Clinician's Pocket Drug Reference 2008

Dolasetron 83Peds. Cont IV inf of 2.5–15 mcg/kg/min; rarely, 40 mcg/kg/min required; titrate;2–20 mcg/kg/min; titrate to HR not > 10% of baseline (ECC 2005) Caution: [C, ?]Contra: Sensitivity to sulfites, IHSS Disp: Inj 250 mg/20 mL, 12.5/mL SE: Chestpain, HTN, dyspnea Notes: Monitor PWP & cardiac output if possible; ECG for↑ HR, ectopic activity; follow BPDocetaxel (Taxotere) WARNING: Do not administer if neutrophil count< 1500 cell/mm 3 ; severe rxns possible in hepatic dysfxn Uses: *Breast (anthracycline-resistant),ovarian, lung, & prostate CA* Action: Antimitotic agent; promotesmicrotubular aggregation; semisynthetic taxoid Dose: 100 mg/m 2 over 1 hIV q3wk (per protocols); dexamethasone 8 mg bid prior & continue for 3–4 d;↓ dose w/ ↑ bilirubin levels Caution: [D, –] Contra: Sensitivity to meds w/polysorbate 80, component sensitivity Disp: Inj 20 mg/0.5 mL, 80 mg/2 mL SE:↓ BM, neuropathy, N/V, alopecia, fluid retention synd; cumulative doses of300–400 mg/m 2 w/o steroid prep & posttreatment & 600–800 mg/m 2 w/ steroidprep; allergy possible (rare w/steroid prep) Notes: bili, SGOT or SGPT and alkphos prior to each cycle; frequent CBC during therapyDocusate Calcium (Surfak)/Docusate Potassium (Dialose)/Docusate Sodium (DOSS, Colace) Uses: *Constipation; adjunct topainful anorectal conditions (hemorrhoids)* Action: Stool softener Dose: Adults.50–500 mg PO ÷ daily–qid. Peds. Infants–3 y: 10–40 mg/24 h ÷ daily–qid. 3–6 y:20–60 mg/24 h ÷ daily–qid. 6–12 y: 40–120 mg/24 h ÷ daily–qid Caution: [C, ?]Contra: Use w/mineral oil; intestinal obst, acute abd pain, N/V Disp: Ca: Caps50, 240 mg. K: Caps 100, 240 mg. Na: Caps 50, 100 mg; syrup 50, 60 mg/15 mL;liq 150 mg/15 mL; soln 50 mg/mL SE: Rare abd cramping, D Notes: Take w/ fullglass of H 2 O; no laxative action; do not use >1 wkDofetilide (Tikosyn) WARNING: To minimize the risk of induced arrhythmia,hospitalize for minimum of 3 days to provide calculations of CrCl, continuousECG monitoring, & cardiac resuscitation Uses: *Maintain normal sinusrhythm in AF/A flutter after conversion* Action: Type III antiarrhythmic, prolongsaction potential Dose: Based on CrCl & QTc; CrCl > 60 mL/min 500 mcg POq12h, check QtC 2–3h after, if QTc > 15% over baseline or > 500 msec, ↓ to 250mcg Q 12h, after each dose; if CrCl < 60 mL/sec, see insert; D/C if QTc > 500msec after dosing adjustments Caution: [C, –] Contra: Baseline QTc > 440 ms,CrCl < 20 mL/min; w/verapamil, cimetidine, trimethoprim, ketoconazole,quinolones, ACE inhibitors/HCTZ combo Disp: Caps 125, 250, 500 mcg SE: Ventarrhythmias, QT ↑, torsades de pointes, rash, HA, CP, dizziness Notes: Avoid w/other drugs that ↑ QT interval; hold class I/III antiarrhythmics for 3 half-lives priorto dosing; amiodarone level should be < 0.3 mg/L before use, do not initiate if HR< 60 BPM; restricted to participating prescribers.Dolasetron (Anzemet) Uses: *Prevent chemo-associated N/V* Action:5-HT 3 receptor antagonist Dose: Adults & Peds. IV: 1.8 mg/kg IV as single dose30 min prior to chemo Adults. PO: 100 mg PO as a single dose 1 h prior to chemo