Clinician's Pocket Drug Reference 2008

Sulfacetamide 193mg/mL (1-g vial) SE: ↑ incidence of vestibular & auditory tox, ↑ neurotoxicityrisk in pts w/ impaired renal function Notes: Monitor levels: Peak 20–30 mcg/mL,Trough 50, Trough > 10; IV over 30–60 minStreptozocin (Zanosar) Uses: *Pancreatic islet cell tumors* & carcinoid tumorsAction: DNA–DNA (interstrand) cross-linking; DNA, RNA, & protein synth inhibitorDose: Per protocol; ↓ in renal failure Caution: w/renal failure [D, ?/–]Contra: w/ rotavirus vaccine, PRG Disp: Inj 1 g SE: N/V/D, duodenal ulcers, depression,↓ BM rare (20%) & mild; nephrotox (proteinuria & azotemia dose related), hypophosphatemiadose limiting; hypo-/hyperglycemia; inj site Rxns Notes: Monitor CrSuccimer (Chemet) Uses: *Lead poisoning (levels > 45 mcg/mL)* Action:Heavy-metal chelating agent Dose: Adults & Peds. 10 mg/kg/dose q8h × 5 d, then10 mg/kg/dose q12h for 14 d; ↓ in renal impair Caution: [C, ?] Contra: AllergyDisp: Caps 100 mg SE: Rash, fever, GI upset, hemorrhoids, metallic taste, drowsiness,↑ LFTs Notes: Monitor lead levels, maintain hydration, may open capsulesSuccinylcholine (Anectine, Quelicin, Sucostrin, others)WARNING: Risk of cardiac arrest from hyperkalemic rhabdomyolysis Uses:*Adjunct to general anesthesia, facilitates ET intubation; induce skeletal musclerelaxation during surgery or mechanical ventilation* Action: Depolarizing neuromuscularblocker; rapid onset, short duration (3–5 min) Dose: Adults. Rapid sequenceintubation 1–2 mg/kg IV over 10–30 s or 2–4 mg/kg IM (ECC 2005)Peds. 1–2 mg/kg/dose IV, then by 0.3–0.6 mg/kg/dose q5min use of CI not OK; ↓w/ severe renal/hepatic impair Caution: See warning [C, M] Contra: w/Malignanthyperthermia risk, myopathy, recent major burn, multiple trauma, extensive skeletalmuscle denervation, NAG, pseudocholinesterase deficiency Disp: Inj 20, 50,100 mg/mL SE: Fasciculations, ↑ intraocular, intragastric, intracranial pressure,salivation, myoglobinuria, malignant hyperthermia, resp depression, or prolongedapnea; multiple drugs potentiate; CV effects (arrhythmias, ↓ BP, brady/tachycardia)Notes: May be given IVP/inf/IM deltoid; hyperkalemic rhabdomyolysis inchildren with undiagnosed myopathy such as Duchenne muscular dystrophySucralfate (Carafate) Uses: *Duodenal ulcers,* gastric ulcers, stomatitis,GERD, preventing stress ulcers, esophagitis Action: Forms ulcer-adherent complexthat protects against acid, pepsin, & bile acid Dose: Adults. 1 g PO qid, 1 h prior tomeals & hs. Peds. 40–80 mg/kg/d ÷ q6h; continue 4–8 wk unless healing demonstratedby x-ray or endoscopy; separate from other drugs by 2 h; on empty stomach ac Caution:[B, +] Contra: Component allergy Disp: Tabs 1 g; susp 1 g/10 mL SE: Constipation;D, dizziness, xerostomia Notes: Aluminum may accumulate in renal failureSulfacetamide (Bleph-10, Cetamide, Sodium Sulamyd)Uses: *Conjunctival Infxns* Action: Sulfonamide antibiotic Dose: 10% oint applyqid & hs; soln for keratitis apply q2–3h based on severity Caution: [C, M] Contra:Sulfonamide sensitivity; age