i MOSBY’S DRUG REFERENCE HEALTH for PROFESSIONS FOURTH EDITION Writer and Consultant MaryAnne Hochadel, PharmD, BCPS Editor Emeritus ELSEVIER/Gold Standard; Clinical Pharmacist Bayfront Medical Center St. Petersburg, Florida; Clinical Assistant Professor of Pharmacy Practice University of Florida, College of Pharmacy Gainesville, Florida 3251 Riverport Lane St. Louis, Missouri 63043 MOSBY’S DRUG REFERENCE FOR HEALTH PROFESSIONS, FOURTH EDITION ISBN: 978-0-323-07737-8 Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Copyright © 2012, 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treat- ment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evalu- ating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. International Standard Book Number 978-0-323-07737-8 Vice President and Publisher: Linda Duncan Executive Content Strategist: Kellie White Content Manager: Rebecca Leenhouts Publishing Services Manager: Pat Joiner-Myers Senior Book Designer: Paula Catalano Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 DRUG INFORMATION REVIEWER PANEL Dana A. Brown, PharmD, BCPS Puja Patel, PharmD Assistant Dean for Academics, Ambulatory/Managed Care Resident, Assistant Professor of Pharmacy Kaiser Permanente, Atlanta, Practice, Lloyd L. Gregory School Georgia of Pharmacy, Palm Beach Atlantic University, West Palm Beach, Florida Julie Phillips Karpinski, RPh, PharmD, BCPS Assistant Professor, Pharmacy Prac- tice, Director, Drug Information, Concordia University, Wisconsin School of Pharmacy, Mequon, Wisconsin REVIEWERS Carlos Chavez, MEd, CDA, RDA Marie E. Mitchell, CPhT Curriculum Manager, Corinthian Instructor, Pharmacy Technician Colleges, Inc., Santa Ana, Department, Everest Institute, California Kalamazoo, Michigan Kimberli Lopez, AS, CPhT, RPhT Meredith Narcisse, CPhT Instructor, University of California, Pharmacy Technician Instructor, Riverside, Riverside, California; United Educational Institute, California State University, Long Gardena, Gardena, California Beach, Long Beach, California; United Educational Institute Omid Parto, PharmD, CPhT College, Riverside, California Department Chair for Pharmacy Technology, Everest College, Vinu Mathew Santa Ana, Santa Ana, California Pharmacy Technician Instructor, United Educational Institute Hwa (Jennifer) Yeon, CPhT, MS College, Anaheim Campus, North Orange County Community Anaheim, California College District, School of Continuing Education, Anaheim, California iii PAST REVIEWERS Karissa N. Dahlke, BS Evie Mann, RMA Florida Society of Health System Associate Director of Education, The Pharmacists Council Member Medical Institute of Kentucky, 2010–2011, Orlando, Florida Florence, Kentucky Deborah A. DeLuca, MS, JD Kim D. McKenna, MEd, RN, CEN, Assistant Professor, University EMT-P School of Health and Medical Sci- Director of Education, St. Charles ences, South Orange, New Jersey County Ambulance District, St. Peters, Missouri Gautam J. Desai, DO, FACOFP, CPI Associate Professor, Department of David Nissen, PharmD Family Medicine, Kansas City Pharmacy Informatics, Missouri University of Medicine and Bio- Baptist Medical Center, St. Louis, sciences, College of Osteopathic Missouri Medicine, Kansas City, Missouri Bernie R. Olin, PharmD Karen Drummond, CPC, CPC-H, CPC- Associate Clinical Professor and I, CHA, MCMC, PCS, FCS, ACS-RA, Director of Drug Information, Au- ACS-OB/GYN, CIBS, CMC, CMBS-I burn University, Harrison School Instructor, Auditor, Consultant, of Pharmacy, Auburn, Alabama AAPC Approved PMCC Instruc- tor, Advisory Board Member Kazi Parvez, MBBS, RCT for Board of Advanced Medical Formerly, Program Chair, Cardiology Specialty Coding, Board Member Technologist Program, Everest of American Institute for Health- College, Toronto, Ontario, Canada care Compliance Online, Medical Coding and Billing Instructor for John J. Smith, EdD Health Care Consulting Services, AVP, Curriculum and Instruction, Irmo, South Carolina Corinthian Colleges, Inc., Santa Ana, California Sandy Fritz, MS, NCTMB Owner and Head Instructor, Health Linda M. Smith, CPC, CPC-I, CEMC, Enrichment Center School of PCS, CAC, CMBS Therapeutic Massage, Lapeer, Medical Billing and Coding Consult- Michigan ant; Owner, MedOffice Resources, Greene, New York Douglas S. Gardenhire, RRT-NPS Director of Clinical Education, Karen A. Vezina, RCT School of Health Professions, Cardiology Technologist Program Division of Respiratory Therapy, Chair, Everest College of Busi- Georgia State University, Atlanta, ness, Technology and Health Care, Georgia Ottawa, Ontario, Canada Trisha LaPointe, PharmD, BCPS Assistant Professor of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, School of Pharmacy, Boston Department of Pharmacy Practice, Boston, Massachusetts INTRODUCTION INTRODUCTION actions of the drug is given, fol- Mosby’s Drug Reference for Health lowed by a brief statement of Professions is designed as a concise, therapeutic effect. easy-to-use resource for drug infor- • Pharmacokinetics. A relevant, yet mation for the busy health care pro- concise, summary of the absorp- fessional. The information is provided tion, distribution, metabolism, and in a standardized monograph format. excretion characteristics is pro- A number of important new medica- vided for each entry. tions have been introduced in the past • Availability. Dosage forms cur- few years, and these have been incor- rently approved for marketing in porated into this guide, which con- the United States are listed. Users tains a concise overview of over 900 should note that this information generic and over 2400 brand-name may change frequently. Users medications widely used in medical are encouraged to speak with practice. This latest edition will be a their pharmacists regarding local welcome addition to any health care drug availability, since market- professional’s drug reference library ing status and shortages of drug and will be used often for its practi- products may occur frequently in cality, currency, and quick summaries practice. of essential drug facts. • Indications and dosages. Ap- proved indications, routes, and DETAILS OF THE CONTENTS dosages for approved populations Essential drug information in a user- of use are provided in a concise friendly format. The bulk of this hand- format. Pediatric and geriatric book contains an alphabetical listing data are included when available. of drug entries by generic name. Drug When specified, dosages for he- entries include the following: patic and renal impairment are • Generic and brand name. Drug also provided. entries are categorized by generic • Contraindications. Contraindi- name alphabetically, followed by cations are listed as provided in marketed product names. manufacturer labeling, indicating • Category and schedule. The U.S. circumstances under which a drug FDA pregnancy risk category, should not be used. as well as pertinent information • Interactions. Common interac- regarding over-the-counter (OTC) tions with drugs, herbal and status and U.S. DEA Controlled dietary supplements, and food Substance Schedules, is listed. are provided in a quick-reference State DEA schedules may vary format so that practitioners can from the U.S. listing; practitioners easily screen medication profiles. should refer to their state laws New interaction data are often regarding any variations. published as new drugs enter • Classification. Each entry high- the market or are used widely in lights important pharmacologic, the intended populations, so the chemical, and/or therapeutic use information presented may not classifications. always reflect the most current • Mechanism of action. A brief data. Practitioners are encouraged pharmacologic description of the to use the information provided to v vi Introduction screen for important interactions noted in clinical trials. Although but also consider the need for the included frequencies are not other sources. always reflective of the frequen- • Diagnostic test effects. This sec- cies seen once a drug is on the tion provides a brief summary of market, the guide provides a basic both the expected and the poten- understanding of side effects that tial effects that a drug has on are expected, frequent, occa- commonly monitored laboratory sional, or rare, including esti- testing (e.g., blood chemistry, mated percentages associated renal function, liver function, with the definitions. Although not and hematologic testing), as well meant to be absolutely inclusive, as any known assay interference. this guide includes the more com- When a therapeutic range is monly reported reactions in each defined for a drug, it will also be category that are likely to be caus- presented in this section. ally associated with a given drug. • IV incompatibilities and IV • Serious reactions. Most practi- compatibilities. Medications tioners would like to have a good that are used intravenously must understanding of those reactions be approached with caution, that, because of their severity especially with respect to the and potentially life-threatening use of other parenteral medica- nature, would require prompt tions. In these sections, the user intervention or lead to hospital- is presented with common and ization. This section highlights well-known incompatibilities and those side effects, apart from published compatibilities with other reactions, that often require other medications at the Y-site. specialized warnings or alerts. However, these data often depend The practitioner is encouraged to on concentration and method of always check these listings when administration and are constantly reviewing an entry. updated. New incompatibility • Precautions and considerations. data may emerge at any time. Using a practice-oriented format The user is encouraged to always for health care professionals, this consult specialized resources for section very concisely summa- new incompatibility informa- rizes the most relevant concepts in tion before mixing or infusing considerations for prescribing and any parenteral medication. The monitoring a drug in given patient information provided is not meant populations, including those who to be inclusive but rather to be are pregnant or breastfeeding, as exemplary of the concerns with well as children and the elderly. regard to IV incompatibility. This The user of this guide will gain information is clarified with icons practical advice for monitoring representing compatibilities and drug effects during treatment and incompatibilities. will appreciate the care-focused • Side effects. The health care pro- context of the information. fessional will appreciate the prior- • Storage. The proper storage of itized presentation of side effects. medications, and their stabil- This section provides an under- ity, is a concern in health care standing of the general frequency and patient home environments. of commonly reported side effects Proper storage helps ensure that Introduction vii appropriate drug effects will be • Full-color pill atlas. maintained. This section quickly • Additional generic drug summarizes proper storage for monographs. each entry. • Monographs for herbal • Administration. A concise sum- remedies, compound drugs, and mary of administering each OTC drugs. dosage form is provided for the • Generic-to-trade-name reference practitioner. Proper administra- table. tion technique helps ensure that • Medication math exercises. desired medication effects are • Information on drugs of abuse attained. When known, tech- and general anesthetics. niques for limiting side effects • English-Spanish translations during administration are high- of common medication-related lighted. Alerts to hazards are also phrases. presented for important medica- tions, such as chemotherapy. SUMMARY When it comes to providing quality Appendices. Quick reference guides information, Mosby’s Drug Reference to FDA pregnancy categories and for Health Professions is an important normal laboratory values are pro- and practical resource. The spectrum vided. of drug entries, the current informa- Electronic Resources. Register tion, and health care professional tips for free resources at www.mosby will be invaluable to providing patient drugref.com. The following assets and client care. are available: • Audio drug name pronunciations MaryAnne Hochadel, and an audio glossary (including PharmD, BCPS definitions) in MP3 format. CONTENTS Drug Information Reviewer Panel, iii Reviewers, iii Introduction, v A to Z Drug Entries, 1 Appendices A FDA Pregnancy Categories, 1700 B Normal Laboratory Values, 1701 Index, 1703 For the glossary and other drug information resources, please visit www.mosbydrugref.com. viii