Clinician's Pocket Drug Reference 2008

Selenium Sulfide 185chemo/RT Disp: Inj 250, 500 mcg SE: Bone pain, fever, ↓ BP, tachycardia, flushing,GI upset, myalgia Notes: Rotate inj sites; use APAP PRN for painScopolamine, Scopolamine transdermal and ophthalmic(Scopace, Transderm-Scop) Uses: *Prevent N/V associated w/ motionsickness, anesthesia, opiates; mydriatic,* cycloplegic, Rx uveitis & iridiocyclitisAction: Anticholinergic, inhibits iris and ciliary bodies, antiemetic Dose: 1 mg/ 72hr, 1 patch behind ear q3d; apply > 4 h before exposure; cycloplegic 1–2 gtt 1 hpre, uveitis 1–2 gtt up to QID max; ↓ in elderly Caution: [C, +] w/APAP, levodopa,ketoconazole, digitalis, KCl Contra: NAG, GI or GU obst, thyrotoxicosis,paralytic ileus Disp: Patch 1.5 mg, (releases 1 mg over 72 hrs), ophth 0.25% SE:Xerostomia, drowsiness, blurred vision, tachycardia, constipation Notes: Do notblink excessively after dose, wait 5 min before dosing other eye; anti-emetic activityw/ patch requires several hoursSecobarbital (Seconal) [C-II] Uses: *Insomnia, short-term use,* preanestheticagent Action: Rapid-acting barbiturate Dose: Adults. 100–200 mg HS,100–300 mg preop. Peds. 2–6 mg/kg/dose, 100 mg/max, ↓ in elderly Caution: [D,+] CYP2C9, 3A3/4, 3A5/7 inducer (Table 11); ↑ tox w/ other CNS depressantsContra: Porphyria, w/voriconazole, PRG Disp: Caps 50, 100 mg SE: Tolerance in1–2 wk; resp depression, CNS depression, porphyria, photosensSelegiline, oral (Eldepryl, Zelapar) Uses: * Parkinson Dz* Action:MAOI Dose: 5 mg PO bid; 1.25–2.5 OD tabs PO qam (before breakfast w/o liquid)2.5 mg/day max; ↓ in elderly Caution: [C, ?] w/ drugs that induce CYP3A4 (Table11) (eg, phenytoin, carbamazepine, nafcillin, phenobarbital, and rifampin); avoidw/ antidepressants Contra: w/meperidine, MAOI, dextromethorphan, generalanesthesia w/in 10 d, pheochromocytoma Disp: Tabs/caps 5 mg; OD Tabs 1.25 mgSE: N, dizziness, orthostatic ↓ BP, arrhythmias, tachycardia, edema, confusion, xerostomiaNotes: ↓ carbidopa/levodopa if used in combo; see transdermal formSelegiline, transdermal (Emsam) WARNING: May ↑ risk of suicidalthinking and behavior in children and adolescents with major depression disorderUses: *Depression* Action: MAOI Dose: Adults. Apply patch daily toupper torso, upper thigh, or outer upper arm Contra: Tyramine-containing foodsw/ 9- or 12-mg doses; serotonin-sparing agents Caution: [C, –] ↑ carbamazepineand oxcarbazepine levels Disp: ER Patches 6, 9, 12 mg SE: Local rxns requiringtopical steroids; HA, insomnia, orthostatic, ↓ BP, serotonin synd, suicide riskNotes: Rotate site; see oral formSelenium Sulfide (Exsel Shampoo, Selsun Blue Shampoo,Selsun Shampoo) Uses: *Scalp seborrheic dermatitis,* scalp itching &flaking due to *dandruff*; tinea versicolor Action: Antiseborrheic Dose: Dandruff,seborrhea: Massage 5–10 mL into wet scalp, leave on 2–3 min, rinse, repeat; use 2× wk, then once q1–4wk PRN. Tinea versicolor: Apply 2.5% daily × on area &lather w/ small amounts of water; leave on 10 min, then rinse Caution: [C, ?]