Clinician's Pocket Drug Reference 2008

78 Diazoxidesedation* Action: Benzodiazepine Dose: Adults. Status epilepticus: 5–10 mgq10–20 min to 30 mg max in 8-h period. Anxiety, muscle spasm: 2–10 mg PObid–qid or IM/IV q3–4h PRN. Preop: 5–10 mg PO or IM 20–30 min or IV justprior to procedure. EtOH withdrawal: Initial 2–5 mg IV, then 5–10 mg q5–10 min,100 mg in 1 h max. May require up to 1,000 mg/24-h for severe withdrawal; titrateto agitation; avoid excessive sedation; may lead to aspiration or resp arrest. Peds.Status epilepticus: < 5 y: 0.05–0.3 mg/kg/dose IV q15–30 min up to a max of5 mg. > 5 y: to max of 10 mg. Sedation, muscle relaxation: 0.04–0.3 mg/kg/doseq2–4h IM or IV to max of 0.6 mg/kg in 8 h, or 0.12–0.8 mg/kg/24 h PO ÷ tid–qid;↓ w/hepatic impair Caution: [D, ?/–] Contra: Coma, CNS depression, resp depression,NAG, severe uncontrolled pain, PRG Disp: Tabs 2, 5, 10 mg; soln 1,5 mg/mL; inj 5 mg/mL; rectal gel 2.5, 5, 10, 20 mg/mL SE: Sedation, amnesia,bradycardia, ↓ BP, rash, ↓ resp rate Notes: 5 mg/min IV max in adults or 1–2mg/min in peds (resp arrest possible); IM absorption erratic; avoid abrupt D/CDiazoxide (Proglycem) Uses: *Hypoglycemia due to hyperinsulinism(Proglycem); hypertensive crisis (Hyperstat)* Action: ↓ Pancreatic insulin release;antihypertensive Dose: Repeat in 5–15 min until BP controlled; repeat every 4–24 h;monitor BP closely. Hypoglycemia: Adults & Peds. 3–8 mg/kg/24 h PO ÷ q8–12h.Neonates. 8–15 mg/kg/24 h ÷ in 3 equal doses; maint 8–10 mg/kg/24 h PO in 2–3equal doses Caution: [C, ?] ↓ effect w/ phenytoin; ↑ effect w/ diuretics, warfarinContra: Allergy to thiazides or other sulfonamide-containing products; HTN associatedw/ aortic coarctation, AV shunt, or pheochromocytoma Disp: Caps 50 mg;PO susp 50 mg/mL SE: Hyperglycemia, ↓ BP, dizziness, Na + & H 2 O retention,N/V, weakness Notes: Can give false-negative insulin response to glucagons; Rxextrav w/ warm compressDibucaine (Nupercainal) Uses: *Hemorrhoids & minor skin conditions*Action: Topical anesthetic Dose: Insert PR w/ applicator bid & after eachbowel movement; apply sparingly to skin Caution: [C, ?] Contra: Componentsensitivity Disp: 1% Oint w/ rectal applicator; 0.5% cream SE: Local irritation,rashDiclofenac (Cataflam, Felctor, Voltaren) WARNING: May ↑ riskof cardiovascular events & GI bleeding Uses: *Arthritis & pain* Action: NSAIDDose: 50–75 mg PO bid; w/ food or milk; 1 patch to painful area BID Caution:[B (D 3rd tri or near delivery), ?] CHF, HTN, renal/hepatic dysfunction, & Hx PUDContra: NSAID/aspirin allergy; porphyria; peri-operative pain following CABGDisp: Tabs 50 mg; tabs DR 25, 50, 75, 100 mg; XR tabs 100 mg; Flector Patch 10× 14 cm, ophthal soln 0.1% SE: Abd cramps, heartburn, GI ulceration, rash, interstitialnephritis; patch: pruritus, dermatitis, burning, N, HA Notes: Do not crushtabs; watch for GI bleed; do not apply patch to damaged skin or while bathingDicloxacillin (Dynapen, Dycill) Uses: *Rx of pneumonia, skin, & softtissue Infxns, & osteomyelitis caused by penicillinase-producing staphylococci*Action: Bactericidal; ↓ cell wall synth. Spectrum: S. aureus & Strep Dose: Adults.