Clinician's Pocket Drug Reference 2008

180 RanitidineRanitidine Hydrochloride (Zantac) Uses: *Duodenal ulcer, active benignulcers, hypersecretory conditions, & GERD* Action: H 2 -receptor antagonistDose: Adults. Ulcer: 150 mg PO bid, 300 mg PO hs, or 50 mg IV q6–8h; or 400 mgIV/d cont inf, then maint of 150 mg PO hs. Hypersecretion: 150 mg PO bid, up to 600mg/d. GERD: 300 mg PO bid; maint 300 mg PO hs. Dyspepsia: 75 mg PO daily–bidPeds. 0.75–1.5 mg/kg/dose IV q6–8h or 1.25–2.5 mg/kg/dose PO q12h; ↓ in renal insuff/failureCaution: [B, +] Contra: Component allergy Disp: Tabs 75 [OTC], 150,300 mg; Caps 150, 300 mg; Effervescent tabs 150 mg; syrup 15 mg/mL; inj 25mg/mL SE: Dizziness, sedation, rash, GI upset Notes: PO & parenteral doses differRanolazine (Ranexa) Uses: *Chronic angina* Action: ↓ ischemiarelatedNa + entry into myocardium Dose: Adults. 500 mg PO bid to 1000 mg PObid Contra: w/hepatic impair, CYP3A inhibitors (Table 11); w/ agents that ↑ QTinterval; ↓ K + Caution: [C, ?/–] HTN may develop w/renal impairment Disp: SRtabs 500 mg SE: Dizziness, HA, constipation, arrhythmias Notes: Not first line;use w/amlodipine, nitrates, beta blockersRasagiline mesylate (Azilect) Uses: *Early Parkinson disease monotherapy;levodopa adjunct w/advanced dz* Action: MAO B inhibitor Dose: Adults.Early dz: 1 mg PO daily, start 0.5 mg PO daily w/levodopa; ↓ w/CYP1A2 inhibitorsor hepatic impair Contra: MAOIs, sympathomimetic amines, meperidine,methadone, tramadol, propoxyphene, dextromethorphan, mirtazapine, cyclobenzaprine,St. John’s wort, sympathomimetic vasoconstrictors, general anesthetics, SSRIsCaution: [C, ?] Avoid tyramine-containing foods; moderate/severe hepatic impairmentDisp: Tabs 0.5, 1 mg SE: Arthralgia, indigestion, dyskinesia, hallucinations, ↓wgt, postural ↓ BP, N, V, constipation, xerostomia, rash, sedation, CV conductiondisturbances Notes: Rare melanoma reported; do periodic skin exams; d/c 14 daysprior to elective surgery; initial ↓ levodopa dose recommendedRasburicase (Elitek) Uses: *Reduce ↑ uric acid due to tumor lysis (peds)*Action: Catalyzes uric acid Dose: Peds. 0.15 or 0.20 mg/kg IV over 30 min, daily× 5 Caution: [C, ?/–] Falsely ↓ uric acid values Contra: Anaphylaxis, screen forG6PD deficiency to avoid hemolysis, methemoglobinemia Disp: 1.5 mg inj SE:Fever, neutropenia, GI upset, HA, rash Note: Place blood test tube for uric acidlevel on ice to stop enzymatic rxn; removed by dialysisRepaglinide (Prandin) Uses: *Type 2 DM* Action: ↑ pancreatic insulinrelease Dose: 0.5–4 mg ac, PO start 1–2 mg, ↑ to 16 mg/d max; take pc Caution:[C, ?/–] Contra: DKA, type 1 DM Disp: Tabs 0.5, 1, 2 mg SE: HA, hyper-/hypoglycemia,GI upsetRetapamulin (Altabax) Uses: *Topical Rx impetigo in patients > 9 mo*Action: Pleuromutilin antibiotic; Spectrum: S. aureus (MRSA), S. pyogenes Dose:Apply BID x 5 days Caution: [B; ?] Disp: 10 mg/1 g SE: Local irritationReteplase (Retavase) Uses: *Post-AMI* Action: Thrombolytic Dose: 10units IV over 2 min, 2nd dose in 30 min, 10 units IV over 2 min; 10 units IV bolusover 2 min; 30 min later, 10 units IV bolus over 2 min NS flush before and after