Clinician's Pocket Drug Reference 2008

194 Sulfacetamide & PrednisoloneSulfacetamide & Prednisolone (Blephamide, others) Uses:*Steroid-responsive inflammatory ocular conditions w/ Infxn or a risk of Infxn* Action:Antibiotic & antiinflammatory Dose: Adults & Peds >2 y. Apply oint lowerconjunctival sac daily–qid; soln 1–3 gtt 2–3 h while awake Caution: [C, ?/–] Sulfonamidesensitivity; age < 2 mon Disp: Oint: sulfacetamide 10%/prednisolone 0.5%,sulfacetamide 10%/prednisolone 0.2%, sulfacetamide 10%/prednisolone 0.25%;susp: sulfacetamide 10%/prednisolone 0.25%, sulfacetamide 10%/prednisolone0.5%, sulfacetamide 10%/prednisolone 0.2% SE: Irritation, burning, blurred vision,brow ache, Stevens–Johnson synd, photosens Notes: OK ophth susp use as otic agentSulfasalazine (Azulfidine, Azulfidine EN) Uses: *Ulcerative colitis,RA, juvenile RA,* active Crohn Dz, ankylosing spondylitis, psoriasis Action:Sulfonamide; actions unclear Dose: Adults. Initial, 1 g PO tid–qid; ↑ to a max of 8g/d in 3–4 ÷ doses; maint 500 mg PO qid. Peds. Initial, 40–60 mg/kg/24 h PO ÷q4–6h; maint, 20–30 mg/kg/24 h PO ÷ q6h. RA > 6 y: 30–50 mg/kg/d in 2 doses,start w/ 1/4–1/3 maint dose, ↑ weekly until dose reached at 1 mo, 2 g/d max; ↓ inrenal failure Caution: [B (D if near term), M] Contra: Sulfonamide or salicylatesensitivity, porphyria, GI or GU obst; avoid in hepatic impair Disp: Tabs 500 mg;EC delayed-release tabs 500 mg SE: GI upset; discolors urine; dizziness, HA, photosens,oligospermia, anemias, Stevens–Johnson synd Notes: May cause yelloworangeskin/contact lens discoloration; avoid sunlight exposureSulfinpyrazone Uses: *Acute & chronic gout* Action: ↓ renal tubular absorptionof uric acid Dose: 100–200 mg PO bid for 1 wk, ↑ PRN to maint of 200–400 mgbid; max 800 mg/d; take w/ food or antacids, & plenty of fluids; avoid salicylatesCaution: [C (D if near term), ?/–] Contra: Renal impair, avoid salicylates; pepticulcer; blood dyscrasias, near term PRG, allergy Disp: Tabs 100 mg; caps 200 mg SE:N/V, stomach pain, urolithiasis, leukopenia Notes: Take w/ plenty of H 2 OSulindac (Clinoril) WARNING: May ↑ risk of cardiovascular events & GIbleeding Uses: *Arthritis & pain* Action: NSAID; ↓ prostaglandins Dose: 150–200mg bid, 400 mg/day max; w/ food Caution: [B (D if 3rd tri or near term), ?] Contra:NSAID or ASA sensitivity, w/ ketorolac, ulcer, GI bleeding, postop pain in CABGDisp: Tabs 150, 200 mg SE: Dizziness, rash, GI upset, pruritus, edema, ↓ renal bloodflow, renal failure (? fewer renal effects than other NSAIDs), peptic ulcer, GI bleedingSumatriptan (Imitrex) Uses: *Rx acute migraine* Action: Vascular serotoninreceptor agonist Dose: Adults. SQ: 6 mg SQ as a single dose PRN; repeatPRN in 1 h to a max of 12 mg/24 h. PO: 25 mg, repeat in 2 h, PRN, 100 mg/d maxPO dose; max 300 mg/d. Nasal spray: 1 spray into 1 nostril, repeat in 2 h to 40mg/24 h max. Peds. Nasal spray: 6–9 y: 5–20 mg/d. 12–17 y: 5–20 mg, up to 40mg/d Caution: [C, M] Contra: Angina, ischemic heart Dz, uncontrolled HTN, severehepatic impair, ergot use, MAOI use w/in 14 d Disp: OD tabs 25, 50, 100 mg;Inj 6, 8, 12 mg/mL; OD tabs 25, 50, 100 mg, orally disintegrating tabs 25, 50, 100mg; nasal spray 5, 10, 20 mg/spray SE: Pain & bruising at site; dizziness, hotflashes, paresthesias, CP, weakness, numbness, coronary vasospasm, HTN