Clinician's Pocket Drug Reference 2008

Hydroxyzine 117Hydrocortisone, Rectal (Anusol-HC Suppository, CortifoamRectal, Proctocort, others) Uses: *Painful anorectal conditions,* radiationproctitis, ulcerative colitis Action: Anti-inflammatory steroid Dose: Adults.Ulcerative colitis: 10–100 mg PR daily–bid for 2–3 wk Caution: [B, ?/–] Contra:Component sensitivity Disp: Hydrocortisone acetate: Rectal aerosol 90 mg/applicator;supp 25 mg. Hydrocortisone base: Rectal 0.5%, 1%, 2.5%; rectal susp 100mg/60 mL SE: Minimal systemic effectHydrocortisone, Topical & Systemic (Cortef, Solu-Cortef)See Steroids page 185 and Tables 3 & 4 Caution: [B, –] Contra:Viral, fungal, or tubercular skin lesions; serious Infxns (except septic shock orTB meningitis) SE: Systemic: ↑ appetite, insomnia, hyperglycemia, bruisingNotes: May cause HPA axis suppressionHydromorphone (Dilaudid) [C–II] Uses: *Moderate/severe pain* Action:Narcotic analgesic Dose: 1–4 mg PO, IM, IV, or PR q4–6h PRN; 3 mg PRq6–8h PRN; ↓ w/ hepatic failure Caution: [B (D if prolonged use or high dosesnear term), ?] ↑ respiratory depression and CNS effects CNS depressants, phenothiazines,TCA Contra: Component sensitivity Disp: Tabs 2, 4 mg, 8 mg; liq 5 mg/5mL or 1 mg/mL; inj 1, 2, 4, 10 mg/mL; supp 3 mg SE: Sedation, dizziness, GIupset Notes: Morphine 10 mg IM = hydromorphone 1.5 mg IMHydroxocobalamin (Cyanokit) Uses: *Cyanide poisoning* Action:Binds cyanide to form nontoxic cyanocobalamin excreted in urine Dose: 70 mg/kgIV x1, repeat X1 PRN max 5-gm single dose; inf over 7.5 min Caution: [C, ?]Contra: None known Disp: Kit 2 2.5 gm vials w/inf set SE: ↑ BP (can be severe)anaphylaxis, chest tightness, edema, urticaria, rash, chromaturia, N, HA, inj siterxnsHydroxyurea (Hydrea, Droxia) Uses: *CML, head & neck, ovarian& colon CA, melanoma, ALL, sickle cell anemia, polycythemia vera, HIV* Action:↓ ribonucleotide reductase Dose: (per protocol) 50–75 mg/kg for WBC>100,000 cells/mL; 20–30 mg/kg in refractory CML. HIV: 1000–1500 mg/d in singleor ÷ doses; ↓ in renal insuff Caution: [D, –] ↑ effects w/ zidovudine, zalcitabine,didanosine, stavudine, fluorouracil Contra: Severe anemia, BMsuppression, WBC