Clinician's Pocket Drug Reference 2008

88 ElectriptanEletriptan (Relpax) Uses: *Acute Rx of migraine* Action: Selective serotoninreceptor (5-HT 1 B/ 1 D) agonist Dose: 20–40 mg PO, may repeat in 2 h; 80mg/24 h max Caution: [C, +] Contra: Hx ischemic heart Dz, coronary arteryspasm, stroke or TIA, peripheral vascular Dz, IBD, uncontrolled HTN, hemiplegicor basilar migraine, severe hepatic impair, w/in 24 h of another 5-HT 1 agonist orergot, w/in 72 h of CYP3A4 inhibitors Disp: Tabs 20, 40 mg SE: Dizziness, somnolence,N, asthenia, xerostomia, paresthesias; pain, pressure, or tightness in chest,jaw or neck; serious cardiac eventsEmedastine (Emadine) Uses: *Allergic conjunctivitis* Action: Antihistamine;selective H 1 -antagonist Dose: 1 gtt in eye(s) up to qid Caution: [B, ?] Contra:Allergy to ingredients (preservatives benzalkonium, tromethamine) Disp:0.05% soln SE: HA, blurred vision, burning/stinging, corneal infiltrates/staining,dry eyes, foreign body sensation, hyperemia, keratitis, tearing, pruritus, rhinitis, sinusitis,asthenia, bad taste, dermatitis, discomfort Notes: Do not use contact lensesif eyes are redEmtricitabine (Emtriva) WARNING: Class warning for lipodystrophy,lactic acidosis, & severe hepatomegaly Uses: HIV-1 Infxn Action: NRTI Dose:200 mg cap or 240 mg sol PO daily; ↓ w/ renal impair Caution: [B, –] risk of liverdz Contra: Component sensitivity Disp: Soln: 10 mg/mL, 200 mg caps SE: HA,D, N, rash, rare hyperpigmentation of feet & hands, posttreatment exacerbation ofhepatitis Notes: First one-daily NRTI; caps/sol not equivalent; not rec asmonotherapy; screen for HepB, do not use in established HIV and HepB coinfectionEnalapril (Vasotec) Uses: *HTN, CHF, LVD,* DN Action: ACE inhibitorDose: Adults. 2.5–40 mg/d PO; 1.25 mg IV q6h. Peds. 0.05–0.08 mg/kg/day POq12–24h; ↓ w/renal impair Caution: [C (1st tri; D 2nd & 3rd tri), +] D/C immediatelyonce pregnancy detected w/NSAIDs, K + supls Contra: Bilateral RAS, angioedemaDisp: Tabs 2.5, 5, 10, 20 mg; IV 1.25 mg/mL (1, 2 mL) SE: ↓ BP w/initial dose (especially w/ diuretics), ↑ K + , nonproductive cough, angioedemaNotes: Monitor Cr; D/C diuretic for 2–3 d prior to startEnfuvirtide (Fuzeon) WARNING: Rarely causes allergy; never rechallengeUses: *w/ antiretroviral agents for HIV-1 Infxn in treatment-experiencedpts with evidence of viral replication despite ongoing antiretroviral therapy* Action:Viral fusion inhibitor Dose: 90 mg (1 mL) SQ bid in upper arm, anteriorthigh, or abdomen; rotate site Caution: [B,–] Contra: Previous allergy to drugDisp: 90 mg/mL reconstituted; pt kit w/ monthly supplies SE: Inj site rxns (inmost); pneumonia, D, N, fatigue, insomnia, peripheral neuropathy Notes: Availableonly via restricted distribution system; use immediately on recons or refrigerate(24 h max)Enoxaparin (Lovenox) WARNING: Recent or anticipated epidural/spinal anesthesia ↑ risk of spinal/epidural hematoma w/ subsequent paralysisUses: *Prevention & Rx of DVT; Rx PE; unstable angina & non-Q-wave MI*