Clinician's Pocket Drug Reference 2008

136 Lymphocyte Immune Globulintion, intracranial lesion, AUB, hormone-dependent GU tumor, ovarian cyst, PRGDisp: Inj 75 units SE: HA, N, ovarian hyperstimulation synd, breast pain, ovariancysts; ↑ risk of multiple births Notes: Rotate inj sites; do not exceed 14 d durationunless signs of imminent follicular developmentLymphocyte Immune Globulin [Antithymocyte Globulin,ATG] (Atgam) WARNING: Should only be used by physician experiencedin immunosuppressive TX or management of solid organ and/or bone marrowtransplant patients. Adequate lab and supportive medical resources must be readilyavailable in the facility for patient management Uses: *Allograft rejection intransplant pts; aplastic anemia if not candidates for BMT* Action: ↓ circulatingT lymphocytes Dose: Adults. Prevent rejection: 15 mg/kg/day IV ×14 d, then qod×7; initial w/in 24 h before/after transplant. Rx rejection: Same except use 10–15mg/kg/d; max 28 doses in 21 d. Peds. 5–25 mg/kg/d IV. Caution: [C, ?] Contra:Hx Rxn to other equine g-globulin preparation, leukopenia, thrombocytopeniaDisp: Inj 50 mg/mL SE: D/C w/ severe thrombocytopenia/leukopenia; rash, fever,chills, ↓ BP, HA, ↑ K + Notes: Test dose: 0.1 mL 1:1000 dilution in NSMagaldrate (Riopan, Lowsium) [OTC] Uses: *Hyperacidity associatedw/ peptic ulcer, gastritis, & hiatal hernia* Action: Low-Na antacid Dose:5–10 mL PO between meals & hs Caution: [B, ?] Contra: Ulcerative colitis, diverticulitis,ileostomy/colostomy, renal insuff (Mg content) Disp: Susp (OTC) SE:GI upset Notes: < 0.3 mg Na/tab or tspMagnesium Citrate (various) [OTC] Uses: *Vigorous bowel preparation*;constipation Action: Cathartic laxative Dose: Adults. 120–300 mL PO PRN.Peds. 0.5 mL/kg/dose, to 200 mL PO max; w/ a beverage Caution: [B, +] Contra:Severe renal Dz, heart block, N/V, rectal bleeding Disp: Effervescent soln (OTC)SE: Abd cramps, gasMagnesium Hydroxide (Milk of Magnesia) [OTC] Uses: *Constipation*,hyperacidity, Mg replacement Action: NS Laxative Dose: Adults.Antacid 5–15 mL PO PRN qid, 2–4 tab PO PRN QID; Laxative 30–60 mL POdaily or in ÷ doses Peds. < 2 yrs 0.5 mL/kg/dose PO PRN; (follow dose w/ 8 oz ofH 2 O Caution: [B, +] Contra: Renal insuff, intestinal obst, ileostomy/colostomyDisp: Chew tabs 311 mg; liq 400, 800 mg/5 mL (OTC) SE: D, abd crampsMagnesium Oxide (Mag-Ox 400, others) [OTC] Uses: *Replacelow Mg levels* Action: Mg supl Dose: 400–800 mg/d ÷ daily–qid w/ fullglass of H 2 O Caution: [B, +] Contra: Ulcerative colitis, diverticulitis,ileostomy/colostomy, heart block, renal insuff Disp: Caps 140 mg; tabs 400 mg(OTC) SE: D, NMagnesium Sulfate (various) Uses: *Replace low Mg +2 ; preeclampsia& premature labor, cardiac arrest; AMI*; refractory ↓ K + & ↓ Ca 2+ Action: Mg+2supl Dose: Adults. 3 gm PO q6h × 4 PRN; Supl: 1–2 g IM or IV; repeat PRN.Preeclampsia/premature labor: 4 g load then 1–4 g/h IV inf; Cardiac arrest: 1–2 gIV push (2–4 mL 50% soln) in 10 mL D5W AMI: Load 1–2 g in 50–100 mL D5W,