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General information Dornase alfa is human recombinant deoxyribonuclease. Daily therapy with dornase alfa in patients with cystic fibrosis can reduce the frequency of respiratory infections and improve lung function in patients with bronchiectasis. 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 Dopexamine, which is related structurally to dopamine, is a potent β 2 -adrenoceptor agonist and dopamine D 1 receptor agonist, which is a vasodilator at low doses, with beneficial effects on splanchnic blood flow, and a vasconstrictor at high doses [ , ]. It has been used to treat circulatory failure [ ] and after cardiac [ ] and gastrointestinal surgery [ ]. Reported…

General information Dopamine is a naturally occurring catecholamine and central neurotransmitter capable of raising cardiac output, reducing peripheral resistance, and specifically increasing renal blood flow. Infusions (generally up to 10 micrograms/kg/hour) have proven valuable in shock and congestive heart failure. Common adverse reactions during infusion include extra beats, tachycardia, and palpitation. Angina pectoris, bradycardia, altered cardiac conduction, nausea and vomiting, headache, and dyspnea can occur. Piloerection…

General information The approval of donepezil in several countries in America and Europe has been hailed as a major milestone, because it has met regulatory guidelines for the approval of anti-dementia drugs [ ]. Donepezil belongs to a piperidine class of reversible acetylcholinesterase inhibitors, chemically unrelated to either tacrine or physostigmine. It is highly specific for acetylcholinesterase and does not inhibit butyrylcholinesterase. The incidence of adverse…

General information Domperidone is a neuroleptic antiemetic, a dopamine receptor antagonist. It produces the expected range of dystonic and extrapyramidal adverse effects [ ], which seem, as with metoclopramide, to be more likely to occur in children [ ]. It is difficult to accept that claims for lower frequencies than with metoclopramide are justified, particularly when one reads a report of neuroleptic malignant syndrome [ ].…

General information Dofetilide is a pure Class III antidysrhythmic drug, without actions of any other class. It was developed following the observation that bis(arylalkyl)amines with methanesulfonamido moieties on both aryl groups prolong the cardiac action potential without significantly altering the maximum rate of depolarization [ ]. The pharmacology, clinical pharmacology, uses, adverse effects, and interactions of dofetilide have been reviewed [ ]. Cardiovascular adverse effects of…

See also Cytotoxic and immunosuppressant drugs General information Docetaxel is a taxane that is used in combination with doxorubicin in the treatment of metastatic breast cancer and as a single agent in metastatic lung cancer. Organs and systems Respiratory Interstitial pneumonitis has been attributed to docetaxel in four cases [ ]. None of the patients had lung disease and they all had normal liver function. Within…

General information Dobutamine is a relatively selective β 1 -adrenoceptor agonist with only slight β 2 – and α-adrenoceptor activity. It has been developed as a positive inotropic agent that is less vasoconstrictive than high doses of dopamine. Organs and systems 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…

General information Diuretics are among the most widely used drugs, particularly for the treatment of hypertension and of various conditions associated with sodium retention. Considering the widespread use of diuretics over a long period (chlorothiazide was introduced in 1957) their safety record is remarkable, and reports of adverse effects of any significance with the best-known drugs of this type are uncommon. When problems do arise they…

See also Diethyldithiocarbamate General information Oxidation of sodium diethyldithiocarbamate gives a disulfide, also called thiuram disulfide or disulfiram. Disulfiram has been widely used since the late 1940s to facilitate abstinence from alcohol [ ]. Concomitant use of alcohol during disulfiram therapy results in an autonomic symptom complex that can involve headache, flushing, nausea and vomiting, sweating, tachycardia, hypotension, and confusion. The mechanism of action of disulfiram…

See also Antidysrhythmic drugs General information The use, clinical pharmacology, and adverse effects of disopyramide have been reviewed [ , ]. Drug studies Observational studies Because of its negative inotropic effect, disopyramide reduces the left ventricular outflow gradient and improves symptoms in patients with hypertrophic obstructive cardiomyopathy. However, its long-term effects have not been well studied. In 118 patients who took disopyramide (mean dose 432 mg/day…

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See also Macrolide antibiotics General information Adverse reactions to dirithromycin were studied in 4263 patients [ ]. There was abdominal pain in 5.6%, diarrhea in 5.0%, and nausea in 4.9%. Headache was relatively common (4.5%). In 63% of cases the adverse events were considered mild, in 31% moderate, and in 6.3% severe. Adverse events resulted in withdrawal in 3.1%, mainly because of gastrointestinal symptoms such as…

General information Dipyridamole inhibits platelet aggregation by inhibiting platelet cyclic AMP phosphodiesterase, potentiating adenosine inhibition of platelet function by blocking adenosine reuptake by vascular and blood cells and breakdown of adenosine, and by potentiating prostaglandin I 2 antiaggregatory activity and enhancement of its synthesis. These independent processes inhibit platelet aggregation by increasing platelet cyclic AMP through a reduction in enzymatic breakdown of cyclic AMP and stimulation…

See also Vaccines ; Pertussis vaccines General information Diphtheria vaccine contains diphtheria toxoid carried on aluminium hydroxide or calcium phosphate. Single antigen products are available only for cases in which combined antigens should not be used. The formulations used in most countries are a childhood formulation containing 25–30 Lf (flocculating units) of diphtheria toxoid (D) and an adult formulation containing 2 Lf of diphtheria toxoid (d).…

See also Antihistamines General information Diphenylpyraline is an antihistamine, a piperidine derivative [ ], with antimuscarinic and sedative properties. It has been used to treat allergic and vasomotor rhinitis [ ], chronic urticaria [ ], and the symptoms of the common cold [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

General information Diphenoxylate is a synthetic compound designed to have the antidiarrheal effects of the opiates, but it also retains some less desirable opiate effects. It is generally combined with atropine, as co-phenotrope, which was originally added to the formulation in the hope of preventing misuse, although it can itself cause problems, especially if the combination is intentionally or accidentally used to excess. In one instance…

See also Antihistamines General information Diphenhydramine is a typically sedating first-generation antihistamine. It is still widely used, mainly in over-the-counter products, often in combination with other drugs. Diphenhydramine inhibits CYP2D6 and can cause clinically important interactions with many CYP2D6 substrates, particularly those with a narrow therapeutic index. Organs and systems Nervous system Diphenhydramine can cause significant daytime neurological impairment comparable to intoxication with alcohol [ ].…

General information Diphencyprone (diphenylcyclopropenone) is a potent sensitizing chemical used to induce a contact dermatitis of the scalp in the topical immunotherapy of alopecia areata [ ] and warts [ ]. 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