Clinician's Pocket Drug Reference 2008

36 AmilorideNephro/oto/neurotox, neuromuscular blockage, resp paralysis Notes: May be effectivein gram(–) bacteria resistant to gent & tobra; follow Cr; Levels: Peak: 30min after inf; Trough 35 mcg/mL; 1 ⁄2 life: 2 hAmiloride (Midamor) Uses: *HTN, CHF, & thiazide-induced ↓ K + * Action:K + -sparing diuretic; interferes w/ K + /Na + exchange in distal tubule Dose:Adults. 5–10 mg PO daily Peds. 0.625 mg/kg/d; ↓ in renal impair Caution: [B, ?]Contra: ↑ K + , SCr > 1.5, BUN > 30, diabetic neuropathy Disp: Tabs 5 mg SE: ↑K + ; HA, dizziness, dehydration, impotence Notes: monitor K +Aminocaproic Acid (Amicar) Uses: *Excessive bleeding from systemichyperfibrinolysis & urinary fibrinolysis* Action: ↓ fibrinolysis; via inhibition ofTPA substances Dose: Adults. 5 g IV or PO (1st h) followed by 1–1.25 g/h IV orPO (max dose/d: 30 g) Peds. 100 mg/kg IV (1st h) then 1 g/m 2 /h; max 18 g/m 2 /d; ↓in renal failure Caution: [C, ?] Upper urinary tract bleeding Contra: DIC Disp:Tabs 500, syrup 250 mg/mL; inj 250 mg/mL SE: ↓ BP, bradycardia, dizziness,HA, fatigue, rash, GI disturbance, ↓ plt Fxn Notes: Administer X 8 h or untilbleeding controlled; not for upper urinary tract bleedingAmino-Cerv pH 5.5 Cream Uses: *Mild cervicitis,* postpartum cervicitis/cervicaltears, postcauterization, postcryosurgery, & postconization Action:Hydrating agent; removes excess keratin in hyperkeratotic conditions Dose: 1 Applicatorfulintravag hs X 2–4 wk Caution: [C, ?] W/viral skin Infxn Disp: Vaginalcream SE: Stinging, local irritation Notes: AKA carbamide or urea; contains8.34% urea, 0.5% sodium propionate, 0.83% methionine, 0.35% cystine, 0.83% inositol,& benzalkonium chlorideAminoglutethimide (Cytadren) Uses: *Cushing synd* Adrenocorticalcarcinoma, breast CA & CAP Action: ↓ adrenal steroidogenesis & conversion ofandrogens to estrogens; aromatase inhibitor Dose: Initial 250 mg po 4 x D, titrate q1–2 wks max 2 gm/D; w/hydrocortisone 20–40 mg/d; ↓ in renal insuff Caution:[D, ?] Disp: Tabs 250 mg SE: Adrenal insuff (“medical adrenalectomy”), hypothyroidism,masculinization, ↓ BP, V, rare hepatotox, rash, myalgia, feverAminophylline Uses: *Asthma, COPD* & bronchospasm Action: Relaxessmooth muscle (bronchi, pulm vessels); stimulates diaphragm Dose: Adults. Acuteasthma: Load 6 mg/kg IV, then 0.4–0.9 mg/kg/h IV cont inf. Chronic asthma: 24mg/kg/24 h PO ÷ q6h. Peds. Load 6 mg/kg IV, then 1 mg/kg/h IV cont inf; ↓ in hepaticinsuff & w/ certain drugs (macrolide & quinolone antibiotics, cimetidine, &propranolol) Caution: [C, +] Uncontrolled arrhythmias, HTN, Sz disorder, hyperthyroidism,peptic ulcers Disp: Tabs 100, 200 mg; PR tabs 100 mg, 200 mg, soln105 mg/5 mL, inj 25 mg/mL SE: N/V, irritability, tachycardia, ventricular arrhythmias,Szs Notes: Individualize dosage; Level 10 to 20 mcg/mL, toxic > 20mcg/mL; aminophylline 85% theophylline; erratic rectal absorptionAmiodarone (Cordarone, Pacerone) Uses: *Recurrent VF or hemodynamicallyunstable VT,* supraventricular arrhythmias, AF Action: Class III an-