Clinician's Pocket Drug Reference 2008

90 Epinastine1:2000, 1:10,000, 1:100,000; susp for inj 1:200; aerosol 220 mcg/spray; 1% inhalsoln; EpiPen Autoinjector one dose 0.30 mg; EpiPen Jr 0.15 mg SE: CV (tachycardia,HTN, vasoconstriction), CNS stimulation (nervousness, anxiety, trembling),↓ renal blood flow Notes: Can give via ET tube if no central line (use 2–2.5 × IVdose); EpiPen for pt self-use (www.EpiPen.com)Epinastine (Elestat) Uses: Itching w/ allergic conjunctivitis Action: AntihistamineDose: 1 gtt bid Caution: [C, ?/–] Disp: Soln 0.05% SE: Burning, folliculosis,hyperemia, pruritus, URI, HA, rhinitis, sinusitis, cough, pharyngitisNotes: Remove contacts before, reinsert in 10 minEpirubicin (Ellence) WARNING: Do not give IM or SQ. Potential cardiotoxicity;severe myelosupp Uses: *Adjuvant therapy for + axillary nodes afterresection of primary breast CA*, Actions: Anthracycline cytotoxic agent Dose:Per protocols; ↓ dose w/ hepatic impair Caution: [D, –] Contra: Baseline neutrophilcount < 1500 cells/mm 3 , severe myocardial insuff, recent MI, severe arrhythmias,severe hepatic dysfunction, previous anthracyclines Rx to maxcumulative dose Disp: Inj 50 mg/25 mL, 200 mg/100 mL SE: Mucositis, N/V/D,alopecia, ↓ BM, cardiotox, secondary AML, tissue necrosis w/ extrav, lethargyEplerenone (Inspra) Uses: *HTN* Action: Selective aldosterone antagonistDose: Adults: 50 mg PO daily–bid, doses > 100 mg/d no benefit w/ ↑ K + ; ↓ to25 mg PO daily if giving w/ CYP3A4 inhibitors Caution: [B, +/–] w/CYP3A4 inhibitors(Table 11); monitor K + with ACE inhibitor, ARBs, NSAIDs, K + -sparing diuretics;grapefruit juice, St. John’s wort Contra: K + >5.5 mEq/L; NIDDM w/microalbuminuria; SCr > 2 mg/dL (males), > 1.8 mg/dL (females); CrCl < 50mL/min; w/ K + supls/K + -sparing diuretics, ketoconazole Disp: Tabs 25, 50, 100mg SE: Hypertriglyceridemia, ↑ K + , HA, dizziness, gynecomastia, ↑ cholesterol,D, orthostatic ↓ BP Notes: May take 4 wk for full effectEpoetin Alfa [Erythropoietin, EPO] (Epogen, Procrit) WARN-ING: Use lowest dose possible; may be associated with ↑ CV, thromboembolicevents and/or mortality; d/c if Hgb > 12 g/dl Uses: * CRF associated anemia* zidovudineRx in HIV-infected pts, CA chemo; ↓ transfusions associated w/surgeryAction: Induces erythropoiesis Dose: Adults & Peds. 50–150 units/kg IV/SQ3×/wk; adjust dose q4–6wk PRN. Surgery: 300 units/kg/d × 10 d before to 4 dafter; ↓ dose if Hct≈ 36% or Hgb, ↑ > ≅ 12 g/dL or Hgb ↑ > 1 g/dL in 2-wk period;hold dose if Hgb > 12 gm/dL Caution: [C, +] Contra: Uncontrolled HTN Disp:Inj 2000, 3000, 4000, 10,000, 20,000, 40,000 units/mL SE: HTN, HA, fatigue,fever, tachycardia, N/V Notes: Refrigerate; monitor baseline & posttreatmentHct/Hgb, BP, ferritinEpoprostenol (Flolan) Uses: *Pulm HTN* Action: Dilates pulm/systemicarterial vascular beds; ↓ plt aggregation Dose: Initial 2 ng/kg/min; ↑ by2 ng/kg/min q15min until dose-limiting SE (CP, dizziness, N/V, HA, ↓ BP, flushing);IV cont inf 4 ng/kg/min < maximum-tolerated rate; adjust based on response;see package insert Caution: [B, ?] ↑ tox w/diuretics, vasodilators, acetate in dialy-