Clinician's Pocket Drug Reference 2008

134 Lithium Carbonatetion: [D, –] Contra: ACE inhibitor sensitivity Disp: Tabs 2.5, 5, 10, 20, 30, 40 mgSE: Dizziness, HA, cough, ↓ BP, angioedema, ↑ K + Notes: To prevent DN, startwhen urinary microalbuminemia beginsLithium Carbonate (Eskalith, Lithobid, others) Uses: *Manicepisodes of bipolar Dz* Action: Effects shift toward intraneuronal metabolism ofcatecholamines Dose: Adults. Bipolar, acute mania: 1800 mg/day PO in 3 ÷ dosesin desired serum cns. 1–15 mg/L. Bipolar maintenance: 900–1200 /day PO in 2–3÷ dose Peds 2–12 y. 15–60 mg/kg/d in 3–4 ÷ doses; must titrate; ↓ in renal insuff,elderly Caution: [D, –] Many drug interactions Contra: Severe renal impair orCV Dz, lactation Disp: Caps 150, 300, 600 mg; tabs 300 mg; SR tabs 300, CR tabs450 mg; syrup 300 mg/5 mL SE: Polyuria, polydipsia, nephrogenic DI, tremor; Naretention or diuretic use may ↑ tox; arrhythmias, dizziness Notes: Levels: Trough:just before next dose: Therapeutic: 0.8–1.2 mEq/mL; Toxic >2 mEq/mL; 1 ⁄2 life:18–20hLodoxamide (Alomide) Uses: *Vernal conjunctivitis/keratitis* Action:Stabilizes mast cells Dose: Adults & Peds >2 y. 1–2 gtt in eye(s) qid ≤3 mo Caution:[B, ?] Disp: Soln 0.1% SE: Ocular burning, stinging, HALomefloxacin (Maxaquin) Uses: *UTI, acute exacerbation of chronicbronchitis; prophylaxis in transurethral procedures* Action: Quinolone antibiotic;↓ DNA gyrase. Spectrum: Good gram(–) including H. influenzae exceptStenotrophomonas maltophilia, Acinetobacter sp, & some P. aeruginosa Dose: 400mg/d PO; ↓ w/renal insuff, avoid antacids Caution: [C, –] Interactions w/ cationcontainingproducts Contra: Quinolone allergy, children < 18 y,↑ Qt interval, ↓K +Disp: Tabs 400 mg SE: N/V/D, abd pain, photosens, Szs, HA, dizziness, tendonrupture, peripheral neuropathy, pseudomembranous colitis, anaphylaxis,Loperamide (Imodium) [OTC] Uses: *D* Action: Slows intestinalmotility Dose: Adults. Initial 4 mg PO, then 2 mg after each loose stool, up to 16mg/d. Peds. 2–5 y, 13–20 kg: 1 mg PO tid. 6–8 y, 20–30 kg: 2 mg PO bid. 8–12 y,>30 kg: 2 mg PO tid Caution: [B, +] Not for acute D caused by Salmonella,Shigella, or C. difficile Contra: Pseudomembranous colitis, bloody D Disp: Caps2 mg; tabs 2 mg; liq 1 mg/5 mL (OTC) SE: Constipation, sedation, dizzinessLopinavir/Ritonavir (Kaletra) Uses: *HIV Infxn* Action: Proteaseinhibitor Dose: Adults. TX naïve: 2 tab PO daily or 1 tab PO bid; TX experiencedpt: 1 tab PO bid (↑ dose if w/ amprenavir, efavirenz, fosamprenavir, nelfinavir,nevirapine). Peds. 7–15 kg: 12/3 mg/kg PO bid. 15–40 kg: 10/2.5 mg/kg PO bid.>40 kg: Adult dose; w/ food Caution: [C, ?/–] Numerous interactions Contra:w/drugs dependent on CYP3A/CYP2D6 (Table 11) Disp: (mg lopinavir/ritonavir)Tab 200/50, soln 400/100/5 mL SE: Avoid disulfiram (soln has ETOH), metronidazole;GI upset, asthenia, ↑ cholesterol/triglycerides, pancreatitis; protease metabolicsyndLoracarbef (Lorabid) Uses: *Upper & lower resp tract, skin, urinarytract* Action: 2nd-gen cephalosporin; ↓ cell wall synth. Spectrum: Weaker than