Clinician's Pocket Drug Reference, 2011 by Gomella Leonard G. & Haist Steven A. & Adams Aimee G

Author:Gomella, Leonard G. & Haist, Steven A. & Adams, Aimee G. [Gomella, Leonard G.]
Language: eng
Format: mobi
Publisher: McGraw-Hill Medical
Published: 2010-12-26T16:00:00+00:00

Lacosamide (Vimpat) BOX: Antiepileptics associated w/ ↑ risk of suicide ideation Uses: *Adjunct in partial-onset Szs* Action: Anticonvulsant Dose: Initial: 50 mg IV or PO BID, ↑ weekly; Maint: 200-400 mg/d; 300 mg/d max if CrCl < 30 mL/min or mild/mod hepatic Dz Caution: [C, /?] CI: None Disp: IV: 10 mg/mL; Tabs: 50, 100, 150, 200 mg SE: Dizziness, N/V, ataxia Notes: ECG before dosing; may ↑ PR interval

Lactic Acid & Ammonium Hydroxide [Ammonium Lactate] (LacHydrin) Uses: *Severe xerosis & ichthyosis* Acts: Emollient moisturizer, humectant Dose: Apply bid Caution: [B, ?] Disp: Cream, lotion, lactic acid 12% w/ ammonium hydroxide SE: Local irritation, photosens Notes: Shake well before use

Lactobacillus (Lactinex Granules) [OTC] Uses: *Control of D*, especially after antibiotic Rx Acts: Replaces nl intestinal flora, lactase production;Lactobacillus acidophilus and Lactobacillus helveticus. Dose: Adults & Peds >3 y: 1 packet, 1–2 caps, or 4 tabs q day-qid Caution: [A, +] Some products may contain whey CI: Milk/lactose allergy Disp: Tabs, caps; granules in packets (all OTC) SE: Flatulence Notes: May take granules on food

Lactulose (Constulose, Generlac, Enulose, others) Uses: *Hepatic encephalopathy; constipation* Acts: Acidifies the colon, allows ammonia to diffuse into colon; osmotic effect to ↑ peristalsis Dose: Acute hepatic encephalopathy: 30–45 mL PO q1h until soft stools, then tid-qid, adjust 2–3 stool/d. Constipation: 15–30 mL/d, ↑ to 60 mL/d 1–2 ÷ doses, adjust to 2–3 stools. Rectally: 200 g in 700 mL of H2O PR, retain 30–60 min q4–6h. Peds. Infants: 2.5–10 mL/24 h ÷ tid-qid. Other Peds: 40–90 mL/24 h ÷ tid-qid. Peds Constipation: 5 g (7.5 mL) PO after breakfast Caution: [B, ?] CI: Galactosemia Disp: Syrup 10 g/15 mL, soln 10 g/15 mL;, 10, 20 g/packet SE: Severe D, N/V, cramping, flatulence; life-threatening electrolyte disturbances

Lamivudine (Epivir, Epivir-HBV, 3TC [Many Combo Regimens]) BOX: Lactic acidosis & severe hepatomegaly w/ steatosis reported w/ nucleoside analogs Uses: *HIV Infxn, chronic hep B* Acts: NRTI, ↓ HIV RT & hep B viral polymerase, causes viral DNA chain termination Dose: HIV: Adults & Peds >16 y: 150 mg PO bid or 300 mg PO daily. Peds able to swallow pills: 14–21 kg: 75 mg bid; 22–29 kg: 75 mg q A.M., 150 mg q P.M.; >30 kg: 150 mg bid. Neonates <30 d: 2 mg/kg bid. Epivir-HBV: Adults. 100 mg/d PO. Peds 2–17 y: 3 mg/kg/d PO, 100 mg max; ↓ w/ CrCl <50 mL/min Caution: [C, −] w/ Interferon-α and ribavirin may cause liver failure; do not use w/ zalcitabine or w/ ganciclovir/valganciclovir Disp: Tabs 100 mg (Epivir-HBV) 150 mg, 300 mg; soln 5 mg/mL (Epivir-HBV), 10 mg/mL SE: malaise, fatigue, N/V/D, HA, pancreatitis, lactic acidosis, peripheral neuropathy, fat redistribution, rhabdomyolysis hyperglycemia, nasal Sxs Notes: Differences in formulations; do not use Epivir-HBV for hep in pt w/ unrecognized HIV d/t rapid emergence of HIV resistance

Lamotrigine (Lamictal) BOX: Serious rashes requiring hospitalization & D/C of Rx reported; rash less frequent in adults; ↑ suicidality risk for antiepileptic drug, higher for those w/ epilepsy vs. those using drug for psychological indications Uses:

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