Cefepime (Maxipime ®)
1 gm, 2 gm Vials
Bristol-Myers-Squibb
Cefepime, a fourth generation cephalosporin, is indicated for the treatment of: 1) uncomplicated urinary tract infections, including pyelonephritis, caused by Escherichia coli or Klebsiella pneumoniae when the infections is severe or caused by E.coli, K.pneumoniae, or Proteus mirabilis when the infection is mild to moderate, 2) uncomplicated skin and skin structure infections caused by Staphylococcus aureus (methicillin susceptible strains only) or Streptococcus pyogenes, 3) moderate to severe pneumonia, with or without bacteremia, caused by Streptococcus pneumoniae, Pseudomonas aeruginosa, K. pneumonia or Enterobacter species. Cefepime is contraindicated in patients with known hypersensitivity reactions to cefepime or other beta-lactam products.
Cefepime is an enhanced spectrum antibiotic with activity against most gram negative bacilli and beta-lactamase producers, slightly less active against Staphylococci and less active against Pseudomonas and Acinetobacter. It has a degree of anti-pseudomonal activity similar to ceftazidime and has good beta-lactamase stability and improved gram positive activity over existing compounds in its class.
Adverse reactions in clinical trials have included infusion site reactions (phlebitis, pain, inflammation), rash, diarrhea, colitis, nausea, vomiting, pruritus, urticaria, headache, lightheadedness, drug fever, oral moniliasis, vaginitis, and transient elevations in AST and ALT. Cefepime is well tolerated after IM administration. Clostridium difficile has been reported with Cefepime use. Cefepime has also been associated with reduction in prothrombin activity. Encephalopathy, seizures and neuromuscular excitability have occurred in renally impaired patients treated with unadjusted doses of cefepime. No drug interactions with cefepime have been reported.
The recommended dose of cefepime in various infections is 1 gm to 2 gm every 12 hours. Prothrombin times should be monitored in patients at risk of reduced prothrombin activity (patients with renal or hepatic impairment, poor nutrition state or receiving extended courses of antimicrobials).
Cefepime carries a KUMC Cost Code Index of G.
FOOD/DRUG INTERACTION: Coadministration of cefepime with food has no clinically significant effect on rate or extent of absorption. |
Topotecan (Hycamtin ®)
4 mg Vials
SmithKline Beecham Pharmaceuticals
Topotecan, an anti-tumor drug with topoisomerase 1-inhibitory activity, is indicated for the treatment of patients with metastatic carcinoma of the ovary after failure of initial or subsequent chemotherapy.
Commonly reported side effects in clinical trials have included alopecia, nausea, and vomiting. Others reported include diarrhea, constipation, abdominal pain, headache, and dyspnea.
Prior to administration of the first course of topotecan, patients must have a baseline neutrophil count of > 1500 cells/mm3 and a platelet count of > 100,000 cells/mm3. The recommended dose of topotecan is 1.5 mg/m2 by intravenous infusion over 30 minutes daily for five consecutive days, starting on day one of a 21 day course. A minimum of four courses is recommended because the median time to response in three clinical trials was nine to 12 weeks. In the event of severe neutropenia during any course, the dose should be reduced by 0.25 mg/m2 for subsequent doses. Alternatively, in the event of severe neutropenia, G-CSF may be administered following the subsequent course (before resorting to dose reduction) starting from day six of the course (24 hours after completion of topotecan administration).
Topotecan carries a KUMC Cost Code Index of J.
FOOD/DRUG INTERACTION: Topotecan may be administered without regard to food. |
Dexfenfluramine (Redux ®) C-IV
15 mg Capsules
Wyeth-Ayerst Laboratories
** Please see separate Pharmacy Key for complete information regarding
dexfenfluramine.
Changes in the KUMC Formulary since 1996-1997 publications
Bicalutamide (Casodex ® )
Cefepime (Maxipime ® )
Ceftriaxone (Rocephin ® )
-restriction removed
Dexfenfluramine (Redux ® )
-restricted to obesity clinic
Famiclovir (Famvir ® )
Fenfluramine (Pondimin ® )
-restricted to obesity clinic
Indinavir (Crixivan ® )
Phentermine (Adipex-P ® ,Fastin ® )
-restricted to obesity clinic
Ritonavir (Norvir ® )
Simvastatin (Zocor ® )
Sonicated Albumin 5% (Albunex ® )
-restricted to cardiac cath lab
Testosterone Patch (Androderm ® )
Topotecan (Hycamtin ® )
Cefoperazone (Cefobid ® )
Ceftizoxime (Cefizox ® )
Cefuroxime Axetil (Ceftin ® )[suspension]
Omeprazole (Prilosec ® )
