Clinician's Pocket Drug Reference 2008

Calcium Salts 531–4 mg IM or IV q3–4h PRN. Migraine: 1 spray in 1 nostril, repeat x 1 60–90minutes, then q3–4 hrs. ↓ in renal impair Caution: [C (D if high dose or prolongeduse at term), +] Disp: Inj 2 mg/mL; nasal 1 mg/spray SE: Drowsiness, dizziness,nasal congestion Notes: May induce withdrawal in opioid dependencyCalcipotriene (Dovonex) Uses: *Plaque psoriasis* Action: KeratolyticDose: Apply bid Caution: [C, ?] Contra: ↑ Ca 2+ ; vitamin D tox; do not apply toface Disp: Cream; oint; soln 0.005% SE: Skin irritation, dermatitisCalcitonin (Fortical, Miacalcin) Uses: *Paget Dz of bone, ↑ Ca 2+ ,* osteogenesisimperfecta, *postmenopausal osteoporosis* Action: Polypeptide hormoneDose: Paget Dz: 100 units/d IM/SC initial, 50 units/d or 50–100 units q1–3dmaint. ↑ Ca 2+ 4 units/kg IM/SC q12h; ↑ to 8 units/kg q12h, max q6h. Osteoporosis:100 units/qod IM/SQ; intranasal 200 units = 1 nasal spray/d Caution: [C, ?]Disp: Spray, nasal 200 units/activation; inj, salmon 200 units/mL (2 mL) SE: Facialflushing, N, injection site edema, nasal irritation, polyuria Notes: For nasalspray alternate nostrils dailyCalcitriol (Rocaltrol, Calcijex) Uses: *Reduction of ↑ PTH levels, ↓Ca 2+ on dialysis* Action: 1,25-Dihydroxycholecalciferol (vitamin D analog)Dose: Adults. Renal failure: 0.25 mcg/d PO, ↑ 0.25 mcg/d q4–6wk PRN; 0.5 mcg3 ×/wk IV, ↑ PRN. Hypoparathyroidism: 0.5–2 mcg/d. Peds. Renal failure: 15ng/kg/d, ↑ PRN; maint 30–60 ng/kg/d. Hypoparathyroidism: 6 y, 0.5–2 mcg/d Caution: [C, ?] Contra: ↑ Ca 2+ ; vitamin D tox Disp: Inj1, 2 mcg/mL (in 1-mL); caps 0.25, 0.5 mcg; sol 1 mcg/mL SE: ↑ Ca 2+ possibleNotes: Monitor to keep Ca 2+ WNLCalcium Acetate (PhosLo) Uses: *ESRD-associated hyperphosphatemia*Action: Ca 2+ supl w/o aluminum to ↓ PO -2 4 absorption Dose: 2–4 tabsPO w/ meals Caution: [C, ?] Contra: ↑ Ca 2+ Disp: Gelcap 667 mg SE: Can ↑Ca 2+ , hypophosphatemia, constipation Notes: Monitor Ca 2+Calcium Carbonate (Tums, Alka-Mints) [OTC] Uses: *Hyperacidityassociated w/peptic ulcer Dz, hiatal hernia, etc* Action: Neutralizesgastric acid Dose: 500 mg–2 g PO PRN; ↓ in renal impair Caution: [C, ?]Disp: Chew tabs 350, 420, 500, 550, 750, 850 mg; susp SE: ↑ Ca 2+ , ↓PO-4 , constipationCalcium Glubionate (Neo-Calglucon) [OTC] Uses: *Rx & preventcalcium deficiency* Action: Ca 2+ supl Dose: Adults. 6–18 g/d ÷ doses. Peds.600–2000 mg/kg/d ÷ qid (9 g/d max); ↓ in renal impair Caution: [C, ?] Contra: ↑Ca 2+ Disp: OTC syrup 1.8 g/5 mL = elemental Ca 115 mg/5 mL SE: ↑ Ca 2+ , ↓ PO-4, constipationCalcium Salts (Chloride, Gluconate, Gluceptate) Uses: *Ca 2+replacement,* VF, Ca 2+ blocker tox, Mg 2+ intox, tetany, *hyperphosphatemia inESRD* Action: Ca 2+ supl/replacement Dose: Adults. Replacement: 1–2 g/d PO.Tetany: 1 g CaCl over 10–30 min; repeat in 6 h PRN; Hyperkalemia/calcium channelblocker overdose: 8-16 mg/kg (usually 5-10 mL) IV; 2–4 mg/kg