Clinician's Pocket Drug Reference 2008

32 AlfentanilAlfentanil (Alfenta) [C-II] Uses: *Adjunct in the maint of anesthesia;analgesia* Action: Short-acting narcotic analgesic Dose: Adults & Peds >12 y.3–75 mcg/kg (IBW) IV inf; total depends on duration of procedure Caution:[C, +/–] ↑ ICP, resp depression Disp: Inj 500 mcg/mL SE: Bradycardia, ↓ BP arrhythmias,peripheral vasodilation, ↑ ICP, drowsiness, resp depressionAlfuzosin (Uroxatral) WARNING: May prolong QTc interval Uses:*BPH* Action: a-Blocker Dose: 10 mg PO daily immediately after the same mealCaution: [B, –] Contra: W/CYP3A4 inhibitors; moderate-severe hepatic impairDisp: Tabs 10 mg SE: Postural ↓ BP, dizziness, HA, fatigue Notes: XR tablet donot cut or crush; ↓ ejaculatory disorders compared w/similar drugsAlginic Acid + Aluminum Hydroxide & Magnesium Trisilicate(Gaviscon) [OTC] Uses: *Heartburn*; hiatal hernia pain Action: Protectivelayer blocks gastric acid Dose: 2–4 tabs or 15–30 mL PO qid followed byH 2 O; Caution: [B, –] Avoid in renal impair or Na + -restricted diet Disp: Tabs, suspSE: D, constipationAlglucosidase alfa (Myozyme) WARNING: Life-threatening anaphylacticRxns have occurred w/infusion; appropriate medical support measuresshould be immediately available Uses: *Rx Pompe DZ* Action: Recombinantacid alpha-glucosidase; degrades glycogen in lysosomes Dose: 20 mg/kg IV q 2wks over 4 h (see insert) Caution: [B,?/–] Illness at time of inf may ↑ inf RxnsDisp: Powder 50 mg/vial SE: Hypersensitivity, fever, rash, D,V, gastroenteritis,pneumonia, URI, cough, respiratory distress, infxns, cardiorespiratory failure, cardiacarrhythmia w/general anesthesiaAliskiren (Tekturna) WARNING: May cause injury and death to a developingfetus; D/C immediately when pregnancy is detected Uses: HTN Action:Direct renin inhibitor Dose: 150–300mg PO day Caution: [C (1st trim), D (2nd &3rd trim);?]; w/severe renal impair Disp: Tabs 150, 300 mg SE: D, abd pain, dyspepsia,GERD, cough, ↑ K + , angioedema, ↓ BPAllopurinol (Zyloprim, Lopurin, Aloprim) Uses: *Gout, hyperuricemiaof malignancy, uric acid urolithiasis* Action: Xanthine oxidase inhibitor;↓ uric acid production Dose: Adults. PO: Initial 100 mg/d; usual 300 mg/d; max800 mg/d. IV: 200–400 mg/m 2 /d (max 600 mg/24 h); (after meal w/ plenty offluid). Peds. Only for hyperuricemia of malignancy if