Clinician's Pocket Drug Reference 2008

Pamidronate 163Paclitaxel (Taxol, Abraxane) WARNING: Administration only byphysician experienced in chemotherapy; fatal anaphylaxis and hypersensitivitypossible; severe myelosuppression possible Uses: *Ovarian & breast CA, PCa*,Kaposi sarcoma, NSCLC Action: Mitotic spindle poison; promotes microtubuleassembly & stabilization against depolymerization Dose: Per protocols; use glassor polyolefin containers (eg, nitroglycerin tubing set); PVC sets leach plasticizer;↓ in hepatic failure Caution: [D, –] Contra: Neutropenia < 1500 WBC/mm 3 ;solid tumors, component allergy Disp: Inj 6 mg/mL, 5 mg/mL albumin bound(Abraxane) SE: ↓ BM, peripheral neuropathy, transient ileus, myalgia, bradycardia,↓ BP, mucositis, N/V/D, fever, rash, HA, phlebitis; hematologic tox scheduledependent;leukopenia dose-limiting by 24-h inf; neurotox limited w/ short (1–3 h)inf; allergic Rxns (dyspnea, ↓ BP, urticaria, rash) Notes: Maintain hydration; allergicRxn usually w/in 10 min of inf; minimize w/ corticosteroid, antihistamine pretreatmentPalivizumab (Synagis) Uses: *Prevent RSV Infxn* Action: MoAbDose: Peds. 15 mg/kg IM monthly, typically Nov–Apr Caution: [C, ?] Renal/hepatic dysfunction Contra: Component allergy Disp: Vials 50, 100 mg SE:URI, rhinitis, cough, ↑ LFT, local irritationPalifermin (Kepivance) Uses: *Oral mucositis w/ BMT * Action: Synthetickeratinocyte GF Dose: Phase 1: 60 mcg/kg IV daily × 3, 3rd dose 24–48 hbefore chemo Phase 2: 60 mcg/kg IV daily × 3, immediately after stem cell infusionCaution: [C, ?/–] Contra: N/A Disp: Inj 6.25 mg SE: Unusual mouth sensations,tongue thickening, rash, ↑ amylase & lipase Notes: E coli-derived; separatephases by 4 d; safety unknown w/ nonhematologic malignanciesPalonosetron (Aloxi) WARNING: May ↑ QT c interval Uses: *Preventionacute & delayed N/V w/ emetogenic chemo* Action: 5HT3-receptor antagonistDose: 0.25 mg IV 30 min prior to chemo; do not repeat w/in 7 d Caution:[B, ?] Contra: Component allergy Disp: 0.25 mg/5 mL vial SE: HA, constipation,dizziness, abd pain, anxietyPaliperidone (Invega) WARNING: Not for dementia-related psychosisUses: *Schizophrenia * Action: Risperidone metabolite, antagonizes dopamine receptorsDose: 6 mg PO QAM, 12 mg/day max; CrCl 50–79: 6 mg/day max; CrCl10–49 3 mg/day max Caution: [C; ?/–] w/ bradycardia, ↓ K + /Mg +2 , renal/hepaticimpair Contra: Risperidone hypersensitivity, w/phenothiazines, ranolazine,ziprasidone, prolonged QT, hx arrhythmia Disp: ER Tabs 3, 6, 9 mg SE: Impairedtemp regulation, ↑ QT and HR, HA, anxiety, dizziness, N, dry mouth, fatigue, EPSNotes: Do not chew/cut/crush pillPamidronate (Aredia) Uses: *↑ Ca 2+ of malignancy, Paget Dz, palliatesymptomatic bone metastases* Action: ↓ Nl & abnormal bone resorption Dose: ↑Ca 2+ 60 mg IV over 4 h or 90 mg IV over 24 h. Paget Dz: 30 mg/d IV slow inf for3 d Caution: [D, ?/–] Avoid invasive dental procedures w/use Contra: PRG Disp:Inj 30, 60, 90 mg SE: Fever, inj site Rxn, uveitis, fluid overload, HTN, abd pain,