Clinician's Pocket Drug Reference 2008

126 Isosorbide MononitrateSL tabs 2.5, 5, mg; SR caps 40 mg SE: HA, ↓ BP, flushing, tachycardia, dizzinessNotes: Higher PO dose needed for same results as SL formsIsosorbide Mononitrate (Ismo, Imdur) Uses: *Prevention/Rx ofangina pectoris* Action: Relaxes vascular smooth muscle Dose: 5–10 mg PO bid,w/ the 2 doses 7 h apart or XR (Imdur) 30–60 mg/d PO, max 240 mg Caution:[C, ?] Contra: Head trauma/cerebral hemorrhage (can ICP), w/ sildenafil, tadalafil,vardenafil Disp: Tabs 10, 20 mg; XR 30, 60, 120 mg SE: HA, dizziness, ↓ BPIsotretinoin [13-cis Retinoic Acid] (Accutane, Amnesteem,Claravis, Sotret) WARNING: Must not be used by PRG females; can inducesevere birth defects; pt must be capable of complying w/ mandatory contraceptivemeasures; prescribed according to product-specific risk managementsystem. Because of teratogenicity, Accutane is approved for marketing only undera special restricted distribution FDA program called iPLEDGE Uses: *Refractorysevere acne* Action: Retinoic acid derivative Dose: 0.5–2 mg/kg/d PO ÷ bid;↓ in hepatic Dz, take w/ food Caution: [X, –] Avoid tetracyclines Contra:Retinoid sensitivity, PRG Disp: Caps 10, 20, 30, 40 mg SE: Rare: Depression,psychosis, suicidal thoughts; derm sensitivity, xerostomia, photosens, LFTs,triglycerides Notes: Risk management program requires 2 (–) PRG tests before Rx& use of 2 forms of contraception 1 mo before, during, & 1 mo after therapy; toprescribe isotretinoin, the Prescriber must access the iPLEDGE system via the Internet(www.ipledgeprogram.com); monitor LFTs & lipidsIsradipine (DynaCirc) Uses: *HTN* Action: CCB Dose: Adults. 2.5–5mg PO bid. Caution: [C, ?] Contra: Severe heart block, sinus bradycardia, CHF,dosing w/in several hours of IV β-blockers Disp: Caps 2.5, 5 mg; tabs CR 5, 10 mgSE: HA, edema, flushing, fatigue, dizziness, palpitationsItraconazole (Sporanox) WARNING: Potential for negative inotropiceffects on the heart; if signs or Sxs of CHF occur during administration, continueduse should be assessed Uses: *Fungal Infxns (aspergillosis, blastomycosis, histoplasmosis,candidiasis)* Action: ↓ ergosterol synth Dose: 200 mg PO or IVdaily–bid (capsule w/ meals or cola/grapefruit juice); PO soln on empty stomach;avoid antacids Caution: [C, ?] Numerous interactions Contra: Inj. if CrCl < 30mL/min, Hx of CHF or ventricular dysfunction, w/ H 2 -antagonist, omeprazoleDisp: Caps 100 mg; soln 10 mg/mL; inj 10 mg/mL SE: N, rash, hepatitis, ↓ K + ,CHF (mostly w/ IV use) Notes: PO soln & caps not interchangeable; useful in ptswho cannot take ampho B, can cause ↑ QTc in combo w/ other drugsKaolin-Pectin (Kaodene, Kao-Spen, Kapectolin) [OTC] Uses: *D*Action: Absorbent demulcent Dose: Adults. 60–120 mL PO after each loose stool orq3-4h PRN. Peds. 3–6 y: 15–30 mL/dose PO PRN. 6–12 y: 30–60 mL/dose PO PRNCaution: [C, +] Contra: D due to pseudomembranous colitis Disp: Multiple OTCforms; also available w/ opium (Parepectolin [CII]) SE: Constipation, dehydrationKetoconazole (Nizoral, Nizoral AD Shampoo) [Shampoo–OTC] Uses: *Systemic fungal Infxns; topical for local fungal Infxns due to der-