General information The ketolides cethromycin (ABT-773) and telithromycin are semisynthetic derivatives of 14-membered-ring macrolide antibiotics, members of the macrolide-lincosamide-streptogramin-B, MLS(B), class of antimicrobials, but they differ from macrolides by having a 3-keto group instead of an l -cladinose group on the erythronolide A ring [ ]. In a study of the efficacy of the ketolides HMR 3004 (previously RU 004) and telithromycin (HMR 3647, previously 66…

See also Antifungal azoles [for systemic use] General information Ketoconazole was the first azole available for oral administration, apart from metronidazole. However, it has been supplanted by newer azoles with fewer adverse effects and more reliable absorption from the gastrointestinal tract. Even after years of use, new adverse reactions (often related to high doses and/or newer indications) continue to be reported. Pharmacokinetics The oral absorption of…

General information Ketobemidone is an opioid receptor agonist, with pharmacokinetics and potency similar to morphine. Combined with the antispasmodic drug, N,N-dimethyl-3,3-diphenyl-1-methylallylamine chloride, ketobemidone is often used in Scandinavia. In a study of postoperative pain relief, ketobemidone equalled morphine and pethidine with respect to efficacy of analgesia and adverse effects, such as shivering, nausea, and vomiting [ ]. You’re Reading a Preview Become a Clinical Tree membership…

General information Ketanserin is a selective 5-HT 2 receptor antagonist with antihypertensive action. Because it antagonizes the vasoconstriction and platelet aggregation induced by 5-HT and increases erythrocyte deformability, its potential usefulness in peripheral vascular disease has been extensively investigated, although never convincingly demonstrated. It has been reported to be beneficial in pre-eclampsia [ ]. Most of the adverse reactions that are attributable to ketanserin are on…

General information Ketamine is a non-competitive antagonist at the phencyclidine site of the N-methyl- d -aspartate (NMDA) receptor for glutamate. However, its effects are also mediated by interactions with many others receptors. It is a short-acting anesthetic that has been widely used by emergency physicians [ ] and can be given intravenously, intramuscularly, orally, and even nasally [ ]. Multiple ketamine anesthetics may be safe […

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Kebuzone (ketophenylbutazone, ketazone) is an NSAID that is related to phenylbutazone. Allergic reactions, gastrotoxicity, nephrotoxicity, local reactions with necrosis [ ], and liver damage have been reported [ ]. The Japanese authorities have asked that the package insert should indicate that this drug must be used only as a last resort when other anti-inflammatory agents and uricosuric drugs…

General information Kaolin is commonly given together with pectin in the treatment of diarrhea, and can be combined with an opioid such as morphine. It has also been used in poultices an in hemostatic dressings [ ]. 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 Aminoglycoside antibiotics General information Kanamycin can be used for short-term treatment of severe infections caused by susceptible strains (for example Escherichia coli , Proteus species, Enterobacter aerogenes , Klebsiella pneumoniae , Serratia marcescens , and Mima-Herellea ) that are resistant to other less ototoxic aminoglycosides. It is not indicated for long-term therapy, for example in tuberculosis. Organs and systems You’re Reading a Preview Become…

General information The family of Juglandaceae contains three genera: 1. Carya (hickory, pecan); 2. Juglans (walnut); 3. Pterocarya (pterocarya). Carya spp 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 Macrolide antibiotics General information In a randomized open study, 325 children aged 2–15 years with acute tonsillitis and a positive test for Streptococcus pyogenes antigen were treated with josamycin 25 mg/kg bd for 5 days, or penicillin 50 000–100 000 IU/day for 10 days; in five patients taking josamycin treatment was withdrawn because of gastrointestinal adverse events (nausea/vomiting) [ ]. Organs and systems Fluid…

General information Japanese encephalitis is an important arboviral disease in man in Japan, China, Korea, Thailand, India, Nepal, Sri Lanka, and Vietnam. In 1954, Japanese encephalitis vaccine of the mouse brain type for human use was licensed in Japan. However, there was strong criticism of mouse brain vaccine, and in 1965 the Nippon Institute of Biological Products and the Biken Foundation implemented more advanced purification procedures,…

General information Ivermectin, a dihydroavermectin B1, is an effective microfilaricide used in the treatment of strongyloides, scabies, and all types of filariasis except Dipalonema ( Mansonella ) perstans infections. Over a number of years, ivermectin has shown excellent results in the treatment of onchocerciasis, both in controlled studies and in the field, including use in the WHO-sponsored program of treatment. This experience has provided a thorough…

See also Antifungal azoles [for systemic use] General information Itraconazole is a triazole antifungal drug. It is used orally to treat oropharyngeal and vulvovaginal candidiasis, pityriasis versicolor, dermatophytoses unresponsive to topical treatment, and systemic infections, including aspergillosis, blastomycosis, chromoblastomycosis, coccidioidomycosis, cryptococcosis, histoplasmosis, paracoccidioidomycosis, and sporotrichosis. It is also used to prevent fungal infections in immunocompromised patients. Pharmacokinetics The systemic availability of itraconazole and the bioequivalence of…

See also Calcium channel blockers General information Isradipine is a dihydropyridine calcium channel blocker. Drug studies Comparative studies The MIDAS study [ ] was a randomized trial of isradipine versus hydrochlorothiazide over 3 years in 883 patients, designed primarily to assess the effect on the rate of progression of medial intimal thickness in carotid arteries. The control of diastolic blood pressure was equivalent in both groups,…

See also Adrenoceptor agonists General information Isoxsuprine is a beta 2 -adrenoceptor agonist that also has antagonist action at alpha-adrenoceptors. It has been variously described as a beta-agonist, a specific vasorelaxant, a uterine relaxant, and an agent that reduces blood viscosity. In high dosages it also inhibits platelet aggregation. There is slim evidence that isoxsuprine improves cognitive function and mental performance in a limited number of…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information The oxicam NSAID isoxicam has a shorter half-life (30 hours) than piroxicam. However, there are large variations in half-life, clearance, and mean steady-state plasma concentrations. Except for edema, the incidence of adverse reactions is unrelated to age [ ]. Organs and systems Gastrointestinal The main adverse reactions to isoxicam are gastrointestinal pain, dyspepsia, nausea, vomiting, stomatitis, constipation, and…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Isoxepac has been used as an analgesic after joint surgery [ ] and in the management of rheumatoid arthritis [ ] and dysmenorrhea [ ]. 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 Isopropanolamine is used in cosmetics, hair perms, hair sprays, and in tanning lotions as a buffering agent. Derivatives of isopropanolamine have been developed as HIV protease inhibitors [ , ]. Occupational exposure to monoisopropanolamine can irritate the upper respiratory tract and eyes [ ]. Direct splashes into the eye can cause serious damage. Dermatitis can occur as a result of a single exposure, and…

See also Anticholinergic drugs General information A 5–10 mg oral dose of the anticholinergic drug isopropamide iodide produces typical anticholinergic effects and has been used to treat a range of disorders of the gastrointestinal tract [ , ] and urinary bladder [ ]. In patients with Zollinger–Ellison syndrome the combination of cimetidine plus isopropamide 20–40 mg/day was generally more effective in suppressing acid secretion than cimetidine…

See also Adrenoceptor agonists General information As a non-selective beta-adrenoceptor agonist, isoprenaline produces a wide range of adrenergic effects. Those that involve the heart present the most marked problems in practice. Doses of up to 10 micrograms/minute are used to improve the peripheral circulation in shock. In respiratory disease, isoprenaline in sublingual tablets (up to 10 mg) and inhalers were used in the past, but have…