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None (34) · Tropane alkaloids: hyoscyamine (dominant; the racemic form is atropine), scopolamine. Competitive muscarinic antagonism. (1) · '"`UNIQ--vote-0000001D-QINU`"' '''QT prolongation''' risk at high doses prompted the FDA's 2015 caution against use in patients with prolonged QT or with concurrent QT-prolonging medicines'"`UNIQ--ref-0000001E-QINU`"'. (1) · '"`UNIQ--vote-0000001D-QINU`"' Major Beers-list concern in elderly patients for cognitive and fall risks. CYP2D6 substrate. At massive overdose, also produces sodium channel blockade with cardiac toxicity'"`UNIQ--ref-0000001E-QINU`"'. '"`UNIQ--effect-0000001F-QINU`"' (1) · '"`UNIQ--vote-000009FD-QINU`"' Active against gram-positive cocci including MRSA; the unique target underlies the absence of cross-resistance with other antibiotic classes. High-level resistance (plasmid-mediated mupA) is rising and limits prolonged or repeated use'"`UNIQ--ref-000009FE-QINU`"'. (1) · '"`UNIQ--vote-00000D11-QINU`"' Same mechanistic family as amphotericin B but with prohibitive systemic toxicity at therapeutic doses, hence restriction to topical and luminal-gut indications. No clinically meaningful resistance after decades of use'"`UNIQ--ref-00000D12-QINU`"'. (1) · '"`UNIQ--vote-00001014-QINU`"' Activates the glucocorticoid receptor to broadly remodel inflammatory, immune, and metabolic transcription. The dipropionate, valerate, and augmented dipropionate ester forms determine topical potency (high to super-high)'"`UNIQ--ref-00001015-QINU`"'. (1) · '"`UNIQ--vote-00001067-QINU`"' Chronic use is associated with cathartic colon (colonic dilation, loss of haustration), hypokalemia, and laxative dependence; reserved for short-term use or bowel prep with breaks between courses'"`UNIQ--ref-00001068-QINU`"'. (1) · '"`UNIQ--vote-00001233-QINU`"' Onychomycosis cure rates with nail lacquer are modest (mycologic cure ~30-50%, complete cure ~5-12% at 48 weeks); oral terbinafine remains substantially more effective when systemic therapy is acceptable'"`UNIQ--ref-00001234-QINU`"'. (1)

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None (1) · '''4.5 mg/kg (without epinephrine), 7 mg/kg (with epinephrine)''' for infiltration; serum level monitoring required for prolonged IV antiarrhythmic use (1) · 10 mg/day (anxiety, oral) (1) · 100 mg/day (adult) (1) · 150 mg/day (oral); use lowest effective dose for shortest duration per FDA NSAID class guidance (1) · 200 mg/day (typical adult oral) (1) · 250 mg/d (1) · 30 mg/d for short-term use (1) · 300 mg/day (depression, hospitalized); 150 mg/day outpatient; 6 mg/day for insomnia (1) · 300 mg/day (oral) (1) · 4 g/d (rarely tolerated due to GI effects) (1) · 4 g/d in healthy adults; 3 g/d conservative limit; 2 g/d in cirrhosis or chronic alcohol use (1) · 4% topical; limit duration of use (1) · 4.8 g/d (IV severe infection) (1) · 40 mg/day (oral, anxiety) (1) · 400 mg/day theoretical; in practice rarely exceeds 200 mg/day (1) · 4000 mg/day (analgesic) (1) · 50 g/week (cream/ointment); 2-week continuous limit; 4-week maximum cumulative (1) · 8 g/day (oral, short-term load); 6 g/day (chronic) (1) · BID topical; once daily nail lacquer (1) · Formulation-specific; ~4.8 g/d typical maximum oral (1) · ICS 880 mcg/d (asthma); intranasal 200 mcg/d (1) · Indication-dependent; 200-400 mg/d oral typical (1) · Indication-specific (4) · Indication-specific; high-dose IV regimens for encephalitis or disseminated disease (1) · Indication-specific; titrated to effect (1) · Intranasal 200 mcg/d (adults); inhaled 880 mcg/d (1) · Limit topical to 10-day courses to reduce resistance pressure (1) · No fixed ceiling; titrate to clinical effect and tolerability with CDC opioid prescribing guidance constraints on morphine-milligram-equivalent (MME) totals (1) · Per formulation (1) · Rheumatologic ~25 mg/week; oncology indication-specific (1) · Single 200-400 mcg/kg per dose for systemic indications (1) · Titrated; risk of hypercalcemia is the limiting factor (1) · Topical: BID; troche: 5×/day (1) · Topical: nightly; oral APL: 45 mg/m²/d (1) · Topical: nightly; systemic: regimen-specific (1) · Topical: per formulation; oral supplement age-dependent (1) · ~4 g/d (severe systemic infection) (1) · ~500 mg/d typical (1)

None (1) · 1-3 days (1) · 15-30 minutes (oral) (1) · 15-30 minutes (oral); 1-2 minutes (IV) (1) · 15-60 minutes (oral); 1-5 minutes (IV); 4-10 minutes (rectal or intranasal) (1) · 20 minutes (oral); 5 minutes (IV) (1) · 30-60 minutes (oral); 5 minutes (IV); 15-30 minutes (IM) (1) · 30-60 minutes (oral); rapid relief in acute gout (1) · 30-60 minutes (oral); slower for topical (1) · 5-10 minutes (IV); 30 minutes (oral IR); slower for ER and rectal (1) · <1 minute (IV); 1-2 minutes (infiltration); 30+ minutes (patch on adult skin, faster on thinner pediatric skin) (1) · Antiplatelet effect within 30-60 minutes; analgesic effect 30-60 minutes (1) · Caries reduction over months to years of consistent use (1) · Clinical and mycologic cure follows the full course; nail clearance over months of regrowth (1) · Days (2) · Days for calcium effect; weeks for PTH suppression (1) · Days for dermatophyte clearance; nail clearance over months (1) · Hours (5) · Hours to days (1) · Hours to days for inflammation; substantial improvement within 1 week (1) · Inhaled: bronchial effect 1-2 weeks; nasal: symptom relief 12-24 hours; topical: hours (1) · Intranasal: symptom relief 12-24 hours; inhaled: bronchial effect 1-2 weeks (1) · Minutes (1) · PO 6-12 hours; PR 15-60 minutes (1) · PO: 30-60 minutes; IV: minutes (1) · Rheumatologic effect at 4-8 weeks; ectopic resolution over 2-3 weeks (1) · Sedation/dizziness within hours of oral dose; endometrial effects over days (1) · SL/spray: 1-3 minutes; IV: minutes; patch: 30-60 minutes (1) · Sleep effect from first dose; antidepressant effect over 1-4 weeks (1) · Symptom relief within 24-48 hours of starting episodic treatment (1) · Symptom relief within days (1) · Symptomatic improvement 2-4 weeks (1) · Topical hours; intra-articular days to weeks (1) · Topical: inflammation, erythema, crusting at 2 weeks; complete response weeks to months after course (1) · Topical: irritation within days; acne improvement 6-12 weeks; oral APL response within days (1) · Visible lightening at 4-12 weeks (1) · ~30 minutes (oral) (1)

None (1) · '''Antiplatelet effect lasts the platelet's lifetime (~7-10 days)''' due to irreversible COX-1 acetylation; analgesic 4-6 hours (1) · 12-24 hours per dose (1) · 24 hours (2) · 24 hours (HS dosing) (1) · 24 hours (most ER formulations) (1) · 3-5 hours (IR); 8-24 hours (ER); 12-24 hours (epidural / intrathecal) (1) · 30-90 minutes (infiltration without epinephrine); 90-200 minutes (with epinephrine); 12 hours (patch) (1) · 4-6 hours (5) · 4-6 hours (IR); 24 hours (ER) (1) · 6-24 hours (parent); much longer when accounting for the long-lived active metabolites (1) · 6-8 hours (3) · 6-8 hours (IR oral); 12-24 hours (ER) (1) · 8 hours per oral dose (1) · 8-12 hours (1) · Biologic 36-54 hours (long-acting) (1) · Biologic ~8-12 hours (short-acting) (1) · Hours (2) · Hours per application (5) · Hours per dose (much shorter biologic effect than ergocalciferol/cholecalciferol because it is the already-active form, not the storage form) (1) · Hours per topical application (1) · Hours to days per application (1) · Intra-articular 3-6 months (depot effect of acetonide microcrystals) (1) · N/A (2) · Once-weekly dosing in rheumatology (1) · Oral: 8-12 hours; vaginal: 24+ hours; IM: days (1) · Persistent activity 6+ hours (residual binding to skin and oral surfaces) (1) · SL: 30 minutes; patch: 12-14 hours; IV continuous (1) · Variable (1)

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