Clinician's Pocket Drug Reference 2008

186 SertaconazoleContra: Open wounds Disp: Shampoo [OTC]; 2.5% lotion SE: Dry or oily scalp,lethargy, hair discoloration, local irritation Notes: Do not use more than 2 ×/wkSertaconazole (Ertaczo) Uses: *Topical Rx interdigital tinea pedis* Action:Imidazole antifungal. Spectrum: Trichophyton rubrum, T. mentagrophytes,Epidermophyton floccosum Dose: Adults & Peds > 12. Apply between toes & immediatesurrounding healthy skin bid × 4 wk Caution: [C, ?] Contra: Componentallergy Disp: 2% cream SE: Contact dermatitis, dry/burning skin, tendernessNotes: Use in immunocompetent pts; not for oral, intravaginal, ophthalmic useSertraline (Zoloft) WARNING: Closely monitor pts for worseningdepression or emergence of suicidality, particularly in ped pts Uses: *Depression,panic disorders, obsessive–compulsive disorder (OCD), posttraumatic stressdisorders (PTSD),* social anxiety disorder, eating disorders, premenstrual disordersAction: ↓ neuronal uptake of serotonin Dose: Adults. Depression: 50–200mg/d PO. PTSD: 25 mg PO daily × 1 wk, then 50 mg PO daily, 200 mg/d maxPeds. 6–12 y: 25 mg PO daily; 13–17 y: 50 mg PO daily Caution: [C, ?/–] w/haloperidol (serotonin synd), sumatriptan, linezolid, hepatic impair Contra: MAOIuse w/in 14 d; concomitant pimozide Disp: Tabs 25, 50, 100, 150, 200 mg; 20mg/mL oral SE: Activate manic/hypomanic state, ↓ wgt, insomnia, somnolence,fatigue, tremor, xerostomia, N/D, dyspepsia, ejaculatory dysfunction, ↓ libido, hepatotoxSevelamer (Renagel) Uses: *↓ serum phosphorus in ESRD* Action:Binds intestinal PO 3+ Dose: 2–4 capsules PO tid w/ meals; adjust based on PO 3+ ,max 4 g/dose Caution: [C, ?] Contra: Hypophosphatemia, Bowel obst Disp: Capsules403 mg, tabs 400, 800 mg SE: BP changes, N/V/D, dyspepsia, thrombosisNotes: Do not open/chew capsules; may ↓ fat-soluble vitamin absorption; giveother meds 1h before or 3 h after; 800 mg sevelamer = 667 mg Ca acetateSibutramine (Meridia) [C-IV] Uses: *Obesity* Action: Blocks uptakeof norepinephrine, serotonin, dopamine Dose: 10 mg/d PO, may ↓ to 5 mg after 4wk Caution: [C, –] w/SSRIs, lithium, dextromethorphan, opioids Contra: MAOIw/in 14 d, uncontrolled HTN, arrhythmias Disp: Caps 5, 10, 15 mg SE: HA, insomnia,xerostomia, constipation, rhinitis, tachycardia, HTN Notes: Use w/ lowcaloriediet, monitor BP & HRSildenafil (Viagra, Revatio) Uses: Viagra: *Erectile dysfunction,* Revatio:*Pulm artery HTN* Action: ↓ Phosphodiesterase type 5 (responsible forcGMP breakdown); ↑ cGMP activity to relax smooth muscles & ↑ flow to corpuscavernosum and pulm vasculature; ?antiproliferative on pulm artery smooth muscleDose: ED: 25–100 mg PO 1 h before sexual activity, max 1 × d; ↓ if > 65 y;avoid fatty foods w/ dose; Revatio Pulm HTN: 20 mg PO tid Caution: [B, ?]CYP3A4 inhibitors (Table 11) Contra: W/nitrates or if sex activity not advised; retinitispigmentosa; hepatic/severe renal impair Disp: Tabs (Viagra) 25, 50, 100 mg,tabs (Revatio) 20 mg SE: HA; flushing; dizziness; blue haze visual change, hearingloss Notes: Cardiac events in absence of nitrates debatable