Pharmacology.
Leflunomide’s active metabolite (M1) inhibits dihydro-oratate dehydrogenase, thereby inhibiting pyrimidine biosynthesis. M1 exhibits immunomodulating and anti-inflammatory effects.
Administration and Adult Dosage.
PO for rheumatoid arthritis 100 mg/day for 3 days, then 20 mg/day. Reduce dose to 10 mg if 20 mg is not tolerated.
Pediatric Dosage.
Safety and efficacy not established.
Geriatric Dosage.
Same as adult dosage.
Dosage Forms.
Pharmacology.
Infliximab is a chimeric monoclonal antibody that binds to soluble and transmembrane forms of TNF a, thereby neutralizing the activity of TNFa and inhibiting TNFa binding to its receptor sites. It has no effect on lymphotoxin (TNFa).Infliximab induces pro-inflammatory cytokines including interleukins 1 and 6 and increases endothelial cell permeability by enhancing leukocyte migration.
Administration and Adult Dosage.
Pharmacology.
Sumatriptan is a serotonin (5-HT) analogue and a selective agonist at 5-HT1D receptors in cerebral vascular smooth muscle. Receptor activation results in migraine relief by vasoconstriction of intracranial blood vessels and attenuation of the release of vasoactive peptides responsible for inflammation of sensory nerves.
Administration and Adult Dosage.
Pharmacology.
Clavulanic acid has weak antibacterial activity but is a potent inhibitor of plasmid-mediated Beta-lactamases,including those produced by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, Staphylococcus aureus, Neisseria gonorrhoeae, and Bacteroides fragilis. Thus, when combined with certain other beta-lactam antibiotics, the combination is very active against many bacteria resistant to the beta-lactam alone.
Adult Dosage.
PO One “250” or “500” tablet q 8 hr or 1 “875” tablet q 12 hr.
Pediatric Dosage.
Pharmacology.
Amoxicillin differs from ampicillin by the presence of a hydroxyl group on the amino side chain. It has activity essentially identical to ampicillin.
Adult Dosage.
PO 250–500 mg q 8 hr or 500-875 mg bid, to a maximum of 4.5 g/day. PO for endocarditis prophylaxis 2 g 1 hr before dental or upper airway procedures.
Pediatric Dosage.
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