Clinician's Pocket Drug Reference 2008

120 ImipramineContra: Ped pts w/ CNS Infxn (↑ Sz risk) & < 30 kg w/ renal impair Disp: Inj(imipenem/cilastatin) 250/250 mg, 500/500 mg SE: Szs if drug accumulates, GIupset, thrombocytopeniaImipramine (Tofranil) WARNING: Close observation for suicidal thinkingor unusual changes in behavior Uses: *Depression, enuresis,* panic attack,chronic pain Action: TCA; ↑ CNS synaptic serotonin or norepinephrine Dose:Adults. Hospitalized: Initial 100 mg/24 h PO in ÷ doses; ↑ over several wks 300mg/d max. Outpatient: Maint 50–150 mg PO hs, 300 mg/24 h max. Peds. Antidepressant:1.5–5 mg/kg/24 h ÷ daily–qid. Enuresis: >6 y: 10–25 mg PO qhs; ↑ by10–25 mg at 1–2-wk intervals (max 50 mg for 6–12 y, 75 mg for >12 y); Rx for2–3 mo, then taper Caution: [D, ?/–] Contra: Use with MAOIs, NAG, acute recoveryfrom MI, PRG, CHF, angina, CVD, arrhythmias Disp: Tabs 10, 25, 50 mg;caps 75, 100, 125, 150 mg SE: CV Sxs, dizziness, xerostomia, discolored urineNotes: Less sedation than amitriptylineImiquimod Cream, 5% (Aldara) Uses: *Anogenital warts, HPV,condylomata acuminata* Action: Unknown; ? cytokine induction Dose: Apply3×/wk, leave on 6–10 h & wash off w/soap & water, continue 16 wk max Caution:[B, ?] Contra: Component sensitivity Disp: Single-dose packets 5% (250 mgcream) SE: Local skin rxns Notes: Not a cure; may weaken condoms/vaginal diaphragms,wash hands before & after useImmune Globulin, IV (Gamimune N, Sandoglobulin, GammarIV) Uses: *IgG Ab deficiency Dz states, (eg, congenital agammaglobulinemia,CVH, & BMT), HIV, Hep A prophylaxis, ITP* Action: IgG supl Dose:Adults & Peds. Immunodeficiency: 100–200 mg/kg/mo IV at 0.01–0.04mL/kg/min to 400 mg/kg/dose max. ITP: 400 mg/kg/dose IV daily × 5 d. BMT:500 mg/kg/wk; ↓ in renal insuff Caution: [C, ?] Separate administration of livevaccines by 3 mo Contra: IgA deficiency w/ Abs to IgA, severe thrombocytopeniaor coagulation disorders Disp: Inj SE: Associated mostly w/inf rate; GI upsetImmune Globulin, Subcutaneous (Vivaglobin) Uses: *Primaryimmunodeficiency* Action: IgG supl Dose: 100–200 mg/kg BW subQ weekly abdomen,thighs, upper arms, or lateral hip Caution: [C, ?] Contra: Hx anaphylaxisto immune globulin; some IGA deficiency Disp: 10- & 20-mL vials w/160mg/IgG/mL SE: Inj site Rxns, HA, GI complaint, fever, N, D, rash, sore throatNotes: May instruct in home administration; keep refrigerated; discard unused drugInamrinone [Amrinone] (Inocor) Uses: *Acute CHF, ischemic cardiomyopathy*Action: Inotrope w/ vasodilator Dose: IV bolus 0.75 mg/kg over2–3 min; maint 5–10 mcg/kg/min, 10 mg/kg/d max; ↓ if ClCr < 10 mL/min Caution:[C, ?] Contra: Bisulfite allergy Disp: Inj 5 mg/mL SE: Monitor fluid, electrolyte,& renal changes Notes: Incompatible w/ dextrose solns, LFTs, observefor arrhythmiasIndapamide (Lozol) Uses: *HTN, edema, CHF* Action: Thiazide diuretic;↑ Na, Cl, & H 2 O excretion in distal tubule Dose: 1.25–5 mg/d PO Caution: