Page numbers followed by f denoted a figure, the letter n denotes an endnote, and the letter t denotes a table.

A

Abemaciclib, 393t

Absorption. See also Bioavailability

 of aminoglycosides, 127, 127t–128t

 of antirejection agents, 238–240, 240t

 of carbamazepine, 259–260, 260t

 clearance and, 31–32

 of clobazam, 208

 of ethosuximide, 296, 296t

 in geriatrics, 102t, 103–104

 of levetiracetam, 196

 of lidocaine, 341, 342t

 of lithium, 360–361

 with obesity, 54

 of phenobarbital, 387, 387t

 of theophylline, 427–428

 of UFH, 305–306, 306t

 of vancomycin, 460, 461t

 of VPA, 444–445, 445t

 of warfarin, 496, 496t

Acetaminophen

 carbamazepine and, 266t

 in pediatrics, 85t

 warfarin and, 507t

Acetazolamide

 carbamazepine and, 267t

 in geriatrics, 105t, 107t

Acetoacetate, 13t

α1-acid glycoprotein (AAG)

 antidepressants and, 178

 carbamazepine and, 261

 in geriatrics, 104

 lidocaine and, 343–344

 in pediatrics, 82

 V of, 32

Activated clotting time (ACT), 306, 313t, 314

Activated partial thromboplastin time (aPTT)

 for fondaparinux, 327

 LMWHs and, 323

 UFH and, 304, 306, 307, 308f, 309t, 310, 313t, 314, 315

Actual body weight (ABW)

 aminoglycosides and, 131

 CrCl and, 15–16

 dose proportionality and, 58, 58t

 lidocaine and, 351

 obesity and, 19, 49, 50t, 52–53, 53t

 UFH and, 304

 vancomycin and, 458, 460, 476, 479

Acute coronary syndrome (ACS)

 fondaparinux and, 327

 lidocaine and, 340

 LMWHs and, 321

Acute kidney injury (AKI)

 CRRT for, 27–28

 GFR and, 11

 vancomycin and, 459, 466, 476, 477

Acute myocardial infarction (AMI), 340, 345t, 351

Acyclovir

 aminoglycosides and, 147

 CKD and, 34t

 clearance of, 31t

 hemodialysis and, 39t

 SLC and, 68t

Adefovir, 68t

β-adrenergic antagonists, 372

Adverse drug events (ADEs). See also Drug-drug interactions

 with digoxin, 285

 drug concentration monitoring and, 7

 in geriatrics, 108–110, 110t–114t

 with opioids, 61

β-agonists

 in geriatrics, 108

 theophylline and, 424

AIDS, phenytoin and, 415

Albumin

 carbamazepine and, 261

 in geriatrics, 104

 GFR and, 11

 lidocaine and, 343

 in pediatrics, 82

 phenytoin and, 405–406

 V of, 32

 VPA and, 446

 warfarin and, 496–497

 zonisamide and, 199

Alcohol/alcoholism

 antidepressants and, 177–178

 theophylline and, 435t

 warfarin and, 500, 506t, 507t, 510

Allopurinol, 507t

Alopecia

 carbamazepine and, 265

 tacrolimus and, 246

 UFH and, 318t

Alprazolam, 111t

Amantadine

 in geriatrics, 107t

 renal drug transporters and, 30t

Amikacin

 dosing for, 126, 127t

 hemodialysis and, 39t

 in pediatrics, 87, 89

Amiloride, 113t

α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), 193

Aminoglycosides, 123–149

 absorption of, 127, 127t–128t

 assays of, 144

 bioavailability of, 127, 127t–128t

 DDIs with, 147

 distribution of, 128–129, 129t

 dosing for, 124–137, 125t–150t

 drug concentration monitoring for, 4, 139–144, 141f–143f

 drug-disease interactions with, 147–149

 elimination of, 129, 130t, 131–132

 in geriatrics, 107t

 half-life of, 130, 130t, 132

 loading dose for, 124–125, 125t

 in pediatrics, 81, 82, 85, 88, 89, 135–137, 135t–137t

 pharmacodynamics of, 144–147

 pharmacogenomics of, 149

 pharmacokinetics of, 127–130, 127t–130t

 protein binding of, 129

 therapeutic range for, 138–139

 time to steady state for, 130, 130t

 toxicity of, 7

 vancomycin and, 476

 V of, 32

Aminophylline, 424

Amiodarone

 digoxin and, 286t

 in geriatrics, 111t

 lidocaine and, 350t

 phenytoin and, 412t

 warfarin and, 507t

Amitriptyline

 carbamazepine and, 266t

 dosing of, 165t, 166t

 in geriatrics, 103t, 105t, 111t

 metabolism of, 170t

 pharmacokinetics of, 167t

 therapeutic range of, 173t

Ammonium chloride, 30

Amobarbital, 111t

Amoxapine

 dosing of, 165t, 166t

 in geriatrics, 111t

 metabolism of, 170t

 pharmacokinetics of, 167t

 therapeutic range of, 173t

Amoxicillin

 CKD and, 34t

 hemodialysis and, 39t

Amphetamine, 30

Amphotericin B

 aminoglycosides and, 147

 hemodialysis and, 39t

Ampicillin

 aminoglycosides and, 147

 CKD and, 34t

 hemodialysis and, 39t

Ampicillin/sulbactam, 39t

Andexanet alfa, 328

Androgens, 112t

Angiotensin-converting enzyme inhibitors (ACEI)

 digoxin and, 286t

 in geriatrics, 101, 107t, 113t

 lithium and, 372t

Angiotensin receptor blockers (ARBs)

 in geriatrics, 113t

 lithium and, 372, 372t

Antacids

 digoxin and, 286t

 gabapentin and, 190

 phenytoin and, 412t

Antibiotics. See also β-lactams; Macrolide antibiotics

 drug concentration monitoring for, 4

 lithium and, 372

 VPA and, 452

 warfarin and, 507t

Anticoagulants

 carbamazepine and, 266t

 in geriatrics, 101

 VPA and, 452

Anticonvulsants, 452

Antidepressants, 163–179. See also Tricyclic antidepressants

 adolescence and, 177

 alcoholism and, 177–178

 carbamazepine and, 266t

 cardiology and, 178

 DDIs with, 176–177, 176t

 dosing for, 164–166, 165t–167t

 drug concentration monitoring for, 175–176

 drug-disease interactions with, 177–179

 in geriatrics, 108

 geriatrics and, 177

 half-life of, 169–170

 hepatic insufficiency and, 178

 hypothyroidism and, 179

 malnutrition and, 178

 metabolism of, 169, 170t

 pharmacodynamics of, 176–179, 176t

 pharmacogenetics and, 71–72

 pharmacokinetics of, 167–170, 167t–168t, 179t

 protein binding of, 178

 renal insufficiency and, 178

 smoking and, 178–179

 therapeutic range of, 172–175, 173t–174t

Antiepileptic drugs (AEDs), 185–219

 carbamazepine and, 266t, 269

 dosing of, 186, 186t–187t

 drug concentration monitoring of, 5–6

 generic substitution for, 219

 in geriatrics, 101

 new types of, 218–219

 pharmacogenetics and, 71

 TDM of, 185–186

 VPA and, 447, 451

Anti-factor Xa heparin

 LMWHs and, 320–321, 320t, 325

 UFH and, 310, 312, 312t, 313t, 314

Antifungal agents

 carbamazepine and, 266t, 267t

 phenobarbital and, 394t

 warfarin and, 507t

Antihistamines, 110t

Antihypertensive agents, 108

Anti-infective medications, 110t

Antiparkinson drugs, 108, 110t

Antipsychotics

 in geriatrics, 111t, 113t

 obesity and, 61

Antirejection agents, 233–251

 absorption of, 238–240, 240t

 bioavailability of, 240, 240t

 DDIs with, 248–249, 248t–249t

 distribution of, 240–241, 241t

 dosing of, 234–237, 235t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 half-life of, 243, 243t

 metabolism of, 242, 243t

 molecular weights of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 pharmacokinetics of, 238–243, 240t, 241t, 243t

 protein binding of, 241

 TDM of, 245

 therapeutic range of, 244–245, 244t

 time to steady state of, 243

 V of, 241, 241t

Antispasmodics, 110t

Antithrombin (AT)

 fondaparinux and, 328

 UFH and, 305, 311, 316t

Antithrombotics

 in geriatrics, 110t

 UFH and, 316

Antivirals

 VPA and, 452

 warfarin and, 506t

Apixaban

 CKD and, 34t

 in geriatrics, 113t

Aprepitant

 phenobarbital and, 393t

 warfarin and, 506t

Aripiprazole, 394t

Ascites, 147

Asphyxia, in pediatrics, 85–86

Aspirin

 in geriatrics, 112t, 113t

 with LMWHs, 325t

 UFH and, 319t

 VPA and, 451, 452

 warfarin and, 508t

Assays, 13, 13t

 of aminoglycosides, 144

 of digoxin, 284, 284t–285t

 of LMWHs, 323

 of phenobarbital, 30

 of UFH, 315

 of vancomycin, 481

Asthma. See Theophylline

Atazanavir, 286t

Atenolol

 CKD and, 34t

 hemodialysis and, 39t

Atorvastatin

 carbamazepine and, 267t

 SLC and, 68t

ATP-binding cassette (ABC), 67, 68t

Atrial fibrillation

 digoxin and, 286

 warfarin and, 502t

Atropine, 110t

Autoinduction, of carbamazepine, 261–262, 264–265

Axitinib, 393t

Azathioprine, 234

 absorption of, 238–240, 240t

 distribution of, 241, 241t

 dosing of, 237t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 protein binding of, 241

 warfarin and, 506t

Azithromycin

 carbamazepine and, 267t

 digoxin and, 286t

Aztreonam

 CKD and, 34t

 clearance of, 31t

 hemodialysis and, 39t

B

Bacitracin, 147

Barbiturates

 ethosuximide and, 299

 in geriatrics, 105, 111t

 warfarin and, 506t

Belladonna alkaloids, 110t

Benazepril

 CKD and, 34t

 in geriatrics, 105t

 hemodialysis and, 39t

Benzodiazepines, 106, 108, 111t

Benztropine, 110t

Benzylpenicillin, 30t

Bepridil, 32

Bicarbonate, 392t

Bioavailability

 of aminoglycosides, 127, 127t–128t

 of antirejection agents, 240, 240t

 of cannabidiol, 214–215, 214t

 of carbamazepine, 259–260, 260t

 of clobazam, 208, 208t

 of digoxin, 279, 279t

 of eslicarbazepine, 210–211, 211t

 of ethosuximide, 296, 296t

 of ezogabine, 206, 206t–207t, 207

 of felbamate, 177t

 of gabapentin, 189t

 in geriatrics, 103, 103t

 of levetiracetam, 196t

 of lidocaine, 341, 342t

 of lithium, 361

 of oxcarbazepine, 198t

 of perampanel, 209t–210t

 of phenobarbital, 387, 387t

 of pregabalin, 200t–201t

 of rufinamide, 203, 203t–204t

 of theophylline, 427–428, 427t

 of tiagabine, 193t

 of topiramate, 194t

 of UFH, 305–306, 306t

 of vancomycin, 460, 461t

 of VPA, 444–445, 445t

 of warfarin, 496–497, 496t

Bisoprolol

 CKD and, 34t

 hemodialysis and, 39t

β-blockers

 digoxin and, 286t

 in geriatrics, 108

 lidocaine and, 350t

 theophylline and, 435t

Blood-brain barrier (BBB)

 antidepressants and, 178

 DMEs and, 69, 69t, 70f

 DMTs and, 69, 69t, 70f

 topiramate and, 194

 zonisamide and, 199

Blood-brain multidrug efflux transporters, 209

Blood urea nitrogen (BUN), 364

Boceprevir, 286t

Body mass index (BMI)

 carbamazepine and, 262

 fondaparinux and, 327

 LMWHs and, 325

 obesity and, 50, 50t, 53t

 UFH and, 304

Body surface area (BSA)

 GFR and, 16

 obesity and, 50t, 52, 53t, 59

 rufinamide and, 203

Bosentan, 506t

Bradycardia

 digoxin and, 286t, 287t

 lidocaine and, 349t

LMWH and, 325t

 theophylline and, 423, 432, 434

 UFH and, 318t

Breast cancer resistance protein (BCRP), 69t

Breast milk. See Lactation

Brexpiprazole, 394t

Brigatinib, 393t

Brivaracetam, 212–213, 212t

 dosing of, 187t

 VPA and, 452t

Brompheniramine, 110t

Bumetanide, 68t

Bupropion

 carbamazepine and, 266t

 clearance of, 31t

 DDIs with, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 167t

 therapeutic range of, 173t

Buspirone, 394t

Butabarbital, 111t

Butalbital, 111t

C

Caffeine

 in pediatrics, 85t

 theophylline and, 429

Calcium channel blockers

 carbamazepine and, 267t, 268t

 digoxin and, 286t

 in geriatrics, 106, 108

 lithium and, 372

 theophylline and, 435t

Canagliflozin, 287t

Cannabidiol, 213–215, 214t

 carbamazepine and, 266t

 dosing of, 187t

 VPA and, 451, 452t

Capecitabine, 507t

Capreomycin, 147

Captopril, 31t

Carbamazepine, 257–269, 258t–263t

 brivaracetam and, 213

 DDIs with, 266–268, 266t–268t

 dosing of, 257–259, 258t, 259t, 263–264

 ethosuximide and, 299

 in geriatrics, 113t

 lacosamide and, 202, 203

 lamotrigine and, 191

 oxcarbazepine and, 198

 phenobarbital and, 395t

 phenytoin and, 412t

 rufinamide and, 204

 theophylline and, 435t

 topiramate and, 195

 VPA and, 451, 452t

 warfarin and, 506t

Carbapenem, 452

Carbinoxamine, 110t

Carboplatin

 aminoglycosides and, 147

 warfarin and, 508t

Cardiology

 antidepressants and, 178

 in geriatrics, 110t–111t

 pharmacogenetics and, 71

Carisoprodol, 112t

Carnitine, 68t

Carvedilol

 clearance of, 31t

 digoxin and, 286t

Catecholamines, 13t

Cefazolin

 CKD and, 34t

 hemodialysis and, 39t

Cefepime

 CKD and, 34t

 clearance of, 31t

 hemodialysis and, 39t

Cefoperazone, 147

Cefotaxime

 CKD and, 34t

 clearance of, 31t

 SLC and, 68t

Cefoxitin

 CKD and, 34t

 creatinine assays for, 13t

Ceftaroline

 CKD and, 34t

 hemodialysis and, 39t

Ceftazidime

 CKD and, 34t

 hemodialysis and, 39t

 in pediatrics, 89

Ceftolozane/tazobactam, 34t

Ceftriaxone

 clearance of, 31t

 in geriatrics, 105t

 hemodialysis and, 39t

Cefuroxime, 34t

Cenobamate, 217–218, 217t

 dosing of, 187t

 VPA and, 451, 452t

Central nervous system (CNS)

 geriatrics and, 111t

 lidocaine and, 349

 phenobarbital and, 387

 VPA and, 445, 452

Cephalexin, 34t

Cephalosporins

 aminoglycosides and, 147

 creatinine assays for, 13t

 V of, 32

 warfarin and, 507t

Cephalothin

 aminoglycosides and, 147

 creatinine assays for, 13t

Ceritinib, 287t

Cerivastatin, 31t

Cetirizine, 34t

Charcoal

 phenobarbital and, 392t

 theophylline and, 435t

Child-Pugh

 cannabidiol and, 215

 lidocaine and, 345t–346t

 theophylline and, 437t

Chloramphenicol

 in pediatrics, 79t

 phenobarbital and, 392t

 warfarin and, 507t

Chlordiazepoxide, 103t, 111t

Chloroquine, 287t

Chlorpheniramine, 110t

Chlorpromazine, 105t

Chlorpropamide, 107t, 112t, 395t

Chlorzoxazone, 112t

Cholestyramine

 digoxin and, 287t

 warfarin and, 506t

Cholinesterase inhibitors, 101

Chronic kidney disease (CKD)

 dosing for, 27–43, 29t, 31t, 32–33, 34t–37t

 GFR and, 16

 GFR for, 29

 lidocaine and, 345t

 in pediatrics, 83

 vancomycin and, 459

Chronic kidney disease epidemiology collaboration equation (CKD-EPI), 16–17, 28

Chronic obstructive pulmonary disease (COPD). See Theophylline

Cidofovir

 CKD and, 34t

 hemodialysis and, 39t

 renal drug transporters and, 30

Cilastatin, 31t

Cimetidine

 carbamazepine and, 267t

 CKD and, 34t

 clearance of, 31t

 in geriatrics, 103t, 107t, 114t

 hemodialysis and, 39t

 lidocaine and, 350t

 oxcarbazepine and, 198

 phenytoin and, 412t

 renal drug transporters and, 30t

 theophylline and, 436t

 VPA and, 451

 warfarin and, 507t

Ciprofloxacin

 CKD and, 35t

 clearance of, 31t

 in geriatrics, 113t

 hemodialysis and, 39t

 lidocaine and, 350t

 phenytoin and, 412t

 renal drug transporters and, 30t

Cirrhosis

 aminoglycosides and, 147

 brivaracetam and, 213

 phenobarbital and, 395t

 phenytoin and, 414

 theophylline and, 437t

 VPA and, 453

Cisplatin

 ABC and, 68t

 aminoglycosides and, 147

 carbamazepine and, 267t

 MRP6 and, 69t

 SLC and, 68t

Citalopram

 carbamazepine and, 266t

 DDIs with, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 167t

 therapeutic range of, 173t

Clarithromycin

 carbamazepine and, 267t

 CKD and, 35t

 digoxin and, 287t

 hemodialysis and, 39t

 theophylline and, 436t

Clavulanic acid, 13t

Clearance. See also Creatinine clearance

Clearance (CL, elimination)

 of aminoglycosides, 129, 130t, 131–132

 of antirejection agents, 242, 243t

 of cannabidiol, 214t

 of carbamazepine, 261–263, 262t

 of cenobamate, 217t

 of clobazam, 208t

 of digoxin, 280t, 281–282, 282t

 of eslicarbazepine, 211t

 of ethosuximide, 297, 297t

 of ezogabine, 207t

 of felbamate, 177t

 of gabapentin, 189t, 190t

 in geriatrics, 106–107, 107t

 GFR and, 29

 of lacosamide, 202, 202t

 of lamotrigine, 191t

 of levetiracetam, 196t

 of lidocaine, 343, 344, 344t–345t

 of lithium, 362, 362t, 365

 metabolism for, 30–31, 31t

 nonrenal mechanisms, 30–32, 31t

 obesity and, 55–57

 of oxcarbazepine, 198t

 in pediatrics, 82–84

 of perampanel, 209t, 210

 of phenobarbital, 388, 389t

 of phenytoin, 406–408

 of pregabalin, 200t

 renal drug transporters and, 29–30, 30t

 renal elimination, 28–29

 of rufinamide, 203t

 of stiripentol, 216t

 of theophylline, 425, 428–430, 429t

 of tiagabine, 193t

 of topiramate, 194t

 of UFH, 306, 307t

 of vancomycin, 462, 462t

 of vigabatrin, 205, 205t

 of VPA, 447, 448t

 of warfarin, 496t, 497

Clemastine, 110t

Clidinium-chlordiazepoxide, 110t

Clindamycin

 in pediatrics, 79t

 phenobarbital and, 395t

Clobazam, 207–209, 208t

 cannabidiol and, 214–215

 dosing of, 187t

 stiripentol and, 216–217

 VPA and, 452t

Clomipramine

 carbamazepine and, 266t

 dosing of, 165t, 166t

 in geriatrics, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 173t

Clonazepam, 111t

Clonidine, 110t

Clopidogrel, 71

Clorazepate, 103, 111t

Clozapine, 394t

Cobicistat, 287t

Cobimetinib, 393t

Cockroft-Gault (CG) equation, 15–16

 for aminoglycosides, 129

 obesity and, 55–57

Codeine

 clearance of, 31t

 in pediatrics, 85t

Colchicine

 digoxin and, 287t

 in geriatrics, 114t

Colestipol, 506t

Colistin

 aminoglycosides and, 147

 hemodialysis and, 39t

Congestive heart failure (CHF)

 carbamazepine and, 269

 lidocaine and, 344t, 350

 theophylline and, 437t

 warfarin and, 511

Continuous renal replacement therapies (CRRT)

 for AKI, 27–28

 dosing for, 42–43

 phenobarbital and, 395t

 phenytoin and, 414

 vancomycin and, 480, 480t

Continuous venovenous hemodiafiltration (CVVHDF)

 dosing for, 39t–41t, 42–43

 vancomycin and, 480

Continuous venovenous hemofiltration (CVVH), 39t–41t, 42–43

Cooper, T. B., 364

Corticosteroids, 234

 carbamazepine and, 267t

 pharmacodynamics of, 245–248, 247t

 phenobarbital and, 395t

 sirolimus and, 245

 theophylline and, 423–424, 436t

 warfarin and, 508t

Cortisone, 284t

C-reactive protein, 100

Creatinine assays, 12–13, 13t

Creatinine clearance (CrCl)

 for aminoglycosides, 129, 131–132

 for clobazam, 208t

 CRRT and, 28

 of digoxin, 278, 279t, 281–282, 282t

 for fondaparinux, 327

 in geriatrics, 106–107

 for kidney function assessment, 12–17

 for lacosamide, 202

 for lithium, 362, 365

 for LMWHs, 325–326

 for obesity, 50, 55–57

 in pediatrics, 82–83

 for vancomycin, 459–460, 463, 464, 467, 477

 for vigabatrin, 205

Cyclic GMP, 68t

Cyclobenzaprine, 112t

Cyclophosphamide

 clearance of, 31t

 digoxin and, 287t

 warfarin and, 508t

Cyclosporine, 233

 absorption of, 238–240, 240t

 carbamazepine and, 267t

 DDIs with, 249, 249t–250t

 distribution of, 240, 241t

 dosing of, 235t, 237t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 protein binding of, 241

 renal drug transporters and, 30t

 therapeutic monitoring of, 245

 therapeutic range of, 244, 244t

 warfarin and, 506t

Cyproheptadine, 110t

Cystatin C, 12, 13, 14, 17

Cystic fibrosis (CF)

 aminoglycosides and, 129, 147

 in pediatrics, 88–89

 theophylline and, 437t

Cytochrome P450 (CYP), 66, 67, 71

 antidepressants and, 169, 176–177, 176t

 antirejection agents and, 245

 BBB and, 69t

 brivaracetam and, 213

 cannabidiol and, 214–215

 carbamazepine and, 261, 266

 cenobamate and, 218

 for clobazam, 208t

 clobazam and, 209

 eslicarbazepine and, 211

 ethosuximide and, 297

 ezogabine and, 206, 207

 felbamate and, 188

 in geriatrics, 106

 lacosamide and, 202

 levetiracetam and, 197

 lidocaine and, 343

 obesity and, 61

 oxcarbazepine and, 197, 198

 in pediatrics, 84, 84t–85t, 90

 perampanel and, 210

 phenobarbital and, 388, 391, 393

 phenytoin and, 407

 prednisone and, 249

 rufinamide and, 204

 stiripentol and, 215, 216

 theophylline and, 429, 435

 tiagabine and, 193

 vigabatrin and, 206

 VPA and, 447

 warfarin and, 497, 509

 zonisamide and, 199

D

Dabigatran

 in geriatrics, 113t, 114t

 UFH and, 307

Daclatasvir, 287t

Dalteparin, 320t, 321t

Danazol, 267t

Daptomycin

 CKD and, 35t

 hemodialysis and, 39t

Darunavir, 268t

Dasabuvir

 digoxin and, 287t

 phenobarbital and, 393t

Dasatinib, 394t

Daunorubicin, 69t

Debrisoquine, 67

Deep vein thrombosis (DVT)

 fondaparinux and, 328

 LMWHs and, 320

 UFH and, 312, 312t, 314, 315t

Delafloxacin, 39t

Delafloxacin/meglumine, 35t

Desiccated thyroid, 112t

Desipramine

 dosing of, 165t, 166t

 in geriatrics, 103t, 105t, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 173t

Desmopressin, 112t

Desvenlafaxine

 DDIs with, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 173t

Dexamethasone

 digoxin and, 284t

 phenobarbital and, 394t

 phenytoin and, 412t

Dexbrompheniramine, 110t

Dexchlorpheniramine, 110t

Dextromethorphan/quinidine, 113t

Dextropropoxyphene, 268t

Deziel-Evans, L. M., 145

Dialysis. See also Hemodialysis

 aminoglycosides and, 148

 lidocaine and, 345t

 lithium and, 373

 phenobarbital and, 396t

 vancomycin and, 478–481, 478t–480t

Diazepam

 in geriatrics, 105t, 106, 111t

 lithium and, 372

 in pediatrics, 79t, 81, 84, 84t

 pharmacogenetics and, 72

 phenobarbital and, 387

Diclofenac, 112t

Dicloxacillin, 506t

Dicumarol, 266t

Dicyclomine, 110t

Didanosine, 39t

Diethylenetriaminepentaacetic acid (DTPA), 82

Diflunisal, 104, 105t, 112t

Digoxin, 277–290, 278t–281t, 283t–290t

 carbamazepine and, 267t

 DDIs with, 286, 286t–289t

 dosing of, 278–279, 278t, 279t, 281–283, 282f

 in geriatrics, 103, 107t, 111t

 lacosamide and, 202

 lithium and, 372

 in pediatrics, 79t, 88

 renal drug transporters and, 30t

Diltiazem

 carbamazepine and, 268t

 digoxin and, 287t

Dimenhydrinate, 110t

Diphenhydramine, 110t

Dipyridamole, 110t

Direct-acting oral anticoagulant (DOAC), 308

Disopyramide

 digoxin and, 286t

 in geriatrics, 105t, 107t, 111t

 V of, 32

Distribution. See also Volume of distribution

 of aminoglycosides, 128–129, 129t

 of antirejection agents, 240–241, 241t

 of carbamazepine, 260–261, 261t

 of digoxin, 280t

 of ethosuximide, 296–297, 297t

 in geriatrics, 104–106, 105t

 of lidocaine, 342

 of lithium, 361, 361t

 in pediatrics, 81–82

 of phenobarbital, 387, 388t

 of theophylline, 428, 428t

 of UFH, 306

 of VPA, 446

 of warfarin, 496–497, 496t

Disulfiram

 phenytoin and, 413t

 theophylline and, 436t

 warfarin and, 507t

Diuretics

 aminoglycosides and, 147

 digoxin and, 288t

 in geriatrics, 113t

 lithium and, 372t

 vancomycin and, 476

Dobutamine, 13t

Dofetilide

 in geriatrics, 114t

 renal drug transporters and, 30t

Dopamine, 13t

Doravirine, 393t

Doripenem, 35t

Dose proportionality

 for cenobamate, 217

 for lacosamide, 202, 202t

 obesity and, 58, 58t

 for topiramate, 194

 for zonisamide, 199

Dosing

 of AEDs, 186, 186t–187t

 of aminoglycosides, 124–137, 125t–150t

of antidepressants, 164–166, 165t–167t

 of antirejection agents, 234–237, 235t–238t

 of azathioprine, 237t–238t

 of brivaracetam, 212–213, 212t

 of cannabidiol, 214–215, 214t

 of carbamazepine, 257–259, 258t, 259t, 263–264

 of cenobamate, 217–218, 217t

 for chronic kidney disease, 27–43, 29t, 31t, 32–33, 34t–37t

 for CRRT, 42–43

 for CVVH, 39t–41t, 42–43

 for CVVHD, 42–43

 for CVVHDF, 39t–41t

 of cyclosporine, 235t, 237t–238t

 of digoxin, 278–279, 278t, 279t, 281–283, 282t

 drug concentration monitoring and, 3–8

 of eslicarbazepine, 210–211, 211t

 of ethosuximide, 295–296, 296t, 298

 of ezogabine, 206–207, 206t–207t

 of felbamate, 177t

 of fondaparinux, 327

 of fosphenytoin, 402–403

 of gabapentin, 189t

 for hemodialysis, 38–42, 38t–41t

 kidney function assessment and, 17–18

 of lacosamide, 201–202, 202t

 of lamotrigine, 191t

 of levetiracetam, 196t

 of lidocaine, 340–341, 340t–342t, 346–348, 346t–347t

 of lithium, 358–360, 359t, 360t, 363–365

 of LMWHs, 321–323, 321t

 of mycophenolate, 237t–238t

 for obesity, 49–61, 53t–54t, 60f

 of oxcarbazepine, 197, 198t

 in pediatrics, 77–90

 of perampanel, 209–210, 209t–210t

 of phenobarbital, 385–386, 386t, 387t

 of phenytoin, 402–403, 402t, 403t

 of prednisone, 237t–238t

 of pregabalin, 200–201, 200t–201t

 of rufinamide, 203, 203t–204t

 of sirolimus, 236t, 237t–238t

 of stiripentol, 215, 216t

 of tacrolimus, 235t–236t, 237t–238t

 of theophylline, 430–431

 of tiagabine, 192–193, 193t

 of topiramate, 194–195, 194t

 of UFH, 304–305, 307–311, 308f, 309t–311t

 of vancomycin, 458–460, 459t, 460t, 463–467, 463t–465t

 of vigabatrin, 204–205, 205t

 of VPA, 443, 444t, 448–449

 of warfarin, 494–496, 495t, 498–501, 498t, 500t, 501t

 of zonisamide, 199, 199t

Down syndrome, 437t

Doxazosin

 in geriatrics, 110t

 metabolism of, 170t

 therapeutic range of, 173t

Doxepin

 dosing of, 165t, 166t

 in geriatrics, 111t

 pharmacokinetics of, 168t

Doxorubicin

 ABC and, 68t

 carbamazepine and, 267t

 P-GP and, 67

 phenobarbital and, 394t

Doxycycline

 carbamazepine and, 267t

 lithium and, 372

Doxylamine, 110t

Dravet syndrome (DS), 213

 cannabidiol and, 215

 stiripentol and, 215

Dronedarone

 digoxin and, 287t

 in geriatrics, 111t

 phenobarbital and, 393t

Drug concentration monitoring

 adherence and, 6

 for aminoglycosides, 139–144, 141f–143f

 for antidepressants, 175–176

 dosing and, 3–8

 efficacy of, 6–7

 evaluation of need for, 4–6, 5t

 immediate effect and, 6–8

 toxicity and, 6–8

Drug-disease/condition interactions

 with aminoglycosides, 147–149

 with antidepressants, 177–179

 with carbamazepine, 268–269

 with digoxin, 290

 drug concentration monitoring and, 7

 with ethosuximide, 300

 with fondaparinux, 328

 with lidocaine, 350–352

 with lithium, 372–374, 373t

 with LMWHs, 325–326

 with phenobarbital, 395, 395t–396t

 with phenytoin, 414–415

 with theophylline, 436, 437t–438t

with UFH, 310, 310t–311t, 319

 with vancomycin, 476–480, 478t–480t

 with VPA, 453

 with warfarin, 510–511

Drug-drug interactions (DDIs)

 with aminoglycosides, 147

 with antidepressants, 176–177, 176t

 with antirejection agents, 248–249, 248t–249t

 with carbamazepine, 266–268, 266t–268t

 with clobazam, 209

 with digoxin, 286, 286t–289t

 with ethosuximide, 299–300

 in geriatrics, 108–110, 110t–114t

 with lidocaine, 349–350, 350t

 with lithium, 371–372, 372t

 with LMWHs, 325

 with oxcarbazepine, 198

 pharmacogenomics and, 67

 with phenobarbital, 392–393, 392t–395t

 with phenytoin, 412, 412t–413t

 with theophylline, 435, 435t–436t

 with UFH, 319, 319t

 with vancomycin, 476

 with VPA, 451–452, 452t

 with warfarin, 506–510, 506t–508t

Drug-gene interactions

 with antirejection agents, 250–251, 251t

 with azathioprine, 234

Drug membrane transporters (DMTs), 65

 BBB and, 69, 69t, 70f

 polymorphisms in, 70

Drug metabolizing enzymes (DMEs), 65, 66

 BBB and, 69, 69t, 70f

 CYP and, 67

 polymorphisms in, 70

Drug Reaction with Eosinophilia and Systematic Symptoms (DRESS), 192, 217, 218

Duloxetine

 carbamazepine and, 266t

 DDIs with, 176t

 dosing of, 165t, 166t

 in geriatrics, 114t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 173t

E

Edoxaban

 in geriatrics, 114t

 UFH and, 307

Efavirenz, 507t

Elagolix, 68t

Elderly. See Geriatrics

Elexacaftor/tezacaftor/ivacaftor, 393t

Eliglustat, 287t

Elimination. See Clearance

Emtricitabine

 CKD and, 35t

 hemodialysis and, 39t

Enalapril

 CKD and, 35t

 hemodialysis and, 39t

Endogenous digoxin-like substances (EDLS), 283t, 284, 284t

End-stage renal disease (ESRD)

 levetiracetam and, 196t

 phenytoin and, 414

 vancomycin and, 478

Enoxaparin, 320t, 321t

 in geriatrics, 114t

Entecavir

 clearance of, 31t

 SLC and, 68t

Entrectinib, 393t

Enzalutamide, 394t

Enzyme multiplied immunoassay (EMIT), 481

Epigenetics, 61

Epinephrine, 13t

Erythromycin

 carbamazepine and, 267t

 clearance of, 31t

 digoxin and, 287t

 lidocaine and, 350t

 oxcarbazepine and, 198

 theophylline and, 436t

Escitalopram

 carbamazepine and, 266t

 DDIs with, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 173t

Eslicarbazepine, 210–211, 211t

 dosing of, 187t

 VPA and, 451, 452t

Estazolam, 111t

Estimate glomerular filtration rate (eGFR), 16, 17–18, 28, 29–30

Estradiol, 104

Estriol, 395t

Estrogens

 in geriatrics, 112t

 theophylline and, 436t

Eszopiclone, 111t

Ethacrynic acid, 147

Ethambutol, 107t

Ethinylestradiol, 198

Ethosuximide, 295–300, 296t–298t

 carbamazepine and, 266t

 VPA and, 451

Ethylenediaminetetraacetic acid (EDTA), 144

Etodolac, 112t

Etomidate, 105t

Etoposide

 ABC and, 68t

 phenobarbital and, 394t

 renal drug transporters and, 30t

 warfarin and, 508t

Eutectic mixture of lidocaine and prilocaine (EMLA), 79t, 81

Everolimus, 394t

Extracorporeal life support (ECLS), 312t, 313t, 315t

Extracorporeal membrane oxygenation (ECMO)

 in pediatrics, 86–87

 theophylline and, 437t

Ezogabine, 206–207, 206t–207t

 dosing of, 187t

F

Famciclovir

 CKD and, 35t

 hemodialysis and, 39t

Famotidine

 CKD and, 35t

 clearance of, 31t

 in geriatrics, 114t

 hemodialysis and, 39t

 in pediatrics, 79t

Fat free mass (FFM), 50t, 52–53, 54t

Febrile neutropenia, 148

Felbamate, 187–189

 carbamazepine and, 263, 267t

 clearance of, 31t

 dosing of, 186t

 in geriatrics, 101

 VPA and, 452t

Felodipine

 carbamazepine and, 267t

 oxcarbazepine and, 198

Fenofibrate, 508t

Fenoprofen, 112t

Fentanyl

 carbamazepine and, 267t

 in geriatrics, 104

Fexofenadine

 CKD and, 35t

 hemodialysis and, 39t

 renal drug transporters and, 30t

 SLC and, 68t

Fingolimod, 287t

Flecainide, 286t

Flibanserin, 393t

Fluconazole

 carbamazepine and, 266t, 267t

 hemodialysis and, 40t

 phenytoin and, 413t

Flucytosine

 CKD and, 35t

 creatinine assays for, 13t

Fludrocortisone, 284t

Fluorescence polarization immunoassay (FPIA)

 for digoxin, 284

 for phenobarbital, 390

 for vancomycin, 481

Fluoroquinolones

 in geriatrics, 101

 warfarin and, 507t

Fluorouracil, 507t

Fluoxetine

 carbamazepine and, 267t

 DDIs with, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenytoin and, 413t

 therapeutic range of, 173t

Fluphenazine, 105t

Flurazepam, 105t, 111t

Fluvoxamine

 carbamazepine and, 267t

 DDIs with, 176t

 dosing of, 165t, 166t

 lidocaine and, 350t

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenytoin and, 413t

 theophylline and, 436t

 therapeutic range of, 173t

Folic acid

 in geriatrics, 103

 phenytoin and, 413t

Fondaparinux, 326–328

 in geriatrics, 114t

Foscarnet

 CKD and, 35t

 hemodialysis and, 40t

Fosphenytoin

 dosing for, 402–403

 in geriatrics, 101

 warfarin and, 506t, 507t

Free fatty acids

 in pediatrics, 82

 VPA and, 446–447

Free fraction, 104

Furosemide

 aminoglycosides and, 147

 creatinine assays for, 13t

 SLC and, 68t

 vancomycin and, 476

 V of, 32

G

Gabapentin, 189–191, 190t

 CKD and, 35t

 dosing of, 186t

 in geriatrics, 101, 114t

 hemodialysis and, 40t

 SLC and, 68t

 VPA and, 451, 452t

Galantamine, 101

Ganciclovir

 CKD and, 35t

 hemodialysis and, 40t

Gefitinib, 508t

Gemcitabine, 508t

Gemfibrozil, 508t

Gemigliptin, 393t

Genetics. See also Pharmacogenetics; Pharmacogenomics

 ethosuximide and, 300

 obesity and, 61

Gentamicin

 aminoglycosides and, 147

 dosing for, 126, 127t

 in geriatrics, 104

 hemodialysis and, 40t

 in pediatrics, 79t, 88

Geriatrics (elderly), 99–114

 absorption in, 102t, 103–104

 ADEs in, 108–110, 110t–114t

 antidepressants and, 177

 bioavailability in, 103, 103t

 clearance in, 106–107, 107t

 DDIs in, 108–110, 110t–114t

 distribution in, 104–106, 105t

 elimination in, 106–107, 107t

 free fraction in, 104

 intramuscular absorption in, 104

 kidney function assessment in, 19–20, 20t–21t

 LBW to fat ratio in, 105–106

 lidocaine in, 351

 lithium in, 373, 373t

 metabolism in, 106

 oral absorption in, 103, 103t

 pharmacodynamics in, 101, 102t, 107–108

 pharmacokinetics in, 100–107, 102t

 theophylline in, 433

 tissue sensitivity in, 107–108

 VPA in, 450

 warfarin in, 510

Gilbert syndrome, 206

Glecaprevir, 288t

Glimepiride, 112t

Glipizide

 CKD and, 35t

 hemodialysis and, 40t

Glomerular filtration rate (GFR)

 for aminoglycosides, 129, 131–132

 CKD and, 29

 clearance and, 29

 in geriatrics, 106–107

 for kidney function assessment, 11–22

 for lithium, 358, 362, 372

 obesity and, 56–57

 in pediatrics, 82–84

Glucocorticoids, 13

Glucuronide, 86t

Glutathione, 68t

Glyburide

 CKD and, 35t

 in geriatrics, 112t

Glycinexylidide (GX), 343, 344t

Glycoprotein IIb/IIIa antagonists

 LMWHs and, 325t

 UFH and, 305, 319t

 warfarin and, 508t

Griseofulvin, 506t

Growth hormone, 112t

Guanabenz, 110t

Guanfacine

 in geriatrics, 110t

 phenobarbital and, 394t

H

H2-antagonists, 107t

Half-life

 of aminoglycosides, 130, 130t, 132

 of antidepressants, 169–170

of antirejection agents, 243, 243t

 of carbamazepine, 263, 263t

 of digoxin, 281t

 of ethosuximide, 297, 298t

 of ezogabine, 207

 of lidocaine, 345, 345t–346t

 of lithium, 362–363, 363t

 of phenobarbital, 389, 389t

 of phenytoin, 408

 of stiripentol, 215

 of theophylline, 430, 430t

 of UFH, 306, 307t, 310

 of vancomycin, 462, 462t–463t

 of VPA, 448, 448t

 of warfarin, 496t, 497

 of zonisamide, 200

Haloperidol

 ethosuximide and, 299

 in geriatrics, 105t

Halothane, 108

Hartford method, for aminoglycosides, 143

Hematopoietic stem cell transplantation

 obesity and, 59

 in pediatrics, 82

Hemodialysis

 aminoglycosides and, 148

 carbamazepine and, 266, 269

 CKD and, 34–42, 38t–41t

 dosing for, 38–42, 38t–41t

 ethosuximide and, 300

 gabapentin and, 190t

 phenobarbital and, 396t

 pregabalin and, 200, 201t

 UFH and, 311t

 vancomycin and, 478–479, 479t

 VPA and, 447

 warfarin and, 511

Heparin. See also Low-molecular-weight heparins; Unfractionated heparin

 aminoglycosides and, 144

Heparin-induced thrombocytopenia (HIT)

 fondaparinux and, 326, 328

 LMWHs and, 324

 UFH and, 307, 317t

Hepatic insufficiency/disease. See also Cirrhosis

 antidepressants and, 178

 brivaracetam and, 213

 cannabidiol and, 214t, 215

 cenobamate and, 217t

 clobazam and, 208t

 ethosuximide and, 300

 ezogabine and, 207t

 kidney function assessment for, 21

 lidocaine and, 345t, 351

 perampanel and, 210t

 phenobarbital and, 392t, 395t

 UFH and, 306, 310t

 vancomycin and, 477

 vigabatrin and, 205

 VPA and, 451, 453

 warfarin and, 510–511

Hepatitis

 mycophenolate and, 234

 phenobarbital and, 395t

 theophylline and, 437t

Hexachlorophene, 81

HIV/AIDS, phenytoin and, 415

Human leukocyte antigen (HLA)

 carbamazepine and, 265, 269

 phenobarbital and, 391

 phenytoin and, 407–408

Hydrocortisone, 284t

Hydroxychloroquine, 287t

Hydroxymethylglutaryl-CoA (HMG-CoA), 248

Hydroxymidazolam glucuronide, 87

Hydroxyzine, 108, 110t

Hyoscyamine, 110t

Hyperthermia, zonisamide and, 200

Hyperthyroidism

 digoxin and, 290

 theophylline and, 437t

 warfarin and, 511

Hypnotic drugs, 101

Hypothermia

 aminoglycosides and, 148

 phenobarbital and, 396t

 UFH and, 314

Hypothyroidism

 antidepressants and, 179

 theophylline and, 437t

 warfarin and, 511

I

Ibuprofen

 in geriatrics, 105t, 106, 112t

 in pediatrics, 88–89

Ideal body weight (IBW)

 aminoglycosides and, 131

 CrCl and, 15–16

 digoxin and, 282

 dose proportionality and, 58t

 lidocaine and, 351

obesity and, 19, 50, 50t, 52–53, 53t

 theophylline and, 428

 UFH and, 304

 vancomycin and, 460

Idelalisib, 393t

Ifosfamide, 507t

I-iothalamate, 16

Imatinib

 phenobarbital and, 394t

 SLC and, 68t

Imipenem, 31t

Imipenem/cilastatin, 40t

Imipramine

 carbamazepine and, 266t

 dosing of, 165t, 166t

 in geriatrics, 103t, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Improving Global Outcomes Guideline for Evaluation and Management of Chronic Kidney Disease (KDIGO-CKD), 13–14

Indinavir, 267t

Indomethacin

 in geriatrics, 112t

 in pediatrics, 88

 vancomycin and, 476

Insulin

 CKD and, 35t

 in geriatrics, 112t

Interferon, 436t

Interleukin-6, 100

International normalized ratio (INR)

 for fondaparinux, 327

 for UFHs, 307, 308, 323

 for warfarin, 494–495, 498–500, 503–505

International Sensitivity Index (ISI), for warfarin, 502–503

Irinotecan, 393t

Isoniazid

 carbamazepine and, 267t

 clearance of, 31t

 phenytoin and, 413t

 warfarin and, 507t

Isotope dilution mass spectrometry (IDMS), 12, 83

Itraconazole

 carbamazepine and, 266t, 267t

 CKD and, 35t

 digoxin and, 288t

 renal drug transporters and, 30t

Ivabradine

 digoxin and, 286t

 phenobarbital and, 393t

J

Jaffe-based assays, 12, 13t

Janmahasatian, S., 129

Jermain, D. M., 365

K

Kaolin-pectin, 288t

Ketoconazole, 266t, 267t

Ketones, 13t

Ketoprofen, 112t

Ketorolac, 31t

Kidney. See Renal insufficiency/disease

Kidney function assessment, 11–22

 assay standardization for, 13–14

 CrCl for, 12–17

 cystatin C for, 12, 14, 17

 dosing and, 17–18

 eGFR for, 16, 17–18, 28, 29–30

 for elderly, 19–20, 20t–21t

 equations for adults for, 15

 filtration markers for, 12

 for liver disease, 21

 for obesity, 18–19

 in pediatrics, 21–22, 22t

 SCr for, 13–15

L

Labetalol, 103t

Lacosamide, 201–203, 202t

 dosing of, 187t

 VPA and, 451, 452t

β-lactams

 aminoglycosides and, 147

 drug concentration monitoring for, 4

 in pediatrics, 82, 89

Lactate, 68t

Lactation (breast milk)

 lidocaine and, 352

 phenobarbital and, 388

 phenytoin and, 415

 theophylline and, 428

 VPA and, 445

 warfarin and, 510

Lactulose, 13t

Lamivudine

 CKD and, 35t

 hemodialysis and, 40t

Lamotrigine, 191–192, 191t

 carbamazepine and, 266t

 dosing of, 186t

 ezogabine and, 207

 in geriatrics, 101

 lacosamide and, 203

 oxcarbazepine and, 198

 rufinamide and, 204

 VPA and, 451, 452t

Lapatinib, 288t

Large dose-extended interval (LDEI), for aminoglycosides, 124–125, 125t–126t, 133–137, 134t–137t, 138–144

Larotrectinib, 394t

Lasmiditan, 288t

Lean body weight (LBW)

 aminoglycosides and, 129

 to fat ratio, in geriatrics, 105–106

 lithium and, 365

 obesity and, 50t, 52–53, 53t

Ledipasvir, 288t

Leflunomide, 507t

Lemborexant, 393t

Lennox-Gastaut syndrome (LGS), 191, 194, 203, 207, 213

 cannabidiol and, 215

Levetiracetam, 195–197, 196t

 CKD and, 35t

 dosing of, 186t

 in geriatrics, 101, 114t

 hemodialysis and, 40t

 VPA and, 451, 452t

Levodopa, 103t

Levofloxacin

 CKD and, 35t

 hemodialysis and, 40t

 lithium and, 372

Levomilnacipran, 176t

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Levonorgestrel, 198

Levothyroxine, 267t

Lidocaine, 339–352, 340t–350t

 clearance of, 31t, 343, 344, 344t–345t

 creatinine assays for, 13t

 DDIs with, 349–350, 350t

 dosing of, 340–341, 340t–342t, 346–348, 346t–347t

 in geriatrics, 103t, 104, 105t

Linezolid, 40t

Link, Karl, 493

Lisinopril, 35t

Lithium, 357–374, 359t–363t, 366t, 367f, 368f, 369t–373t

 DDIs with, 371–372, 372t

 dosing of, 358–360, 359t, 360t, 363–365

 in geriatrics, 107t

 pharmacodynamics of, 369–370, 369t, 370t

Liver. See Hepatic insufficiency/disease

Liver function tests

 ethosuximide and, 299

 for felbamate, 188

Loading dose

 for aminoglycosides, 124–125, 125t

 for digoxin, 278t

 for obesity, 59

 for phenobarbital, 386t

 for phenytoin, 402, 402t

for theophylline, 424–425, 425t

 for UFH, 304–305, 311

 of vancomycin, 458–459, 459t, 479

Lopinavir, 268t

Lorazepam

 in geriatrics, 105t, 106, 111t

 phenobarbital and, 387

Losartan, 31t

Lovastatin

 carbamazepine and, 267t

 clearance of, 31t

Low-molecular-weight heparins (LMWHs), 320–326

 dosing of, 321–323, 321t

 pharmacodynamics of, 320, 320t, 323–324

 reversing effects of, 324–325, 325t

 warfarin and, 508t

Loxapine, 299

Lumefantrine, 393t

M

Macitentan, 393t

Macrolide antibiotics

 carbamazepine and, 267t

 warfarin and, 507t

Maculopapular eruptions (MPEs), 269

Maintenance dose

 for digoxin, 278–279, 278t, 279t

 for lithium, 359, 359t

 for obesity, 59–60

 for phenobarbital, 386t

 for phenytoin, 402, 402t

 for theophylline, 425, 425t

 for UFH, 305, 311

 for vancomycin, 459–460

 for warfarin, 500, 500t

Malnutrition

 aminoglycosides and, 148

 antidepressants and, 178

 VPA and, 446

Mammalian target of rapamycin (mTOR), 234

Mannitol, 147

Maprotiline

 dosing of, 165t, 166t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Meclizine, 110t

Meclofenamate, 112t

Mefenamic acid

 in geriatrics, 112t

 lithium and, 372

Megestrol, 112t

Meloxicam, 112t

Meningitis, 148

Meperidine, 104, 105t

Mephenytoin, 72

Mephobarbital, 111t

Mercaptopurine, 506t

Meropenem

 CKD and, 35t

 hemodialysis and, 40t

Mesalamine, 508t

Metabolism

 of antidepressants, 169, 170t

 of antirejection agents, 242, 243t

 of brivaracetam, 213

 of carbamazepine, 261–263, 262t

 for clearance, 30–31, 31t

 of clobazam, 208–209

 in geriatrics, 106

 of lamotrigine, 192

 in pediatrics, 84–85, 84t–86t

 of perampanel, 210

 of phenytoin, 406

 of rufinamide, 204

 of theophylline, 428–429

 of topiramate, 195

Metaxalone, 112t

Metformin

 CKD and, 35t

 in geriatrics, 107t

 hemodialysis and, 40t

 lacosamide and, 202

 renal drug transporters and, 30t

 SLC and, 68t

Methadone, 267t

Methemoglobinemia, 79t

Methicillin

 CKD and, 35t

 in pediatrics, 88, 89

Methicillin-resistant Staphylococcus aureus (MRSA), 458, 459, 466, 469, 470, 475

Methimazole, 506t

Methocarbamol, 112t

Methotrexate

 ABC and, 68t

 in geriatrics, 107t

 phenytoin and, 413t

Methscopolamine, 110t

Methsuximide, 392t

Methyldopa

 in geriatrics, 110t

 lithium and, 372

Methylprednisolone, 284t

Methyltestosterone, 112t

Methylxanthines, 424, 432

Metoclopramide

 CKD and, 35t

 clearance of, 31t

 in geriatrics, 108, 112t

 hemodialysis and, 40t

Metoprolol, 103t

Metronidazole

 CKD and, 35t

 in geriatrics, 103t

 hemodialysis and, 40t

 lithium and, 372

 warfarin and, 507t

Mexiletine

 lidocaine and, 350t

 theophylline and, 436t

Midazolam

 in pediatrics, 85t, 87

 phenobarbital and, 387

Mifepristone, 393t

Mineral oil, 112t

Minimum inhibitory concentration (MIC)

 for aminoglycosides, 124, 139, 144

 CF and, 89

 for vancomycin, 459, 466, 467–468, 477

Minocycline

 digoxin and, 289t

 lithium and, 372

Minoxidil, 31t

Mirabegron, 288t

Mirtazapine

 carbamazepine and, 266t

 dosing of, 165t, 166t

 in geriatrics, 113t

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenobarbital and, 395t

 therapeutic range of, 174t

Mitotane, 506t

Modification of Diet in Renal Disease (MDRD), 28, 56–57

Monoamine oxidase inhibitors, 452

Monoethylglycinexylidide (MEGX), 343, 344t, 351

Monohydroxylated derivative (MHD), 197

Moore, R. D., 145

Morphine

 clearance of, 31t

 in pediatrics, 85t, 90

Moxifloxacin, 40t

Multidrug and toxin extrusion (MATE), 29

Multidrug-resistance 1 (MDR1)

 antirejection agents and, 251t

 digoxin and, 290

Multidrug resistance proteins (MRPs), 29, 69t

Muscle relaxants, 112t

Mycophenolate, 234

 absorption of, 238–240, 240t

 DDIs with, 248–249, 248t–249t

 distribution of, 240–241, 241t

 dosing of, 237t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 protein binding of, 241

 SLC and, 68t

N

Nabumetone, 112t

N-acetyltransferase 2 (NAT2), 206

Nafcillin, 506t

Naldemedine, 393t

Naproxen, 104, 105t, 112t

National Kidney Disease Education Program (NKDEP), 13–14

N-demethylation pathway

 clobazam and, 208, 208t

 theophylline and, 429

N-desmethylclobazam, 208–209, 208t

 cannabidiol and, 214–215

Nefazodone

 carbamazepine and, 267t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Neonates

 lidocaine and, 344t

 theophylline and, 428, 432–433, 434

 UFH and, 311t

 vancomycin for, 467

Neuromuscular-blocking agents, 372

Niacinamide, 268t

Nicardipine, 31t

Nifedipine

 in geriatrics, 111t

 phenobarbital and, 393t

 phenytoin and, 413t

Nilotinib, 393t

Nimodipine

 clearance of, 31t

 phenobarbital and, 393t

Nitrofurantoin, 110t

Nitroglycerin

 LMWHs and, 325t

 UFH and, 319t

Nizatidine, 114t

Nonsteroidal antiinflammatory drugs (NSAIDs)

 digoxin and, 288t

 in geriatrics, 101, 104, 112t

 lithium and, 372t

 with LMWHs, 325t

 UFH and, 319t

 warfarin and, 508t

Norepinephrine, 13t

Norepinephrine reuptake inhibitors (NRIs), 164

Nortriptyline

 carbamazepine and, 266t

 dosing of, 165t, 167t

 in geriatrics, 105t, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

NSTE myocardial infarction (NSTEMI)

 fondaparinux and, 328

 LMWHs and, 320, 321

O

Obesity/overweight

 aminoglycosides and, 148

 body composition changes with, 51–52

 carbamazepine and, 262

clearance and, 55–57

 CrCl with, 50, 55–57

 dose proportionality and, 58, 58t

 dosing for, 49–61, 53t–54t, 60f

 fondaparinux and, 327

 genetics and, 61

 intramuscular absorption with, 54–55

 kidney function assessment for, 18–19

 lidocaine and, 344t, 351

 lithium in, 373t

 LMWHs and, 325

 loading dose for, 59

 maintenance doses for, 59–60

 nonrenal clearance and, 57

 oral absorption with, 54

 in pediatrics, 82

 phenytoin and, 414

 renal clearance and, 55–57

 size descriptors for, 50t–51t, 52–53, 53t–54t

 UFH and, 311

 vancomycin and, 460, 476–477

 V (V) with, 55

O-desmethyltramadol, 90

Omeprazole

 carbamazepine and, 268t

 warfarin and, 507t

Oncology, 70

Opioids

 obesity and, 61

 phenobarbital and, 395t

Oral contraceptives

 ezogabine and, 207

 lacosamide and, 202

 lamotrigine and, 192

 VPA and, 451, 452

 zonisamide and, 200

Organic anion and carnitine transporters (OCTNs), 29

Organic anionic transporter (OAT), 29–30, 66

 BBB and, 69t

Organic cationic transporter (OCT), 29–30, 66

 BBB and, 69t

Orlistat, 507t

Orphenadrine, 112t

Osteomalacia, 265

Osteoporosis, 318t

Overweight. See Obesity

Oxaprozin, 112t

Oxazepam, 111t

Oxcarbazepine, 113t, 197–199, 198t

 CKD and, 35t

 dosing of, 186t

 in geriatrics, 101

 lacosamide and, 203

 phenobarbital and, 395t

 VPA and, 452t

Oxypurinol, 68t

P

Paclitaxel

 SLC and, 68t

 warfarin and, 508t

Pancreatitis, 148

Pancuronium bromide, 267t

Paraquat, 68t

Paroxetine

 DDIs with, 176t

 dosing of, 165t, 167t

 in geriatrics, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Patent ductus arteriosus (PDA)

 aminoglycosides and, 148

 in pediatrics, 88

 vancomycin and, 476

Pazopanib, 394t

Pediatric Advanced Weight Prediction in the Emergency Room (PAWPER), 51

Pediatrics. See also Neonates

 age groups in, 78t

 aminoglycosides in, 135–137, 135t–137t

 asphyxia in, 85–86

 CF in, 88–89

 distribution in, 81–82

 dosing in, 77–90

 ECMO in, 86–87

 elimination in, 82–84

 exchange transfusion in, 86

 intramuscular absorption in, 81

 kidney function assessment in, 21–22, 22t

 lidocaine in, 344t

 metabolism in, 84–85, 84t–86t

 obesity in, 82

 oral absorption in, 80–81

 PDA in, 88

 percutaneous absorption in, 81

 pharmacogenomics in, 89–90

 pharmacokinetics in, 78–81, 78t–79t

 rectal absorption in, 81

 theophylline in, 432–433

 vancomycin in, 466–467

 vigabatrin for, 204

Penicillin G

 CKD and, 35t

 in pediatrics, 79t

Penicillins

 aminoglycosides and, 147

 in pediatrics, 79t, 89

 V of, 32

Pentamidine, 35t

Pentobarbital, 111t

Pepin, S. M., 365

Perampanel, 209–210, 209t–210t

 dosing of, 187t

 VPA and, 451, 452t

Percutaneous coronary intervention (PCI), 314

Perry, P. J., 364

Pexidartinib, 394t

P-glycoprotein (P-GP), 29, 66

 ABC and, 68t

 antidepressants and, 169, 177

 antirejection agents and, 245

 BBB and, 69t

 carbamazepine and, 266

 digoxin and, 290

 doxorubicin and, 67

 in geriatrics, 106

 phenobarbital and, 388, 391

Pharmacodynamics

 of aminoglycosides, 144–147

 of antidepressants, 176–179, 176t

 of antirejection agents, 245–248, 247t

 of carbamazepine, 265–266

 defined, 65

 of digoxin, 285–286

 of ethosuximide, 299

 in geriatrics, 101, 102t, 107–108

 of lidocaine, 349, 349t

 of lithium, 369–370, 369t, 370t

 of LMWHs, 320, 320t, 323–324

 pharmacokinetics and, 66f

 of phenobarbital, 391, 391t, 392t

 of phenytoin, 411–412

 of theophylline, 434–435, 435t

 of UFH, 315–317, 316t–318t

 of vancomycin, 469–476

 of VPA, 451

 of warfarin, 503–505, 505t

Pharmacogenetics, 66f

 cardiology and, 71

 defined, 65

 history of, 66–67

 oncology and, 70

 psychiatry and, 71–72

Pharmacogenomics

 of aminoglycosides, 149

 defined, 66

 of lithium, 374

 in pediatrics, 89–90

 pharmacokinetics and, 65–72

 of phenytoin, 407–408

Pharmacogenomics Knowledgebase (PharmGKB), 67

Pharmacokinetics

 of aminoglycosides, 127–130, 127t–130t

 of antidepressants, 167–170, 167t–168t, 179t

 of antirejection agents, 238–243, 240t, 241t, 243t

 of brivaracetam, 212–213, 212t

 of cannabidiol, 214–215, 214t

 of carbamazepine, 259–263, 260t–263t

 of cenobamate, 217–218, 217t

 of clobazam, 207–208, 208t

 defined, 66

 of digoxin, 280, 280t, 281t

 of eslicarbazepine, 210–211, 211t

 of ethosuximide, 296–297, 296t–298t

 of ezogabine, 206–207, 206t–207t

 of felbamate, 177t

 of fondaparinux, 327

 of gabapentin, 189t

 in geriatrics, 100–107, 102t

 for lacosamide, 202, 202t

 of lamotrigine, 191, 191t

 of levetiracetam, 196, 196t

 of lidocaine, 342–345, 342t–346t

 of lithium, 360–363, 361t–363t

 of LMWHs, 320–321, 320t, 322

 of oxcarbazepine, 197, 198t

 in pediatrics, 78–81, 78t–79t

 of perampanel, 209–210, 209t–210t

 pharmacodynamics and, 66f

 pharmacogenomics and, 65–72

 of phenobarbital, 387–389, 387t–389t

 of phenytoin, 404–408, 404t, 407t

 of pregabalin, 200–201, 200t–201t

 of rufinamide, 203, 203t–204t

 of stiripentol, 215, 216t

 of theophylline, 427–430, 428t–430t

 of tiagabine, 192–193, 193t

 of topiramate, 194–195, 194t

 of UFH, 305–306, 306t, 307t, 308–311, 309t–311t

 of vancomycin, 460–462, 461t–463t, 464–467, 464t

 of vigabatrin, 204–205, 205t

 of VPA, 444–448, 445t, 446t, 448t

 of warfarin, 496–501, 496t, 498t, 500t, 501t

 of zonisamide, 199, 199t

Pharmacology, 66

Phenelzine

 dosing of, 165t, 167t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Phenobarbital, 385–395, 386t–396t

 carbamazepine and, 263

 cenobamate and, 218

 DDIs with, 392–393, 392t–395t

 dosing of, 385–386, 386t, 387t

 in geriatrics, 111t

 lacosamide and, 202

 lamotrigine and, 191

 oxcarbazepine and, 198

 in pediatrics, 85

 phenytoin and, 413t

 renal drug transporters and, 30

 rufinamide and, 204

 theophylline and, 436t

 VPA and, 451, 452t

Phenothiazines

 ethosuximide and, 299

 in geriatrics, 106, 108

Phenylthiocarbamide, 66–67

Phenytoin, 401–415, 402t–404t, 407t, 409t, 412t–413t

 brivaracetam and, 213

 carbamazepine and, 267t

 cenobamate and, 218

 DDIs with, 412, 412t–413t

 digoxin and, 288t

 dosing of, 402–403, 402t, 403t

 drug concentration monitoring for, 4

 ethosuximide and, 299–300

 in geriatrics, 104, 105t, 106

 lacosamide and, 202, 203

 lamotrigine and, 191

 oxcarbazepine and, 198

 in pediatrics, 79t, 82, 84, 84t

 pharmacogenetics and, 72

 rufinamide and, 204

 theophylline and, 436t

 topiramate and, 195

 toxicity of, 7

 vigabatrin and, 206

 V of, 32

 VPA and, 452t

 warfarin and, 506t, 507t

Phenytoin and, 403, 407, 414

Piperacillin, 35t

Piperacillin/tazobactam

 hemodialysis and, 40t

 vancomycin and, 476

Piroxicam, 112t

Platelet factor 4 (PF4)

 fondaparinux and, 328

 LMWHs and, 325

 UFH and, 316, 316t

Plazomicin, 126, 127t

Pneumonia

 SDSI and, 138

 theophylline and, 437t

Posaconazole, 288t

Pramipexole, 30t

Prasugrel, 113t

Prazosin, 103, 110t

Predicted normal weight (PNWT), 54t

Prednisolone, 284t

Prednisone

 absorption of, 238–240, 240t

 DDIs with, 249, 249t–250t

 digoxin and, 284t

 distribution of, 241, 241t

 dosage of, 237t–238t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 protein binding of, 241

Pregabalin, 200–201, 200t–201t

 dosing of, 186t

 ethosuximide and, 300

 in geriatrics, 114t

 VPA and, 451, 452t

Pregnancy

 aminoglycosides and, 149

 brivaracetam and, 213

 cannabidiol and, 214t, 215

 carbamazepine and, 262–263

 cenobamate and, 217t

 clobazam and, 208t

 CrCl and, 15

 eslicarbazepine and, 211t

 ethosuximide and, 299

 ezogabine and, 207t

 felbamate and, 177t, 188

 gabapentin and, 190t

 lacosamide and, 202, 202t

 lamotrigine and, 191t

 LDEI and, 133

 levetiracetam and, 196t, 197

 lidocaine and, 352

 lithium and, 372, 373–374, 373t

 oxcarbazepine and, 197, 198t

 perampanel and, 210t

 phenobarbital and, 388, 396t

 phenytoin and, 415

pregabalin and, 201t

 rufinamide and, 204t

 stiripentol and, 216t

 theophylline and, 437t

 tiagabine and, 193t

 topiramate and, 194t

 UFH and, 316t

 vigabatrin and, 205, 205t

 VPA and, 450, 453

 warfarin and, 510

 zonisamide and, 199

Pretomanid, 394t

Primaquine, 66–67

Primidone

 carbamazepine and, 267t

 ethosuximide and, 299

 lamotrigine and, 191

 rufinamide and, 204

 VPA and, 452t

 warfarin and, 506t

PR interval

 AEDs and, 203

 digoxin and, 286t

 phenytoin and, 403, 412

Probenecid

 in geriatrics, 114t

 renal drug transporters and, 30, 30t

Procainamide

 clearance of, 31t

 in geriatrics, 107t

Progesterone, 284t

Prolonged intermittent RRT (PIRRT), 478, 480

Promethazine, 110t

Propafenone

 digoxin and, 288t

 lidocaine and, 350t

 theophylline and, 436t

 warfarin and, 507t

Propantheline, 110t

Propoxyphene

 carbamazepine and, 268t

 phenobarbital and, 392t

Propranolol

 clearance of, 31t

 in geriatrics, 103t, 104, 105t

 with LMWHs, 325t

 UFH and, 319t

Propylthiouracil, 506t

Protamine sulfate

 LMWHs and, 324–325, 325t

 UFH and, 318–319, 318t

Protease inhibitors

 carbamazepine and, 267t, 268t

 warfarin and, 506t

Protein binding

 of aminoglycosides, 129

 of antidepressants, 178

 of antirejection agents, 241

 of cannabidiol, 214t

 of carbamazepine, 261, 261t

 of cenobamate, 217t

 CF and, 88

 of clobazam, 208, 208t

 of digoxin, 280t

 distribution and, 81–82

 of eslicarbazepine, 211, 211t

 of ethosuximide, 297

 of ezogabine, 207t

 of felbamate, 177t

 of gabapentin, 189t

 GFR and, 82

 hemodialysis and, 38t

 of lacosamide, 202, 202t

 of lamotrigine, 191t

 of levetiracetam, 196, 196t

 of lidocaine, 343

 of oxcarbazepine, 198t

 of perampanel, 209t

 pharmacokinetics and, 100

 of phenobarbital, 388, 388t

 of phenytoin, 405–406

 of pregabalin, 200t

 of rufinamide, 203t

 of stiripentol, 215, 216t

 of theophylline, 428

 of tiagabine, 193t

 of topiramate, 194, 194t

 of UFH, 306

 of vancomycin, 461

 V and, 32

 of vigabatrin, 205t

 of VPA, 446–447, 452

 of warfarin, 496–497, 496t

Proton-pump inhibitors

 in geriatrics, 101, 112t

 mycophenolate and, 249, 250t

Protriptyline

 dosing of, 165t, 167t

 in geriatrics, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Psychiatry, 71–72

Pulmonary edema

 CHF and, 350

 theophylline and, 437t

Pulmonary embolism (PE)

 fondaparinux and, 328

 LMWHs and, 320

 UFH and, 312, 312t, 314, 315t

 UIFH and, 308

Pyridoxine, 392t

Pyrilamine, 110t

Q

QRS interval, phenytoin and, 403, 412

QT interval

 lidocaine and, 340

 phenytoin and, 403, 412

 rufinamide and, 204

Quazepam, 111t

Quetiapine

 carbamazepine and, 268t

 phenobarbital and, 394t

Quinapril, 31t

 CKD and, 35t

 hemodialysis and, 40t

Quinidine

 digoxin and, 288t

 in geriatrics, 103t, 107t

 with LMWHs, 325t

 renal drug transporters and, 30t

 UFH and, 319t

 warfarin and, 507t

Quinine, 507t

Quinolones, 436t

R

Raloxifene, 31t

Ramipril

 CKD and, 35t

 hemodialysis and, 40t

Ranitidine

 CKD and, 35t

 in geriatrics, 114t

 hemodialysis and, 40t

 VPA and, 451

Ranolazine, 288t

Reboxetine, 31t

Renal insufficiency/disease. See also Acute kidney injury; Chronic kidney disease; End-stage renal disease

 antidepressants and, 178

 clobazam and, 208t

 ethosuximide and, 300

 ezogabine and, 207t

 gabapentin and, 190t

 levetiracetam and, 196t

 lidocaine and, 351

 oxcarbazepine and, 197

 perampanel and, 210t

 phenobarbital and, 395t

 UFH and, 306, 310t

 vigabatrin and, 205

 VPA and, 453

 warfarin and, 511

Repaglinide, 31t, 68t

Reserpine, 110t

Ribavirin, 506t

Rifampin

 carbamazepine and, 267t

 digoxin and, 289t

 lidocaine and, 350t

 phenobarbital and, 392t

 phenytoin and, 413t

 theophylline and, 436t

Rimegepant, 394t

Risperidone, 394t

Ritonavir

 carbamazepine and, 268t

 digoxin and, 289t

 renal drug transporters and, 30t

Rivaroxaban

 CKD and, 35t

 in geriatrics, 101, 113t, 114t

Rivastigmine, 101

Roflumilast, 394t

Rosuvastatin

 BCRP and, 69t

 clearance of, 31t

 SLC and, 68t

Roux-en-Y bypass, 54

Rufinamide, 203–204, 204t

 dosing of, 187t

S

Salazar-Corcoran equation, 19

Salicylates

 in geriatrics, 104

 phenytoin and, 413t

 warfarin and, 508t

Sampling time

 for aminoglycosides, 139, 142f

 for antidepressants, 175

 for carbamazepine, 264–265

for digoxin, 283–284

 for ethosuximide, 298–299

 for lidocaine, 348, 348t

 for lithium, 366

 for phenobarbital, 390–291

 for phenytoin, 409–410

 for theophylline, 432–433

 for UFH, 314–315, 315t

 for VPA, 450–451

Saquinavir, 268t

Schwartz formula, 83

Scopolamine, 110t

Screening Tool of Older Persons potentially inappropriate Prescriptions (STOPP), 109

Screening Tool to Alert doctors to Right Treatment (START), 109

Secobarbital, 111t

Sefcick, A. A., 499

Selective serotonin norepinephrine reuptake inhibitors (SNRIs), 164

Selective serotonin reuptake inhibitors (SSRIs), 164

 dosing of, 171

 in geriatrics, 113t

 therapeutic range of, 175–176

 warfarin and, 508t

Selegiline

 carbamazepine and, 266t

 dosing of, 165t, 167t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

 dosing of, 171

 in geriatrics, 113t

Sertraline

 carbamazepine and, 266t

 DDIs with, 176t

 dosing of, 165t, 167t

 in geriatrics, 101

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenobarbital and, 395t

 phenytoin and, 413t

 therapeutic range of, 174t

Serum creatinine (SCr)

 for kidney function assessment, 12–14

 in pediatrics, 83

Short bowel syndrome, 54

Short QT syndrome, 204

Shoulder-hand syndrome, 392t

Simeprevir

 digoxin and, 289t

 phenobarbital and, 394t

Simvastatin

 carbamazepine and, 267t

 clearance of, 31t

Sirolimus, 234

 corticosteroids and, 245

 distribution of, 240, 241t

 dosing of, 236t, 237t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 phenobarbital and, 394t

 protein binding of, 241

 therapeutic range of, 244, 244t

Sitagliptin, 31t

Sleep-inducing medications, 101

Smoking/tobacco

 antidepressants and, 163, 178–179

 cystatin C and, 13

 pediatrics and, 85t

 pharmacogenetics and, 67

 theophylline and, 436t, 437t

 warfarin and, 506t, 511

Solute carrier (SLC), 67, 68t

Sorafenib, 394t

Sorbitol, 392t

Sotalol

 CKD and, 35t

 digoxin and, 286t

Spinal cord injury

 aminoglycosides and, 149

 CrCl and, 16

 LMWHs and, 320

Spironolactone

 CKD and, 35t

 digoxin and, 285t, 289t

 in geriatrics, 114t

Standard dose, standard interval (SDSI), for aminoglycosides, 124–125, 125t–126t, 132–133, 138–144

Status asthmaticus, 424

Status epilepticus

 phenobarbital and, 387, 390t

 phenytoin and, 403

Stevens-Johnson syndrome (SJS)

 carbamazepine and, 265, 269

 ethosuximide and, 299

 phenytoin and, 407–408

Stiripentol, 215–217, 216t

 dosing of, 187t

St. John's wort, 289t

Sucralfate, 506t

Sulfamethoxazole, 89

Sulfasalazine

 BCRP and, 69t

 in pediatrics, 86t

Sulfonamides

 in pediatrics, 82

 phenytoin and, 413t

Sulfonylureas, 112t

Sulindac, 112t

Sunitinib, 394t

Synaptic vesicle glycoprotein 2A (SV2A), 195, 212

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

 carbamazepine and, 265, 269

 in geriatrics, 113t

Systemic lupus erythematosus

 ethosuximide and, 299

 phenytoin and, 411

T

Tacrine, 436t

Tacrolimus, 233–234

 absorption of, 238–240, 240t

 carbamazepine and, 267t

 dosing of, 235t–236t, 237t–238t

 drug-gene interactions with, 250–251, 251t

 elimination of, 242, 243t

 molecular weight of, 251, 251t

 pharmacodynamics of, 245–248, 247t

 protein binding of, 241

 therapeutic monitoring of, 245

 therapeutic range of, 244, 244t

Tadalafil, 394t

Tait, R. C., 499

Tamoxifen

 in geriatrics, 101

 phenobarbital and, 394t

 warfarin and, 508t

Tazemetostat, 394t

99mTc-labeled diethylenetriamine, 56, 82

Telaprevir, 289t

Temazepam, 105t, 106, 111t

Tenofovir

 ABC and, 68t

 hemodialysis and, 40t

 SLC and, 68t

Terao, T., 364

Terazosin, 110t

Terbinafine, 436t

Testosterone

 in geriatrics, 104, 112t

 warfarin and, 508t

Tetracycline

 digoxin and, 289t

 hemodialysis and, 40t

 lithium and, 372

 warfarin and, 507t

Theophylline, 423–436, 425t–430t, 433t–438t

 DDIs with, 435, 435t–436t

 dosing of, 430–431

 in geriatrics, 105t

 in pediatrics, 84t, 85

 V of, 32

Therapeutic drug monitoring (TDM). See also Drug concentration monitoring

 of AEDs, 185–186

 of antirejection agents, 245

 for brivaracetam, 213

 of carbamazepine, 264–265

 of digoxin, 283–284, 283t–285t

 of ethosuximide, 298–299

 of fondaparinux, 328

 of lithium, 366–368, 367f, 368t

 of LMWHs, 323

 of phenobarbital, 30

 of phenytoin, 409–410

 of theophylline, 432–433, 433t–434t

 of UFH, 313–315, 315t

 of vancomycin, 469, 469t

 of VPA, 450–451

 of warfarin, 502–503

Therapeutic range

 of antidepressants, 172–175, 173t–174t

 of carbamazepine, 264

 of digoxin, 283, 283t

 of ethosuximide, 298

 of lidocaine, 348

 of lithium, 365–366, 366t

 of LMWHs, 323

 of phenobarbital, 389, 389t–390t

 of phenytoin, 406, 409

 of theophylline, 431–432

 of UFH, 311–312, 312t, 313t

 of vancomycin, 467–468

 of VPA, 449–451

 of warfarin, 502, 502t

Thiopurine methyltransferase (TPMT), 234

Thioridazine/mesoridazine, 393t

Thiotepa, 394t

Thrombocytopenia. See also Heparin-induced thrombocytopenia

 LMWHs and, 324

 UFH and, 314

 VPA and, 451

Tiagabine, 192–193, 193t

 carbamazepine and, 266t

 dosing of, 186t

 in geriatrics, 101

 VPA and, 452t

Ticagrelor, 394t

Ticarcillin, 88, 89

Ticarcillin/clavulanate, 40t

Ticlopidine

 phenytoin and, 413t

 theophylline and, 436t

Tigecycline, 36t

Time to steady state

 of aminoglycosides, 130, 130t

 of antirejection agents, 243

 of carbamazepine, 263, 263t

 of digoxin, 281t

 of ethosuximide, 297, 298t

 of lidocaine, 345, 345t–346t

 of lithium, 362–363, 363t

 of phenobarbital, 389, 389t

 of phenytoin, 408

 of theophylline, 430, 430t

 of vancomycin, 462, 462t–463t

 of VPA, 448, 448t

 of warfarin, 496t, 497

Tinzaparin, 320t, 321t

Tobacco. See Smoking

Tobramycin

 dosing for, 126, 127t

 hemodialysis and, 40t

 in pediatrics, 87

Tolbutamide, 105t

Tolmetin, 112t

Tolterodine, 508t

Tolvaptan, 289t

Topiramate, 193–195, 194t

 carbamazepine and, 266t

 CKD and, 36t

 dosing of, 186t

 in geriatrics, 101

 hemodialysis and, 40t

 lithium and, 372

 VPA and, 452t

Topotecan, 68t

Toremifene, 101

Toxic epidermal necrosis (TEN)

 carbamazepine and, 269

 phenytoin and, 407–408

Tramadol

 carbamazepine and, 267t

 in geriatrics, 113t, 114t

 warfarin and, 508t

Tranylcypromine

 dosing of, 165t, 167t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Trazodone

 dosing of, 165t, 167t

 in geriatrics, 103t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Triamterene, 114t

Triazolam, 101, 105t, 111t

Tricyclic antidepressants (TCAs), 163–164

 carbamazepine and, 266

 dosing of, 171

 ethosuximide and, 299

 in geriatrics, 105, 113t

 lithium and, 364

 therapeutic range of, 172–173

Trihexyphenidyl, 110t

Trimethoprim

 CKD and, 36t

 phenytoin and, 413t

Trimethoprim/sulfamethoxazole

 in geriatrics, 113t

 hemodialysis and, 41t

 renal drug transporters and, 30t

Trimipramine

 dosing of, 165t, 167t

 in geriatrics, 111t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Triprolidine, 110t

Tumor necrosis factor, 100

U

Unfractionated heparin (UFH), 304–319, 306t, 307t, 308f, 309t–313t, 315t–319t

 DDIs with, 319, 319t

 dosing of, 304–305, 307–311, 308f, 309t–311t

 pharmacokinetics of, 305–306, 306t, 307t, 308–311, 309t–311t

reversing effects of, 318–319, 318t

 toxicity of, 316, 317t–318t

Unstable angina (UA), 328

Urate, 68t

Uric acid, 68t

Uridine 5′-diphospho-glucuronosyltransferase (UGT)

 AEDs and, 197

 carbamazepine and, 261, 266

 cenobamate and, 218

 eslicarbazepine and, 211

 ezogabine and, 206

 mycophenolate and, 248

 prednisone and, 249

 VPA and, 447, 451

V

Valbenazine, 394t

Valganciclovir, 41t

Valproate (valproic acid, VPA), 443–453, 444t–446t, 448t, 452t

 carbamazepine and, 266t, 268t

 drug concentration monitoring for, 4

 ethosuximide and, 299–300

 in geriatrics, 106

 lamotrigine and, 191

 phenobarbital and, 393t

 phenytoin and, 413t

 zonisamide and, 200

Valsartan, 31t

Vancomycin, 457–481, 459t–465t, 469t–471t, 472f, 478t–480t

 aminoglycosides and, 147

 clearance of, 31t, 462, 462t

 CrCl and, 56

 dosing of, 458–460, 459t, 460t, 463–467, 463t–465t

 drug concentration monitoring for, 4

 in geriatrics, 107t

 hemodialysis and, 41t

 in pediatrics, 88

 toxicity of, 7

Vandetanib, 289t

Vecuronium, 267t

Vemurafenib, 289t

Venlafaxine

 CKD and, 36t

 DDIs with, 176t

 dosing of, 165t, 167t

 metabolism of, 170t

 pharmacokinetics of, 168t

 therapeutic range of, 174t

Venous thromboembolism (VTE)

 fondaparinux and, 327

 LMWHs and, 320, 322–323, 325

 UFH and, 304, 307–308

 warfarin and, 494, 502t

Ventricular fibrillation (VF), 340

Ventricular tachycardia (VT), 340

Verapamil

 carbamazepine and, 268t

 clearance of, 31t

 digoxin and, 289t

 in geriatrics, 103t

Vigabatrin, 204–206, 205t

 CKD and, 36t

 dosing of, 187t

 hemodialysis and, 41t

 rufinamide and, 204

 VPA and, 451, 452t

Vilazodone

 DDIs with, 176t

 dosing of, 165t, 167t

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenobarbital and, 394t

 therapeutic range of, 174t

Vincristine

 digoxin and, 287t

 phenobarbital and, 394t

Vitamin D

 in pediatrics, 79t

 phenobarbital and, 392t

Vitamin E

 in pediatrics, 79t

 warfarin and, 507t

Vitamin K

 phenobarbital and, 392t

 warfarin and, 494, 494t, 500, 506t, 511

VKOR complex unit 1 (VKORCI), 71, 497, 499

Vogel, F., 67

Volume of distribution (V), 32

 of antirejection agents, 241, 241t

 of cannabidiol, 214t

 of carbamazepine, 261, 261t

 of cenobamate, 217t

 of clobazam, 208t

 of digoxin, 280t, 283

 of eslicarbazepine, 211t

 of ethosuximide, 297, 297t

 of lidocaine, 342, 342t–343t

 of lithium, 361, 361t

 with obesity, 55

 of phenobarbital, 387, 388t

of phenytoin, 414

 of stiripentol, 216t

 of theophylline, 428, 428t

 of UFH, 306, 307t

 of vancomycin, 461, 461t, 477

 of VPA, 446, 446t

 of warfarin, 496, 496t

Voriconazole

 hemodialysis and, 41t

 phenobarbital and, 393

 phenytoin and, 413t

Vortioxetine

 DDIs with, 176t

 dosing of, 165t, 167t

 metabolism of, 170t

 pharmacokinetics of, 168t

 phenobarbital and, 394t

 therapeutic range of, 174t

Voxelotor, 394t

W

Warfarin, 71, 493–511, 494t–496t, 498t, 500t–502t, 505t–509t

 carbamazepine and, 266t

 DDIs with, 506–510, 506t–508t

 dosing of, 494–496, 495t, 498–501, 498t, 500t, 501t

 in geriatrics, 105t, 106, 108

 with LMWHs, 325t

 in pediatrics, 82

 phenobarbital and, 393

 phenytoin and, 413t

 UFH and, 308, 319t

White blood cells (WBCs)

 antirejection agents and, 247t

 carbamazepine and, 266

 LDEI and, 144

Withering, William, 277

Wolff-Parkinson-White syndrome

 digoxin and, 277

 lidocaine and, 340

X

Xanthines, 30

Z

Zafirlukast

 theophylline and, 436t

 warfarin and, 507t

Zaleplon

 in geriatrics, 111t

 phenobarbital and, 394t

Zanubrutinib, 394t

Zetin, M., 364

Zidovudine

 clearance of, 31t

 renal drug transporters and, 30t

 VPA and, 452

Zileuton, 436t

Zolpidem

 in geriatrics, 101, 111t

 phenobarbital and, 395t

Zonisamide, 199–200, 199t

 carbamazepine and, 266t

 dosing of, 186t

 topiramate and, 195