Clinician's Pocket Drug Reference 2008

Ranibizumab 179Dose: 10–80 mg PO daily; ↓ in renal impair Caution: [D, +] w/ RAS, volume depletionContra: ACE inhibitor sensitivity, angioedema, PRG Disp: Tabs 5, 10, 20, 40 mgSE: Dizziness, HA, ↓ BP, impaired renal Fxn, angioedema, taste perversion, coughQuinidine (Quinidex, Quinaglute) Uses: *Prevention of tachydysrhythmias,malaria* Action: Class 1A antiarrhythmic Dose: Adults. AF/flutterconversion: After digitalization, 200 mg q2–3h × 8 doses; ↑ daily to 3–4 g max ornl rhythm. Peds. 15–60 mg/kg/24 h PO in 4–5 ÷ doses; ↓ in renal impair Caution:[C, +] w/ ritonavir Contra: Digitalis tox & AV block; conduction disorders Disp:Sulfate: Tabs 200, 300 mg; SR tabs 300 mg. Gluconate: SR tabs 324 mg; inj 80mg/mL SE: Extreme ↓ BP w/ IV use; syncope, QT prolongation, GI upset, arrhythmias,fatigue, cinchonism (tinnitus, hearing loss, delirium, visual changes),fever, hemolytic anemia, thrombocytopenia, rash Notes: Levels: Trough: just beforenext dose: Therapeutic: 2–5 mcg/mL; Toxic >10 mcg/mL; 1 ⁄2 life: 6–8h; sulfatesalt 83% quinidine; gluconate salt 62% quinidine; use w/ drug that slows AV conduction(eg, digoxin, diltiazem, β-blocker)Quinupristin–Dalfopristin (Synercid) Uses: *Vancomycin-resistantInfxns due to E. faecium & other gram(+)* Action: ↓ ribosomal protein synth.Spectrum: Vanco-resistant Enterococcus faecium, methicillin-susceptible Staphylococcusaureus, Streptococcus pyogenes; not against Enterococcus faecalis Dose:Adults & Peds. 7.5 mg/kg IV q8–12h (central line preferred); incompatible w/ NSor heparin; flush IV w/ dextrose; ↓ w/ hepatic failure Caution: [B, M] Multipledrug interactions (eg, cyclosporine) Contra: Component allergy Disp: Inj 500 mg(150 mg quinupristin/350 mg dalfopristin) 600 mg (180 quinupristin/420 mg dalfopristin)SE: Hyperbilirubinemia, inf site Rxns & pain, arthralgia, myalgiaRabeprazole (AcipHex) Uses: *PUD, GERD, ZE* H. pylori Action:Proton-pump inhibitor Dose: 20 mg/d; may ↑ to 60 mg/d; H. pylori 20 mg PO bid× 7 days (w/amoxicillin and clarithromycin); do not crush/chew tabs Caution: [B,?/–] Disp: Tabs 20 mg ER SE: HA, fatigue, GI upsetRaloxifene (Evista) Uses: *Prevent osteoporosis* Action: Partial antagonistof estrogen, behaves like estrogen Dose: 60 mg/d Caution: [X, –] Contra:Thromboembolism, PRG Disp: Tabs 60 mg SE: Chest pain, insomnia, rash, hotflashes, GI upset, hepatic dysfunctionRamipril (Altace) WARNING: ACE inhibitors used during PRG can causefetal injury & death Uses: *HTN, CHF, DN, post-MI* Action: ACE inhibitorDose: 2.5–20 mg/d PO ÷ daily–bid; ↓ in renal failure Caution: [D, +] Contra:ACE-inhibitor-induced angioedema Disp: Caps 1.25, 2.5, 5, 10 mg SE: Cough,HA, dizziness, ↓ BP, renal impair, angioedema Notes: OK in combo w/ diureticsRanibizumab (Lucentis) Uses: *Neovascular “wet” macular degeneration* Action: Vascular endothelial growth factor inhibitor Dose: 0.5 mg intravitrealinj qmo Caution: [C; ?] Hx thromboembolism Contra: periocular infxn Disp:Inj SE: Endophthalmitis, retinal detachment/hemorrhage, cataract, intraocular inflammation,conjunctival hemorrhage, eye pain, floaters, eye pain