See also Manitimus General information Teriflonumide (A77 1726) is the active metabolite of the prodrug leflunomide ( N -(4′-trifluoromethylphenyl)-5-methylisoxazole-4-carboxamide), an isoxazole derivative. [ ]. Mechanism of action Teriflunomide inhibits dihydro-orotate dehydrogenase, the rate-limiting enzyme in pyrimidine synthesis. It inhibits the proliferation of T and B cells, and probably acts via the production and action of interleukin-2. Besides its immunomodulatory action, teriflunomide also has an anti-inflammatory action…

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General information Lead is a heavy soft bluish-gray metal (symbol Pb; atomic no. 82) that is widespread as different salts in minerals such as chromite (oxide), crocoisite (chromate), Jamesonite and zinkenite (sulfides), mimetite (arsenate and chloride), pyromorphite (phosphate and chloride), and vanadinite (vanadate and chloride). Lead has no place in internal medical treatment, although lead acetate has retained a very small place as an astringent. Its…

General information Laxatives can be classified according to their several mechanisms of action: bulk-forming laxatives, such as bran, methylcellulose, Plantago extracts (ispaghula and psyllium), and sterculia; stimulant laxatives, such as the anthraquinones (senna and dantron), bisacodyl, docusate sodium (also a fecal softener), and sodium picosulfate; cascara, castor oil, oxyphenisatine, and phenolphthalein are obsolete stimulant laxatives; fecal softeners, such as arachis oil and the obsolete liquid paraffin;…

General information Lauromacrogols are mixtures of monolauryl esters of macrogols. They have the following general formula: C 12 H 25 (OCH 2 CH 2 ) n OH. Each is named after the number n in its formula. For example, in lauromacrogol 400 (polidocanol), n = 400. They have been used as surfactants, spermicides, solvents, and non-ionic emulsifiers. Lauromacrogol 9 has been used as a sclerosant and…

General information The genera in the family of Lauraceae ( Table 1 ) include bay, cinnamon, laurel, and sassafras. Table 1 Genera of Lauraceae Aniba (aniba) Beilschmiedia (beilschmiedia) Cassytha (cassytha) Cinnamonum (cinnamon) Cryptocarya (cryptocarya) Endiandra (walnut) Eusideroxylon (ironwood) Laurus (laurel) Licaria (licaria) Lindera (spicebush) Litsea (litsea) Nectandra (sweetwood) Ocotea (sweetwood) Persea (bay) Sassafras (sassafras) Umbellularia (California laurel) Cinnamonum camphora Camphor is a white crystalline substance, obtained…

See also Etherified starches . General information Latex is present in many medical devices, including surgical and examination gloves, catheters, intubation tubes, anesthesia masks, and dental fillers. Reported allergic reactions range from contact urticaria to anaphylaxis [ ]. There has been a marked worldwide increase during recent years in the rate of reactions to latex. These reactions are due to either or both: 1. The formulation…

See also Prostaglandins . General information Latanoprost is an analogue of prostaglandin F 2α , used to treat glaucoma. The use of latanoprost and unoprostone in the treatment of open-angle glaucoma and ocular hypertension has been reviewed [ ]. More data on safety are needed to calculate its benefit-to-harm balance. Latanoprost caused reduced intraocular pressure by 20–40% in adults with open-angle glaucoma or ocular hypertension, but…

General information Tyrosine kinase inhibitors are effective in the targeted treatment of various malignancies. Imatinib was the first to be introduced into clinical oncology, and it was followed by drugs such as gefitinib, erlotinib, sorafenib, sunitinib, and dasatinib. Although they share the same mechanism of action, namely competitive ATP inhibition at the catalytic binding site of tyrosine kinase, they differ from each other in the spectrum…

General information The lanthanoids form a group of elements with atomic numbers from 57 to 71, from lanthanum to lutetium. Lanthanum, cerium, and gadolinium have gained attention in the use and design of pharmaceutical drugs [ ]; lanthanum has been used in the management of hyperphosphatemia and gadolinium as a contrast agent in MRI and in cancer treatment. Gadolinium salts are covered in a separate monograph.…

See also Proton pump inhibitors General information Lansoprazole is a proton pump inhibitor. Its adverse reactions profile has been reviewed based on premarketing clinical studies, and has to be regarded with the reservations appropriate to this type of material. In 4749 patients the most frequent adverse reactions were headache (4.7%), diarrhea (3.2%), abdominal pain (2.2%), pharyngitis (1.8%), and nausea (1.4%); some patients had upper respiratory complaints…

See also Antiepileptic drugs General information Lamotrigine is widely used in the management of partial and generalized seizures. It has a favorable tolerability profile, even though neurological adverse reactions and hypersensitivity reactions are sometimes troublesome. Its pharmacology, clinical pharmacology, adverse effects, and interactions have been reviewed [ ]. Adverse reactions to lamotrigine are primarily neurological, gastrointestinal, and dermatological and are typically mild or moderate and transient,…

See also : Nucleoside analogue reverse transcriptase inhibitors (NRTIs) General information Lamivudine (3TC) is a nucleoside analogue reverse transcriptase inhibitor that has been widely used against HIV infection which also has antiviral effects against hepatitis B [ , ]. In chronic hepatitis B in adults and children lamivudine increases the rate of loss of hepatitis B e antigen and seroconversion in compensated chronic carriers, with improvement…

General information The genera in the family of Lamiaceae ( Table 1 ) include basil, catnip, germander, lavender, mints, origanum, rosemary, sage, skullcap, and thyme. Table 1 Genera of Lamiaceae Acanthomintha (thorn mint) Acinos (acinos) Agastach (giant hyssop) Ajuga (bugle) Ballota (horehound) Blephilia (pagoda plant) Brazoria (brazos mint) Calamintha (calamint) Cedronella (cedronella) Chaiturus (lion’s tail) Clinopodium (clinopodium) Coleus (coleus) Collinsonia (horsebalm) Conradina (false rosemary) Cunila (cunila)…

General information Lactose is a disaccharide, galactopyranosyl-glucose, which is found in mammalian milk and, because it is readily compressible, is used as an excipient in many oral drug formulations and dry powder inhalers. It is also added to infant formula milk in order to mimic the composition of human milk. Since lactose is not fermented by brewer's yeast, it is used to sweeten the beer known…

See also Beta-adrenoceptor antagonists General information Labetalol is a non-selective alpha- and beta-adrenoceptor antagonist; these actions reside in four different enantiomers. Labetalol is less likely to increase airways resistance in patients with bronchial asthma or to reduce peripheral blood flow. However, it can produce postural hypotension [ ], and paresthesia of the scalp [ ] and perioral numbness [ ] have been described. Organs and systems…

General information The family of Krameriaceae contains the single genus Krameria (ratany), species of which have anti-inflammatory [ ], antioxidant [ ], antibacterial [ ], and molluscicidal [ ] actions. 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

See also Antihistamines General information Ketotifen was originally developed as a drug that would inhibit the release of vasoactive substances from mast cells, as an oral alternative to cromoglicate, but its actions in asthma are probably attributable to its antihistaminic effect [ , ], which occurs within minutes after administration and lasts for up to 12 hours. It also stabilizes mast cells, preventing histamine release, inhibits…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Ketorolac is a pyrrolizine carboxylic acid derivative, structurally and pharmacologically related to tolmetin, zomepirac, and indometacin. The trometamol salt of ketorolac enhances its solubility and allows parenteral administration. Opinions on the safety of ketorolac in EC drug regulatory authorities are conflicting [ ]. However, the risk of adverse reactions is higher when ketorolac is used in higher doses,…

General information The spectrum of adverse effects of ketoprofen is similar to that of ibuprofen. Ketoprofen was originally approved for over-the-counter sales in the USA by the FDA, but in the same year, in Italy, the Ministry of Health transferred two ketoprofen-containing products from non-prescription to prescription status [ ]. The reasons for this difference are not clear. Organs and systems Respiratory A fatal asthmatic reaction…