Clinician's Pocket Drug Reference 2008

72 Cytarabine Liposome100 mg/mL SE: ↓ BM, N/V/D, stomatitis, flulike synd, rash on palms/soles, hepatic/cerebellardysfunction, noncardiogenic pulm edema, neuropathy, feverNotes: Little use in solid tumors; high-dose tox limited by corticosteroid ophthsolnCytarabine Liposome (DepoCyt) WARNING: Can cause chemicalarachnoiditis (N/V/HA, fever) ↓ severity w/dexamethasone. Administer by experiencedphysician in properly equipped facilty Uses: *Lymphomatous meningitis*Action: Antimetabolite; interferes w/DNA synth Dose: 50 mg IT q14d for 5 doses,then 50 mg IT q28d × 4 doses; use dexamethasone prophylaxis Caution: [D, ?]May cause neurotox; blockage to CSF flow may ↑ the risk of neurotox; use in pedsnot established Contra: Active meningeal Infxn Disp: IT inj 50 mg/5 mL SE:Neck pain/rigidity, HA, confusion, somnolence, fever, back pain, N/V, edema, neutropenia,↓ plt, anemia Notes: Cytarabine liposomes are similar in microscopic appearanceto WBCs; caution in interpreting CSF studiesCytomegalovirus Immune Globulin [CMV-IG IV] (CytoGam)Uses: *Attenuation CMV Dz associated w/ transplantation* Action: ExogenousIgG antibodies to CMV Dose: 150 mg/kg/dose w/in 72 h of transplant, for 16 wkposttransplant; see insert Caution: [C, ?] Anaphylactic Rxns; renal dysfunctionContra: Allergy to immunoglobulins; IgA deficiency Disp: Inj 50 mg/mL SE:Flushing, N/V, muscle cramps, wheezing, HA, fever Notes: IV only; administer byseparate line; do not shakeDacarbazine (DTIC) WARNING: Causes hematopoietic depression, hepaticnecrosis, may be carcinogenic, teratogenic Uses: *Melanoma, Hodgkin Dz,sarcoma* Action: Alkylating agent; antimetabolite as a purine precursor; ↓ proteinsynth, RNA, & especially DNA Dose: 2–4.5 mg/kg/d for 10 consecutive d or 250mg/m 2 /d for 5 d (Per protocols); ↓ in renal impair Caution: [C, ?] In BM suppression;renal/hepatic impair Contra: Component sensitivity Disp: Inj 100, 200, 500mg SE: ↓ BM, N/V, hepatotox, flulike synd, ↓ BP, photosens, alopecia, facialflushing, facial paresthesias, urticaria, phlebitis at inj site Notes: Avoid extrav,CBC, pltDaclizumab (Zenapax) WARNING: Administer under skilled supervisionin equipped facility Uses: *Prevent acute organ rejection* Action: IL-2 receptorantagonist Dose: 1 mg/kg/dose IV; 1st dose pretransplant, then 4 doses 14 dapart post-transplant Caution: [C, ?] Contra: Component sensitivity Disp: Inj5 mg/mL SE: Hyperglycemia, edema, HTN, ↓ BP, constipation, HA, dizziness,anxiety, nephrotox, pulm edema, pain, anaphylaxis/hypersensivity Notes: Administerw/in 4 h of preparationDactinomycin (Cosmegen) WARNING: Administer under skilled supervisionin equipped facility; powder and soln toxic, corrosive, mutagenic, carcinogenicand teratogenic, avoid exposure and use precautions Uses:*Choriocarcinoma, Wilms’ tumor, Kaposi and Ewing sarcoma, rhabdomyosarcoma,uterine and testicular CA* Action: DNA intercalating agent Dose: Adult: