Clinician's Pocket Drug Reference 2008

Letrozole 129H. pylori Infxn, erosive esophagitis, & hypersecretory conditions, GERD Action:Proton pump inhibitor Dose: 15–30 mg/d PO; NSAID ulcer prevention 15 mg/dPO ≤12 wk, NSAID ulcers 30 mg/d PO, × 8 wk; 30 mg IV daily ≤7 d change to POfor 6–8 wk; ↓ in severe hepatic impair Caution: [B, ?/–] Disp: Caps 15, 30 mg;granules for susp 15, 30 mg, IV 30 mg; OD tabs 15, 30 mg SE: HA, fatigue Notes:For IV provided in-line filter must be usedLanthanum Carbonate (Fosrenol) Uses: *Hyperphosphatemia inrenal disease * Action: Phosphate binder Dose: 750–1500 mg PO daily ÷ doses,w/ or immed after meal; titrate every 2–3 wk based on PO –2 4 levels Caution:[C, ?/–] No data in GI disease Disp: Chew tabs 250, 500, 750, 1000 mg SE: N/V,graft occlusion, HA ↓ BP Notes: Chew tabs before swallowing; separate frommeds that interact with antacids by 2 hLapatinib (Tykerb) Uses: *Advanced breast CA w/capecitabine w/tumorsthat overexpress HER2 and have failed therapy w/ anthracycline, taxane, andtrastuzumab* Action: Tyrosine kinase inhibitor Dose: Per protocol, 1250 mg POdays 1–21 w/capecitabine 2000 mg/m2/day divided 2 doses/day day 1–14 Caution:[D; ?] avoid CYP3A4 inhibitors Contra: w/ phenothiazines Disp: Tabs 250mg SE: N/V/D, anemia, ↓ plt, neutropenia, hand-foot synd, ↑ LFTs, rash, ↓ LVEFNotes: Consider baseline LVEF and periodic ECGLatanoprost (Xalatan) Uses: *Open angle glaucoma, ocular HTN* Action:Prostaglandin, ↑ outflow of aqueous humor Dose: 1 gtt eye(s) hs Caution: [C, ?] Disp:0.005% soln SE: May darken light irides; blurred vision, ocular stinging, & itchingLeflunomide (Arava) WARNING: PRG must be excluded prior to startof Rx Uses: *Active RA* Action: ↓ Pyrimidine synth Dose: Initial 100 mg/d POfor 3 d, then 10–20 mg/d Caution: [X, –] Contra: PRG Disp: Tabs 10, 20, 100 mgSE: D, Infxn, HTN, alopecia, rash, N, joint pain, hepatitis Notes: Monitor LFTsduring initial therapyLenalidomide (Revlimid) WARNING: Significant teratogen; patientmust be enrolled in RevAssist risk reduction program Uses: *MDS* multiplemyeloma Action: Thalidomide analog, immune modulator Dose: Adults. 10 mgPO daily; swallow whole w/water Caution: [X,–] w/ renal impair Disp: Caps 5,10, 15, 25 mg SE: D, pruritus, rash, fatigue, ↓ BM, thromboembolism, ↑ LFTNotes: Monitor CBC and for thromboembolism, hepatotoxicity; routine PRG testsrequired; Rx only in 1-mo increments; limited distribution network; males mustuse condom and not donate sperm; use contraception at least 4 wks beyond D/CLepirudin (Refludan) Uses: *HIT* Action: Direct thrombin inhibitorDose: Bolus 0.4 mg/kg IV, then 0.15 mg/kg/h inf (↓ dose & inf rate if CrCl < 60mL/min) Caution: [B, ?/–] Hemorrhagic event or severe HTN Contra: Activebleeding Disp: Inj 50 mg SE: Bleeding, anemia, hematoma Notes: Adjust basedon aPTT ratio, maintain aPTT 1.5–2.0Letrozole (Femara) Uses: *Advanced breast CA in postmenopausal* Action:Nonsteroidal aromatase inhibitor Dose: 2.5 mg/d PO Caution: [D, ?] Con-