Clinician's Pocket Drug Reference 2008

Dapsone, topical 730.5 mg/d for 5 d; 2 mg/wk for 3 consecutive wk; 15 mcg/kg or 0.45 mg/m 2 /d (max0.5 mg) for 5 d q3–8 wk Peds: Sarcoma (per protocols); ↓ in renal impair Caution:[C, ?] Contra: concurrent/recent chickenpox or herpes zoster; infants < 6 moDisp: Inj 0.5 mg SE: Myelo/immunosuppression, severe N/V, alopecia, acne, hyperpigmentation,radiation recall phenomenon, tissue damage w/extrav, hepatotoxDalteparin (Fragmin) WARNING: ↑ risk of spinal/epidural hematomawith LP Uses: *Unstable angina, non-Q-wave MI, prevention of ischemic compsdue to clot formation in pts on concurrent ASA, prevent & Rx DVT followingsurgery* Action: LMW heparin Dose: Angina/MI: 120 units/kg (max 10,000units) SQ q12h w/ ASA. DVT prophylaxis: 2500–5000 units SC 1–2 h preop, thendaily for 5–10 d. Systemic anticoagulation: 200 units/kg/d SQ or 100 units/kg bidSQ Caution: [B, ?] in renal/hepatic impair, active hemorrhage, cerebrovascularDz, cerebral aneurysm, severe HTN Contra: HIT; pork product allergy; w/ mifepristoneDisp: Inj 2500 units (16 mg/0.2 mL), 5000 units (32 mg/0.2 mL), 7,500 units(48 mg/0.3 mL), 10,000 units (64 mg/mL), 25,000 units/mL (3.8 mL); prefilledvials: 10,000 units/mL (9.5 mL) SE: Bleeding, pain at site, ↓ plt Notes: Predictableeffects eliminates lab monitoring; not for IM/IV useDantrolene (Dantrium) WARNING: Hepatotoxicity reported; DC after45 days if no benefit observed Uses: *Rx spasticity due to upper motor neuron disorders(eg, spinal cord injuries, stroke, CP, MS); malignant hyperthermia* Action:Skeletal muscle relaxant Dose: Adults. Spasticity: 25 mg PO daily; ↑ 25 mg to effectto 100 mg max PO qid PRN. Peds. 0.5 mg/kg/dose bid; ↑ by 0.5 mg/kg to effect,to 3 mg/kg/dose max qid PRN. Adults & Peds. Malignant hyperthermia: Rx:Continuous rapid IV, start 1 mg/kg until Sxs subside or 10 mg/kg is reached. PostcrisisF/U: 4–8 mg/kg/d in 3–4 ÷ doses for 1–3 d to prevent recurrence Caution:[C, ?] Impaired cardiac/pulm Fxn Contra: Active hepatic Dz; where spasticityneeded to maintain posture or balance Disp: Caps 25, 50, 100 mg; powder for inj20 mg/vial SE: Hepatotox, ↑ LFTs, drowsiness, dizziness, rash, muscle weakness,D/N/V pleural effusion w/ pericarditis, D, blurred vision, hepatitis Notes: MonitorLFT; avoid sunlight/EtOH/CNS depressantsDapsone, oral Uses: *Rx & prevent PCP; toxoplasmosis prophylaxis; leprosy*Action: Unknown; bactericidal Dose: Adults. PCP prophylaxis 50–100mg/d PO; Rx PCP 100 mg/d PO w/ TMP 15–20 mg/kg/d for 21 d. Peds. PCP prophylaxisalternated dose: (> 1 mo) 4 mg/kg/dose once/week (max 200 mg); Prophylaxisof PCP 1–2 mg/kg/24 h PO daily; max 100 mg/d Caution: [C, +] G6PDdeficiency; severe anemia Contra: Component sensitivity Disp: Tabs 25, 100 mgSE: Hemolysis, methemoglobinemia, agranulocytosis, rash, cholestatic jaundiceNotes: Absorption ↑ by an acidic environment; for leprosy, combine w/ rifampin& other agentsDapsone, topical (Aczone) Uses: *Topical for acne vulgaris* Action:Unknown; bactericidal Dose: Apply pea sized amount and rub into areas BID;wash hands after Caution: [C, +] G6PD deficiency; severe anemia Contra: