Clinician's Pocket Drug Reference 2008

Pemetrexed 165constipation Notes: Contains anhydrous morphine from opium; short-term useonlyParoxetine (Paxil, Paxil CR) WARNING: Closely monitor for worseningdepression or emergence of suicidality, particularly in ped pts Uses: *Depression,OCD, panic disorder, social anxiety disorder,* PMDD Action: SSRIDose: 10–60 mg PO single daily dose in AM; CR 25 mg/d PO; ↑ 12.5 mg/wk (maxrange 26–62.5 mg/d) Caution: [D, ?/] Contra: MAOI Disp: Tabs 10, 20, 30, 40mg; susp 10 mg/5 mL; CR 12.5, 25, 37.5 mg SE: Sexual dysfunction, HA, somnolence,dizziness, GI upset, D, xerostomia, tachycardiaPegfilgrastim (Neulasta) Uses: *↓ Frequency of Infxn in pts w/ nonmyeloidmalignancies receiving myelosuppressive anti-CA drugs that cause febrileneutropenia* Action: Granulocyte and macrophage stimulating factor Dose:Adults. 6 mg SQ × 1/chemo cycle. Peds. 100 mcg/kg SQ × 1/chemo cycle Caution:[C, M] in sickle cell Contra: Allergy to E. coli derived proteins or filgrastimDisp: Syringes: 6 mg/0.6 mL SE: Splenic rupture, HA, fever, weakness, fatigue,dizziness, insomnia, edema, N/V/D, stomatitis, anorexia, constipation, taste perversion,dyspepsia, abd pain, granulocytopenia, neutropenic fever, ↑ LFT & uric acid,arthralgia, myalgia, bone pain, ARDS, alopecia, worsen sickle cell Dz Notes:Never give between 14 d before & 24 h after dose of cytotoxic chemoPeg Interferon Alfa-2a (Pegasys) WARNING: Can cause or aggravatefatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectiousdisorders. Monitor patients closely Uses: *Chronic Hep C w/ compensatedliver Dz* Action: Biologic response modifier Dose: 180 mcg (1 mL) SQ qwk × 48wk; ↓ in renal impair Caution: [C, /?–] Contra: Autoimmune hepatitis, decompensatedliver Dz Disp: 180 mcg/mL inj SE: Depression, insomnia, suicidal behavior,GI upset, neutro & thrombocytopenia, alopecia, pruritus Notes: Mayaggravate neuropsychiatric, autoimmune, ischemic, & infectious disordersPeg Interferon Alfa-2b (PEG-Intron) WARNING: Can cause or aggravatefatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectiousdisorders. Monitor patients closely Uses: *Rx Hep C* Action: Immunemodulation Dose: 1 mcg/kg/wk SQ; 1.5 mcg/kg/wk combined w/ribavirin Caution:[C, ?/–] w/psychiatric Hx Contra: Autoimmune hepatitis, decompensatedliver Dz, hemoglobinopathy Disp: Vials 50, 80, 120, 150 mcg/0.5 mL; Redipen 50,80,120,150 mcg/5 mL; reconstitute w/0.7 mL w/sterile water SE: Depression, insomnia,suicidal behavior, GI upset, neutropenia, thrombocytopenia, alopecia, pruritusNotes: Give hs or w/APAP to ↓ flu-like Sxs; monitor CBC/platelets; useimmediately or store in refrigerator × 24 h; do not freezePemetrexed (Alimta) Uses: *w/ cisplatin in nonresectable mesothelioma*NSCLC Action: Antifolate antineoplastic Dose: 500 mg/m 2 IV over 10min every 3 wk; hold if CrCl