See also Antihistamines General information Levocetirizine is the R-enantiomer of cetirizine dihydrochloride and, like cetirizine, undergoes minimal hepatic metabolism [ ]. Levocetirizine has twice the affinity for H 1 receptors as cetirizine [ ]. It is efficacious and well tolerated in patients with seasonal allergic rhinitis [ ]. Levocetirizine, has pharmacodynamically and pharmacokinetically favorable characteristics. Clinical trials have shown that it is safe and effective in…

See also Antihistamines General information Levocabastine is a second-generation antihistamine [ ]. Since levocabastine is applied locally in the eye or nose, local reactions are most often seen. Most frequent is ocular irritation followed by nasal irritation. Sedation does not seem to be common and no cardiac effects have been registered. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited…

General information Levobupivacaine is the levorotatory isomer, S(−)-bupivacaine, of bupivacaine, an amide local anesthetic. In a comparison of the clinical efficacy of epidural S(−)-bupivacaine with standard racemic RS-bupivacaine in 88 patients S(−)-bupivacaine was clinically indistinguishable from RS-bupivacaine in the three groups studied (0.75% or 0.5% S(−)-bupivacaine and 0.5% RS-bupivacaine). Hypotension was distributed evenly across the groups and five patients complained of minor neurological abnormalities (hypesthesia and…

See also Antiepileptic drugs . General information Levetiracetam is a piracetam derivative used in the treatment of refractory partial seizures. In trials it has shown an excellent tolerability profile. The main dose-related adverse reactions are sedation, fatigue, and headache. Other possible adverse reactions include dizziness, unsteadiness, diplopia, nausea, infection, memory impairment, and disturbances of mood and behavior, although in controlled trials the incidences of most of…

General information Levamisole is the levorotatory isomer of tetramisole. Originally used only as an antihelminthic drug, it acts by paralysing the musculature of susceptible nematodes so that they are expelled by peristalsis. It is rapidly metabolized and excreted, with a half-life of about 4 hours. It is used as an immunomodulating drug in adjuvant therapy for colon cancer, usually in combination with 5-fluorouracil, and in other…

General information The leukotriene receptor antagonists are antagonists of cysteinyl leukotrienes at CysLT 1 receptors and include zafirlukast, montelukast, and pranlukast. Drug studies Placebo-controlled studies The efficacy and tolerability of montelukast, in combination with a selective histamine H 1 receptor antagonist (loratadine), has been investigated in a randomized, double-blind, crossover study for 2 weeks in 125 asthmatic subjects (mean FEV 1 67% predicted), who took montelukast…

General information Letosteine is a mucolytic, used orally to loosen bronchial secretions and facilitate expectoration [ , ]. In a systematic review of six randomized controlled trials in 438 children, antitussives, antihistamine-decongestant combinations, other fixed drug combinations, and antihistamines were no more effective than placebo in relieving symptoms of acute cough; however, based on a single study, letosteine was more effective than placebo [ ]. You’re…

General information Lesopitron is a non-benzodiazepine anxiolytic drug. Its structure is similar to that of buspirone, and it is an agonist at central serotonin (5-HT 1A ) receptors [ ]. In a 6-week, double-blind, randomized, parallel, phase II, single-center, outpatient comparison of lesopitron 40–80 mg/day, lorazepam 2–4 mg/day, and placebo in 161 patients with generalized anxiety disorder, the most common adverse events associated with lesopitron were…

See also Calcium channel blockers General information Lercanidipine is a third-generation dihydropyridine for once-daily dosing in hypertension. It has similar antihypertensive efficacy and adverse effects to other calcium channel blockers [ ]. Drug studies 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

General information Lepirudin is a direct thrombin inhibitor obtained by recombinant technology from the medicinal leech and used for treatment of patients with heparin-induced thrombocytopenia and allergic reactions [ ]. An 85-year-old woman developed localized infiltrated plaques followed by a disseminated exanthematous reaction 10 days after the start of dalteparin therapy [ ]. Intradermal tests with a comprehensive series of undiluted commercial drugs yielded positive reactions…

General information Lentinan is an immunomodulating glucan that is extracted from the mushroom Lentinus edodes. It has been used in small numbers of patients with gastric cancers [ ] and malignant effusions [ ]. It has also been used in HIV-positive patients [ ] and to ameliorate impairment of natural killer cell activity after cardiopulmonary bypass [ ]. Of 98 patients with HIV infection, treatment had…

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…