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Oxazolidinones

General information When first marketed, the oxazolidinones represented the first truly new class of antibacterial agents to reach the marketplace in several decades [ ]. They have a unique mechanism of action, involving inhibition of the first step in protein synthesis. This unique mechanism of action makes cross-resistance with other antimicrobial agents unlikely. The first marketed member of the class, linezolid, has inhibitory activity against a…

Oxazepam

See also Benzodiazepines General information Oxazepam, which is a metabolite of temazepam and desmethyldiazepam, is itself used as a benzodiazepine for the management of insomnia. It is slowly absorbed, has a relatively short half-life (5–15 hours), and is metabolized primarily by glucuronidation [ ]. Drug studies Comparative studies Oxazepam has been compared with Passiflora incarnata extract in a double-blind, randomized trial in 26 out-patients with DSM-IV…

Oxatomide

See also Antihistamines General information Oxatomide is a second-generation antihistamine [ ]. Organs and systems You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Oxaprozin

General information In controlled studies, oxaprozin caused adverse effects in 23–58% of patients [ ]. It was considered better than aspirin and similar to other NSAIDs in long-term studies [ ]. However, treatment had to be interrupted owing to adverse effects in 8–31% of patients. Organs and systems Nervous system Headache, dizziness, vertigo, and tinnitus are less frequent with oxaprozin than with indometacin or aspirin […

Oxamniquine

General information Oxamniquine, in doses of 15 mg/kg or in a single oral dose of up to 15 mg/kg bd for 2 days, depending on the sensitivity of Schistosoma mansoni in the area concerned, is effective with minimal toxicity. It has no effect in Schistosoma hematobium . It is no longer given intramuscularly, because of severe pain at the injection site. Reactions occur in up to…

Oxametacin

See also : Non-steroidal anti-inflammatory drugs (NSAIDs) General information The adverse reactions pattern of oxametacin is similar to that of indometacin. In one study, 17% of 771 patients taking oxametacin had adverse effects, which led to withdrawal of treatment in 87. Gastrointestinal adverse effects accounted for 60% and nervous system reactions (headache, dizziness) for 31% [ ]. You’re Reading a Preview Become a Clinical Tree membership…

Otamixaban

See also Factor Xa inhibitors, direct General information Otamixaban is direct factor Xa inhibitor [ , ]. Its pharmacokinetics have been studied in healthy men over a wide range of intravenous doses, with durations of administration varying between 1-minute infusions (bolus doses) and 24-hour infusions, using non-compartmental and multicompartmental methods; the half-life was about 0.5 hours [ ]. Drug studies You’re Reading a Preview Become a…

Osmic acid

General information Osmic acid is injected into joints for chemical synovectomy [ ]. It is associated with local pain, effusions, and fever; skin necrosis is less frequent [ ]. Nerve damage and abnormal urinary findings (hematuria, proteinuria, and leukocyturia) can occur. A potentially dangerous drug, it certainly should not be given to young patients. Drug studies You’re Reading a Preview Become a Clinical Tree membership for…

Orphenadrine

See also Adrenoceptor agonists General information Orphenadrine is related to an antihistamine (diphenhydramine), and appears to have been developed in the hope of producing a greater effect in Parkinson’s disease by combining both anticholinergic and antihistaminic effects in a single molecule. In the doses commonly used, any of the well-recognized anticholinergic effects can occur. Some patients become drowsy, whilst others are stimulated. With increasing dosages, some…

Ornidazole

See also Benzimidazoles General information Used in single large doses for the treatment of Trichomonas urogenitalis or Giardia infections, ornidazole can cause gastrointestinal symptoms [ ]. Organs and systems Cardiovascular Cardiac arrest has been attributed to intravenous ornidazole in a 10-year-old girl with a brain abscess [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership…

Medical Issues in Pregnancy

Of the over 70 million women of reproductive age in the United States, women are increasingly entering pregnancy at a later age. The mean age was 27.1 years in 2020, up from 23 years in 1994. Pregnancy, which has always served as a stress test for a woman’s health, is now becoming even more of a challenge as women, especially non-White women ( E-Fig. 221-1 ),…

Contraception

Contraceptive Use Contraception enables people to avoid unwanted fertility by preventing pregnancy. Methods can be classified in many ways. Some classification schemes distinguish among mechanisms (e.g., barriers to the encounter of sperm and ovum versus methods that prevent ovulation); other categories emphasize the timing of use (at the time of intercourse vs. ongoing); still other classifications focus on the permanence of the method (sterilization, which is…

Approach to Women’s Health

An approach to the care of women must go beyond an understanding of differences in the incidence of disease between men and women. Providers need to consider the impact of sex differences (differences based on genetic and hormonal differences) and gender differences (differences attributable to the roles men and women are ascribed in society). Therapeutic decisions should take into account both genetic and environmental differences in…

Reproductive Endocrinology and Infertility

The Normal Menstrual Cycle Endometrium The endometrium undergoes histologic and cytologic changes that culminate with menstrual bleeding when the corpus luteum ceases to secrete progesterone ( Fig. 218-1 ). The basal layer of the endometrium then regenerates the superficial layer of compact epithelial cells that line the uterine cavity and an intermediate layer of spongiosa. Endometrial glands proliferate under the influence of estrogen, and the mucosa…

Ovaries and Pubertal Development

Definition The ovaries or female gonads episodically release female gametes (oocytes or eggs) and secrete sex steroid hormones, principally estradiol and progesterone but also various androgens. Oocytes are released only during the adult reproductive years, when the secretion of sex steroids is also greatest, but the ovaries are physiologically active throughout life. Sex steroids affect the growth, differentiation, and function of a variety of tissues and…

The Testis and Male Hypogonadism, Infertility, and Sexual Dysfunction

Male Reproductive Physiology The testis is a bifunctional organ that serves as the site for synthesis of sex steroids (mainly testosterone) and the production of sperm. Androgens and their metabolites (including estrogens) also act on nonreproductive organs and serve essential roles in muscle, adipose tissue, bone, hematopoietic cells, liver, and brain. The male reproductive axis consists of three main components: (1) hypothalamus, where the kisspeptin-neurokinin B-dynorphin…

Transgender Medicine

Definition and Epidemiology Gender identity is the internal sense of one’s own sex, whether male, female, neither, both, or something else. Transgender is a broad term to reference individuals with gender identity that differs from sex recorded at birth, typically based on external genitalia ( Table 215-1 ). In the United States, an estimated 0.6% of adults, or approximately 1.4 million individuals, are transgender. Cisgender describes…

Sexual Development

Definition Individuals with differences of sexual development lack concordance of various aspects of gender. These aspects include chromosomal sex (46,XX, 46,XY, or other), gonadal or reproductive sex (ovaries, fallopian tubes, and uterus vs. testes, seminal vesicles, prostate gland, and ejaculatory ducts), genital sex (vagina and clitoris vs. scrotum and penis), and gender-specific behavior. Depending on chromosomal sex, most patients can be classified as incompletely masculinized 46,XY…

Neuroendocrine Neoplasms

Definition Neuroendocrine neoplasms, , formerly called neuroendocrine tumors, are now subclassified as well-differentiated neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas. This new division has important implication for both prognosis and treatment. Neuroendocrine neoplasms occur in almost all tissues but have historically been divided into two large groups, pancreatic neuroendocrine neoplasms/tumors compared with neuroendocrine neoplasms in other locations, often called carcinoid tumors in older classifications. Epidemiology The…