Download Transplantation Drug Manual by John Pirsch, William D. Simmons, Hans, M.D. Sollinger PDF

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Genital herpes: Initial episodes: The recommended dosage for treatment of initial genital herpes is 1 gram twice daily for 3 days. Recurrent episodes: The recommended dosage for the treatment of recurrent genital herpes is 500 mg twice daily for 3 days. Suppressive therapy: The recommended dosage for chronic suppressive therapy of recurrent genital herpes is 1 gram once daily. In patients with a history of 9 or fewer recurrences a year, an alternative dose is 500 mg once daily. Antiplatelets Contraindication Warning Diabetes Agents Indication Ulcer Treatment Mechanism of Action Valtrex® GlaxoSmithKline Valacyclovir is the hydrochloride salt of L-valyl ester of acyclovir, synthetic nucleoside analogue with antiviral properties against herpesvirus • Inhibits the replication of herpesvirus cells by interfering with DNA polymerase, incorporation and termination of the growing viral DNA chain • Treatment of herpes zoster (shingles) • Treatment of genital herpes • Hypersensitivity to acyclovir or valacyclovir • Thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS), which has resulted in death, has occurred in immunocompromised patients receiving acyclovir therapy Continued … Other Agents Brand Name Company Class Diuretics Valacyclovir Antiosteo- Cardiovascular ImmunoAntimicrobials porosis Agents Agents suppression 31 Other Agents Diuretics Ulcer Treatment Diabetes Agents Antiplatelets ImmunoAntiosteo- Cardiovascular Antimicrobials porosis Agents Agents suppression 32 Valacyclovir Dosage Indications Herpes zoster Patients with Acute or Chronic Renal Impairment In patients with reduced renal function, reduction in dosage is recommended (see Table) Dosing Adjustments for Patients with Renal Impairment Normal Dosage Regimen (Creatinine Creatinine Clearance (mL/min) Clearance >/=50) 30-49 10-29 <10 1 gram every Igram every 1 gram every 500 mg every 8 hours 12 hours 24 hours 24 hours Genital herpes: Initial treatment Recurrent episodes Suppressive therapy Suppressive therapy 1 gram every 12 hours 500 mg every 12 hours 1 gram every 24 hours 500 mg every 24 hours no reduction no reduction no reduction no reduction 1 gram every 24 hours 500 mg every 24 hours 500 mg every 24 hours 500 mg every 48 hours 500 mg every 24 hours 500 mg every 24 hours 500 mg every 24 hours 500 mg every 48 hours Hemodialysis: During hemodialysis, the half-life of acyclovir after administration of valacyclovir is approximately 4 hours.

Brand Name • Zyvox® Company • Pharmacia & Upjohn Company Class • oxazolidinone, synthetic antibacterial agent Mechanism of Action • Binds to a site on the bacterial 23S ribosomal RNA of the 50S subunit and prevents the formation of a functional 70S initiation complex, which is an essential component of the bacterial translation process. • Vancomycin-resistant Enterococcus faecium infections, including cases with cocurrent bacteremia • Nosocomial pneumonia caused by Staphylococcus aureus (methicillinsusceptible and -resistant strains), or Streptococcus pneumoniae (penicillin-susceptible strains only).

Antiplatelets Treatment of CMV retinitis Induction - IV 5 mg/kg (over 1 hour) every 12 hours for 14 to 21 days Maintenance - IV 5 mg/kg once daily, 7 days per week or 6 mg/kg 5 days per week PO 1000 mg three times daily with food Diabetes Agents Dosage Ulcer Treatment • 10 mL vial containing 500 mg • 250 mg capsules in bottles of 180 capsules • 500 mg capsules in bottles of 180 capsules Diuretics Formulation Other Agents Ganciclovir Antiosteo- Cardiovascular ImmunoAntimicrobials porosis Agents Agents suppression 35 Valganciclovir Brand Name • Valcyte® Company • Roche Laboratories Class • L-valyl ester prodrug of ganciclovir, synthetic analogue of 2’deoxyguanine, with antiviral properties against herpes including human cytomegalovirus Mechanism of Action • Inhibits replication by interfering with viral DNA synthesis Indications • Treatment of cytomegalovirus retinitis in patients with acquired immunodeficiency syndrome Contraindications • Hypersensitivity to valganciclovir or ganciclovir Warnings • Should not be administered if the absolute neutrophil count is less than 500 cells/microliter or platelet count less than 25,000 cells/microliter or the hemoglobin is less than 8 g/dl • Should be used in caution in patients with pre-existing cytopenias or who have received or who are receiving myelosuppressive drugs or irratdiation • May impair fertility • Because of the mutagenic and tertogenic potential of gangciclovir, women of childbearing age should use effective contraceptionPregnancy Category C Adverse Reactions Diabetes Agents Special Precaution • Exceeding recommended dosage could result in increased toxicity.