The PAs complete guide to prescribing drug therapy 2018

Hull, PA-C Director, Chair, and Assistant Professor of Physician Assistant Studies, Milligan College, Tennessee “Th is is a user-friendly, compact, and thorough prescribing guide with ve

“Th is appears to be an excellent prescribing reference that both PA students and practicing PAs in all types of clinical settings will fi nd very useful.”

Andrew W Hull, PA-C

Director, Chair, and Assistant Professor of Physician Assistant Studies, Milligan College, Tennessee

“Th is is a user-friendly, compact, and thorough prescribing guide with very helpful referencing and useful appendices that will be a benefi t to any practicing PA.”

cross-Heather C Justice, MSPAP, PA-C

Assistant Professor, Milligan College, Tennessee; Palliative Care Practitioner, Wellmont Medical System, Kingsport, Tennessee

“Th is is a great idea Th ere are many websites, apps, and booklets with similar information But everyone likes a document that is special for their profession the treatment recommendations will be valuable this will be well received by PAs [particularly by] newer graduates.”

Lucy W Kibe, DrPH, MS, MHS, PA-C

Director of Doctoral Education, Assistant Professor, Department of Physician Assistant Medicine, School of Graduate Health Sciences, Lynchburg College, Lynchburg, Virginia

“Th e text material is well-thought out and organized Categorizing the information

by diagnosis allows for quick and easy referencing in the classroom or in the clinic Th e expanded prescribing information provides succinct clinical pearls that are invaluable

to the clinician in training and the seasoned provider alike.”

Maureen Knechtel, MPAS, PA-C

Assistant Professor, Physician Assistant Studies, Milligan College, Tennessee

“A clinical ‘must’ in today’s busy  practice  environment brilliantly linking the most common disease entities with a most user-friendly and extremely well laid out prescribing guide .”

Keith Laff erty, MD, FAAEM

Co-Director Department of Emergency Medicine, Director of Education, Gulf Coast Medical Center, Fort Myers, Florida; Adjunct Assistant Professor of Emergency Medicine, Temple University, Philadelphia, Pennsylvania

“Excellent resource for physician assistants whether practicing or in training All the necessary information is at your fi ngertips—not only Rx relevant,  but clinically also A must-have in your personal medical reference collection!”

Amee Naidu, MMS, PA-C

Director of Student Aff airs, Senior Lecturer, MEDEX  NW–Physician  Assistant Program, University of Washington, Seattle, Washington

Mari J Wirfs, PhD, MN, RN, ANP-BC, FNP-BC, CNE, is a nationally certified adult

nurse practitioner (ANCC since 1997) and family nurse practitioner (AANP since 1998) and certified nurse educator (NLN since 2008) Her career spans 45  years

in collegiate undergraduate and graduate nursing education and clinical practice

in critical care, pediatrics, psychiatric–mental health nursing, and advanced practice primary care nursing Her PhD is in higher education administration and leadership During her academic career, she has achieved the rank of professor with tenure in two university systems She is a frequent guest lecturer on a variety of advanced practice topics to professional groups and general health care topics to community groups

Dr Wirfs was a member of the original medical staff in the establishment of Baptist Community Health Services, a community-based nonprofit primary care clinic founded post-hurricane Katrina in the New Orleans Lower Ninth Ward Since 2002, Dr Wirfs has served as clinical director and primary care provider at the Family Health Care Clinic, serving faculty, staff, students, and their families at New Orleans Baptist Theological Seminary (NOBTS) She is also adjunct graduate faculty, teaching Neuropsychology and Psychopharmacology, in the NOBTS Guidance and Counseling program She is a long-time member of the National Organization of Nurse Practitioner Faculties (NONPF), Sigma Theta Tau National Honor Society of Nursing, and several other academic honor societies

Dr Wirfs has completed, published, and presented six quantitative research studies focusing on academic leadership, nursing education, and clinical practice issues, including one for the Army Medical Department conducted during her

8 years reserve service in the Army Nurse Corps Dr Wirfs has co-authored family primary care certification review books and study materials Her first prescribing

guide, Clinical Guide to Pharmacotherapeutics for the Primary Care Provider, was

published by Advanced Practice Education Associates (APEA) from 1999 to 2014

The APRN’s Complete Guide to Prescribing Drug Therapy 2018 (launched in 2016), The APRN’s Complete Guide to Prescribing Pediatric Drug Therapy 2018 (launched in 2017), and The PA’s Complete Guide to Prescribing Drug Therapy

2018 (launched in 2017) are Springer Publishing handbook editions accompanied

by the free e-book version with quarterly electronic updates

All rights reserved

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form

or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, info@copyright.com or on the Web at www.copyright.com

Springer Publishing Company, LLC

11 West 42nd Street

New York, NY 10036

www.springerpub.com

Acquisitions Editor : Margaret Zuccarini

Composition : Exeter Premedia Services Private LTD

ISBN : 978-0-8261-6656-2

e-book ISBN : 978-0-8261-6657-9

17 18 / 5 4 3 2 1

has been extrapolated from a variety of professional sources and is presented in condensed and summary form It is not intended to replace or substitute for complete and current manufacturer prescribing information, current research, or knowledge and experience of the user For complete prescribing information, including toxicities, drug interactions, contraindications, and precautions, the reader is

brand name neither implies nor suggests that the author or publisher advises or recommends the use of that particular product or considers it superior to similar products available by other brand names Neither the author nor the publisher makes any warranty, expressed or implied, with respect to the information, including any errors or omissions, herein

Library of Congress Cataloging-in-Publication Data

Names: Wirfs, Mari J., author.

Wirfs.

Description: New York, NY: Springer Publishing Company, [2018]

Identifi ers: LCCN 2017008918 | ISBN 9780826166562

Handbooks

Classifi cation: LCC RM301.15 | NLM WB 39 | DDC 615.1—dc23

LC record available at https://lccn.loc.gov/2017008918

Contact us to receive discount rates on bulk purchases

We can also customize our books to meet your needs.

For more information please contact: sales@springerpub.com

Printed in the United States of America by McNaughton & Gunn.

v

FOREWORD

Th is is a succinct, pocket-sized prescribing guide that allows speedy drug reference for over 500 clinical diagnoses It is a must-have book for both seasoned and new physician assistants Unlike trad itional pharmacology textbooks, the information has been organized alphabetically by clinical diagnosis, which allows speedy access of information by the busy clinician in all settings Th e author also did an excellent job of providing clinically important information, such as mechanisms of action, in a way that

is not overwhelming to the reader Th e book is accompanied by an electronic version allowing periodic content updates to keep users current all year Th e author is a very experienced clinician educator who has worked in various health care settings for over four decades

Educators, students, and clinicians from various clinical settings will fi nd this book very handy As a primary care PA, I am very excited about the various disease conditions that are covered in this book Pharmacologic agents are evolving very quickly; I commend the author in creating such a current inventory and for keeping us up to date with the current treatment guidelines With the rapidly changing treatment algorithms and drug prices, prescribers need to have up-to-date references at their fi ngertips Th is book does exactly that It provides excellent resources on the various drugs that can

be used for diff erent conditions It discusses drug rationales, side eff ects, effi cacy, and safety as well as drug-to-drug interactions

Whether you are a PA working in outpatient or inpatient settings, or in pediatrics

or geriatrics, this book is an easy go-to resource for your prescribing needs For PA educators and students, this book should be recommended in your syllabus

Gerald Kayingo, PhD, MMSc, PA-C

Assistant Clinical Professor Director of the Physician Assistant Program University of California Davis Medical Center

t

Alcohol Dependence/Alcohol Withdrawal Syndrome  9

Aldosterone Receptor Blocker  216

Allergic Reaction: General  10

Anemia of Chronic Kidney Disease (CKD) and

Chronic Renal Failure (CRF)  15

Anemia: Folic Acid Defi ciency  16

Anemia: Iron Defi ciency  16

Anemia: Megaloblastic/Anemia: Pernicious  16

Angina Pectoris: Stable  17

Angiotensin Converting Enzyme Inhibitors (ACEIs)  212

Angiotensin II Receptor Blockers (ARBs)  213

Ankylosing Spondylitis (see Osteoarthritis)  292

Anorexia/Cachexia  20

Anthrax (Bacillus anthracis)  20

Anxiety Disorder: Generalized (GAD)/Anxiety Disorder: Social (SAD)  22 Aphthous Stomatitis (Mouth Ulcer, Canker Sore)  26

Arterial Insuffi ciency (Peripheral Vascular Disease, PVD) Arthritis

(see Gouty Arthritis)  163

Aspergillosis (Scedosporium apiospermum, Fusarium spp.)  27

Asthma  28

t

Share The P ’s Complete Guide to Prescribing Drug Therapy 2018

Foreword Gerald Kayingo, PhD, MMSc, PA-C  v

A

Attention Defi cit Hyperactivity Disorder (ADHD)  37

Bacterial Endocarditis: Prophylaxis  41

Bacterial Vaginosis (BV; Gardnerella vaginalis)  43

Baldness: Male Pattern  44

Bartonella Infection (Cat Scratch Fever)  71

Basal Cell Carcinoma: Superfi cial (see Actinic Keratosis)  8

Bell’s Palsy  44

Benign Essential Tremor  44

Benign Prostatic Hyperplasia (BPH)  45

Bile Acid Defi ciency  46

Binge Eating Disorder  46

Bipolar I Disorder: Depression  47

Bipolar I Disorder: Mania  51

Bloating (see Flatulence)  148

Boil (see Skin Infection: Bacterial)  396

Bordetella pertussis  332

Breast Abscess (see Mastitis)  261

Breast Cancer: Prophylaxis  58

Bronchiolitis  59

Bronchitis: Acute/Acute Exacerbation of Chronic Bronchitis (AECB)  59 Bronchitis: Chronic/Chronic Obstructive Pulmonary Disease (COPD)  63 Bulimia Nervosa  65

Candidiasis: Abdomen, Bladder, Esophagus, Kidney  66

Candidiasis: Oral (Th rush)  67

Candidiasis: Skin  67

Candidiasis: Vulvovaginal (Moniliasis)  69

Canker Sore (see Aphthous Stomatitis)  26

Carbuncle (see Skin Infection: Bacterial)  396

Carpal Tunnel Syndrome (CTS)  71

Cat Scratch Fever (Bartonella Infection)  71

Chest Wall Syndrome (Costochondritis)  98

Chickenpox (Varicella)  77

Chlamydia trachomatis  78

Cholelithiasis  80

Cholera (Vibrio cholerae)  80

Chloasma (see Hyperpigmentation)  206

Chronic Obstructive Pulmonary Disease (COPD)  63

Clostridium tetani (Tetanus)  408

Cluster Headache  167

Colic: Infantile  83

Colitis  364

Common Cold (Viral Upper Respiratory Infection [URI])  83

Community Acquired Pneumonia (CAP)  340

Costochondritis (Chest Wall Syndrome)  98

Cramps: Abdominal, Intestinal  98

Depression, Major Depressive Disorder (MDD)  105

Dermatitis: Atopic (Eczema)  110

Dermatitis: Contact  113

Chancroid  76

viii ■ C o n t e n t s

Dermatitis: Diaper (see Diaper Rash)  117

Dermatitis: Seborrheic  113

Diabetes Mellitus, Type 1  426

Diabetes Mellitus, Type 2  431

Diabetic Peripheral Neuropathy  115

Donovanosis (see Granuloma Inguinale)  164

Dry Eye Syndrome  125

Dry Mouth Syndrome  395

Dysentery (see Amebiasis)  12

Dyshidrosis  126

Dyshydrotic Eczema (Dyshidrosis, Pompholyx)  126

Dysfunctional Uterine Bleeding (DUB)  126

Dyslipidemia (Hypercholesterolemia, Hyperlipidemia, Mixed

Dyslipidemia)  126

Dysmenorrhea: Primary  131

Dyspareunia (Postmenopausal/Painful Intercourse)  132

Eating Disorder, Binge  46

Eczema (Atopic Dermatitis)  110

Enterobius vermicularis (see Pinworm Infection)  337

Enuresis: Primary, Nocturnal  138

Foreign Body: Esophagus  150

Foreign Body: Eye  150

Furuncle  396

Fusarium spp.  27

Gardnerella Vaginalis (Bacterial Vaginosis)  43

Generalized Anxiety Disorder (GAD)  22

Genital Herpes (Herpes Genitalis, HSV Type II)  188 Genital Warts  460

German Measles (Rubella)  388

Gastritis  151

Gastroesophageal Refl ux Disease (GERD)  151

Giardiasis (Giardia lamblia)  155

Gingivitis/Periodontitis  156

Glaucoma: Open Angle  156

Golfer’s Elbow (see Epicondylitis)  139

Gonorrhea (Neisseria gonorrhoeae)  159

Herpes Genitalis (HSV Type II)  188

Herpes Labialis/Herpes Facialis (Herpes Simplex Virus Type I,

Cold Sore, Fever Blister)  190

Herpes Simplex Type I  190

x ■ C o n t e n t s

Herpes Simplex Type II  188

Herpes Zoster (Shingles)  191

Hiccups: Intractable  192

Hidradenitis Suppurativa  192

Hives (Urticaria)  458

Hookworm (Uncinariasis, Cutaneous Larvae Migrans)  193

Hordeolum (see Stye)  403

Human Immunodefi ciency Virus (HIV) Exposure, Antiretroviral

Hypopnea Syndrome (see Sleep Apnea)  400

Hypotension: Neurogenic, Orthostatic  232

Hypotestosteronemia  406

Hypothyroidism  232

Idiopathic Peripheral Neuritis  329

Idiopathic Pulmonary Fibrosis (IPF)  233

Impetigo Contagiosa (Indian Fire)  233

Impotence (Erectile Dysfunction, ED)  140

Irritable Bowel Syndrome With Constipation (IBS-C)  247

Irritable Bowel Syndrome With Diarrhea (IBS-D)  248

Juvenile Rheumatoid Arthritis (JRA)   250

Keratitis/Keratoconjunctivitis: Herpes Simplex   251

Keratitis/Keratoconjunctivitis: Vernal  251

Labyrinthitis  252

Lactose Intolerance  252

Larva Migrans: Cutaneous/Visceral  252

Lead Encephalopathy (Lead Poisoning, Lead Toxicity)  253

Lead Poisoning  253

Lead Toxicity (Lead Poisoning, Lead Encephalopathy)  253

Leg Cramps: Nocturnal, Recumbency  253

Leishmaniasis: Cutaneous, Mucosal, Visceral  253

Lentigines: Benign, Senile  254

Lice (see Pediculosis)  325

Listeriosis  254

Low Back Strain  255

Low Libido, Hypoactive Sexual Desire Disorder (HSDD)  255

Lyme Disease (Erythema Chronicum Migrans)  255

Lymphadenitis  257

Lymphogranuloma Venereum  257

Magnesium Defi ciency (Hypomagnesemia)  230

Major Depressive Disorder (MDD)  105

Malaria (Plasmodium falciparum, Plasmodium vivax)  259

Mastitis (Breast Abscess)  261

Moniliasis (Candidiasis: Vulvovaginal)  69

Mononucleosis (Mono)  268

Motion Sickness  269

Mouth Ulcer (Aphthous Stomatitis)  26

Multiple Sclerosis (MS)  269

Mumps (Infectious Parotitis)  271

Muscle Contraction Headache (Headache: Tension)  173

Nerve Agent Poisoning  282

Neurogenic, Orthostatic Hypotension  232

Nicotine Withdrawal Syndrome (see Tobacco Dependence)  416

Nocturnal Enuresis (Primary Enuresis)  138

Non-24 Sleep-Wake Disorder  282

Obesity  282

Obsessive-Compulsive Disorder (OCD)  284

Odor: Fecal (Fecal Odor)  143

Onychomycosis (Fungal Nail)  286

Ophthalmia Neonatorum: Chlamydial  287

Ophthalmia Neonatorum: Gonococcal  288

Opioid Dependence Opioid Withdrawal Syndrome  288

Opioid-Induced Constipation (OIC)  291

Opioid Overdose  291

Opioid Withdrawal Syndrome (see Opioid Dependence)  288

Orthostatic Hypotension, Neurogenic  232

Otitis Media: Acute  301

Otitis Media: Serous  304

Overactive Bladder  236

Overdose: Opioid  291

Paget’s Disease: Bone  305

Pain  306

Painful Intercourse (Dyspareunia, Postmenopausal)  132

Pancreatic Enzyme Defi ciency  317

Panic Disorder  318

Parathyroid Hormone Defi ciency (Hypoparathyroidism)  230

C o n t e n t s ■ xiii

Parkinson’s Disease  322

Paronychia (Periungual Abscess)  324

Parotitis: Infectious (Mumps)  271

Pediculosis: Pediculosis Humanus Capitis (Head Lice)/

Phthirus (Pubic Lice)   325

Pelvic Infl ammatory Disease (PID)  326

Peptic Ulcer Disease (PUD)  327

Periodontitis (Gingivitis)  156

Peripheral Neuritis, Idiopathic  329

Peripheral Neuritis, Diabetic Neuropathic Pain, Peripheral

Neuropathic Pain  329

Peripheral Neuropathic Pain  329

Peripheral Neuritis, Diabetic  329

Neuropathic Pain, Peripheral  329

Neuropathic Pain  329

Peripheral Vascular Disease (PVD, Arterial Insuffi ciency,

Intermittent Claudication)  331

Periungal Abscess (Paronychia)  324

Pernicious Anemia (Vitamin B12 Defi ciency)  16

Perspiration: Excessive (Hyperhidrosis)  204

Pertussis (Whooping Cough)  332

Plague (Yersinia pestis)  338

Plantar Wart (Verruca plantaris)  459

Polyarticular Juvenile Idiopathic Arthritis (PJIA)  349

Polycystic Ovarian Syndrome (PCOS, Stein-Leventhal Disease)  350 Polymyalgia Rheumatica  350

Pomphylox (Dyshidrosis, Dyshydrotic Eczema)  126

Postherpetic Neuralgia  351

Postmenopausal Dyspareunia  132

xiv ■ C o n t e n t s

Post-Traumatic Stress Disorder (PTSD)  355

Potassium Defi ciency (Hypokalemia)  229

Pregnancy  358

Premenstrual Dysphorphic Disorder (PMDD)  359

Pressure Sore (Decubitus Ulcer)  444

Primary Immunodefi ciency in Adults  360

Proctitis: Acute (Proctocolitis/Enteritis)  361

Proctitis, Proctocolitis, Enteritis  361

Prostatitis: Acute  361

Prostatitis: Chronic  362

Pruritus  363

Pruritus Ani (see Pruritis)  363

Pruritus Ani (see Hemorrhoids)  181

Pseudobulbar Aff ect (PBA) Disorder  364

Pulmonary Arterial Hypertension (PAH) (WHO Group I)  371

Pulmonary Fibrosis, Idiopathic (IPF)  233

Pyelonephritis: Acute  373

Pyrexia (Fever)  143

Rabies   374

Red Measles (Rubeola, 3-Day Measles)  388

Respiratory Syncytial Virus (RSV)  375

Restless Legs Syndrome (RLS)  375

Rhinosinusitis: Acute Bacterial (ABRS)  393

Rickets (Hypophosphatasia, Osteomalacia)   231

Rickettsia rickettsii (Rocky Mountain Spotted Fever)  386

Rocky Mountain Spotted Fever (Rickettsia rickettsii)  386

Rosacea (Acne Rosacea)  3

Roseola (Exanthem Subitum)  386

Rotavirus Gastroenteritis  387

Roundworm (Ascariasis)  387

Rubella (German Measles)  388

Rubeola (Red Measles)  388

Salmonella typhi (Typhoid Fever)  442

Salmonellosis  388

C o n t e n t s ■ xv

Sarcoptes scabiei (Scabies)  389

Scabies (Sarcoptes scabiei)  389

Scarlet Fever (Scarlatina)  389

Sebaceous Cyst: Infected (see Skin Infection)  396

Seborrhea (Seborrheic Dermatitis)  113

Seizure Disorder  391

Sexual Assault (STD/STI/VD Exposure)  391

Shigellosis  392

Shingles (Herpes Zoster)  191

Sinusitis/Rhinosinusitis: Acute Bacterial (ABRS)  393

Solar Keratosis (Actinic Keratosis)  8

Sprain  401

Status Asthmaticus  401

Status Epilepticus  402

STD/STI/VD Exposure, Sexual Assault  391

Stein-Leventhal Disease (Polycystic Ovarian Syndrome, PCOS)  350 Stomatitis (Aphthous Stomatitis)  26

Stress Incontinence  236

Strongyloidiasis stercoralis (Th readworm)  408

Stye (Hordeolum)  403

Sunburn  403

Swimmer’s Ear (Otitis Externa)  299

Syphilis (Treponema pallidum)  403

Tapeworm (Cestode)  405

Temporal Arteritis  406

Temporomandibular Joint (TMJ) Disorder  406

Tennis Elbow (see Epicondylitis)  139

Tension Headache  173

Testosterone Defi ciency  406

Testosterone Defi ciency, Hypotestosteronemia, Hypogonadism  406 Tetanus (Clostridium tetani)  408

Th readworm (Strongyloidides stercoralis)  408

Th rush (Oral Candidiasis)  67

Th yroid Hormone Excess (Hyperthyroidism)  224

Th yroid Hormone Defi ciency (Hypothyroidism)  232

Tic Douloureux (Trigeminal Neuralgia)  422

xvi ■ C o n t e n t s

Tinea Capitis  409

Tinea Corporis (Ringworm)  410

Tinea Cruris (Jock Itch)  411

Tinea Pedis (Athlete’s Foot)  413

Tinea Versicolor  415

Tobacco Dependence (Nicotine Withdrawal Syndrome)  416

Tonsillitis: Acute  418

Tremor: Benign Essential  44

Trichinosis (Trichinella spiralis)  420

Trichomoniasis (Trichomonas vaginalis)  421

Trichuriasis (Whipworm)  461

Trigeminal Neuralgia (TIC Douloureux)  422

Pulmonary Tuberculosis (TB) (Mycobacterium tuberculosis)  424

Type 1 Diabetes Mellitus  426

Type 2 Diabetes Mellitus  431

Typhoid Fever (Salmonella typhi)  442

Ulcer: Diabetic, Neuropathic (Lower Extremity)  444

Ulcer: Venous Insuffi ciency (Lower Extremity)  444

Ulcer: Decubitus/Pressure  444

Ulcerative Colitis  445

Urethritis: Nongonococcal (NGU)  447

Urinary Retention: Unobstructive  449

Urinary Tract Infection (UTI, Cystitis: Acute)  449

Urolithiasis (Renal Calculi, Kidney Stones)  456

Urticaria: Chronic Idiopathic (CIU)  458

Urticaria: Acute (Hives)  458

Uncinariasis (Hookworm, Cutaneous Larvae Migrans)  193

Upper Respiratory Infection (URI, Common Cold)  83

Vaginal Irritation: External  458

Varicella (Chickenpox)  77

Variola Major (Smallpox)  401

Vascular Headache (Migraine Headache)  167

Vasomotor Rhinitis  386

Venereal Warts (Wart: Venereal)  460

Verruca plantaris (Plantar Wart)  459

Verruca vulgaris (Common Wart)  459

Vertigo  458

Viral Upper Respiratory Infection (URI, Common Cold)  83

Vitiligo  459

Vomiting (see Nausea/Vomiting)  278

Wart: Common (Verruca vulgaris)  459

Wart: Plantar (Verruca plantaris)  459

Wart: Venereal, Human Papillomavirus (HPV), Condyloma Acuminata  460 Whipworm (Trichuriasis)  461

C o n t e n t s ■ xvii

Whooping Cough (Pertussis)  332

Wound: Infected, Nonsurgical, Minor  461

Wrinkles: Facial (Crow’s Feet, Frown Lines, Smile Lines)  464

Xerosis  465

Yersinia pestis (Plague)  338

Zollinger-Ellison Syndrome  466

SECTION II: APPENDICES

Appendix A: FDA Pregnancy Categories  471

Appendix B: U.S Schedule of Controlled Substances  471

Appendix C: JNC-8* and ASH** Hypertension Evaluation and Treatment

Recommendations  472

Appendix D: ATP-IV Target Lipid Recommendations  476

Appendix E: Eff ects of Selected Drugs on Insulin Activity  477

Appendix F: Glycosylated Hemoglobin (HbA1c) and Average

Blood Glucose Equivalent  478

Appendix G: Routine Immunization Recommendations  478

Appendix H: Contraceptives: Contraindications and Recommendations  486  Appendix H.1: 28-Day Oral Contraceptives  487

 Appendix H.2: Extended-Cycle Oral Contraceptives  495

 Appendix H.3: Progesterone-Only Oral Contraceptives (“Mini-Pill”)  496  Appendix H.4: Injectable Contraceptives  496

  Appendix H.4.1: Injectable Progesterone  496

 Appendix H.5: Transdermal Contraceptive  497

 Appendix H.6: Contraceptive Vaginal Rings  497

 Appendix H.7: Subdermal Contraceptives  497

 Appendix H.8: Intrauterine Contraceptives  498

 Appendix H.9: Emergency Contraception  498

Appendix I: Anesthetic Agents for Local Infi ltration and Dermal/Mucosal

Membrane Application  499

Appendix J: Oral Prescription NSAIDs  501

Appendix K: Topical Corticosteroids by Potency  506

Appendix L: Oral Corticosteroids  509

Appendix M: Parenteral Corticosteroid Th erapy  511

Appendix N: Inhalational Corticosteroid Th erapy  512

Appendix O: Oral Antiarrhythmia Drugs  513

Appendix P: Oral Antineoplasia Drugs  516

Appendix Q: Oral and Depot Antipsychosis Drugs  518

Appendix R: Oral Anticonvulsant Drugs  520

Appendix S: Oral Anti-HIV Drugs With Dose Forms  523

Appendix T: Coumadin (Warfarin)  526

Appendix U: Low Molecular Weight Heparins  527

Appendix V: Factor Xa Inhibitor Th erapy  528

xviii ■ C o n t e n t s

Appendix W: Direct Th rombin Inhibitor Th erapy  530

Appendix X: Platelet Aggregation Inhibitor Th erapy  531

Appendix Y: Protease-Activated Receptor-1 (PAR-1) Inhibitor Th erapy  532 Appendix Z: Prescription Prenatal Vitamins  532

Appendix AA: Oral Prescription Drugs for the Management of Allergy,

Cough, and Cold Symptoms  535

Appendix BB: Systemic Anti- infective Drugs  541

Appendix CC.1: Acyclovir (Zovirax Suspension)  552

Appendix CC.2: Amantadine (Symmetrel Syrup)  553

Appendix CC.3: Amoxicillin (Amoxil Suspension, Trimox Suspension)  554 Appendix CC.4: Amoxicillin/clavulanate (Augmentin Suspension)  556

Appendix CC.5: Amoxicillin/clavulanate (Augmentin

Appendix CC.8: Cefaclor (Ceclor Suspension)  560

Appendix CC.9: Cefadroxil (Duricef Suspension)  561

Appendix CC.10: Cefdinir (Omnicef Suspension)  562

Appendix CC.11: Cefi xime (Suprax Oral Suspension)  563

Appendix CC.12: Cefpodoxime Proxetil (Vantin Suspension)  564

Appendix CC.13: Cefprozil (Cefzil Suspension)  565

Appendix CC.14: Ceft ibuten (Cedax Suspension)  566

Appendix CC.15: Cefuroxime Axetil (Ceft in Suspension)  567

Appendix CC.16: Cephalexin (Kefl ex Suspension)  568

Appendix CC.17: Clarithromycin (Biaxin Suspension)  569

Appendix CC.18: Clindamycin (Cleocin Pediatric Granules)  570

Appendix CC.19: Dicloxacillin (Dynapen Suspension)  571

Appendix CC.20: Doxycycline (Vibramycin Syrup/Suspension)  572

Appendix CC.21: Erythromycin Estolate (Ilosone Suspension)  573

Appendix CC.22: Erythromycin Ethylsuccinate (E.E.S Suspension,

Ery-Ped Drops/Suspension)  574

Appendix CC.23: Erythromycin/Sulfamethoxazole (Eryzole, Pediazole)  576 Appendix CC.24: Fluconazole (Difl ucan Suspension)  577

Appendix CC.25: Furazolidone (Furoxone Liquid)  578

Appendix CC.26: Griseofulvin, Microsize (Grifulvin V Suspension)  579

Appendix CC.27: Itraconazole (Sporanox Solution)  580

Appendix CC.28: Loracarbef (Lorabid Suspension)  581

Appendix CC.29: Nitrofurantoin (Furadantin Suspension)  582

Appendix CC.30: Penicillin V Potassium (Pen-Vee K Solution,

Veetids Solution)  583

Appendix CC.31: Rimantadine (Flumadine Syrup)  584

Appendix CC.32: Tetracycline (Sumycin Suspension)  585

C o n t e n t s ■ xix

Appendix CC.33: Trimethoprim (Primsol Suspension)  586

Appendix CC.34: Trimethoprim/Sulfamethoxazole (Bactrim Suspension,

Septra Suspension)  587

Appendix CC.35: Vancomycin (Vancocin Suspension)  588

Resources  589

Index: Brand/Generic Drug Name Cross-Reference With FDA Pregnancy Category and

Controlled Drug Category  595

xx ■ C o n t e n t s

Kathleen Bradbury-Golas, DNP, RN, FNP-C, ACNS-BC

Associate Clinical Professor, Drexel University, Philadelphia, Pennsylvania

Family Nurse Practitioner, Virtua Medical Group, Hammonton and Linwood, New Jersey

Lori Brien, MS, ACNP-BC

Instructor, AG-ACNP Program, Georgetown University School of Nursing & Health Studies, Washington, DC

Jill C Cash, MSN, APN

Nurse Practitioner, Logan Primary Care, West Frankfort, Illinois

Catherine M Concert, DNP, RN, FNP-BC, AOCNP, NE-BC, CNL, CGRN

Nurse Practitioner—Radiation Oncology, Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center; Clinical Assistant Professor, Pace University Lienhard School of Nursing, New York, New York

Aileen Fitzpatrick, DNP, RN, FNP-BC

Clinical Assistant Professor, Pace University Lienhard School of Nursing, New York, New York

Tracy P George, DNP, APRN-BC, CNE

Assistant Professor of Nursing, Amy V Cockroft Fellow 2016–2017, Francis Marion University, Florence, South Carolina

Norma Stephens Hannigan, DNP, MPH, FNP-BC, DCC, FAANP

Clinical Professor of Nursing, Coordinator, Accelerated Second Degree (A2D) Program/Sophomore Honors Program, Hunter College, CUNY Hunter-Bellevue School of Nursing, New York, New York

Ella T Heitzler, PhD, WHNP-BC, FNP-BC, RNC-OB

Assistant Professor, Georgetown University School of Nursing and Health Studies, Washington, DC

t

xxii ■ R e v i e w e r s

Andrew W Hull, PA-C

Director, Chair, and Assistant Professor of Physician Assistant Studies, Milligan College, Milligan College, Tennessee

Heather C Justice, MSPAP, PA-C

Assistant Professor, Milligan College, Tennessee; Palliative Care Practitioner, Wellmont Medical System, Kingsport, Tennessee

Lucy Wachera Kibe, DrPH, MS, MHS, PA-C

Director of Doctoral Education, Assistant Professor, Department of Physician Assistant Medicine, School of Graduate Health Sciences, Lynchburg College, Lynchburg, Virginia

Melissa H King, DNP, FNP-BC, ENP-BC

Director of Advanced Practice Providers, Director of TelEmergency, Department of Emergency Medicine, University of Mississippi Medical Center, Jackson, Mississippi

Maureen Knechtel, MPAS, PA-C

Assistant Professor, Physician Assistant Studies, Milligan College, Milligan College, Tennessee

Keith Laff erty, MD, FAAEM

Co-Director, Department of Emergency Medicine, Director of Education, Gulf Coast Medical Center, Fort Myers, Florida; Adjunct Assistant Professor of Emergency Medicine, Temple University, Philadelphia, Pennsylvania

Michael Watson, DNP, APRN, FNP-BC

Lead Family Nurse Practitioner, Wadley Regional Medical Center, Emergency Department, Texarkana, Texas

ACEI angiotensin converting enzyme inhibitor

ALT liver enzyme; alanine transaminase (ALT)

calib applicator calibrated applicator

CFC chlorofl uorocarbon, inhaler propellant

Child-Pugh A mild liver disease/dysfunction

Child-Pugh B moderate liver disease/dysfunction

Child-Pugh C severe liver disease/dysfunction

t

xxiv ■ A b b r e v i a t i o n s

conj estra conjugated estrogen

COPD chronic obstructive pulmonary disease

DMARDs disease modifying anti-rheumatoid drugs

EIAED enzyme-inducing antiepileptic drug

emol, emol crm emollient, emollient cream

A b b r e v i a t i o n s ■ xxv

GABHS group a beta-hemolytic streptococcus

HDL, HDL-C high density lipoprotein cholesterol

HFA hydrofl uoroalkane (inhaler propellent phasing in)

IBS-C irritable bowel syndrome with constipation

IBS-D irritable bowel syndrome with diarrhea

xxvi ■ A b b r e v i a t i o n s

LDL, LDL-C low density lipoprotein cholesterol

mfr manufacturer

mg/kg/day milligram per kilogram per day

NMDA n-methyl-d-aspartate receptor antagonistNNRTI nonnucleoside reverse transcriptase inhibitor

non-HDL-C non-high density lipoprotein cholesterol

nPEP non-occupational post-exposure prophylaxis

NR not rated, pregnancy category not assigned NRTI nucleoside reverse transcriptase inhibitor

A b b r e v i a t i o n s ■ xxvii

NSAID nonsteroidal anti-infl ammatory drug

PCOS polycystic ovarian syndrome; Stein-Leventhal DiseasePediatric newborn to ≤18 years-of-age

PDE5 phosphodiesterase type 5 inhibitor

PJIA polyarticular juvenile idiopathic arthritis

PTSD post traumatic stress disorder

pwdr w diluent powder with diluent

xxviii ■ A b b r e v i a t i o n s

RAI reversible anticholinesterase inhibitor

SGOT serum glutamic-oxaloacetic transaminase SGPT serum glutamic-pyruvic transaminase

SNRI selective serotonin and norepinephrine reuptake

inhibitor

SSRI selective serotonin reuptake inhibitor

PREFACE

Th e APRN’s Complete Guide to Prescribing Drug Th erapy is a prescribing reference

intended for use by health care providers in all clinical practice settings who are involved in the primary care management of patients with acute, episodic, and chronic health problems It is organized in a concise and easy-to-read format Comments are interspersed throughout, including such clinically useful information as laboratory values to be monitored, patient teaching points, and safety information

Th is clinical guide is divided into two sections Section I presents drug treatment

regimens for over 500 clinical diagnoses Each drug is listed alphabetically by generic name, followed by the FDA pregnancy category (A, B, C, D, X, or NR if a pregnancy category has not been assigned), whether the drug is available over-the-counter (OTC), DEA schedule (I, II, III, IV, V), generic availability (G), adult and pediatric dosing regimens, brand names and available dose forms, whether tablets, caplets, or chew tabs are scored (*) or cross-scored (**), fl avors of chewable, sublingual, buccal, and liquid forms, and information regarding additives (e.g., dye-free, sugar-free, preservative-free

or preservative type, and alcohol-free or alcohol content)

Section II presents clinically useful information in convenient table format, including: the JNC-8 recommendations for hypertension management, the U.S schedule of controlled substances and the FDA pregnancy categories, measurement conversions, childhood and adult immunization recommendations, brand-name drugs (with contents) for the management of common respiratory symptoms, anti-infectives

by classifi cation, pediatric dosing by weight for liquid forms, gluco-corticosteroids by potency and route of administration, and contraceptives by route of administration and estrogen and/or progesterone content An alphabetical cross reference index of drugs by generic and brand name, with FDA pregnancy category and controlled drug schedule, facilitates quick identifi cation of drugs by alternate names, relative safety during pregnancy, and DEA schedule

Selected diagnoses (e.g., angina, ADHD, growth failure, glaucoma, Parkinson’s disease, CMV retinitis, multiple sclerosis, cystic fi brosis) and selected drugs (e.g., anti-neoplastics, antipsychotics, anti-arrhythmics, anti-HIV drugs, and anticoagulants) are included as patients are oft en referred by surgeons and emergency and urgent care providers to the primary care provider for follow-up monitoring and management Safe, effi cacious, prescribing and monitoring of drug therapy regimens require adequate knowledge about (a) the pharmacodynamics and pharmacokinetics of drugs, (b) concomitant therapies, and (c) individual characteristics of the patient (e.g., current and past medical history, physical examination fi ndings, hepatic and renal function, and co-morbidities) Users of this clinical guide are encouraged to utilize the manufacturer’s package insert, recommendations and guidance of specialists, standard of practice protocols, and the current research literature for more comprehensive information about specifi c drugs (e.g., special precautions, drug-drug and drug-food interactions, risk versus benefi t, age-related considerations, adverse reactions) and appropriate use with individual patients

t

xxx

on behalf of Springer Publishing Company, understood the critical nature of exactness

in this prescribing resource, and faithfully managed the complex fi les as content was updated and cross-paginated for the fi nal product Th e work of the reviewers from academia and clinical practice was essential to the process and their contributions are greatly appreciated I am proud of my association with these dedicated professionals and I thank them on behalf of the medical and advanced practice nursing community worldwide, for supporting the end goal of quality health care for all

t

Share The PA’s Complete Guide to Prescribing

Drug Therapy 2018

SECTION I

DRUG THERAPY BY CLINICAL DIAGNOSIS

t

A c n e R o s a c e a ■ 3

ACETAMINOPHEN OVERDOSE

ANTIDOTE/CHELATING AGENT

acetylcysteine (B)(G) Loading Dose: 150 mg/kg administered over 15 minutes;

Mainte-nance: 50 mg/kg administered over 4 hours; then 100 mg/kg administered over 16 hours Pediatric: same as adult

Acetadote Vial: soln for IV infusion aft er dilution: 200 mg/ml (30 ml; dilute in

D5W (preservative-free)

Comment: acetaminophen overdose is a medical emergency due to the risk of irreversible hepatic injury An IV infusion of acetylcysteine should be started as

soon as possible and within 24 hours if the exact time of ingestion is unknown

Use a serum acetaminophen nomogram to determine need for treatment Extreme

caution is needed if used with concomitant hepatotoxic drugs

ACNE ROSACEA

Comment: All acne rosacea products should be applied sparingly to clean, dry skin as

directed Avoid use of topical corticosteroids

ivermectin (C) apply bid

Soolantra Crm: 1% (30 g)

Comment: Soolantra is a macrocyclic lactone Exactly how it works to treat

rosacea is unknown

TOPICAL ALPHA-2 AGONIST

brimonidine (B) apply once daily

Pediatric: <18 years: not recommended

Mirvaso apply to aff ected area once daily

Gel: 0.33% (30, 45 g tube; 30 g pump)

Comment: For persistant erythema; constricts dilated facial blood vessels to reduce redness

TOPICAL ANTIMICROBIALS

azelaic acid (B) apply bid

Azelex Crm: 20% (30, 50 g)

Finacea Gel: 15% (30 g); Foam: 15% (50 g)

metronidazole (B) apply to clean dry skin

MetroCream apply bid

Emol crm: 0.75% (45 g)

MetroGel apply once daily

Gel: 1% (60 g tube; 55 g pump)

MetroLotion apply bid

Lotn: 0.75% (2 oz)

sodium sulfacetamide (C)(G) apply 1-3 x daily

Klaron Lotn: 10% (2 oz)

sodium sulfacetamide/sulfur (C)

Clenia Emollient Cream apply 1-3 x daily

Wash: sod sulfa 10%/sulfur 5% (10 oz)

4 ■ A c n e R o s a c e a

Clenia Foaming Wash wash aff ected area once or twice daily

Wash: sod sulfa 10%/sulfur 5% (6, 12 oz)

Rosula Gel apply 1-3 x daily

Gel: sod sulfa 10%/sulfur 5% (45 ml)

Rosula Lotion apply tid

Lotn: sod sulfa 10%/sulfur 5% (45 ml) (alcohol-free)

Rosula Wash wash bid

Clnsr: sod sulfa 10%/sulfur 5% (335 ml)

ORAL ANTIMICROBIALS

doxycycline (D)(G) 40-100 mg bid

Pediatric: <8 years: not recommended; ≥8 years, <100 lb: 2 mg/lb on fi rst day in 2

divided doses, followed by 1 mg/lb/day in 1-2 divided doses; ≥8 years, ≥100 lb: same

as adult; see page 572 for dose by weight

Actilate Tab: 75, 150** mg

Adoxa Tab: 50, 75, 100, 150 mg ent-coat

Doryx Tab: 50, 75, 100, 150, 200 mg del-rel

Monodox Cap: 50, 75, 100 mg

Oracea Cap: 40 mg del-rel

Vibramycin Tab: 100 mg; Cap: 50, 100 mg; Syr: 50 mg/5 ml (raspberry-apple)

(sulfi tes); Oral susp: 25 mg/5 ml (raspberry)

Vibra-Tab Tab: 100 mg fi lm-coat

Comment: doxycycline is contraindicated <8 years-of-age, in pregnancy, and

lactation (discolors developing tooth enamel) A side eff ect may be

photo-sensitivity (photophobia) Do not give with antacids, calcium supplements, milk or other dairy, or within two hours of taking another drug

minocycline (D)(G) 200 mg on fi rst day; then 100 mg q 12 hours x 9 more days

Pediatric: <8 years: not recommended; ≥8 years, <100 lb: 2 mg/lb on fi rst day in

2 divided doses, followed by 1 mg/lb q 12 hours x 9 more days; ≥8 years, ≥100 lb: same as adult

Dynacin Cap: 50, 100 mg

Minocin Cap: 50, 75, 100 mg; Oral susp: 50 mg/5 ml (60 ml) (custard) (sulfi tes,

alcohol 5%)

Comment: minocycline is contraindicated <8 years-of-age, in pregnancy, and

lactation (discolors developing tooth enamel) A side eff ect may be

photo-sensitivity (photophobia) Do not give with antacids, calcium supplements, milk or other dairy, or within two hours of taking another drug

ACNE VULGARIS

ANTIBACTERIAL SOAPS

Dial (OTC) wash aff ected area bid

Lever 2000 Antibacterial (OTC) wash aff ected area bid

TOPICAL ANTIMICROBIALS

Comment: All topical antimicrobials should be applied sparingly to clean, dry skin

t

Comment: benzoyl peroxide may discolor clothing and linens.

Benzac-W initially apply to aff ected area once daily; increase to bid-tid as tolerated

Gel: 2.5, 5, 10% (60 g)

Benzac-W Wash wash aff ected area bid

Wash: 5% (4, 8 oz); 10% (8 oz)

Benzagel apply to aff ected area one or more times/day

Gel: 5, 10% (1.5, 3 oz) (alcohol 14%)

Benzagel Wash wash aff ected area bid

Triaz apply to aff ected area daily bid

Lotn: 3, 6, 9% (bottle), 3% (tube); Pads: 3, 6, 9% (jar)

ZoDerm apply once or twice daily

Gel: 4.5, 6.5, 8.5% (125 ml); Crm: 4.5, 6.5, 8.5% (125 ml); Clnsr: 4.5, 6.5, 8.5% (400 ml)

clindamycin topical (B) apply bid

Pediatric: not recommended

Cleocin T Pad: 1% (60/pck; alcohol 50%); Lotn: 1% (60 ml); Gel: 1% (30, 60 g);

Soln w applicator: 1% (30, 60 ml) (alcohol 50%)

Clindagel Gel: 1% (42, 77 g)

Evoclin Foam: 1% (50, 100 g) (alcohol)

clindamycin/benzoyl peroxide topical (C) apply sparingly to clean dry skin once daily

Pediatric: <12 years: not recommended; ≥12 years: same as adult

Acanya (G) apply once daily-bid

Gel: clin 1.2%/benz 2.5% (50 g)

BenzaClin (G) apply bid

Gel: clin 1%/benz 5% (25, 50 g)

Duac apply daily in the evening

Gel: clin 1%/benz 5% (45 g)

Onexton Gel apply once daily

Gel: clin 1.2%/benz 3.75% (50 g pump) (alcohol-free) (preservative-free)

dapsone topical (C) apply bid

Pediatric: <12 years: not recommended; ≥12 years: same as adult

Aczone Gel: 5, 7.5% (30, 60, 90 g pump)

erythromycin/benzoyl peroxide (C) initially apply once daily; increase to bid as tolerated Benzamycin Topical Gel Gel: eryth 3%/benz 5% (46.6 g/jar)

sodium sulfacetamide (C)(G) apply tid

Klaron Lotn: 10% (2 oz)

ORAL ANTIMICROBIALS

doxycycline (D)(G) 100 mg bid

Pediatric: <8 years: not recommended; ≥8 years, <100 lb: 2 mg/lb on fi rst day in 2

divided doses, followed by 1 mg/lb/day in 1-2 divided doses; ≥8 years, ≥100 lb: same

as adult; see page 572 for dose by weight

6 ■ A c n e V u l g a r i s

Actilate Tab: 75, 150**mg

Adoxa Tab: 50, 75, 100, 150 mg ent-coat

Doryx Tab: 50, 75, 100, 150, 200 mg del-rel

Monodox Cap: 50, 75, 100 mg

Oracea Cap: 40 mg del-rel

Vibramycin Tab: 100 mg; Cap: 50, 100 mg; Syr: 50 mg/5 ml (raspberry-apple)

(sulfi tes); Oral susp: 25 mg/5 ml (raspberry)

Vibra-Tab Tab: 100 mg fi lm coat

Comment: doxycycline is contraindicated <8 years-of-age, in pregnancy, and

lactation (discolors developing tooth enamel) A side eff ect may be sensitivity (photophobia) Do not give with antacids, calcium supplements, milk

photo-or other dairy, photo-or within two hours of taking another drug

erythromycin base (B)(G) 250 mg qid, 333 mg tid or 500 mg bid x 7-10 days; then

taper to lowest eff ective dose

Pediatric: <45 kg: 30-50 mg in 2-4 divided doses x 7-10 days; ≥45 kg: same as adult

Ery-Tab Tab: 250, 333, 500 mg ent-coat

PCE Tab: 333, 500 mg

Comment: erythromycin may increase INR with concomitant warfarin, as well as

increase serum level of digoxin, benzodiazepines and statins.

erythromycin ethylsuccinate (B)(G) 400 mg qid x 7-10 days

Pediatric: 30-50 mg/kg/day in 4 divided doses x 7-10 days; may double dose with severe infection; max 100 mg/kg/day; see page 574 for dose by weight

EryPed Oral susp: 200 mg/5 ml (100, 200 ml) (fruit); 400 mg/5 ml (60, 100,

200 ml) (banana); Oral drops: 200, 400 mg/5 ml (50 ml) (fruit); Chew tab:

200 mg wafer (fruit)

E.E.S Oral susp: 200, 400 mg/5 ml (100 ml) (fruit)

E.E.S Granules Oral susp: 200 mg/5 ml (100, 200 ml) (cherry)

E.E.S 400 Tablets Tab: 400 mg

Comment: erythromycin may increase INR with concomitant warfarin, as well as increase serum level of digoxin, benzodiazepines and statins.

minocycline (D)(G) initially 50-200 mg/day in 2 divided doses; reduce dose aft er

Comment: minocycline is contraindicated <8 years-of-age, in pregnancy, and

lactation (discolors developing tooth enamel) A side eff ect may be

photo-sensitivity (photophobia) Do not give with antacids, calcium supplements, milk or other dairy, or within two hours of taking another drug

tetracycline (D)(G) initially 1 g/day in 2-4 divided doses; aft er improvement,

125-500 mg daily

Pediatric: <8 years: not recommended; ≥8 years, <100 lb: 25-50 mg/kg/day in 2-4 divided doses; ≥8 years, ≥100 lb: same as adult; see page 585 for dose by weight

Achromycin V Cap: 250, 500 mg

Sumycin Tab: 250, 500 mg; Cap: 250, 500 mg; Oral susp: 125 mg/5 ml (100,

200 ml) (fruit) (sulfi tes)

Comment: tetracycline is contraindicated <8 years-of-age, in pregnancy,

and lactation (discolors developing tooth enamel) A side eff ect may be