Clinician's Pocket Drug Reference 2008

Bismuth subcitrate/metroindazole/tetracycline 49[C (1st tri), D (2nd or 3rd tri), ?/–] Disp: Soln 0.5%; susp 0.25% SE: Local irritation,photophobiaBethanechol (Urecholine, Duvoid, others) Uses: *Neurogenicbladder atony w/ retention,* acute *postop* & postpartum functional *(nonobstructive)urinary retention* Action: Stimulates cholinergic smooth muscle receptorsin bladder & GI tract Dose: Adults. 10–50 mg PO tid-qid or 2.5–5 mg SQtid-qid & PRN. Peds. 0.6 mg/kg/24 h PO ÷ tid-qid or 0.15–2 mg/kg/d SQ ÷ 3–4 ×(take on empty stomach) Caution: [C, ?/–] Contra: BOO, PUD, epilepsy, hyperthyroidism,bradycardia, COPD, AV conduction defects, parkinsonism, ↓ BP, vasomotorinstability Disp: Tabs 5, 10, 25, 50 mg; inj 5 mg/mL SE: Abd cramps, D,salivation, ↓BP Notes: Do not use IM/IVBevacizumab (Avastin) WARNING: Associated w/ GI perforation,wound dehiscence, & fatal hemoptysis Uses: *Met colorectal ca, w/5-FUNSCLC w/paclitaxel and carboplatin* Action: Vascular endothelial GF inhibitorDose: Adults. Colon: 5 mg/kg or 10 mg/kg IV q14d; NSCLC: 15 mg/kg Q 21 days;1st dose over 90 min; 2nd over 60 min, 3rd over 30 min if tolerated Caution: [C,–] Do not use w/in 28 d of surgery if time for separation of drug & anticipated surgicalprocedures is unknown; D/C w/ serious adverse events Disp: 100 mg/4 mL,400 mg/16 mL vials SE: Wound dehiscence, GI perforation, tracheo-espohagealfistula, hemoptysis, hemorrhage, HTN, proteinuria, CHF, inf Rxns, D, leucopenia,thromboembolism Notes: Monitor for ↑ BP & proteinuriaBicalutamide (Casodex) Uses: *Advanced CAP (met)* (w/ GnRH agonists[eg, leuprolide, goserelin]) Action: Nonsteroidal antiandrogen Dose: 50 mg/dCaution: [X, ?] Contra: Women Disp: Caps 50 mg SE: Hot flashes, loss of libido,impotence, D/N/V, gynecomastia, & LFT elevationBicarbonate (See Sodium Bicarbonate, page 188)Bisacodyl (Dulcolax) [OTC] Uses: *Constipation; preop bowel prep* Action:Stimulates peristalsis Dose: Adults. 5–15 mg PO or 10 mg PR PRN. Peds.2 y.: 5 mg PO or 10 mg PR PRN (do not chew tabs or givew/in 1 h of antacids or milk) Caution: [B, ?] Contra: Acute abdomen or bowel obst,appendicitis, gastroenteritis Disp: EC tabs 5 mg; DR Tab 5 mg; supp 10 mg, enemasoln 10 mg/30 mL SE: Abd cramps, proctitis, & inflammation w/ suppositoriesBismuth Subcitrate/Metronidazole/Tetracycline (Pylera)WARNING: Metronidazole carcinogenic in mice and rats; avoid use unless absolutelynecessary Uses: *H. pylori infection w/ omeprazole* Action: eradicationof H. pylori, see agents Dose: 3 caps 4X day w/omeprazole 20 mg 2X day for10 days Caution: [D, –] Contra: Pregnancy, childhood to 8 yrs (tetracycline duringtooth development causes teeth discoloration), w/renal/hepatic impair, componenthypersensitivity Disp: Caps w/ 140 mg bismuth subcitrate potassium, 125 mgmetronidazole, and 125 mg tetracycline hydrochloride SE: stool abnormality, D,dyspepsia, abd pain, HA, flu-like synd, taste perversion, vaginitis, dizziness; seeSE for each component