Clinician's Pocket Drug Reference 2008

Glyburide 111Susp, ophth: Prednisolone acetate 1% & gentamicin sulfate 0.3% (2, 5, 10 mL)SE: Local irritationGentamicin, Ophthalmic (Garamycin, Genoptic, Gentacidin,Gentak, others) Uses: *Conjunctival Infxns* Action: Bactericidal; ↓ proteinsynth Dose: Oint: Apply 1 ⁄2 in. bid–tid. Soln: 1–2 gtt q2–4h, up to 2 gtt/h for severeInfxn Caution: [C, ?] Contra: Aminoglycoside sensitivity Disp: Soln & oint0.1% and 0.3% SE: Local irritation Notes: Do not use other eye drops w/in 5–10mins; do not touch dropper to eyeGentamicin, Topical (Garamycin, G-Mycitin) Uses: *SkinInfxns* caused by susceptible organisms Action: Bactericidal; ↓ protein synthDose: Adults & Peds >1 y. Apply tid–qid Caution: [C, ?] Contra: Aminoglycosidesensitivity Disp: Cream & oint 0.1% SE: IrritationGlimepiride (Amaryl) Uses: *Type 2 DM* Action: Sulfonylurea; ↑ pancreaticinsulin release; ↑ peripheral insulin sensitivity; ↓ hepatic glucoseoutput/production Dose: 1–4 mg/d, max 8 mg Caution: [C, –] Contra: DKADisp: Tabs 1, 2, 4 mg SE: HA, N, hypoglycemia Notes: Give w/ 1st meal of dayGlimepiride/pioglitazone (Duetact) Uses: *Adjunct to exercise type2 DM not controlled by single agent* Action: Sulfonylurea (↓ glucose) w/ agentthat ↑ insulin sens & ↓ gluconeogenesis Dose: initial 30 mg/2 mg PO qam; 45 mgpioglitazone/8 mg glimepiride/day max; w/food Caution: [C, ?/–] w/ liver impair,elderly Contra: Component hypersensitivity, DKA Disp: Tabs 30/2, 30 mg/4 mgSE: Hct, ↑ ALT, ↓ glucose, URI, ↑ wgt, edema, HA, N/D, may ↑ CV mortalityNotes: Monitor CBC, ALT, Cr, wgtGlipizide (Glucotrol, Glucotrol XL) Uses: *Type 2 DM* Action: Sulfonylurea;↑ pancreatic insulin release; ↑ peripheral insulin sensitivity; ↓ hepaticglucose output/production; ↓ intestinal glucose absorption Dose: 5 mg initial, ↑ by2.5–5 mg/d, max 40 mg/d; XL max 20 mg; 30 min ac; hold if NPO Caution:[C, ?/–] Severe liver Dz Contra: DKA, Type 1 DM, sulfonamide sensitivity Disp:Tabs 5, 10 mg; XL tabs 2.5, 5, 10 mg SE: HA, anorexia, N/V/D, constipation, fullness,rash, urticaria, photosens Notes: Counsel about DM management; wait severaldays before adjusting dose; monitor glucoseGlucagon Uses: Severe *hypoglycemic* Rxns in DM with sufficient liverglycogen stores; β-blocker OD Action: Accelerates liver gluconeogenesis Dose:Adults. 0.5–1 mg SQ, IM, or IV; repeat in 20 min PRN. β-blocker OD: 3–10 mg IV;repeat in 10 min PRN; may give cont infus 1–5 mg/h (ECC 2005). Peds. Neonates:0.3 mg/kg/dose SQ, IM, or IV q4h PRN. Children: 0.025–0.1 mg/kg/dose SQ, IM,or IV; repeat in 20 min PRN Caution: [B, M] Contra: Pheochromocytoma Disp:Inj 1 mg SE: N/V, ↓ BP Notes: Administration of glucose IV necessary; ineffectivein starvation, adrenal insuff, or chronic hypoglycemiaGlyburide (DiaBeta, Micronase, Glynase) Uses: *Type 2 DM*Action: Sulfonylurea; ↑ pancreatic insulin release; ↑ peripheral insulin sensitivity;↓ hepatic glucose output/production; ↓ intestinal glucose absorption Dose: