Clinician's Pocket Drug Reference 2008

202 Ticlopidinesensitivity Disp: Inj 3g/1g vial SE: Hemolytic anemia, false + proteinuria Notes:Often used in combo w/ aminoglycosides; penetrates CNS with meningeal irritation;see also ticarcillinTiclopidine (Ticlid) WARNING: Neutropenia/agranulocytosis, TTP, aplasticanemia reported Uses: *↓ risk of thrombotic stroke,* protect grafts status postCABG, diabetic microangiopathy, ischemic heart Dz, DVT prophylaxis, graft prophylaxisafter renal transplant Action: Plt aggregation inhibitor Dose: 250 mg PObid w/ food Caution: [B, ?/–], ↑ tox of ASA, anticoagulation, NSAIDs, theophyllineContra: Bleeding, hepatic impair, neutropenia, thrombocytopenia Disp:Tabs 250 mg SE: Bleeding, GI upset, rash, ↑ on LFTs Notes: Follow CBC1st 3 moTigecycline (Tygacil) Uses: *Rx complicated skin & soft tissue Infxns, &complicated intraabd Infxns* Action: New class: related to tetracycline; Spectrum:Broad gram (+), gram (–), anaerobic, some mycobacterial; E. coli, Enterococcusfaecalis (vanco-susceptible isolates), Staph aureus (meth-susceptible/resistant),Strep (agalactiae, anginosus grp, pyogenes), Citrobacter freundii, Enterobactercloacae, B. fragilis group, C. perfringens, Peptostreptococcus Dose: Adults. 100mg, then 50 mg q12h IV over 30–60 min every 12 h Caution: [D, ?] hepatic impair,monotherapy w/ intestinal perf, not OK in peds Contra: Component sensitivityDisp: Inj 50 mg vial SE: N/V, inj site RxnTimolol (Blocadren) WARNING: Exacerbation of ischemic heart Dz w/abrupt D/C Uses: *HTN & MI* Action: β-adrenergic receptor blocker, β 1 , β 2Dose: HTN: 10–20 mg bid, up to 60 mg/d. MI: 10 mg bid Caution: [C (1st tri; D if2nd or 3rd tri), +] Contra: CHF, cardiogenic shock, bradycardia, heart block,COPD, asthma Disp: Tabs 5, 10, 20 mg SE: Sexual dysfunction, arrhythmia, dizziness,fatigue, CHFTimolol, Ophthalmic (Timoptic) Uses: *Glaucoma* Action: β-blockerDose: 0.25% 1 gt bid; ↓ to daily when controlled; use 0.5% if needed; 1 gtt/d gelCaution: [C (1st tri; D 2nd or 3rd), ?/+] Disp: Soln 0.25/0.5%; Timoptic XE (0.25,0.5%) gel-forming soln SE: Local irritationTinidazole (Tindamax) WARNING: Off-label use discouraged (animalcarcinogenicity w/ other drugs in class) Uses: Adults/children > 3 y. * Trichomoniasis& giardiasis; intestinal amebiasis or amebic liver abscess * Action: Antiprotozoalnitroimidazole; Spectrum: Trichomonas vaginalis, Giardia duodenalis,Entamoeba histolytica Dose: Adults. Trichomoniasis: 2 g PO; Rx partner; Giardiasis:2 g PO; Amebiasis: 2 g PO daily × 3; Amebic liver abscess: 2 g PO daily ×3–5; Peds. Trichomoniasis: 50 mg/kg PO, 2 g/day max; Giardiasis: 50 mg/kg PO,2 g max; Amebiasis: 50 mg/kg PO daily × 3, 2 g/day max; Amebic liver abscess:50 mg/kg PO daily × 3–5, 2 g/day max; w/ food Caution: [C, D in 1st trim; –] Maybe cross-resistant with metronidazole; Sz/peripheral neuropathy may require D/C;w/ CNS/hepatic impair Contra: Metronidazole allergy, 1st trim PRG, w/ EtOH useDisp: Tabs 250, 500 SE: CNS disturbances; blood dyscrasias, taste disturbances,