Clinician's Pocket Drug Reference 2008

200 Thalidomidemor cerebri, hepatic impair Notes: Can stain tooth enamel & depress bone formationin childrenThalidomide (Thalomid) WARNING: Restricted use; use associated w/severe birth defects and ↑ risk of venous thromboembolism Uses: *Erythema nodosumleprosum (ENL),* GVHD, aphthous ulceration in HIV(+) Action: ↓ Neutrophilchemotaxis, ↓ monocyte phagocytosis Dose: GVHD: 100–1600 mg POdaily. Stomatitis: 200 mg bid for 5 d, then 200 mg daily up to 8 wk. ENL: 100–300mg PO qhs Cautions: [X, –] May ↑ HIV viral load; Hx Szs Contra: PRG; sexuallyactive males not using latex condoms, or females not using 2 forms of contraceptionDisp: 50, 100, 200 mg cap SE: Dizziness, drowsiness, rash, fever,orthostasis, Stevens–Johnson synd, peripheral neuropathy, Szs Notes: MD mustregister w/ STEPS risk management program; informed consent necessary; immediatelyD/C if rash developsTheophylline (Theo24, TheoChron) Uses: *Asthma, bronchospasm*Action: Relaxes smooth muscle of the bronchi & pulm blood vessels Dose:Adults. 900 mg PO ÷ q6h; SR products may be ÷ q8–12h (maint). Peds. 16–22mg/kg/24 h PO ÷ q6h; SR products may be ÷ q8–12h (maint); ↓ in hepatic failureCaution: [C, +] Multiple interactions (eg, caffeine, smoking, carbamazepine, barbiturates,β-blockers, ciprofloxacin, E-mycin, INH, loop diuretics) Contra: Arrhythmia,hyperthyroidism, uncontrolled Szs Disp: Elixir 80, 15 mL; Soln 80mg/15 mL; Syrup 80, 150 mg/15 mL; Caps 100, 200, 250 mg; Tabs 100, 125, 200,250, 300 mg; SR Caps 100, 125, 200, 250, 260, 300 mg; SR tabs 100, 200, 300,400, 450, 600 mg SE: N/V, tachycardia, Szs, nervousness, arrhythmias Notes:Levels IV: Sample 12–24 h after inf started; Therapeutic: 5–15 mcg/mL; Toxic >20 mcg/mL; 1 ⁄2 life: nonsmoking adults 8 h/children and smoking adults 4 h; LevelsPO: Trough just before next dose; Therapeutic: 5–15 mcg/mLThiamine [Vitamin B 1 ] Uses: *Thiamine deficiency (beriberi), alcoholicneuritis, Wernicke encephalopathy* Action: Dietary supl Dose: Adults. Deficiency:100 mg/d IM for 2 wk, then 5–10 mg/d PO for 1 mo. Wernicke encephalopathy:100 mg IV single dose, then 100 mg/d IM for 2 wk. Peds. 10–25mg/d IM for 2 wk, then 5–10 mg/24 h PO for 1 mo Caution: [A (C if doses exceedRDA), +] Contra: Component allergy Disp: Tabs 5, 10, 25, 50, 100, 250, 500 mg;inj 100, 200 mg/mL SE: Angioedema, paresthesias, rash, anaphylaxis w/ rapid IVNotes: IV use associated w/ anaphylactic Rxn; give IV slowlyThiethylperazine (Torecan) Uses: *N/V* Action: Antidopaminergicantiemetic Dose: 10 mg PO, PR, or IM daily–tid; ↓ in hepatic failure Caution:[X, ?] Contra: Phenothiazine & sulfite sensitivity, PRG Disp: Tabs 10 mg; supp10 mg; inj 5 mg/mL SE: EPS, xerostomia, drowsiness, orthostatic ↓ BP, tachycardia,confusion6-Thioguanine [6-TG] (Tabloid) Uses: *AML, ALL, CML* Action:Purine-based antimetabolite (substitutes for natural purines interfering w/ nucleotidesynth) Dose: 2–3 mg/kg/d; ↓ in severe renal/hepatic impair Caution: