Clinician's Pocket Drug Reference 2008

104 Flumazenilmg/d PO. Peds. 0.05–0.1 mg/d PO Caution: [C, ?] Contra: Systemic fungal Infxns;known allergy Disp: Tabs 0.1 mg SE: HTN, edema, CHF, HA, dizziness,convulsions, acne, rash, bruising, hyperglycemia, HPA suppression, cataractsNotes: For adrenal insuff, use w/ glucocorticoid; dose changes based on plasmarenin activityFlumazenil (Romazicon) Uses: *Reverse sedative effects of benzodiazepines& general anesthesia* Action: Benzodiazepine receptor antagonist Dose:Adults. 0.2 mg IV over 15 s; repeat PRN, to 1 mg max (3 mg max in benzodiazepineOD). Peds. 0.01 mg/kg (0.2 mg/dose max) IV over 15 s; repeat 0.005mg/kg at 1-min intervals to max 1 mg total; ↓ in hepatic impair Caution: [C, ?]Contra: TCA OD; if pts given benzodiazepines to control life-threatening conditions(ICP/status epilepticus) Disp: Inj 0.1 mg/mL SE: N/V, palpitations, HA, anxiety,nervousness, hot flashes, tremor, blurred vision, dyspnea, hyperventilation,withdrawal synd Notes: Does not reverse narcotic Sx or amnesia, use associated w/seizuresFlunisolide (AeroBid, Aerospan, Nasarel) Uses: *Asthma in ptsrequiring chronic steroid therapy; relieve seasonal/perennial allergic rhinitis* Action:Topical steroid Dose: Adults. Met-dose inhal: 2 inhal bid (max 8/d). Nasal:2 sprays/nostril bid (max 8/d). Peds >6 y. Met-dose inhal: 2 inhal bid (max 4/d).Nasal: 1–2 sprays/nostril bid (max 4/d) Caution: [C, ?] w/adrenal insufficiencyContra: Status asthmaticus, viral, TB, fungal, bacterial Infxn; Disp: Aerobid 0.25mg/inh; Nasarel 29 mcg/spray; Aerospan 80 mcg/Inh (CFC-Free) SE: Tachycardia,bitter taste, local effects, oral candidiasis Notes: Not for acute asthmaFluorouracil [5-FU] (Adrucil) WARNING: Administration by experiencedphysician only; patients should be hospitalized for first course due to risk forsevere rxn Uses: *Colorectal, gastric, pancreatic, breast, basal cell,* head, neck,bladder, CAs Action: Inhibitor of thymidylate synthetase (interferes with DNAsynth, S-phase specific) Dose: 370–1000 mg/m 2 /d for 1–5 d IV push to 24-h continf; protracted venous inf of 200–300 mg/m 2 /d (Per protocol); 800 mg/d max Caution:[D, ?] ↑ tox w/ allopurinol; do not give MRX before 5-FU Contra: Poor nutritionalstatus, depressed BM Fxn, thrombocytopenia, major surgery w/in past mo,G6PD enzyme deficiency, PRG, serious Infxn, bilirubin >5 mg/dL Disp: Inj 50mg/mL SE: Stomatitis, esophagopharyngitis, N/V/D, anorexia, ↓ BM, rash/dryskin/photosens, tingling in hands/feet w/pain (palmar–plantar erythrodysesthesia),phlebitis/discoloration at inj sites Notes: ↑ thiamine intake; contraception recommended.Fluorouracil, Topical [5-FU] (Efudex) Uses: *Basal cell carcinoma;actinic/solar keratosis* Action: Inhibits thymidylate synthetase (↓ DNA synth,S-phase specific) Dose: 5% cream bid × 2–6 wk Caution: [D, ?] Irritant chemoContra: Component sensitivity Disp: Cream 0.5, 1, 5%; soln 1, 2, 5% SE: Rash,dry skin, photosens Notes: Healing may not be evident for 1–2 mo; wash handsthoroughly; avoid occlusive dressings; do not overuse