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Gastrointestinal (Other)
Alosetron (Lotronex®) |
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Drug Category: Selective 5-HT3 Receptor Antagonist.
Indication: Treatment of women with severe
diarrhea-predominant irritable bowel syndrome (IBS) who have failed to
respond to conventional therapy Dosing (Adults) IBS: Female: Oral: Initial: 0.5 mg twice daily for 4 weeks, with or without food; if tolerated, but response is inadequate, may be increased after 4 weeks to 1 mg twice daily. If response is inadequate after 4 weeks of 1 mg twice-daily dosing, discontinue treatment. Note: Discontinue immediately if constipation or signs/symptoms of ischemic colitis occur. Do not reinitiate in patients who develop ischemic colitis. Renal Dosing: The need for dosage adjustment has not been defined (due to limited information on activity of metabolites). Supplied: Tablet: 0.5 mg, 1 mg |
infliximab (Remicade ®): |
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Monoclonal antibody that binds to tumor necrosis factor.
Biological activities of TNFa include the induction of proinflammatory
cytokines (interleukins), enhancement of leukocyte migration, activation
of neutrophils and eosinophils, and the induction of acute phase
reactants and tissue degrading enzymes. Dosing (Adults): Ankylosing spondylitis: 5 mg/kg IV at 0, 2, and 6 weeks, followed by 5 mg/kg every 6 weeks thereafter. Crohn's disease: Induction regimen: 5 mg/kg IV over 2 hours. Repeat dose at 2 and 6 weeks, followed by 5 mg/kg every 8 weeks. Dose may be increased to 10 mg/kg in patients who respond but then lose their response. If no response by week 14, consider discontinuing therapy. Psoriatic arthritis (with or without methotrexate): 5 mg/kg IV at 0, 2, and 6 weeks, then every 8 weeks. Rheumatoid arthritis: (In combination with methotrexate therapy): 3 mg/kg IV at 0, 2, and 6 weeks then every 8 weeks thereafter. Doses have ranged from 3-10 mg/kg intravenous infusion repeated at 4 to 8 week intervals. |
Mesalamine (Asacol ® , Pentasa) |
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Dosing (Adults): Asacol ®: 800mg
orally three times daily. (Pentasa): 1000mg orally four times daily. |
misoprostol (Cytotec ® ) |
| Dosing (Adults): 200 mcg orally four times daily with food. If poorly tolerated may decrease dose to 100 mcg orally four times daily or 200mcg orally twice daily. Supplied: [100, 200 mcg tablets]. |
Neomycin: |
| Hepatic encephalopathy: 4 to 12 grams/day orally divided every 6 hours. |
octreotide (Sandostatin ®) |
| Dosing (Adults): Variceal bleed: Bolus 25-50 mcg IV, followed by 25-50 mcg/hr. AIDs diarrhea: 100-500 mcg SC three times daily. |
osalazine (Dipentum ® ) |
| Dosing (Adults): Ulcerative colitis: 500mg orally bid. |
Orlistat (Xenical ®) |
| lipase inhibitor for obesity management that acts by inhibiting the absorption of dietary fats. Dosing (Adults): Weight loss: 120mg orally three times daily with meals [120] |
sucralafate (Carafate ® ) |
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Dosing (Adults): Active duodenal ulcer: 1 gram orally four times daily on an empty stomach. Prophylaxis: 1 gram orally twice daily. [Supplied: 1 gram tablet; susp: 1 gram/10ml] |
Sulfasalazine (Azulfadine ®) |
| Dosing (Adults): 500-1000mg orally four times daily. |
Ursodiol (Actigall ®) |
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Gallstone dissolution: Oral: 8-10 mg/kg/day in
2-3 divided doses; use beyond 24 months is not established; obtain
ultrasound images at 6-month intervals for the first year of therapy;
30% of patients have stone recurrence after dissolution. Gallstone prevention: Oral: 300 mg twice daily. Primary biliary cirrhosis: Oral: 13-15 mg/kg/day in 2-4 divided doses (with food). Supplied: [Supplied: 300 capsule] |
vasopressin (Pitressin ®) |
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ADH Bleeding esophageal varices and other types of upper GI bleeds: initially 0.2 u/min, then increase each hour by 0.2 u/min until the hemorrhage is controlled. Doses as high as 2 u/min may be tolerated, but a more prudent dosage limit is 1 u/min. After 12 hours of control of the hemorrhage the dose of vasopressin may be decreased by 50%, then may discontinue in the next 12-24 hrs. Intravenous nitroglycerin should be administered concomitantly to control side effects. MOA: ADH and pressor activity. Portal blood pressure is significantly decreased. A decrease in porto-systemic collateral flow and an increase in the muscular tone of the lower esophagus reduces blood flow to esophageal varices. The smooth muscle of the GI tract is also effected by large doses and peristaltic activity of the bowel and smooth muscles of the uterus are stimulated. |
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any diagnosis or treatment made in reliance thereon. David F. McAuley, Pharm.D., R.Ph. GlobalRPh Inc. |
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