1.

Intranasal Mometasone

Adult Dosing & Uses

Dosing Forms & Strengths
nasal spray suspension

50mcg/spray

Allergic Rhinitis
Indicated for treatment of nasal symptoms of allergic rhinitis 2 sprays (100 mcg) in each nostril qDay

Seasonal Allergic Rhinitis

Indicated for treatment of nasal congestion associated with seasonal allergic rhinitis; also indicated for prophylaxis of seasonal allergic rhinitis Treatment: 2 sprays (100 mcg) in each nostril qDay Prophylaxis: 2 sprays (100 mcg) in each nostril qDay; initiate 2-4 weeks prior to allergy season

Nasal Polyps
2 sprays (100 mcg) in each nostril BID; qDay dosing may be effective in some patients

Pharmacology
Minimal systemic absorption occurs, mostly by small amount swallowed during nasal administration Bioavailability: <1% Protein Bound: 98-99% Metabolized by: CYP3A4 Half-life: 5.8 hr

Mechanism of Action
Corticosteroid with potent anti-inflammatory properties; elicits effects on various cells, including mast cells and eosinophils; also elicits effects on inflammatory mediators (eg, histamine, eicosanoids, leukotrienes, cytokines)

2. Chlorpheniramine

Adult Dosing & Uses

Dosing Forms & Strengths
tablet

4mg 8mg 12mg

Allergic Rhinitis
Tablets or syrup: 4 mg q4-6hr; not to exceed 24 mg/24 hours Extended-release tablets: 8 mg q8-12hr or 12 mg q12hr; not to exceed 24 mg/24 hours Extended-release capsules: 12 mg PO qDay; not to exceed 24 mg/24 hours Sustained-release capsules: 8-12 mg q12hr, up to 16-24 mg/day

Additional Information
See also combo with hydrocodone (Tussionex)

Other Indications & Uses

Perennial & seasonal allergic & vasomotor rhinitis, relief of symptoms from colds, urticaria, angioedema, anaphylactic reactions, pruritus, allergic conjunctivitis

Pharmacology
Half-Life: 12-43 hr Duration: 24 hr Onset: 6 hr Peak Plasma Time: 2-6 hr Protein Bound: 69-72% Vd: 2.5-3.2 L/kg Metabolism: GI mucosa, liver

Metabolites: monodesmethylchlorpheniramine, didesmethylchlorpheniramine Excretion: urine Sedative effect: low Antihistamine activity: moderate Anticholinergic acitivity: moderate

Mechanism of Action
Histamine H1-receptor antagonist
3. Pseudoephedrine (Sudafed) = Decongestant

Adult Dosing & Uses

Dosing Forms & Strengths
tablet

15mg 30mg 60mg 120mg

syrup, Peds

3mg/mL

Nasal Congestion
60 mg PO q6hr PRN Time release: 120 mg PO BID

Priapism (Off-label)
60-120 mg PO

See Also Combos

with fexofenadine with desloratadine with loratadine

Other Indications & Uses

Eustachian tube congestion Off-label: low-flow priapism

Pharmacology
Absorption: minimal systemic Half-Life: 5-8 hr Onset: 30 min

Duration
60 mg: 4-6 hr 120 mg: 12 hr

Peak Plasma
Time: 1.97 hr Concentration: 422 ng/mL

Other Information
Metabolism: liver, by N-demethylation Metabolites: inactive Clearance: 7.3-7.6 mL/min/kg Excretion: urine

Mechanism of Action
Alpha adrenergic agonist
4. Paracetamol (Acetaminophen)

Adult Dosing & Uses

Dosing Forms & Strengths
(tablet)

325mg 500mg

(capsule)

500 mg

(caplet, extended-release)

650 mg

(tablet, chewable)

80mg 160mg

(tablet, oral-disintegrating)

80mg 160mg

(oral solution/suspension)

160mg/5mL

(suppository rectal)

120 mg 325 mg 650 mg

Analgesia & Fever

Immediate-release: 325-650 mg PO/PR q4hr PRN, or 500 mg PO q8hr PRN Extended-release: 2 capsules (1300 mg) PO q8hr PRN Maximum dose Acetaminophen containing products: Not to exceed a cumulative dose of 4 g/day of acetaminophen Tylenol Extra-Strength (ie, 500 mg/tab or cap): Not to exceed 3 g/day (6 tabs or caps)

See Also Combo

Acetaminophen Combos Acetaminophen & NSAIDs

Renal Impairment
CrCl 10-50 mL/min: give q6hr CrCl <10 mL/min: give q8hr

Other Indications & Uses

Potent analgesic & antipyretic activity with weak anti-inflammatory activity

Pharmacology
Mechanism of Action
Acts on hypothalamus to produce antipyresis May work peripherally to pain impulse generation; may also inhibit prostaglandin synthesis in CNS

Absorption
Peak Plasma Time: 10-60 min (PO immediate-release); 60-120 min (PO extendedrelease); 6 hr (PO 500 mg, conventional tablet); 8 hr (PO 650 mg, extended-release tablet) Peak Plasma Concentration: 2.1 mcg/mL (PO 500 mg, conventional tablet); 1.8 mcg/mL (PO 650 mg, extended-release tablet)

Distribution
Distribution: rapid & uniform Protein Bound: 25%

Metabolism
Metabolism: liver (microsomal enzyme systems); conjugation (glucuronic/sulfuric acid) Metabolites: N-acetyl-p-benzoquinoneimine, N-acetylimidoquinone, NAPQI; further metabolized via conjugation with glutathione

Elimination
Half-life: 1.25-3 hr Excretion: urine (principally as acetaminophen glucuronide with acetaminophen sulfate/mercaptate)