Beruflich Dokumente
Kultur Dokumente
Special considerations: Taper gradually after long-term use; give IV slowly; monitor
injection sites
In: Relief of symptoms of depression; enuresis in children older than 6 years;
off-label consideration— control of chronic pain.
Ac: Inhibits presynaptic reuptake of norepinephrine and serotonin;
anticholinergic at CNS and peripheral receptors; sedating.
Pharmacokinetics:
Rout
e Onset Peak
Oral Varies2–4 h
T1/2: 8 to 16 hours, metabolized in the liver, excretion in the urine.
Ae: sedation, anticholinergic effects, confusion, anxiety, orthostatic
hypotension, dry mouth, constipation, urinary retention, rash, bone marrow
depression.
Adult: 50–200 mg/d PO
Pediatric: 30–40 mg/d PO
In: Treatment of patients with depression who are unresponsive to other
antidepressive therapy or in whom other antidepressive therapy is
contraindicated.
Ac: Irreversibly inhibits MAO, allowing norepinephrine, serotonin, and
dopamine to accumulate in the synaptic cleft; this accumulation is thought to be
responsible for the clinical effects.
Pharmacokinetics:
RouteOnsetDuration
Oral Slow 48–96 h
T1/2: Unknown; metabolized in the liver, excreted in urine.
Ae: Dizziness, vertigo, headache, overactivity, hyperreflexia, tremors, mania,
weakness, drowsiness, fatigue, sweating, orthostatic hypotension, constipation,
diarrhea, dry mouth, edema, anorexia, potential for hypertensive crisis.
15 mg PO t.i.d.; maintenance 15 mg/day PO
In: Treatment of depression, OCDs, bulimia, PMDD, panic disorders; off-label
uses include chronic pain, alcoholism, neuropathies, obesity.
Ac: Inhibits CNS neuronal reuptake of serotonin, with little effect on
norepinephrine and little affinity for cholinergic, histaminic, or alpha-adrenergic
sites.
Pharmacokinetics:
Rout
e OnsetPeak
Oral Slow 6–8 h
T1/2: 2 to 4 weeks; metabolized in the liver, excreted in urine and feces.
Ae: Headache, nervousness, insomnia, drowsiness, anxiety, tremor, dizziness,
sweating, rash, nausea, vomiting, diarrhea, dry mouth, anorexia, sexual
dysfunction, upper respiratory infections, weight loss, fever.
20 mg/d PO in the AM; do not exceed 60 mg/d; reduce dose with hepatic impairment;
also available in a 90-mg, once-a-week formulation
In: Management of manifestations of psychotic disorders; relief of preoperative
restlessness; adjunctive treatment of tetanus; acute intermittent porphyria; severe
behavioral problems in children; control of hiccups, nausea, and vomiting.
Ac: Blocks postsynaptic dopamine receptors in the brain; depresses those parts
of the brain involved in wakefulness and emesis; anticholinergic; antihistaminic;
alpha-adrenergic blocking.
Pharmacokinetics:
Route Onset Peak Duration
Oral 30–60 min2–4 h 4–6 h
Intramuscula 10–15 min15–20 min4–6 h
r
T1/2: 2 hours, then 30 hours; metabolized in the liver, excreted in the urine.
Ae: Drowsiness, insomnia, vertigo, extrapyramidal symptoms, orthostatic
hypotension, photophobia, blurred vision, dry mouth, nausea, vomiting,
anorexia, urinary retention, photosensitivity.
Adult: 25 mg IM for acute episode, may be repeated; switch to 25–50 mg PO t.i.d.
Pediatric: 0.5–1 mg/kg q4–8h PO, IM, or PR
In: Long-term treatment of generalized tonic–clonic and cortical focal seizures; emergency
control of certain acute convulsive episodes (status epilepticus, tetanus, eclampsia, meningitis);
anticonvulsant treatment of generalized tonic– clonic seizures and focal seizures (parenteral).
Ac: General CNS depressant; inhibits impulse conduction in the ascending RAS; depresses the
cerebral cortex; alters cerebellar function; depresses motor output; and can produce excitation,
sedation, hypnosis, anesthesia, and deep coma.
Pharmacokinetics:
Route Onset Duration
Oral 30–60 min10–16 h
IM, SC10–30 min4–6 h
IV 5 min 4–6 h
T1/2: 79 hours; metabolized in the liver, excreted in the urine.
Ae: Somnolence, insomnia, vertigo, nightmares, lethargy, nervousness, hallucinations, insomnia,
anxiety, dizziness, bradycardia, hypotension, syncope, nausea, vomiting, constipation, diarrhea,
hypoventilation, respiratory depression, tissue necrosis at injection site, withdrawal syndrome.
Adult: 60–100 mg/d PO; 200–320 mg IM or IV for acute episodes, may be repeated in
6 h; reduce dose with elderly and with renal or hepatic impairment
Pediatric: 3–6 mg/kg per day PO; 4–6 mg/kg per day IM or IV; 15–20 mg/kg IV over
10–15 min for status epilepticus
In: Management of anxiety disorders; acute alcohol withdrawal; muscle relaxant; treatment of tetanus;
adjunct in status epilepticus and severe recurrent convulsive seizures; preoperative relief of anxiety and
tension; management of epilepsy in patients who require intermittent use to control bouts of increased
seizure activity.
Ac: Acts in the limbic system and reticular formation; potentiates the effects of GABA; has little effect on
cortical function.
Pharmacokinetics:
Rout
e Onset Peak Duration
Oral 30–60 min1–2 h 3h
IM 15–30 min30–45 min3 h
IV 1–5 min 30 min 15–60 min
Recta Rapid 1.5 h 3h
l
T1/2: 20 to 80 hours; metabolized in the liver, excreted in the urine.
Ae: Drowsiness, sedation, depression, lethargy, apathy, fatigue, disorientation, bradycardia, tachycardia,
paradoxical excitatory reactions, constipation, diarrhea, incontinence, urinary retention, drug dependence
with withdrawal syndrome.
Adult: 2–10 mg PO b.i.d. to q.i.d.; or 0.2 mg/kg PR, may repeat in 4–12 h; 2–20 mg IM
or IV
Geriatric or debilitated patients: 2–2.5 mg PO daily to b.i.d.; or 2–5 mg IM or IV
Pediatric: 1–2.5 mg PO t.i.d. to q.i.d.; or 0.3–0.5 mg/kg PR with a repeat in 4–12 h if
needed; 0.25 mg/kg IV over 3 min, may repeat in 15–30 min for up to three doses
In: Relief of moderate to severe acute or chronic pain; preoperative medication; component of
combination therapy for severe chronic pain; intraspinal to reduce intractable pain.
Ac: Acts as an agonist at specific opioid receptors in the CNS to produce analgesia, euphoria,
and sedation.
Pharmacokinetics:
Rout
e Onset Peak Duration
Oral Varies 60 min 5–7 h
PR Rapid 20–60 min5–7 h
SQ Rapid 50–90 min5–7 h
IM Rapid 30–60 min5–6 h
IV Immediate20 min 5–6 h
T1/2: 1.5 to 2 hours; metabolized in the liver, excreted in the urine and bile.
Ae: Light-headedness, dizziness, sedation, nausea, vomiting, dry mouth, constipation, ureteral
spasm, respiratory depression, apnea, circulatory depression, respiratory arrest, shock, cardiac
arrest.
Adult: 10 to 20-mg solution PO or 15- to 30-mg tablets PO q4h, or 10 mg SQ or IM
q4h, or 2–10 mg/70 kg IV over 4–5 min, or 10–20 mg PR q4h
Pediatric: 0.1–0.2 mg/kg IM or SQ q4h