Clinician's Pocket Drug Reference 2008

Diphtheria, Tetanus Toxoids 81Dinoprostone (Cervidil Vaginal Insert, Prepidil Vaginal Gel,Prostin E2 ) WARNING: Should only be used by trained personnel in an appropriatehospital setting Uses: *Induce labor; terminate PRG (12–20 wk); evacuateuterus in missed abortion or fetal death* Action: Prostaglandin, changesconsistency, dilatation, & effacement of the cervix; induces uterine contractionDose: Gel: 0.5 mg; if no cervical/uterine response, repeat 0.5 mg q6h (max 24-hdose 1.5 mg). Vaginal insert: 1 insert (10 mg = 0.3 mg dinoprostone/h over 12 h);remove w/ onset of labor or 12 h after insertion. Vaginal supp: 20 mg repeatedevery 3–5 h; adjust PRN supp: 1 high in vagina, repeat at 3–5-h intervals untilabortion (240 mg max) Caution: [X, ?] Contra: Ruptured membranes, allergy toprostaglandins, placenta previa or AUB, when oxytocic drugs contraindicated or ifprolonged uterine contractions are inappropriate (Hx C-section, cephalopelvic disproportion,etc) Disp: Endocervical gel: 0.5 mg in 3-g syringes (w/10-mm & 20-mm shielded catheter) Vaginal gel: 0.5 mg/3 g Vaginal supp: 20 mg Vaginal insert,CR: 10 mg SE: N/V/D, dizziness, flushing, HA, fever, abnormal uterine contractionsDiphenhydramine (Benadryl) [OTC] Uses: *Rx & prevent allergicRxns, motion sickness, potentiate narcotics, sedation, cough suppression, & Rx ofextrapyramidal Rxns* Action: Antihistamine, antiemetic Dose: Adults. 25–50 mgPO, IV, or IM bid–tid. Peds. > 2 y. 5 mg/kg/24 h PO or IM ÷ q6h (max 300 mg/d);↑ dosing interval w/ moderate–severe renal insuff Caution: [B, –] Contra: acuteasthma Disp: Tabs, caps 25, 50 mg; chew tabs 12.5 mg; elixir 12.5 mg/5 mL; syrup12.5 mg/5 mL; liq 6.25 mg/5 mL, 12.5 mg/5 mL; inj 50 mg/mL, cream: 2% SE:Anticholinergic (xerostomia, urinary retention, sedation)Diphenoxylate + Atropine (Lomotil, Lonox) [C-V] Uses: *D*Action: Constipating meperidine congener, ↓ GI motility Dose: Adults. Initial,5 mg PO tid–qid until controlled, then 2.5–5 mg PO bid; 20 mg/day max Peds >2 y: 0.3–0.4 mg/kg/24 h (of diphenoxylate) bid–qid, 10 mg/day max Caution:[C, +] Contra: Obstructive jaundice, D due to bacterial Infxn; children < 2 y Disp:Tabs 2.5 mg diphenoxylate/0.025 mg atropine; liq 2.5 mg diphenoxylate/0.025 mgatropine/5 mL SE: Drowsiness, dizziness, xerostomia, blurred vision, urinary retention,constipationDiphtheria, Tetanus Toxoids, & Acellular pertussis adsorbed,Hepatitis B (Recombinant), & Inactivated PoliovirusVaccine [IPV] combined (Pediarix) Uses: *Vaccine against diphtheria,tetanus, pertussis, HBV, polio (types 1, 2, 3) as a 3-dose primary series in infants& children < 7, born to HBsAg– mothers* Actions: Active immunizationDose: Infants: Three 0.5-mL doses IM, at 6–8-wk intervals, start at 2 mo; childgiven 1 dose of hep B vaccine, same; previously vaccinated w/ one or more dosesIPV, use to complete series Caution: [C, N/A] Contra: HbsAG+ mother, adults,children > 7 y, immunosuppressed, allergy to yeast, neomycin, polymyxin B, orany component, encephalopathy, or progressive neurologic disorders; caution in