Clinician's Pocket Drug Reference 2008

Mesalamine 139tigue, arthralgia, Guillain-Barré Notes: Keep epi available for Rxns; use polysaccharide> 55 yMeningococcal Polysaccharide Vaccine (Menomune A/C/Y/W-135) Uses: *Immunize against N. meningitidis (meningococcus)* Action:Active immunization Dose: Adults & Peds >2 y. 0.5 mL SQ (not IM, intradermally,IV) may repeat 3–5 yrs if high risk Caution: [C, ?/–] Contra: Thimerosal/latex/sensitivity; w/ pertussis or typhoid vacc, < 2 yo Disp: Inj SE: Local inj siteRxns, HA Notes: Preferred in > 55 y, conjugate vaccine (Menactra) in 11–55 y; activeagainst serotypes A, C, Y, & W-135; not group B; keep epi (1:1000) availablefor RxnsMeperidine (Demerol) [C–II] Uses: *Moderate–severe pain* Action:Narcotic analgesic Dose: Adults. 50–150 mg PO or IM/SQ q3–4h PRN. Peds.1–1.5 mg/kg/dose PO or IM/SQ q3–4h PRN, up to 100 mg/dose; ↓ in elderly/renalimpair Caution: [C/D (prolonged use or high dose at term), +] ↓ Sz thresholdContra: w/ MAOIs, renal failure Disp: Tabs 50, 100 mg; syrup 50 mg/5 mL; inj10, 25, 50, 75, 100 mg/mL SE: Resp depression, Szs, sedation, constipation Notes:Analgesic effects potentiated w/ hydroxyzine; 75 mg IM = 10 mg morphine IMMeprobamate (Equinil, Miltown) [C-IV] Uses: *Short-term reliefof anxiety* Action: Mild tranquilizer; antianxiety Dose: Adults. 400 mg POtid–qid, max 2400 mg/d. Peds 6–12 y. 100–200 mg bid–tid; ↓ in renal/liver impairCaution: [D, +/–] Contra: NAG, porphyria, PRG Disp: Tabs 200, 400 mg SE:Drowsiness, syncope, tachycardia, edemaMercaptopurine [6-MP] (Purinethol) Uses: *Acute leukemias,*2nd-line Rx of CML & NHL, maint ALL in children, immunosuppressant w/ autoimmuneDzs (Crohn Dz) Action: Antimetabolite, mimics hypoxanthine Dose:Adult: 80–100 mg/m 2 /d or 2.5–5 mg/kg/d; maint 1.5–2.5 mg/kg/d; w/ allopurinoluse 67–75% ↓ dose of 6-MP (interference w/ xanthine oxidase metabolism); Peds:per protocol ↓ w/renal/hepatic insuff; on empty stomach Caution: [D, ?] Contra:Severe hepatic Dz, BM suppression, PRG Disp: Tabs 50 mg SE: Mild hematotox,mucositis, stomatitis, D rash, fever, eosinophilia, jaundice, hepatitis Notes: Handleproperly; limit use to experienced physicians; ensure adequate hydrationMeropenem (Merrem) Uses: *IntraAbd Infxns, bacterial meningitis*Action:Carbapenem; ↓ cell wall synth, a β-lactam. Spectrum: Excellent gram (+)(except MRSA & E. faecium); excellent gram(–) including extended-Spectrumβ-lactamase producers; good anaerobic Dose: Adults. 1 to 2 g IV q8h. Peds. >3mo,