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Diuretics

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…

Disulfiram

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…

Disopyramide

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…

Dirithromycin

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…

Dipyridamole

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…

Diphtheria vaccine

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).…

Diphenylpyraline

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…

Diphenoxylate

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…

Diphenhydramine

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 [ ].…

Diphencyprone

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

Dipeptidyl peptidase IV inhibitors

See also individual agents General information Sitagliptin ([2R]-4-oxo-4-[3-(trifluoromethyl)-5,6-dihydro(1,2,4)triazolo(4,3-a)pyrazin-7(8H)-yl]-1-[2,4,5-trifluorophenyl]butan-2-amine) [ ] was the first inhibitor of dipeptidyl peptidase type 4 (DPP-4) to have received a licence in the UK (in 2007). Other are linagliptin, saxagliptin, and vildagliptin. DPP-4 is an enzyme that is involved in the rapid metabolism of incretins, such as glucagon-like peptide. Inhibitors of DPP-4 therefore extend the action of incretins. The incretins increase glucose-dependent…

Diosmin and hidrosmin

Agathosma betulina (buchu) contains diosmin (also known as venosmine), a bioflavonoid, and a synthetic form of diosmin is also available. Hidrosmin is 3',5-di-O-(2-hydroxyethyl)diosmin. Diosmin is marketed as Daflon and Detralex, which contain 90% diosmin plus 10% hesperidin, a flavanone glycoside found in citrus fruits. Uses Diosmin and hidrosmin have been used to treat the pain and bleeding of hemorrhoids [ , ], in chronic venous disease…

Dinoprostone

See also Prostaglandins General information Dinoprostone is PGE 2 available for exogenous administration. 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

Dinitrochlorobenzene

General information Dinitrochlorobenzene is a potent sensitizer that has been applied topically in the evaluation of delayed hypersensitivity. It has also been used as an immunostimulant in conditions such as leprosy, HIV infection, and some forms of cancer, and to treat alopecia and warts. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

Dimethyltryptamine

General information Dimethyltryptamine is a psychedelic drug [ , ]. It can be smoked, inhaled, injected, or used as an enema. It is inactive by mouth, except when there is inhibition of gut monoamine oxidase (MAO type A). Its effects are similar to those of lysergide [ , ]. The derivative 5-methoxy- N , N -dimethyltryptamine has similar actions. Both compounds are found in various plants…

Dimethylsulfoxide

General information Dimethylsulfoxide is an agent with a wide spectrum of pharmacological effects, including membrane penetration, anti-inflammatory effects, local analgesia, and weak bacteriostasis. The principal use of dimethylsulfoxide is as a vehicle for other drugs, thereby enhancing the effect of the drug, and aiding penetration of other drugs into the skin. Dimethylsulfoxide has been given orally, intravenously, or topically for a wide range of indications. It…