General information Interleukin-4 is a pleiotropic cytokine, mostly produced by activated T cells, which acts on the proliferation and differentiation of B and T lymphocytes and enhances the function of natural killer cells, eosinophils, and mast cells [ ]. It is being investigated for potential antitumor and hemopoietic actions. General adverse effects and adverse reactions Moderate fever with flu-like symptoms, arthralgias, fatigue, anorexia, nausea, vomiting, headache,…

General information Interleukin-3 is produced by activated T lymphocytes and stimulates the proliferation and differentiation of the granulocyte, macrophage, eosinophil, basophil, erythroid, megakaryocyte, and mast cell lineages [ ]. Drug studies Observational studies Subcutaneous recombinant interleukin-3 has been investigated in patients with chemotherapy-induced myelotoxicity, in the setting of autologous bone marrow transplantation or peripheral stem cell harvesting, or in patients with myelodysplastic syndrome, aplastic anemia, and…

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General information Interleukin-1-alfa and interleukin-1-beta are produced by two distinct genes with only 25% homology, but they act through the same receptor and share similar in vitro biological properties. Interleukin-1 on its own has modest antitumor activity and limited hemopoietic effects. It also acts synergistically with other colony-stimulating factors (for example GM-CSF, G-CSF, interleukin-3, or interleukin-6) to promote colony formation and stimulate hemopoietic recovery in patients…

See also Individual agents General information The interferons, first described in 1957, include at least five natural human glycoproteins (alfa, beta, gamma, omega, and tau). Only the first three types are currently used, and they differ both structurally and antigenically. Interferon alfa is produced by macrophages, B cells, and null lymphocytes, interferon beta by fibroblasts, epithelial cells, and macrophages, and interferon gamma from T lymphocytes and…

See also Interferons . General information Recombinant interferon gamma (interferon gamma-1b) is currently approved only as an adjunct to antibacterial therapy in chronic granulomatous disease [ ], although its immunoregulatory potential has been investigated in other diseases. Clinical experience with interferon gamma is therefore limited and the most relevant information on long-term safety has been obtained from the ICGDSCG trial [ ]. In this study, adverse…

See also Interferons General information Interferon beta is used in the form of natural fibroblast or recombinant preparations (interferon beta-1a and interferon beta-1b) and exerts antiviral and antiproliferative properties similar to those of interferon alfa. Although its efficacy has been debated [ , ], interferon beta has been approved for the treatment of relapsing–remitting multiple sclerosis and secondary progressive multiple sclerosis. Adverse reactions to interferon beta…

See also Interferons General information Interferon alfa is used as purified natural leukocyte or lymphoblastoid human interferon, or as a recombinant DNA preparation. Work to assign the most frequently observed amino acids at each position has led to a so-called consensus interferon alfa [ ]. Relatively low doses (3–10 MU three times a week) are now being used in most indications, except in AIDS-related Kaposi’s sarcoma…

General information Insulin-like growth factor (IGF) and the IGF-I receptor are structurally comparable to insulin and the insulin receptor. Recombinant human IGF-I has 54% identity to proinsulin. Insulin and IGF-I can bind to both receptors, but insulin can only transfer 1% of the IGF message on the IGF receptor and IGF-I only 1% of the insulin message on the insulin receptor. Recombinant human IGF-I is used…

See also Insulin . General information Insulin lispro induces more rapid and constant release of insulin from the injection site, since it consists of monomeric insulin. The change of one or more amino acids in the insulin molecule prevents insulin from forming dimers or hexamers. More rapid absorption, rapid availability, and rapid inactivation make the action better than that of endogenously secreted insulin. When the interval…

See also Insulin General information Insulin glargine is a long-acting human insulin analogue, in which phenylalanine is removed from site 30 of the C terminal of the B chain and two arginine molecules replace it, adding two positive charges; asparagine on site 21 of the A chain is replaced by the more stable glycine to avoid deamination. Older long-acting insulins, such as protamine zinc insulin and…

See also Insulin . General information Insulin detemir is a long-acting insulin analogue that lacks threonine at the B30 position and is acylated with a 14-carbon myristoyl fatty acid side-chain at the epsilon-amino group of the lysine in the B28 position. This stimulates binding to albumin and increases the half-life, extending its duration of action. The pharmacokinetic profile of detemir does not differ in various age…

See also Insulin General information Insulin aspart is a rapid-acting synthetic insulin in which proline is replaced by aspartate at position 28 in the B chain. Insulin aspart has been reviewed [ ]. Its adverse effects and the resulting adverse reactions do not differ from those of soluble human insulin and it has a similar effect on the blood glucose concentration [ ]. The binding of…

See also Insulin aspart ; Insulin detemir ; Insulin glargine ; Insulin lispro General information Insulin is used for substitution therapy in patients with an absolute or relative deficiency of insulin. Most of the insulins now prescribed are either human or highly purified insulins of animal origin or synthetic insulins closely related to human insulin. The use of insulin of lesser purity is declining, but it…

General information Inosine pranobex is a synthetic product, also known as isoprinosine or inosine dimepranol acedobene, with antiviral properties that are assumed to be related to its effect on T cell-mediated immunity rather than to direct antiviral activity. It has been tried in a wide range of viral diseases and also in rheumatoid arthritis [ ], multiple sclerosis [ ], and alopecia [ ]. However, clinical…

General information Pulmonary delivery of drugs is the administration route of choice in respiratory diseases such as chronic obstructive pulmonary disease and asthma. Different devices are available, including metered-dose inhalers, dry powder inhalers, and nebulizers, and nearly 80% of asthmatic patients worldwide use metered dose inhalers [ ]. Chlorofluorocarbons have been used as an aerosol propellant in metered-dose inhalers; however, they deplete the ozone layer and…

See also Vaccines General information Influenza vaccine viruses are propagated in embryonated chicken eggs. The virus-containing extra-embryonic fluid is harvested, purified, and inactivated with formalin. Inactivated flu vaccine is produced either as whole virus vaccine or ether-disrupted split or subunit preparations. However, many other new or modified influenza vaccines are already available or are expected to appear in the near future, for example vaccines containing new…

See also Monoclonal antibodies General information Infliximab is a chimeric, human-murine anti-TNF monoclonal antibody. It was initially approved by the Food and Drug and Administration in August 1998 for the treatment of moderately to severely active Crohn’s disease [ , ] in patients with an inadequate response to conventional therapies and those with enterocutaneous fistulae. The indications were expanded in June 2002 and April 2003 to…

See also Alpha-adrenoceptor antagonists General information Indoramin is a postsynaptic selective alpha 1 -adrenoceptor antagonist that is chemically distinct from the quinazolines. Unlike some other alpha-blockers, indoramin lowers blood pressure without a resulting reflex tachycardia or postural hypotension [ ]. However, it has largely been supplanted by more modern drugs, such as doxazosin, prazosin, and terazosin. You’re Reading a Preview Become a Clinical Tree membership for…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Indoprofen is one of several NSAIDs that have been withdrawn because of adverse reactions. The UK Licensing Authority suspended the product licence on grounds of safety in 1983, and in 1984 the Italian manufacturers decided to withdraw it from the world market. The UK decision was taken because there was a high rate of adverse drug reactions in…