Clinician's Pocket Drug Reference 2008

74 DaptomycinComponent sensitivity Disp: 5% gel SE: Skin oiliness/peeling, dryness erythemaNotes: Not for oral, ophthalmic, or intravaginal use; check G6PD levels beforeuse; follow CBC if G6PD deficientDaptomycin (Cubicin) Uses: *Complicated skin/skin structure Infxns dueto gram(+) organisms* Staph aureus, bacteremia, right sided MSA, MRSA endocarditisAction: Cyclic lipopeptide; rapid membrane depolarization & bacterialdeath Spectrum: Staph aureus (including MRSA), Streptococcus pyogenes,S. agalactiae, S. dysgalactiae subsp Equisimilis & Enterococcus faecalis (vancomycin-susceptiblestrains only) Dose: Bacteremia: 4 mg/kg IV daily × 7–14 d(over 30 min); 6mg/kg IV daily for 2–6 wks; Endocarditis: 6 mg/kd q 48; ↓ w/CrCl < 30 mL/min/ or dialysis: 4 mg/kg q48h Caution: [B, ?] w/HMG-CoA inhibitorsDisp: Inj 250, 500 mg/10 mL SE: Anemia, constipation, N/V/D, HA, rash,site Rxn, muscle pain/weakness, edema, cellulitis, hypo/hyperglycemia, ↑ alkalinephosphatase, cough, back pain, abd pain, ↓ K + , anxiety, chest pain, sore throat, cardiacfailure, confusion, Candida Infxns Notes: CPK baseline & weekly; considerD/C HMG-CoA reductase inhibitors to ↓ myopathy riskDarbepoetin Alfa (Aranesp) Warning: Associated with ↑ CV, thromboembolicevents and/or mortality; d/c if HB > 12 g/dl; may increase tumor progressionand death in cancer patients Uses: *Anemia associated w/ CRF*,anemia in nonmyeloid malignancy w/ concurrent chemo Action: ↑ Erythropoiesis,recombinant erythropoietin variant Dose: 0.45 mcg/kg single IV or SQ qwk;titrate, do not exceed target Hgb of 12 g/dL; use lowest doses possible, see insert toconvert from Epogen Caution: [C, ?] May ↑ risk of CV &/or neurologic SE inrenal failure; HTN; w/ Hx Szs Contra: Uncontrolled HTN, component allergyDisp: 25, 40, 60, 100, 200, 300, mcg/mL, 150 mcg/.075 mL in polysorbate or albuminexcipient SE: May ↑ cardiac risk, CP, hypo/hypertension, N/V/D, myalgia,arthralgia, dizziness, edema, fatigue, fever, ↑ risk Infxn Notes: Longer 1 ⁄2-life thanEpogen; weekly CBC until stableDarifenacin (Enablex) Uses: *OAB* Urinary antispasmodic, Action:Muscarinic receptor antagonist Dose: 7.5 mg/d PO; 15 mg/d max (7.5 mg/d w/moderate hepatic impair or w/ CYP3A4 inhibitors); w/ drugs metabolized byCYP2D) (Table 11); swallow whole Caution: [C, ?/–] w/hepatic impair Contra:Urinary/gastric retention, uncontrolled NAG, paralytic ileus Disp: Tabs ER 7.5 mg,15 mg SE: Xerostomia/eyes, constipation, dyspepsia, abd pain, retention, abnormalvision, dizziness, astheniaDarunavir (Prezista) Uses: *Rx HIV w/resistance to multiple protease inhibitors*Action: HIV-1 protease inhibitor Dose: 600 mg PO BID, administer w/ritonavir 100 mg BID Caution: [B, ?/–] hx sulf allergy, CYP3A4 substrate, increaseor decrease levels of many medications including ↑ amnodarone, ↑ dihydropyridines,↑ HMG-CoA reductase inhibitors (statins), ↓ SSRIs, ↓ rifampin,↓ methadone Contra: w/ astezole, terfadine, dihydroergotamine, ergonovine,ergotamine, methylergonovine, pimozide, midazolam, triazolam Supplied: Tabs