Clinician's Pocket Drug Reference 2008

148 Multivitamins, Oral OTC(+) except MRSA & E. faecium; good gram (–) except P. aeruginosa, S. maltophilia,& Acinetobacter sp; good anaerobic coverage Dose: 400 mg/d PO/IV;avoid cation products, antacids. Ophth: 1 gtt tid X7d; take PO 4 h before or 8 hafter antacids Caution: [C, ?/–] Quinolone sensitivity; interactions w/ Mg-, Ca-,Al-, Fe-containing products & class IA & III antiarrhythmic agents Contra:Quinolone/component sensitivity Disp: Tabs 400 mg, inj, ophth 0.5% SE: Dizziness,N, QT prolongation, Szs, photosens, tendon ruptureMultivitamins, Oral [OTC] (Table 13, page 243)Mupirocin (Bactroban) Uses: *Impetigo; eradicate MRSA in nasal carriers*Action: ↓ bacterial protein synth Dose: Topical: Apply small amount to area 3 ×/day× 5–14 d. Nasal: Apply bid in nostrils × 5d Caution: [B, ?] Contra: Do not use w/other nasal products Disp: Oint 2%; cream 2% SE: Local irritation, rash. Notes: Instructpatient to c ontact health-care provider if no improvement in 3–5 days.Muromonab-CD3 (Orthoclone OKT3) WARNING: Can cause anaphylaxis;monitor fluid status Uses: *Acute rejection following organ transplantation*Action: Murine Ab, blocks T-cell Fxn Dose: Per protocol Adults. 5 mg/dIV for 10–14 d. Peds. 0.1 mg/kg/d IV for 10–14 d Caution: [C, ?/–]w/hx of Szs,PRG, uncontrolled HTN, Contra: Murine sensitivity, fluid overload Disp: Inj 5mg/5 mL SE: Anaphylaxis, pulm edema, fever/chills w/1st dose (premedicate w/steroid/APAP/antihistamine) Notes: Monitor during inf; use 0.22-micron filterMycophenolic Acid (Myfortic) WARNING: ↑ Risk of Infxns, possibledevelopment of lymphoproliferative disorders Uses: *Prevent rejection afterrenal transplant* Action: Cytostatic to lymphocytes Dose: Adults. 720 mg PObid; Peds. BSA 400 mg/m 2 : max 720 mg BID; ↓ in renal insuff/neutropenia; takeon empty stomach Caution: [C, ?/–] Contra: Component allergy Disp: DR tabs180, 360 mg SE: N/V/D, pain, fever, HA, Infxn, HTN, anemia, leukopenia,edemaMycophenolate Mofetil (CellCept) WARNING: ↑ Risk of Infxns,possible development of lymphoma Uses: *Prevent organ rejection after transplant*Action: ↓ immunologically mediated inflammatory responses Dose:Adults. 1 g PO bid; Peds. BSA 1.2–1.5 m 2 : 750 mg PO bid; BSA >1.5 m 2 : 1 g PObid; may taper up to 600 mg/m 2 PO bid; used w/ steroids & cyclosporine; ↓ inrenal insuff or neutropenia. IV: Infuse over > 2 h. PO: Take on empty stomach, donot open capsules Caution: [C, ?/–] Contra: Component allergy; IV use inpolysorbate 80 allergy Disp: Caps 250, 500 mg; susp 200 mg/mL, inj 500 mg SE:N/V/D, pain, fever, HA, Infxn, HTN, anemia, leukopenia, edemaNabilone (Cesamet) [CII] WARNING: Psychotomimetic rxns, may persistfor 72 h following D/C; caregivers should be present during initial use ordosage modification; patients should not operate heavy machinery; avoid alcohol,sedatives, hypnotics, other psychoactive substances Uses: *Refractory chemo-inducedemesis* Action: Synthetic cannabinoid Dose: Adults. 1 – 2 mg PO bid 1–3 hbefore chemo, 6 mg/d max; may continue for 48 h beyond final chemo dose