Clinician's Pocket Drug Reference 2008

Vinblastine 211Vasopressin [Antidiuretic Hormone, ADH] (Pitressin) Uses:*DI; Rx postop abd distension*; adjunct Rx of GI bleeding & esophageal varices;asystole and PEA pulseless VT & VF, adjunct systemic vasopressor (IV drip) Action:Posterior pituitary hormone, potent GI and peripheral vasoconstrictor Dose:Adults & Peds. DI: 2.5–10 units SQ or IM tid–qid. GI hemorrhage: 0.2–0.4units/min; ↓ in cirrhosis; caution in vascular Dz. VT/VF: 40 units IVP X1. Vasopressor:0.01–0.04 units/min Caution: [B, +] Contra: Allergy Disp: Inj 20units/mL SE: HTN, arrhythmias, fever, vertigo, GI upset, tremor Notes: Additionof vasopressor to concurrent norepinephrine or epi infsVecuronium (Norcuron) Uses: *Skeletal muscle relaxation* Action: Nondepolarizingneuromuscular blocker; onset 2–3 min Dose: Adults & Peds. 0.1–0.2mg/kg IV bolus (also rapid intubation ECC 2005); maint 0.010–0.015 mg/kg after25–40 min; additional doses q12–15 min PRN; ↓ in severe renal/hepatic impair Caution:[C, ?] Drug interactions cause ↑ effect (eg, aminoglycosides, tetracycline, succinylcholine)Disp: Powder for inj 10, 20 mg SE: Bradycardia, ↓ BP, itching, rash,tachycardia, CV collapse Notes: Fewer cardiac effects than succinylcholineVenlafaxine (Effexor, Effexor XR) WARNING: Monitor for worseningdepression or emergence of suicidality, particularly in ped pts Uses: *Depression,generalized anxiety,* social anxiety disorder; obsessive–compulsive disorder,chronic fatigue synd, ADHD, autism Action: Potentiation of CNS neurotransmitteractivity Dose: 75–375 mg/d ÷ into 2–3 equal doses; ↓ w/renal/hepatic impair Caution:[C, ?/–] Contra: MAOIs Disp: Tabs 25, 37.5, 50, 75, 100 mg; ER caps 37.5,75, 150 mg SE: HTN, ↑ HR, HA, somnolence, GI upset, sexual dysfunction; actuatesmania or Szs Notes: Avoid EtOHVerapamil (Calan, Isoptin, Verelan) Uses: *Angina, HTN, PSVT,AF, atrial flutter,* migraine prophylaxis, hypertrophic cardiomyopathy, bipolar DzAction: CCB Dose: Adults. Arrhythmias: 2nd line for PSVT w/ narrow QRS complex& adequate BP 2.5–5 mg IV over 1–2 min; repeat 5–10 mg in 15–30 min PRN(30 mg max). Angina: 80–120 mg PO tid, ↑ 480 mg/24 h max. HTN: 80–180 mgPO tid or SR tabs 120–240 mg PO daily to 240 mg bid; 2.5–5.0 mg IV over 1–2min; repeat 5–10 mg, in 5–30 min PRN; or 5-mg bolus q 15 min (max 30 mg)(ECC 2005) Peds. < 1 y: 0.1–0.2 mg/kg IV over 2 min (may repeat in 30 min).1–16 y: 0.1–0.3 mg/kg IV over 2 min (may repeat in 30 min); 5 mg max. PO: 1–5 y:4–8 mg/kg/d in 3 ÷ doses. > 5 y: 80 mg q6–8h; ↓ in renal/hepatic impair Caution:[C, +] Amiodarone/β-blockers/flecainide can cause bradycardia; statins, midazolam,tacrolimus, theophylline levels may be ↑; w/ elderly pts Contra: Conductiondisorders, cardiogenic shock; beta blocker/thiazide combo, dofetilide, pimozide,ranolazine Disp: Tabs 40, 80, 120 mg; tablets ER 120, 180, 240 mg; tablets ER 24Hr 180, 240, mg; inj 5 mg/2 mL SE: Gingival hyperplasia, constipation, ↓ BP,bronchospasm, HR or conduction disturbancesVinblastine (Velban, Velbe) WARNING: Chemotherapeutic agent;handle w/ caution Uses: *Hodgkin Dz & NHLs, mycosis fungoides, CAs (testis,