Clinician's Pocket Drug Reference 2008

Fluticasone, Nasal 105Fluoxetine (Prozac, Sarafem) WARNING: Closely monitor for worseningdepression or emergence of suicidality, particularly in ped pts Uses: *Depression,OCD, panic disorder, bulimia (Prozac)* *PMDD (Sarafem)* Action:SSRI Dose: 20 mg/d PO (max 80 mg/d ÷ dose); weekly 90 mg/wk after 1–2 wk ofstandard dose. Bulimia: 60 mg q AM. Panic disorder: 20 mg/d. OCD: 20–80 mg/d.PMDD: 20 mg/d or 20 mg intermittently, start 14 d prior to menses, repeat witheach cycle; ↓ in hepatic failure Caution: [B, ?/–] Serotonin synd with MAOI,SSRI, serotonin agonists, linezolid; QT prolongation w/ phenothiazines Contra:MAOI/thioridazine (wait 5 wk after D/C before MAOI) Disp: Prozac: Caps 10, 20,40 mg; scored tabs 10 mg; SR cap 90 mg; soln 20 mg/5 mL. Sarafem: Caps 10, 20mg SE: N, nervousness, wgt loss, HA, insomniaFluoxymesterone (Halotestin, Androxy) Uses: Androgen-responsivemet *breast CA, hypogonadism* Action: ↓ Secretion of LH & FSH (feedbackinhibition) Dose: Breast CA: 10–40 mg/d ÷ × 1–3 mo. Hypogonadism: 5–20 mg/dCaution: [X, ?/–] ↑ effect w/ anticoagulants, cyclosporine, insulin, lithium, narcoticsContra: Serious cardiac, liver, or kidney Dz; PRG Disp: Tabs 2, 5, 10 mgSE: Priapism, edema, virilization, amenorrhea & menstrual irregularities, hirsutism,alopecia, acne, N, cholestasis; suppression of factors II, V, VII, & X &polycythemia; ↑ libido, HA, anxiety Notes: Radiographic exam of hand/wristq6mo in prepubertal children; ↓ total T 4 levelsFlurazepam (Dalmane) [C-IV] Uses: *Insomnia* Action: BenzodiazepineDose: Adults & Peds >15 y. 15–30 mg PO qhs PRN; ↓ in elderly Caution:[X, ?/–] Elderly, low albumin, hepatic impair Contra: NAG; PRG Disp: Caps 15,30 mg SE: “Hangover” due to accumulation of metabolites, apnea, anaphylaxis,angio edma, amnesia Notes: May cause dependencyFlurbiprofen (Ansaid,Ocufen) WARNING: May ↑ risk of cardiovascularevents and GI bleeding Uses: *Arthritis, ocular surgery* Action: NSAIDDose: 50–300 mg/d ÷ bid–qid, max 300 mg/d w/ food, ocular 1 gtt Q 30 min × 4,beginning 2 h preop Caution: [B (D in 3rd tri), +] Contra: PRG (3rd tri); aspirinallergy Disp: Tabs 50, 100 mg SE: Dizziness, GI upset, peptic ulcer Dz, ocular irritationFlutamide (Eulexin) WARNING: Liver failure & death reported. MeasureLFT before, monthly, & periodically after; D/C immediately if ALT 2 × upper limitsof nl or jaundice develops Uses: Advanced *PCa* (w/LHRH agonists, eg, leuprolideor goserelin); w/radiation & GnRH for localized CAP Action:Nonsteroidal antiandrogen Dose: 250 mg PO tid (750 mg total) Caution: [D, ?]Contra: Severe hepatic impair Disp: Caps 125 mg SE: Hot flashes, loss of libido,impotence, N/V/D, gynecomastia, hepatic failure Notes: LFT, avoid EtOHFluticasone, Nasal (Flonase) Uses: *Seasonal allergic rhinitis* Action:Topical steroid Dose: Adults & Peds > 12 y: 2 sprays/nostril/d. Peds 4–11 y:1–2 sprays/nostril/d Caution: [C, M] Contra: Primary Rx of status asthmaticusDisp: Nasal spray 50 mcg/actuation SE: HA, dysphonia, oral candidiasis