Clinician's Pocket Drug Reference 2008

Fosfomycin 107DVT or PE in combo w/ warfarin Action: Synthetic inhibitor of activated factor X;a LMW heparin Dose: 2.5 mg SQ daily, up to 5–9 d; start at least 6 h postop Caution:[B, ?] ↑ bleeding risk w/ anticoagulants, antiplatelets, drotrecogin alfa,NSAIDs Contra: Wt < 50 kg, CrCl < 30 mL/min, active bleeding, SBE, ↓ plt w/antiplatelet Ab Disp: Prefilled syringes w/ 27 ga needle: 2.5 /0.5, 5/0.4, 7.5 /0.6,10/0.8, mg/mL SE: Thrombocytopenia, anemia, fever, N Notes: D/C if plts< 100,000 mm 3 ; only give SQ; may monitor antifactor Xa levelsFormoterol (Foradil Aerolizer) WARNING: Increased risk of worseningwheezing or asthma-related death with long-acting β-2 adrenergic agonistsUses: Maint Rx of *asthma & prevent bronchospasm* w/ reversible obstructiveairway Dz; exercise-induced bronchospasm Action: LA β 2 -adrenergic agonist,bronchodilator Dose: Adults & Peds >5 y. Asthma: Inhale one 12-mcg cap q12h w/aerolizer, 24 mcg/d max. Adults & Peds > 12 y. Exercise-induced bronchospasm:1 inhal 12-mcg cap 15 min before exercise Caution: [C, ?] Contra: Acute asthma,phenothiazines Disp: 12-mcg powder for inhal (as caps) for use in Aerolizer SE:Paradoxical bronchospasm, URI, pharyngitis, back pain Notes: Do not swallowcaps; only use w/ inhaler; do not start w/ worsening or acutely deteriorating asthmaFosamprenavir (Lexiva) WARNING: Do not use with severe liver dysfunction,reduce dose with mild–moderate liver impair (fosamprenavir 700 mg bidw/o ritonavir) Uses: HIV Infxn Action: Protease inhibitor Dose: 1400 mg bidw/o ritonavir; w/ritonavir, fosamprenavir 1400 mg + ritonavir 200 mg daily or fosamprenavir700 mg + ritonavir 100 mg bid; w/ efavirenz & ritonavir: fosamprenavir1400 mg + ritonavir 300 mg daily Caution: [C, ?/–]; Contra: w/ergotalkaloids, midazolam, triazolam, or pimozide; sulfa allergy Disp: Tabs 700 mg SE:N/V/D, HA, fatigue, rash Notes: Numerous drug interactions because of hepaticmetabolismFoscarnet (Foscavir) Uses: *CMV retinitis*; acyclovir-resistant *herpesInfxns* Action: ↓ Viral DNA polymerase & RT Dose: CMV retinitis: Induction:60 mg/kg IV q8h or 100 mg/kg q12h × 14–21 d. Maint: 90–120 mg/kg/d IV (Monday–Friday).Acyclovir-resistant HSV: Induction: 40 mg/kg IV q8–12h × 14–21 d;use central line; ↓ with renal impair Caution: [C, –] ↑ Sz potential w/ fluoroquinolones;avoid nephrotoxic Rx (cyclosporine, aminoglycosides, ampho B, proteaseinhibitors) Contra: CrCl < 0.4 mL/min/kg Disp: Inj 24 mg/mL SE:Nephrotox, electrolyte abnormalities Notes: Sodium loading (500 mL 0.9% NaCl)before & after helps minimize nephrotox; monitor ionized Ca +2Fosfomycin (Monurol) Uses: *Uncomplicated UTI* Action: ↓ cell wallsynth. Spectrum: gram (+) (staph, pneumococci); gram (–) (E. coli, Enterococcus,Salmonella, Shigella, H. influenzae, Neisseria, indole-negative Proteus, Providencia);B. fragilis & anaerobic gram(–) cocci are resistant Dose: 3 g PO in 90–120mL of H 2 O single dose; ↓ in renal impair Caution: [B, ?] ↓ absorption w/antacids/Ca salts Contra: Component sensitivity Disp: Granule packets 3 g SE:HA, GI upset Notes: May take 2–3 d for Sxs to improve