Clinician's Pocket Drug Reference 2008

214 ZidovudineZidovudine (Retrovir) WARNING: Neutropenia, anemia, lactic acidosis,& hepatomegaly w/ steatosis Uses: *HIV Infxn, prevention of maternal HIVtransmission of HIV* Action: ↓ RT Dose: Adults. 200 mg PO tid or 300 mg PObid or 1–2 mg/kg/dose IV q4h. PRG: 100 mg PO 5 ×/d until labor starts; duringlabor 2 mg/kg over 1 h followed by 1 mg/kg/h until clamping of the cord. Peds.160 mg/m 2 /dose q8h; ↓ in renal failure Caution: [C, ?/–] Contra: Allergy Disp:Caps 100 mg; tabs 300 mg; syrup 50 mg/5 mL; inj 10 mg/mL SE: Hematologictox, HA, fever, rash, GI upset, malaise, myopathyZidovudine & Lamivudine (Combivir) WARNING: Neutropenia,anemia, lactic acidosis, & hepatomegaly w/ steatosis Uses: *HIV Infxn* Action:Combo of RT inhibitors Dose: Adults & Peds > 12 y. 1 tab PO bid; ↓ in renal failureCaution: [C, ?/–] Contra: Component allergy Disp: Caps zidovudine 300mg/lamivudine 150 mg SE: Hematologic tox, HA, fever, rash, GI upset, malaise,pancreatitis Notes: Combo product ↓ daily pill burdenZileuton (Zyflo) Uses: *Chronic Rx of asthma* Action: Inhibitor of 5-lipoxygenase Dose: Adults & Peds ≥ 12 y. 600 mg PO qid Caution: [C, ?/–] Contra:Hepatic impair Disp: Tabs 600 mg SE: Hepatic damage, HA, GI upset,leukopenia Notes: Monitor LFTs every month × 3, then q2–3 mo; take on regularbasis; not for acute asthmaZiprasidone (Geodon) WARNING: ↑ mortality in elderly with dementia-relatedpsychosis Uses: *Schizophrenia, acute agitation* Action: Atypicalantipsychotic Dose: 20 mg PO bid, may ↑ in 2-d intervals up to 80 mg bid; agitation10–20 mg IM PRN up to 40 mg/d; separate 10 mg doses by 2 h & 20 mg dosesby 4h (w/ food) Caution: [C, –] w/ ↓ Mg 2+ , ↓ K + Contra: QT prolongation, recentMI, uncompensated heart failure, meds that ↑ QT interval Disp: Caps 20, 40, 60,80 mg; susp 10 mg/mL; Inj 20 mg/mL; susp 10 mg/mL SE: Bradycardia; rash,somnolence, resp disorder, EPS, wgt gain, orthostatic ↓ BP Notes: Monitor lytesZoledronic Acid (Zometa, Reclast) Uses: *↑ Ca 2+ of malignancy(HCM),↓ skeletal-related events in CAP, multiple myeloma, & met bone lesions(Zometa)* *post-menopausal osteoporosis, Paget Dz (Reclast)* Action: Bisphosphonate;↓ osteoclastic bone resorption Dose: HCM: 4 mg IV over at least 15 min; may retreatin 7 d if adequate renal Fxn. Bone lesions/myeloma: 4 mg IV over at least 15 min,repeat q3–4wk PRN; prolonged w/ Cr ↑; Reclast: 5 mg IV annually Caution: [C, ?/–]Loop diuretics, aminoglycosides; ASA-sensitive asthmatics; avoid invasive dental proceduresw/ CR Contra: Bisphosphonate allergy; w/dental procedures Disp: Vial 4 mg, 5mg SE: all are adverse effects ↑ w/ renal dysfunction; fever, flulike synd, GI upset, insomnia,anemia; electrolyte abnormalities, osteonecrosis of jaw Notes: Requires vigorousprehydration; do not exceed recommended doses/inf duration to ↓ dose-related renaldysfunction; follow Cr; effect prolonged w/ Cr ↑; avoid oral surgery; dental exam recommendedprior to therapy; ↓ dose w/ renal dysfunctionZolmitriptan (Zomig, Zomig XMT, Zomig Nasal) Uses: *AcuteRx migraine* Action: Selective serotonin agonist; causes vasoconstriction Dose: