Clinician's Pocket Drug Reference 2008

50 Bismuth SubsalicylateBismuth Subsalicylate (Pepto-Bismol) [OTC] Uses: Indigestion,N, & *D;* combo for Rx of *H. pylori Infxn* Action: Antisecretory & anti-inflammatoryDose: Adults. 2 tabs or 30 mL PO PRN (max 8 doses/24 h). Peds.3–6 y: 1/3 tab or 5 mL PO PRN (max 8 doses/24 h). 6–9 y.: 2/3 tab or 10 mL POPRN (max 8 doses/24 h). 9–12 y: 1 tab or 15 mL PO PRN (max 8 doses/24 h)Caution: [C, D (3rd tri), –] Avoid w/renal failure; hx severe GI bleed Contra: Influenzaor chickenpox (↑ risk of Reye’s synd), ASA allergy (see aspirin) Disp:Chew tabs 262 mg; Caplets 262 mg, liq 262, 525 mg/15 mL, susp 262 mg/15 mLSE: May turn tongue & stools blackBisoprolol (Zebeta) Uses: *HTN* Action: Competitively blocks β 1 -adrenergic receptors Dose: 2.5–10 mg/d (max dose 20 mg/d); ↓ w/renal impairCaution: [C (D 2nd & 3rd tri), +/–] Contra: Sinus bradycardia, AV conduction abnormalities,uncompensated cardiac failure Disp: Tabs 5, 10 mg SE: Fatigue,lethargy, HA, bradycardia, edema, CHF Notes: Not dialyzedBivalirudin (Angiomax) Uses: *Anticoagulant w/ ASA in unstableangina undergoing PTCA, PCI or in patients undergoing PCI w/ or at risk ofHIT/HITTS* Action: Anticoagulant, thrombin inhibitor Dose: 0.75 mg/kg IVbolus, then 1.75 mg/kg/h for duration of procedure and up to 4 h post; ACT 5min after bolus, may repeat 0.3 mg/kg bolus if necessary (give w/ aspirin 300–325mg/d; start pre-PTCA) Caution: [B, ?] Contra: Major bleeding Disp: Powder 250mg for inj SE: Bleeding, back pain, N, HABleomycin Sulfate (Blenoxane) Uses: *Testis CA; Hodgkin Dz &NHLs; cutaneous lymphomas; & squamous cell CA (head & neck, larynx, cervix,skin, penis); malignant pleural effusion sclerosing agent* Action: Induces DNAbreakage (scission) Dose: (Per protocols); ↓ w/renal impair Caution: [D, ?] Severepulm Dz (pulm fibrosis) Disp: Inj: Powder for recons 15, 30 units SE: Hyperpigmentation(skin staining) & allergy (rash to anaphylaxis); fever in 50%; lung tox(idiosyncratic & dose related); pneumonitis w/fibrosis; Raynaud phenomenon,N/V Notes: Test dose 1 unit, especially in lymphoma pts; lung tox w/ total dose>400 units or single dose >30 unitsBortezomib (Velcade) WARNING: May worsen preexisting neuropathyUses: *Rx multiple myeloma or mantel cell lymphoma with one previous RX* Action:Proteasome inhibitor Dose: 1.3 mg/m 2 bolus IV 2 ×/wk × 2 wk, w/ 10-dayrest period (=1 cycle); ↓ dose w/hematologic tox, neuropathy Caution: [D, ?/–]w/drugs CYP450 metabolized (Table 11) Disp: 3.5-mg vial SE: Asthenia, GIupset, anorexia, dyspnea, HA, orthostatic ↓ BP, edema, insomnia, dizziness, rash,pyrexia, arthralgia, neuropathyBotulinum Toxin Type A (Botox, Botox Cosmetic) Uses: *Glabellarlines (cosmetic), blepharospasm, cervical dystomia, axillary hyperhidrosis, strabismus*Action: ↓ acetylcholine release from nerve endings, ↓ neuromusculartransmission and local muscle activity; neurotoxin Dose: Adults: Glabellar lines(cosmetic): 0.1 mL IM x5 sites q3–4mo; Blepharospasm: 1.25–2.5 units IM/site