Lactation, children younger than 12 yr, hepatic impairment, coronary insufficiency, dysrhythmias, hypertension, convulsive disorders; not for acute symptoms, not to exceed recommended dose, paradoxic bronchospasm may occur with use; not recommended for use with a spacer or other aerosol device
• Acute asthmatic episodes may be precipitated in the dental office. Rapid-acting sympathomimetic inhalants should be available for emergency use. Salmeterol is not a rapid-acting drug and is not intended for use in acute asthmatic attacks.
• Severe stomach bleeding may occur in patients who regularly use NSAIDs in recommended doses, when the patient is also taking another NSAID, a blood thinning, or steroid drug, if the patient has GI or peptic ulcer disease, if they are 60 yr or older, or when NSAIDs are taken longer than directed. Warn patients of the potential for severe stomach bleeding.
Headache, peripheral edema, arthralgia, polyuria, agitation, dizziness, upper respiratory tract infection, diarrhea, abdominal pain, upper respiratory tract infection, pharyngolaryngeal pain, nausea, vomiting
• Phenylketonuric patients frequently exhibit manifestations of neurologic injury, including mental retardation and must be managed accordingly, including knowledge of the patient’s dietary restrictions.
Poorly absorbed after PO administration (absorption increased with high-calorie and high-fat meals). Protein binding: 99%. Metabolized in the liver to inactive metabolite. Primarily eliminated in feces. Unknown if removed by hemodialysis. Half-life: 13 hr.
Therapeutic Effect: Assists bone marrow in making new WBCs and increases their chemotactic, antifungal, and antiparasitic activity. Increases cytoneoplastic cells and activates neutrophils to inhibit tumor cell growth.
Usual parenteral dosage: 250 mcg/m2/day for 21 days (as 2-hr infusion). Begin 2–4 hr after autologous bone marrow infusion and not less than 24 hr after last dose of chemotherapy or not less than 12 hr after last radiation treatment. Discontinue if blast cells appear or underlying disease progresses.
Use 12 hr before or after radiation therapy; 24 hr before or after chemotherapy; excessive leukemic myeloid blasts in bone marrow or peripheral blood (10%); known hypersensitivity to GM-CSF, yeast-derived products, or components of drug
• Patient on chronic drug therapy may rarely present with symptoms of blood dyscrasias, which can include infection, bleeding, and poor healing. If dyscrasia is present, caution patient to prevent oral tissue trauma when using oral hygiene aids.
Rapidly and well absorbed following PO administration. Protein binding: negligible. Metabolized in by CYP3A4/5. Partial excretion in feces, partial excretion in urine. Half-life: 2.5 hr; 3.1 hr (active metabolite).
! A hypersensitivity reaction may be life threatening. Signs and symptoms include fever, rash, fatigue, intractable nausea and vomiting, severe diarrhea, abdominal pain, cough, pharyngitis, and dyspnea.
A barbiturate that depresses the CNS activity by binding to barbiturate site at the gamma-aminobutyric acid (GABA)-receptor complex, enhancing GABA activity and depressing the reticular activity system.
Well absorbed from the GI tract. Protein binding: 52%–57%. Crosses blood-brain barrier. Widely distributed. Metabolized in liver by microsomal enzyme system to inactive and active metabolites. Primarily excreted in urine. Not removed by hemodialysis. Half-life: 15–40 hr.
Agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, abnormality in thinking, hypoventilation, apnea, bradycardia, hypotension, syncope, nausea, vomiting, constipation, headache
Rapidly absorbed from the GI tract. Crosses the blood-brain barrier. Metabolized in the liver to the active metabolites. Primarily excreted in urine. Half-life: 17 hr (amphetamine), 20 hr (methamphetamine).
! Other serious effects may include involuntary movements, impaired motor coordination, loss of balance, blepharospasm, facial grimaces, feeling of heaviness in the lower extremities, depression, nightmares, delusions, overstimulation, sleep disturbance, and anger.
An antidepressant, anxiolytic, and obsessive-compulsive disorder adjunct that blocks the reuptake of the neurotransmitter serotonin at CNS neuronal presynaptic membranes, increasing its availability at postsynaptic receptor sites.
Incompletely and slowly absorbed from the GI tract; food increases absorption. Protein binding: 98%. Widely distributed. Undergoes extensive first-pass metabolism in the liver to active compound. Excreted in urine and feces. Not removed by hemodialysis. Half-life: 26 hr.
• Physician should be informed if significant xerostomic side effects occur (e.g., increased caries, sore tongue, problems eating or swallowing, difficulty wearing prosthesis) so that a medication change can be considered.
An antihyperphosphatemic agent that binds with dietary phosphorus in the GI tract, thus allowing phosphorus to be eliminated through the normal digestive process and decreasing the serum phosphorus level.