Clinician's Pocket Drug Reference 2008

Imipenem-Cilastatin 119may repeat X 1; < 60 kg use 0.01 mg/kg (ECC 2005; DC cardioversion preferred)Caution: [C, –] Contra: w/ class I/III antiarrhythmics (Table 10); QTc > 440 msDisp: Inj 0.1 mg/mL SE: Arrhythmias, HA Notes: give w/ECG monitoringIdarubicin (Idamycin) WARNING: Administer only under supervisionof an MD experienced in leukemia and in an institution with resources to maintaina patient compromised by drug toxicity Uses: *Acute leukemias* (AML, ALL,ANLL), *CML in blast crisis, breast CA* Action: DNA intercalating agent;↓ DNA topoisomerases I & II Dose: (per protocol) 10–12 mg/m 2 /d for 3–4 d; ↓ inrenal/hepatic impairment Caution: [D, –] Contra: Bilirubin >5 mg/dL, PRGDisp: Inj 1 mg/mL (5, 10, 20 mg vials) SE: ↓ BM, cardiotox, N/V, mucositis,alopecia, & IV site Rxns, rarely ↓ renal/hepatic Fxn Notes: Avoid extrav, potentvesicant; IV onlyIfosfamide (Ifex, Holoxan) Uses: Lung, breast, pancreatic & gastricCA, HL/NHL, soft tissue sarcoma Action: Alkylating agent Dose: (per protocol)1.2 g/m 2 /d for 5 d bolus or cont inf; 2.4 g/m 2 /d for 3 d; w/ Mesna uroprotection;↓ in renal/hepatic impair Caution: [D, M] ↑ effect w/ phenobarbital, carbamazepine,phenytoin; St. John’s wort may ↓ levels Contra: ↓ BM Fxn, PRG Disp:Inj 1, 3 g SE: Hemorrhagic cystitis, nephrotox, N/V, mild–moderate leukopenia,lethargy & confusion, alopecia, ↑ hepatic enzyme Notes: Administer w/ mesna toprevent hemorrhagic cystitisIloprost (Ventavis) WARNING: Associated with syncope; may requiredosage adjustment Uses: NYHA Class III/IV pulm arterial HTN* Action:Prostaglandin analog Dose: Initial 2.5 mcg; if tolerated, ↑ to 5 mcg inh 6–9 X/d (atleast 2 h apart) while awake Caution: [C, ?/–] Antiplatelet effects, ↑ bleeding riskw/ anticoagulants; additive hypotensive effects Contra: SBP