The 5 Minute Urology Consult 3rd Ed.

Urologic Drug Reference

MAGNESIUM HYDROXIDE (MILK OF MAGNESIA) [OTC]

USES: *Constipation*, hyperacidity, Mg2+ replacement.

ACTIONS: NS laxative.

DOSE:

Adults: Antacid: 5–15 mL (400 mg/5 mL) or 2–4 tabs (311 mg) PO PRN up to QID. Laxative: 30–60 mL (400 mg/5 mL) or 15–30 mL (800 mg/5 mL) or 8 tabs (311 mg) PO qhs or ÷ doses.

Peds: Antacid and <12 yr not OK. Laxative: <2 yr not OK. 2–5 yr: 5–15 mL (400 mg/5 mL) PO qhs or ÷ doses. 6–11 yr: 15–30 mL (400 mg/5 mL) or 7.5–15 mL (800 mg/5 mL) PO qhs or ÷ doses. 3–5 yr: 2 (311 mg) tabs PO qhs or ÷ doses. 6–11 yr: 4 (311 mg) tabs PO qhs or ÷ doses.

W/P: [B, +] w/ Neuromuscular disease or renal impairment.

CI: Component hypersens.

DISP: Chew tabs 311, 400 mg; liq 400, 800 mg/5 mL (OTC).

SE: Diarrhea, abdominal cramps.

NOTES: For occasional use in constipation, different forms may contain Al2+.

MAGNESIUM OXIDE (MAG-OX 400, OTHERS) [OTC]

USES: *Replace low Mg2+ levels.*

ACTIONS: Mg2+ supl.

DOSE: 400–800 mg/d or ÷ w/ food in full glass of H2O; ↓ w/ renal impairment.

W/P: [B, +] w/ Neuromuscular disease & renal impairment, w/ bisphosphonates, calcitriol, CCBs, neuromuscular blockers, tetracyclines, quinolones.

CI: Component hypersens.

DISP: Caps 140, 250, 500, 600 mg; tabs 400 mg (OTC).

SE: Diarrhea, N.

MAGNESIUM SULFATE (GENERIC)

USES: *Replace low Mg2+; preeclampsia, eclampsia, & premature labor, cardiac arrest, AMI arrhythmias, cerebral edema, barium poisoning, seizures, pediatric acute nephritis*; refractory ↓ K+ & ↓ Ca2+.

ACTIONS: Mg2+ supl, bowel evacuation, ↓ acetylcholine in nerve terminals, ↓ rate of sinoatrial node firing.

DOSE:

Adults: 1 g q6h IM × 4 doses & PRN 1–2 g q3–6h IV then PRN to correct deficiency.

Peds & Neonates: 25–50 mg/kg/dose IV, repeat PRN; max. 2 g single dose.

W/P: [A/C (manufacturer specific), +] w/ Neuromuscular disease; interactions see Magnesium Oxide and aminoglycosides.

CI: Heart block, myocardial damage.

DISP: Premix Inj: 10, 20, 40, 80 mg/mL; Inj 125, 500 mg/mL; oral/topical powder 227, 454, 1,810, 2,720 g.

SE: CNS depression, diarrhea, flushing, heart block, ↓ BP, vasodilation.

NOTES: Different formulation may contain Al2+, monitor Mg2+ levels.

MANNITOL, INTRAVENOUS (GENERIC)

USES: *Cerebral edema, ↑ IOP, renal impairment, poisonings.*

ACTIONS: Osmotic diuretic.

DOSE: Test dose: 0.2 g/kg/dose IV over 3–5 min; if no diuresis w/in 2 hr, D/C. Oliguria: 50–100 g IV over 90 min ↑ IOP: 0.25–2 g/kg IV over 30 min. Cerebral edema: 0.25–1.5 g/kg/dose IV q6–8h PRN, maintain serum osmolarity <300–320 mOsm/kg.

W/P: [C, ?/M] w/ CHF or vol overload, w/ nephrotoxic drugs & lithium.

CI: Anuria, dehydration, heart failure, PE intracranial bleeding.

DISP: Inj 5%, 10%, 15%, 20%, 25%.

SE: May exacerbate CHF, N/V/diarrhea, ↓ / ↑ BP, ↑ HR.

NOTES: Monitor for vol depletion.

MEGESTROL ACETATE (MEGACE, MEGACE-ES)

USES: *Anorexia, cachexia, or an unexplained significant weight loss in patients with AIDS; palliative treatment of advanced carcinoma of the breast or endometrium.*

ACTIONS: Hormone; anti-leuteinizing; progesterone analog.

DOSE: Appetite: Megace-ES 625 mg/day (5 mL or 1 teaspoon/d). Breast cancer: 160 mg/d (40 mg QID); Endometrial cancer: 40–320 mg/d divided doses.

W/P: [D (tablet)/X (suspension), −] Thromboembolism; handle w/ care.

CI: Pregnancy.

DISP: Tabs 20, 40 mg; susp 40 mg/ mL, Megace-ES 125 mg/mL.

SE: DVT, edema, menstrual bleeding, photosensitivity, N/V/diarrhea, headache, mastodynia, ↑ Ca, ↑ glucose, insomnia, rash, ↓ BM, ↑ BP, CP, palpitations.

NOTES: Do not D/C abruptly; Megace-ES not equivalent to others mg/mg.

MELPHALAN [L-PAM] (ALKERAN, GENERIC)

WARNING: Administer under the supervision of a qualified physician experienced in the use of chemotherapy; severe BM depression, leukemogenic, & mutagenic hypersens (including anaphylaxis in ∼2%).

USES: *Palliative treatment multiple myeloma and ovariant cancer*, breast & testicular cancer, melanoma; allogenic & ABMT (high dose), neuroblastoma, rhabdomyosarcoma.

ACTIONS: Alkylating agent, nitrogen mustard.

DOSE:

Adults: Multiple myeloma: 16 mg/ m2 IV q2wk × 4 doses then at 4-wk intervals after tox resolves; w/ renal impairment ↓ IV dose 50% or 6 mg PO qd × 2–3 wk, then D/C up to 4 wk, follow counts then 2 mg qd. Ovarian cancer:0.2 mg/kg qd × 5 days, repeat q4–5wk based on counts, ↓ in renal insufficiency.

W/P: [D, ?/−] w/ Cisplatin, digitalis, live vaccines extravasation, need central line.

CI: Allergy or resistance.

DISP: Tabs 2 mg; Inj 50 mg.

SE: N/V, secondary malignancy, AF, ↓ LVEF, ↓ BM, secondary leukemia, alopecia, dermatitis, stomatitis, pulm fibrosis; rare allergic reactions, thrombocytopenia.

NOTES: Take PO on empty stomach, false(+) direct Coombs test.

MEPERIDINE (DEMEROL, GENERIC) [C–II]

USES: *Mod–severe pain*, postoperative shivering, rigors from amphotericin B.

ACTIONS: Narcotic analgesic.

DOSE:

Adults: 50–150 mg PO or IV/IM/SQ q3–4h PRN.

Peds: 1–1.5 mg/kg/ dose PO or IM/SQ q3–4h PRN, up to 100 mg/dose; hepatic impairment, avoid in renal impairment, avoid use in elderly.

W/P: [C, −] risk for dependency, ↓ seizure threshold, adrenal insufficiency, head injury, ↑ ICP, hepatic impairment, not OK in sickle cell disease.

CI: w/ MAOIs.

DISP: Tabs 50, 100 mg; syrup/soln 50 mg/5 mL; Inj 25, 50, 75, 100 mg/mL.

SE: Resp/CNS depression, seizures, sedation, constipation, ↓ BP, rash N/V, biliary and urethral spasms, dyspnea.

NOTES: Analgesic effects potentiated w/ hydroxyzine; 75 mg IM = 10 mg morphine IM; not best in elderly; do not use oral for acute pain; not OK for repetitive use in ICU setting, naloxone does not reverse neurotox, used as analgesic, is not recommended, limit Tx to <48 hr.

MEROPENEM (MERREM, GENERIC)

USES: *Intra-abdominal infections, bacterial meningitis, skin infection.*

ACTIONS: Carbapenem; ↓ cell wall synth. Spectrum: Excellent gram(+) (except MRSA, methicillin-resistant S. epidermidis [MRSE] & E. faecium); excellent gram(−) including extended-spectrum β-lactamase producers; good anaerobic.

DOSE:

Adults: Abdominal infection: 1–2 g IV q8h. Skin infection: 500 mg IV q8h.

Peds: >3 mo, <50 kg: Abdominal infection: 20 mg/kg IV q8h. Skin infection: 10 mg/kg IV q8h; Peds >50 kg. Use adult dose; max. 2 g IV q8h; ↓ in renal insufficiency (see package insert).

W/P: [B, ?/M] w/ Probenecid, valproic acid.

CI: β-Lactam anaphylaxis.

DISP: Inj 1 g, 500 mg.

SE: Less seizure potential than imipenem; C. difficile enterocolitis, diarrhea, ↓ plt.

NOTES: Overuse ↑ bacterial resistance.

MESNA (MESNEX [ORAL], GENERIC [IV])

USES: *Prevent hemorrhagic cystitis d/t ifosfamide* or cyclophosphamide.

ACTIONS: Antidote, reacts w/ acrolein and other metabolites to form stable compounds (sodium 2-mercaptoethane sulfonate).

DOSE: Per protocol; dose as % of ifosfamide or cyclophosphamide dose. IV bolus: 20% (eg, 10–12 mg/kg) IV at 0, 4, & 8 hr; IV Inf: 20% prechemotherapy, 40% w/ chemotherapy for 12–24 hr; Oral: 100% ifosfamide dose given as 20% IV at hour 0 then 40% PO at hours 4 & 8; if PO dose vomited repeat or give dose IV; mix PO w/ juice.

W/P: [B; ?/−].

CI: Thiol sensitivity.

DISP: Inj 100 mg/mL; (Mesnex) tabs 400 mg.

SE: ↓ BP, ↓ plt, ↑ HR, ↑ RR allergic reactions, rash, headache, GI upset, taste perversion; false positive urinary ketones.

NOTES: Hydration helps ↓ hemorrhagic cystitis; higher dose for BMT; IV contains benzyl alcohol.

METHENAMINE HIPPURATE (HIPREX)

USES: *Suppress recurrent UTI long term; use only after infection cleared by antibiotics.*

ACTIONS: Converted to formaldehyde & ammonia in acidic urine; nonspecific bactericidal action.

DOSE:

Adults: 1 g PO BID.

Peds: 6–12 yr: 0.5–1 g PO BID PO ÷ BID; w/ food, ascorbic acid w/ hydration.

W/P: [C, +] Large doses (8 g/d for 3–4 wk) have caused bladder irritation, painful/frequent micturition, albuminuria, and gross hematuria.

CI: Renal insufficiency, severe hepatic disease, severe dehydration w/ sulfonamides (may precipitate in urine).

DISP: Tabs 1 g.

SE: Rash, GI upset, dysuria, ↑ LFTs, super infection w/ prolonged use, C. difficile-associated diarrhea.

NOTES: Not indicated in peds <6 yr. Not for pts w/ indwelling catheters as dwell time in bladder required for action.

METHENAMINE COMBINATION PRODUCTS (HYOPHEN, URIBEL, UROGESIC BLUE, OTHERS)

(Note: This labeling has not been approved by the FDA)

USES: *Relief of local symptoms, such as inflammation, hypermotility, and pain, which accompany lower UTIs and symptoms caused by diagnostic procedures.*

ACTIONS: Based on individual components: Methenamine in acid urine releases formaldehyde (antiseptic); phenyl salicylate is a mild analgesic; methylene blue/benzoic acid are mild antiseptics; hyoscyamine is parasympatholytic (belladonna alkaloid) ↓ bladder spasm; sodium phosphate monobasic is an acidifier to maintain an acid pH for the degradation of methenamine.

DOSE:

Adults & Peds: >12 yr: 1 tab PO QID w/ liberal fluid intake.

W/P: [C, ?/−] Avoid w/ sulfonamides, narrow-angle glaucoma, pyloric/duodenal obst, bladder outlet obstruction, coronary artery spasm.

CI: Component hypersens.

DISP: Tabs and capsules (see representative products below).

HYOPHEN (methenamine, benzoic acid, phenyl salicylate, methylene blue, hyoscyamine sulfate) tablet

PROSED (methenamine, phenyl salicylate, methylene blue, benzoic acid, hyoscyamine) tablet

URIBEL (methenamine, sodium phosphate monobasic monohydrate, phenyl salicylate, methylene blue, hyoscyamine sulfate) capsule

URIMAR-T, URIN D/S, UROGESIC BLUE, UTIRA-C (methenamine, sodium phosphate monobasic, phenyl salicylate, methylene blue, hyoscyamine sulfate) tablet

USTELL (methenamine, sodium phosphate monobasic, phenyl salicylate, methylene blue, and hyoscyamine sulfate) capsule.

SE: Rash, dry mouth, flushing, ↑ pulse, dizziness, blurred vision, urine/feces discoloration (blue/light green), voiding difficulty/retention.

NOTES: Take w/ plenty of fluid, can cause crystalluria; not rec in peds ≤6 yr; Not for pts w/ indwelling catheters as dwell time in bladder required for action; see also hyoscyamine and phenazopyridine listings.

METHOTREXATE (RHEUMATREX DOSE PACK, TREXALL, GENERIC)

WARNING: Administration only by experienced physician; do not use in women of child-bearing age unless absolutely necessary (teratogenic); impaired elimination w/ impaired renal function, ascites, pleural effusion; severe ↓ BM w/ NSAIDs; hepatotox, occasionally fatal; can induce life-threatening pneumonitis; diarrhea and ulcerative stomatitis require D/C; lymphoma risk; may cause tumor lysis syndrome; can cause severe skin reaction, opportunistic infections; w/ RT can ↑ tissue necrosis risk. Preservatives make this agent unsuitable for intrathecal IT or higher-dose use.

USES: *ALL, AML, leukemic meningitis, trophoblastic tumors (choriocarcinoma, hydatidiform mole), breast, lung, head, & neck, cancers, Burkitt’s lymphoma, mycosis fungoides, osteosarcoma, Hodgkin disease & NHL, psoriasis; rheumatoid arthritis, JRA, SLE*, chronic disease.

ACTIONS: ↓ Dihydrofolate reductase-mediated prod of tetrahydrofolate, causes ↓ DNA synth.

DOSE:

Adults: Cancer: Per protocol. Rheumatoid arthritis: 7.5 mg/wk PO 1/wk or 2.5 mg q12h PO for 3 doses/wk. Psoriasis: 2.5–5 mg PO q12h × 3 d/wk or 10–25 mg PO/IM qwk. Chronic: 15–25 mg IM/SQ qwk, then 15 mg/wk.

Peds: JIA: 10 mg/m2 PO/IM qwk, then 5–14 mg/m2 × 1 or as 3 divided doses 12 hr apart; ↓ elderly, w/ renal/hepatic impairment.

W/P: [X, −] w/ Other nephro/hepatotoxic meds, multiple interactions, w/ seizure, profound ↓ BM other than cancer related.

CI: Severe renal/hepatic impairment, pregnancy/lactation.

DISP: Dose pack 2.5 mg in 8, 12, 16, 20, or 24 doses; tabs 2.5, 5, 7.5, 10, 15 mg; Inj 25 mg/mL; Inj powder 20 mg, 1 g.

SE: ↓ BM, N/V/diarrhea, anorexia, mucositis, hepatotox (transient & reversible; may progress to atrophy, necrosis, fibrosis, cirrhosis), rashes, dizziness, malaise, blurred vision, alopecia, photosensitivity, renal failure, pneumonitis; rare pulm fibrosis; chemical arachnoiditis & headache w/ IT delivery.

NOTES: Monitor CBC, LFTs, Cr, MTX levels & CXR; “high dose” >500 mg/m2 requires leucovorin rescue to ↓ tox; w/ IT, use preservative-/alcohol-free soln; systemic levels: Therapeutic: >0.01 μmole; Toxic: >10 micromole over 24 hr.

METHYLENE BLUE (UROLENE BLUE, VARIOUS)

USES: *Methemoglobinemia, vasoplegic syndrome, ifosfamide-induced encephalopathy, cyanide poisoning, dye in therapeutics/diagnosis.*

ACTIONS: Low IV dose converts methemoglobin to hemoglobin; excreted, appears in urine as green/green-blue color; MAOI activity.

DOSE: 1–2 mg/kg or 25–50 mg/m2 IV over 5–10 min, repeat q1h; direct instillation into fistulous tract.

W/P: [X, −] w/ Severe renal impairment w/ psych meds such as SSRI, SNRI, TCA (may cause serotonin syndrome), w/ G6PD deficiency.

CI: Intra spinal Inj, severe renal insufficiency.

DISP: 1, 10 mL Inj.

SE: IV use: N, abdominal, CP, sweating, fecal/urine discoloration, hemolytic anemia.

NOTES: Component of some oral medications; stains tissue blue, limits repeat use in surgical visualization.

METHYLPREDNISOLONE (DEPO-MEDROL, MEDROL, MEDROL DOSEPAK, SOLU-MEDROL, GENERIC) [SEE STEROIDS]

USES: *Steroid responsive conditions (endocrine, rheumatic, collagen, dermatologic, allergic, ophthalmic, respiratory, hematologic, neoplastic, edematous, GI, CNS, others).*

ACTIONS: Glucocorticoid.

DOSE:

See Steroids Peds: Status asthmaticus, anaphylactic shock: 2 mg/kg IV/IO/IM (max. 60 mg). Maint: 0.5 mg/kg IV q6h or 1 mg/kg q12h to 120 mg/d.

W/P: [C, ?/M] May mask Infx, cataract w/ prolonged use; avoid vaccines.

CI: Fungal Infx, component allergy.

DISP: Oral (Medrol) 4, 8, 16, 32 mg, (Medrol Dosepak) 21 4-mg tabs taken over 6 days; Inj acetate (Depo-Medrol) 20, 40, 80 mg/mL; Inj succinate (Solu-Medrol) 40, 125, 500 mg, 1, 2 g.

SE: Fluid and electrolyte disturbances, muscle weakness/loss, ulcers, impairment wound healing, others (see label).

NOTES: Taper dose to avoid adrenal insufficiency.

METOCLOPRAMIDE (METOZOLV, REGLAN, GENERIC)

WARNING: Chronic use may cause tardive dyskinesia; D/C if Sxs develop; avoid prolonged use (> 2 wk).

USES: *Diabetic gastroparesis, symptomatic GERD; chemo & postop N/V, facilitate small bowel intubation & upper GI radiologic exam*, *GERD, diabetic gastroparesis (Metozolv) stimulate gut in prolonged postop ileus.*

ACTIONS: ↑ Upper GI motility; blocks dopamine in chemoreceptor trigger zone, sensitized tissues to ACH.

DOSE:

Adults: Gastroparesis (Reglan): 10 mg PO 30 min ac & hs for 2–8 wk PRN, or same dose IM/IV for 10 days, then PO. Reflux: 10–15 mg PO 30 min ac & hs. Chemo antiemetic: 1–2 mg/kg/dose IV 30 min before chemo, then q2h × 2 doses, then q3h × 3 doses. Postop: 10–20 mg IV/IM q4–6h PRN.

Adults & Peds: >14 yr: Intestinal intubation: 10 mg IV × 1 over 1–2 min.

Peds: Reflux: 0.1–0.2 mg/kg/dose PO 30 min ac & hs. Chemo antiemetic: 1–2 mg/kg/dose IV as adults. Postop: 0.25 mg/kg IV q6–8h PRN.

Peds: Intestinal intubation:6–14 yr: 2.5–5 mg IV × 1 over 1–2 min; <6 yr: Use 0.1 mg/kg IV × 1.

W/P: [B, M] Drugs w/ extrapyramidal ADRs, MAOIs, tricyclic antidepressants, sympathomimetics.

CI: w/ EPS meds, GI bleeding, pheochromocytoma, seizure disorders, GI obst.

DISP: Tabs 5, 10 mg; syrup 5 mg/5 mL; ODT (Metozolv) 5, 10 mg; Inj 5 mg/mL.

SE: Dystonic reactions common w/ high doses (Treat w/ IV diphenhydramine), fluid retention, restlessness, diarrhea, drowsiness.

NOTES: ↓ w/ Renal impairment/elderly; check baseline Cr.

METRONIDAZOLE (FLAGYL, FLAGYL ER, METROCREAM, METROGEL, METROLOTION)

WARNING: Carcinogenic in rats.

USES: *Bone/joint, endocarditis, intra-abdominal, meningitis, & skin infections; amebiasis & amebic liver abscess; trichomoniasis in pt and partner; bacterial vaginosis; PID; giardiasis; antibiotic-associated pseudomembranous colitis (C. difficile), eradicate H. pylori w/ combo Treat, rosacea, prophylactic in postop colorectal surgery.*

ACTIONS: Interferes w/ DNA synth. Spectrum: Excellent anaerobic, C. difficile.

DOSE:

Adults: Anaerobic infections: 500 mg IV q6–8h. Trichomonas: 250 mg PO TID for 7 days or 2 g PO × 1 (Treat partner). C. difficile: 500 mg PO or IV q8h for 7–10 days (PO preferred; IV only if pt NPO), if no response, change to PO vancomycin. Vaginosis: 1 applicator intravag qd or BID × 5 days, or 500 mg PO BID × 7 days or 750 mg PO qd × 7 days. Acne rosacea/skin: Apply BID.

Peds: Anaerobic infections: PO: 15–35 mg/kg/d ÷ q8h IV: 30 mg/kg IV/d ÷ q6H, 4 g/d max. ÷ dose; Trichomonas: 15–30 mg/kg/d PO ÷ q8h × 7 days. C. difficile: 30 mg/kg/d PO ÷ q6h × 10 days, max. 2 g/d; ↓ w/ severe hepatic/renal impairment.

W/P: [B, −] Avoid EtOH, w/ warfarin, CYP3A4 substrates, ↑ Li levels.

CI: 1st tri pregnancy.

DISP: Tabs 250, 500 mg; ER tabs 750 mg; caps 375 mg; IV 500 mg/100 mL; lotion 0.75%; gel 0.75, 1%; intravag gel 0.75% (5 g/applicator 37.5 mg in 70-g tube), cream 0.75, 1%.

SE: Disulfiram-like reaction; dizziness, headache, GI upset, anorexia, urine discoloration, flushing, met allic taste.

NOTES: For trichomoniasis, Treat pt’s partner; no aerobic bacteria activity; use in combo w/ serious mixed infections; wait 24 hr after 1st dose to breast-feed or 48 hr if extended Treat, take ER on empty stomach.

MICAFUNGIN (MYCAMINE)

USES: *Candidemia, acute dissem and esophageal candidiasis, Candida peritonitis & abscesses; prophylaxis Candida infection w/ HSCT.*

ACTIONS: Echinocandin; ↓ fungal cell wall synth.

DOSE: Candidemia, acute disseminated candidiasis, Candida peritonitis & abscesses: 100 mg IV daily; Esophageal candidiasis: 150 mg IV daily; Prophylaxis of Candida infection: 50 mg IV daily over 1 hr.

W/P: [C, ?/−] w/ Sirolimus, nifedipine, itraconazole dosage adj may be necessary.

CI: Component or other echinocandin allergy.

DISP: Inj 50, 100 mg vials.

SE: N/V/diarrhea, headache, pyrexia, abdominal pain, ↓ K+, ↓ plt, histamine Sxs (rash, pruritus, facial swelling, vasodilatation), anaphylaxis, anaphylactoid reaction, hemolysis, hemolytic anemia, ↑ LFTs, hepatotox, renal impairment.

MICONAZOLE (MONISTAT 1 COMBO, MONISTAT 3, MONISTAT 7 [OTC]) (MONISTAT-DERM)

USES: *Candidal infections, dermatomycoses (tinea pedis/ tinea cruris/tinea corporis/tinea versicolor/candidiasis).*

ACTIONS: Azole antifungal, alters fungal membrane permeability.

DOSE: Intravag: 100 mg supp or 2% cream intravag qhs × 7 days or 200 mg supp or 4% cream intravag qhs × 3 days. Derm: Apply BID, a.m./p.m. Tinea versicolor: Apply qd. Treat tinea pedis and tinea corporis for 1 mo and other infections for 2 wk.

Peds: ≥12 yr: 100 mg supp or 2% cream intravag qhs × 7 days or 200 mg supp or 4% cream intravag qhs × 3 days. Not for OTC use in children <2 yr.

W/P: [C, ?] Azole sensitivity.

DISP: Monistat-Derm: (Prescription) Cream 2%; Monistat 1 combo: 2% cream w/ 1,200 mg supp, Monistat 3: Vag cream 4%, supp 200 mg; Monistat 7: cream 2%, supp 100 mg; lotion 2%; powder 2%; effervescent tab 2%, oint 2%, spray 2%; Vag supp 100, 200, 1,200 mg; Vag cream 2%, 4%; [OTC].

SE: Vag burning; on skin contact dermatitis, irritation, burning.

NOTES: May interfere w/ condom and diaphragm, do not use w/ tampons.

MICONAZOLE/ZINC OXIDE/PETROLATUM (VUSION)

USES: *Candidal diaper rash.*

ACTIONS: Combo antifungal.

DOSE:

Peds:4 wk: Apply at each diaper change × 7 days.

W/P: [C, ?].

CI: None.

DISP: Miconazole/zinc oxide/petrolatum oint 0.25/15/81.35%, 50-, 90-g tube.

SE: None.

NOTES: Keep diaper dry, not for prevention.

MINERAL OIL [OTC]

USES: *Constipation, bowel irrigation, fecal impaction.*

ACTIONS: Lubricant laxative.

DOSE:

Adults: Constipation: 15–45 mL PO/d PRN. Fecal impaction or after barium: 118 mL rectally × 1.

Peds: >6 yr: Constipation: 5–25 mL PO qd. 2–12 yr: Fecal impaction: 59 mL rectally × 1.

W/P: [?, ?] w/ N/V, difficulty swallowing, bedridden pts; may ↓ absorption of vits A, D, E, K, warfarin.

CI: Colostomy/ileostomy, appendicitis, diverticulitis, ulcerative colitis.

DISP: All [OTC] liq, PO microemulsion 2.5 mL/5 mL, rectal enema 118 mL.

SE: Lipid pneumonia (aspiration of PO mineral oil), N/V, temporary anal incontinence.

NOTES: Take PO upright, do not use PO in peds <6 yr; no longer recommended as lubricant for surgical instruments (not water soluble).

MINERAL OIL/PRAMOXINE HCL/ZINC OXIDE (TUCKS OINTMENT [OTC])

USES: *Temporary relief of anorectal disorders (itching, etc.).*

ACTIONS: Topical anesthetic.

DOSE:

Adults & Peds:12 yr: Cleanse, rinse, & dry, apply externally or into anal canal w/ tip 5×/d × 7 days max.

W/P: [?, ?] Do not place into rectum.

CI: None.

DISP: Oint 1% 30-g tube.

SE: Local irritation.

NOTES: D/C w/ or if rectal bleeding occurs or if condition worsens or does not improve w/in 7 days.

MINOCYCLINE (DYNACIN, MINOCIN, SOLODYN, GENERIC)

USES: *Mod–severe nonnodular acne (Solodyn), anthrax, rickettsiae, skin infection, URI, UTI, nongonococcal urethritis, amebic dysentery, asymptomatic meningococcal carrier, Mycobacterium marinum.*

ACTIONS: Tetracycline, bacteriostatic, ↓ protein synth.

DOSE:

Adults & Peds: >12 yr: Usual: 200 mg, then 100 mg q12h or 100–200 mg IV or PO, then 50 mg QID. Gonococcal urethritis, men: 100 mg q12h × 5 days. Syphilis: Usual dose × 10–15 days. Meningococcal carrier: 100 mg q12h × 5 days. M. marinum: 100 mg q12h × 6–8 wk. Uncomp urethral, endocervical, or rectal infection: 100 mg q12h × 7 days minimum.

Adults & Peds: >12 yr: Acne: (Solodyn) 1 mg/kg PO qd × 12 wk. > yr: 4 mg/kg initially then 2 mg/kg q12h w/ food to ↓ irritation, hydrate well, ↓ dose or extend interval w/ renal impairment.

W/P: [D, −] Associated w/ pseudomembranous colitis, w/ renal impairment, may ↓ OCP, or w/ warfarin may ↑ INR.

CI: Allergy, children <8 yr.

DISP: Tabs 50, 75, 100 mg; tabs ER (Solodyn) 45, 65, 90, 115, 135 mg, caps (Minocin) 50, 100 mg, susp 50 mg/mL.

SE: diarrhea, headache, fever, rash, joint pain, fatigue, dizziness, photosensitivity, hyperpigmentation, SLE syndrome, pseudotumor cerebri.

NOTES: Do not cut/crush/chew; keep away from children, tooth discoloration in <8 yr or w/ use last half of pregnancy.

MIRABEGRON (MYRBETRIQ)

USES: *Overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency. *

ACTIONS: β-3 adrenergic agonist; relaxes smooth muscle.

DOSE: Start 25 mg PO daily; ↑ to 50 mg daily after 8 wk PRN; 25 mg max. daily w/ severe renal or mod hepatic impairment; swallow whole, do not cut/chew.

W/P: [C, −] w/ Severe uncontrolled HTN; urinary retention w/ bladder outlet obstruction & antimuscarinic drugs; w/ drugs metabolized by CYP2D6 (eg, thioridazine, flecainide, propafenone); do not use w/ ESRD or severe hepatic impairment; monitor serum digoxin when starting both together.

CI: None.

DISP: Tabs ER 25, 50 mg.

SE: ↑ BP, headache, UTI, nasopharyngitis, N/diarrhea, constipation, abdominal pain, dizziness, tachycardia, URI, arthralgia, fatigue.

MITOMYCIN (GENERIC)

WARNING: Administer only by physician experienced in chemotherapy; myelosuppressive; can induce HUS w/ irreversible renal failure.

USES: *Stomach, pancreas*, breast, colon cancer; squamous cell carcinoma of the anus; NSCLC, head & neck, cervical; bladder cancer (intravesically).

ACTIONS: Alkylating agent; generates oxygen-free radicals w/ DNA strand breaks.

DOSE: (Per protocol) 20 mg/m2 q6–8wk IV or 10 mg/m2 combo w/ other myelosuppressive drugs q6–8wk. Bladder cancer: 20–40 mg in 40 mL NS via a urethral catheter once/wk; immediately postop if no evidence of extravasation × 1 to reduce recurrences following TURBT; ↓ in renal/hepatic impairment.

W/P: [D, −] w/ Cr >1.7 mg/dL/ ↑ cardiac tox w/ vinca alkaloids/doxorubicin.

CI: ↓ Plt, coagulation disorders, ↑ bleeding tendency, pregnancy.

DISP: Inj 5, 20, 40 mg.

SE: ↓ BM (persists for 3–8 wk, may be cumulative; minimize w/ lifetime dose <50–60 mg/m2), N/V, anorexia, stomatitis, renal tox, microangiopathic hemolytic anemia w/ renal failure (HUS), veno-occlusive liver disease, interstitial pneumonia, alopecia, extrav reactions, contact dermatitis; CHF w/ doses >30 mg/m2.

MITOTANE (LYSODREN)

WARNING: Administer only by physician experienced in chemotherapy; discontinue temporarily immediately following shock or severe trauma since adrenal suppression is its prime action. Exogenous steroids should be administered in such circumstances.

USES: *Inoperable adrenocortical carcinoma (functioning/nonfunctioning).

ACTIONS: Adrenal cytotoxic agent, suppresses cortisol production by inhibiting 11β-hydroxylase (ortho-para-DDD).

DOSE: 2–6 g/d in divided dose TID–QID; increase as tolerated to max. tolerated dose (generally 2–18 g/d); decrease dose with side effects; administer with glucocorticoid and if needed mineralocorticoid replacement.

W/P: [C/?]; increases warfarin metabolism.

CI: Hypersensitivity to compound.

DISP: Tablets 500 mg.

SE: Adrenal insufficiency, GI distress, depression, lethargy, somnolence, dizziness, vertigo, orthostasis.

NOTES: Neuropsychiatric testing with use >2 yr; higher doses of glucocorticoid required due to metabolism; treat until there is no clinical benefit.

MITOXANTRONE (GENERIC)

WARNING: Administer only by physician experienced in chemotherapy; except for acute leukemia, do not use w/ ANC count of <1,500 cells/mm3; severe neutropenia can result in infection, follow CBC; cardiotoxic (CHF), secondary AML reported.

USES: *Combination for myelogenous, promyelocytic, monocytic, and erythroid acute leukemias, progressive relapsing MS; pain related to advanced hormone refractory prostate cancer. *

ACTIONS: Anthracenedione; DNA-intercalating agent; ↓ DNA synth by interacting w/ topoisomerase II.

DOSE: Per protocol; Cap 12–14 mg/m2 short IV infusion every 21 days with steroids (such as prednisone 10 qd or 5 mg PO BID); ↓ dose w/ hepatic impairment, leukopenia, thrombocytopenia.

W/P: [D, −] Reports of secondary AML, w/ MS ↑ CV risk, do not treat MS pt w/ low LVEF.

CI: Pregnancy, sig ↓ in LVEF.

DISP: Inj 2 mg/mL.

SE: ↓ BM, N/V, stomatitis, alopecia (infrequent), cardiotox, urine discoloration, secretions & scleras may be blue-green.

NOTES: Maintain hydration; baseline CV evaluation w/ ECG & LVEF; cardiac monitoring prior to each dose; not for intrathecal use.

MORPHINE (AVINZA XR, ASTRAMORPH/PF, DURAMORPH, INFUMORPH, MS CONTIN, KADIAN SR, ORAMORPH SR, ROXANOL) [C-II]

WARNING: Do not crush/chew SR/CR forms; swallow whole or sprinkle on applesauce. 100 and 200 mg for opioid-tolerant pt only for mod–severe pain when pain control needed for an extended period and not PRN. Be aware of misuse, abuse, diversion. No alcoholic beverages while on therapy.

USES: *Treat severe pain*, AMI, acute pulmonary edema.

ACTIONS: Narcotic analgesic; SR/CR forms for chronic use.

DOSE:

Adults: Short-term use PO: 5–30 mg q4h PRN; IV/IM: 2.5–15 mg q2–6h; Supp: 10–30 mg q4h. SR formulations 15–60 mg q8–12h (do not chew/crush); use w/ caution; can be reversed w/ 0.4–2 mg IV naloxone.

Peds: >6 mo: 0.1–0.2 mg/kg/dose IM/IV q2–4h PRN; 0.15–0.2 mg/kg PO q3–4h PRN.

W/P: [C, +/−] Severe resp depression possible; w/ head injury; chewing delayed release forms can cause severe rapid release of morphine.

CI: (Many product specific) Severe asthma, resp depression, GI obst/ileus; Oral soln: CHF d/t lung disease, head injury, arrhythmias, brain tumor, acute alcoholism, DTs, seizure disorders; MS Contin and Kadian CI include hypercarbia.

DISP: IR tabs 15, 30 mg; soln 10, 20, 100 mg/5 mL; supp 5, 10, 20, 30 mg; Inj 2, 4, 5, 8, 10, 15, 25, 50 mg/mL; MS Contin CR tabs 15, 30, 60, 100, 200 mg; Oramorph SR tabs 15, 30, 60, 100 mg; Kadian SR caps 10, 20, 30, 40, 50, 60, 70, 80, 100, 130, 150, 200 mg; Avinza XR caps 30, 60, 90, 120 mg; Duramorph/Astramorph PF: Inj 0.5, 1 mg/mL; Infumorph 10, 25 mg/mL.

SE: Narcotic SE (resp depression, sedation, constipation, N/V, pruritus, diaphoresis, urinary retention, biliary colic), granulomas w/ IT.

NOTES: May require scheduled dosing to relieve severe chronic pain.

MOXIFLOXACIN (AVELOX)

WARNING: ↑ Risk Achilles tendon rupture and tendonitis, ↑ in pts >60 yr, on steroids or with organ transplant; avoid w/ myasthenia gravis, may ↑ muscle weakness.

USES: *Acute sinusitis & bronchitis, skin/soft-tissue/intra-abdominal infections, conjunctivitis, community-acquired pneumonia* TB, anthrax, endocarditis.

ACTIONS: 4th-gen quinolone; ↓ DNA gyrase. Spectrum: Excellent gram(+) except MRSA & E. faecium; good gram(−) except P. aeruginosa, Stenotrophomonas maltophilia, & Acinetobacter sp; good anaerobic.

DOSE: 400 mg/d PO/IV daily; avoid cation products, antacids TID.

W/P: [C, −] Quinolone sensitivity; interactions w/ Mg2+, Ca2+, Al2+, Fe2+-containing products, & class IA & III antiarrhythmic agents.

CI: Quinolone/component sensitivity.

DISP: Tabs 400 mg, ABC Pak 5 tabs, Inj.

SE: Dizziness, N, QT prolongation, seizures, photosensitivity, peripheral neuropathy risk.

MUPIROCIN (BACTROBAN, BACTROBAN NASAL)

USES: *Impetigo (oint); skin lesion infect w/ S. aureus or S. pyogenes; eradicate MRSA in nasal carriers.*

ACTIONS: ↓ Bacterial protein synth.

DOSE: Topical: Apply small amount 3×/d × 5–14 days. Nasal: Apply 1/2 single-use tube BID in nostrils × 5 days.

W/P: [B, ?/M].

CI: Do not use w/ other nasal products.

DISP: Oint 2%; cream 2%; nasal oint 2% 1-g single-use tubes.

SE: Local irritation, rash.

NOTES: Pt to contact healthcare provider if no improvement in 3–5 days.

MYCOPHENOLATE MOFETIL (CELLCEPT, GENERIC)

WARNING: ↑ Risk of infections, lymphoma, other cancers, progressive multifocal leukoencephalopathy (PML); risk of pregnancy loss and malformation; female of child-bearing potential must use contraception.

USES: *Prevent organ rejection after transplant.*

ACTIONS: Cytostatic to lymphocytes.

DOSE:

Adults: 1 g PO BID, doses differ based on transplant.

Peds: BSA 1.2–1.5 m2: 750 mg PO BID. BSA >1.5 m2: 1 g PO BID; used w/ steroids & cyclosporine or tacrolimus; ↓ in renal insufficiency or neutropenia. IV: Infuse over >2 hr. PO: Take on empty stomach, do not open caps.

W/P: [D, −].

CI: Component allergy; IV use in polysorbate 80 allergy.

DISP: Caps 250, 500 mg; susp 200 mg/mL, Inj 500 mg.

SE: N/V/diarrhea, pain, fever, headache, infection, HTN, anemia, leukopenia, edema.

NOTES: Cellcept & Myfortic are not interchangeable.



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