Clinician's Pocket Drug Reference 2008

178 Pseudoephedrinegive IV slowly; 1 mg reverses approx. 100 units of heparin given in the preceding3–4 h, 50 mg max Caution: [C, ?] Contra: Allergy Disp: Inj 10 mg/mL SE: Followcoags; anticoag effect if given w/o heparin; ↓ BP, bradycardia, dyspnea, hemorrhagePseudoephedrine (Sudafed, Novafed, Afrinol, others) [OTC]Uses: *Decongestant* Action: Stimulates α-adrenergic receptors w/ vasoconstrictionDose: Adults. 30–60 mg PO q6–8h Peds. 4 mg/kg/24 h PO ÷ qid; ↓ in renalinsuff Caution: [C, +] Contra: Poorly controlled HTN or CAD, w/MAOIs Disp:Tabs 30, 60 mg; caps 60 mg; SR tabs 120, 240 mg; liq 7.5 mg/0.8 mL, 15, 30 mg/5mL SE: HTN, insomnia, tachycardia, arrhythmias, nervousness, tremor Notes:Found in many OTC cough/cold preparations; OTC restricted distributionPsyllium (Metamucil, Serutan, Effer-Syllium) Uses: *Constipation& colonic diverticular Dz * Action: Bulk laxative Dose: 1 tsp (7 g) in glass ofH 2 O PO daily–tid Caution: [B, ?] Effer-Syllium (effervescent psyllium) usuallycontains K + caution w/ renal failure; phenylketonuria (in products w/ aspartame)Contra: Suspected bowel obst Disp: Granules 4, 25 g/tsp; powder 3.5 g/packet,Caps 0.52g (3 g/6 caps), wafers 3.4 g/dose SE: D, abd cramps, bowel obst, constipation,bronchospasmPyrazinamide (generic) Uses: *Active TB in combo w/ other agents*Action: Bacteriostatic; unknown mechanism Dose: Adults. 15–30 mg/kg/24 h PO÷ tid–qid; max 2 g/d; dosing based on lean body wgt; ↓ dose in renal/hepatic impairmentPeds. 15–30 mg/kg/d PO ÷ daily–bid; ↓ w/ renal/hepatic impair Caution:[C, +/–] Contra: Severe hepatic damage, acute gout Disp: Tabs 500 mg SE: Hepatotox,malaise, GI upset, arthralgia, myalgia, gout, photosens Notes: Use in combow/ other anti-TB drugs; consult MMWR for latest TB recommendations; dosageregimen differs for “directly observed” therapyPyridoxine [Vitamin B 6 ] Uses: *Rx & prevention of vitamin B 6 deficiency*Action: Vitamin B 6 supl Dose: Adults. Deficiency: 10–20 mg/d PO. Druginducedneuritis: 100–200 mg/d; 25–100 mg/d prophylaxis. Peds. 5–25 mg/d × 3wk Caution: [A (C if doses exceed RDA), +] Contra: Component allergy Disp:Tabs 25, 50, 100 mg; inj 100 mg/mL SE: Allergic Rxns, HA, NQuetiapine (Seroquel, Seroquil XR) WARNING: Closely monitor ptsfor worsening depression or emergence of suicidality, particularly in ped pts; ↑mortalityin elderly with dementia-related psychosis Uses: *Acute exacerbations ofschizophrenia* Action: Serotonin & dopamine antagonism Dose: 150–750 mg/d;initiate at 25–100 mg bid–tid; slowly ↑ dose; XR: 400–800 mg PO QPM, start 300mg/day, ↑ 300 mg/day, 800 mg day max ↓ dose w/ hepatic & geriatric pts Caution:[C, –] Contra: Component allergy Disp: Tabs 25, 50, 100, 200, 300, 400 mg; 200,300, 400 XR SE: Confusion w/ nefazodone; HA, somnolence, ↑ wgt, ↓ BP, dizziness,cataracts, neuroleptic malignant synd, tardive dyskinesia, ↑ QT internalQuinapril (Accupril) WARNING: ACE inhibitors used during PRG cancause fetal injury & death Uses: *HTN, CHF, DN, post-MI* Action: ACE inhibitor