Clinician's Pocket Drug Reference 2008

80 Digoxin Immune Fabdose, then 1 ⁄3 of the dose at 8–12-h intervals for 2 doses. Maint: 8–10 mcg/kg/24 hPO or 6–8 mcg/kg/24 h IV ÷ q12h. 7–10 y: Same as for adults; ↓ in renal impairCaution: [C, +] Contra: AV block; idiopathic hypertrophic subaortic stenosis;constrictive pericarditis Disp: Caps 0.05, 0.1, 0.2 mg; tabs 0.125, 0.25, 0.5 mg;elixir 0.05 mg/mL; inj 0.1, 0.25 mg/mL SE: Can cause heart block; ↓ K + potentiatestox; N/V, HA, fatigue, visual disturbances (yellow-green halos around lights),cardiac arrhythmias Notes: Multiple drug interactions; IM inj painful, has erraticabsorption & should not be used;. Levels: Trough: just before next dose: Therapeutic:0.8–2.0 ng/mL; Toxic > 2 ng/mL; 1 ⁄2 life: 36 hDigoxin Immune Fab (Digibind, DigiFab) Uses: *Life-threateningdigoxin intox* Action: Antigen-binding fragments bind & inactivate digoxinDose: Adults & Peds. Based on serum level & pt’s wgt; see charts provided w/drug Caution: [C, ?] Contra: Sheep product allergy Disp: Inj 38 mg/vial SE:Worsening of cardiac output or CHF, ↓ K + , facial swelling, & redness Notes: Eachvial binds ≈0.6 mg of digoxin; renal failure may require redosing in several daysDiltiazem (Cardizem, Cardizem CD, Cardizem SR, Cartia XT,Dilacor XR, Diltia XT, Taztia XT, Tiamate, Tiazac ) Uses:*Angina, prevention of reinfarction, HTN, AF or flutter, & PAT* Action: CCBDose: PO: Initial, 30 mg PO qid; ↑ to 180–360 mg/d in 3–4 ÷ doses PRN. SR:60–120 mg PO bid; ↑ to 360 mg/d max. CD or XR: 120–360 mg/d (max 480mg/d). IV: 0.25 mg/kg IV bolus over 2 min; may repeat in 15 min at 0.35 mg/kg;begin inf of 5–15 mg/h; Acute Rate Control: 15–20 mg (0.25 mg/kg) IV over2 min, Repeat in 15 min at 20–25 mg (0.35 mg/kg) over 2 min (ECC 2005) Caution:[C, +] ↑ effect w/ amiodarone, cimetidine, fentanyl, lithium, cyclosporine,digoxin, β-blockers, theophylline Contra: SSS, AV block, ↓ BP, AMI, pulm congestionDisp: Cardizem CD: Caps 120, 180, 240, 300, 360 mg; Cardizem SR: caps60, 90, 120 mg; Cardizem: Tabs 30, 60, 90, 120 mg; Cartia XT: Caps 120, 180,240, 300 mg; Dilacor XR: Caps 180, 240 mg; Diltia XT: Caps 120, 180, 240 mg;Tiazac: Caps 120, 180, 240, 300, 360, 420 mg; Tiamate (XR): Tabs 120, 180, 240mg; inj 5 mg/mL; Taztia XT: 120, 180, 240, 300, 360 mg SE: Gingival hyperplasia,bradycardia, AV block, ECG abnormalities, peripheral edema, dizziness, HANotes: Cardizem CD, Dilacor XR, & Tiazac not interchangeableDimenhydrinate (Dramamine, others) Uses: *Prevention & Rx ofN/V, dizziness, or vertigo of motion sickness* Action: Antiemetic Dose: Adults.50–100 mg PO q4–6h, max 400 mg/d; 50 mg IM/IV PRN. Peds. 2–6 yrs: 12.5–25mg Q6–8 H max 75 mg/day, 6–12 yrs: 25–50 mg q6–8h max 150 mg/d; Caution:[B, ?] Contra: Component sensitivity Disp: Tabs 50 mg; chew tabs 50 mg; liq12.5 mg/4 mL, 12.5 mg/5 mL, 15.62 mg/5 mL; SE: Anticholinergic side effectsDimethyl Sulfoxide [DMSO] (Rimso 50) Uses: *Interstitialcystitis* Action: Unknown Dose: Intravesical, 50 mL, retain for 15 min; repeatq2wk until relief Caution: [C, ?] Contra: Component sensitivity Disp: 50% &100% soln SE: Cystitis, eosinophilia, GI, & taste disturbance