Calcitriol IV to PO conversion coreg

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Despite the accepted practice and dogma dictating diltiazem IV to PO conversion, there’s little, if any, evidence to explain why the formula seems to work. 2010

Unstable angina: 5 mg IV bolus x3 q2min f/b 2 to 5 mg hourly titrated to min HR of 55 to 60 BPM or min systolic BP of 80 .

25-50 mg PO twice daily. coreg-cr-carvedilol-342357 2500055-overview 2002 Deficiency of 1,25-dihydroxyvitamin D plays an important role in the pathogenesis of secondary hyperparathyroidism. Immediate release: 6.25 mg PO twice daily initially; after 7-14 days, increased as tolerated, first to 12.5 mg PO twice daily and then to 25 mg PO twice dailyExtended release: 20 mg/day PO; maintained for 1-2 weeks if tolerated; may be increased to 40 mg/day PO if necessary; not to exceed 80 mg/day POImmediate release: 3.125-6.25 mg PO q12hr initially; after 3-10 days, increased as tolerated, first to 12.5 mg PO q12hr and then to 25 mg PO q12hr (target dosage)Extended release: 10-20 mg/day PO; increased every 3-10 days as tolerated up to 80 mg/day PO (target dosage)Hepatic impairment: Contraindicated in severe liver impairmentMay break capsule and sprinkle on spoonful of applesauce; to be eaten immediatelyIncreased triglyceride levels and insulin resistance with decreased high-density lipoprotein (HDL) levelsImmune system: Hypersensitivity (eg, anaphylactic reactions, angioedema, urticaria) with Coreg and Coreg CR, including cases occurring after initiation of Coreg CR in patients previously treated with CoregRespiratory system, thorax, and mediastinum: Interstitial pneumonitisSkin and subcutaneous tissue: Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiformeHistory of serious hypersensitivity reaction (eg, Stevens-Johnson syndrome, anaphylactic reaction, angioedema) to any component of this medication or other medications containing carvedilol2°/3° AV block, sick sinus syndrome without permanent pacemaker, cardiogenic shock, severe bradycardia, decompensated heart failure requiring IV inotropic medicationUse cautioin in anesthesia or surgery (myocardial depression), cerebrovascular insufficiency, diabetes mellitus, hyperthyroidism or thyrotoxicosis, liver disease, peripheral vascular disease (monitor for progression of arterial obstruction), compromised left ventricular function, heart failure, pheochromocytoma, and myasthenia gravisAvoid beta-blocker use in non-allergic bronchospasm (e.g., chronic bronchitis and emphysema); if deemed necessary, use with caution and at lowest effective doseCombined incidence of hypotension, syncope, or dizziness reported in elderly patients (>65 years) switched from highest dose of immediate-release carvedilol (25 mg q12hr) to extended-release carvedilol 80 mg/dayWhen elderly patients are switched from higher doses of immediate-release carvedilol to extended-release carvedilol, a lower starting dose is recommendedSudden discontinuance can exacerbate angina and lead to myocardial infarctionDosage should be reduced if bradycardia (HR <55 beats/min) developsMay worsen arterial insufficiency in patients with peripheral vascular diseaseUse caution in patients with mild to moderate hepatic impairmentHeart failure patients may experience a worsening of renal function, especially during upward titration; dose reduction or temporary discontinuation may be necessary; may also need to adjust other medicationsExtended release: Separate any form of alcohol intake by at least 2 hoursIntraoperative floppy iris syndrome observed during cataract surgery in some patients treated with alpha1-blocking agentsBeta-blockers may cause induction or exacerbation of psoriasisAvailable data in pregnant women are insufficient to determine whether there are drug-associated risks of adverse developmental outcomes; there are risks to mother and fetus associated with poorly controlled hypertension in pregnancy; the use of beta blockers during third trimester of pregnancy may increase risk of hypotension, bradycardia, hypoglycemia, and respiratory depression in neonates; in animal reproduction studies, there was no evidence of adverse developmental outcomes at clinically relevant doses; observe newborns for symptoms of hypotension, bradycardia, hypoglycemia, and respiratory depression and manage accordinglyHypertension in pregnancy increases maternal risk for pre-eclampsia, gestational diabetes, premature delivery, and delivery complications (e.g., need for cesarean section and post-partum hemorrhage); hypertension increases fetal risk for intrauterine growth restriction and intrauterine death; pregnant women with hypertension should be carefully monitored and managed accordinglyThere are no data on presence of carvedilol in human milk, effects on breastfed infant, or on milk production; drug is present in the milk of lactating rats; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed infant from treatment or from underlying maternal conditionA: Generally acceptable.

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