PocketDavis’sClinicalDrugReferenceShamim Tejani, PharmDPediatric Clinical PharmacistSt. Joseph’s Hospital and Medical CenterPhoenix, ArizonaCynthia A. Sanoski, B.S., PharmD, FCCP, BCPSChair, Department of Pharmacy PracticeJefferson School of PharmacyThomas Jefferson UniversityPhiladelphia, Pennsylvania

F. A. Davis Company1915 Arch StreetPhiladelphia, PA 19103www.fadavis.comCopyright 2009 by F. A. Davis CompanyCopyright 2009 by F. A. Davis Company. All rights reserved. This book isprotected by copyright. No part of it may be reproduced, stored in a retrievalsystem, or transmitted in any form or by any means, electronic, mechanical,photocopying, recording, or otherwise, without written permission from thepublisher.Printed in the United States of AmericaLast digit indicates print number 10 9 8 7 6 5 4 3 2 1Director of Content Development: Darlene D. PedersenSenior Acquisitions Editor: Thomas A. CiavarellaProject Editor: Meghan K. ZieglerDesign and Illustration Manager: Carolyn O’BrienAs new scientific information becomes available through basic and clinicalresearch, recommended treatments and drug therapies undergo changes. Theauthor(s) and publisher have done everything possible to make this bookaccurate, up to date, and in accord with accepted standards at the time ofpublication. The author(s), editors, and publisher are not responsible forerrors or omissions or for consequences from application of the book, andmake no warranty, expressed or implied, in regard to the contents of thebook. Any practice described in this book should be applied by the reader inaccordance with professional standards of care used in regard to the uniquecircumstances that may apply in each situation. The reader is advised always tocheck product information (package inserts) for changes and new informationregarding dose and contraindications before administering any drug. Cautionis especially urged when using new or infrequently ordered drugs.ISBN-13: 978-0-8036-2078-0ISBN-10: 0-8036-2078-0Authorization to photocopy items for internal or personal use, or the internalor personal use of specific clients, is granted by F. A. Davis Company forusers registered with the Copyright Clearance Center (CCC) TransactionalReporting Service, provided that the fee of .25 per copy is paid directly toCCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizationsthat have been granted a photocopy license by CCC, a separate system ofpayment has been arranged. The fee code for users of the TransactionalReporting Service is: 8036-2078-0/09 0 .25.

To my son, Cameron, the “transformer” who has changed mylife forever.To my daughter, Sierra, the “big star” without whom I couldnot navigate.Your patience made this book possible.Shamim TejaniTo my mother, Geraldine, whose continual love, support and guidanceare present in all that I do. Thank you for your patience and understanding as I worked on this important project.Cynthia Sanoski

Table of ContentsPreface ixReviewers xiList of Abbreviations xiiiDrug Monographs in Alphabetical Order by Generic Name 1Appendices 280Appendix A. Commonly Used Antidotes for DrugOverdoses 280Appendix B. Controlled Substances Schedules 282Appendix C. Critical Care Drug Infusions 283Appendix D. Cytochrome P450 Substrates/Inducers/Inhibitors 285Appendix E. Formulas Helpful for Calculating Doses 289Appendix F. Equianalgesic Dosing Guidelines 290Appendix G. Insulins and Insulin Therapy 292Appendix H. Measurement Conversion Table 295Appendix I. Pediatric Intravenous Medication QuickReference Chart 296Appendix J. Pregnancy Categories 298Appendix K. Routine Pediatric and Adult Immunizations 299Comprehensive Generic/Trade Index 301vii

PrefaceDavis’s Pocket Clinical Drug Reference is a quick resource for the mostcommonly used drugs in clinical practice. The monographs aredesigned to highlight pertinent information; specifically, each monograph includes a drug’s generic name, brand name, therapeuticindication, pharmacologic class, pregnancy class, contraindications,adverse drug reactions, drug interactions, dose, availability, and monitoring parameters.To incorporate as many drugs as possible into a pocket drugguide format, only the most common adverse drug reactions and druginteractions are presented within each monograph. The table entitledCytochrome P450 Substrates/Inhibitors/Inducers (page 285) provides more specific information regarding the drugs that may beinvolved in certain drug interactions. Additionally, within eachmonograph, a Notes section is included to highlight miscellaneousinformation that users should consider when initiating or monitoring drug therapy in their patients.In the Appendix, a number of useful tables and charts, coveringtopics such as immunization guidelines, intravenous drugs, and narcotic equianalgesic dosing guidelines, provide additional informationthat is relevant to clinical practice. To obtain detailed drug information beyond what is supplied in the monographs of this pocket drugguide, the user should refer to the medical literature or the completeproduct information supplied by the manufacturer.ix

ReviewersNaveed Ahmed, MPAS, PA-CDrexel UniversityHahnemann Physician AssistantProgramPhiladelphia, PennsylvaniaCarole Berube, BSN, MSN, MA(Psychology), RNProfessor Emerita in Nursing,Instructor in Health SciencesBristol Community CollegeFall River, MassachusettsMary Anne Crandall, RN, BS,MS, PhD, CLT, CCTDoctor Therapeutic Laser andThermal Imaging CenterMedford, OregonDori Gilman, MALPN Coordinator, LPN & RNInstructorNorth Country CommunityCollegeSaranac Lake, New YorkCheryl Gilton, RN, BSN, MedDirector, Pharmacy TechnicianProgramAllegany College of MarylandSpecial Health InitiativesCumberland, MarylandCatherine C. Goodman, PT, MBAFaculty Affiliate, Medical Writer(Medical Multimedia Group)University of MontanaSchool of Pharmacy and AlliedHealthMissoula, MontanaEllen Wruble Hakim, PT, DScPT,MS, CWS, FACCWSVice Chair for ProfessionalPrograms Director forEntry-Level DPT ProgramUniversity of Maryland Schoolof MedicineDepartment of Physical Therapyand RehabilitationBaltimore, MarylandKen Harbert, PhD, CHES, PA-CDean and Program DirectorSouth CollegeKnoxville, TennesseeKris Hardy, CMA, RHE, CDFMedical Assistant ProgramDirector/InstructorBrevard Community CollegeCocoa, FloridaMarsha Hemby, ADN, CMADepartment Chair, MedicalAssistingPitt Community CollegeGreenville, North CarolinaMary Ann Laxen, PA-C, MABDirector, Physician AssistantProgramUniversity of North Dakota,School of Medicine and HealthSciencesGrand Forks, North DakotaKathy Makkar, PharmDClinical Pharmacy Specialist,CardiologyLancaster General HospitalLancaster, Pennsylvaniaxi

Allison A. Morgan, MPA, PA-CInstructorDuquesne UniversityJohn H. Rangos, Sr.School of Health SciencesPittsburgh, PennsylvaniaPatti Pagels, MPAS, PA-CAssistant Professor/Vice-Chair,Clinical ServiceUniversity of North Texas HealthScience CenterFort Worth, TexasKaren Snipe, CPhT, MedPharmacy Technician ProgramCoordinator Department Head,Diagnostic & Imaging ServicesTrident Technical CollegeCharleston, South CarolinaxiiDaniel Thibodeau, MHP, PA-CAssistant Professor, PhysicianAssistant ProgramEastern Virginia Medical SchoolNorfolk, VirginiaMarilyn M. Turner, RN, CMAMedical Assisting ProgramDirectorOgeechee Technical CollegeStatesboro, Georgia

List of Abbreviations increase, increaseddecrease, decreasedA1C glycosylated hemoglobinABG arterial blood gasABW actual body weightac before mealsACE angiotensin-convertingenzymeACEI angiotensin-convertingenzyme inhibitorACLS advanced cardiac lifesupportACS acute coronary syndromeACT activated clotting timeAD Alzheimer’s diseaseADH antidiuretic hormoneADHD attention-deficit hyperactivity disorderADR adverse drug reactionAF atrial fibrillationAFl atrial flutterAIDS acquired immunedeficiency syndromealk phos alkaline phosphataseALL acute lymphocytic leukemiaALT alanine aminotransferaseAML acute myelogenousleukemiaANA antinuclear antibodiesANC absolute neutrophil countANLL acute nonlymphocyticleukemiaaPTT activated partial thromboplastin timeARB angiotensin receptorblockerARDS adult respiratory distresssyndromeARF acute renal failureASA aspirinASM aggressive systemicmastocytosisAST aspartate aminotransferaseATP adenosine triphosphateAV atrioventricularAvailability (G):generic availabilityAVM arteriovenousmalformationBG blood glucosebid two times a dayBMD bone mineral densityBMI body mass indexBMT bone marrowtransplantationBP blood pressureBPH benign prostatichyperplasiabpm beats per minuteBSA body surface areaBUN blood urea nitrogenBZ benzodiazepineCa calciumCA cancerCABG coronary artery bypassgraftCAD coronary artery diseasecap capsuleCAP community-acquiredpneumoniaCBC complete blood countCCB calcium channel blockerCEL chronic eosinophilicleukemiaCK creatine kinaseCKD chronic kidney diseaseCI contraindicationCML chronic myelogenousleukemiaCMV cytomegalovirusCNS central nervous systemCOMT catechol-OmethyltransferaseCOPD chronic obstructivepulmonary diseaseCP chest painxiii

CR controlled-releaseCrCl creatinine clearanceCSF colony-stimulating factor;cerebrospinal fluidCT computed tomographyCV cardiovascularCVA cerebrovascular accidentCVP central venous pressureCXR chest x-rayCYP cytochrome P450D5/LR 5% dextrose and lactatedRinger’s solutionD5/0.9% NaCl5% dextrose and 0.9% NaCl;5% dextrose and normalsalineD5/0.25% NaCl5% dextrose and 0.25% NaCl;5% dextrose and quarternormal salineD5/0.45% NaCl5% dextrose and 0.45% NaCl;5% dextrose and half normalsalineD5W 5% dextrose in waterD10W 10% dextrose in waterDBP diastolic blood pressurederm dermatologicDFSP dermatofibrosarcomaprotuberansDI diabetes insipidusdiff differentialDKA diabetic ketoacidosisdl deciliter(s)DM diabetes mellitusDMARD disease-modifyingantirheumatic drugDNA deoxyribonucleic acidDR delayed-releaseDRE digital rectal examDVT deep vein thrombosisEC enteric-coatedECG electrocardiogramECMO extracorporealmembrane oxygenationED erectile dysfunctionEENT eye, ear, nose, and throatxivEGFRepidermal growth factorreceptorendo endocrineENL erythema nodosumleprosumEPS extrapyramidal symptomsER extended-releaseES extra-strengthesp. especiallyESRD end-stage renal diseaseET endotrachealFAP familial adenomatouspolyposisF and E fluid and electrolyteFQ fluoroquinoloneFSH follicle-stimulatinghormoneg gram(s)GABA gamma-aminobutyricacidGAD generalized anxietydisorderGERD gastroesophageal refluxdiseaseGFR glomerular filtration rateGI gastrointestinalGIST gastrointestinal stromaltumorsGNR Gram-negative rodsGnRH gonadotropin releasinghormoneG6PD glucose-6-phosphatedehydrogenaseGP glycoproteinGPC Gram-positive coccigtt drop(s)GU genitourinaryH2 histamine-2HA headacheHBV hepatitis B virusHct hematocritHCV hepatitis C virusHD hemodialysisHDL high-density lipoproteinHES hypereosinophilic syndromeHF heart failureHgb hemoglobin

5-HIAA5-hydroxyindoleaceticacidHIT heparin-inducedthrombocytopeniaHITTS heparin-inducedthrombocytopenia andthrombosis syndromeHIV human immunodeficiencyvirusHMG-CoAhydroxymethyl glutarylcoenzyme AHPA hypothalamicpituitary-adrenalhr hour(s)HR heart rateHRT hormone replacementtherapyHSV herpes simplex virus5-HT 5-hydroxytriptamine(serotonin)HTN hypertensionIE infective endocarditisIA intra-articularIBD inflammatory bowel diseaseIBW ideal body weightICP intracranial pressureICU intensive care unitIDDM insulin-dependentdiabetes mellitusIL intralesionalIM intramuscularin. inch(es)inhaln inhalationinject injectionINR international normalizedratioI/O intake and outputIOP intraocular pressureIPPB intermittent positivepressure breathingIR immediate-releaseIS intrasynovialIT intrathecalITP immune thrombocytopenicpurpuraIUD intrauterine deviceIV intravenousK potassiumKCl potassium chloridekg kilogram(s)KS Kaposi’s sarcomaL liter(s)LA long-actingLD loading doseLDH lactic dehydrogenaseLDL low-density lipoproteinLFT liver function testLH luteinizing hormoneLHRH luteinizing hormonerelease hormoneLMWH low molecular weightheparinloz lozengeLR lactated Ringer’s solutionLV left ventricularLVEF left ventricular ejectionfractionLVH left ventricularhypertrophyM molarMAC Mycobacterium aviumcomplex; monitoredanesthesia careMAOI monoamine oxidaseinhibitormax maximummcg microgram(s)MD maintenance doseMDI metered dose inhalerMDRSP multi-drug resistantStreptococcuspneumoniaeMDS myelodysplastic syndromemeds medicationsmEq milliequivalent(s)metab metabolicmg milligram(s)Mg magnesiumMI myocardial infarctionmin minute(s)misc miscellaneousml milliliter(s)mM millimole(s)xv

MMSEMini-Mental StateExaminationmo monthMPD myeloproliferative diseaseMRI magnetic resonanceimagingMRSA methicillin-resistantStaphylococcus aureusMS multiple sclerosisMSSA methicillin-sensitiveMUGA multiple-gatedacquisition (scan)Na sodiumNaCl sodium chlorideNaPO4 sodium phosphateneb nebulizerNEC necrotizing enterocolitisneuro neurologicng nanogram(s)NG nasogastricNIDDM noninsulin-dependentdiabetes mellitusNMS neuroleptic malignantsyndromeNPO nothing by mouthNRTI nucleoside reversetranscriptase inhibitorNS sodium chloride, normalsaline (0.9% NaCl)NSAID nonsteroidal antiinflammatory drugNSTEMI non-ST-segmentelevation myocardialinfarctionN/V nausea and vomitingN/V/D nausea, vomiting, anddiarrheaNYHA New York HeartAssociationOA osteoarthritisOCD obsessive-compulsivedisorderODT orally disintegratingtabletsoint ointmentOM otitis mediaophth ophthalmicxviOTC over-the-counteroz ounce(s)PAD peripheral arterialdiseasePALS pediatric advanced lifesupportPAT paroxysmal atrialtachycardiaPBPC peripheral bloodprogenitor cellpc after mealsPCA patient-controlledanalgesiaPCI percutaneous coronaryinterventionPCP Pneumocystis cariniipneumoniaPCWP pulmonary capillarywedge pressurePDA patent ductus arteriosusPDE phosphodiesterasePE pulmonary embolismPEA pulseless electrical activityPFT pulmonary function testpg picogram(s) Philadelphia chromosomePh positivePID pelvic inflammatory diseasepkt packetPMDD premens