Rapidly and extensively absorbed after PO administration. Protein binding: 20%–25%. Rapidly metabolized to penciclovir by enzymes in the GI wall, liver, and plasma. Eliminated unchanged in urine. Removed by hemodialysis. Half-life: 2 hr.
|Creatinine Clearance||Herpes Zoster||Genital Herpes|
|40–59 ml/min||500 mg q12h||125 mg q12h|
|20–39 ml/min||500 mg q24h||125 mg q24h|
|Less than 20 ml/min||250 mg q24h||125 mg q24h|
Short-term treatment of active duodenal ulcer, maintenance therapy for duodenal ulcer, Zollinger-Ellison syndrome, multiple endocrine adenomas, benign gastric ulcers, gastroesophageal reflux disease (GERD); OTC: heartburn, acid indigestion
Partially absorbed. Protein binding: 99.2%. Extensively metabolized by both conjugation via uridine diphosphate glucuronosyltransferase enzymes and oxidation via CYP enzymes, including CYP1A2, 2C8, and 2C9. Partially excreted in urine; partially excreted in feces. Half-life: 5–8 hr.
An anticonvulsant, structurally similar to meprobamate, that weakly blocks repetitive, sustained firing of neurons by enhancing the ability of γ-aminobutyric acid (GABA) and antagonizes the strychnine-insensitive glycine recognition site of the N-methyl-D-aspartate receptor-ionophore complex.
Used alone or as adjunct therapy in partial seizures; also for partial seizures associated with Lennox-Gastaut syndrome in children; because of severe side effects use only for severe seizures when other therapy is inadequate
Monotherapy or Adjunctive Therapy in the Treatment of Partial Seizures, with and without Generalization
Initially, 1200 mg/day in divided doses 3–4 times a day. At week 2, increase the felbamate dosage to 2400 mg/day while reducing the dosage of other antiepileptic drugs (AEDs) up to an additional one-third of their original dosage. At week 3, increase the felbamate dosage up to 3600 mg/day and continue to reduce the dosage of other AEDs as clinically indicated.
Add 1200 mg/day in divided doses 3–4 times a day while reducing present AEDs by 20% in order; control plasma concentrations of concurrent phenytoin, valproic acid, and carbamazepine and its metabolites. Increase dosage by 1200 mg/day increments at weekly intervals to 3600 mg/day.
Chest pain, palpitations, tachycardia, depression and behavioral changes, anxiety, nervousness, ataxia, malaise, agitation, rash, acne, pruritus, diarrhea, weight gain, tremors, abnormal vision, diplopia, sinusitis, difficulty with coordination, taste perversion
Rapidly, completely absorbed from the GI tract. Protein binding: greater than 99%. Undergoes first-pass metabolism in the liver. Primarily excreted in urine. Not removed by hemodialysis. Half-life: 11–16 hr.
• Monitor cardiac status; take vital signs at each appointment because of cardiovascular side effects. Consider a stress reduction protocol to prevent stress-induced angina during the dental appointment.
Well absorbed from the GI tract. Absorption increased when given with food. Protein binding: 99%. Rapidly metabolized in the liver to active metabolite. Excreted primarily in urine; lesser amount in feces. Not removed by hemodialysis. Half-life: 20 hr.
! Rare reactions with long-term use include peptic ulcer disease, GI bleeding, gastritis, severe hepatic reaction (jaundice), nephrotoxicity (hematuria, dysuria, proteinuria) and a severe hypersensitivity reaction (bronchospasm, angioedema).
• 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 years or older, or when NSAIDs are taken longer than directed. Warn patients of the potential for severe stomach bleeding.