Clinician's Pocket Drug Reference 2008

154 Nicotine Nasal SprayNicotine Nasal Spray (Nicotrol NS) Uses: *Aid to smoking cessation,relieve nicotine withdrawal* Action: Systemic delivery of nicotine Dose: 0.5mg/actuation; 1–2 sprays/h, 10 sprays/h max Caution: [D, M] Contra: Lifethreateningarrhythmias, unstable angina Disp: Nasal inhaler 10 mg/mL SE: Localirritation, tachycardia, HA, taste perversion Notes: Must stop smoking & performbehavior modification for max effectNicotine Transdermal (Habitrol, Nicoderm CQ [OTC],Nicotrol [OTC], others) Uses: *Aid to smoking cessation; relief of nicotinewithdrawal* Action: Systemic delivery of nicotine Dose: Individualized;1 patch (14–21 mg/d), & taper over 6 wk Caution: [D, M] Contra: Life-threateningarrhythmias, unstable angina Disp: Habitrol & Nicoderm CQ 7, 14, 21 mg of nicotine/24h; Nicotrol 5, 10, 15 mg/24 h SE: Insomnia, pruritus, erythema, local siteRxn, tachycardia Notes: Nicotrol worn for 16 h to mimic smoking patterns; othersworn for 24 h; must stop smoking & perform behavior modification for max effectNifedipine (Procardia, Procardia XL, Adalat, Adalat CC)Uses: *Vasospastic or chronic stable angina & HTN*; tocolytic Action: CCBDose: Adults. SR tabs 30–90 mg/d. Tocolysis: 10–20 mg PO q4–6h. Peds. 0.6–0.9mg/kg/24 h ÷ tid–qid Caution: [C, +] Heart block, aortic stenosis Contra: Immediate-releasepreparation for urgent or emergent HTN; acute MI Disp: Caps 10, 20mg; SR tabs 30, 60, 90 mg SE: HA common on initial Rx; reflex tachycardia mayoccur w/ regular release dosage forms; peripheral edema, ↓ BP, flushing, dizzinessNotes: Adalat CC & Procardia XL not interchangeable; SL administration not OKNilutamide (Nilandron) WARNING: Interstitial pneumonitis possible;most cases in 1st 3 mo; follow CXR before Rx Uses: *Combo w/ surgical castrationfor met CAP* Action: Nonsteroidal antiandrogen Dose: 300 mg/d PO in ÷doses × 30 d, then 150 mg/d Caution: [not used in females] Contra: Severe hepaticimpair, resp insuff Disp: Tabs 150 mg SE: Interstitial pneumonitis, hotflashes, ↓ libido, impotence, N/V/D, gynecomastia, hepatic dysfunction Notes:May cause Rxn when taken w/ EtOH, follow LFTNimodipine (Nimotop) Uses: *Prevent vasospasm following subarachnoidhemorrhage* Action: CCB Dose: 60 mg PO q4h for 21 d; ↓ in hepatic failure Caution:[C, ?] Contra: Component allergy Disp: Caps 30 mg SE: ↓ BP, HA, constipationNotes: Give via NG tube if caps cannot be swallowed whole, PO administration onlyNisoldipine (Sular) Uses: *HTN* Action: CCB Dose: 10–60 mg/d PO;do not take w/ grapefruit juice or high-fat meal; ↓ start doses w/ elderly or hepaticimpair Caution: [C, ?] Disp: ER tabs 10, 20, 30, 40 mg SE: Edema, HA, flushingNitazoxanide (Alinia) Uses: *Cryptosporidium or Giardia-induced D inpts 1–11 y* Action: Antiprotozoal interferes w/ pyruvate ferredoxin oxidoreductaseSpectrum: Cryptosporidium, Giardia Dose: Peds 12–47 mo. 5 mL (100 mg)PO q 12h × 3 d. 4–11 y: 10 mL (200 mg) PO q 12h × 3 d; ≥ 12 y: 500 mg q12º for3 days take w/ food Caution: [B, ?] Disp: 100 mg/5 mL PO susp, 500 tab SE: Abdpain Notes: Susp contains sucrose, interacts w/ highly protein-bound drugs