Clinician's Pocket Drug Reference 2008

196 Tamsulosinin high-risk women, met male breast CA,* ductal carcinoma in situ, mastalgia, pancreaticCA, gynecomastia, ovulation induction Action: Nonsteroidal antiestrogen;mixed agonist–antagonist effect Dose: 20–40 mg/d (typically 10 mg bid or 20 mg/d)Prevention: 10 mg PO bid × 5y Caution: [D, –] w/ leukopenia, thrombocytopenia,hyperlipidemia Contra: PRG, undiagnosed vag bleeding, Hx thromboembolismDisp: Tabs 10, 20 mg, oral soln 10 mg/5 mL SE: Uterine malignancy & thromboticevents noted in breast CA prevention trials; menopausal Sxs (hot flashes, N/V) inpremenopausal pts; vaginal bleeding & menstrual irregularities; skin rash, pruritusvulvae, dizziness, HA, peripheral edema; acute flare of bone metastasis pain & ↑Ca 2+ ; retinopathy reported (high dose) Notes: ↑ risk of PRG in premenopausalwomen (induces ovulation); brand Nolvadex suspended in USTamsulosin (Flomax) Uses: *BPH* Action: Antagonist of prostatic α-receptorsDose: 0.4 mg/d, may ↑ to 0.8 mg PO daily; Caution: [B, ?] Contra: Femalegender Disp: Caps 0.4 mg SE: HA, dizziness, syncope, somnolence, ↓ libido,GI upset, retrograde ejaculation, rhinitis, rash, angioedema, IFIS Notes: Not foruse as antihypertensive; do not open/crush/chewTazarotene (Tazorac, Avage) Uses: *Facial acne vulgaris; stableplaque psoriasis up to 20% BSA* Action: Keratolytic Dose: Adults & Peds > 12 y.Acne: Cleanse face, dry, & apply thin film daily hs on acne lesions. Psoriasis:Apply hs Caution: [X, ?/–] Contra: Retinoid sensitivity Disp: Gel 0.05, 0.1%;Cream 0.05%, 0.1% SE: Burning, erythema, irritation, rash, photosens, desquamation,bleeding, skin discoloration Notes: D/C w/ excessive pruritus, burning, skinredness or peeling occur until Sxs resolveTelbivudine (Tyzeka) WARNING: May cause lactic acidosis and severe hepatomegalyw/ steatosis when used alone or with antiretrovirals; D/C of the drug maylead to exacerbations of hep B; monitor LFTs Uses: *Rx chronic Hep B* Action: NucleosideRT inhibitor Dose: CrCl > 50 mL/min: 600 mg PO daily; CrCl 30–49 mL/min:600 mg q 48 hrs; CrCl < 30 mL/min: 600 mg q 72 hrs; ESRD: 600 mg q 96hrs Caution:[B; ?/–]; may cause myopathy; follow closely w/other myopathy causing drugs Disp:Tabs 600 mg SE: Fatigue, abdominal pain, N/V/D, HA, URI, nasopharyngitis, ↑LFTs/CPK, myalgia, flulike symptoms, dizziness, insomnia, dyspepsiaTelithromycin (Ketek) WARNING: May be associated with pseudomembranouscolitis and hepatic failure Uses: *Acute bacterial exacerbations of chronicbronchitis, acute bacterial sinusitis; mild–moderate community-acquired pneumonia*Action: Unique macrolide, blocks ↓ protein synth; bactericidal. Spectrum: Staphylococcusaureus, Streptococcus pneumoniae, H. influenzae, M. catarrhalis, Chlamydophilapneumoniae, M. pneumoniae Dose: Chronic bronchitis/sinusitis: 800 mg(2 tabs) PO daily × 5; Pneumonia: 800 mg (2 tabs) PO daily × 7–10 d Caution:[C, M] pseudomembranous colitis, ↑ QTc interval, MyG exacerbations, visual disturbances,hepatic dysfunction; dosing in renal impair unknown Contra: Macrolide allergy,use w/ pimozide, w/myasthenia gravis Disp: Tabs 300, 400 mg SE: N/V/D,dizziness, blurred vision Notes: A CYP450 inhibitor; multiple drug interactions