Pediatric Primary Care (151 page)

Ophthalmic:

  Tilt patient's head back, place solution in conjunctival sac.

  Do not use ophthalmic solution for injection.

Otic:

  Eardrops should be at room temperature.

  Instruct patient to lie down with head turned so affected ear is upright.

  Pull the auricle down and posterior in children, pull up and posterior in older adolescents and adults.

  Instill toward canal wall.

OMEPRAZOLE–GASTRIC ACID PUMP INHIBITOR

Brand Name

Prilosec

Uses

Short-term treatment (4-8 weeks) and maintenance of erosive esophagitis, gastroesophageal reflux disease (GERD), poorly responsive to other treatments. Unlabeled treatment of
Helicobacter
pylori-associated duodenal ulcer.

Availability

Tablets: 10 mg, 20 mg, 40 mg.

Indications/Routes/Dosage

Children older than 2 years: 20 mg/day, 20 kg 10 mg/day.

Adverse Reactions

May increase concentration of oral anticonvulsants diazepam; phenytoin may increase serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), alanine aminotransferase (ALT).

Implications

  Report headache to provider.

  Take before meals.

  Swallow capsule whole; do not crush or chew.

PAROXETINE HYDROCHLORIDE–SELECTIVE SEROTONIN REUPTAKE INHIBITOR, ANTIDEPRESSANT, ANTIPANIC, ANTIANXIETY

Brand Name

Paxil, Paxil CR

Uses

Treat major depressive disorder, obsessive-compulsive disorder (OCD), panic and generalized anxiety disorders.

Availability

Oral suspension: 10 mg/kg. Tablets: 10 mg, 20 mg, 30 mg, 40 mg. Tablets, controlled-release (CR): 12.5 mg, 25 mg, 37.5 mg.

Indications/Routes/Dosage

Children, adolescents: initial dose 5-10 mg, titrate up to 20 mg and monitor for side effects. Paxil CR: Children, adolescents: initial dose 12 mg titrate up to 25 mg.

Adverse Reactions

Nausea, headache, nervousness, insomnia, sedation, agitation, fatigue, dry mouth, constipation, diarrhea, decreased libido/sexual dysfunction.

Implications

  Dose changes should occur at 1-week intervals for both drugs.

  Do not use with MAO inhibitor.

  Use with cimetidine may increase concentrations.