General information Famciclovir is an oral prodrug of penciclovir, a selective antiviral drug with activity against Varicella zoster virus, Herpes simplex virus types 1 and 2, and Epstein–Barr virus, as well as human hepatitis B virus. After oral administration, famciclovir is well absorbed (systemic availability 77%), with little intersubject variability, and is rapidly converted to penciclovir. This compares favorably with aciclovir, the absorption of which is…

See also individual agents General information The direct inhibitors of factor Xa are short polysaccharides [ ]. They include rivaroxaban [BAY 59-7939; 5-chloro-N-(({(5S)-2-oxo-3-(4-(3-oxomorpholin-4-yl)phenyl)-1,3-oxazolidin-5-yl}methyl)thiophene-2-carboxamide)], apixaban, edoxaban, otamixaban, and DX-9065 [(+)-2S-2-[4-[[(3S)-1-acetimidoyl-3-pyrrolidinyl]oxy]phenyl]-3-(7-amidino-2-naphthyl) propanoic acid hydrochloride pentahydrate]. Direct inhibitors of factor Xa bind to factor Xa with 1:1 stoichiometry and block the interaction of factor Xa with its substrates. Their action is reversible and they not only inhibit free factor…

See also Coagulation proteins General information Factor IX is used as substitution therapy in patients with hemophilia B. Although the half-lives of recombinant and plasma factor IX products are comparable, the in vivo recovery of recombinant factor IX is 28% lower than a highly purified plasma-derived product. To treat hemorrhage the dosage of recombinant factor IX needs to be 20% higher than plasma-derived products to increase…

See also Coagulation proteins General information Lyophilized factor VIII has been used as substitution therapy in patients with hemophilia A. Most, but not all, recombinant factor VIII (recFVIII) is structurally and immunologically similar to plasma-derived factor VIII, and it has been well tolerated by patients in clinical trials. A major concern about recombinant factor VIII has been the occurrence inhibitors [ ]. However, there is evidence…

See also Coagulation proteins General information Factor VII is the most sensitive of the vitamin K-dependent clotting factors. The mode of action is tissue factor-dependent activation of factors Xa and IXa on the surfaces of activated platelets [ ]. Factor Xa leads to thrombin generation and hemostasis, by converting fibrinogen to fibrin. This process is limited to the site of injury, since exposure of tissue factor…

General information The genera in the family of Fabaceae ( Table 1 ; formerly Leguminosae) include broom, licorice, senna, tamarind, and a variety of pulses, such as fava beans, lentil, peas, and vetches. Table 1 Genera of Fabaceae Abrus (abrus) Ebenopsis (Texas ebony) Parkinsonia (paloverde) Acacia (acacia) Entada (callingcard vine) Parkia (parkia) Adenanthera (bead tree) Enterolobium (enterolobium) Parryella (parryella) Aeschynomene (joint vetch) Eriosema (sand pea) Pediomelum…

General information Ezetimibe is a selective potent inhibitor of the intestinal absorption of dietary and biliary cholesterol. A total of 432 patients were included in a pooled analysis of two phase-II studies, both lasting for 12 weeks; ezetimibe was well tolerated, with an adverse events profile similar to that of placebo [ ]. In 668 patients who took ezetimibe with simvastatin, the adverse reactions were similar…

General information Eyedrops and ointments are specialized pharmaceutical formulations intended to produce therapeutic concentrations of the active drug in ocular structures; a lower dose can be used than would be necessary to obtain the same effect by systemic administration. They can cause local adverse effects in the eye due either to the active ingredient or to excipients in the liquid or solid vehicle. The excipients included…

General information Exenatide (synthetic exendin-4, from the saliva from a lizard) is an incretin mimetic [ ]. Incretins are compounds that increase insulin secretion from the pancreas in a glucose-dependent manner; they are therefore potential therapies for the treatment of diabetes mellitus. Glucagon-like peptide-1 (GLP-1; 30 amino acids) is a naturally occurring incretin. It is largely produced in the distal ileum and colon in response to…

General information Everolimus is an immunosuppressive macrolide that also has synergistic actions with ciclosporin and interrupts the proliferative responses of vascular and bronchial smooth muscle cells. In a phase I trial, its safety profile and pharmacokinetics were assessed during a 4-week course of once-daily sequential ascending doses (0.75, 2.5, or 7.5 mg/day) in renal transplant recipients on a stable regimen of ciclosporin and prednisone [ ].…

General information The genera in the family of Euphorbiaceae ( Table 1 ) include various spurges, such as poinsettia and croton. Table 1 Genera of Euphorbiaceae Acalypha (copperleaf) Croton (croton) Mercurialis (mercurialis) Adelia (wild lime) Dalechampia (dalechampia) Pedilanthus (pedilanthus) Alchornea (alchornea) Ditta (ditta) Pera (pera) Alchorneopsis (alchorneopsis) Drypetes (drypetes) Phyllanthus (leaf flower) Aleurites (aleurites) Euphorbia (spurge) Reverchonia (reverchonia) Antidesma (china laurel) Flueggea (bushweed) Ricinus (castor) Argythamnia…

General information Etomidate, a non-barbiturate anesthetic, is considered to be safe, especially in patients with hemodynamic instability. The most common complications of using etomidate are venous sequelae, pain on injection [ ], and involuntary muscle movements [ ]. Organs and systems Cardiovascular The cardiorespiratory tolerance of etomidate is usually excellent [ ], but cardiovascular instability has been described after a bolus dose [ ]. You’re Reading…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Etodolac, a pyranocarboxylic acid, was first marketed in the UK in 1986. By 1988, etodolac had been reported 27 times to the UK Committee on Safety of Medicines as being suspected of causing serious adverse reactions [ ]. In a French postmarketing safety study in 51 355 patients taking 200–600 mg/day, 10% of patients reported a total of…

General information Etifoxine is a non-benzodiazepine drug, licensed in France for psychosomatic manifestations of anxiety. 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 Etidocaine is a highly lipid-soluble, long-acting aminoamide. It has a similar adverse reactions profile to that of bupivacaine and there is an increased risk of life-threatening cardiac events compared with lidocaine [ ]. 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 Ethylenediamine is used to improve the solubility of theophylline in the formulation known as aminophylline (theophylline ethylenediamine). Aminophylline is converted to theophylline after oral and intravenous administration. Ethylenediamine is also used as a stabilizer in creams and ointments. Ethylenediamine tetra-acetic acid is a chelating agent that is used as an anticoagulant for collecting blood samples and for removing calcium from experimental fluids in laboratories.…

See also Disinfectants and antiseptics General information Ethylene oxide is a gas that is used in the sterilization of equipment too large for other techniques, and for sterilizing rubber, plastic goods, and other materials that are damaged by heat and not adequately disinfected by other cold methods. Ethylene oxide is highly toxic. If it is not eliminated after sterilization it can produce severe irritation and burns.…

See also Antiepileptic drugs General information The main adverse reactions to ethosuximide include gastrointestinal disturbances, anorexia, dizziness, fatigue, drowsiness, headache, mood and behavioral disturbances, dyskinesias, and hiccups [ ]. Skin rashes (including Stevens–Johnson syndrome), systemic lupus erythematosus, scleroderma, nephrotic syndrome, blood dyscrasias, liver dysfunction, and autoimmune thyroiditis are rare. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become…

See also Antituberculosis drugs General information Ethionamide is a synthetic derivative of thio-isonicotinamide. The initial oral dosage for adults is 250 mg/day, slowly increasing up to 15–20 mg/kg/day (maximum 1 g/day). Protionamide is a pyridine derivative of ethionamide. The dosage is 250–300 mg Ethionamide and protionamide have often proved to be effective in non-tuberculous mycobacterial infections. Acute rheumatic symptoms and difficulty in the management of diabetes…

General information Etherified starches are synthetic colloids containing over 90% amylopectin, a waxy starch derived from maize, that has been variably etherified. There are two major forms, hetastarch and pentastarch (both BAN and USAN). They are produced synthetically by introducing hydroxyethyl groups into glucose units of starch molecules, followed by acid hydrolysis, which results in a product with a molecular weight of several thousands of daltons.…