Clinician's Pocket Drug Reference 2008

98 Ethosuximidetion; heavy smoking if > 35 y Disp: 20 cm 2 patch (6 mg norelgestromin [activemetabolite norgestimate] & 0.75 mg of ethinyl estradiol) SE: Breast discomfort,HA, site Rxns, N, menstrual cramps; thrombosis risks similar to OCP Notes: Lesseffective in women > 90 kg; instruct patient does not protect against STD/HIVEthosuximide (Zarontin) Uses: *Absence (petit mal) Szs* Action: Anticonvulsant;↑ Sz threshold Dose: Adults. Initial, 250 mg PO ÷ bid; ↑ by 250 mg/dq4–7d PRN (max 1500 mg/d) usual maint 20–30 mg/kg. Peds 3–6 y. Initial: 15mg/kg/d PO ÷ bid. Maint: 15–40 mg/kg/d ÷ bid, max 1500 mg/d Caution: [C, +]in renal/hepatic impair Contra: Component sensitivity Disp: Caps 250 mg; syrup250 mg/5 mL SE: Blood dyscrasias, GI upset, drowsiness, dizziness, irritabilityNotes: Levels: Trough: just before next dose; Therapeutic: Peak 40–100 mcg/ml;Toxic Trough > 100 mcg/mL; 1 ⁄2 life: 30–60hEtidronate Disodium (Didronel) Uses: *↑ Ca 2+ of malignancy, PagetDz, & heterotopic ossification* Action: ↓ Nl & abnormal bone resorption Dose:Paget Dz: 5–10 mg/kg/d PO ÷ doses (for 3–6 mo). ↑ Ca 2+ : 7.5 mg/kg/d IV inf over2 h × 3 d, then 20 mg/kg/d PO on last day of inf × 1–3 mo Caution: [B PO (C parenteral),?] Contra: Overt osteomalacia, SCr >5 mg/dL Disp: Tabs 200, 400 mg;inj 50 mg/mL SE: GI intolerance (↓ by ÷ daily doses); hypophosphatemia, hypomagnesemia,bone pain, abnormal taste, fever, convulsions, nephrotox Notes: TakePO on empty stomach 2 h before any mealEtodolac WARNING: May ↑ risk of cardiovascular events & GI bleedingUses: *Osteoarthritis & pain,* RA Action: NSAID Dose: 200–400 mg PO bid–qid(max 1200 mg/d) Caution: [C (D 3rd tri), ?] ↑ bleeding risk w/aspirin, warfarin;↑ nephrotox w/ cyclosporine; Hx CHF, HTN, renal/hepatic impair, PUD Contra:Active GI ulcer Disp: Tabs 400, 500 mg; ER tabs 400, 500, 600 mg; caps 200, 300mg SE: N/V/D, gastritis, abd cramps, dizziness, HA, depression, edema, renal impairNotes: Do not crush tabsEtonogestrel/Ethinyl Estradiol (NuvaRing) Uses: *Contraceptive*Action: Estrogen & progestin combo Dose: Rule out PRG first; insert ring vaginallyfor 3 wk, remove for 1 wk; insert new ring 7 d after last removed (even ifbleeding) at same time of day ring removed. First day of menses is day 1, insert beforeday 5 even if bleeding. Use other contraception for first 7 d of starting therapy.See insert if converting from other contraceptive; after delivery or 2nd tri abortion,insert 4 wk postpartum (if not breast-feeding) Caution: [X, ?/–] HTN, gallbladderDz, ↑ lipids, migraines, sudden HA Contra: PRG, heavy smokers > 35 y, DVT,PE, cerebro-/CV Dz, estrogen-dependent neoplasm, undiagnosed abnormal genitalbleeding, hepatic tumors, cholestatic jaundice Disp: Intravaginal ring: ethinylestradiol 0.015 mg/d & etonogestrel 0.12 mg/d Notes: If ring removed, rinsew/cool/lukewarm H 2 O (not hot) & reinsert ASAP; if not reinserted w/in 3 h, effectiveness↓; do not use with diaphragmEtonogestrel subdermal implant (Implanon) Uses: *Contraception* Action: transforms endometrium from proliferative to secretory Dose: 1 im-