Clinician's Pocket Drug Reference 2008

Epinephrine 89Action: LMW heparin; inhibit thrombin by complexing w/ antithrombin III Dose:Adults. Prevention: 30 mg SQ bid or 40 mg SQ q24h. DVT/PE Rx: 1 mg/kg SQq12h or 1.5 mg/kg SQ q24h. Angina: 1 mg/kg SQ q12h; Ancillary to fibrinolysis inAMI: 30 mg IV bolus, then 1 mg/kg SQ BID (ECC 2005); CrCl < 30 mL ↓ to1/mg/kg SQ daily Peds. Prevention: 0.5 mg/kg SQ q12h. DVT/PE Rx: 1 mg/kg SQq12h; ↓ dose w/ CrCl < 30 mL/min Caution: [B, ?] Not for prophylaxis in prostheticheart valves Contra: Active bleeding, HIT Ab(+), Cr > 2.5 mg/dL men, 2g/dL women Disp: Inj 10 mg/0.1 mL (30-,40-,60-,80-,100-,120-,150-mg syringes)300-mg/mL multidose vial SE: Bleeding, hemorrhage, bruising, thrombocytopenia,fever, pain/hematoma at site, ↑ AST/ALT Notes: No effect on bleeding time,plt Fxn, PT, or aPTT; monitor plt for HIT, clinical bleeding; may monitor antifactorXa; not for IMEntacapone (Comtan) Uses: *Parkinson Dz* Action: Selective & reversiblecarboxymethyl transferase inhibitor Dose: 200 mg w/ each levodopa/carbidopadose; max 1600 mg/d; ↓ levodopa/carbidopa dose 25% w/levodopa dose >800 mg Caution: [C, ?] Hepatic impair Contra: Use w/MAOI Disp: Tabs 200 mgSE: Dyskinesia, hyperkinesia, N, D, dizziness, hallucinations, orthostatic ↓ BP,brown-orange urine Notes: LFT; do not D/C abruptlyEphedrine Uses: *Acute bronchospasm, bronchial asthma, nasal congestion,*↓ BP, narcolepsy, enuresis, & MyG Action: Sympathomimetic; stimulates α- &β-receptors; bronchodilator Dose: Adults. Congestion: 25–50 mg PO q6h PRN;↓ BP: 25–50 mg IV q 5–10 min, 150 mg/d max. Peds. 0.2–0.3 mg/kg/dose IVq4–6h PRN Caution: [C, ?/–] Contra: Arrhythmias; NAG Disp: Nasal soln0.48%, 0.5%, oral capsule: 25, 37.5, 50 mg Inj 50 mg/mL; nasal spray 0.25% SE:CNS stimulation (nervousness, anxiety, trembling), tachycardia, arrhythmia, HTN,xerostomia, dysuria Notes: Protect from light; monitor BP, HR, urinary output; cancause false (+) amphetamine EMIT; take last dose 4–6h before hs; abuse potential,OTC sales mostly banned/restrictedEpinephrine (Adrenalin, Sus-Phrine, EpiPen, EpiPen Jr, others)Uses: *Cardiac arrest, anaphylactic Rxn, bronchospasm, open-angle glaucoma*Action: β-adrenergic agonist, some α-effects Dose: Adults. 1.0 mg IVpush, repeat q 3–5 min; (0.2 mg/kg max) if 1 mg dose fails. Inf: 30 mg (30 mL of1:1000 soln) in 250 mL NS or D5W, at 100 mL/h, titrate. ET 2.0–2.5 mg in 20 mLNS. Profound bradycardia/hypotension: 2–10 mcg/min (1 mg of 1:1000 in 500 mLNS, infuse 1–5 mL/min) (ECC 2005); Anaphylaxis: 0.3–0.5 mL SQ of 1:1000 dilution,repeat PRN q5–15min to max 1 mg/dose & 5 mg/d. Asthma: 0.1–0.5 mLSQ of 1:1000 dilution, repeat Q 20-min to 4-h or 1 inhal (met-dose) repeat in 1–2min or susp 0.1–0.3 mL SQ for extended effect. Peds. ACLS: 1st dose 0.1 mL/kgIV of 1:10,000 dilution, then 0.1 mL/kg IV of 1:1000 dilution q3–5 min to response.Anaphylaxis: 0.15–0.3 mg IM depending on wgt < 30 kg 0.01 mg/kgAsthma: 0.01 mL/kg SQ of 1:1000 dilution q8–12h. Caution: [C, ?] ↓ bronchodilationwith β-blockers Contra: Cardiac arrhythmias, NAG Disp: Inj 1:1000,