2016年11月19日 星期六

藥物總覽


IV fluid,
Saline
Dextrose
Dextrose in Saline
Electrolyte
NSI    N/S 0.9% 500ml ()
NSI25  N/S 0.9% 250ml ()
NS0.5I  half (0.5%) saline
NSI2    20ml/vial
NSI5   N/S 500ml (軟袋)
NSI1   N/S 1000ml (軟袋)
NSIE   N/S 1000ml (沖洗)
NACLI3 3%N/S 500ml ()
D5WI,  5% destrose 500ml
D10WI, 10% dextrose 500ml
50I, 50% dextrose 20ml/amp
D5SI, 5%dextrose in N/S       500ml 
0.33I, 5%dextrose in 0.33%NaCl 500ml

Water
DWI,  water for inj., 20ml/bot
KCLI10,  KCl, 20mEq/10ml/amp
RADIK, Potassium gluconate, Radi-K
  595mg/# (K=2.54mEq)
  3-9#/day (b-tid)
K3PO4I, Potassium phosphate, K3PO4 ,
  20ml/amp,
TAITI4, Taita soln 4, 500ml/bot
 (Na, K, Cl, P, acetate, glucose)
 I: diarrhea


L (2)
Na
K
Cl
PO4
Acetate
Glucose
Mg
4
TAITI4
110
20
102
12
16
8g

5
TAITI5
36
18
17
12
28
100g
3

代用血漿:
TETRAI, TETRASPAN inj. Hydroxyethyl starch 10% 500ml
  Dose: : 10-20ml, slow ivd,  max: 30ml/kg/d (60kg=1800ml/d =3)

胃腸道出血:
一般bleeding
Tranexamic acid
Transamin
TRANI, 250mg/5ml/amp
TRANS, 250mg/ cap
1-2 amp, ivp, q6-8h
1-2 cap, PO q6-8h
N/S,



PRBC

42U

Tetraspan

1500ml

GI bleeding
Pantoprazole
Pantoloc

1 vial q12;  5 vial in N/S 500, run 20
Sucralfate
Ulsanic
2# qid

EV bleeding
Somatostatin
Stilamin, Somatosan
SOMA3MI, 3mg(3000mcg)/ vial
2 in N/S 500(or D5W), run 20, x2-3d
 Terlipressin acetate
Terlissin
TERLI, 1mg/ vial
 = 0.85mg terlipressin
EV bleeding: : 2-4iv q4h, : 1, q4-6h x2-3d  (max: 5d)
Phytonadione
Vit K1
VITKI, Vit K1 inj, 10mg/1ml/amp
IM, SC 2.5-10-25mg, qd (q6-8h prn)
1 ivd in N/S 30ml, qd
FFP 3-4U



ESRD,
Desmopressin
Minirin
DDAVP inj
DDAVP intranasal, 0.1mg/ml, 2.5ml/bot
DDAVPI,  4mcg/ml/amp

4 in N/S 50ml, run 30’ q6h x1d
Premarin 3# QID

0.625mg/#


NESP

1(20ug)
1 iv, post HD
SHOCK
Tetraspan 1

500ml

Albumin (C)
Albumin
ALBUI, 25% inj, 50ml/ bot
,(ARDS),,肝衰竭
(nephrotic),(),腹內感染

SZ
Lorazepam (D) 四級
Ativan
Ativan 0.5mg /#
Ativan 2mg/ #
Ativan 2mg/ml/amp
ATIV0.5
ATIV2
ATIV2I
Status epilepticus:
 0.1mg/kg (max: 4mg=2),
 2mg/min IVD, 
 1 + N/S 10ml ivd x1min, q5-10’ 再給一次prn
Phenytoin (C)
Dilantin
100mg/ cap
250mg/5ml/amp
4 amp=1000mg
5 amp=1250mg
DILAN
DILA5I
: 1 cap TID (3 cap HS)
: 15-20mg/kg (60kg=900-1200mg) ivd x30’, st
   (4-5 in N/S 100ml, run 30’)
: 100mg, in N/S 50ml, ivd x 5’, q6-8h
Max infusion rate: 50mg/min

高血壓
ACEi




 Captopril (C,D)
Capoten
CAPO
25mg/#
HTN: 12.5mg-25mg (0.5-1#) b-t-qid
Nitroglycerine




 Nitrate
Nitrostat
Nitroglycerin inj
(Millisrol)
NTG
NTG1I
0.6mg/ #
5mg/ 10ml
(500mcg/1ml)
=300mcg/0.6ml

: 5mcg/min (300mcg=0.6ml/h ~90ml/h), 5分增5mcg,
BB




 Atenolol (D)
Tenormin
TENO50
TENO100
50mg/#
100mg/#
HTN: : 25-50mg/d (0.5-1#qd)
 Bisoprolol (C)
Concor
CONC
CONC125
5mg/#
1.25mg/#

 Labetalol
Trandate
TRAND

TRANDI
200mg/ #

25mg/5ml/amp
+D5w
(=1mg/1ml)
: 0.5# BID; : 1-2# bid
HTN urgency: 100-200mg (0.5-1#), q2-3h
=20mg ivd (4ml +D5W 16ml) x2min; 40mg & 80mg, at 10min interval (max: 300mg)
=2mg/min (120mg/1h)








高血壓危症 (hypertensive crisis)
  Hypertensive urgencies: DBP >120-130 mmHg (↓30% = 36-39mmHg=)
  Hypertensive emergencies: severe HTN + end-organ damage (需數小時內降低BP) =>住院ICU
 降壓目標: 24h內降30%

HTN Urgency (PO)
HTN emergency (inj)
Capoten  0.5-1# bid-qid
         15-30’ / 4-6h
Nitrate  0.6ml/h ~ (5分增5mcg)
Trandate  0.5-1#, q2-3h
         30-120’/ 8-12h
Trandate inj (20mg=4ml (+D5W 16ml) ivd x2’)

新陳代謝科
Biguanide





  Metformin (B)
Glucomine
Glucophage
500mg/ #
850mg/ #
GLUC
GLUC85

Max: 2550mg
SU





  Glibenclamide (C)
Euglucon =glyburide
5mg/ #
EUGL
: 0.5-1#qd,
(: 0.25# ~ max:4#)

  Gliclazide
Diamicron MR(長效)
30mg/ #
DIAM30
Qd- bid
Max: 120mg (4#)
Ps: 非長效劑型: max: 320mg
  Glipizide (C)
Glupizide
=Minidiab
5mg/ #
GLUP
1# qd (max: 8#/ d)



Metformin
Metformin extended
Dose
500-850mg TID; 1000mg BID
晚餐QD (500-2000mg)
Max
2550mg
2000mg
半衰期 (h)
6
1.5-4.9
Duration
~6
~24h
代謝/排出
原型藥, 腎排出
同左
Ps
,腎功能差避免用
同左


Glimepiride
Gliclazide
Glipizide
Glibenclamide
Gliquidone

Amaryl®
amaryl-M (500)
Diamicron MR®
Glupizide®
Minidiab
Euglucon®
Glyburide

Duration (h)
24
12-24
10-24
16-24
8-12
用法
Qd-bid
Qd-bid
Qd-bid
qd

排出 /
60/ 40
60-80/ 20
80-85/ 11
50/ 50
5/ 95



呼吸道用藥
止咳





Benproperine
Mecola
20mg/#
MECOLA
1#  TID

Benzonatate
Bensau
100mg/cap
BENZ
1-2 cap TID

Codeine
Codeine
30mg/#
CODE30
0.5-1-2# Q3-6h
二級管制
Codeine 5mg
Terpin 40mg
COLD

COLD
1# TID

Terpin 祛痰
Dextromethorphan
Medicon
20mg/#
MEDI
10-20mg q4h
30mg (1.5#) q6-8h
Max: 120mg/d
Dextromethorphan 20mg
Pot. Cresolsulfonate 90mg
Lysozyme 20mg
Medicon-A

MEDIA
1 cap TID

1ml =
Codeine 0.48mg
Methylephedrine 1 mg
Chlorpheniramine 0.2mg
Pot. Guaiacol  3mg
Platycodon extract 0.06ml
Antico-B syr
(Codin-P)
60ml/ bt
ANTB6S
15ml T-QID
I: 乾咳
Tincture Opium camphor 0.12ml
Ext. glycyrrhiza  0.12ml
Pot. Antimony tartrate 0.24ml
Spirit ethylnitrite  0.03ml
Brown Mixture
0.12ml/ml
120ml/ bt
BROWS
2-10ml TID

Butamirate
Sutussi Liquid
0.8mg/ml
SUTUS
7.5ml, t-qid


化痰





Acetylcysteine
Flumucil
Acetyleine
Actein
300mg/3ml/
100mg/5g/
600mg/#
FLUMI
FLUIM
ACTEIN
1 amp  BID
1-2 TID
1# 發泡錠QD
MAX: 600mg
Ambroxol
Mucosolvan
30mg/ #
MUCO
1# BI ~ 2# TID

Serratiopeptidase
Danzen
5mg/ #
DANZ
1-2#   TID


支氣管擴張劑/ 氣喘用藥





Beta-2 agonist





Bambuterol
Bambec
10mg/ #
BAMB
1# HS
->1~2wks may 2# HS
Lungtec
 Salbutamol
Ventoline
Ventoline nebules 
Ventoline inhaler
2mg/ #
5mg/ml/vial
100mcg/ds, 200ds
VENT2
VENTN
VENTE
1-3# t-qid

 Terbutaline
Bricanyl UDV
2.5mg/ml
2ml/vial
BRICN
1-2,吸入B-QID

 Salmeterol/ Fluticasone
Seretide accuhaler



SEREA50
SEREA25
SEREA10
Inh. BID
50 mcg/ 500 mcg
50/ 250
50/ 100

Seretide evohaler 250

SERE250E

25/ 250 mcg
Xanthine der.
 Aminophylline
 (茶鹼+乙二胺)->水溶性

Aminophylline
Aminophylline inj

100mg/#
250mg/10ml

AMIN
AMINI
       
1# TID    300mg/d
1 ivd
相當無水theophylline
5mg/kg ->3天後may 600mg/d
水解後-> theophylline
 Theophylline
Xanthium
200mg/ cap
XANT
T-QID (抽菸者需qid)

Steroid
 Budesonide

Duasma
Pulmicort

40mcg/ds/10ml inh
64mcg/ds nasal aqua

DUAS10I
PULM64N
         
400-1600/d  200-400
Bi-qid       Bi
控制慢性氣喘
(不用於急性發作)
Leukotriene antagonist
 Montelukast

Singulair
Singulair
Singulair
Singulair oral granules

10mg/ #
4mg/ chewable #
5mg/ chewable #
4mg/ packet

SING
SING4
SING5
SINGU4

15y: 10mg HS
6-14y: 5mg HS

<6y/o 小心用
Mast cell stabilizer
 Ketotifen

Asthan, zaditen
Zaditen Oph sln

1mg/ #

ZADI
ZADIE

1-2# BI

長期預防
其他
 Ipratropium

Atrovent UDV

0.5mg/ 2ml/

ATRON

1-2 q4-6-8h

 Ipratropium / fenoterol
Berodual N MDI
20mcg/ 50mcg
BERODUE
: 1-2puff, q5min prn
: 1-2puff, t-qid
200 puff/ 10ml
 Tiotropium 225mcg
Spiriva respimat
2.5mg/ puff.
SPIRRN
1 cap (18mcg), qd
Via HandiHaler device
 Salbutamol/ Ipratropium
  120mg  / 20mg
Combivent UDV
0.2mg/ml, 2.5ml/
COMBI
1-2 t-qid nebulization
Max: 12/day
 Budesonide / formoterol
  160mcg/ 4.5mcg
Symbicort turbuhaler

SYMBT
1-2 inhalations, BI
長效β-agonist

肝膽胃腸藥

消化性潰瘍藥






H2-blocker





Cimetidine
Tagamet (defense)
Cimetidine
Tagamet
300mg/2ml/amp
200mg/ #
400mg/ #
TAGAI
CIME
CIME400
UGIB: 1 q6h
Tx: 300mg QI,
 600mg BI

 Ranitidine
Zantac
150mg/#



PPI (-prazole)          





 Esomeprazole (B)   
Nexium           
Nexium inj
40mg/ #     14
40mg/ vial
NEXI
NEXII

0.5-1# (vial), QD

 Lansoprazole (B)
Takepron OD
30mg/ #     22
TAKEOD
1# QD
GERD: 8wks
DU: 6wks
 Omeprazole (C)
Losec            
Losec inj
20mg/ cap   2.5
40mg/ vial
LOSE
LOSEI
2# (1), QD
PUD/ GERD: 4-8 wks
 Pantoprazole
Pantoloc   
Pantoloc inj    
40mg/ #     22
40mg/ vial
PANT
1-2# QD

 Rabeprazole
Pariet           
20mg/ #     17
PARIE
1# AM, PC
4-8 wks
 Dexlansoprazole
Dexilant
60mg/ cap   29
DEXI

骨鬆
其他





 Misoprostol
Cytotec
200mcg/ #
CYTO

NSAID-induced GU預防

其他腸胃藥 





Mosapride
Mopride
5mg/ #
MOPRID
1# TI
DM gastroparesis, indigestion
Domperidone
Motilium
10mg/ #
MOTI
1-2-3# t-qid
止吐, DM gastroparesis,
飯後dyspepsia: 1#TIA
Metoclopramide (B)
Primperan
Primperan inj
5mg/ #
10mg/ 2ml/ amp
PRIM5
PRIMI
1-2# t-qia
DM Gastroparesis, 2#QIA
GERD
flopropine
Cospanon
40mg/ cap
COSP
1-2 cap TID
膽管解痙劑
(膽管結石(), 胰臟炎)
Sucralfate (B)
Ulsanic
500mg/ #
ULSA
預防: 2# bi; 治療: 2#qi
S/P: GIB, 腎差


抗生素
PCN





Amoxicillin (B)
Amoxicillin
250mg/cap
500mg/cap
AMOX25
AMOX50
250-500mg q8h

Amoxicillin/
clavulanic acid
Augmentin syrup (400/ 57mg)
Augmentin F.C. 1g (875/ 125mg)
Augmentin 600mg (500/100mg)
Augmentin 1.2g (1000/200mg)
457mg /5ml
1g /#
600mg /vial
1.2g /vial
AUGMS2
AUGM
AUGMI
AUGM12I
輕:250mg q8h
中:500mg q12
重:500mg-875mg q8

Ampicillin (B)
Ampicillin
500mg/cap
500mg/ vial
AMPI50
AMPI5I
250-500mg q6h

Ampicillin/
Sulbactam
Unasyn (1000/500mg/vial)
Unasyn (250/125mg/#)
Ambacillin 3g (2g/1g/vial)
1.5g/vial
375mg/ #
3g/ vial
UNASI

PO: 2-4# BID
Iv: 3g q6-8, (max 12g/d)


1.5g q6(6g/d)~3g q8 (9g/d)
Dicloxacillin
Dicloxacillin
250mg/cap
DICL
1-4 cap q6h (max: 6g/d)
Diclocin ®
Flucloxacillin ()
Flucloxin
1g/vial)
FLUCLO1I
250mg-2g, slow ivd q6h

Oxacillin (B)
Prostaphylin
1g/vial
PROS1I
250mg-1g iv q4-6h
Ocillina ®
Piperacillin (B)
Pipril
2g/ vial
PIPRI
3-4g, iv q4-6h

Piperacillin /
Tazobactam (B)
Tazocin (2g/ 0.25g)
Betamycin (4.5g/ vial)
2.25g/ vial
4.5g/ vial
TAZOI
BETAI
4.5g iv q6-8h



CPL





Cefazolin (B)
Cephazoline
1g/vial
CEFAI
250mg-1.5g, iv q6-8h

Cefuroxime (B)
Zinacef
Zinnat
750mg/vial
250mg/ #
ZINAI75
ZINN
750mg-1.5g-3g iv q8h
PO: 1-2# bid



















































腦神經科用藥
痙攣/sz
治療:使用單一種藥物為佳(好控制/monitor,少彼此交互作用,遵從性佳,more cost effective, wider therapeutic index
Valproic acid: 首選(對所有癲癇都有療效)
Carbamazepine & Dilantin (幾乎所有癲癇皆有效,except失神性癲癇無效)
Status epilepticus: Ativan (or valium), -> Dilantin

Note that although there is evidence to support the use of these medications for these seizure types, the medication may not be indicated for this use by the US Food and Drug Administration.
* Previously referred to as secondary generalized seizures.
¶ Some evidence of efficacy for generalized-onset tonic-clonic seizures, but may also worsen certain generalized seizure types.
Δ Potential to worsen certain generalized seizure types.
§ May worsen or precipitate myoclonic seizures.
¥ Ezogabine (retigabine) is being permanently discontinued by the manufacturer and will not be available commercially after June 2017.



Tonic clonic
Dilantin & carbamazepine
Generalized SZ
Ethosuximide & valproic acid
Partial SZ
Carbamazepine & phenytoin
STATUS EPILEPTICUS
Lorazepam (D) 四級
Ativan
0.5mg /#
2mg/ #
2mg/ml/amp
ATIV0.5
ATIV2
ATIV2I
Status epilepticus:
 0.1mg/kg (max: 4mg=2),
 2mg/min IVD, 
 1 + N/S 10ml ivd x1min, q5-10’ 再給一次prn
Phenytoin (C)
4-5 in N/S 100ml, run 30’

Dilantin
100mg/ cap
250mg/5ml/amp
4 amp=1000mg
5 amp=1250mg
DILAN
DILA5I
: 1 cap TID (3 cap HS)
: 15-20mg/kg (60kg=900-1200mg)
  1000mg in N/S 100, ivd x30’, st
: 100mg, in N/S 50ml, ivd x 5’, q6-8h
Max infusion rate: 50mg/min

SZ




Use

Lorazepam
Ativan
0.5mg /#
2mg/ #
2mg/ml/amp
ATIV0.5
ATIV2
ATIV2I
Status epilepticus:

 1 + N/S 10ml ivd x1min, q5-10’ 再給一次prn


0.1mg/kg (max: 4mg (2)),
Clonazepam (四級)
Rivotril
0.5mg/ #
2mg/ #
RIVO0.5
RIVO2
初:0.5mg TID (3d0.5-1mg)
Myoclonic SZ, absence SZ
窄效





Carbamazepine (C)
Tegretol CR
200mg/#
TEGRCR
初:1# BI
維:1.5-3#BI
Epilepsy, trigeminal neuralgia
副:Steven-Johnson synd
Phenytoin
Dilantin
100mg/ cap
250mg/5ml/amp
DILAN
DILA5I
初:1 cap TID, 3-6#HS
Status epilepticus
Pregabalin
Pregabalin ()
(Lyrica ®)
75mg/ cap
LIRICA
初:1# BI
維:150-600mg/d (max: 4 cap BI)

廣效





 Lamotrigine (C) 
Lamictal
50mg/ #
LAMI
1# BI

 Levetiracetam (C)
Keppra 
500mg/#
500mg/ vial
KEPP
KEPPI
1# B-tid (max: 3# BI)
Partial SZ, adjunct
 Topiramate (C)
Topamax
25mg/ cap
100mg/ #
TOPA25
TOPAMA
初:1# (25mg) BI
Max: 200mg BI
 Valproic acid (D) 
Convulex
Depakine
Depakine soln
300mg/ cap
500mg/ #
200mg/ml (40ml/bt)
CONVU
DEPA500
DEPAS
初:1cap (300mg) BI
維:1-2g/ d
  2-6ml BI-qid


: euclidan (50) (nican) 1#TI
   Nilasen (16) betadine 1#TI
   Sibelium (5) 1#HS