Clinician's Pocket Drug Reference 2008

172 PiroxicamPiroxicam (Feldene) WARNING: May ↑risk of cardiovascular events &GI bleeding Uses: *Arthritis & pain* Action: NSAID; ↓ prostaglandins Dose:10–20 mg/d Caution: [B (1st tri; D if 3rd tri or near term), +] GI bleeding Contra:ASA/NSAID sensitivity Disp: Caps 10, 20 mg SE: Dizziness, rash, GI upset,edema, acute renal failure, peptic ulcerPlasma Protein Fraction (Plasmanate, others) Uses: *Shock &↓ BP* Action: Plasma volume expander Dose: Initial, 250–500 mL IV (not > 10mL/min); subsequent inf based on response. Peds. 10–15 mL/kg/dose IV; subsequentinf based on response Caution: [C, +] Contra: Renal insuff, CHF Disp: Inj5% SE: ↓ BP w/ rapid inf; hypocoagulability, metabolic acidosis, PE Notes:130–160 mEq Na/L; not substitute for RBCPneumococcal 7-Valent Conjugate Vaccine (Prevnar) Uses:*Immunization against pneumococcal Infxns in infants & children* Action: Activeimmunization Dose: 0.5 mL IM/dose; series of 3 doses; 1st dose age 2 mo; thendoses q2mo, 4th dose at age 12–15 mo Caution: [C, +] Thrombocytopenia Contra:Diphtheria toxoid sensitivity, febrile illness Disp: Inj SE: Local rxns, arthralgia,fever, myalgiaPneumococcal Vaccine, Polyvalent (Pneumovax-23) Uses:*Immunization against pneumococcal Infxns in pts at high risk (eg, all = 65 y ofage)* Action: Active immunization Dose: 0.5 mL IM. Caution: [C, ?] Contra:Do not vaccinate during immunosuppressive therapy Disp: Inj 0.5 mL SE: Fever,inj site Rxn, hemolytic anemia, thrombocytopenia, anaphylaxisPodophyllin (Podocon-25, Condylox Gel 0.5%, Condylox)Uses: *Topical therapy of benign growths (genital & perianal warts [condylomataacuminata],* papillomas, fibromas) Action: Direct antimitotic effect; exact mechanismunknown Dose: Condylox gel & Condylox: Apply bid for 3 consecutive d/wkfor 4 wk; 0.5 mL/day max; Podocon-25: Use sparingly on the lesion, leave on for1–4 h, thoroughly wash off Caution: [X, ?] Immunosuppression Contra: DM,bleeding lesions Disp: Podocon-25 (w/ benzoin) 15-mL bottles; Condylox gel0.5% 35 g clear gel; Condylox soln 0.5% 35 g clear SE: Local rxns, significant absorption;anemias, tachycardia, paresthesias, GI upset, renal/hepatic damageNotes: Podocon-25 applied by the clinician; do not dispense directly to patientPolyethylene Glycol [PEG]-Electrolyte Soln (GoLYTELY,CoLyte) Uses: *Bowel prep prior to examination or surgery* Action: Osmoticcathartic Dose: Adults. Following 3–4-h fast, drink 240 mL of soln q10min until4 L consumed or until BMs are clear. Peds. 25–40 mL/kg/h for 4–10 h Caution:[C, ?] Contra: GI obst, bowel perforation, megacolon, ulcerative colitis Disp:Powder for recons to 4 L SE: Cramping or N, bloating Notes: 1st BM should occurin approximately 1 h; Note: Chilled soln more palatablePolyethylene Glycol [PEG] 3350 (MiraLax) Uses: *Occasionalconstipation* Action: Osmotic laxative Dose: 17 g powder (1 heaping Tbsp) in8 oz (1 cup) of H 2 O & drink; max 14 d Caution: [C, ?] R/O bowel obst before use