CARDIOVASCULAR SYSTEM
Hyperlipoproteinemias 2F
; POTASSIUM CHLORIDE
KLOR-CON M Upsher-Smith
Potassium (as chloride) 10mEq, 15mEq;, 20mEq;;
ext-rel tabs (;scored).
; Also: Potassium chloride
KLOR-CON
Potassium (as chloride) 8mEq, 10mEq; ext-rel tabs.
; Also: Potassium chloride
KLOR-CON POWDER
Potassium (as chloride) 20mEq/packet,
25mEq/packet; pwd for oral soln; fruit flavor.
; Also: Potassium chloride
KLOR-CON/EF
Potassium (as bicarbonate) 25mEq; effervescent
tabs; fruit flavor.
Indications: Hypokalemia, including that caused by
diuretics. Digitalis intoxication without AV block.
Adults: Take with meals and fluids. Swallow
tabs whole; may break Klor-Con M tabs in half,
or mix in 4oz water. Effervescent tabs, pwd:
dissolve in beverage. Prophylaxis: 20mEq daily.
Treatment: 40–100mEq daily in divided doses; max
20mEq/dose.
Children: Not recommended.
Contraindications: Hyperkalemia. Chronic
renal disease. Acute dehydration. Heat cramps.
Severe tissue destruction. Adrenal insufficiency.
Familial periodic paralysis. Acidosis (potassium
chloride products). Alkalosis (potassium bicarbonate
products). Tablets: Esophageal compression due to
enlarged left atrium. Decreased GI motility.
Warnings/Precautions: Discontinue if GI bleed,
ulceration, or other disturbances occur. Renal or
cardiac disease. Monitor potassium level, clinical
status, acid-base balance, and ECG. Elderly.
Pregnancy (Cat.C). Nursing mothers.
Interactions: Hyperkalemia with ACE
inhibitors, spironolactone, triamterene, amiloride,
and potassium-containing salt substitutes.
Anticholinergics, other agents that decrease GI
motility increase risk of serious GI reactions with
tablets.
Adverse reactions: Hyperkalemia, GI discomfort
and irritation, diarrhea, rash (rare). Tablets:
Esophageal and GI ulceration, bleeding, obstruction,
perforation.
How supplied: M10–90, 100, 1000; M15–100,
1000; M20–90, 100, 500, 1000; Klor-Con 8,
10–100, 500; Pwd (20mEq packets)– 30, 100; Pwd
(25mEq packets)– 30, 100, 250; Klor-Con/EF– 30,
100
;TOLVAPTAN
SAMSCA Otsuka
Selective vasopressin V2-receptor antagonist.
Tolvaptan 15mg, 30mg; tabs.
Indications: Clinically significant euvolemic
and hypervolemic hyponatremia (serum sodium
;125mEq/L or less marked hyponatremia that is
symptomatic and has resisted correction with fluid
restriction), including patients with heart failure,
cirrhosis, and syndrome of inappropriate antidiuretic
hormone (SIADH).
Adults: Initiate and re-initiate only in a hospital.
Initially 15mg once daily, may increase dose after
;24hrs to 30mg once daily, then to max 60mg once
daily as needed to raise serum sodium. Avoid fluid
restriction during the first 24hrs of therapy; resume
fluid restriction after drug discontinuation.
Children: Not recommended.
Contraindications: Urgent need to raise serum
sodium acutely. Inability of patient to sense or
appropriately respond to thirst. Hypovolemic
hyponatremia. Concomitant strong CYP3A inhibitors
(eg, clarithromycin, ketoconazole, itraconazole,
ritonavir, indinavir, nelfinavir, saquinavir, nefazodone,
telithromycin. Anuric patients.
Warnings/Precautions: Discontinue or interrupt
therapy if too rapid a rise in serum sodium occurs
(eg, ;12mEq/L/24hrs) or if significant signs/
symptoms of hypovolemia develop. Severe renal
impairment. Monitor frequently for changes in
serum electrolytes, volume, and neurologic status
during initiation and titration. Severe malnutrition,
alcoholism, advanced liver disease: slower rates of
correction advisable. Monitor serum potassium in
patients with potassium;5mEq/L or on drugs known
to increase potassium. Pregnancy (Cat.C). Nursing
mothers: not recommended.
Interactions: See Contraindications. Potentiated
by CYP3A inhibitors, grapefruit juice; avoid moderate
CYP3A inhibitors (eg, erythromycin, fluconazole,
aprepitant, diltiazem, verapamil). Antagonized by
CYP3A inducers (eg, rifampin, rifabutin, rifapentin,
barbiturates, phenytoin, carbamazepine, St. John’s
wort); avoid. Concomitant P-gp inhibitors (eg,
cyclosporine); consider reducing tolvaptan dose.
Monitor digoxin. Concomitant hypertonic saline: not
recommended.
Adverse reactions: Thirst, dry mouth, asthenia,
constipation, pollakiuria, polyuria, hyperglycemia;
GI bleeding (in cirrhotic patients; use only if need
outweighs risk).
How supplied: Tabs– 10
;ATORVASTATIN
LIPITOR Pfizer
HMG-CoA reductase inhibitor. Atorvastatin (as
calcium) 10mg, 20mg, 40mg, 80mg; tabs.
Indications: Adjunct to diet in primary
hypercholesterolemia (heterozygous familial and
nonfamilial) and mixed dyslipidemia (Types IIa
and IIb) to reduce total-C, LDL-C, apo B and TG,
and to increase HDL-C. Adjunct to diet in treating
elevated serum TG (Type IV). Treatment of primary
dysbetalipoproteinemia (Type III) not adequately
responsive to diet. Adjunct to other lipid-lowering
treatments (or when these are unavailable), in
