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Benzodiazepine Equivalence

Intermediate Acting:    Alprazolam (Xanax) 0.5 mg OP Peak: 1-2 hrs Half-life: 6-12hrs Use: anxiolytic Lorazepam (Ativan) 1 mg PO Peak: 2 hrs Half-life: 12 hrs Use: anxiolytic, anticonvulsant, hypnotic Clonazepam (Klonopin) 0.5 mg PO Peak: 1-4 hrs Half-life: 30-40 hrs Use: anxiolytic, anticonvulsant Temazepam (Restoril) 10 mg PO Peak: 1-2 hrs Half-life: 8-10 hrs Use: anxiolytic, hypnotic Long Acting:  

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Breastfeeding and Medications

General Rule Of Thumb: If the mediation can be safely prescribed to an infant, then there is no restriction on breastfeeding when mother is taking it. Antibiotics To Avoid: Sulfa drugs: Avoid prescribing to mother of a jaundice baby younger than 1 month of age. Avoid if baby is known to have G6PD. Erythromycin: Avoid until infant is 1 month

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Florida Opioid Prescribing Law

Effective July 1, 2018 Quantity of Schedule II Opioids 3 day limit on prescriptions for “acute pain” 7 day supply for acute pain may be prescribed if Rx contains “Acute Pain Exception” AND the reason for exception is documented in the medical record. E-FORCSE ( Login Page) Must access for EVERY prescription of schedule II-IV opioids. Only exception is schedule V

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Topical Steroids

Low Potency: Class 7 Hydrocortisone acetate 0.5% – 1% Class 6 Desonide 0.05% Fluocinolone 0.01% cream Medium Potency: Class 5 Hydrocortisone valerate 0.2% cream or butyrate 0.1% cream / ointment Traimcinolone 0.1% cream / lotion Fluocinolone 0.025% cream Class 4 Hydrocortisone valerate 0.2% ointment Fluocinolone 0.025% ointment High Potency: Class 3 Betamethasone 0.05% cream Traimcinolone acetonide 0.5% cream Class 2

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Opioid Equivalence

Given the national shortage of varying opiates, you may find this information helpful: IV equianelgesic: Morphine 4mg – typically given 4-8mg Hydromorphone (Dilaudid) 0.6 mg – typically given 0.5-1 mg Fentanyl 40mcg (0.4mg) – typically given 50-100 mcg PO equianalgesic: Morphine sulfate 5mg Hydrocodone 5mg Oxycodone 5mg Tramadol 50mg Hydromorphone (Dilaudid) 1.25mg IV to PO conversion: Morphine 5 mg IV

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Tranexamic Acid (TXA)

Tranexamic acid is a synthetic form of lysine, an amino acid. It is classified as an “anti-fibrinolytic” which means it is a  pro-coagulant. It binds to receptors on plasmin preventing it from breaking down fibrin clots. Tranexamic acid was originally discovered in 1962 and is currently on the World Health Organization’s list of Essential Medicines.  The drug has been studied

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