Clinician's Pocket Drug Reference 2008

158 Omeprazoleerides Dose: Hypertriglyceridemia: 4 gm/day divided in 1–2 doses Caution: Pregnancyrisk factor [C,–] w/ anticoagulant use, w/bleed risk Contra: Hypersensitivityto components Disp: 1000-mg gelcap SE: Dyspepsia, N, GI pain, rash, flulikesyndrome Notes: Only FDA approved fish oil supplement; not for exogenous hypertriglyceridemia(type 1 hyperchylomicronaemia); many OTC products (page202). D/C after 2 mo if TG levels do not ↓; Previously called “Omacor”Omeprazole (Prilosec, Zegerid) Uses: *Duodenal/gastric ulcers, ZEsynd, GERD,* H. pylori Infxns Action: Proton-pump inhibitor Dose: 20–40 mgPO daily–bid; Zegerid powder/mix; in small cup w/ 2 Tbsp H 2 O (not food or otherliquids) refill and drink Caution: [C, –] Disp: DR tabs 20 mg; DR caps 10, 20, 40mg; Zegerid powder for oral susp: 20, 40 mg. Zegerid caps 20, 40 mg SE: HA, DNotes: Combo (ie, antibiotic) Rx for H. pylori, take Zegerid 1 hr before mealsOndansetron (Zofran, Zofran ODT) Uses: *Prevent chemo-associated& postop N/V* Action: Serotonin receptor antagonist Dose: Chemo: Adults& Peds. 0.15 mg/kg/dose IV prior to chemo, then 4 & 8 h after 1st dose or 4–8 mgPO tid; 1st dose 30 min prior to chemo & give on a schedule, not PRN. Postop:Adults. 4 mg IV immed pre anesthesia or postop. Peds. < 40 kg: 0.1 mg/kg. > 40kg: 4 mg IV ; ↓ dose w/ hepatic impair Caution: [B, +/–] Disp: Tabs 4, 8, 24 mg,soln 4 mg/5 mL, inj 2 mg/ml, 32 mg/50 mL; Zofran ODT tab, 4, 8 mg SE: D, HA,constipation, dizzinessOprelvekin (Neumega) WARNING: Allergic Rxn w/anaphylaxis reported;D/C w/ any allergic Rxn Uses: *Prevent ↓ plt w/ chemo* Action: ↑Proliferation& maturation of megakaryocytes (interleukin-11) Dose: Adults. 50mcg/kg/d SQ for 10–21 d. Peds > 12 y: 75–100 mcg/kg/d SQ for 10–21 d. < 12 y:Use only in clinical trials. Caution: [C, ?/–] Disp: 5 mg powder for inj SE: Tachycardia,palpitations, arrhythmias, edema, HA, dizziness, insomnia, fatigue, fever,N, anemia, dyspnea, allergic rxns including anaphylaxisOral Contraceptives, Biphasic, Monophasic, Triphasic, ProgestinOnly (Table 6) WARNING: Cigarette smoking ↑ risk of serious CVside effects; ↑ risk w/ > 15 cigarettes/day, > 35 y; strongly advise women on OCP tonot smoke Uses: *Birth control; regulation of anovulatory bleeding; dysmenorrhea;endometriosis; polycystic ovaries; acne* (Note: FDA approvals vary widely,see insert) Action: Birth control: Suppresses LH surge, prevents ovulation; progestinsthicken cervical mucus; ↓ fallopian tubule cilia, ↓ endometrial thickness to ↓chances of fertilization. Anovulatory bleeding: Cyclic hormones mimic body’s naturalcycle & regulate endometrial lining, results in regular bleeding q28d; may ↓uterine bleeding & dysmenorrhea Dose: Start day 1 menstrual cycle or 1st Sundayafter onset of menses; 28-d cycle pills take daily; 21-d cycle pills take daily, no pillsduring last 7 d of cycle (during menses); some available as transdermal patch Caution:[X, +] Migraine, HTN, DM, sickle cell Dz, gallbladder Dz; monitor for breastdz, K + if taking drugs with ↑ K + risk Contra: AUB, PRG, estrogen-dependentmalignancy, ↑ hypercoagulation/liver Dz, hemiplegic migraine, smokers > 35 y