,CONTENTS
DRUGS BY DISORDER xv
DRUG CLASSIFICATIONS 1C
A–Z DRUG ENTRIES 1
APPENDIXES 1278
A. Calculation of Doses 1279
B. Controlled Drugs (United States) 1280
C. Chronic Wound Care 1281
D. Drugs of Abuse 1285
E. Equianalgesic Dosing 1290
F. FDA Pregnancy Categories 1291
G. Herbals: Common Natural Medicines 1292
H. Lifespan, Cultural Aspects,
and Pharmacogenomics of Drug Therapy 1298
I. Normal Laboratory Values 1302
J. Cytochrome P450 (CYP) Enzymes 1304
K. Poison Antidote Chart 1307
L. Preventing Medication Errors and Improving
Medication Safety 1311
M. Recommended Childhood and Adult
Immunizations 1314
N. Parenteral Fluid Administration 1320
O. Spanish Phrases Often Used in Clinical
Settings 1322
GENERAL INDEX 1331
iii
,xiv Newly Approved Medications
Name Indication
Lorcaserin Serotonin 2C agonist for chronic weight
(Belviq) management
Loxapine Antipsychotic for acute treatment of agitation
(Adasuve) associated with schizophrenia or bipolar 1
disorder in adults
Lucinactant Synthetic surfactant for prevention of respiratory
(Surfaxin) distress syndrome in premature infants
Mirabegron Beta3-adrenergic agonist for overactive bladder
(Myrbetriq)
Omacetaxine (Synribo) Treatment of adults with chronic or accelerated
phase chronic myeloid leukemia
Pasireotide Somatostatin analog for treatment of
(Signifor) Cushing’s disease
Perampanel AMPA antagonist in adjunctive therapy for treat-
(Fycompa) ment of partial-onset seizures with or without
secondary generalized seizures
Pertuzumab HER2/neu receptor antagonist for HER2-
(Perjeta) positive metastatic breast cancer
Ponatinib (Iclusig) Kinase inhibitor for treatment of chronic myeloid
leukemia and Philadelphia chromosome–positive
acute lymphoblastic leukemia
Regorafenib Kinase inhibitor for treatment of metastatic
(Stivarga) colorectal cancer previously treated
Stribild (cobicistat, Complete once-daily single-tablet regimen for
elvitegravir, HIV-1 infection in treatment-naïve adults
emtricitabine, and te-
nofovir)
Tbo-filgrastim Leukocyte growth factor for reduction in
duration of severe neutropenia in patients with
nonmyeloid malignancies receiving
myelosuppressive anticancer drugs
Teduglutide Recombinant analog of human glucagon-like pep-
(Gattex) tide 2 for treatment of short bowel syndrome
in adults
Teriflunomide Oral immunomodulatory, disease-modifying drug
(Aubagio) with anti-inflammatory properties for treatment of
relapsing forms of multiple sclerosis
Tofacitinib Treatment of moderate to severe rheumatoid
(Xeljanz) arthritis
Vismodegib Hedgehog pathway inhibitor for advanced basal
(Erivedge) cell carcinoma
, apixaban e2
A
apixaban LIFESPAN CONSIDERATIONS
Pregnancy/Lactation: Unknown if dis-
a-pix-a-ban tributed in breast milk. Pregnancy Cate-
(Eliquis) gory B. Children: Safety and efficacy not
Do not confuse apixaban with established. Elderly: No age-related pre-
rivaroxaban, argatroban, or cautions noted.
dabigatran.
BLACK BOX ALERT Discontinuation in INTERACTIONS
absence of alternative anticoagulation in- DRUG: CYP3A4 inducers (e.g., carba-
creases risk for thrombotic events. An in-
creased rate of stroke noted following
mazepine, rifampin) may decrease
discontinuation in pts with non-valvular levels/effects. Aspirin, NSAIDs, warfa-
atrial fibrillation. If apixaban must be dis- rin, heparin, antiplatelet agents,
continued based on other than pathologic CYP3A4 inhibitors, (e.g., ketocon-
bleeding, coverage with another antico- azole, clarithromycin) may increase
agulant should be strongly considered.
concentration, bleeding risk. HERBAL:
u CLASSIFICATION St. John’s wort may decrease levels/ef-
fects. FOOD: Grapefruit juice may in-
PHARMACOTHERAPEUTIC: Factor Xa
crease levels/adverse effects. LAB VAL-
inhibitor. CLINICAL: Anticoagulant. UES: May decrease platelet count, Hgb,
LFTs.
ACTION AVAILABILITY (Rx)
Selectively blocks active site of factor Xa, Tablets: 2.5 mg, 5 mg.
a key factor in the intrinsic and extrinsic
pathway of blood coagulation cascade. ADMINISTRATION/HANDLING
Prevents new clot formation, secondary b ALERT c Discontinuation in absence
thromboembolic complications. Cata- of alternative anticoagulation increases
lyzes conversion of prothrombin to risk for thrombotic events.
thrombin. Therapeutic Effect: Inhibits
platelet activation, fibrin clot formation. PO
• Give without regard to meals. • If elec-
PHARMACOKINETICS tive surgery or invasive procedures with
Readily absorbed after PO administra- moderate or high risk for bleeding, dis-
tion. Peak plasma concentration: 3–4 continue apixaban 24 hrs prior to proce-
hrs. Protein binding: 87%. Metabolized dure.
in liver. Excreted primarily in urine, fe-
ces. Half-life: 12 hrs. INDICATIONS/ROUTES/DOSAGE
Usual Dosage
USES PO: ADULTS, ELDERLY: 5 mg twice daily, in
Reduces risk for stroke, systemic embo- those with at least 2 of the following
lism in pts with nonvalvular atrial fibrilla- characteristics: age 80 yrs or older, body
tion. OFF-LABEL: Reduces risk of recur- weight 60 kg or less, serum creatinine
rent DVT and/or PE. 1.5 mg/dl or greater, concurrent use with
CYP3A4, P-gp inhibitors (e.g., ketocon-
PRECAUTIONS azole, ritonavir).
Contraindications: Active pathologic
bleeding. Cautions: Mild to moderate he- Usual Dosage
patic impairment, severe renal impair- PO: ELDERLY: 2.5 mg daily twice daily.
ment. Avoid use in those with severe he-
patic impairment, prosthetic heart valve.
Canadian trade name Non-Crushable Drug High Alert drug
DRUGS BY DISORDER xv
DRUG CLASSIFICATIONS 1C
A–Z DRUG ENTRIES 1
APPENDIXES 1278
A. Calculation of Doses 1279
B. Controlled Drugs (United States) 1280
C. Chronic Wound Care 1281
D. Drugs of Abuse 1285
E. Equianalgesic Dosing 1290
F. FDA Pregnancy Categories 1291
G. Herbals: Common Natural Medicines 1292
H. Lifespan, Cultural Aspects,
and Pharmacogenomics of Drug Therapy 1298
I. Normal Laboratory Values 1302
J. Cytochrome P450 (CYP) Enzymes 1304
K. Poison Antidote Chart 1307
L. Preventing Medication Errors and Improving
Medication Safety 1311
M. Recommended Childhood and Adult
Immunizations 1314
N. Parenteral Fluid Administration 1320
O. Spanish Phrases Often Used in Clinical
Settings 1322
GENERAL INDEX 1331
iii
,xiv Newly Approved Medications
Name Indication
Lorcaserin Serotonin 2C agonist for chronic weight
(Belviq) management
Loxapine Antipsychotic for acute treatment of agitation
(Adasuve) associated with schizophrenia or bipolar 1
disorder in adults
Lucinactant Synthetic surfactant for prevention of respiratory
(Surfaxin) distress syndrome in premature infants
Mirabegron Beta3-adrenergic agonist for overactive bladder
(Myrbetriq)
Omacetaxine (Synribo) Treatment of adults with chronic or accelerated
phase chronic myeloid leukemia
Pasireotide Somatostatin analog for treatment of
(Signifor) Cushing’s disease
Perampanel AMPA antagonist in adjunctive therapy for treat-
(Fycompa) ment of partial-onset seizures with or without
secondary generalized seizures
Pertuzumab HER2/neu receptor antagonist for HER2-
(Perjeta) positive metastatic breast cancer
Ponatinib (Iclusig) Kinase inhibitor for treatment of chronic myeloid
leukemia and Philadelphia chromosome–positive
acute lymphoblastic leukemia
Regorafenib Kinase inhibitor for treatment of metastatic
(Stivarga) colorectal cancer previously treated
Stribild (cobicistat, Complete once-daily single-tablet regimen for
elvitegravir, HIV-1 infection in treatment-naïve adults
emtricitabine, and te-
nofovir)
Tbo-filgrastim Leukocyte growth factor for reduction in
duration of severe neutropenia in patients with
nonmyeloid malignancies receiving
myelosuppressive anticancer drugs
Teduglutide Recombinant analog of human glucagon-like pep-
(Gattex) tide 2 for treatment of short bowel syndrome
in adults
Teriflunomide Oral immunomodulatory, disease-modifying drug
(Aubagio) with anti-inflammatory properties for treatment of
relapsing forms of multiple sclerosis
Tofacitinib Treatment of moderate to severe rheumatoid
(Xeljanz) arthritis
Vismodegib Hedgehog pathway inhibitor for advanced basal
(Erivedge) cell carcinoma
, apixaban e2
A
apixaban LIFESPAN CONSIDERATIONS
Pregnancy/Lactation: Unknown if dis-
a-pix-a-ban tributed in breast milk. Pregnancy Cate-
(Eliquis) gory B. Children: Safety and efficacy not
Do not confuse apixaban with established. Elderly: No age-related pre-
rivaroxaban, argatroban, or cautions noted.
dabigatran.
BLACK BOX ALERT Discontinuation in INTERACTIONS
absence of alternative anticoagulation in- DRUG: CYP3A4 inducers (e.g., carba-
creases risk for thrombotic events. An in-
creased rate of stroke noted following
mazepine, rifampin) may decrease
discontinuation in pts with non-valvular levels/effects. Aspirin, NSAIDs, warfa-
atrial fibrillation. If apixaban must be dis- rin, heparin, antiplatelet agents,
continued based on other than pathologic CYP3A4 inhibitors, (e.g., ketocon-
bleeding, coverage with another antico- azole, clarithromycin) may increase
agulant should be strongly considered.
concentration, bleeding risk. HERBAL:
u CLASSIFICATION St. John’s wort may decrease levels/ef-
fects. FOOD: Grapefruit juice may in-
PHARMACOTHERAPEUTIC: Factor Xa
crease levels/adverse effects. LAB VAL-
inhibitor. CLINICAL: Anticoagulant. UES: May decrease platelet count, Hgb,
LFTs.
ACTION AVAILABILITY (Rx)
Selectively blocks active site of factor Xa, Tablets: 2.5 mg, 5 mg.
a key factor in the intrinsic and extrinsic
pathway of blood coagulation cascade. ADMINISTRATION/HANDLING
Prevents new clot formation, secondary b ALERT c Discontinuation in absence
thromboembolic complications. Cata- of alternative anticoagulation increases
lyzes conversion of prothrombin to risk for thrombotic events.
thrombin. Therapeutic Effect: Inhibits
platelet activation, fibrin clot formation. PO
• Give without regard to meals. • If elec-
PHARMACOKINETICS tive surgery or invasive procedures with
Readily absorbed after PO administra- moderate or high risk for bleeding, dis-
tion. Peak plasma concentration: 3–4 continue apixaban 24 hrs prior to proce-
hrs. Protein binding: 87%. Metabolized dure.
in liver. Excreted primarily in urine, fe-
ces. Half-life: 12 hrs. INDICATIONS/ROUTES/DOSAGE
Usual Dosage
USES PO: ADULTS, ELDERLY: 5 mg twice daily, in
Reduces risk for stroke, systemic embo- those with at least 2 of the following
lism in pts with nonvalvular atrial fibrilla- characteristics: age 80 yrs or older, body
tion. OFF-LABEL: Reduces risk of recur- weight 60 kg or less, serum creatinine
rent DVT and/or PE. 1.5 mg/dl or greater, concurrent use with
CYP3A4, P-gp inhibitors (e.g., ketocon-
PRECAUTIONS azole, ritonavir).
Contraindications: Active pathologic
bleeding. Cautions: Mild to moderate he- Usual Dosage
patic impairment, severe renal impair- PO: ELDERLY: 2.5 mg daily twice daily.
ment. Avoid use in those with severe he-
patic impairment, prosthetic heart valve.
Canadian trade name Non-Crushable Drug High Alert drug
