Clinician's Pocket Drug Reference 2008

Norepinephrine 155Nitrofurantoin (Macrodantin, Furadantin, Macrobid) WARN-ING: Pulm rxns possible Uses: *Prevention & Rx UTI* Action: Bacteriostatic;interferes w/ carbohydrate metabolism. Spectrum: some gram(+)&(–) bacteria;Pseudomonas, Serratia, & most Proteus-resistant Dose: Adults. Suppression:50–100 mg/d PO. Rx: 50–100 mg PO qid. Peds. Suppression: 1–2 mg/kg/d div. 1–2doses, max 100 mg/day. Rx: 5–7 mg/kg/24 h in 4 ÷ doses (w/ food/milk/antacid)Caution: [B, +] Avoid w/CrCl < 60 mL/min, pregnant at term Contra: Renal failure,infants < 1 mo Disp: Caps 25, 50, 100 mg; susp 25 mg/5 mL SE: GI effects,dyspnea, various acute/chronic pulm rxns, peripheral neuropathy Notes: Macrocrystals(Macrodantin) cause < N than other formsNitroglycerin (Nitrostat, Nitrolingual, Nitro-Bid Ointment,Nitro-Bid IV, Nitrodisc, Transderm-Nitro, others) Uses: *Anginapectoris, acute & prophylactic therapy, CHF, BP control* Action: Relaxes vascularsmooth muscle, dilates coronary arteries Dose: Adults. SL: 1 tab q5 min SL PRNfor 3 doses. Translingual: 1–2 met-doses sprayed onto PO mucosa q3–5 min, max 3doses. PO: 2.5–9 mg tid. IV: 5–20 mcg/min, titrated to effect. Topical: Apply 1 ⁄2 in.of oint to chest wall tid, wipe off at night. TD: 0.2–0.4 mg/h/patch daily; IV bolus:12.5–25 µg; infuse at 10–20 µg/min. SL: 0.3–0.4 mg, repeat q 5 min. Aerosol spray:Spray 0.5–1.0 s at 5-min intervals (ECC 2005) Peds. 0.25–0.5 mcg/kg/min IV,titrate. Caution: [B, ?] Restrictive cardiomyopathy Contra: IV: Pericardial tamponade,constrictive pericarditis. PO: w/ sildenafil, tadalafil, vardenafil, head trauma,NAG Disp: SL tabs 0.3, 0.4, 0.6 mg; translingual spray 0.4 mg/dose; SR caps 2.5,6.5, 9; SR tabs 2.6, 6.5, 9.0 mg; inj 0.1, 0.2, 0.4 mg/mL (premixed); 5 mg/mL injectionsoln; oint 2%; TD patches 0.1, 0.2, 0.4, 0.6 mg/h; buccal CR 2, 3 mg SE: HA,↓ BP, lightheadedness, GI upset Notes: Nitrate tolerance w/ chronic use after 1–2wk; minimize by providing nitrate-free period daily, using shorter-acting nitrates tid,& removing LA patches & oint before sleep to ↓ toleranceNitroprusside (Nipride, Nitropress) Uses: *Hypertensive crisis,CHF, controlled ↓ BP periop (↓ bleeding),* aortic dissection, pulm edema Action:↓ Systemic vascular resistance Dose: Adult & Peds. 0.5–10 mcg/kg/min IV inf,titrate; usual dose 3 mcg/kg/min Caution: [C, ?] ↓ cerebral perfusion Contra: Highoutput failure, compensatory HTN Disp: Inj 25 mg/mL SE: Excessive hypotensiveeffects, palpitations, HA Notes: Thiocyanate (metabolite w/renal excretion) w/ toxat 5–10 mg/dL, more likely if used for > 2–3 d; w/aortic dissection use w/ β-blockerNizatidine (Axid, Axid AR [OTC]) Uses: *Duodenal ulcers, GERD,heartburn* Action: H 2 -receptor antagonist Dose: Adults. Active ulcer: 150 mg PObid or 300 mg PO hs; maint 150 mg PO hs. GERD: 150 mg PO bid. Heartburn: 75mg PO bid. Peds. GERD: 10 mg/kg PO bid in ÷ doses, 150 mg bid max; ↓ in renalimpair Caution: [B, +] Contra: H 2 -receptor antagonist sensitivity Disp: Caps 75[OTC], 150, 300 mg; sol 15 mg/mL SE: Dizziness, HA, constipation, DNorepinephrine (Levophed) Uses: *Acute ↓ BP, cardiac arrest (adjunct)*Action: Peripheral vasoconstrictor of arterial/venous beds Dose: Adults.