GENERIC AND SELECTED BRAND DRUG DATA
Pneumococcal 7-Valent Conjugate Vaccine (Prevnar) Uses:
*Immunization against pneumococcal Infxns in infants & children* Action: Active immunization Dose: 0.5 mL IM/dose; series of 3 doses; 1st dose age 2 mo; then doses q2mo, 4th dose at age 12–15 mo Caution: [C, +] Thrombocytopenia Con-tra: Diphtheria toxoid sensitivity, febrile illness Disp: Inj SE: Local rxns, arthral-gia, fever, myalgia
Pneumococcal Vaccine, Polyvalent (Pneumovax-23) Uses:
*Immunization against pneumococcal Infxns in pts at high risk (eg, all = 65 y of age)* Action: Active immunization Dose: 0.5 mL IM. Caution: [C, ?] Contra:
Do not vaccinate during immunosuppressive therapy Disp: Inj 0.5 mL SE: Fever, inj site Rxn, hemolytic anemia, thrombocytopenia, anaphylaxis
Podophyllin (Podocon-25, Condylox Gel 0.5%, Condylox) Uses: *Topical therapy of benign growths (genital & perianal warts [condylomata acuminata],* papillomas, fibromas) Action: Direct antimitotic effect; exact mecha-nism unknown Dose: Condylox gel & Condylox: Apply bid for 3 consecutive d/wk for 4 wk; 0.5 mL/day max; Podocon-25: Use sparingly on the lesion, leave on for 1–4 h, thoroughly wash off Caution: [X, ?] Immunosuppression Contra: DM, bleeding lesions Disp: Podocon-25 (w/ benzoin) 15-mL bottles; Condylox gel 0.5% 35 g clear gel; Condylox soln 0.5% 35 g clear SE: Local rxns, significant ab-sorption; anemias, tachycardia, paresthesias, GI upset, renal/hepatic damage Notes: Podocon-25 applied by the clinician; do not dispense directly to patient Polyethylene Glycol [PEG]-Electrolyte Soln (GoLYTELY, CoLyte) Uses: *Bowel prep prior to examination or surgery* Action: Osmotic cathartic Dose: Adults. Following 3–4-h fast, drink 240 mL of soln q10min until 4 L consumed or until BMs are clear. Peds. 25–40 mL/kg/h for 4–10 h Caution:
[C, ?] Contra: GI obst, bowel perforation, megacolon, ulcerative colitis Disp:
Powder for recons to 4 L SE: Cramping or N, bloating Notes: 1st BM should occur in approximately 1 h; Note: Chilled soln more palatable
Polyethylene Glycol [PEG] 3350 (MiraLax) Uses: *Occasional constipation* Action: Osmotic laxative Dose: 17 g powder (1 heaping Tbsp) in 8 oz (1 cup) of H2O & drink; max 14 d Caution: [C, ?] R/O bowel obst before use
172 Piroxicam
Contra: GI obst, allergy to PEG Disp: Powder for recons; bottle cap holds 17 g SE: Upset stomach, bloating, cramping, gas, severe D, hives Notes: Can add to H2O, juice, soda, coffee, or tea
Polymyxin B & Hydrocortisone (Otobiotic Otic) Uses: *Super-ficial bacterial Infxns of external ear canal* Action: Antibiotic/anti-inflammatory combo Dose: 4 gtt in ear(s) tid–qid Caution: [B, ?] Disp: Soln polymyxin B 10,000 units/hydrocortisone 0.5%/mL SE: Local irritation Notes: Useful in neomycin allergy
Posaconazole (Noxafil) Uses: *Prevent Aspergillus and Candida Infxns in severely immunocompromised* Action:↓ cell membrane ergosterol synth Dose: Adult. Invasive fungal prophylaxis: 200 mg PO TID; Oropharyngeal can-didiasis: 100 mg PO daily × 13 days, if refractory 40 mg PO BID; Peds > 13 yr.
200 mg PO TID; w/meal Caution: [C; ?] multiple drug interactions; ↑ QT, cardiac diseases, severe renal/liver impair Contra: Component hypersensitivity; w/many drugs including alfuzosin, astemizole, alprazolam, phenothiazines, terfenadine, tri-azolam, others Disp: Sol 40 mg/mL SE:↑ QT, ↑ LFTs, hepatic failure, fever, N/V/D, HA, abd pain, anemia, ↓ plt, ↓ K+rash, dyspnea, cough, anorexia, fatigue Notes: Monitor LFTs, CBC, electrolytes
Potassium Citrate (Urocit-K) Uses: *Alkalinize urine, prevention of urinary stones (uric acid, calcium stones if hypocitraturic)* Action: Urinary alka-linizer Dose: 1 packet dissolved in H2O or 15–30 mL after meals and at bedtime 10–20 mEq PO tid w/ meals, max 100 mEq/d Caution: [A, +] Contra: Severe renal impair, dehydration, ↑ K+, peptic ulcer; w/K+sparing diuretics, salt substitutes Disp: 540, 1080 mg tabs SE: GI upset, ↓ Ca2+,↑ K+, metabolic alkalosis Notes:
Tabs 540 mg = 5 mEq, 1080 mg = 10 mEq
Potassium Citrate & Citric Acid (Polycitra-K) Uses: *Alkalinize urine, prevent urinary stones (uric acid, Ca stones if hypocitraturic)* Action: Uri-nary alkalinizer Dose: 10–20 mEq PO tid w/ meals, max 100 mEq/d Caution:
[A, +] Contra: Severe renal impair, dehydration, ↑ K+, peptic ulcer; w/ use of K+ -sparing diuretics or salt substitutes Disp: Soln 10 mEq/5 mL; powder 30 mEq/packet SE: GI upset, ↓ Ca2+,↑ K+, metabolic alkalosis
Potassium Iodide [Lugol Soln] (SSKI, Thyro-Block) Uses:
*Thyroid storm,*↓ vascularity before thyroid surgery, block thyroid uptake of ra-dioactive iodine, thin bronchial secretions Action: Iodine supl Dose: Adults &
Peds >2 y. Preop thyroidectomy: 50–250 mg PO tid (2–6 gtt strong iodine soln);
give 10 d preop. Peds 1 y. Thyroid crisis: 300 mg (6 gtt SSKI q8h). Peds <1 y: 1⁄2 adult dose Caution: [D, +] ↑ K+, TB, PE, bronchitis, renal impair Contra: Iodine sensitivity Disp: Tabs 130 mg; soln (SSKI) 1 g/mL; Lugol soln, strong iodine 100 mg/mL; syrup 325 mg/5 mL SE: Fever, HA, urticaria, angioedema, goiter, GI upset, eosinophilia
Potassium Supplements (Kaon, Kaochlor, K-Lor, Slow-K, Micro-K, Klorvess, others) Uses: *Prevention or Rx of ↓ K+*
Potassium Supplements 173
174 Pramipexole
(eg, diuretic use) Action: K+supl Dose: Adults. 20–100 mEq/d PO ÷ daily–bid; IV 10–20 mEq/h, max 40 mEq/h & 150 mEq/d (monitor K+levels frequently w/ high-dose IV). Peds. Calculate K+deficit; 1–3 mEq/kg/d PO ÷ daily–qid; IV max dose 0.5–1 mEq/kg/h Caution: [A, +] Renal insuff, use w/ NSAIDs & ACE inhibitors Contra:↑ K+Disp: PO forms (Table 7); inj SE: GI irritation; bradycardia, ↑ K+, heart block Notes: Mix powder & liq w/ beverage (unsalted tomato juice, etc); fol-low K+; Cl–salt OK w/ alkalosis; w/ acidosis use acetate, bicarbonate, citrate, or gluconate salt
Pramipexole (Mirapex) Uses: *Parkinson Dz* Action: Dopamine ago-nist Dose: 1.5–4.5 mg/d PO, initial 0.375 mg/d in 3 ÷ doses; titrate slowly Cau-tion: [C, ?/–] ↓ renal impair Contra: Component allergy Disp: Tabs 0.125, 0.25, 0.5, 1, 1.5 mg SE: Postural↓ BP, asthenia, somnolence, abnormal dreams, GI upset, EPS
Pramoxine (Anusol Ointment, ProctoFoam-NS, others) Uses: *Relief of pain & itching from hemorrhoids, anorectal surgery*; topical for burns & dermatosis Action: Topical anesthetic Dose: Apply freely to anal area q3h Caution: [C, ?] Disp: [OTC] All 1%; foam (Proctofoam-NS), cream, oint, lotion, gel, pads, spray SE: Contact dermatitis, mucosal thinning w/ chronic use Pramoxine + Hydrocortisone (Enzone, Proctofoam-HC) Uses: *Relief of pain & itching from hemorrhoids* Action: Topical anesthetic, anti-inflammatory Dose: Apply freely to anal area tid–qid Caution: [C, ?/–] Disp:
Cream pramoxine 1% acetate 0.5/1%; foam pramoxine 1% hydrocortisone 1%; lo-tion pramoxine 1% hydrocortisone 0.25/1/2.5%, pramoxine 2.5% & hydrocorti-sone 1% SE: Contact dermatitis, mucosal thinning with chronic use
Pravastatin (Pravachol) Uses: *↓ Cholesterol* Action: HMG-CoA re-ductase inhibitor Dose: 10–80 mg PO hs; ↓ in significant renal/hepatic impair Caution: [X –] w/ gemfibrozil Contra: Liver Dz or persistent LFT ↑ Disp: Tabs 10, 20, 40, 80 mg SE: Use caution w/ concurrent gemfibrozil; HA, GI upset, he-patitis, myopathy, renal failure
Prazosin (Minipress) Uses: * HTN* Action: Peripherally acting α-adren-ergic blocker Dose: Adults. 1 mg PO tid; can ↑ to 20 mg/d max PRN. Peds.
0.05–0.1 mg/kg/day in 3 div doses; max 0.5 mg. kg/day Caution: [C, ?] Contra:
Component allergy, concurrent use of PDE-5 inhibitors Disp: Caps 1, 2, 5 mg;
Tabs ER 2.5, 5 mg ER SE: Dizziness, edema, palpitations, fatigue, GI upset Notes:
Can cause orthostatic ↓ BP, take the 1st dose hs; tolerance develops to this effect;
tachyphylaxis may result
Prednisolone [See Steroids page 191 and Table 3, page 227]
Prednisone [See Steroids page 191 and Table 3, page 227]
Pregabalin (Lyrica) Uses: *DM peripheral neuropathy pain; postherpetic neuralgia; fibromyalgia; adjunct w/adult partial onset seizures* Action: Nerve
transmission modulator, antinociceptive, antiseizure effect; mechanism ?; related to gabapentin Dose: Neuropathic pain: 50 mg PO tid, ↑ to 300 mg/d w/in 1 wk based on response, 300 mg/d max; Postherpetic neuralgia: 75–150 mg bid, or 50–100 mg tid; start 75 mg bid or 50 mg tid; ↑ to 300 mg/d w/in 1 wk PRN; if pain persists after 2–4 wk, ↑ to 600 mg/d; Epilepsy: Start 150 mg/d (75 mg bid or 50 mg tid) may↑ to max 600 mg/d; ↓ w/ renal insuffic; w/ or w/o food Caution: [X, –] w/
significant renal impair (see insert), w/elderly & severe CHF avoid abrupt D/C Contra: PRG Disp: Caps 25, 50, 75, 100, 150, 200, 225, 300 mg SE: Dizziness, drowsiness, xerostomia, edema, blurred vision, wgt gain, difficulty concentrating Notes: w/ D/C, taper over at least 1 wk
Probenecid (Benemid, others) Uses: *Prevent gout & hyperuricemia;
prolongs levels of PCNs & cephalosporins* Action: Urocosuric, renal tubular blocker of organic anions Dose: Adults. Gout: 250 mg bid × 1 wk, then 0.5 g PO bid; can ↑ by 500 mg/mo up to 2–3 g/d. Antibiotic effect: 1–2 g PO 30 min before dose Peds >2 y. 25 mg/kg, then 40 mg/kg/d PO ÷ qid Caution: [B, ?] Contra:
High-dose ASA, moderate–severe renal impair, age <2 y Disp: Tabs 500 mg SE:
HA, GI upset, rash, pruritus, dizziness, blood dyscrasias Notes: Do not use during acute gout attack
Procainamide (Pronestyl, Pronestyl SR, Procanbid) WARN-ING: Positive ANA titer or SLE w/prolonged use; only use in life-treating arrhyth-mias; hematologic toxicity can be severe, follow CBC Uses:
*Supraventricular/ventricular arrhythmias* Action: Class 1A antiarrhythmic (Table 10) Dose: Adults. Recurrent VF/VT: 20 mg/min IV (total 17 mg/kg max). Maint:
1–4 mg/min. Stable wide-complex tachycardia of unknown origin, AF w/ rapid rate in WPW: 20 mg/min IV until arrhythmia suppression, ↓ BP, or QRS widens > 50%, then 1–4 mg/min. Chronic dosing: 50 mg/kg/d PO in ÷ doses q4–6h; Recurrent VF/VT: 20–50 mg/min IV; max total 17 mg/kg. Others: 20 mg/min IV until one these: arrhythmia stopped, hypotension, QRS widens > 50%, total 17 mg/kg; then 1–4 mg/min (ECC 2005) Peds. Chronic maint: 15–50 mg/kg/24 h PO ÷ q3–6h; ↓ in renal/hepatic impair Caution: [C, +] Contra: Complete heart block, 2nd- or 3rd-degree heart block w/o pacemaker, torsades de pointes, SLE Disp: Tabs & caps 250, 500 mg; SR tabs 500, 750, 1000 mg; inj 100, 500 mg/mL SE:↓ BP, lupus-like synd, GI upset, taste perversion, arrhythmias, tachycardia, heart block, angioneu-rotic edema, blood dyscrasias Notes: Levels: Trough: just before next dose: Thera-peutic: 4–10 mcg/mL; NAPA+ procaine 5–30 mcg/mL Toxic >10 mcg/mL; NAPA+
procaine > 30 mcg/mL; 1⁄2life: procaine 3–5 h, NAPA 6–10 h
Procarbazine (Matulane) WARNING: Highly toxic; handle w/ care Uses: *Hodgkin Dz,* NHL, brain & lung tumors Action: Alkylating agent; ↓ DNA & RNA synth Dose: Per protocol Caution: [D, ?] W/ EtOH ingestion Con-tra: Inadequate BM reserve Disp: Caps 50 mg SE:↓ BM, hemolytic rxns (w/
G6PD deficiency), N/V/D; disulfiram-like Rxn; cutaneous & constitutional Sxs, myalgia, arthralgia, CNS effects, azoospermia, cessation of menses
Procarbazine 175
Prochlorperazine (Compazine) Uses: *N/V, agitation, & psychotic disorders* Action: Phenothiazine; blocks postsynaptic dopaminergic CNS recep-tors Dose: Adults. Antiemetic: 5–10 mg PO tid–qid or 25 mg PR bid or 5–10 mg deep IM q4–6h. Antipsychotic: 10–20 mg IM acutely or 5–10 mg PO tid–qid for maint; ↑ doses may be required for antipsychotic effect. Peds. 0.1–0.15 mg/kg/dose IM q4–6h or 0.4 mg/kg/24 h PO ÷ tid–qid Caution: [C, +/–] NAG, se-vere liver/cardiac Dz Contra: Phenothiazine sensitivity, BM suppression; age < 2 years old or wt < 9 kg Disp: Tabs 5, 10, 25 mg; SR caps 10, 15 mg; syrup 5 mg/5 mL; supp 2.5, 5, 25 mg; inj 5 mg/mL SE: EPS common; Rx w/ diphenhydramine or benztropine
Promethazine (Phenergan) Uses: *N/V, motion sickness* Action:
Phenothiazine; blocks CNS postsynaptic mesolimbic dopaminergic receptors Dose: Adults. 12.5–50 mg PO, PR, or IM bid–qid PRN. Peds. 0.1–0.5 mg/kg/dose PO or IM q2–6h PRN Caution: [C, +/–] use w/ agents w/ respiratory depressant effects Contra: Component allergy, NAG, age <2 yrs Disp: Tabs 12.5, 25, 50 mg;
syrup 6.25 mg/5 mL, 25 mg/5 mL; supp 12.5, 25, 50 mg; inj 25, 50 mg/mL SE:
Drowsiness, tardive dyskinesia, EPS, lowered Sz threshold, ↓ BP, GI upset, blood dyscrasias, photosens, respiratory depression in children
Propafenone (Rythmol) WARNING: Excess mortality or nonfatal car-diac arrest rate possible; avoid use in asymptomatic and symptomatic non-life-threatening ventricular arrhythmias Uses: *Life-threatening ventricular arrhythmias, AF* Action: Class IC antiarrhythmic (Table 10) Dose: Adults.
150–300 mg PO q8h. Peds. 8–10 mg/kg/d ÷ in 3–4 doses; may ↑ 2 mg/kg/d, 20 mg/kg/d max Caution: [C, ?] w/ amprenavir, ritonavir, MI w/in 2 yrs, w/
liver/renal impair Contra: Uncontrolled CHF, bronchospasm, cardiogenic shock, AV block w/o pacer, Disp: Tabs 150, 225, 300 mg; ER caps 225, 325, 425 mg SE:
Dizziness, unusual taste, 1st-degree heart block, arrhythmias, prolongs QRS & QT intervals; fatigue, GI upset, blood dyscrasias
Propantheline (Pro-Banthine) Uses: *PUD,* symptomatic Rx of small intestine hypermotility, spastic colon, ureteral spasm, bladder spasm, py-lorospasm Action: Antimuscarinic Dose: Adults. 15 mg PO ac & 30 mg PO hs; ↓ in elderly. Peds. 2–3 mg/kg/24h PO ÷ tid–qid Caution: [C, ?] Contra: NAG, ul-cerative colitis, toxic megacolon, GI/GU obst Disp: Tabs 7.5, 15 mg SE: Anti-cholinergic (eg, xerostomia, blurred vision)
Propofol (Diprivan) Uses: *Induction & maint of anesthesia; sedation in intubated pts* Action: Sedative–hypnotic; mechanism unknown; acts in 40 sec Dose: Adults Anesthesia: 2–2.5 mg/kg (also ECC 2005), then 0.1–0.2 mg/kg/
min inf; ICU sedation: 5 mcg/kg/min IV × 5 min, ↑ PRN 5–10 mcg/kg/min q5–10min 5–50 mcg/kg/min cont inf; Peds. Anesthesia: 2.5–3.5 mg/kg induc-tion; then 125–300 mcg/kg/min; ↓ in elderly, debilitated, ASA II/IV pts Cau-tion: [B, +] Contra: If general anesthesia contraindicated, sensitivity to egg, egg products, soybeans, soybean products Disp: Inj 10 mg/mL SE: May↑
triglyc-176 Prochlorperazine