Clinician's Pocket Drug Reference 2008

184 Rosiglitazonepostural ↓ BP, N/V, HA, somnolence, dosed-related hallucinations, dyskinesias,dizziness Notes: D/C w/ 7-day taperRosiglitazone (Avandia) Uses: *Type 2 DM* Action: Thiazolidinedione;↑ insulin sensitivity Dose: 4–8 mg/d PO or in 2 ÷ doses (w/o regard tomeals) Caution: [C, –] w/ ESRD, CHF, edema, Contra: DKA, severe CHF, ALT>2.5 ULN Disp: Tabs 2, 4, 8 mg SE: may ↑ CV & cancer risk; weight gain, hyperlipidemia,HA, edema, fluid retention, worsen CHF, hyper-/hypoglycemia, hepaticdamage w/ ↑ LFTs Notes: Not rec in class III, IV heart dzRosuvastatin (Crestor) Uses: *Rx primary hypercholesterolemia &mixed dyslipidemia* Action: HMG-CoA reductase inhibitor Dose: 5–40 mg POdaily; max 5 mg/d w/cyclosporine, 10 mg/d w/gemfibrozil or CrCl < 30 mL/min(avoid Al-/Mg-based antacids for 2 h after) Caution: [X, ?/–] Contra: Active liverDz, unexplained ↑ LFT Disp: Tabs 5, 10, 20, 40 mg SE: Myalgia, constipation, asthenia,abd pain, N, myopathy, rarely rhabdomyolysis Notes: May ↑ warfarin effect;monitor LFTs at baseline, 12 wk, then q6mo; ↓ dose in Asian patientsRotavirus vaccine, live, oral, pentavalent (RotaTeq) Uses:*Prevent rotavirus gastroenteritis* Action: Active immunization Dose: Peds. Singledose PO at 2, 4, and 6 mo Caution: [?, ?] Disp: Oral susp 2-mL single-usetubes SE: D, V, Notes: Begin series by 12 wks and conclude by 32 wks of ageSalmeterol (Serevent Diskus) WARNING: Long-acting -2 agonists,such as salmeterol, may ↑ the risk of asthma-related death. Should not be usedalone, only as additional therapy for patients not controlled on other asthma medicationsUses: *Asthma, exercise-induced asthma, COPD* Action: Sympathomimeticbronchodilator, β 2 -agonist Dose: Adults & Peds ≥ 12 y. 1 diskus-doseinhaled bid Caution: [C, ?/–] Contra: Acute asthma; w/in 14 d of MAOI Disp: 50mcg/dose, dry powder discus, metered dose inhaler, 21 mcg/activation SE: HA,pharyngitis, tachycardia, arrhythmias, nervousness, GI upset, tremors Notes: Notfor acute attacks; also prescribe short-acting β-agonistSaquinavir (Fortovase, Invirase) WARNING: Invirase and Fortovasenot bioequivalent/interchangeable; must use Invirase in combo w/ ritonavir,which provides saquinavir plasma levels = to those w/Fortovase Uses: *HIVInfxn* Action: HIV protease inhibitor Dose: 1200 mg PO tid w/in 2 h pc (doseadjust w/ ritonavir, delavirdine, lopinavir, & nelfinavir) Caution: [B, +] w/ketoconazole, statins, sildenafil Contra: w/ rifampin, severe hepatic impair, allergy,sun exposure w/o sunscreen/clothing, triazolam, midazolam, ergots, Disp:Caps 200, tabs 500 mg SE: Dyslipidemia, lipodystrophy, rash, hyperglycemia, GIupset, weakness, Notes: Take 2 h after meal, avoid direct sunlightSargramostim [GM-CSF] (Leukine) Uses: *Myeloid recovery followingBMT or chemo* Action: Recombinant GF, activates mature granulocytes& macrophages Dose: Adults & Peds. 250 mcg/m 2 /d IV for 21 d (BMT) Caution:[C, ?/–] Lithium, corticosteroids Contra: > 10% blasts, allergy to yeast, concurrent