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Tuesday, 26 February 2008 |
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Page 8 of 13
Medication continued... Drug Category: Antihistamines (histamine-2 blockers) | Drug Name | Ranitidine (Zantac) | | Description | H2-receptor antagonists competitively inhibit the interaction of histamine with H2 receptors. These are highly selective and have little or no effect on H1 receptors. H2-receptor antagonists are primarily used for the management of active duodenal or benign gastric ulcer disease. They are also used in the healing of duodenal or benign gastric ulcers. | | Adult Dose | 150 mg PO q8-12h
50 mg IV q6-8h | | Pediatric Dose | Safety not established | | Contraindications | Documented hypersensitivity | | Interactions | May decrease effects of ketoconazole and itraconazole; may alter serum levels of ferrous sulfate, diazepam, nondepolarizing muscle relaxants, and oxaprozin | | Pregnancy | B - Usually safe but benefits must outweigh the risks.
| | Precautions | Caution in renal or liver impairment and nursing mothers; if changes in renal function occur during therapy, consider adjusting dose or discontinuing treatment | | Drug Name | Cimetidine (Tagamet) | | Description | H2-receptor antagonists competitively inhibit interaction of histamine with H2 receptors. These are highly selective and have little or no effect on H1 receptors. Used in hypersecretory conditions, intractable duodenal ulcers, and for prevention of upper gastrointestinal bleeding. | | Adult Dose | 300 mg PO q6-8h
300 mg IV q6-8h | | Pediatric Dose | <16 years: Not recommended
>16 years: 20-40 mg/kg/d PO/IV | | Contraindications | Documented hypersensitivity | | Interactions | Can increase blood levels of theophylline, warfarin, TCAs, triamterene, phenytoin, quinidine, propranolol, metronidazole, procainamide, and lidocaine | | Pregnancy | B - Usually safe but benefits must outweigh the risks.
| | Precautions | Elderly patients may experience confusional states; may cause impotence and gynecomastia in young males; may increase levels of many drugs; adjust dose or discontinue treatment if changes in renal function occur | | Drug Name | Famotidine (Pepcid) | | Description | H2-receptor antagonists competitively inhibit the interaction of histamine with H2 receptors. Highly selective and have little or no effect on H1 receptors. Used for active duodenal ulcers, maintenance of healed duodenal ulcers, and active benign gastric ulcers. Also used for gastroesophageal reflux disease and associated esophagitis. Individualize and adjust dose based on response. | | Adult Dose | 20-40 mg PO/IV q12h | | Pediatric Dose | <1 years: Not recommended
1-16 years: 0.5 mg/kg/d divided doses PO/IV; not to exceed 40 mg/d | | Contraindications | Documented hypersensitivity | | Interactions | May decrease effects of ketoconazole and itraconazole | | Pregnancy | B - Usually safe but benefits must outweigh the risks.
| | Precautions | Reduce dose or prolong dosing interval with severe renal insufficiency (CrCl <10 mL/min); not recommended for nursing mothers; adverse reactions include headache, dizziness, constipation, diarrhea, somnolence, seizures, palpitations, depression, and injection site reactions | Drug Category: Bronchodilators Patients experiencing significant adverse respiratory symptoms as part of their food-induced allergic reaction must be managed aggressively with nebulized bronchodilators. Nebulized adrenergic agonists or bronchodilators are usually administered for treatment of bronchospasm. Supplemental oxygen can also be administered with nebulizations. In selected cases, parenteral agents may be employed to achieve sufficient bronchodilation.
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