Clinician's Pocket Drug Reference 2008

156 Norethindrone actetate/ethinyl estradiol tablets8–30 mcg/min IV, titrate. Peds. 0.05–0.1 mcg/kg/min IV, titrate Caution: [C, ?]Contra: ↓ BP due to hypovolemia Disp: Inj 1 mg/mL SE: Bradycardia, arrhythmiaNotes: Correct volume depletion as much as possible before vasopressors;interaction w/ TCAs leads to severe HTN; use large vein to avoid extrav; phentolamine5–10 mg/10 mL NS injected locally for extravNorethindrone acetate/ethinyl estradiol tablets (Femhrt)(See estradiol/ norethindrone acetate)Norfloxacin (Noroxin, Chibroxin ophthal) Uses: *Complicated& uncomplicated UTI due to gram(–) bacteria, prostatitis, gonorrhea,* infectiousD, conjunctivitis Action: Quinolone, ↓ DNA gyrase, bactericidal Spectrum: Broadgram (+) and (–) E. faecalis, E. coli, K. pneumoniae, P. mirabilis, P. aeruginosa,S. epidermidis, S. saprophyticus Dose: 400 mg PO bid; ; Gonorrhea: 800 mg singledose; Prostatitis: 400 mg PO bid; Gastroenteritis, travelers D 400 mg PO ×3–5 d ↓ w/ renal impair Adults, Peds > 1 y: ophthal: 1 gtt each eye qid for 7 d Caution:[C, –] Tendinitis/tendon rupture, quinolone sensitivity Contra: Hx allergy ortendonitis w/ fluoroquinolones Disp: Tabs 400 mg; ophth 3 mg/mL SE: Photosens,HA, GI; ocular burning w/ ophth Notes: Interactions w/ antacids, theophylline,caffeine; good conc in the kidney & urine, poor blood levels; not for urosepsisNorgestrel (Ovrette) Uses: *PO contraceptive* Action: Prevent follicularmaturation & ovulation Dose: 1 tab/d; begin day 1 of menses Caution: [X, ?]Contra: Thromboembolic disorders, breast CA, PRG, severe hepatic Dz Disp:Tabs 0.075 mg SE: Edema, breakthrough bleeding, thromboembolism Notes:Progestin-only products have ↑ risk of failure in prevention of PRGNortriptyline (Aventyl, Pamelor) Uses: *Endogenous depression*Action: TCA; ↑ synaptic CNS levels of serotonin &/or norepinephrine Dose:Adults. 25 mg PO tid–qid; > 150 mg/d not OK. Elderly. 10–25 mg hs. Peds. 6–7 y:10 mg/d. 8–11 y: 10–20 mg/d. > 11 y: 25–35 mg/d, ↓ w/ hepatic insuff Caution:[D, +/–] NAG, CV Dz Contra: TCA allergy, use w/ MAOI Disp: Caps 10, 25, 50,75 mg; soln 10 mg/5 mL SE: Anticholinergic (blurred vision, retention, xerostomia)Notes: Max effect after 2 wkNystatin (Mycostatin) Uses: *Mucocutaneous Candida Infxns (oral,skin, vaginal)* Action: Alters membrane permeability. Spectrum: SusceptibleCandida sp Dose: Adults & children. PO: 400,000–600,000 units PO “swish &swallow” qid. Vaginal: 1 tab vaginally hs × 2 wk. Topical: Apply bid–tid to area.Peds. Infants: 200,000 units PO q6h. Caution: [B (C PO), +] Disp: PO susp100,000 units/mL; PO tabs 500,000 units; troches 200,000 units; vaginal tabs100,000 units; topical cream/oint 100,000 units/g, powder 100,000 units/gram SE:GI upset, Stevens–Johnson synd Notes: Not absorbed PO; not for systemic InfxnsOctreotide (Sandostatin, Sandostatin LAR) Uses: *↓ severe D associatedw/ carcinoid & neuroendocrine GI tumors (eg, VIPoma, ZE synd)*; bleedingesophageal varices Action: LA peptide; mimics natural hormone somatostatinDose: Adults. 100–600 mcg/d SQ/IV in 2–4 ÷ doses; start 50 mcg daily–bid. San-