DRUG STUDY

RENAL SYSTEM

DRUG DOSAGE INDICATIONS ACTION ADVERSE NURSING

REACTION CONSIDERATIONS

H Adults. 25 to 100 To manage Inhibits Dizziness, vertigo, Give

Y mg daily as a hypertension reabsorption of orthostatic hydrochlorothiazide
D single dose or in sodium and hypotension, nausea, in the morning and
R divided doses chloride in distal anorexia, vomiting, early evening to
O twice daily. renal tubules, dry mouth, diarrhea, avoid nocturia.
C Children age 6 increasing the polyuria, nocturia, •Monitor fluid intake
H months and over. excretion of muscle cramps, or and output, daily
L 1 to 2 mg/kg sodium, chloride, spasms. weight, blood
O daily as a single and water by the pressure, and serum
R dose or in kidneys. levels of electrolytes,
O divided doses especially potassium
T twice daily. •Assess for evidence
H Infants under age of hypokalemia, such
I 6 months. Up to as muscle spasms
A 3 mg/ kg daily. and weakness.
Z •Monitor BUN and
I serum creatinine
D levels. •Check blood
E glucose level often,
as ordered, in
diabetic patients, and
expect to increase
antidiabetic dosage,
as needed.

F oral solution, : Treatment of Inhibits the Dizziness, vertigo, •Be aware that
U tablets Adults. 20 edema associated reabsorption of paresthesias, patients who are
R to 80 mg as a with heart failure, sodium and orthostatic allergic to
O single dose, acute pulmonary chloride from the hypotension, rash, sulfonamides may
S increased by 20 edema, distal renal urticaria, nausea, also be allergic to
E to 40 mg every 6 hypertension. tubules and the anorexia, vomiting, furosemide. Monitor
M to 8 hr until loop of Henle, glycosuria, urinary patients closely.
I desired response leading to a bladder spasm. •Know that
D occurs. sodium-rich furosemide may
E Maximum: 600 diuresis. precipitate
mg daily. nephrocalcinosis/nep
Children. 2 hrolithiasis in
mg/kg as a single premature infants.
dose, increased Drugs may also
by 1 to 2 mg/kg increase the risk of
every 6 to 8 hr persistence of patent
until desired ductus arteriosus in
response occurs. premature infants.
 Maximum: 6 •Obtain patient’s
mg/kg/dose. i.v. weight before and
infusion, i.v. or periodically during
i.m. injection furosemide therapy
Adults. 20 to 40 to monitor fluid loss.
mg as a single •For once-a-day
dose, increased dosing, give drugs in
by 20 mg every 2 the morning so the
hr until desired patient's sleep won’t
response occurs. be interrupted by
Children. 1 increased need to
mg/kg as a single urinate. •Prepare
dose, increased drug for infusion with
by 1 mg/kg every normal saline
2 hr until desired solution, lactated
response occurs. Ringer’s solution, or
Maximum: 6 D5W
mg/kg/dose.

A Adults. 250 mg Adjunctive Inhibits carbonic Weakness, fatigue, •Use acetazolamide

C twice daily or treatment of anhydrase, which rash, anorexia, cautiously in patients
E every 4 hr; or 1 open-angle decreases nausea, urinary with calcium-based
T S.R. capsule glaucoma, aqueous humor frequency, renal renal calculi,
A (500 mg) twice secondary formation in the calculi, bone marrow diabetes mellitus,
Z daily; or 500 mg glaucoma; eye, intraocular suppression, weight gout, or respiratory
O initially, followed preoperative use pressure, and loss. impairment.
L by 125 to 250 mg in acute hydrogen •Know that
A every 4 to 6 hr angle-closure secretion by the acetazolamide may
M for severe acute glaucoma when renal tubules increase risk of
I glaucoma. To delay of surgery is hepatic
D initially lower indicated; edema encephalopathy in
E intraocular caused by heart patients with hepatic
pressure rapidly, failure; and drug cirrhosis. •To avoid
500 mg I.V.; may induced edema. painful I.M. injections
repeat in 2 to 4 (caused by alkaline
hr in acute solution), give
cases, acetazolamide by
depending on mouth or I.V. injection
patient response. if possible.
Oral therapy
usually started
after initial I.V.
dose. s.r.
capsules, tablets
Children. 10 to
15 mg/kg daily in
divided doses
every 6 to 8 hr.
i.v. or i.m.
injection
Children. 5 to 10
mg/kg/dose
every 6 hr

S Adults. Initial: 25 Primary Competitively Dizziness, headache, •Be aware that for
P to 200 mg daily hyperaldosteronis blocks the effects drowsiness, rash, children or patients
I in divided doses m, adjunctive of aldosterone in cramping, diarrhea, who have trouble
R twice daily to four therapy in the the renal tubule, hyperkalemia, swallowing,
O times a day for at treatment of causing loss of hirsutism, pharmacists may
N least 5 days. edema associated sodium and water gynecomastia, crush spironolactone
O Maintenance: 75 with heart failure, and retention of deepening of the tablets, mix with
L to 400 mg daily nephrotic potassium. voice, irregular flavored syrup, and
A in divided doses syndrome, hepatic menses. dispense as a
C twice daily to four cirrhosis; suspension. It’s
T times a day. treatment of stable for 1 month
O Maximum: 400 hypokalemia or when refrigerated.
N mg daily. prevention of •In diagnosing
E Children. Initial: 1 hypokalemia in primary
to 3 mg/kg daily patients at high aldosteronism, the
as a single dose risk if hypokalemia test is considered
or in divided occurs; essential positive if the
doses twice daily hypertension. patient's serum
to four times a potassium level rises
day for at least 2 when spironolactone
wk; adjusted, as is given and falls
needed, after 5 when it’s
days. Maximum: discontinued.
3 times initial
dose.

M Adults and Prevention and Elevates the Dizziness, headache, •If crystals form in
A adolescents. treatment of the osmolarity of the hypotension, rash, mannitol solution
N 0.25 to 2 g/kg as oliguric phase of glomerular filtrate, nausea, anorexia, exposed to low
N 15% to 25% renal failure; leading to a loss dry mouth, thirst, temperature, place
I solution given reduction of of water, sodium, diuresis, fluid and solution in hot-water
T over 30 to 60 intracranial and chloride; electrolyte bath to redissolve
O min. If used pressure and creates an imbalances. crystals.
L before eye treatment of osmotic gradient •Check weight and
surgery, 1.5 to 2 cerebral edema; in the eye, monitor BUN and
g/kg 60 to 90 min reduction of reducing IOP; serum creatinine
before elevated creates an electrolyte levels
procedure. intraocular osmotic effect that daily. •Provide
Maximum: 6 g/kg pressure (IOP); decreases frequent mouth care
daily. promotion of swelling after to relieve thirst and
i.v. infusion urinary excretion transurethral dry mouth.
Adults and of toxic surgery
adolescents. 200 substances;
mg/kg or 12.5 diagnostic use for
gas 15% to 20% measurement of
solution given glomerular
over 3 to 5 min. filtration rate; also
Second dose available as an
given only if the irrigant in
patient fails to transurethral
excrete 30 to 50 prostatic resection
ml of urine in 2 to and other
3 hr. Drug transurethral
discontinued if no procedures.
response after
the second dose.
 Or, 100 ml of
20% solution
diluted in 180 ml
normal saline
solution (forming
280 ml of 7.2%
solution) and
infused at 20
ml/min; followed
by measurement
of urine output.
Maximum: 6 g/kg
daily

F For women aged Treatment of Interferes with cell Headache, dizziness, •Use fosfomycin
O 18 and over. 3 g women with wall formation of nausea, diarrhea, cautiously in patients
S as a single dose uncomplicated gram negative vaginitis with impaired renal
F mixed with water. UTIs caused by bacteria, leading function because
O susceptible strains to cell death. drug clearance may
M of bacteria. be decrease
Y •Expect to obtain
C urine specimens for
I culture and sensitivity
N tests before and after
fosfomycin therapy

O e.r. tablets Relief of Acts directly to Drowsiness, •Use cautiously in

X (ditropan xl) symptoms of relax smooth dizziness, blurred patients with
Y Adults. Initial: 5 bladder instability muscle in the vision, tachycardia, myasthenia gravis or
B mg daily, associated with bladder; inhibits dry mouth, nausea, GI disorders because
U adjusted by 5 uninhibited the effects of urinary hesitancy, drugs may adversely
T mg/ wk, as neurogenic and acetylcholine at decreased sweating. affect these
Y prescribed. reflex neurogenic muscarinic conditions. •Assess
N Maximum: 30 mg bladder; treatment receptors urinary symptoms
I daily. syrup, of signs and before and after
N tablets (ditropan) symptoms of treatment. •Make
Adults. 5 mg overactive bladder sure the patient
twice daily or swallows E.R. tablets
three times a whole and doesn’t
day. Maximum: 5 crush, chew, or
mg four times a divide them. Expect
day or 20 mg to see portions of
daily. Children drug in stool
age 5 and over. 5
mg twice daily.
Maximum: 15 mg
three times a
day. transdermal
system (oxytrol)
Adults. System
supplying 3.9 mg
daily, applied
twice weekly.
topical gel
(Gelnique)
 Adults. 1 sachet
(containing 100
mg/g oxybutynin
chloride gel)
applied once
daily to dry, intact
skin on the
abdomen, upper
arms, shoulders,
or thighs.

P Adults and Symptomatic relief Has a direct, Headache; rash; •Notify prescriber if
H adolescents. 200 of pain, urgency, topical analgesic yellowish tinge to yellowish skin or
E mg three times burning, effect on the skin, sclera, urine; sclerae develop in
N daily with or frequency, and urinary tract and gastrointestinal patients taking
A without food for discomfort related mucosa; disturbances. phenazopyridine
Z no longer than 2 to lower urinary mechanism of because this may
O days. Children. 4 tract irritation action is not indicate drug
P mg/kg three caused by known. accumulation from
Y times daily with infection, trauma, impaired renal
R food for no surgery, or various excretion. Expect
I longer than 2 procedures. prescriber to
D days discontinue drug. •Be
I aware that
N phenazopyridine
E treatment should be
limited to 2 days in
patients with UTI

P Adults. 100 mg Relief of bladder Adheres to the Bleeding, headache, •Use pentosan with
E three times a day pain associated bladder wall alopecia, and extreme caution in
N for up to 3 mo, with interstitial mucosal gastrointestinal patients with
T possibly followed cystitis. membrane and disturbances. conditions that
O by another 3 mo acts as a buffer to increase bleeding
S if no control cell risk, such as
A improvement and permeability, aneurysm,
N no adverse preventing diverticula, GI
reactions. irritating solutes in ulceration,
P the urine from hemophilia, polyps,
O reaching the and
L bladder wall cells. thrombocytopenia
Y (especially
S heparin-induced).
U •Use drugs
L cautiously in patients
F with hepatic
A dysfunction because
T the drug is desulfated
E in liver and spleen.
•Monitor patients for
abnormal bleeding,
such as unexplained
bruises and
epistaxis, because
the drug is a weak
 anticoagulant.

D Adults. Initial: 1 Treatment of Blocks Headache, fatigue, •Don’t give drugs to

O mg daily. benign prostatic postsynaptic dizziness, postural hypotensive patients.
X Doubled every 1 hypertrophy alpha1-adrenergic dizziness, lethargy, •Use doxazosin
A to 2 wk, if receptors, which vertigo, tachycardia, cautiously in patients
Z needed to results in a palpitations, nausea, with hepatic disease
O achieve desired dilation of dyspepsia, diarrhea, (because normal
S blood pressure. arterioles and sexual dysfunction, dosage may cause
I Maximum: 16 mg veins and a rash. exaggerated effects)
N daily. relaxation of and in elderly
sympathetic patients (because
effects on the hypotensive
bladder and response may be
urinary tract. more pronounced).

F tablets Adults. 5 Treatment of BPH Inhibits the Impotence, •Be aware that
I mg daily. Adults. intracellular decreased libido, patients should have
N 1 mg daily enzyme that abdominal upset, a urologic evaluation
A converts gynecomastia prior to starting
S testosterone to a finasteride therapy
T potent androgen and periodically
E that the prostate throughout therapy
R depends on for its because drugs can
I development and increase the risk of
D maintenance. prostate cancer,
E especially high-grade
prostate cancer.
•Expect patients to
have a digital rectal
examination of the
prostate before and
periodically during
finasteride therapy.

DRUGS ACTING ON THE CENTRAL AND PERIPHERAL

NERVOUS SYSTEM

DRUG DOSAGE ACTION INDICATION SIDE NURSING

EFFECTS/ADVERSE CONSIDERATION
EFFECTS

D oral solution, Acts in the limbic Management of Mild drowsiness, •Use diazepam with
I tablets Adults. 2 system and reticular anxiety depression, lethargy, extreme caution in
A to 10 mg twice formation to disorders, apathy, fatigue, patients with a
Z daily to four potentiate the effects acute alcohol restlessness, history of alcohol or
E times daily. of withdrawal, bradycardia, drug abuse because
P dosage gamma-aminobutyric muscle tachycardia, it can cause physical
A adjustment acid, an inhibitory relaxation, constipation, diarrhea, and psychological
M Dosage reduced neurotransmitter; treatment of incontinence, urinary dependence, and in
 to 2 to 2.5 mg may act in spinal tetanus, retention, changes in patients with hepatic
daily or twice cord and supraspinal antiepileptic libido, drug disorders such as
daily and sites to produce adjunct in dependence with hepatic fibrosis and
increased muscle relaxation. status withdrawal syndrome. hepatitis because of
gradually as epilepticus, potentially significant
needed and preoperative increase in drug’s
tolerated for relief of anxiety half-life.
elderly or and tension. •Use diazepam
debilitated cautiously in patients
patients. with hepatic or renal
Children age 6 impairment. Severe
months and hepatic impairment is
over. Initial: 1 to a contraindication to
2.5 mg three use.
times daily or •Expect to give a
four times daily. lower diazepam dose
Increased to patients with
gradually as chronic respiratory
needed and insuf deficiency
tolerated. i.v. or because of the risk of
i.m. injection respiratory
Adults. 2 to 5 depression.
mg every 3 to 4
hr, as needed,
for moderate
anxiety; 5 to 10
mg every 3 to 4
hr, as needed,
for severe
anxiety.

P capsules, elixir, Inhibits conduction Sedation, Somnolence, •Be aware that

H tablets Adults. in the ascending short-term agitation, confusion, phenobarbital
E 60 to 250 mg reticular activating treatment of hyperkinesia, ataxia, shouldn’t be given
N daily as a single system; depresses insomnia, vertigo, CNS during the third
O dose or in the cerebral cortex; long-term depression, trimester of
B divided doses. alters cerebellar treatment of hallucinations, pregnancy because
A Children. 1 to 6 function; depresses tonic–clonic bradycardia, repeated use can
R mg/kg daily as a motor output; can seizures and hypotension, syncope, cause dependence in
B single dose or in produce excitation, cortical focal nausea, vomiting, neonate. It also
I divided doses. sedation, hypnosis, seizures, constipation, diarrhea, shouldn’t be given to
T i.v. injection anesthesia, and emergency hypoventilation, breastfeeding women
A Adults. 100 to deep coma; and has control of apnea, withdrawal because it may
L 320 mg, anticonvulsant certain acute syndrome, rash, cause CNS
repeated as activity convulsive Stevens–Johnson depression in infants.
needed. episodes, syndrome •Use I.V. route
Maximum: 600 preanesthetic cautiously in patients
mg daily. with CV disease,
Children. Initial: hypotension,
10 to 20 mg/kg pulmonary disease,
as a single or shock because the
dose. drug may cause
Maintenance: 1 adverse
to 6 mg/kg daily hemodynamic or
respiratory effects.
 •Because drugs can
cause respiratory
depression, assess
respiratory rate and
depth before use,
especially in patients
with
bronchopneumonia,
pulmonary disease,
respiratory tract
infection, or status
asthmaticus.

I capsules Adults. Inhibits presynaptic Relief of Sedation, •Frequently assess

M Initial: 75 mg reuptake of symptoms of anticholinergic effects, for adverse reactions
I daily at bedtime, norepinephrine and depression; confusion, anxiety, during the first 2
P gradually serotonin; enuresis in orthostatic hours of therapy.
R increased as anticholinergic at the children older hypotension, dry •Check supine and
A needed and central nervous than 6 years, mouth, constipation, standing blood
M tolerated. system and off-label urinary retention, pressure for
I Maximum: 300 peripheral receptors; consideration— rash, bone marrow orthostatic
N mg daily sedating. control of depression. hypotension before
E (hospitalized chronic pain and during
patients), 200 imipramine therapy
mg/day and before dosage
(outpatients). increases. •Anticipate
tablets Adults. increased risk of
Initial: 25 to 50 arrhythmias in
mg three times patients with a
daily or four history of cardiac
times daily, disease.
gradually •When a drug is used
increased as for depression,
needed and expect mood
tolerated. elevation to take 2 to
Maximum: 300 3 weeks. Watch
mg daily patients closely for
(hospitalized suicidal tenÂ
patients), 200 dencies, especially
mg daily children and
(outpatients). adolescents and
especially when
therapy starts or
dosage changes,
because depression
may worsen
temporarily at these
times.

P tablets Adults. Irreversibly inhibits Treatment of Dizziness, vertigo, •Use phenelzine

H Initial: 1 mg/kg monoamine oxidase, patients with headache, cautiously in patients
E daily, increased allowing depression overactivity, with epilepsy
N gradually as norepinephrine, who are hyperreflexia, tremors, because drugs may
E prescribed and serotonin, and unresponsive mania, weakness, alter seizure
L tolerated. dopamine to to other drowsiness, fatigue, threshold.
Z Maintenance: accumulate in the antidepressive sweating, orthostatic •Use phenelzine
I 45 mg daily. synaptic cleft; this therapy or in hypotension, cautiously in patients
N Maximum: 90 accumulation is whom other constipation, diarrhea, with diabetes mellitus
E mg daily. thought to be antidepressive dry mouth, edema, because insulin
dosage responsible for the therapy is anorexia, potential for sensitivity may
adjustment For clinical effects. contraindicated hypertensive crisis. increase,
elderly patients, . predisposing the
initially may be patient to
reduced to 0.8 hypoglycemia.
to 1 mg/kg daily •Expect to observe
in divided some therapeutic
doses, effect within 7 to 10
increased as days, but keep in
ordered and mind that full effect
tolerated to may not occur for 4
maximum of 60 to 8 weeks.
mg daily

F (prozac) Adults. Inhibits central Treatment of Headache, •Use fluoxetine

L Initial: 20 mg nervous system depression, nervousness, cautiously in patients
U daily in the neuronal reuptake of obsessive– insomnia, drowsiness, with a history of
O morning. serotonin, with little compulsive anxiety, tremor, seizures.
X Dosage effect on disorders, dizziness, sweating, •Monitor patients
E increased every norepinephrine and bulimia, rash, nausea, closely for evidence
T 4 to 8 wk as little affinity for premenstrual vomiting, diarrhea, dry of GI bleeding,
I needed. Dosage cholinergic, dysphoric mouth, anorexia, especially if the
N greater than 20 histaminic, or disorder, panic sexual dysfunction, patient takes another
E mg daily given alpha-adrenergic disorders; upper respiratory drug known to
twice daily sites. off-label uses infections, weight increase the risk,
morning and include chronic loss, fever. such as aspirin, an
noon. pain, NSAID, or warfarin.
Maximum: 80 alcoholism, •Monitor
mg daily. neuropathies, patient—especially
Children ages 8 obesity an elderly
and older . patient—for
Initial: 10 mg hyperosmolarity of
daily. Increased serum and urine and
after 1 wk to 20 for hyponatremia
mg daily. (headache, difficulty
concentrating,
memory impairment,
weakness,
unsteadiness), which
may indicate
fluoxetine-induced
SIADH

C Adults. 30 to Blocks postsynaptic Management of Drowsiness, •Don’t open or crush

H 300 mg 1 to 3 dopamine receptors manifestations insomnia, vertigo, E.R. capsules.
L times daily, with in the brain, of psychotic extrapyramidal •Chlorpromazine
O dosage adjusted depresses those disorders, relief symptoms, orthostatic shouldn’t be used to
R as needed. parts of the brain of preoperative hypotension, treat
P Maximum: 1 g involved in restlessness, photophobia, blurred dementia-related
R daily.oral wakefulness and adjunctive vision, dry mouth, psychosis in the
O concentrate, emesis, treatment of nausea, vomiting, elderly because of an
M syrup, tablets anticholinergic, tetanus, acute anorexia, urinary increased risk of
A Adults. 10 mg antihistaminic, intermittent retention, death
Z three times daily alpha-adrenergic porphyria, photosensitivity •Because of
I or four times blocking severe chlorpromazine’s
N daily, or 25 mg behavioral anticholinergic
E twice daily or problems in effects, use it
three times children, and cautiously in patients
daily. After 1 or control of with glaucoma. Also
2 days, dose hiccups, use it cautiously in
increased by 20 nausea, and those who are
to 50 mg vomiting. exposed to extreme
semiweekly until heat or
the patient is organophosphate
calm. After 2 wk insecticides and
of calmness, those receiving
dosage atropine or related
gradually drugs.
reduced to
maintenance
level of 200 to
800 mg daily in
equally divided
doses

C Adults. Initial: Blocks dopamine Management of Drowsiness, sedation, •Use clozapine

L 12.5 mg once or and serotonin severely ill seizures, dizziness, cautiously in patients
O twice daily. receptors, depresses patients with syncope, headache, with hepatic, renal, or
Z Increased by 25 the reticular schizophrenia tachycardia, nausea, cardiovascular
A to 50 mg daily to activating system, who are vomiting, fever, disease and in
P 300 to 450 mg anticholinergic, unresponsive neuroleptic malignant elderly patients with
I daily in divided antihistaminic, to standard syndrome. dementia-related
N doses by the alpha-adrenergic drugs; psychosis because
E end of 2 wk. blocking. reduction of they have increased
Dosage titration risk of recurrent risk of serious or fatal
should not suicidal adverse reactions.
exceed 100 mg behavior in Also use cautiously
twice per wk. patients with in patients with risk
Maximum: 900 schizophrenia factors for a stroke
mg daily or because drug use
schizoaffective may increase risk of
disorder. cerebrovascular
adverse events.

L Adults and Alters sodium Treatment of Central nervous •Advise patient to

I children age 12 transport in nerve manic episodes system problems, take lithium with or
T and over. Initial: and muscle cells; of bipolar, including lethargy, after meals to
H 300 to 600 mg inhibits the release manic-depressi slurred speech, minimize adverse
I three times of norepinephrine ve illness. muscle weakness, reactions. •Instruct
U daily. and dopamine, but and fine tremor; patient to swallow
M Maintenance: not serotonin, from polyuria, gastric E.R. or slow release
300 mg three stimulated neurons; toxicity, with nausea, form whole. •Direct
times daily or increases the vomiting, and diarrhea patient to mix syrup
four times daily. intraneuronal stores progressing; form with juice or
Maximum: of norepinephrine cardiovascular other flavored drink
2,400 g daily. and dopamine collapse, coma; before taking. •Inform
 Children up to slightly; and adverse effects are patients that frequent
age 12. 15 to 20 decreases the related to serum drug urination, nausea,
mg/kg daily in intraneuronal levels. and thirst may occur
divided doses content of second during the first few
twice daily or messengers. days of treatment.
three times
daily. e.r. tablets

M Adults and Mild cortical Narcolepsy and Nervousness, •Emphasize the need
E adolescents. 5 stimulant with central attention-deficit insomnia, increased to take drugs exactly
T to 20 mg twice nervous system disorder. or decreased pulse as prescribed
H daily or three actions similar to rate and blood because misuse may
Y times daily those of pressure, tachycardia, cause serious
L Maximum: 90 amphetamines. loss of appetite, adverse
P mg daily. nausea, and cardiovascular
H Children ages 6 abdominal pain. reactions, including
E to 12. 5 mg sudden death.
N twice daily •For transdermal
I before breakfast form, teach a patient
D and lunch; to apply patch to a
A increased by 5 clean, dry location in
T to 10 mg daily at his hip area 2 hours
E 1-wk intervals. before effect is
Maximum: 60 needed and to
mg daily. e.r. remove it 9 hours
oral suspension after application.
(quillivant xr) •Caution patient to
Adults and avoid applying patch
children ages 6 to skin that’s oily,
and older. damaged, or irritated
Initially, 20 mg and to avoid the
once daily in waistline, where
morning; clothing may
increased dislodge the patch.
weekly in Tell patients to rotate
increments of application sites
10 to 20 mg, as between hips.
needed.
Maximum: 60
mg daily. e.r.
once-daily
tablets
(concerta)

P Adults and Stabilizes neuronal Control of Nystagmus, ataxia, •Instruct patients to

H adolescents. membranes and tonic–clonic dysarthria, slurred crush or thoroughly
E Initial: 125 mg prevents and speech, mental chew phenytoin
N suspension or hyperexcitability psychomotor confusion, dizziness, chewable tablets
Y 100 to 125 mg caused by excessive seizures, fatigue, tremor, before swallowing or
T tablet three stimulation; limits the prevention of headache, dermatitis, to shake oral solution
O times a day, spread of seizure seizures during Stevens–Johnson well. •Advise patients
I adjusted every 7 activity from an neurosurgery, syndrome, nausea, to take drugs exactly
N to 10 days as active focus; has control of gingival hyperplasia, as prescribed; she
needed and cardiac status liver damage, should not change
tolerated. antiarrhythmic epilepticus. hematopoietic brands, dosage, or
Children. Initial: effects similar to complications, stop taking drugs
5 mg/kg daily in those of lidocaine. sometimes fatal. unless instructed by
divided doses prescriber. •Instruct
twice daily or patients to avoid
three times a taking antacids or
day, adjusted as calcium products
needed and within 2 hours of
tolerated. phenytoin.
Maintenance: 4
to 8 mg/kg daily
in divided doses
twice daily or
three times
daily. Maximum:
300 mg daily