Clinician's Pocket Drug Reference 2008

Protamine 177erides w/ extended dosing; ↓ BP, pain at site, apnea, anaphylaxis Notes: 1 mLhas 0.1 g fatPropoxyphene (Darvon); Propoxyphene & Acetaminophen(Darvocet); & Propoxyphene & Aspirin (Darvon Compound-65, Darvon-N + Aspirin) [C-IV] WARNING: Excessive doses alone or incombo w/ other CNS depressants can be cause of death; use w/ caution in depressedor suicidal patients Uses: *Mild–moderate pain* Action: Narcotic analgesic Dose:1–2 PO q4h PRN; ↓ in hepatic impair, elderly Caution: [C (D if prolonged use), M]Hepatic impair (APAP), peptic ulcer (ASA); severe renal impair, Hx ETOH abuseContra: Allergy, suicide risk, Hx drug abuse Disp: Darvon: Propoxyphene HCl caps65 mg. Darvon-N: Propoxyphene napsylate 100-mg tabs. Darvocet-N: Propoxyphenenapsylate 50 mg/APAP 325 mg. Darvocet-N 100: Propoxyphene napsylate 100mg/APAP 650 mg. Darvon Compound-65: Propoxyphene HCl caps 65-mg/ASA 389mg/caffeine 32 mg. Darvon-N w/ ASA: Propoxyphene napsylate 100 mg/ASA 325 mgSE: OD can be lethal; ↓ BP, dizziness, sedation, GI upset, ↑ levels on LFTsPropranolol (Inderal) Uses: *HTN, angina, MI, hyperthyroidism, essentialtremor, hypertrophic subaortic stenosis, pheochromocytoma; prevents migraines& atrial arrhythmias* Action: β-adrenergic receptor blocker, β 1 , β 2 ; onlyβ-blocker to block conversion of T 4 to T 3 Dose: Adults. Angina: 80–320 mg/d PO÷ bid–qid or 80–160 mg/d SR. Arrhythmia: 10–80 mg PO tid–qid or 1 mg IVslowly, repeat q5min, 5 mg max. HTN: 40 mg PO bid or 60–80 mg/d SR, ↑ weeklyto max 640 mg/d. Hypertrophic subaortic stenosis: 20–40 mg PO tid–qid. MI:180–240 mg PO ÷ tid–qid. Migraine prophylaxis: 80 mg/d ÷ qid–tid, ↑ weekly160–240 mg/d ÷ tid–qid max; wean if no response in 6 wk. Pheochromocytoma:30–60 mg/d ÷ tid–qid. Thyrotoxicosis: 1–3 mg IV × 1; 10–40 mg PO q6h. Tremor:40 mg PO bid, ↑ PRN 320 mg/d max; 0.1 mg/kg slow IV push, divided 3 equaldoses q 2–3 min, max 1 mg/min; repeat in 2 min PRN (ECC 2005) Peds. Arrhythmia:0.5–1.0 mg/kg/d ÷ tid–qid, ↑ PRN q3–7d to 60 mg/d max; 0.01–0.1 mg/kg IVover 10 min, 1 mg max. HTN: 0.5–1.0 mg/kg ÷ bid–qid, ↑ PRN q3–7d to 2mg/kg/d max; ↓ in renal impair Caution: [C (1st tri, D if 2nd or 3rd tri), +] Contra:Uncompensated CHF, cardiogenic shock, bradycardia, heart block, PE, severeresp Dz Disp: Tabs 10, 20, 40, 80 mg; SR caps 60, 80, 120, 160 mg; oral soln 4, 8,mg/mL; inj 1 mg/mL SE: Bradycardia, ↓ BP, fatigue, GI upset, EDPropylthiouracil [PTU] Uses: *Hyperthyroidism* Action: ↓ Productionof T 3 & T 4 & conversion of T 4 to T 3 Dose: Adults. Initial: 100 mg PO q8h (mayneed up to 1200 mg/d); after pt euthyroid (6–8 wk), taper dose by 1 ⁄2 q4–6wk tomaint, 50–150 mg/24 h; can usually D/C in 2–3 y; ↓ in elderly Peds. Initial: 5–7mg/kg/24 h PO ÷ q8h. Maint: 1 ⁄3– 2 ⁄3 of initial dose Caution: [D, –] Contra: AllergyDisp: Tabs 50 mg SE: Fever, rash, leukopenia, dizziness, GI upset, taste perversion,SLE-like synd Notes: Monitor pt clinically, TFTProtamine (generic) Uses: *Reverse heparin effect* Action: Neutralizeheparin by forming a stable complex Dose: Based on degree of heparin reversal;