presynaptic blockade of central A2 autoRs

Axit, avanza, mirtazon

450-600mg D (in 1-2 doses, usual max 600mg D)

• indications: depression and anxiety
• selective MAO-A-i - inc presynaptic conc's of 5HT, dopamine, NA - take doses no later than early afternoon
• low tyramine diet not required

aurorix

75-150mg D, sometimes 225mg (max 300mg)

hypertension - may be exacerbated, monitor BP when starting

Efexor

• weight
• blood gluclose
• BP
• lipids
• FBCs
• LFTs

• AP: 25-100mg TDS - QID (max 1000mg D)
• acute beh dist: 50-100mg q2h PRN (max 500mg D)

indications: antipsychotic, ST mgt of anxiety/agitation/disturbed beh, intractable hiccup

ADR: photosensitivity, contact dermatitis on contact with soln

largactil

usually 200-600mg D (max 900mg)

monitoring: neutrophils, WBCs

caffeine and smoking - affect dose

Clopine

• chronic psychoses: 1-5mg BD-TDS (max 30mg D); 0.5-10mg D in elderly (EPSE)
• acute psychoses and mania: 5-10mg q2h PRN

indications: acute and chronic psychoses. acute mania, severe anxiety/agitation/beh disturbance

Serenace

• schizophrenia: 10-20mg D
• acute mania and MD in bipolar: 2-20mg D

indications: schizophrenia, bipolar (adjunct to Li/valproate)

• common ADR: hyperglycaemia, T2DM, wt gain, p oedema, constipation
• EPSE infrequent

Smoking - affect levels

Zyprexa

300-800mg D, lower doses generally required for bipolar than schizophrenia

• schizophrenia:
• IR: 150-800mg BD, usual effective dose 400-800mg BD
• CR: 400-800mg D

• bipolar:
• IR: 300-800mg D (in 2 doses)
• CR: 300-800mg D

indications: schizophrenia, monotherapy/adjunct in bipolar (to lithium/valproate), adjunct in major depression

• common: tachycardia, constipation, somnolescence
• infrequent: inc ALT/ALP, wt gain, neutropenia

Seroquel

• schizoprenia, bipolar (acute mania): usual range = 4-6mg D (po), 25-50mg q2weeks (im)
• behaviour dist in demetia: 0.25-1mg BD

Risperdal, Risperdal Consta (im)

250-1000mg D (in divided doses - BD if CR product) (max 2500mg D)

hyponatraemia (e.g. dehydration, low Na diet) - inc risk of toxicity

toxicity = blurred vision, extreme thirst, frequent urination, n/v/d - tell pt!, esp during illness/excessive sweating/low fluid intake

avoid urinary alkalinisers- decreases potency

TDM: 0.4-1mmol (prophylaxis)

monitoring: TSH, ECG, electrolytes, LFT, FBC

• Lithicarb (250mg IR)
• Quilonum (450mg CR)

0.5-4mg D (max 10mg D - panic disorder)

Kalma, Xanax

• depends on indication
• anxiety, agitation, parasomnia: 1-10mg TDS PRN

Valium, Antenex

indications: ST mgt of anxiety, agiation, acute EtOH withdrawaal, muscle spasm, benzo withdrawal

0.5-2mg nocte

Hypnodorm

1-4mg

Ativan

5-10mg nocte

Alodorm, Mogadon

7.5-30mg nocte (3-4 times daily for anxiety)

Serepax, Murelax

5-20mg nocte

normison

5-12.5mg nocte

• Stilnox
• 6.25mg, 12.5mg CR
• 10mg IR

3.75-7.5mg nocte

Imovane

• approx 1mg/kg/day (1.2mg/kg) - give as a single dose mane, or m and late afternoon (max 100mg D)
• MOA: inhibits presynaptic NA reuptake
• ADHD
• common: GI fx, inc BP, somnolescence, aggression
• rare: suicidal thoughts/behaviours, hepatic dysfn
• couselling: L1 + GP for signs of hepatotoxicity (yellowing of skin/eyes, dark urine, tiredness, pale faeces)
• Strattera

• child: 2.5-10mg D
• adult: 10mg m, titrate up to 60mg D (divided doses)
• MOA: enhances dopaminergic and NA NT
• indications: ADHD, narcolepsy
• avoid taking doses after early afternoon
• no brand

• 5-40mg D in divided doses (unless LA prep) (max 60mg in adults)
• 5-10mg daily, titrate to effect (max 40mg D) (<10mg D in 1-2 doses. >10mg D in 2-3 doses)
• MOA: enhance NA and dopaminergic neurotransmission
• indications: ADHD, narcolepsy
• avoid taking doses after early afternoon
• IR: ritalin
• LA: Concerta, Ritalin LA

• adult >60kg: 2 tabs TDS
• adult <60kg: 2 tabs m, 1 midi, 1 n
• tablet = 333mg
• MOA: reduces cravings, GABA analogue
• indications: maintain abstinence in alcohol dependence
• preferred when opiods used for pain
• Campral

• MD: 200mg D (max 300mg D)
• deters EtOH use - blocks acetylaledhyde - prevents usual metabolism of alcohol --> unpleasant effects if EtOH consumed (flushing, sweatgin , n+v, palpitations, dyspnoea, etc.)
• indications: maintenance of abstinence
• precautions: IHD (C/I), isoniazid and metronidazole inc's risk of toxic reactions
• referral: jaundice sx, AVOID ETOH (inc. alcohol containing aftershaves, body lotions, vinegar, etc.) during tx and 7 days after
• Antabuse

• 50mg once D
• MOA: opiod antagonist - reduces cravings and pleasurable fx
• adjust in tx and maintenance of abstinence
• precautions: opiod tx, imp liver fn
• monitor: LFTs (esp. bilirubin)

• 150mg m (3 days), then 150mg BD for 7-9 weeks
• 150mg m in elderly
• take medication for at least a week before you stop smoking - takes this long for it to be effective
• inhibits dopamine and NA reuptake
• may exacerbate schizophrenia, dep, bipolar, seizure
• ADRs: INSOMNIA, agitation, tremor, fever, rash, dry mouth, constipation, tachy (infreq.)
• stop taking if not markedly helpful
• Zyban

• MI/unstable angina/IHD - do not use
• GORD - avoid gum/lozenge
• denture work - avoid gum
• asthma - avoid use of inhaler
• skin cond - avoid patch
• pregnancy - short acting products preferred, remove patch at night if using
• breastfeeding - short acting product after feed
• ADRs: nicotine - sleep disturbance, vivid dreams (esp 24 hr patch), dizziness, wt gain, headache; lozenge/gum - irritation of throat, mouth, sinusitis; patch - redness, itch, rash

• Tx duration - 12 weeks (6-8 wks most ppl)
• gum: 6-10 pieces of 4mg gum D, avoid >1 piece/hr; taper o/ 3months; each piece lasts about 30 mins, can be cut if too bulky/tapering dose, excessive chewing = salivation = indigestion
• inhaler - 6-12 cartridges D (10mg)
• lozenge: 1 q1-2h (max 15/24h for 2 and 4mg, 20/24h for 1.5mg) - dissolve in mouth, do not chew/swallow, try not to eat or drink with lozenge
• patch: 1 D (stop w/in 12 wks)
• s/l tab: 1-2 q1-2h (max 40 tabs/d) - apply to upper body

• initially 0.5mg D for 3 dya, then 0.5mg BD for 4 days, then 1mg BD for 11 weeks (i.e. 12 week tx)
• start 7-14 days before stopping
• if successful in stopping smoking by the last week, consider reducing to 1mg m for the last 2 weeks, then stopping - (insomnia, craving by some after sudden stopping)
• NO NRT!! - worsen n + headache
• MOA: partial agonist at nicotinic Rs - reduces pleasurable fx of smoking and prevents withdrawal
• precaution: psychiatric condition may be worsened; use w/ NRT - may inc. risk of NAUSEA, headache, dizziness, dyspepsia
• Common: NAUSEA, sleep disorder, constipation
• Champix

• usu 12-24 mg D (start with 4mg s/l m; max 32 mg D)
• MOA: partial opioid R agonist - reduces cravings and withdrawal symptoms
• contraindicated if currently intoxicated - delay dose until resolved (will further depress respiration)
• use non-opioid analgesics if possible/consider methadone
• common: constipation, hypotension
• opioids, methadone >30mg, alcohol, benzos (esp during start) - risk ppting withdrawal; give at least 6 hrs after last use (ideally when some sx of withdrawal present - usu 1-4hrs)
• may be possible to admin double dose on alternate days
• subutex (0.5, 2, 8mg tabs)
• suboxone (2/0.5, 8/2mg) - ie: 4:1 ratio

• MD: 60-80mg D (12-16mL) (start at 20-30mg D)
• C/I if currently intoxicated - further resp dep
• ADR: prolong QT (rare, pot from high dose), drowsiness (start, dose inc.)
• may take days to feel effects - don't use
• higher than standard opioid doses for analgesia
• Biodone

• 6-12mcg BD (max 48mcg D)
• w/ Budesonide (symbicort)
• MD: 1-2 BD
• sx relief: 1 PRN (max 6), if sx recur (max 12)
• Oxis

• 1-2 PRN or 5-15 mins before exercise
• repeat TDS-QID as necessary, higher in exacerbations

• 100mcg/dose MDI
• 2.5mg, 5mg nebs

Asmol, ventolin, airomir

50mcg BD (max 100mcg BD in severe disease)

• combination with fluticasone (Seretide)
• MDI (25mcg S) - 2 puffs BD (50, 125, 250mcg F)
• DPI (50mcg S) - 1 puff BD (100, 250, 500mcg F)

COPD: 50mcg BD

• Serevent accuhaler (50mcg/dose)
• Seretide (w/ F)

• 500mcg PRN or 5-15 mins before exercise
• rpt TDS-QID PRN

acute: 4 puffs (repeat after 4 mins until ambulance arrives)

Bricanyl (DPI, inj)

• MDI: 2 puffs (40mcg) TDS-QID PRN
• neb: 250-500mcg TDS-QID PRN

acute: MDI with spacer - 6 puffs (120mcg) OR 500mcg neb q2h WITH SALBUTAMOL

• admin: dilute solution for nebulisation with 2-3mL saline
• refer: eye pain/discomfort/halos

• MDI: 20mcg/dose
• neb: 250mcg, 500mcg

Atrovent

18mcg via HandiHaler mane

spiriva

• MD: max 900mg D - dose deps on response and level
• indications: maintenance in SEVERE asthma and COPD
• TDM 10-20mg/L
• with food
• Nuelin SR (200, 250, 300mg tabs), syrup (50% sugar)

1mg/kg 1 D, then taper

• 100-400mcg BD (adult)
• Pulmicort (DPI 100, 200, 400mcg/dose); neb 0.5mg, 1mg

100-200mcg BD (refer when >800mcg D req'd)

• Flixotide
• Jr = 50mcg/dose
• MDI = 125, 250mcg
• DPI = 100, 250, 500mcg
• neb = 0.5, 2mg

15-30mg 3-4 times D

• 10-20mg q4h OR 30mg TDS-QID (max 120mg D)
• NB: Serotonin toxicity

• 5-10mL q4-6h
• Rikodeine

• 10-15mg 3-4 times D
• Duro-Tuss Dry (reg 1mg/mL; forte 3mg/mL)

diptheria and tetanus

cholera vaccine (oral)

diptheria, tetanus, pertussis vaccine

H influenzae type B vaccine

Influenza vaccine

measles, mumps, rubella