Clinician's Pocket Drug Reference 2008

Medroxyprogesterone 137over 5–60 min IV; then 0.5–1.0 g/h IV up to 24 h (ECC 2005) Peds. 25–50mg/kg/dose IM or IV q4–6h for 3–4 doses; repeat PRN; ↓ dose w/ low urine outputor renal insuff Caution: [B, +] Contra: Heart block, renal failure Disp: Inj 10, 20,40, 80, 125, 500 mg/mL; bulk powder SE: CNS depression, D, flushing, heartblockMannitol (various) Uses: *Cerebral edema, ↑ intraocular pressure, renalimpair, poisonings* Action: Osmotic diuretic Dose: Test dose: 0.2 g/kg/dose IVover 3–5 min; if no diuresis w/in 2 h, D/C. Oliguria: 50 g–100 g IV over 90 min; ↑IOP: 0.5–2 gm/kg IV over 30 min. Cerebral edema: 0.25–1.5 g/kg/dose IV > 30min. Caution: [C, ?] w/ CHF or volume overload Contra: Anuria, dehydration,heart failure, PE Disp: Inj 5, 10, 15, 20, 25% SE: May exacerbate CHF, N/V/DNotes: Monitor for volume depletionMeasles, Mumps, Rubella and Varicella Virus Vaccine Live[MMRV] (Proquad) Uses: *Vaccination against measles, mumps, rubella,& varicella 12 mo–12 y or for second dose of MMR* Action: Active immunization,live attenuated viruses Dose: 1 vial SQ inj Caution: [N/A] Hx of cerebral injuryor Szs (febrile rxn) Contra: Hx anaphylaxis to neomycin, blood dyscrasia,lymphoma, leukemia, w/immunosuppression, febrile illness, untreated TB Disp:Inj SE: Fever, inj site Rxn, rash Notes: Allow 1 mo between inj & any othermeasles vaccine; limited avail; substitute MMR II or VarivaxMecasermin (Increlex) Uses: *Growth failure in IGF-1 deficiency orHGH antibodies* Action: Human IGF-1 Dose: Peds. 0.04–0.08 mg/kg SQ BID;may ↑ by 0.04 mg/kg to 0.12 mg/kg; take w/in 20 min of meal Caution: [C,+/–]Disp: Vial 40 mg SE: HA, inj site rxn, V, hypoglycemia Notes: Rapid dose ↑ maycause hypoglycemia; limited distributionMechlorethamine (Mustargen) WARNING: Highly toxic, handle w/care, limit use to experienced physicians Uses: *Hodgkin Dz & NHL, cutaneousT-cell lymphoma (mycosis fungoides), lung CA, CML, malignant pleural effusions,*& CLL Action: Alkylating agent, bifunctional Dose: Per protocol; 0.4mg/kg single dose or 0.1 mg/kg/d for 4 d; 6 mg/m 2 1–2 × mo Caution: [D, ?] Contra:Known infectious Dz Disp: Inj 10 mg SE: ↓ BM, thrombosis, thrombophlebitisat site; tissue damage w/ extrav (Na thiosulfate used topically to Rx);N/V, skin rash, amenorrhea, sterility (especially in men), secondary leukemia iftreated for Hodgkin Dz Notes: Highly volatile; give w/in 30–60 min of prepMeclizine (Antivert) Uses: *Motion sickness, vertigo* Action: Antiemetic,anticholinergic, & antihistaminic properties Dose: Adults & Peds >12 y 12.5–100mg PO tid–qid PRN Caution: [B, ?] Disp: Tabs 12.5, 25, 50 mg; chew tabs 25 mg;caps 25, 30 mg (OTC) SE: Drowsiness, xerostomia, & blurred visionMedroxyprogesterone (Provera, Depo-Provera) WARNING:May cause loss of bone density; associated w/duration of use Uses: *Contraception;secondary amenorrhea, AUB caused by hormonal imbalance; endometrialCA* Action: Progestin supl Dose: Contraception: 150 mg IM q3mo depo or 104