Clinician's Pocket Drug Reference 2008

76 Demeclocyclinecombine w/other iron chelator therapies; dose to nearest whole tablet;auditory/ophthalmic testing initially and q 12 mo; monthly Cr, urine protein, LFTsDemeclocycline (Declomycin) Uses: *SIADH* Action: Antibiotic, antagonizesADH action on renal tubules Dose: 300–600 mg PO q12h on emptystomach; ↓ in renal failure; avoid antacids Caution: [D, +] Avoid in hepatic/renalimpair & children Contra: Tetracycline allergy Disp: Tabs 150, 300 mg SE: D,abd cramps, photosens, DI Notes: Avoid sunlight, numerous drug interactions.Desipramine (Norpramin) WARNING: Closely monitor for worseningdepression or emergence of suicidality Uses: *Endogenous depression,* chronicpain, peripheral neuropathy Action: TCA; ↑ synaptic serotonin or norepinephrinein CNS Dose: 75–200 mg/d single or ÷ dose; usually single hs dose (max 300mg/d); ↓ dose in elderly Caution: [C, ?/–] CV Dz, Sz disorder, hypothyroidismContra: MAOIs w/in 14 d; during AMI recovery phase Disp: Tabs 10, 25, 50, 75,100, 150 mg; caps 25, 50 mg SE: Anticholinergic (blurred vision, urinary retention,xerostomia); orthostatic ↓ BP; ↑ QT interval, arrhythmias Notes: Numerousdrug interactions; blue-green urine; avoid sunlightDesloratadine (Clarinex) Uses: *Seasonal & perennial allergic rhinitis;chronic idiopathic urticaria* Action: Active metabolite of Claritin, H 1 -antihistamine,blocks inflammatory mediators Dose: Adults & Peds >12 y. 5 mg PO daily;5 mg PO qod w/hepatic/renal impair Caution: [C, ?/–] RediTabs contain phenylalanine;safety not established for < 12 y Disp: Tabs & Reditabs (rapid dissolving)5 mg, syrup 0.5 mg/mL SE: Allergy, anaphylaxis, somnolence, HA, dizziness, fatigue,pharyngitis, xerostomia, N, dyspepsia, myalgiaDesmopressin (DDAVP, Stimate) Uses: *DI (intranasal & parenteral);bleeding due to uremia, hemophilia A, & type I von Willebrand Dz (parenteral),nocturnal enuresis* Action: Synthetic analog of vasopressin (human ADH); ↑ factorVIII Dose: DI: Intranasal: Adults. 0.1–0.4 mL (10–40 mcg/d in 1–3 ÷ doses).Peds 3 mo–12 y. 0.05–0.3 mL/d in 1 or 2 doses. Parenteral: Adults. 0.5–1 mL (2–4mcg/d in 2 ÷ doses); converting from nasal to parenteral, use 1/10 nasal dose. PO:Adults. 0.05 mg bid; ↑ to max of 1.2 mg. Hemophilia A & von Willebrand Dz(type I): Adults & Peds >10 kg. 0.3 mcg/kg in 50 mL NS, inf over 15–30 min. Peds6 y. 20mcg intranasally hs Caution: [B, M] Avoid overhydration Contra: Hemophilia B;CrCl < 50 mL/min, severe classic von Willebrand Dz; pts w/ factor VIII antibodiesDisp: Tabs 0.1, 0.2 mg; inj 4, 15 mcg/mL; nasal soln 0.1, 1.5 mg/mL SE: Facialflushing, HA, dizziness, vulval pain, nasal congestion, pain at inj site, ↓ Na + , H 2 Ointox Notes: In very young & old pts, ↓ fluid intake to avoid H 2 O intox & ↓ Na +Dexamethasone, Nasal (Dexacort Phosphate Turbinaire)Uses: *Chronic nasal inflammation or allergic rhinitis* Action: Anti-inflammatorycorticosteroid Dose: Adult & Peds >12 y. 2 sprays/nostril bid–tid, max 12 sprays/d.Peds 6–12 y. 1–2 sprays/nostril bid, max 8 sprays/d Caution: [C, ?] Contra: UntreatedInfxn Disp: Aerosol, 84 mcg/activation SE: Local irritation