Clinician's Pocket Drug Reference 2008

Sorafenib 189izer Dose: Adults. 2–6 tsp (10–30 mL) diluted in 1–3 oz H 2 O pc & hs. Peds. 1–3tsp (5–15 mL) diluted in 1–3 oz H 2 O pc & hs; best after meals Caution: [C, +]Contra: Aluminum-based antacids; severe renal impair or Na-restricted dietsDisp: 15- or 30-mL unit dose: 16 (473 mL) or 4 (118 mL) fl oz SE: Tetany, metabolicalkalosis, ↑ K + , GI upset; avoid use of multiple 50-mL amps; can cause ↑Na + /hyperosmolality Notes: 1 mL = 1 mEq Na & 1 mEq bicarbSodium Oxybate (Xyrem) [C-III] WARNING: Known drug ofabuse even at recommended doses; confusion, depression, resp. depressionmay occur Uses: *Narcolepsy-associated cataplexy* Action: Inhibitoryneurotransmitter Dose: Adults & Peds ≥ 16 y: 2.25 g PO qhs, second dose 2.5–4 hlater; may ↑ 9 g/d max Caution: [B, ?/–] Contra: Succinic semialdehydedehydrogenase deficiency; potentiates EtOH Disp: 500 mg/mL 180-mL PO solnSE: Confusion, depression, ↓ diminished level of consciousness, incontinence,significant V, resp depression, psychiatric Sxs Notes: May lead to dependence;synonym for γ-hydroxybutyrate (GHB), abused as a “date rape drug”; controlleddistribution (prescriber & pt registration); must be administered when ptin bedSodium Phosphate (Visicol) Uses: *Bowel prep prior to colonoscopy*Action: Hyperosmotic laxative Dose: 3 tabs PO w/ at least 8 oz clear liq every 15min (20 tabs total night before procedure; 3–5 h before colonoscopy, repeat) Caution:[C, ?] Renal impair, electrolyte disturbances Contra: Megacolon, bowel obst,CHF, ascites, unstable angina, gastric retention, bowel perforation, colitis, hypomotility.Disp: Tablets 0.398, 1.102 g SE: ↑ QT, ↑ PO 3 ,↓ K + , Na, D, flatulence,cramps, abd bloating/painSodium Polystyrene Sulfonate (Kayexalate) Uses: *Rx of ↑K + * Action: Na + /K + ion-exchange resin Dose: Adults. 15–60 g PO or 30–60 g PRq6h based on serum K + . Peds. 1 g/kg/dose PO or PR q6h based on serum K + (givenw/ agent, eg, sorbitol, to promote movement through the bowel) Caution: [C, M]Contra: ↑ Na + Disp: Powder; susp 15 g/60 mL sorbitol SE: ↑ Na + , ↓ K + , Na retention,GI upset, fecal impaction Notes: Enema acts more quickly than PO; POmost effectiveSolifenacin (VESIcare) Uses: *OAB* Action: Antimuscarinic, ↓ detrusorcontractions Dose: 5 mg PO daily, 10 mg/d max; ↓ w/ renal/hepatic impairCaution: [C, ?/–] Bladder outflow or GI obst, ulcerative colitis, MyG, renal/hepatic impair, QT prolongation risk Contra: NAG, urinary/gastric retentionDisp: Tabs 5, 10 mg SE: Constipation, xerostomia, dyspepsia, blurred visionNotes: Interacts w/ azole antifungals; do not ↑ dose w/ severe renal/moderate hepaticimpairSorafenib (Nexavar) Uses: *Advanced RCC* met liver cancer Action:Kinase inhibitor Dose: Adults. 400 mg PO bid on empty stomach Caution: [D, –]w/irinotecan, doxorubicin, warfarin; avoid conception (male/female) Disp: Tabs200 mg SE: Hand–foot synd; treatment-emergent hypertension; bleeding, ↑ INR,