DIAZEPAM(VALIUM) Indications Doses Precautions and Adverse Effects

Indications:

Anxiety, epilepsy, muscle relaxation (tetanus), and acute alcohol with drawal.

Doses & Administrations:
Oral: Adult: Anxiety: 2mg three times daily. maximum 30mg/daily. Acute alcohol with drawl: 5-20mg, repeated 2 to 4 hours if required. Muscle Spasm : 2-15mg daily in divided doses. Muscle Spasm (Tetanus) : 3-10mg/kg/day. Pediatric: 0.1-0.8mg/kg/day every 6 to 8 hours. Parenteral: Adult: Severe Anxiety : 2-10mg I/V or I/M repeated after 4 hours if required. Muscle Spasm : 5-10mg I/V or I/M repeated after 4 hours if needed. Tetanus : 0.1-0.3mg/kg I/V repeated at intervals of 1 to 4 hours or by 1.v infusion of 3- 10mg/kg/day. Status Epilepticus: 10-20mg I/V or I/M repeated 30-60 minutes if necessary. Pediatric: 0.1 to 0.3mg/kg repeated in 2 to 4 hours as required.
Contra Indications:
Hypersensitivity to benzodiazepines, respiratory depression, and chronic psychosis.

Precautions:
Avoid prolong use and abrupt withdrawal, respiratory depression, late pregnancy, lactation, hepatic and renal impairment.

Pregnancy Status:
Category "D"

Renal Failure Doses:
No specific dosage adjustment is necessary in renal insufficiency.

Lactation Status:
Contraversial.

Interactions:
Neuroleptics, tranquilizers, antidepressants, analgesics and anaesthetic.

Adverse Effects:
Drowsiness, sedation, ataxia, hypotension, apnoea, G.I, upset skin, rashes, visual disturbance, changes in libido and urinary retention.

Nursing Considerations:
Concentration available are 5mg/ml in 2ml ampoule. The product should be protected from light and retain potency for 3 months at room temperature. For IM administration it should be given deeply in the muscle. Do not use small veins (dorsum of hand or wrist) for IV injection. Reduce dose of narcotic analgesics with IV diazepam. Carefully monitor PULSE, BP, and RESPIRATION during IV administration. Maintain patients receiving parenteral diazepam in bed for 3 hrs. Monitor liver and kidney function, CBC during long term therapy. Report severe dizziness, weakness, drowsiness that persists, rash or skin lesions, palpitations, swelling of the ankles, visual or hearing disturbances, difficulty voiding.

Read More »

Unknown Adverse Effects, DIAZEPAM, doses, indication, Precautions

Levofloxacin Indications Doses Contra Indications Precautions and Adverse Effects

Indications:

Levofloxacin is the active stereisomere of ofloxacin. Levofloxacin is approved for the treatment of COMMUNITY ACQUIRED PNEUMONIA,and other repiratory tract infections.

Doses & Administrations:
ADULTS: RTI: 500 mg ONCE DAILY TB : 500 mg bid or 750 mg qd May take with or with out meals. Take at least 2 hours apart from antacids, zinc and iron containing preps. PEDIATRIC (IV+PO) : Limited data for dose available. 5-10mg/kg/day, maximum : 500 mg/day

Contra Indications:
Hypersensitivity to levofloxacin,other fluoroquinolones, or to any of its components.

Precautions:
CNS disorders (epilepsy) Renal insufficiency (dose reduction) Liver disease (transamine elevations have occured) Risk factors for tendinitis include pt.>60 years of age,renal failure, dialysis,concomitant therapy,and dyslipidemia. Pregnant and nursing women.

Pregnancy Status:
Category "C"

Renal Failure Doses:
Cr.clear(ml/min) Loading Dose Subsequent dose =======20-49 500 mg 250 mg/24 hr. 10-19 500 mg 250 mg/48 hr. Hemodialysis 500 mg 250 mg/48 hr. (<10ml/min) NOTE: No need to give loading dose if pt. is already on Levofloxacin.

Lactation Status:
Unknown,levofloxacin has not been measured in human milk, however, based upon data from ofloxacin,it can be presumed that it will be excreted.

Interactions:
Minor and moderate interactions with drugs like antacids,calcium , cimetidine are reported with levofloxacin. DRUG FOOD INTERACTIONS: *Take atleast 02hrs before or after antacids,dairy products,sucralfate,iron supplements,calcium,magnesium,aluminium,zinc,minerals & multivitamins. * Limit fat & caffeine intake REF: http://www.mdanderson.org/departments/nutrition/index.cfm

Adverse Effects:
The most common adverse effects are nausea,diarrhea,headache,and constipation. Levofloxacin should be avoided in prepubertal children since animal studies have demonstrated erosion of the cartilage and weight-bearing joints.

Nursing Considerations:
THE VIAL IS FOR SINGLE USE ONLY. The diluted solution in compatible fluids is stable for 14 days in refrigerator and 72 hours at room temperature at the concentration of 5mg/ml in plastic IV containers.

Read More »

Unknown Adverse Effects, Contraindicated, doses, indication, Levofloxacin, Precautions

Dexamethasone Indications Doses Contra Indications and Interactions

Indications:Primary or secondary adrenocortical insufficiency; allergy and anaphylaxis, shock, crohn's disease, ulcerative colitis, rheumatic arthritis, skin disorders and cerebral edema.

Doses & Administrations:
Oral: Adult: 0.5-9mg daily individed doses depending on the disease and response of the patient. Maximum: 15 mg daily. Pediatric: 0.03 - 0.15 mg/kg/day every 6 to 12 hours or 1.5mg/m2 every 6 to 12 hours. Parenteral (I/M or I/V): Adult : 0.5 - 9mg daily in divided dose depending an disease being treated. day by constant I/V infusion after bolus dose of 20 mg. by constant I/V infusion after bolus dose of 20mg. I/M every 6 hours as required for 2-10 days. Pediatric: Neonates : 0.2 - 0.5 mg/kg followed by 0.1 mg/kg po or I/V every 6 to 8 hours. Cerebral edema: 1.5 mg/kg/day every 4 to 6 hours for 5 days. Maximum : 6 mg/kg/day.

Contra Indications: Hypersensitivity to Dexamethasone or other component of the preparation dendritic keratitis, varicella and tuberculosis of the eye.

Precautions:Use cautiously in patients with renal insufficiency, diabetes mellitus, hypertension, osteoporosis, glaucoma, active or latent peptic ulcer, viral infection, tuberculosis; avoid abrupt withdrawal, monitor growth in infants and children who are on iron therapy.

Pregnancy Status:Category "C".

Renal Failure Doses:No dosage adjustment is required.

Lactation Status:Unsafe.

Interactions:Phenytoin, ephedrine, rifampicin, barbiturate may decreased blood level of cortico steroids, avoid use of live virus vaccine. Decrease absorption of calcium and phosphorus, urinary excretion of ascorbic acid, calcium, potassium, zinc, nitrogen. Increase blood glucose, triglycerides, cholesterol. Increase need for B6, Ascorbic acid, folate and vitamin D.

Adverse Effects:
Glucoma cataract formation secondary ocular infection and thinning of the cornea.

Nursing Considerations:
- Monitor baseline body weight, temperature, pulse and respiratory rate. - Monitor fluid balance. - Taper systemic steroid carefully. prolonged sore throat and unusual weight gain. - Monitor Baseline body weight, temperature, Pulse and Respiratory. - Monitor fluid balance. - Taper systemic steroids carefully. - Teach patient to report if stool black/Tarry, Muscle weakness, Prolonged sore throat and unusal weight gain. ---------------------------------------------------------------- IV DILUTION: 0 to 50 mg/ 50 ml...OVER 30 MIN. 51 to 100 mg/ 100 ml IN D5W / NS CAN BE GIVEN BY IV PUSH: Over 1 minute to several min. if dose is < 10 mg.

Read More »

Unknown Contraindications, Dexamethasone, doses, Intrerations