Report | Code | Agent |
A | A0001 | LOOK FOR C & S RESULTS |
|
B | B0001 | STEROID THERAPY |
STEROID THERAPY |
B | B0002 | TPN THERAPY |
TPN HAS STARTED. MONITOR NUTRITIONAL STATUS |
B | B0003 | PPN |
PPN HAS STARTED. MONITOR NUTRITIONAL STATUS |
C | C0001 | WARFARIN (COUMADIN) |
MONITOR INR, PT OR PTT |
C | C0002 | PHYTONEDIONE 10MG (VIT K) |
MONITOR INR, PT OR PTT |
C | C0003 | ASPIRIN |
MONITOR INR, PT OR PTT |
C | C0004 | CLOPIDOGREL (PLAVIX) |
MONITOR INR, PT OR PTT |
C | C0005 | ENOXAPARIN (LOVENOX) |
MONITOR INR, PT OR PTT |
C | C0006 | HEPARIN SQ |
MONITOR INR, PT OR PTT |
C | C0007 | CILOSTAZOL (PLETAL) |
MONITOR INR, PT OR PTT |
C | C0008 | DIPYRIDAMOLE (PERSANTINE) |
MONITOR INR, PT |
C | C0009 | AGGRENOX (ASA,DIPYRIDAMOLE) |
MONITOR INR,PT |
C | C0010 | AGGRASTAT AND TIROFIBAN |
MONITOR PLATELETS. IF WITH HEPARIN, MONITOR PTT. PLATELETS <90 MAY REQUIRE INTERRUPTION/DC. CHECK HGB/HCT 6 HOURS AFTER STARTING |
D | D0001 | DIABETIC MEDICATION |
|
D | D0002 | ATYPICAL ANTIPSYCHOTIC |
MONITOR FOR HYPERGLYCEMIA |
D | D0099 | SLIDING SCALE INSULIN |
TOTAL DOSES GIVEN IN PAST 24 HOURS |
F | F0001 | VITAMIN K FOODS |
AVOID FOODS WITH HIGH LEVELS OF VITAMIN K. |
F | F0003 | FOOD DELAYS RESPONSE |
TAKE ON AN EMPTY STOMACH FOR RAPID RESPONSE |
F | F0004 | EMPTY STOMACH |
TAKE ON AN EMPTY STOMACH 1 HOUR BEFORE MEALS OR 2 HOURS AFTER MEALS |
F | F0005 | AVOID HIGH PROTEIN MEALS |
PROTEIN SHOULD BE DISTRUBUTED THROUGHOUT THE DAY. |
F | F0007 | CAFFEINE |
CAFFEINE MAY DECREASE EFFECTIVENESS. AVOID CAFFEINE USE. |
F | F0008 | ADMIN. CONSISTENTLY |
FOOD MAY INCREASE CONCENTRATIONS. TAKE CONSISTENTLY WITH FOOD OR ON EMPTY STOMACH. |
F | F0009 | DAIRY FOODS |
DAIRY FOODS REDUCE ABSORPTION. TAKE 1 HR BEFORE OR 2HR AFTER DAIRY FOODS. |
F | F0010 | POTASSIUM FOODS |
USE WITH POTASSIUM RICH FOODS MAY RESULT IN HYPERKALEMIA |
F | F0011 | GRAPEFRUIT JUICE |
DESCRIPTION WHILE ON THIS DRUG AVOID GRAPEFRUIT AND GRAPEFRUIT JUICE. |
F | F0013 | OXALIC ACID FOODS |
OXALIC ACID FOODS MAY RESULT IN DECREASED EFFECTIVENESS. AVOID OXALIC ACID FOODS. |
F | F0015 | AVOID CAFFEINE |
CAFFEINE CONCENTRATIONS MAY BE INCREASED RESULTING IN INCREASED CNS STIMULATION. AVOID USE. |
F | F0016 | TYRAMINE FOODS |
TYRAMINE FOODS MAY RESULT IN INCREASED BLOOD PRESSURE. AVOID TYRAMINE FOODS. |
F | F0017 | ENTERAL NUTRITION |
ENTERAL NUTRITION MAY RESULT IN DECREASED CONCN. |
F | F0018 | AVOID HIGH LIPID MEALS |
HIGH FAT FOODS MAY RESULT IN INCREASED DRUG CONCENTRATIONS OR DECREASED DRUG ABSORPTION. AVOID HIGH FAT MEALS. |
F | F0019 | DOPAMINE FOODS |
DOPAMINE FOODS MAY RESULT IN INCREASED BLOOD PRESSURE. AVOID DOPAMINE FOODS. |
F | F0020 | CRANBERRY JUICE |
AVOID ALL CRANBERRY JUICE PRODUCTS WHILE ON THIS MEDICATION |
F | F0021 | HIGH ALKALINE FOODS A ABSORP |
HIGH ALKALINE FOODS INCREASE SERUM CONCHS. |
F | F0022 | INSULIN RELEASE DELAY |
WHEN TAKEN WITH FOOD INSULIN RELEASE MAY BE DELAYED. TAKE MEDICATION ON AN EMPTY STOMACH BEFORE MEALS. |
F | F0023 | >30MIN P SAME MEAL QD |
TAKE 30MIN AFTER SAME MEAL EACH DAY |
F | F0024 | ALUMINUM-CONTAINING ANTACIDS |
DO NOT TAKE WITHIN 3-4 HOURS OF ALUMINUM CONTAINING ANTACIDS |
F | F0025 | ZINC |
AVOID FOODS HIGH IN CALCIUM,PHOSPHOROUS OR PHYTATE |
F | F0026 | ALCOHOL (ETHANOL) |
AVOID ALCOHOLIC BEVERAGES WHILE ON THIS DRUG. |
F | F0027 | TAKE WITH FOOD |
TAKE THIS DRUG WITH FOOD. |
F | F0028 | MAY TAKE WITH FOOD IF GI UPSET |
MAY TAKE THIS DRUG WITH FOOD IF GI SIDE EFFECTS OCCUR |
F | F0029 | TAKE 30 MIN BEFORE MEALS |
TAKE THIS DRUG 30 MINUTES BEFORE MEALS |
F | F0030 | CARAFATE |
TAKE CALCIUM OR MAGNESIUM 30 MINUTES BEFORE CARAFATE |
F | F0031 | ALENDRONATE ON EMPTY STOM |
TAKE FOSAMAX 30MIN BEFORE FIRST BITE OF FOOD, BEVERAGE, OR DRUG OF THE DAY. SIT UP FOR 30 MINUTES AFTER TAKING FOSAMAX |
F | F0032 | FIRST BITE |
TAKE THIS DRUG WITH THE FIRST BITE OF EACH MEAL |
F | F0033 | TAKE WITH WATER ONLY |
TAKE THIS DRUG WITH WATER ONLY. NO GRAPEFRUIT, ORANGE OR APPLE JUICE. |
F | F0034 | GIVE PACKAGE INSERT WHEN COUNS |
|
F | F0035 | PED TAKE WITH FOOD |
PEDIATRIC PATIENTS TAKE WITH FOOD |
F | F0036 | HIGH FIBER |
AVOID ADMINISTRATION WITH HIGH FIBER MEALS |
H | H001 | ATORVASTATIN (LIPITOR) |
BASELINE LFT, REPEAT , 6, 12 WEEKS P INITIATION OR ADOSE, THEN Q6MONTHS.IF LFT>3 TIMES ULN, DECREASE DOSE OR STOP. ABNORMALITIES USUALLY OCCUR IN FIRST 3 MONTHS OF TX. |
H | H0002 | FLUVASTATIN (LESCOL,LESCOL XL) |
BASELINE LFT AT 12 WEEKS AFTER INITIATION OR DOSE INCREASE. IF LFT INCREASE, REPEAT TESTS UNTIL RETURN TO NORMAL. IF >3 TIMES ULN OCCURS AND PERSISTS, STOP DRUG. ABNORMALITIES USUALLY OCCUR IN FIRST 3 MONTHS. |
H | H0003 | LOVASTATIN (MEVACOR,ALTOCOR) |
BASELINE LFT AT 6, 12 WEEKS AFTER INITIATION OR DOSE INCREASE. IF LFT INCREASE, REPEAT TESTS UNTIL RETURN TO NORMAL. IF >3 TIMES ULN OCCURS AND PERSISTS, STOP DRUG. ABNORMALITIES USUALLY OCCUR IN FIRST 3-12 MONTHS. |
H | H0004 | PRAVASTATIN (PRAVACHOL) |
BASELINE LFT AT 6, 12 WEEKS AFTER INITIATION OR DOSE INCREASE & AT 6 MONTHS. IF LFT INCREASE, REPEAT TESTS UNTIL RETURN TO NORMAL. IF >3 TIMES ULN OCCURS AND PERSISTS, STOP DRUG. |
H | H0005 | ROSUVASTATION (CRESTOR) |
BASELINE LFT AT 2, 12 WEEKS AFTER INITIATION OR DOSE INCREASE & Q6 MONTHS. IF LFT INCREASE, REPEAT TESTS UNTIL RETURN TO NORMAL. IF >3 TIMES ULN OCCURS AND PERSISTS, STOP DRUG. ABNORMALITIES USUALLY OCCUR IN FIRST 3 MONTHS. |
H | H0006 | SIMVASTATIN (ZOCOR) |
BASELINE LFTS.REPEAT AT 6,12 WEEKS AFTER INITIATION OR DOSE INCREASE & THEN Q6 MONTHS UNTIL 1 YEAR AFTER LAST DOSE. INCREASE FOR PT ON 80MG DAILY, CHECK LFTS AFTER FIRST 3 MONTHS. IF LFTS INCREASED, SECOND TEST SHOULD BE OBTAINED. REPEAT LFTS UNTIL RETURN TO NORMAL. IF >3 TIMES ULN, STOP DRUG |
H | H0007 | GEMFIBROZIL (LOPID) |
BASELINE LFTS,Q3MONTHS FOR 1 YEAR, THEN PERIODICALLY. IF ABNORMALITIES EXIST, STOP DRUG. |
H | H0008 | FENOFIBRATE (TRICOR) |
REGULAR PERIODIC MONITORING FOR DURATION OF THERAPY. IF LFTS ARE >3 TIMES ULN, STOP DRUG. |
I | I0001 | IV TO PO CONVERSION |
DRUGS TARGETED FOR IV-TO-PO CONVERSION |
L | L0002 | RT MEDS INTERACTION REPORT |
PHARMACY AND RT VERIFY FOR ANY DUPLICATIONS FOR INHALERS AND NEBULIZER TREATMENTS. INTERVENE AS NECESSARY |
P | P0001 | PAIN MED CLINICAL MONITORING |
MONITOR PAIN MED USAGE |
P | P0002 | MUSCLE RELAXANT |
MONITOR PAIN MED USE. INTERVENE PRN |
P | P0003 | PAIN MANAGEMENT ADJDNCT MED |
MONITOR PAIN MED USAGE |
R | R0001 | ACETAMINOPHEN (TYLENOL) |
NORMAL DOSE: 325-650MG Q4-6H PRN MAX DOSE=4GM DAILY. IF CRCL=50-10, DOSE Q6H. IF CRCL<10, DOSE QSH (METABOLITES ACCUMULATE) |
R | R0002 | ALLOPURINOL (ZYLOPRIM) |
NORMAL DOSE:200-300MG DAILY X2-3 DOSES. INCREASE FOR CANCER,SEVERE GOUT. CRCL=140, 400MG DAILY. CRCL=120, 350MG DAILY. CRCL=100,300MG DAILY. CRCL=80, 250MG DAILY. CRC=60, 200MG DAILY. CRCL=40, 150MG DAILY. CRCL=20,100MG DAILY. CRCL=10,100MG EVERY 2DAYS. CRCL=O, 100MG EVERY 3DAYS. BASED ON 300MG DAILY IF CRCL=100. |
R | R0003 | ASPIRIN |
NORMAL DOSE:325-650MG Q4-6H CRCL<10, AVOID USE. |
R | R0004 | ATENOLOL (TENORMIN) |
NORMAL DOSE:50-100MG DAILY IF CRCL=15-35, 50MG DAILY MAX IF CRCL<15, 50MG EVERY 2 DAYS MAX OR-CRCL=10-50, 50% OR Q48H CRCL <10, 30-50% OR Q 96H |
R | R0005 | BENAZEPRIL (LOTENSIN) |
NORMAL DOSE:20-40MG DAILY. IF CRCL<30: 5MG DAILY. MAY INCREASE TO CONTROLLED BP OR 40MG MAX. OR CRCL = 10-50, 50-75% OF DOSE <10 CRCL = 25-50% OF DOSE |
R | R0006 | BISOPROLOL (ZEBETA) |
NORMAL DOSE:5-20MG DAILY IF CRCL<40, INITIAL 2.5MG OR, CRCL= 10-50, 75%; CRCL= <10, 50% ALSO DECREASE DOSE IN HEPATIC IMPAIRMENT |
R | R0007 | BUSPIRONE (BUSPAR) |
NORMAL DOSE:15-60MG DAILY IF ANURIC, REDUCE DOSE 25-50% |
R | R0008 | CAPTOPRIL (CAPOTEN) |
NORMAL DOSE:25-150MG TID. MAX=450MG DAILY IF CRCL<50M REDUCE DOSE 50-75% OR, CRCL = 10-50, 75% OF DOSE CRCL = <10, 50% OF DOSE |
R | R0009 | CARBAMAZEPINE (TEGRETOL) |
NORMAL DOSE:200MG BID INIT. 800-1200MG DAILY HAINT. IF CRCL<10, 75% OF NORMAL DOSE. |
R | R0010 | CELECOXIB (CELEBREX) |
NORMAL DOSE:100MG BID IF ADVANCED RENAL DISEASE, MONITOR RENAL FUNCTN. |
R | R0011 | CHLORDIAZEPOXIDE (LIBRIUM) |
NORMAL DOSE:15-100MG DIVIDED 3-4TIMES /DAY. IF CRCL< 10M GIVE 50% OF DOSE. |
R | R0012 | CIMETIDINE (TAGAMET) |
NORMAL DOSE:400MG PO BID IF CRCL 20-40: Q8H OR 75% IF CRCL<20: Q12H OR 50% OR, CRCL = 10-50%, 50%
CRCL = <10, 25% |
R | R0013 | CITALOPRAM (CELEXA) |
NORMAL DOSE: 20-40MG DAILY IF CRCL <20: AVOID |
R | R0014 | CLONIDINE (CATAPRES) |
NORMAL DOSE:0.2-1.2MG DAILY IN 2-4 DIVIDED DOSES. MAX 2.4MG DAILY IF CRCL<10: 50-75% |
R | R0015 | DIFLUNISAL (DOLOBID) |
NORMAL DOSE:250-500MG BID IF CRCL<50: GIVE 50% OF NORMAL DOSE OR, CRCL =10-50%, 50% OF NORMAL DOSE CRCL < 10, GIVE 50% OR LESS |
R | R0016 | DIGOXIN (LANOXIN) |
NORMAL DOSE: 0.125-2.5MG DAILY IF CRCL 50-10:25-75% OR Q36H. IF CRCL<10:10-25% OR Q48H |
R | R0017 | DILTIAZEM (CARDIZEM,DILACOR) |
USE CAUTION:MET BY LIVER, EXCRETED BY KIDNEYS |
R | R0018 | DISOPYRAMIDE (NORPACE) |
NORMAL DOSE: 100MG Q6H OR 200MG CR Q12H IF CRCL 30-40:Q8H IF CRCL 15-30:Q12H IF CRCL <15: Q24H |
R | R0019 | ENALAPRIL(VASOTEC) |
NORMAL DOSE: 5-40MG DAILY PO, 1.25MG Q6H OVER 5 MIN IF CRCL 30-80: START 5MG DAILY, MAX 40MG DAILY
IF CRCL <30: START 2.5MG DAILY, OR, CRCL = 10-50, 75% OF DOSE CRCL < 10, 50% OF DOSE |
R | R0020 | ENOXAPARIN (LOVENOX) |
NORMAL DOSE: BY INDICATION, SEE DRUG INFO IF CRCL<30:PROPH ABD SURG,HIP/KNEE,MED.ILL:30MG DAILY TX UA/MI,INPT DVT/PE, OP DVT:IMG/KG DAILY |
R | R0021 | FAMOTIDINE (PEPCID) |
NORMAL DOSE:20-40MG BID-QID IF CRCL <50 DECREASE DOSE BY 50% OR INCREASE INTERVAL TO Q 36-48 HOURS |
R | R0022 | FENOFIBRATE (TRICOR) |
NORMAL DOSE: 67-201MG DAILY IF RENAL FAILURE, AINTERVAL OR DECREASE DOSE |
R | R0023 | FEXOFENADINE (ALLEGRA) |
NORMAL DOSE: 60MG BID IF CRCL<50, START AT 60MG DAILY, THEN TITRATE TO EFFECT. OR, CRCL =10-50,
Q12-24H CRCL = <10, Q 24 HRS |
R | R0024 | GABAPENTIN (NEURONTIN) |
NORMAL DOSE: 300-600MG Q8H IF CRCL>60, 1200MG DAILY MAX, IF CRCL 30-60, 600MG DAILY IF CRCL 15-30, 300MG DAILY,IF CRCL < 15, 150MG DAILY OR, CRCL 10-50, 300MG Q 12-24 HRS CRCL < 10, 300MG EVERY OTHER DAY |
R | R0025 | GLYBURIDE (GLYNASE, DIABETA) |
NORMAL DOSE:2.5-6MG Q24H MAY DIVIDE DOSES MAX 20MG DAILY IF CRCL<50: NOT RECOMMENDED |
R | R0026 | HCTZ (HYDRODIURIL) |
NORMAL DOSE:25-100MG DAILY IF CRCR<50, AVOID USE |
R | R0027 | HYDRALAZINE (APRESALINE) |
NORMAL DOSE:12.5-50MG QID. IF CRCL 10-50: Q8H. IF CRCL<10: Q8-16H FAST ACETYLATORS, Q12-24H SLOW ACETYLATOR OR, CRCL<10, GIVE Q 8-16 HRS |
R | R0028 | LISINOPRIL (ZESTRIL, PRINIVIL) |
NORMAL DOSE:10-40MG DAILY. IF CRCL 10-50: 50-75% OF NORMAL DOSE. IF CRCL<10: 25-50% OF NORMAL DOSE |
R | R0029 | MAGNESIUM |
CRCL<25: MONITOR SERUM MAG LEVELS |
R | R0030 | METFORMIN (GLUCOPHAGE) |
NORMAL DOSE:500-850MG TID(MEALS) UP TO 2500MG DAILY. IF SCR>1.5 (MALES) OR 1.4 (FEMALES) DO NOT USE. TEMP DC WHEN GETTING IODINATED CONTRAST FOR RADIOLOGIC PROC. AVOID IN PTS OVER 80 UNLESS CrCl NORMAL |
R | R0031 | LEVOFLOXACIN (LEVAQUIN) |
NORMAL DOSE:500MG IV OR PO DAILY. IF CRCL 20-49: 250MG Q24H. IF CRCL 10-19: 250MG Q48H OR, CRCL
10-50, 500MG INITIAL, THEN 250MG Q 24-48H. CRCL<10, 500MG INITIAL, THEN 250MG Q 48HRS |
R | R0032 | METOCLOPRAMIDE (REGLAN) |
NORMAL DOSE:10MG AC &HS. IF CRCL 10-40: GIVE 50% OF DOSE. IF CRCL <10: GIVE 25% OF DOSE OR, CRCL =10-50, 75% OF DOSE CRCL < 10, GIVE 50% OF DOSE |
R | R0033 | METRONIDAZOLE (FLAGYL) |
NORMAL DOSE:500-750MG TID-QID IV/PO. IF CRCL <10: GIVE Q12H |
R | R0034 | MORPHINE SULFATE |
IF CRCL 10-50: GIVE 75% OF USUAL DOSE. IF CRCL <10: GIVE 50% OF USUAL DOSE |
R | R0035 | PENTAZOCINE (TALWIN) |
USUAL DOSE:IM/SC:30-60MG Q3-4H 360MG/DAY MAX. IV:30MG Q3-4H. PO:50-100MG Q3-4H MAX:600MG QD. IF CRCL 10-50:GlVE 75% USUAL DOSE. IF CRCL <10: GIVE 50% USUAL DOSE |
R | R0036 | PRIMIDONE (MYSOLINE) |
USUAL DOSE:INIT:125-250MG HS. A TO 750-1500MG TID-QID. MAX DOSE:2GM DAILY. IF CRCL 50-80: GIVE Q8H. IF CRCL 10-50: GIVE Q8-12H. IF CRCL <10: GIVE Q12-24H |
R | R0037 | PROPOXYPHENE (DARVON,DCN-100) |
USUAL DOSE: HCL SALT:65MG Q3-4H PIN MAX 390MG DAILY. NAPS. SALT: 100MG Q4H PRN MAX:600MG DAILY. IF CRCL<10: AVOID USE |
R | R0038 | PROPRANOLOL (INDERAL) |
USUAL DOSE BASED ON INDICATION SEE DIH. IF CRCL 31-40: GIVE 50% OR Q24-36H. IF CRCL 10-30: GIVE 50% OR Q24-48H. IF CRCL <10: GIVE 25% OR Q40-60H *NOTE , RENAL BOOK LISTS 100% AT ALL PHASES EXCEPT ESRD* |
R | R0039 | QUINIPRIL (ACCUPRIL) |
USUAL DOSE:INIT:10-20MG DAILY MAINT:20-80MG DAILY IF CRCL >60, INIT AT 10MG DAILY IF CRCL 30-60:
INIT 5MG DAILY IF CRCL 10-30: INT 2.5MG DAILY IF CRCL <10 INSUFF DATA TITRATE ALL DOSES TO RESPONSE |
R | R0040 | QUININE |
USUAL DOSE: 260-650MG Q8H OR 325MG BID OR 650MG Q6-8H OR 200-300MG HS IF CRCL 10-50: Q8-12H OR 75% IF CRCL <10: Q24H OR 30-50% |
R | R0041 | RAMIPRIL (ALTACE) |
USUAL DOSE: 2.5-5MG PO DAILY IF CRCL <40: 25% OF USUAL DOSE OR, CRCL =10-50, 50-75% OF DOSE CRCL<10, 25-50% OF DOSE |
R | R0042 | RANITIDINE (ZANTAC) |
USUAL DOSE: IV: 50MG Q6-8H PO:150MG BID OR 300MG HS MAX: 600MG DAILY IF CRCL 10-50; 75% OR Q18-24H,
CRCL<10;50% OR Q18-24H RENAL BOOK; CRCL 10-50, 50%; CRCL <10, 25% OF DOSE |
R | R0043 | RISPERIDONE (RISPERDAL) |
USUAL DOSE: INIT:1MG BID MAINT:4-6MG DAILY IF RENAL IMPAIRED: INIT:0.5MG BID TITRATE |
R | R0044 | SPIRONOLACTONE (ALDACTONE) |
USUAL DOSE: VARIES BY INDICATION IF CRCL 10-50: GIVE Q12-24H IF CRCL<10: AVOID USE |
R | R0045 | TERBUTALINE (BRETHINE) |
USUAL DOSE: 5MG Q6H FOR 3X DAILY MAX DAILY DOSE:15MG IF CRCL 10-50: GIVE 50% IF CRCL <10: AVOID USE |
R | R0046 | CEFUROXIME AXETIL (CEFTIN) |
USUAL DOSE: 250-500MG BID UNCOMPLICATED UTI:125-250MG Q12H IF CRCL 10-20: Q12H IF CRCL<10: Q24H OR,
CRCL =10-50, Q 8-12H CRCL<10, Q 12HRS |
R | R0047 | VERAPAMIL (CALAN, COVERA-HS) |
USUAL DOSE:80-120MG TID OR 240MG SR IF CRCL<10: GIVE 50-75% |
R | R0048 | SMZ/TMP (BACTRIM DS,CO-TRIMOXA |
USUAL DOSE: PO: 1 TAB BID IV:20MG TMP/KG/DAY IN 3-4DOSES IF CRCL 15-30: PO: 1 TAB Q24H IV: 2.5-5MG TMP/KG Q12H IF CRCL <15: PO: AVOID IV: 2.5-5MG TMP/KG Q24H |
R | R0049 | SOTALOL (BETAPACE) |
USUAL DOSE:80MG BID IF CRCL >60: GIVE Q12H IF CRCL 30-60: GIVE Q24H IF CRCL 10-30: GIVE Q36-48H IF CRCL<10: INDIVIDUALIZE DOSE |
R | R0050 | SIMVASTATIN (ZOCOR) |
USUAL DOSE:5-80MG HS IF CRCL<10: 5MG HS; CLOSE MONITORING |
R | R0051 | AMANTADINE (SYMMETREL) |
USUAL DOSE: 100-200MG BID. IF CRCL 50-60: GIVE 200MG QD ALTERNATING WITH 100MG QD. IF CRCL 30-50: 100MG QD IF CRCL 20-30: 200MG BIW. IF CRCL 10-20: 100MG TIW. IF CRCL <10: GIVE 200MG QW ALTERNATING WITH 100MG QW. |
R | R0052 | DEMECLOCYCLINE (DECLOMYCIN) |
AVOID IF RENAL/HEPATIC DYSFUNCTION |
R | R0053 | ALENDRONATE (FOSAMAX) |
USUAL DOSE:5-10MG QAM. PAGETS:40MG QAM X6MO. IF CRCL <35: AVOID (LACK OF EXPERIENCE) |
R | R0054 | VENLAFAXINE (EFFEXOR) |
USUAL DOSE: ID. RELEASE:75MG QD IN 2-3DOSES.MAY INCREASE TO 375MG QD SUS. RELEASE:75MG QD. MAY INCREASE TO 225MG QD IF CRCL 10-70: DECREASE DOSE BY 25% |
R | R0055 | SULFASALAZINE (AZULFIDINE) |
USUAL DOSE: 2GM QD IN 3-4 DOSES. IF CRCL 10-30: GIVE BID. IF CRCL <10: GIVE QD |
R | R0056 | NADOLAL (CORGARD) |
USUAL DOSE:INIT:40MG QDABY 40-80MG Q3-7D TO RESPONSE.MAY NEED 160-240MG QD IN ANGINA,240-320MG QD IN HTN IF CRCL 31-40: 50% OR Q24-36H IF CRCL 10-30: 50% OR Q24-48H IF CRCL <10: 25% OR Q40-60H |
R | R0057 | FLUOXETINE (PROZAC) |
USUAL DOSE: 20MG QD MAY INCREASE TO 80MG QD. IF >20MG, GIVE DIVIDED INTO MORNING AND NOON DOSES. IF SEVERELY RENALLY IMPAIRED, MAY ACCUMULATE |
R | R0058 | AMIKACIN (AMIKIN) |
USUAL DOSE: 7.5MG/KG Q12H. IF CRCL 50-90: 60-90% Q12H. IF CRCL 10-50: 30-70% Q12-18H. IF CRCL <10: 20-30% Q24-48H |
R | R0059 | NETILMICIN (NETROMYCIN) |
USUAL DOSE: 2MG/KG Q8H. IF CRCL 50-90: 50-90% Q8-12H. IF CRCL 10-50: 20-60% Q12H. IF CRCL <10: 10-20% Q24-48H |
R | R0060 | STREPTOMYCIN |
USUAL DOSE: 15MG/KG (MAX 1GM) Q24H. IF CRCL 50-90: 50% Q24H. IF CRCL 10-50: Q24-72H. IF CRCL <10: Q72-96H |
R | R0061 | IMIPENEM (PRIMAXIN) |
USUAL DOSE: 500MG Q6H. IF CRCL 50-90: 250-500MG Q6-8H. IF CRCL 10-50: 250MG Q6-12H. IF CRCL <10: 125-250MG Q12H |
R | R0062 | MEROPENEM (MERONEM) |
USUAL DOSE: 1GM Q8H. IF CRCL 26-50: 1GM Q12H. IF CRCL 10-25: 500MG Q12H. IF CRCL <10: 500MG Q24H |
R | R0063 | CEFAZOLIN (KEFZOL, ANCEF) |
USUAL DOSE: 1-2GM Q8H IF CRCL 10-30: Q12H IF CRCL <10, Q24-48H |
R | R0064 | CEFEPIME (MAXIPIME) |
USUAL DOSE: 2GM Q12H IF CRCL 30-60: 1 GM Q12H IF CRCL 11-29: 1 GM Q24H IF CRCL <10, 500MG Q 24-48 HRS |
R | R0065 | CEFOTAXIME (CLAFORAN) |
USUAL DOSE: 1-2GM Q8H IF CRCL 10-50: Q8-12H IF CRCL <10: Q24H |
R | R0066 | CEFOTETAN (CEFOTAN) |
USUAL DOSE: 1-2GM Q12H IF CRCL 10-30: Q24H IF CRCL <10: Q48H |
R | R0067 | CEFTAZIDIME (TAZIDIME,FORTAZ) |
USUAL DOSE: 2GM Q8H IF CRCL 30-50: Q12H IF CRCL 10-30: Q24H IF CRCL <10: Q48-72H |
R | R0068 | CEFUROXIME (ZINACEF, KEFUROX) |
USUAL DOSE: 750-1500MG Q8H IF CRCL 10-20: Q12H IF CRCL <10: Q24H |
R | R0069 | CIPROFLOXACIN (CIPRO) |
USUAL DOSE: PO: 500-750MG Q12H IV: 400MG Q12H IF CRCL 10-30: 50% OR Q24H IF CRCL <10: 25-50% Q24H |
R | R0070 | OFLOXACIN (FLOXIN) |
USUAL DOSE: 400MG Q12H IF CRCL 10-50: 200-400MG Q24H IF CRCL <10: 100-200MG Q24H |
R | R0071 | CLARITHROMYCIN (BIAXIN) |
USUAL DOSE: 500MG -1 GM Q12H IF CRCL <30: 500MG LOAD, THE 250MG QD OR BID OR, CRCL =10-50, 75% OF DOSE CRCL>10, 50% OF DOSE |
R | R0072 | ERYTHROMYCIN (EMYCIN,ERY-PED) |
USUAL DOSE: 250-500MG Q6H IF CRCL <10: 50-75% |
R | R0073 | AMOXICILLIN (AMOXIL,AUGMENTIN) |
USUAL DOSE: 250-500 Q8H OR 875MG Q12H IF CRCL 10-50: Q12H IF CRCL <10: Q24H AUGMENTIN 875MG OR ANY ER TAB NOT RECOMMENDED IF CRCL<30 |
R | R0074 | AMPICILLIN (OMNIPEN,PRINCIPEN) |
USUAL DOSE: 250MG-2GM Q6H IF CRCL 30-50: Q6-8H IF CRCL 10-30: Q8-12H IF CRCL <10: Q12H |
R | R0075 | AZTREONAM (AZACTAM) |
USUAL DOSE: 2GM Q8H. IF CRCL 10-30: 50% OF DOSE-USUAL INTERVAL. IF CRCL <10: 25% OF DOSE-USUAL INTERVAL |
R | R0076 | MEZLOCILLIN (MEZLIN) |
USUAL DOSE: 3-4GM Q4-6H. IF CRCL 10-30: Q6-8H. IF CRCL <10: Q8H |
R | R0077 | PENICILLIN G |
USUAL DOSE: 2-24MILLION UNITS QD IN DIVIDED DOSES Q4H IF CRCL 30-50; Q6H IF CRCL 10-30: Q8H IF CRCL <10: Q12H OR CRCL>10, GIVE 20-50% OF DOSE |
R | R0078 | PIPERACILLIN (PIPRACIL) |
USUAL DOSE: 2-4GM Q4-6H MAX:24GM QD. IF CRCL 20-40: 3-4GM Q8H. IF CRCL <20: 3-4GM Q12H |
R | R0079 | PIP/TAZO (ZOSYN) |
USUAL DOSE: 3.375GM Q6H. IF CRCL 20-40: 2.25GM Q6H. IF CRCL <20: 2.25GM Q8H |
R | R0080 | TICARCILLIN (TICAR) |
USUAL DOSE: 3GM IV Q4-6H. IF CRCL 30-60: 2GM Q4H OR 3GM Q8H. IF CRCL 10-30: 2GM Q8H OR 3GM Q12H.
IF CRCL <10: 2GM Q12H |
R | R0081 | TICAR/CLAV (TIMENTIN) |
USUAL DOSE: 3.1GM Q4-6H MAX:24GM QD. IF CRCL 30-60: 2GM Q4H OR 3.1GM Q8H. IF CRCL 10-30: 2GM Q8H
OR 3.1GM Q12H. IF CRCL <10: 2GM Q12H |
R | R0082 | TETRACYCLINE (SUMYCIN) |
USUAL DOSE: 250-500MG Q6H. IF CRCL 50-80: Q8-12H. IF CRCL 10-50: Q12-24H. IF CRCL <10: Q24H |
R | R0083 | FLUCONAZOLE (DIFLUCAN) |
USUAL DOSE: 200-400MG FIRST DAY, THEN 100-400MG QD IF CRCL 11-50: 50% OR Q48H IF CRCL <10: Q48-72H |
R | R0084 | FLUCYTOSINE (ANCOBON) |
USUAL DOSE: 50-150MG/KG/DAY IN DIVIDED DOSES Q6H. IF CRCL 50-90: Q12H. IF CRCL 10-50: Q16H. IF
CRCL <10: Q24H |
R | R0085 | ITRACONAZOLE (SPORINOX) |
USUAL DOSE: 100-200MG Q12H. IF CRCL <30: IV NOT RECOMMENDED |
R | R0086 | TERBINAFINE (LAMISIL) |
USUAL DOSE: 250-500MG PO QD. IF CRCL <50: AVOID. NO DATA |
R | R0087 | DOXYCYCLINE |
USUAL DOSE: 100-300MG QD. MAY DIVIDE DOSES. IF CRCL <10: 100MG QD. |
R | R0088 | ETHAMBUTOL (MYAMBUTOL) |
USUAL DOSE: 15-25MG/KG/DAY OR SOMG/KG TWICE WEEKLY. MAX 2. 5G IF CRCL 10-50: Q24-36H IF CRCL <10: Q48H |
R | R0089 | ETHIONAMIDE (TRECATOR-SC) |
USUAL DOSE: 500-1000MG QD IN 1-3 DIVIDED DOSES. IF CRCL <50: 50% |
R | R0090 | ISONIAZID (LANIAZID,NYDRAZID) |
USUAL DOSE: 5MG/KG/DAY MAX:300MG. IF CRCL <10: 50% |
R | R0091 | PYRAZINAMIDE (TEBRAZID) |
USUAL DOSE: 25MG/KG Q24H MAX 2.5GM QD. IF CRCL <50: 10-20MG/KG/DAY OR 40-50NG/KG 3X/WEEK |
R | R0092 | RIFAMPIN (RIFADIN) |
USUAL DOSE: 600MG QD. IF CRCL 10-50: Q24-48H. IF CRCL <10: Q48H |
R | R0093 | ACYCLOVIR (ZOVIRAX) |
DOSED PER INDICATION. FOR OTHER INDICATIONS, SEE DIH SHINGLES:IV:10MG/KG/DOSE Q8H
PO:250-600MG/M2/DOSE 4-5X QD IF CRCL 25-50:IV 5-10MG/KG/DOSE Q12H IF CRCL 10-25:IV 5-10MG/KG/DOSE
Q24H PO:Q8H IF CRCL<10:IV:2.5-5MG/KG/DOSE Q24H PO:Q12H |
R | R0094 | CEPHALEXIN (KEFLEX) |
USUAL DOSE: 250-1000MG Q6H MAX 4GM QD. IF CRCL 10-40: 250-500MG Q8-12H. IF CRCL <10: 250MG Q12-24H |
R | R0095 | ROFECOXIB (VIOXX) |
USUAL DOSE:OA:12.5-25MG QD DYSMEN:50MG QD OTHER:50MG QD RENAL ADVERSE EFFECTS INCREASE IF DOSE>25MG QD. AVOID IF SEVERE RENAL DX. |
R | R0096 | OSELTAMIVIR (TAMIFLU) |
USUAL DOSE: 75MG PO BID X5D. IF CRCL 10-30: 75MG PO QD X5D. IF CRCL <10: AVOID. NO DATA AVAIL ON RENAL FAILURE. |
R | R0097 | TOCAINIDE (TONOCARD) |
USUAL DOSE:1200-1800MG/DAY IN 3 DIVIDED DOSES.MAX 2400MG QD. IF CRCL <30: 50% OR 600MG QD |
R | R0098 | MIDODRINE (PROAMATINE) |
USUAL DOSE: 10MG TID DURING DAYTIME HOURS (Q3-4H). IF RENAL IMPAIRMENT: 2.5MF TID, GRADUALLY
INCREASED AS TOLERATED. |
R | R0099 | ALUMINUM SALTS |
IF SEVERE RENAL FAILURE OR ACUTE RENAL FAILURE, MONITOR ALUMINUM SALT USE |
R | R0100 | HYDROXYUREA (HYDREA) |
NORMAL DOSE:10-30MG/KG/DAY=500-3000MG/DAY. CHK WBC TO ADJUST IF CRCL 10-50: GIVE 50% OF NORMAL DOSE IF CRCL <10: GIVE 20% OF NORMAL DOSE SEE DRUG INFO HANDBOOK FOR DOSE PER INDICATION |
R | R0101 | TOLTERODINE (DETROL) |
USUAL DOSE: IR:1-2MG BID LA:2-4MG QD. IF CRCL 10-30: IR:1MG BID LA:2M QD |
R | R0102 | COLCHICINE |
ACUTE GOUT ATTACK:0.5-1.2MG, THEN 0.5-0.6MG Q1-2H TIL GI UPSET OR RELIEF. MAX TOTAL DOSE OF 8MG PER COURSE. PROPHYLAXIX: 0.5-0.6MG QD OR QOD. IF CRCL <50, MAX 0.6MG PO, 2MG IV DAILY TO Q48H IF CRCL <10, CONTRAINDICATED |
R | R0103 | COLCHICINE IV |
USUAL:1-3MG THEN 0.5MG TIL RELIEF. NOT TO EXCEED 4MG QD. MAY GIVE 1-2MG FOR SEVERAL DAYS, BUT THEN DO NOT GIVE MORE COLCHICINE BY ANY RT FOR 7 DAYS. IF CRCL <50, AVOID CHRONIC USE. IF CRCL <10, DECREASE DOSE BY 50% FOR ACUTE ATTACKS |
R | R0104 | GENTAMICIN |
DOSE PER PHARMACOKINETICS |
R | R0105 | VANCOMYCIN |
DOSED PHARMACOKlNETlCALLY |
R | R0106 | ACARBOSE (PRECOSE) |
NORMAL DOSE:50-200MG TID. IF CRCL <50 AVOID USE |
R | R0107 | ACEBUTOLOL (SECTRAL) |
USUAL DOSE:400-600MG QD OR BID. MAX DAILY DOSE:1200MG. IF CRCL 10-50: USE 50%. IF CRCL <10: USE 30-50% |
R | R0108 | ACETAZOLAMIDE (DIAMOX) |
USUAL DOSE: 250MG Q6-12H. MANY SIGS/DOSES, SEE DIH. IF CRCL >50: Q6H. IF CRCL 10-50: Q12H. IF CRCL <10: AVOID |
R | R0109 | ALBUTEROL (VENTOLIN) |
USUAL DOSE: 2-4MG TID-QID. MAX QD:32MG. IF CRCL 10-50: USE 75%. IF CRCL <10: USE 50% |
R | R0110 | AGGRENOX (ASPIRIN/DIPYRIDAMOLE) |
USUAL DOSE = 1 CAP BID IF CRCL < 10, NO NOT USE. |
R | R0111 | AMPHOTERICIN B (FUNGIZONE) |
USUAL DOSE:0.25-1.5MG/KG/DAY. MAX DOSE:1.5MG/KG/DAY IF RENAL IMPAIR FROM AMPHO: CRCL<10: Q24-36H OR
50% OF DOSE |
R | R0112 | INAMRINONE(AMRINONE OR INOCOR) |
USUAL DOSE BASED UPON CLINICAL RESPONSE:5-10MCG/KG/MIN **DO NOT EXCEED 10MG/KG/24HR** IF CRCL<10:50-75% OF DOSE |
R | R0113 | FAMCICLOVIR (FANVIR) |
USUAL DOSE: ACUTE HZ: 500MG TID X7D, RECURR HZ IN IMMUNO: 125MG BID X5D, GENITAL HZ:125MG BID X5D. IF CRCL 40-59: 500 Q12H. IF CRCL 20-39: 500 Q24H. IF CRCL<20: UNKN |
R | R0114 | RISEDRONATE (ACTONEL) |
USUAL DOSE:5MG QD (OA) OR PAGETS:30MG QD X2 MONTHS. MAY REPEAT. IF CRCL < 30: NOT RECOMMENDED FOR USE |
R | R0115 | CEFIXIME (SUPRAX SUSPENSION) |
USUAL DOSE:CHILDREN -8MG/KG/D DIVIDED Q12-24H. ADULT -400MG QD DIVIDED Q12-24H IF CRCL 21-60:GIVE 75% OF STD DOSE IF CRCL <20 OR WITH CAPD:GIVE 50% OF STD DOSE. |
R | R0116 | BRETYLIUM |
NORMAL DOSE: 5-30MG/KG LOAD, THEN 5-10MG IV Q 6HR. IF CRCL =10-50, 25-50%. IF CRCL = < 10, GIVE 25% |
R | R0117 | BLEOMYCIN |
NORMAL DOSE VARIES BY PROTOCOL. IF CRCL = 10-50; GIVE 75% OF DOSE. IF CRCL < 10; GIVE 50% OF DOSE |
R | R0118 | CARBOPLATIN |
NORMAL DOSE VARIES BY PROTOCOL. IF CRCL = 10-50; GIVE 50% OF DOSE. IF CRCL < 10; GIVE 25% OF DOSE |
R | R0119 | CEFACLOR (CECLOR) |
NORMAL DOSE; 250-500MG TID. IF CRCL =10-50, GIVE 50-100%. IF CRCL < 10, GIVE 50% |
R | R0120 | CEFADROXIL |
NORMAL DOSE; 500-1000MG Q 12HR. IF CRCL = 10-50, GIVE Q 12-24HR. IF CRCL < 10, GIVE Q 24-48HR |
R | R0121 | CEFAMANDOLE |
NORMAL DOSE; 500-1000MG Q 4-8 HR. IF CRCL =10-50, GIVE Q 6-8HR. IF CRCL < 10, GIVE Q 12HR |
R | R0122 | CEFIXIME (SUPRAX) |
NORMAL DOSE IS 200MG Q 12 HR. IF CRCL = 10-50, GIVE 75% OF DOSE. IF CRCL < 10, GIVE 50% OF DOSE |
R | R0123 | TRAMADOL (ULTRAM) |
NORMAL DOSE:50-100MG Q4-6H PRN.MAX 400MG QD. IF CRCL <30:Q12H. MAX 200MG/DAY |
R | R0124 | CEFOTETAN (CEFOTAN) |
NORMAL DOSE; 1-2 GMS Q 12 HRS IV. IF CRCL =10-50, GIVE 50% OF DOSE. IF CRCL < 10, GIVE 25% OF DOSE |
R | R0125 | CLOFIBRATE |
NORMAL DOSE; 500-1000MG Q 12 HRS. IF CRCL = 10-50, GIVE Q 12-18HRS. IF CRCL < 10 AVOID USE |
R | R0126 | DICLOFENAC |
NORMAL DOSE; 25-75MG BID. IF CRCL; =10-50, GIVE 25-50% or DOSE. IF CRCL < 10, GIVE 25% OF DOSE |
R | R0127 | DISOPYRAMIDE |
NORMAL DOSE; 100-200MG Q 6 HRS. IF CRCL =10-50, GIVE Q 12-24HRS. IF CRCL < 10, GIVE Q 24-48 HRS |
R | R0129 | FEXOFENADINE (ALLEGRA) |
NORMAL DOSE; 60MG BID IF CRCL = 10-50, GIVE Q 12-24 HRS IF CRCL < 10 GIVE Q24 HRS |
R | R0130 | FOSINOPRIL (MONOPRIL) |
NORMAL DOSE; 10-40MG Q 24 HR IF CRCL < 10, GIVE 75% OF DOSE |
R | R0131 | ROSUVASTATIN (CRESTOR) |
NORMAL DOSE:10-40MG DAILY IF CRCL<30, START AT 5MG DAILY, MAX 10MG DAILY |
R | R0132 | LEVAQUIN 750MG |
CRCL >50 750MG IV DAILY CRCL 20-49 7S0MG FIRST DOSE THEN 7S0MG Q 48HR CRCL 10-19 7S0MG FIRST DOSE THEN 500MG Q 48RR |
R | R0133 | PREGABALIN (LYRICA) |
CRCL 30-60: TOTAL DAILY DOSE 75-300MG IN 2-3 DIVIDED DOSES CRCL 15-30: TOTAL DAILY DOSE 25-150MG IN
2-3 DIVIDED DOSES CRCL<15: TOTAL DAILY DOSE 25-75MG IN 2-3 DIVIDED DOSES |
R | R0135 | ALDACTONE (SPIRONOLACTONE) |
INCREASED RISK HYPERKALEMIA. CONTRAINDICATED WITH ACE/ARB IF CRCL<30. DO NOT COMBINE WITH ACE/ARB IF K+>5 OR SCR>2.5 IN MALES, 2.0 IN FEMALES. MONITOR K+ ROUTINELY. |
R | R0136 | ERTAPENEM (INVANZ) |
NORMAL DOSE: 1GM DAILY IF CRCL<30, GIVE 500MG DAILY |
R | R0137 | COLCHICINE DRUG CONTRAINDICATI |
COLCHICINE CONTRAINDICATED WITH: AMIODARONE,BIAXIN,CYCLOSPORINE,DILTIAZEM,EES,INDINAVIR,ITRACONAZOLE,KETOCONAZOLE,NICARDIPINE,PROPAFENONE,QUINIDINE, TAMOXIFEN,VERAPAMIL |
R | R0138 | CEFOXITIN (MEFOXIN) |
NORMAL DOSE:1-2GM Q8-12H IF CRCL<30, 1-2GM Q12-24H IF CRCL<10, 500-1000MG Q12-24H IF CRCL<5, 500-1000MG Q24-48H |
R | R0139 | LISINOPRIL |
CRCL = 10-30 INITIAL DOSE IS 5MG MONITOR POTASSIUM LEVELS |
R | R0140 | FENOFIBRATE (TRICOR) |
CRCL =31-80 DOSE=48MG/DAY CRCL<31 DOSE=CONTRAINDICATED |
S | S0002 | PATIENT SAFETY GOALS:SOMNOLENC |
SEDATIVES/HYPNOTICS/ANXIOLYTICS--PATIENT MAY BE AT INCREASED RISK FOR FALLS. SCORE=5 |
S | S0004 | PATIENT SAFETY GOALS:TCA |
TRICYCLIC ANTIDEPRESSANTS/MISC ANTIDEPRESSANTS INCREASE RISK OF FALL SCORE=2 |
S | S0006 | PATIENT SAFETY GOALS:SSRI |
PATIENT ON SSRI/MISC UPTAKE REINHIBITORS HAVE AN INCREASED RISK FOR FALLS. SCORE = 2 |
S | S0007 | PATIENT SAFETY GOALS:NEUROLEPT |
PATIENT ON NEUROLEPTIC MEDICATIONS HAVE AN INCREASED RISK FOR FALLS. SCORE = 5 |
S | S0008 | PATIENT SAFETY GOALS:BENZODIAZ |
PATIENT ON BENZODIAZEPINES HAVE AN INCREASED RISK FOR FALLS. SCORE =5 |
S | S0009 | PATIENT SAFETY GOALS:ANTI-CONV |
ANTI-CONVULSANTS MAY CAUSE ATAXIA AND BONE LOSS. PATIENT MAY BE AT AN INCREASE RISK FOR FALLS. SCORE = 1 |
S | S0012 | PATIENT SAFETY GOALS:NARCOTIC |
PATIENT ON ANARCOTIC/ANALGESIC IF NARC/ANALGESIC CAUSES SOMNOLENCE--PT MAY BE AT INCREASED RISK FOR FALLS SCORE = 1 |
S | S0014 | PT SAFETY GOALS:MAJOR TRANQUIL |
PT ON MAJOR TRANQUILIZER MAY BE AT INCREASED RISK FOR FALLS. INCLUDES PHENOTHIAZINES, BUTYROPHENONES SCORE = 5 |
S | S0015 | PT SAFETY GOALS:ATYP. ANTIPSYC |
PT ON ATYPICAL ANTIPSYCHOTIC MAY BE AT INCREASED RISK FOR FALL. SCORE = 3 |
S | S0016 | PT SAFETY GOALS:ANTI-PARKINSON |
PT ON ANTI-PARKINSON MED MAY BE AT INCREASED RISK FOR FALL SCORE =1 |