Mupirocin

Bactroban®

Uses: *Impetigo, skin lesion infect w/ S. aureus or S. pyogenes, eradicate MRSA in nasal carriers*

MOA: ↓ bacterial protein synth

Dose: Apply small amt TID x 5-14 days. Nasal: Apply 1/2 single-use tube BID in nostrils x 5 days

Caution: B, ?

CI: Do not use w/ other nasal products

Disp: Oint, Cream: 2%, Nasal oint: 2% 1-g single use tubes

SE: Local irritation, rash

Notes: Pt to contact health-care provider if no improvement in 3-5 days

Buspirone HCl

Buspar®

BBW: Closely monitor for worsening depression or emergence of suicidality

Uses: Short-term relief of anxiety

MOA: Anti-anxiety, antagonizes CNS serotonin and dopamine receptors

Dose: Initial: 7.5 mg PO BID, ↑ by 5 mg q2-3 days to effect; usual 20-30 mg/d. Max 60 mg/d

CI: w/ MAOI

Caution: B, ?/-, Avoid w/ severe hepatic/renal insuff

Disp: Tabs ÷ dose 5, 10, 15, 30 mg

SE: Drowsiness, dizziness, HA, N, EPS, serotonin synd, hostility, depression

Notes: No abuse potential or physical/psychological dependence

Gemfibrozil

Lopid®

Uses: Hypertriglyceridemia, coronary heart disease

MOA: Fibric acid

Dose: 1200 mg/d PO ÷ BID 30 min before AM & PM meals

Caution: C, ?, ↑ Warfarin effect, sulfonylureas, ↑ risk of myopathy w/ HMG-CoA reductase inhib, ↓ effects w/ cyclosporine

CI: Renal/hepatic impair (sCr >2.0 mg/dL), gallbladder disease, primary biliary cirrhosis, use w/ repaglinide (↓ glucose)

Disp: Tabs 600 mg

SE: Cholelithiasis, GI upset

Notes: Avoid w/ HMG-CoA reductase inhib, check LFTs & serum lipids

Amphetamine Salt Combo SR

Adderall® XR

Schedule: C-II

BBW: High abuse potential, dependency; Avoid prolonged treatment, may lead to drug dependence, potential for non-therapeutic use ot distribution to others; prescribe/dispense sparingly; serious cardiovascular adverse events and sudden death reported w/ misuse

Uses: ADHD

MOA: Exact mechanism unknown; stimulates CNS activity; blocks reuptake and increases release of NE and dopamine in extraneuronal space

Dose: 20 mg PO qAM, ↑ 10 mg/d q week, Max 60 mg /d

Caution: C, +, elderly, cardiovascular disease, mild HTN, psychosis, bipolar disorder, Tourette syndrome, history/risk of seizures

CI:Hypersensitivity, breastfeeding, advanced arteriosclerosis, structural cardiac abnormalities, cardiomyopathy, severe arrhythmias, severe HTN, history or drug abuse, glaucoma

Disp: Caps 5, 10, 15, 20, 25, 30

SE: HA, weight loss, anorexia, abdominal pain, dry mouth, HTN, dependence, dizziness, insomnia, constipation, palpitations, tachycardia, tremor

Ondansetron

Zofran®

Uses: Prevent chemotherapy associated & post op N/V

MOA: Serotonin receptor (5-HT3) antagonist

Dose: Chemotherapy: 0.15 mg/kg/dose IV prior to chemotherapy & 4 & 8 h after 1st dose or 4-8 mg PO TID; 1st dose 30 min prior to chemotherapy & give on schedule, not PRN. Post-Op: 4 mg IV immediately preanesthesia or post-operation; ↓ w/ hepatic impair

Caution: B, +/-

Disp: Tabs 4, 8, 24, mg; soln 4 mg/5 mL; Inj 2 mg/mL, 32 mg/50 mL; Zofran ODT tabs 4, 8 mg

SE: D, HA, constipation, dizziness

Famotidine

Pepcid®

OTC/RX

Uses: Short-term treatment of duodenal ulcer & benign gastric ulcer; maint for duodenal ulcer, hypersecretory conditions, GERD, & heartburn

MOA: H2-antagonist, ↓ gastric acid

Dose: Ulcer: 20 mg IV q12-24 h or 20-40 mg PO qHS x 4-8 weeks. Hypersecretion: 20-160 mg PO q6h. GERD: 20 mg PO BID x 6 weeks; maint. 20 mg PO qHS. Heartburn: 10 mg PO PRN q12h

Caution: B, M

CI: Component sensitivity

Disp: Tabs 10, 20, 40 mg; chew tabs 10 mg; susp 40 mg/5 mL; gelatin caps 10 mg; Inj 10 mg/2 mL

SE: Dizziness, HA, constipation, N/V/D, ↓ plt, hepatitis

Notes: Chew tabs contain phenylalanine

Sumatriptan

Imitrex®

Uses: Treatment of acute migraine

MOA: Vascular serotonin receptor agonist

Dose: SQ: 6 mg as a singe dose PRN, repeat as needed in 1 hr to max of 12 mg/24 h. PO: 25 mg, repeat in 2 h PRN, 100 mg/d max PO dose; max 300 mg/d. Nasal Spray: 1 spray into each nostril, repeat in 2 h to 40 mg/24 h max

Caution: C, M

CI: Angina, ischemic heart disease, uncontrolled HTN, severe hepatic impair, ergot use, MAOI use w/in 14 d

Disp: OD tabs 25, 50, 100 mg; Inj 6, 8, 12 mg/mL; ODT 25, 50, 100 mg; nasal spray 5, 10, 20 mg/spray

SE: Pain & bruising as site, dizziness, hot flashes, paresthesias, CP, weakness, numbness, coronary vasospasm, HTN 

Promethazine/Codeine

Phenergan® w/ Codeine

Schedule: C-V

BBW: Contraindicated in pediatric pts <6 yrs old; concomitant admin of promethazineand other resp depressants associated w/ resp depression (incl. fatal), in post marketing reports, a wide range of weight-based promethazine doses have resulted in resp depression (incl fatal) in pediatric pts <2 yrs old

Uses: Upper respiratory symptoms (cough)

MOA: ↓ cough reflex, narcotic analgesic; Phenothiazine, blocks CNS postsynaptic mesolimbic dopaminergic receptors

Dose: 5 mL PO q4-6h PRN

Caution: C, ?, hepatic impair, prostatic hypertrophy, asthma, seizure disorder, substance abuse, CNS depressant use, increased ICP, elderly pts

CI: NAG, GI obstruction, pts < 6yo

Disp: 6.25 mg promethazine/10 mg codeine/ 5 mL

SE: Sedation, dry mouth, dizziness, blurred vision, nausea, constipation, urinary retention, itching, hypotension

Propranolol HCl

Inderal®

Uses: HTN, angina, MI, hyperthyroidism, essential tremor, hypertrophic subaortic stenosis, pheochromocytoma, prevents migraines & atrial arrhythmias

MOA: Beta adrenergic receptor blocker, B1-B2, only beta blocker to block conversion of T4 to T3

Dose: Angina: 80-320 mg/d PO ÷ BID-QID or 80-160 mg/d SR. Arrhythmias: 10-80 mg PO TID-QID or 1 mg IV slowly, repeat q5 min, 5 mg max. HTN: 40 mg PO BID or 60-80 mg/d SR, ↑ weekly to max 640 mg/d. Hypertrophic subaortic stenosis: 20-40 mg PO TID-QID. MI: 180-240 mg/d ÷ TID-QID. Migraine prophylaxis: 80 mg/d ÷ TID-QID, ↑ weekly 160-240 mg/d ÷ TID-QID max, wean if no response in 6 wk. Pheochromocytoma: 30-60 mg/d ÷ TID-QID. Thyrotoxicosis: 1-3 mg IV x 1, 10-40 mg PO q6h. Tremor: 40 mg PO BID, ↑ PRN q3-7 d to 60 mg/d max

Caution: C/D/D, +

CI: Uncompensated CHF, cardiogenic shoc, ↓ HR, heart block, PE, severe resp disease

Disp: Tabs 10, 20, 40, 80 mg ; SR caps 60, 80, 120, 160 mg; oral soln 4, 8 mg/mL; Inj 1 mg/mL

SE: ↓ HR, ↓ BP, fatigue, GI upset, ED

Terazosin

Hytrin®

Uses: BPH, HTN

MOA: Alpha-1 blocker (blood vessel & bladder neck/ prostate)

Dose: Initial, 1 mg PO HS; ↑ 20 mg/d max; may ↓ w/ diuretic or other BP medicine

Caution: C, ?, w/ Beta blocker, CCB, ACE Inhibitor, use w/ phosphodiesterase-5 (PDE-5) inhib (eg. sildenafil), can cause ↓ BP

CI: Alpha antagonist sensitivity

Disp: Tabs 1, 2, 5, 10 mg; Caps 1, 2, 5, 10 mg

SE: ↓ BP, syncope following 1st dose or w/ PDE-5 inhib, dizziness, weakness, nasal congestion, peripheral edema, palpitations, GI upset

Notes: Caution w/ 1st dose syncope, if for HTN, combine w/ thiazide diuretic