Pediatric Primary Care (144 page)

CLARITHROMYCIN–MACROLIDE ANTIBIOTIC

Brand Name

Biaxin, Biaxin XL

Uses

Treat bronchitis, otitis media, acute maxillary sinusitis, pharyngitis, tonsillitis, pneumonia, skin infections.

Availability

Suspension: 125/5 mL, 250/5 mL. Tablets: 250 mg, 500 mg. Tablets, extended-release: 500 mg.

Indications/Routes/Dosages

Acute otitis media: Children: 15 mg/kg/day in 2 divided doses for 10 days.

Respiratory/skin infections: Children: 15 mg/kg/day in 2 divided doses for 10 days. Usual adult dose: 250-500 mg q12h for 7-14 days. Extended release: Two 500-mg tablets daily for 7-14 days.

Adverse Reactions

Antibiotic-associated colitis (severe abdominal pain, fever, watery diarrhea), superinfection, hepatotoxicity, thrombocytopenia.

Implications

   Monitor bowel activity and stool consistency.

   For minor GI effects take with food.

   Doses should be evenly spaced.

   Take with 8 oz water.

CLINDAMYCIN–ANTIBIOTIC

Brand Name

Cleocin

Uses

Treat infections from staphylococci, streptococci, Rickettsia,
Pneumocystis carinii
pneumonia.

Availability

Oral solution: 75 mg/mL. Capsules: 75 mg, 150 mg, 300 mg.

Indications/Routes/Dosage

Children younger than 1 month: 15-20 mg/kg/day divided q6-8h. Children older than 1 month 8-25 mg/kg/day divided q6-8h. Adult: 150-450 mg q6h. Max 1.8 g/day.

Adverse Reactions

Nausea, vomiting, diarrhea, pseudomembranous colitis (severe diarrhea), urinary frequency, vaginitis.

Implications

  Take with full glass of water.

  Give with food to reduce GI symptoms.

  Antiperistaltic drugs may worsen diarrhea.

  Do not break, crush, or chew capsules.

  Call provider for diarrhea.

CLOMIPRAMINE HYDROCHLORIDE–TRICYCLIC ANTIDEPRESSANT

Brand Name

Anafranil

Uses

Treat obsessive-compulsive disorder manifested as repetitive tasks producing marked distress; off label: mental depression, panic disorder, neurogenic pain, bulimia.

Availability

Capsules: 25 mg, 50 mg, 75 mg.

Indications/Routes/Dosage

Children: starting dose of 10 mg/day; increase to 75-100 mg/day. Teens: starting dose of 10 mg/day increase to 100-200 mg/day.

Adverse Reactions

Dry mouth, dizziness, sleepiness, tremors, decreased libido, headache, aggressiveness, high doses may produce cardiovascular effects (severe postural hypotension, dizziness, tachycardia, palpitations, arrhythmias, seizures). Abrupt withdrawal from prolonged therapy may produce headache, malaise, nausea, vomiting.

Implications

  Contraindicated within 14 days of MAO inhibitor ingestion.

  Caution with history of seizures, hyperthyroidism, cardiac/hepatic/renal disease, diabetes mellitus.