Clinician's Pocket Drug Reference 2008

Clindamycin 65glove”-type neuropathy, cardiotox (ST, T-wave changes), ↓ Mg 2+ , mild↓ BM, hepatotox;renal impair dose-related & cumulative Notes: Give taxanes before platinumderivativesCitalopram (Celexa) WARNING: Closely monitor for worsening depressionor emergence of suicidality, particularly in patients < 24 y. Uses: *Depression*Action: SSRI Dose: Initial 20 mg/d, may ↑ to 40 mg/d; ↓ in elderly &hepatic/renal insuff Caution: [C, +/–] Hx of mania, Szs & pts at risk for suicideContra: MAOI or w/in 14 d of MAOI use Disp: Tabs 10, 20, 40 mg; dist tabs 10,20, 40 mg; cap 10, 20, 40 mg; Soln 10 mg/5 mL SE: Somnolence, insomnia, anxiety,xerostomia, diaphoresis, sexual dysfunction Notes: May cause ↓ Na + /SIADHCladribine (Leustatin) Uses: *HCL, CLL, NHLs, progressive MS* Action:Induces DNA strand breakage; interferes w/ DNA repair/synth; purine nucleosideanalog Dose: 0.09–0.1 mg/kg/d cont IV inf for 1–7 d (Per protocols)Caution: [D, ?/–] Causes neutropenia & Infxn Contra: Component sensitivityDisp: Inj 1 mg/mL SE: ↓ BM, T-lymphocyte ↓ may be prolonged (26–34 wk),fever in 46%, tumor lysis synd, Infxns (especially lung & IV sites), rash (50%),HA, fatigue Notes: Consider prophylactic allopurinol; monitor CBCClarithromycin (Biaxin, Biaxin XL) Uses: *Upper/lower resp tract,skin/skin structure Infxns, H. pylori Infxns, & Infxns caused by nontuberculosis(atypical) Mycobacterium; prevention of MAC Infxns in HIV-Infxn* Action:Macrolide antibiotic, ↓ protein synth. Spectrum: H. influenzae, M. catarrhalis, S.pneumoniae, Mycoplasma pneumoniae, & H. pylori Dose: Adults. 250–500 mgPO bid or 1000 mg (2 × 500 mg XL tab)/d. Mycobacterium: 500 mg PO bid. Peds>9 mo. 7.5 mg/kg/dose PO bid; ↓ in renal/hepatic impair Caution: [C, ?] Antibiotic-associatedcolitis; rare QT prolongation & ventricular arrhythmias, includingtorsades de pointes Contra: Macrolide allergy; w/ranitidine in pts w/ Hx of porphyriaor CrCl 12 y. 1.34 mg bid-2.68 mg tid; max 8.04 mg/d