Clinician's Pocket Drug Reference 2008

110 Gemifloxacinmg/dL), gallbladder Dz, primary biliary cirrhosis Disp: Tabs 600 mg SE:Cholelithiasis, GI upset Notes: Avoid w/HMG-CoA reductase inhibitors; LFTs & serum lipidsGemifloxacin (Factive) Uses: *CAP, acute exacerbation of chronic bronchitis*Action: ↓ DNA gyrase & topoisomerase IV; Spectrum: S. pneumoniae(including MDR strains), H. influenzae, H. parainfluenzae, M. catarrhalis,M. pneumoniae, Chlamydia pneumoniae, K. pneumoniae Dose: 320 mg PO daily;CrCl < 40 mL/min: 160 mg PO daily Caution: [C, ?/–]; children < 18 y; Hx of↑ QTc interval, electrolyte disorders, w/ Class IA/III antiarrhythmics, erythromycin,TCAs, antipsychotics, ↑ INR and bleed risk w/warfarin Contra: Fluoroquinoloneallergy Disp: Tab 320 mg SE: Rash, N/V/D, abd pain, dizziness, xerostomia,arthralgia, allergy/anaphylactic rxns, peripheral neuropathy, tendon rupture Notes:Take 3 h before or 2 h after Al/Mg antacids, Fe, Z or other metal cationsGemtuzumab Ozogamicin (Mylotarg) WARNING: Can cause severeallergic Rxns & other infusion-related rxns including severe pulm events; hepatotox,including severe hepatic venoocclusive Dz (VOD) reported Uses:*Relapsed CD33+ AML in pts > 60 who are poor candidates for chemo* Action:MoAb linked to calicheamicin; selective for myeloid cells Dose: Per protocol Caution:[D,?/–] Contra: Component sensitivity Disp: 5 mg/20 mL vial SE: ↓ BM,allergy, anaphylaxis, chills, fever, N/V, HA, pulm events, hepatotox Notes: Singleagentuse only, not in combo; premedicate w/diphenhydramine & acetaminophenGentamicin (Garamycin, G-Mycitin, others) Uses: *Serious Infxns*due to Pseudomonas, Proteus, E. coli, Klebsiella, Enterobacter, & Serratia& initial Rx gram(–) sepsis Action: Bactericidal; ↓ protein synth Spectrum:gram(–) (not Neisseria, Legionella, Acinetobacter); synergy w/ PCNs Dose:Adults. 3–7 mg/kg/24h IV ÷ q8–24h. Synergy: 1 mg/kg q8h Peds. Infants 7 d: 2.5 mg/kg/dose IV q8–12h. Children: 2.5 mg/kg/d IV q8h; ↓ w/renalinsuff Caution: [C, +/–] Avoid other nephrotoxics Contra: Aminoglycoside sensitivityDisp: Premixed infus 40, 60, 70, 80, 90, 100, 120 mg; ADD-Vantage inj vials10 mg/mL; inj 40 mg/mL; IT preservative-free 2 mg/mL SE: Nephro/oto/neurotoxicityNotes: Follow CrCl, SCr & serum conc for dose adjustments; daily dosingpopular; use IBW to dose (use adjusted if obese > 30% IBW); Levels: Peak: 30min after inf; Trough < 0.5 h before next dose; Therapeutic: Peak 5–8 mcg/ml,Trough < 2 mcg/mL; Toxic Peak > 12 mcg/mL; 1 ⁄2 life: 2hGentamicin & Prednisolone, Ophthalmic (Pred-G Ophthalmic)Uses: *Steroid-responsive ocular & conjunctival Infxns* sensitive togentamicin Action: Bactericidal; ↓ protein synth w/anti-inflammatory. Spectrum:Staph, E. coli, H. influenzae, Klebsiella, Neisseria, Pseudomonas, Proteus, & Serratiasp Dose: Oint: 1 ⁄2 in. in conjunctival sac daily–tid. Susp: 1 gtt bid–qid, up to1 gtt/h for severe Infxns Contra: Aminoglycoside sensitivity Caution: [C, ?]Disp: Oint, ophth: Prednisolone acetate 0.6% & gentamicin sulfate 0.3% (3.5 g).