Clinician's Pocket Drug Reference 2008

204 Tolazamidesusp 2.5, 5 & 10 mL tobramycin 0.3% & dexamethasone 0.1% SE: Local irritation/edemaNotes: Use under ophthalmologist’s directionTolazamide (Tolinase) Uses: *Type 2 DM* Action: Sulfonylurea; ↑ pancreaticinsulin release; ↑ peripheral insulin sensitivity; ↓ hepatic glucose outputDose: 100–500 mg/d (no benefit > 1 g/d) Caution: [C, +/–] Elderly, hepatic orrenal impair Disp: Tabs 100, 250, 500 mg SE: HA, dizziness, GI upset, rash, hyperglycemia,photosens, blood dyscrasiasTolazoline (Priscoline) Uses: *Peripheral vasospastic disorders* Action:Competitively blocks α-adrenergic receptors Dose: Adults. 10–50 mg IM/IV/SQqid. Neonates. 1–2 mg/kg IV over 10–15 min, then 1–2 mg/kg/h (adjust w/ ↓ renalFxn) Caution: Avoid alcohol, w/CAD, renal impairment, CVA, PUD, ↓ BP [C, ?]Contra: CAD Disp: Inj 25 mg/mL SE: ↓ BP, peripheral vasodilation, tachycardia,arrhythmias, GI upset & bleeding, blood dyscrasias, renal failureTolbutamide (Orinase) Uses: *Type 2 DM* Action: Sulfonylurea; ↑pancreatic insulin release; ↑ peripheral insulin sensitivity; ↓ hepatic glucose outputDose: 500–1000 mg bid; 3 gm/day max; ↓ in hepatic failure Caution: [C, +] Contra:Sulfonylurea sensitivity Disp: Tabs 250, 500 mg SE: HA, dizziness, GI upset,rash, photosens, blood dyscrasias, hypoglycemia, heartburnTolcapone (Tasmar) WARNING: Cases of fulminant liver failure resultingin death have occurred Uses: *Adjunct to carbidopa/levodopa in ParkinsonDz* Action: Catechol-O-methyltransferase inhibitor slows levodopa metabolismDose: 100 mg PO TID w/ first daily levodopa/carbidopa dose, then dose 6 & 12 hlater; ↓ /w renal impair Caution: [C, ?] Contra: Hepatic impair; w/nonselectiveMAOI Disp: Tablets 100 mg, 200 mg SE: Constipation, xerostomia, vivid dreams,hallucinations, anorexia, N/D, orthostasis, liver failure, Rhabdomyolysis Notes:Do not abruptly D/C or ↓ dose; monitor LFTsTolmetin (Tolectin) WARNING: May ↑ risk of cardiovascular events & GIbleeding Uses: *Arthritis & pain* Action: NSAID; ↓ prostaglandins Dose:200–600 mg PO tid; 2000 mg/d max Caution: [C (D in 3rd tri or near term), +]Contra: NSAID or ASA sensitivity; use for pain post CABG Disp: Tabs 200, 600mg; caps 400 mg SE: Dizziness, rash, GI upset, edema, GI bleeding, renal failureTolnaftate (Tinactin) [OTC] Uses: *Tinea pedis, cruris, corporis,manus, versicolor* Action: Topical antifungal Dose: Apply to area bid for 2–4 wkCaution: [C, ?] Contra: Nail & scalp Infxns Disp: OTC 1% liq; gel; powder; topicalcream; ointment, powder, spray soln SE: Local irritation Notes: Avoid ocularcontact, Infxn should improve in 7–10 dTolterodine (Detrol, Detrol LA) Uses: *OAB (frequency, urgency, incontinence)*Action: Anticholinergic Dose: Detrol 1–2 mg PO bid; Detrol LA 2–4mg/d Caution: [C, ?/–] w/ CYP2D6 & 3A3/4 inhibitor (Table 11) Contra: Urinaryretention, gastric retention, or uncontrolled NAG Disp: Tabs 1, 2 mg; DetrolLA tabs 2, 4 mg SE: Xerostomia, blurred vision, headache, constipation Notes:LA form may see “intact” pill in stool