Clinician's Pocket Drug Reference 2008

108 FosinoprilFosinopril (Monopril) Uses: *HTN, CHF,* DN Action: ACE inhibitorDose: 10 mg/d PO initial; max 40 mg/d PO; ↓ in elderly; ↓ in renal impair Caution:[D, +] ↑ K + w/ K + supls, ARBs, K + sparing diuretics; ↑ renal AE w/ NSAIDs,diuretics, hypovolemia Contra: Hereditary/idiopathic angioedema or angiodemaw/ ACE inhibitor, bilateral RAS Disp: Tabs 10, 20, 40 mg SE: Cough, dizziness,angioedema, ↑ K +Fosphenytoin (Cerebyx) Uses: *Status epilepticus* Action: ↓ Sz spreadin motor cortex Dose: As phenytoin equivalents (PE). Load: 15–20 mg PE/kg.Maint: 4–6 mg PE/kg/d; ↓ dosage, monitor levels in hepatic impair Caution: [D, +]May ↑ phenobarbital Contra: Sinus bradycardia, SA block, 2nd-/3rd-degree AVblock, Adams–Stokes synd, rash during Rx Disp: Inj 75 mg/mL SE: ↓ BP, dizziness,ataxia, pruritus, nystagmus Notes: 15 min to convert fosphenytoin to phenytoin;admin < 150 mg PE/min to prevent ↓ BP; administer with BP monitoringFrovatriptan (Frova) Uses: *Rx acute migraine* Action: Vascular serotoninreceptor agonist Dose: 2.5 mg PO repeat in 2 h PRN, 7.5 mg/d max PO dose;max 7.5 mg/d Caution: [C, ?/–] Contra: Angina, ischemic heart Dz, coronaryartery vasospasm, hemiplegic or basilar migraine, uncontrolled HTN, ergot use,MAOI use w/in 14 d Supplied: Tabs 2.5 mg SE: N, V, dizziness, hot flashes,paresthesias, dyspepsia, dry mouth, hot/cold sensation, chest pain, skeletal pain,flushing, weakness, numbness, coronary vasospasm, HTNFulvestrant (Faslodex) Uses: *HR(+) met breast CA in postmenopausalwomen w/ progression following antiestrogen therapy* Action: Estrogen receptorantagonist Dose: 250 mg IM monthly, as single 5-mL inj or two concurrent 2.5-mLIM inj in buttocks Caution: [X, ?/–] ↑ effects w/ CYP3A4 inhibitors (Table 11);w/ hepatic impair Contra: PRG Disp: Prefilled syringes 50 mg/mL (single 5 mL,dual 2.5 mL) SE: N/V/D, constipation, abd pain, HA, back pain, hot flushes,pharyngitis, inj site Rxns Notes: Only use IMFurosemide (Lasix) Uses: *CHF, HTN, edema,* ascites Action: Loop diuretic;↓ Na & Cl reabsorption in ascending loop of Henle & distal tubule Dose:Adults 20–80 mg PO or IV bid. Peds. 1 mg/kg/dose IV q6–12h; 2 mg/kg/dose POq12–24h (max 6 mg/kg/dose) Caution: [C, +] ↓ K+, ↑ risk of digoxin tox; ↑ riskof ototox w/ aminoglycosides, cisplatin (esp in renal dysfunction) Contra: Allergyto sulfonylureas; anuria; hepatic coma; electrolyte depletion Disp: Tabs 20, 40, 80mg; soln 10 mg/mL, 40 mg/5 mL; inj 10 mg/mL SE: ↓ BP, hyperglycemia, ↓ K +Notes: lytes, renal Fxn; high doses IV may cause ototoxGabapentin (Neurontin) Uses: Adjunct in *partial Szs; postherpeticneuralgia (PHN)*; chronic pain synds Action: Anticonvulsant Dose: Anticonvulsant:300–1200 mg PO tid (max 3600 mg/d). PHN: 300 mg day 1, 300 mg bidday 2, 300 mg tid day 3, titrate (1800–3600 mg/d); ↓ in renal impair Caution:[C, ?] Contra: Component sensitivity Disp: Caps 100, 300, 400, soln 250 mg/5mL; tab 600, 800 mg SE: Somnolence, dizziness, ataxia, fatigue Notes: Not necessaryto monitor levels