Clinician's Pocket Drug Reference 2008

198 TenofovirTenofovir (Viread) WARNING: Lactic acidosis & severe hepatomegalywith steatosis, including fatal cases, have been reported with the use of nucleosideanalogs alone or in combo w/ other antiretrovirals. Not OK w/ chronic hepatitis;effects in patients co-infected with Hep B & HIV unknown Uses: *HIV Infxn*Action: Nucleotide RT inhibitor Dose: 300 mg PO daily ∆ to w/ or w/o meal; CrCl∆≥50 mL/min ∆ q24h, CrCl 30–49 mL/min q48H, CrCl 10–29 mL/min 2 × weekCaution: [B, ?/–] Didanosine (separate admin times), lopinavir, ritonavir w/known risk factors for liver Dz Contra: Hypersensitivity Disp: Tabs 300 mg SE:GI upset, metabolic synd, hepatotox; separate didanosine doses by 2 h Notes:combo product w/emtricitabine is TruvadaTenofovir/Emtricitabine (Truvada) WARNING: Lactic acidosis &severe hepatomegaly with steatosis, including fatal cases, have been reported withthe use of nucleoside analogs alone or in combo w/ other antiretrovirals. Not OKw/ chronic hepatitis; effects in patients co-infected with Hep B & HIV unknownUses: *HIV Infxn* Action: Dual nucleotide RT inhibitor Dose: 300 mg PO dailyw/ or w/o a meal adjust w/ renal impairment Caution: w/ known risk factors forliver Dz [B, ?/–] Contra: CrCl < 30 mL/min; Disp: Tabs: 200 mg emtricitabine/300mg tenofovir SE: GI upset, rash, metabolic synd, hepatotoxTerazosin (Hytrin) Uses: *BPH & HTN* Action: α1-blocker (blood vessel& bladder neck/prostate) Dose: Initial, 1 mg PO hs; ↑ 20 mg/d max Caution:[C, ?] w/ BB, CCB, ACEI Contra: α-antagonist sensitivity Disp: Tabs 1, 2, 5, 10mg; caps 1, 2, 5, 10 mg SE: ↓ BP, & syncope following 1st dose; dizziness, weakness,nasal congestion, peripheral edema, palpitations, GI upset Notes: Caution w/1st dose syncope; if for HTN, combine w/ thiazide diureticTerbinafine (Lamisil) Uses: *Onychomycosis, athlete’s foot, jock itch,ringworm,* cutaneous candidiasis, pityriasis versicolor Action: ↓ squalene epoxidaseresulting in fungal death Dose: PO: 250 mg/d PO for 6–12 wk. Topical:Apply to area; ↓ in renal/hepatic impair Caution: [B, –] ↑ effects of drug metab byCYP2D6, liver dz, renal impairment (CrCl < 60) Disp: Tabs 250 mg; cream, gel,soln 1%; SE: HA, dizziness, rash, pruritus, alopecia, GI upset, taste perversion,neutropenia, retinal damage, Stevens–Johnson synd Notes: Effect may take monthsdue to need for new nail growth; do not use occlusive dressingsTerbutaline (Brethine) Uses: *Reversible bronchospasm (asthma,COPD); inhibit labor* Action: Sympathomimetic; tocolytic Dose: Adults. Bronchodilator:2.5–5 mg PO qid or 0.25 mg SQ; repeat in 15 min PRN ;max 0.5 mg in4 h; Met-dose inhaler: 2 inhal q4–6h. Premature labor: Acutely 2.5–10mg/min/IV, gradually ↑ as tolerated q10–20 min; maint 2.5–5 mg PO q4–6h untilterm Peds. PO: 0.05–0.15 mg/kg/dose PO tid; max 5 mg/24h; ↓ in renal failureCaution: [B, +] ↑ tox w/ MAOIs, TCAs; DM, HTN, hyperthyroidism, CV disease,DM, convulsive disorders, ↓ K + Contra: Component allergy Disp: Tabs 2.5, 5 mg;inj 1 mg/mL; met-dose inhaler SE: HTN, hyperthyroidism, β 1 -adrenergic effectsw/ high dose, nervousness, trembling, tachycardia, HTN, dizziness