Clinician's Pocket Drug Reference 2008

140 Mesnadoses (tid–qid); delayed release 2.4–4.8 g PO daily 8 wk max, do notcut/crush/chew w/food; ↓ initial dose in elderly Caution: [B, M] Contra: Salicylatesensitivity Disp: Tabs 400 mg; caps 250, 500 mg; delayed release tab (Lialda)1.2 g; supp 500, 1000 mg; rectal susp 4 g/60 mL SE: Yellow-brown urine, HA,malaise, abd pain, flatulence, rash, pancreatitis, pericarditisMesna (Mesnex) Uses: *Prevent hemorrhagic cystitis due to ifosfamide orcyclophosphamide* Action: Antidote, reacts with acrolein and other metabolitesto form stable compounds Dose: Per protocol; dose as % of ifosfamide or cyclophosphamidedose IV bolus: 20% (eg, 10–12 mg/kg) IV at 0, 4 and 8 h, then40% at 0, 1, 4 and 7 h; IV inf: 20% prechemo, 50–100% w/chemo, then 25–50%for 12 h following chemo; Oral: 20% IV dose at hour 0, 4, and 8 h (mix with juice)Caution: [B; ?/–] Contra: Thiol sensitivity Disp: Inj 100 mg/mL; tablets 400 mgSE: ↓ BP, allergic Rxns, HA, GI upset, taste perversion Notes: Hydration helps ↓hemorrhagic cystitis; higher dose for BMTMesoridazine (Serentil) WARNING: Can prolong QT interval in doserelatedfashion; torsades de pointes reported Uses: *Schizophrenia,* acute &chronic alcoholism, chronic brain synd Action: Phenothiazine antipsychotic Dose:Initial, 25–50 mg PO or IV tid; ↑ to 300–400 mg/d max Caution: [C, ?/–] Contra:Phenothiazine sensitivity, coadministration w/ drugs that cause QT c prolongation,CNS depression Disp: Tabs 10, 25, 50, 100 mg; PO conc 25 mg/mL; inj 25 mg/mLSE: Low incidence of EPS; ↓ BP, xerostomia, constipation, skin discoloration,tachycardia, lowered Sz threshold, blood dyscrasias, pigmentary retinopathy athigh dosesMetaproterenol (Alupent, Metaprel) Uses: *Asthma & reversiblebronchospasm* Action: Sympathomimetic bronchodilator Dose: Adults. Inhal:1–3 inhal q3–4h, 12 inhal max/24 h; wait 2 min between inhal. PO: 20 mg q6–8h.Peds. Inhal: 0.5 mg/kg/dose, 15 mg/dose max inhaled q4–6h by neb or 1–2 puffsq4–6h. PO: 0.3–0.5 mg/kg/dose q6–8h Caution: [C, ?/–] Contra: Tachycardia,other arrhythmias Disp: Aerosol 0.65 mg/inhal; soln for inhal 0.4%, 0.6%; tabs 10,20 mg; syrup 10 mg/5 mL SE: Nervousness, tremor, tachycardia, HTN Notes:Fewer β 1 effects than isoproterenol & longer actingMetaxalone (Skelaxin) Uses: *Painful musculoskeletal conditions* Action:Centrally acting skeletal muscle relaxant Dose: 800 mg PO tid–qid Caution:[C, ?/–] anemia Contra: Severe hepatic/renal impair Disp: Tabs 400, 800 mg SE:N/V, HA, drowsiness, hepatitisMetformin (Glucophage, Glucophage XR) WARNING: Associatedw/ lactic acidosis Uses: *Type 2 DM* Action: ↓ Hepatic glucose production& intestinal absorption of glucose; ↑ insulin sensitivity Dose: Adults. Initial:500 mg PO bid; or 850 mg daily, may ↑ to 2,550 mg/d max; take w/ AM & PMmeals; can convert total daily dose to daily dose of XR Peds 10–16 y. 500 mg PObid, ↑ 500 mg/wk to 2,000 mg/d max in ÷ doses; do not use XR formulation inpeds Caution: [B, +/–] avoid EtOH; hold dose before & 48 h after ionic contrast