Vignettes Peds Pharmacology; # 1
1. Rx of Scabies:
i) Best: Permethrin
ii) Lindane is neuro-toxic and hence best avoided.
iii) Benzyl benzoate: is no longer available in the US; not considered safe.
iv) What about Crotamiton which Dr USP used to prescribe as a local oint in addition to GBH?
Prep says: Crotamiton cream or lotion is not recommended for treatment of scabies because of lack of efficacy and toxicity data.
Thus:
The most efficacious recommended therapy: Permethrin 5% cream applied from head to toe.
Permethrin 5% cream is a more effective scabicide than lindane, but it also is more expensive. It is poorly absorbed and rapidly metabolized by tissue esterases, which limits its toxicity.
2. Foscarnet:
We know that if a new born baby has CNS involvement of CMV, we give ganciclovir. That is neonatal story of CMV.
Now Foscarnet: for pediatric age population-
It is approved for i) both induction and maintenance treatment of CMV retinitis in immunocompromised patients (eg HIV), ii) for treatment of severe mucocutaneous disease caused by acyclovir-resistant HSV, and iii) for zoster caused by acyclovir-resistant varicella zoster virus.
So will you treat a newborn with foscarnet if resistant to ganciclovir: no idea, man!
3. Rx of GER:
i) antacids (eg, magnesium and aluminum hydroxide),
ii) Histamine2 receptor antagonists (eg, cimetidine, ranitidine, famotidine, nizatidine),
iii) prokinetics (eg, metoclopramide, bethanechol)
iv) proton pump antagonists (eg, omeprazole, lansoprazole, pantoprazole, rabeprazole): Of the currently available therapies, it is the most effective class of agents to suppress gastric acid secretion.
4. Relative C/I to sucralfate therapy: q 114/07
End-stage renal disease
Now:
Sucralfate is an aluminum hydroxide complex of sucrose that...
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