Clinician's Pocket Drug Reference 2008

84 DopaminePeds. 1.8 mg/kg PO to max 100 mg as single dose Caution: [B, ?] Contra: Componentsensitivity Disp: Tabs 50, 100 mg; inj 20 mg/mL SE: ↑ QT interval, D,HTN, HA, abd pain, urinary retention, transient ↑ LFTsDopamine (Intropin) Uses: *Short-term use in cardiac decompensationsecondary to ↓ contractility; ↑ organ perfusion (at low dose)* Action: Positive inotropicagent w/dose response: 1–10 mcg/kg/min β-effects (↑ CO & renal perfusion);10–20 mcg/kg/min β-effects (peripheral vasoconstriction, pressor); > 20mcg/kg/min peripheral & renal vasoconstriction Dose: Adults & Peds.5 mcg/kg/min by cont inf, ↑ by 5 mcg/kg/min to 50 mcg/kg/min max to effect(ECC 2005) Caution: [C, ?] Contra: Pheochromocytoma, VF, sulfite sensitivityDisp: Inj 40, 80, 160 mg/mL, premixed 0.8 , 1.6 , 3.2 mg/mL SE: Tachycardia,vasoconstriction, ↓ BP, HA, N/V, dyspnea Notes: >10 mcg/kg/min ↓ renal perfusion;monitor urinary output & ECG for ↑ HR, BP, ectopy; monitor PCWP & cardiacoutput if possible , phentolamine used for extravDornase Alfa (Pulmozyme, DNase) Uses: *↓ Frequency of resp Infxnsin CF* Action: Enzyme cleaves extracellular DNA, ↓ mucous viscosity Dose:Adult: Inhal 2.5 mg/BID dosing w/ FVC >85% w/ recommended nebulizer Peds >5 yr: Inhal 2.5 mg/daily, BID if FVC > 85% Caution: [B, ?] Contra: Chinesehamster product allergy Disp: Soln for inhal 1 mg/mL SE: Pharyngitis, voice alteration,CP, rashDorzolamide (Trusopt) Uses: *Glaucoma* Action: Carbonic anhydraseinhibitor Dose: 1 gtt in eye(s) tid Caution: [C, ?] Contra: Component sensitivityDisp: 2% soln SE: irritation, bitter taste, punctate keratitis, ocular allergic RxnDorzolamide & Timolol (Cosopt) Uses: *Glaucoma* Action: Carbonicanhydrase inhibitor w/ β-adrenergic blocker Dose: 1 gtt in eye(s) bid Caution:[C, ?] CrCl < 30 Contra: Component sensitivity, asthma, severe COPD,sinus bradycardia Disp: Soln dorzolamide 2% & timolol 0.5% SE: Irritation, bittertaste, superficial keratitis, ocular allergic RxnDoxazosin (Cardura, Cardura XL) Uses: *HTN & symptomaticBPH* Action: α 1 -adrenergic blocker; relaxes bladder neck smooth muscle Dose:HTN: Initial 1 mg/d PO; may be ↑ to 16 mg/d PO. BPH: Initial 1 mg/d PO, may ↑to 8 mg/d; XL 2–8mg Q AM Caution: [B, ?] Contra: Component sensitivityDisp: Tabs 1, 2, 4, 8 mg; XL 4, 8 mg SE: Dizziness, HA, drowsiness, sexual dysfunction,doses > 4 mg ↑ postural ↓ BP risk Notes: First dose hs; syncope mayoccur w/in 90 mins of initial doseDoxepin (Adapin) WARNING: Closely monitor for worsening depressionor emergence of suicidality Uses: *Depression, anxiety, chronic pain* Action:TCA; ↑ synaptic CNS serotonin or norepinephrine Dose: 25–150 mg/d PO, usuallyhs but can ÷ doses; up to 300 mg/day for depression ↓ in hepatic impair Caution:[C, ?/–] Contra: NAG, urinary retention, MAOI use w/in 14 d, in recoveryphase of MI Disp: Caps 10, 25, 50, 75, 100, 150 mg; PO conc 10 mg/mL SE: AnticholinergicSEs, ↓ BP, tachycardia, drowsiness, photosens