Clinician's Pocket Drug Reference 2008

Diazepam 77Dexamethasone, Ophthalmic (AK-Dex Ophthalmic,Decadron Ophthalmic) Uses: *Inflammatory or allergic conjunctivitis*Action: Anti-inflammatory corticosteroid Dose: Instill 1–2 gtt tid–qid Caution:[C, ?/–] Contra: Active untreated bacterial, viral, & fungal eye Infxns Disp: Susp& soln 0.1%; oint 0.05% SE: Long-term use associated w/ cataractsDexamethasone Systemic, Topical (Decadron) See Steroids,Systemic, page 185, & Tables 3 and 4Dexpanthenol (Ilopan-Choline PO, Ilopan) Uses: *Minimize paralyticileus, Rx postop distention* Action: Cholinergic agent Dose: Adults. Reliefof gas: 2–3 tabs PO tid. Prevent postop ileus: 250–500 mg IM stat, repeat in 2 h,then q6h PRN. Ileus: 500 mg IM stat, repeat in 2 h, then q6h, PRN Caution: [C, ?]Contra: Hemophilia, mechanical bowel obst Disp: Inj 250 mg/mL; tabs 50 mg;cream 2% SE: GI crampsDexrazoxane (Zinecard) Uses: *Prevent anthracycline-induced (eg,doxorubicin) cardiomyopathy* Action: Chelates heavy metals; binds intracellulariron & prevents anthracycline-induced free radicals Dose: 10:1 ratio dexrazoxane:doxorubicin30 min prior to each dose, 5:1 ratio w/CrCl < 40 mL/min Caution:[C, ?] Contra: Component sensitivity Disp: Inj powder 250, 500 mg (10mg/mL) SE: ↓ BM (esp. leukopenia), fever, Infxn, stomatitis, alopecia, N/V/D;mild ↑ transaminase, inj site painDextran 40 (Rheomacrodex, Gentran 40) Uses: *Shock, prophylaxisof DVT & thromboembolism, adjunct in peripheral vascular surgery* Action:Expands plasma volume; ↓ blood viscosity Dose: Shock: 10 mL/kg infrapidly; 20 mL/kg max 1st 24 h; beyond 24 h 10 mL/kg max; D/C after 5 d. Prophylaxisof DVT & thromboembolism: 10 mL/kg IV day of surgery, then 500 mL/dIV for 2–3 d, then 500 mL IV q2–3d based on risk for up to 2 wk Caution: [C, ?]Inf Rxns; w/corticosteroids Contra: Major hemostatic defects; cardiac decompensation;renal Dz w/ severe oliguria/anuria Disp: 10% dextran 40 in 0.9% NaCl or5% dextrose SE: Allergy/anaphylactoid Rxn (observe during 1st min of inf),arthralgia, cutaneous Rxns, ↓ BP, fever Notes: Monitor Cr & lytes; keep wellhydratedDextromethorphan (Mediquell, Benylin DM, PediaCare 1,Delsym, others) [OTC] Uses: *Control nonproductive cough* Action:Suppresses medullary cough center Dose: Adults. 10–30 mg PO q4h PRN (max120 mg/24 h). Peds. 2–6 y: 2.5–7.5 mg q4–8h (max 30 mg/24 h). 7–12 y: 5–10 mgq4–8h (max 60 mg/24/h) Caution: [C, ?/–] Not for persistent or chronic coughcontra: