Clinician's Pocket Drug Reference 2008

118 HyoscyamineHyoscyamine (Anaspaz, Cystospaz, Levsin, others) Uses:*Spasm w/ GI & bladder disorders* Action: Anticholinergic Dose: Adults.0.125–0.25 mg (1–2 tabs) SL/PO tid–qid, ac & hs; 1 SR cap q12h Caution: [C, +]↑ effects w/ amantadine, antihistamines, antimuscarinics, haloperidol, phenothiazines,TCA, MAOI Contra: BOO, GI obst, NAG, MyG, paralytic ileus, ulcerativecolitis, MI Disp: (Cystospaz-M, Levsinex): time release caps 0.375 mg; elixir(EtOH); soln 0.125 mg/5 mL; inj 0.5 mg/mL; tab 0.125 mg; tab (Cystospaz) 0.15mg; XR tab (Levbid): 0.375 mg; SL (Levsin SL) 0.125 mg SE: Dry skin, xerostomia,constipation, anticholinergic SE, heat prostration w/hot weather Notes: Administertabs before meals/foodHyoscyamine, Atropine, Scopolamine, & Phenobarbital(Donnatal, others) Uses: *Irritable bowel, spastic colitis, peptic ulcer,spastic bladder* Action: Anticholinergic, antispasmodic Dose: 0.125–0.25 mg(1–2 tabs) tid–qid, 1 cap q12h (SR), 5–10 mL elixir tid–qid or q8h Caution:[D, M] Contra: NAG Disp: Many combos/manufacturers; Cap (Donnatal, others):Hyosc. 0.1037 mg/atropine 0.0194 mg/scop 0.0065 mg/phenobarbital 16.2 mg.Tabs (Donnatal, others): Hyosc. 0.1037 mg/atropine 0.0194 mg/scop 0.0065mg/phenobarbital 16.2 mg. LA (Donnatal): Hyosc. 0.311 mg/atropine 0.0582mg/scop 0.0195 mg/phenobarbital 48.6 mg. Elixirs (Donnatal, others): Hyosc.0.1037 mg/atropine 0.0194 mg/scop 0.0065 mg/phenobarbital 16.2 mg/5 mL SE:Sedation, xerostomia, constipationIbandronate (Boniva) Uses: *Rx & prevent osteoporosis in postmenopausalwomen* Action: Bisphosphonate, ↓ osteoclast-mediated bone-resorptionDose: 2.5 mg PO daily or 150 mg once/month on same day (do not lie downfor 60 min after); 3 mg IV over 15–30 sec q 3 mo Caution: [C, ?/–] avoid w/ CrCl< 30 mL/min Contra: Uncorrected ↓ Ca 2+ ; inability to stand/sit upright for 60 min(PO) Disp: Tabs 2.5, 150 mg, inj IV 3 mg/3 mL SE: jaw osteonecrosis (avoid extensivedental procedures) N/D, HA, dizziness, asthenia, HTN, Infxn, dysphagia,esophagitis, esophageal/gastric ulcer, musculoskeletal pain Notes: Take 1st thingin AM w/ H 2 O (6–8 oz) > 60 min before 1st food/beverage & any meds w/multivalentcations; give adequate Ca 2+ & vit D suplsIbuprofen (Motrin, Rufen, Advil, others) [OTC] WARNING:May ↑ risk of cardiovascular events & GI bleeding Uses: *Arthritis, pain, fever*Action: NSAID Dose: Adults. 200–800 mg PO bid–qid (max 2.4 g/d). Peds.30–40 mg/kg/d in 3–4 ÷ doses (max 40 mg/kg/d); w/ food Caution: May interferew/ aspirin’s antiplatelet effect if given < 8 hrs before aspirin [B, +] Contra: 3rd triPRG, severe hepatic impair, allergy, use w/ other NSAIDs, UGI bleed, ulcers Disp:Tabs 100, 200, 400, 600, 800 mg; chew tabs 50, 100 mg; caps 200 mg; susp 100mg/2.5 mL, 100 mg/5 mL, 40 mg/mL (200 mg OTC form) SE: Dizziness, pepticulcer, plt inhibition, worsening of renal insuffIbutilide (Corvert) Uses: *Rapid conversion of AF/flutter* Action: Class IIIantiarrhythmic Dose: Adults > 60 kg 0.01 mg/kg (max 1 mg) IV inf over 10 min;