Clinician's Pocket Drug Reference 2008

Influenza Vaccine 121[D, ?] ↑ effect w/ loop diuretics, ACE inhibitors, cyclosporine, digoxin, Li Contra:Anuria, thiazide/sulfonamide allergy, renal insuff, PRG Disp: Tabs 1.25, 2.5 mgSE: ↓ BP, dizziness, photosens Notes: No additional effects w/ doses > 5 mg; takeearly to avoid nocturia; use sunscreen; OK w/ food/milkIndinavir (Crixivan) Uses: *HIV Infxn* Action: Protease inhibitor;↓ maturation of noninfectious virions to mature infectious virus Dose: 800 mg POq8h; in combo w/ other antiretrovirals; on empty stomach; ↓ w/hepatic impairCaution: [C, ?] Numerous drug interactions Contra: w/ triazolam, midazolam, pimozide,ergot alkaloids, simvastatin, lovastatin, sildenafil, St. John’s wort, amiodaroneDisp: Caps 100, 200, 333, 400 mg SE: Nephrolithiasis, dyslipidemia,lipodystrophy, GI effects Notes: Drink six 8-oz glasses of H 2 O/dIndomethacin (Indocin) WARNING: May ↑ risk of cardiovascularevents & GI bleeding Uses: *Arthritis; close ductus arteriosus; ankylosingspondylitis* Action: ↓ prostaglandins Dose: Adults. 25–50 mg PO bid–tid, max200 mg/d. Infants: 0.2–0.25 mg/kg/dose IV; may repeat in 12–24 h up to 3 doses;w/ food Caution: [B, +] Contra: ASA/NSAID sensitivity, peptic ulcer/active GIbleed, precipitation of asthma/urticaria/rhinitis by NSAIDs/aspirin, prematureneonates w/ NEC, ↓ renal Fxn, active bleeding, thrombocytopenia, 3rd tri PRGDisp: Inj 1 mg/vial; caps 25, 50 mg; SR caps 75 mg; susp 25 mg/5 mL SE: GIbleeding or upset, dizziness, edema Notes: Monitor renal FxnInfliximab (Remicade) WARNING: TB, invasive fungal Infxns, & otheropportunistic Infxns reported, some fatal; perform TB skin testing prior to use;possible association with rare lymphoma Uses: *Moderate–severe Crohn Dz; fistulizingCrohn Dz; ulcerative colitis; RA (w/ MTX) psoriasis, ankylosing spondylitis*Action: IgG1K neutralizes TNF-α Dose: Adult: Crohn Dz: Induction: 5mg/kg IV inf, w/doses 2 & 6 wk after. Maint: 5 mg/kg IV inf q8wk. RA: 3 mg/kgIV inf at 0, 2, 6 wk, then q8wk Peds > 6 yo: 5 mg/kg IV q 8 wk Caution: [B, ?/–]Active Infxn, hepatic impairment, Hx or risk of TB, Hep B Contra: Murine allergy,moderate–severe CHF, live w/ live vaccines (eg, smallpox) Disp: 100 mg InjSE: Allergic Rxns; HA, fatigue, GI upset, infusion Rxns; hepatotoxicity; reactivationHep B, pneumonia, BM suppression, systemic vasculitis, pericardial effusionNotes: Monitor LFTs, PPD at baseline, monitor HepB carrier, skin exam for malignancyw/psoriasisInfluenza Vaccine (Fluarix, Flulaval, Fluzone, Fluvirin) Uses:*Prevent influenza* in adults >50 y, children 6–23 mo, pregnant women (2nd/3rdtri during flu season), nursing home residents, chronic Dzs, health-care workers,household contacts of high-risk pts, children < 9 y receiving vaccine for the firsttime Action: Active immunization Dose: Adults and Peds > 9 y. 0.5 mL/dose IMannually Peds.6 mo > 3 y: 0.25 mL IM annually; 0.25 mL IM x2 doses > 4 wkapart 1st vacc; give 2 doses in 2nd vacc. year if only 1 dose given in 1st year–;3–8 y 0.5 mL IM annually, start 0.5 mL IM × 2 doses 4> wks >in 1st vacc yearCaution: [C, +] Contra: Egg, gentamicin, or thimerosal allergy, Infxn at site,