Clinician's Pocket Drug Reference 2008

Cyanocobalamin 69dysfunction Contra: Bowel obst Disp: Tabs 1 g; granules 5, 7.5, 300, 450, 500 gSE: Constipation, abd pain, bloating, HA Notes: Do not use dry powder; mix w/beverages, cereals, etc; may ↓ absorption of other medications and fat-soluble vitaminsConivaptan HCL (Vaprisol) Uses: Euvolemic hyponatremia Action:Dual arginine vasopressin V 1A /V 2 receptor antagonist Dose: 20 mg IV × 1 over 30min, then 20 mg cont IV inf over 24 h; 20 mg/d cont IV inf for 1–3 more d; may ↑to 40 mg/d if Na + not responding; 4 d max use; use large vein, change site q 24 hCaution: [C; ?/–] Rapid ↑ Na + (>12 mEq/L/24 h) may cause osmotic demyelinationsynd; impaired renal/hepatic fxn; may ↑ digoxin levels; CYP3A4 inhibitor(Table 11) Contra: Hypovolemic hyponatremia;w/CYP3A4 inhibitors Disp: Ampule20 mg/4 mL SE: Infusion site Rxns, HA, N/V/D, constipation, ↓ K + , orthostatic↓ BP, thirst, dry mouth, pyrexia, pollakiuria, polyuria, Infxn Notes: MonitorNa + , volume and neurologic status; D/C w/very rapid ↑ Na + ; mix only w/ 5% dextroseCopper IUD Contraceptive (ParaGard T 380A) Uses: *Contraception,long term (up to 10 yrs)* Action: ?, interfere w/sperm survival/transportDose: Insert any time during menstrual cycle; replace @ 10 y. max Caution: [C, ?]Remove w/intrauterine PRG, increased risk of comps w/PRG and device in placeContra: Acute PID or in high-risk behavior, post-partum endometritis, cervicitisDisp: 52 mg IUD SE: PRG, ectopic PRG, pelvic infection immunocompromise,embedment, perforation expulsion, Wilson’s dz, fainting w/ insert, vag bleeding,expulsion Notes: Counsel patient does not protect against STD/HIV; see insert fordetailed instructions; 99% effectiveCortisone See Steroids (page 191) and Tables 3 & 4Cromolyn Sodium (Intal, NasalCrom, Opticrom, others)Uses: *Adjunct to the Rx of asthma; prevent exercise-induced asthma; allergicrhinitis; ophth allergic manifestations*; food allergy Action: Antiasthmatic; mastcell stabilizer Dose: Adults & Children >12 y. Inhal: 20 mg (as powder in caps) inhaledqid or met-dose inhaler 2 puffs qid. PO: 200 mg qid 15–20 min ac, up to 400mg qid. Nasal instillation: Spray once in each nostril 2–6 ×/d. Ophth: 1–2 gtt ineach eye 4–6 × d-. Peds. Inhal: 2 puffs qid of met-dose inhaler. PO: Infants