Clinician's Pocket Drug Reference 2008

144 Mexiletinetid for 7 d or 2 g PO × 1. C. difficile: 500 mg PO or IV q8h for 7–10 d (PO preferred;IV only if pt NPO). Vaginosis: 1 applicatorful intravag bid or 500 mg PObid for 7 d. Acne rosacea/skin: Apply bid. Peds. 30 mg/ kg PO/IV/day dividedq6H, 4 gm day max÷. Amebic dysentery: 35–50 mg/kg/24 h PO in 3 ÷ doses for5–10 d;, Rx 7-10 day for c. diff; ↓ in hepatic impair Caution: [B, M] Avoid EtOHContra: First tri of PRG Disp: Tabs 250, 500 mg; XR tabs 750 mg; caps 375 mg;IV 500 mg/100mL; topical lotion & gel 0.75%; intravag gel 0.75% (5 g/applicator37.5 mg in 70-g tube), cream 1% SE: Disulfiram-like Rxn; dizziness, HA, GIupset, anorexia, urine discoloration Notes: For trichomoniasis, Rx pt’s partner; noaerobic bacteria activity; use in combo w/ serious mixed InfxnsMexiletine (Mexitil) WARNING: Mortality risks noted for flecainide and/orencanite (type 1 anti-arrhythmics). Reserve for use in patients with life-threatening VentricularArrhythmias Uses: *Suppress symptomatic ventricular arrhythmias*; diabeticneuropathy Action: Class IB antiarrhythmic (Table 10) Dose: Adults. 200–300 mg POq8h; 1200 mg/d max. Peds. 2.5–5 mg/kg PO q 8h; w/ food or antacids Caution: [C, +]May worsen severe arrhythmias; interacts w/ hepatic inducers & suppressors (dosagechanges) Contra: Cardiogenic shock or 2nd-/3rd-degree AV block w/o pacemakerDisp: Caps 150, 200, 250 mg SE: Lightheadedness, dizziness, anxiety, incoordination,GI upset, ataxia, hepatic damage, blood dyscrasias Notes: monitor LFTs CBCMiconazole (Monistat, others) Uses: *Candidal Infxns, dermatomycoses(various tinea forms)* Action: Fungicide; alters fungal membrane permeabilityDose: Apply to area bid for 2–4 wk. Intravag: 1 applicatorful or supp hs for3 (4% or 200 mg) or 7 d (2% or 100 mg) Caution: [C, ?] Azole sensitivity Disp:Topical cream 2%; lotion 2%; powder 2%; spray 2%; vag supp 100, 200 mg; vagcream 2%, 4% [OTC] SE: Vag burning, may ↑ warfarin Notes: Antagonistic toamphotericin B in vivoMiconazole/zinc oxide/petrolatum (Vusion) Uses: *Candidaldiaper rash* Action: Combo antifungal Dose: Peds > 4 wks: apply at each diaperchange × 7d Caution: [C, ?] Contra: None Disp: Miconazole/zinc oxide/petrolatumoint 0.25%/81.35%/15% SE: None Notes: Keep diaper dryMidazolam [C-IV] Uses: *Preop sedation, conscious sedation for shortprocedures & mechanically ventilated pts, induction of general anesthesia* Action:Short-acting benzodiazepine Dose: Adults. 1–5 mg IV or IM; titrate to effect.Peds. Preop: > 6 mo 0.25–1 mg/kg PO, 20 mg max. Conscious sedation: 0.08mg/kg × 1. > 6 mo 0.1–0.15 mg/kg IM × 1 max 10 mg. General anesthesia: 0.025–0.1 mg/kg IV q2min for 1–3 doses PRN to induce anesthesia (↓ in elderly, w/ narcoticsor CNS depressants) Caution: [D, +/–] w/CYP3A4 substrate (Table 11),multiple drug interactions Contra: NAG; w/amprenavir, nelfinavir, ritonavir Disp:Inj 1, 5 mg/mL; syrup 2 mg/mL SE: Resp depression; ↓ BP w/ conscious sedation,N Notes: Reversal w/ flumazenil; monitor for resp depressionMifepristone [RU 486] (Mifeprex) WARNING: Pt counseling & informationrequired; associated w/ fatal infections & bleeding Uses: *Terminate