Pediatric Primary Care (146 page)

ERYTHROMYCIN–ANTIBIOTIC

Brand Name

Erythromycin, EES

Uses

Treat upper and lower respiratory infections such as pneumonia, bronchitis, pharyngitis, otitis media, pertussis, Legionnaires' disease, prophylaxis for rheumatic fever, oral surgery, intestinal and skin infections, gonorrheal pelvic inflammatory infection (if penicillin is contraindicated), Lyme disease (younger than 9 years).

Availability

Tablets: 250 mg, 333 mg, 500 mg. Tablets, delayed-release: 333 mg. Capsules, delayed-release: 250 mg.

Estolate: Oral suspension: 125 mg/5 mL, 250 mg/5 mL. Tablets: 500 mg. Capsules: 250 mg.

Ethylsuccinate: Oral suspension: 200 mg/5 mL, 400 mg/5 mL. Tablets: 400 mg. Tablets, chewable: 200 mg.

Stearate: Tablets: 250 mg, 500 mg.

Indications/Routes/Dosage

Base and ethylsuccinate: Children: 30-50 mg/kg/day divided q6-8h up to 60-100 mg/ kg/day for severe infections for 10 days, not to exceed 2 g/day. Adults: delayed-release: 333 mg q8h increase up to 4 g/day.

Ethylsuccinate: Adults: 400-800 mg q6-12h.

Estolate: 30-50 mg/kg/day divided q6-12h. Do not exceed 2 g/day. Adults: 250-500 mg q6-12h.

Stearate: 30-50 mg/kg/day divided q6h. Do not exceed 2 g/day. Adults: 250-500 mg q6-12h.

Pertussis: 40-50 mg/kg/day divided q6h for 14 days.

Prophylaxis for rheumatic fever: 250 mg bid if penicillin allergy.

Chlamydia trachomatis:
50 mg/kg/day divided q6h for 10-14 days.

Adverse Reactions

Nausea, vomiting, abdominal pain, diarrhea, rash, anaphylaxis.

Implications

  Avoid milk and acidic beverages 1 hour before or after a dose.

  Take with food or snack to decrease GI upset.

  Do not break or chew tablets or capsules.

  Suspension is stable for 14 days at room temperature.

FERROUS SULFATE–IRON PREPARATION

Brand Name

Feosol, Fer-In-Sol

Uses

Treat iron-deficiency anemia.

Availability

Feosol: Tablets: 200 mg (65 mg elemental iron). Fer-In-Sol: Drops: 75 mg/0.6 mL (15 mg elemental iron/0.6 mL).

Indications/Routes/Dosage

Mild to moderate iron deficiency: 3 mg elemental iron/kg/day in 1-2 divided doses.

Severe iron deficiency: 4-6 mg elemental iron/kg/day in 3 divided doses.

Adverse Reactions

Nausea, diarrhea, black stools, constipation, black urine, teeth staining.

Implications

  Interactions: antacids, tetracycline will reduce absorption. Vitamin C enhances absorption.

  Give between meals with orange juice; do not give with milk. Give with a straw or brush teeth after giving.

  May cause abdominal discomfort, keep out of the reach of small children.

FEXOFENADINE HYDROCHLORIDE–ANTIHISTAMINE

Brand Name

Allegra

Uses

Treat seasonal allergic rhinitis.

Availability

Tablets: 30 mg, 60 mg, 180 mg. Capsules: 60 mg. Capsules, extended-release: 180 mg.

Indications/Routes/Dosage

Children older than 12 years: 60 mg bid or 180 mg once daily.

Children 6-11 years: 30 mg bid.

Adverse Reactions

Dry mouth, nose, headache, fatigue, nausea, vomiting.

Implications

   Avoid tasks that require alertness, motor skills until response to drug is known.

   Avoid alcohol, coffee, or tea; may decrease drowsiness.

FLUOXETINE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI), ANTIDEPRESSANT

Brand Name

Prozac, Sarafem (Prozac weekly)

Uses

Treat major depression, obsessive-compulsive disorder (OCD), bulimia nervosa, premenstrual dysphoric disorder (PMDD).

Availability

Oral solution: 20 mg/5 mL. Tablets: 10 mg, 20 mg. Capsules: 10 mg, 20 mg, 40 mg.

Indications/Routes/Dosage

Anxiety disorders: starting dose of 5 mg/day, increase to 15-30 mg/day for children and 10-40 mg/day for teens.

Major depression: starting dose of 5 mg/day increase to 15-40 mg per day for children, 10-60 mg/day for teens.

Adverse Reactions

Headache, nervousness, insomnia, drowsiness, anxiety, tremor, dizziness, sedation, poor concentration, abnormal dreams, decreased libido, dry mouth, diarrhea, weight loss.

Implications

   Take with food and milk for GI symptoms.