Clinician's Pocket Drug Reference 2008

Ethinyl Estradiol & Norelgestromin 97Eszopiclone (Lunesta) [C-IV] Uses: *Insomnia* Action: Nonbenzodiazepinehypnotic Dose: 2–3 mg/d hs Elderly: 1–2 mg/d hs; w/ hepatic impair/usew/ CYP3A4 inhibitor (Table 11): 1 mg/d hs Caution: [C, ?/–] Disp: Tabs 1, 2, 3mg SE: HA, xerostomia, dizziness, somnolence, hallucinations, rash, Infxn, unpleasanttaste, anaphylaxis, angioedema Notes: High-fat meals ↓ absorptionEtanercept (Enbrel) Uses: *Reduces Sxs of RA in pts who fail otherDMARD,* Crohn Dz Action: Binds TNF Dose: Adults. RA 50 mg sc weekly or25 mg sc 2×/wk (separated by at least 72–96 h). Peds 4–17 y. 0.8 mg/kg/week(max 50 mg/week) or 0.4 mg/kg (max 25 mg/dose) twice weekly 72–96 h apartCaution: [B, ?] w/ predisposition to Infxn (ie, DM) Contra: Active Infxn; Disp:Inj 25 mg/vial, 50 mg/mL SE: HA, rhinitis, inj site Rxn, URI Notes: Rotate injsitesEthambutol (Myambutol) Uses: *Pulm TB* & other mycobacterial Infxns,MAC Action: ↓ RNA synth Dose: Adults & Peds >12 y. 15–25 mg/kg/d POsingle dose; ↓ in renal impair, take w/ food, avoid antacids Caution: [B, +] Contra:unconscious patients, Optic neuritis Disp: Tabs 100, 400 mg SE: HA, hyperuricemia,acute gout, abd pain, ↑ LFTs, optic neuritis, GI upsetEthinyl Estradiol (Estinyl, Feminone) Uses: *Menopausal vasomotorSxs; female hypogonadism* Action: Estrogen supl Dose: 0.02–1.5 mg/d ÷daily–tid Caution: [X, –] Contra: Severe hepatic impair; genital bleeding of unknowncause, breast CA, estrogen-dependent tumors, thromboembolic disorders,thrombophlebitis Disp: Tabs 0.02, 0.05, 0.5 mg SE: N, bloating, breast enlargement/tenderness,edema, HA, hypertriglyceridemia, gallbladder DzEthinyl Estradiol & Levonorgestrel (Preven) Uses: *Emergencycontraceptive* (“morning-after pill”); prevent PRG (contraceptive failure, unprotectedintercourse) Actions: Estrogen & progestin; interferes with implantationDose: 4 tabs, take 2 tabs q12h × 2 (w/in 72 h of intercourse) Caution: [X, M]Contra: Known/suspected PRG, AUB, Hx or current DVT/PE, stroke, MI CVD,CAD; severe HTN; Severe HA with focal neurological Sx; breast or endometrialcancer; estrogen-dependent neoplasms; undiagnosed abnormal genital bleeding;hepatic dysfn; jaundice; pgy; major surgery with prolonged immobilization; heavysmoking if > 35 yo Disp: Kit: ethinyl estradiol (0.05), levonorgestrel (0.25) blisterpack with 4 pills & urine PRG test SE: Peripheral edema, N/V/D, bloating, abdpain, fatigue, HA, & menstrual changes Notes: Will not induce abortion; may ↑risk of ectopic PRGEthinyl Estradiol & Norelgestromin (Ortho Evra) Uses: *Contraceptivepatch* Action: Estrogen & progestin Dose: Apply patch to abdomen,buttocks, upper torso (not breasts), or upper outer arm at the beginning of the menstrualcycle; new patch is applied weekly for 3 wk; week 4 is patch-free Caution:[X, M] Contra: PRG, Hx or current DVT/PE, stroke, MI, CVD, CAD; severeHTN; severe HA w/focal neurological Sx; breast/endometrial Ca; estrogen-dependentneoplasms; hepatic dysfn; jaundice; major surgery w/prolonged immobiliza-