Clindamycin Phosphate topical and Milrinone Lactate

• Generic Name: clindamycin topical
• Dosage Forms: n.a.
• Other Brand Names: Cleocin T, Clindacin ETZ, Clindacin P, Clindagel, Clindamax, Evoclin, Cleocin, Clindesse, Clindamax, Clindesse Cream, Clindets, ClindaReach Pledget

Treatment of inflammatory acne vulgaris; used alone or in conjunction with benzoyl peroxide.

Generally effective for treatment of mild to moderate inflammatory acne.

May induce bacterial resistance when used as monotherapy; resistance associated with decreased clinical efficacy.

Particularly useful when used in combination with benzoyl peroxide or topical retinoids; reduction in total lesion count of 50–70% reported when combination therapy used.

Treatment of bacterial vaginosis (formerly called Haemophilus vaginitis, Gardnerella vaginitis, nonspecific vaginitis, Corynebacterium vaginitis, or anaerobic vaginosis).

CDC recommends treatment of bacterial vaginosis in all symptomatic women (including pregnant women). In addition, asymptomatic pregnant women at high risk for complications of pregnancy should be screened (preferably at the first prenatal visit) and treatment initiated if needed.

Treatment recommendations for bacterial vaginosis in HIV-infected women are the same as those for women without HIV infection.

Regimens of choice in nonpregnant women are a 7-day regimen of oral metronidazole; a 5-day regimen of intravaginal metronidazole gel; or a 7-day regimen of intravaginal clindamycin cream; alternative regimens are a 7-day regimen of oral clindamycin or 3-day regimen of intravaginal clindamycin suppositories. The preferred regimens for pregnant women are a 7-day regimen of oral metronidazole or oral clindamycin.

Regardless of regimen used, relapse or recurrence is common; an alternative regimen (e.g., oral therapy when topical was used initially) may be used in such situations.

Routine treatment of asymptomatic male sexual contacts of women who have relapsing or recurrent bacterial vaginosis not recommended.

• Generic Name: milrinone
• Dosage Forms: n.a.
• Other Brand Names: Primacor, Primacor IV.

Short-term management of acute decompensated heart failure. In most clinical studies, used in patients with NYHA class III or IV CHF who were receiving cardiac glycosides (e.g., digoxin) and diuretics. No evidence to date that milrinone decreases mortality.

Not found to be safe and effective in the long-term (>48 hours) treatment of heart failure. (See Mortality Associated with Long-term Use under Cautions.) Some clinicians recommend reserving milrinone therapy for patients with severe heart failure whose condition is refractory to therapy with cardiac glycosides, diuretics, ACE inhibitors, and/or β-adrenergic blocking agents.

Because positive inotropic agents have not demonstrated improved outcomes and can be potentially harmful (e.g., increased risk of arrhythmias in patients with heart failure), the ACCF and AHA recommend that these drugs be reserved for patients with severe systolic dysfunction who have low cardiac index and evidence of systemic hypoperfusion and/or congestion, or for palliative therapy in those with end-stage heart failure. To minimize risk of adverse effects, use lowest possible dosage and evaluate regularly for need for continued inotropic therapy.

Has been used for treatment of heart failure associated with cardiac surgery.

Also has been used for postresuscitation stabilization in patients who require additional cardiac output and BP support following cardiac arrest.