General information The most frequent adverse reactions to dextropropoxyphene are dizziness, sedation, and nausea and vomiting. Other reported reactions include constipation, abdominal pain, skin rashes, light-headedness, headache, weakness, euphoria, dysphoria, minor reversible visual disturbances, and liver dysfunction [ ]. A systematic review of single-dose dextropropoxyphene for postoperative pain identified 130 published articles [ ]. Of these, 11 placebo-controlled studies met the inclusion criteria for the review,…

General information Dextromethorphan is the dextrorotatory isomer of the synthetic opioid levorphanol [ ]. It is a non-competitive antagonist at N -methyl- d -aspartate (NMDA) receptors. It also binds to CNS sigma opioid binding sites [2] and increases 5-HT concentrations by inhibiting the uptake of 5-HT and by enhancing its release [ ]. It is antitussive and has antihyperalgesic effects. Dextromethorphan is metabolized by CYP2D6 to…

General information Dextrans are mixtures of polymerized glucose molecules, mostly alpha-1,6-glucans, of variable molecular weight from 1 to 110 kDa. Infused dextran is mainly eliminated unmodified by the kidney at a rate of 50% in the first 24 hours and 20% in the following 48 hours. The remaining 30%, which is made up of the molecules with the highest molecular weights, is partly eliminated by the…

General information The α 2 -adrenoceptor agonist dexmedetomidine has potent sedative and analgesic-sparing properties. In therapeutic doses it does not cause respiratory depression, making it attractive for infusion sedation. However, it causes reduced sympathetic outflow, which might cause untoward hemodynamic upset but might also have beneficial β-adrenoceptor antagonist-like action in patients undergoing cardiovascular surgery. You’re Reading a Preview Become a Clinical Tree membership for Full access…

General information Dexloxiglumide is a cholecystokinin CCK 1 receptor antagonist [ ]. 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 See also Non-steroidal anti-inflammatory drugs (NSAIDs) Dexketoprofen is the dextrorotatory stereoisomer of ketoprofen. The analgesic effect of ketoprofen is due to the S(+)-enantiomer (dexketoprofen), while the R(−)-enantiomer has no analgesic activity [ ] but may be ulcerogenic [ ]. Thus, dexketoprofen should produce equivalent analgesia to twice the dose of ketoprofen, but with less risk of gastrointestinal damage. Pharmacokinetics Dexketoprofen is formulated as the…

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General information Dexibuprofen is the dextrorotatory isomer of ibuprofen. Clinical experience is still inadequate to judge its safety profile, although there are claims that it is of comparable safety to celecoxib [ ]. Pharmacokinetics The pharmacokinetics of dexibuprofen 400 mg and ibuprofen arginate 600 mg have been compared in 24 healthy volunteers in an open, randomized, two-period, crossover study [ ]. Ibuprofen arginate had a 45%…

See also Antihistamines General information Dexchlorpheniramine maleate [ ] is the dextrorotatory isomer of chlorphenamine. 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 Antihistamines General information Dexbrompheniramine is the dextrorotatory isomer of the first-generation H 1 antihistamine brompheniramine. 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 Amphetamines General information Dexamfetamine or (+)-amfetamine is significantly more potent than (−)-amfetamine. The use of dexamfetamine as an appetite suppressant has rapidly declined, because of appreciation of its potential for abuse and addiction. These arise mainly from euphoria, which may be followed by depression as the effect of the drug wears off. Stimulant effects were reported in 23% of 347 patients using dexamfetamine as…

See also Vasopressin and analogues General information Desmopressin ( N -deamino-8- d -arginine vasopressin, dDAVP) is a longer acting analogue of vasopressin. It has very little vasoactive effect but is antidiuretic by an action on vasopressin V 2 receptors in the renal tubule and is used to treat central diabetes insipidus and nocturnal enuresis. At higher doses desmopressin also has significant hematological effects and can significantly…

See also Antihistamines General information Desloratadine is the primary metabolite of loratadine, with superior H1 receptor binding, potent antihistaminic activity compared with the parent compound, and proven efficacy in allergic disease [ ]. It is effective and well tolerated in seasonal allergic rhinitis, including relief of nasal congestion [ ]. In a randomized, open, four-way, crossover study in 20 healthy men desloratadine was given as single…

See also Anesthetics, general General information Desflurane is identical in structure to isoflurane, except that it is halogenated completely with fluorine instead of fluorine and chlorine. Desflurane is a volatile anesthetic that combines low blood gas solubility with moderate potency and high volatility. Its pharmacology has been reviewed [ , ]. Compared with volatile anesthetics in current use, desflurane has the advantages of being practically inert…

General information Deoxyspergualin is a synthetic analogue of the immunosuppressive anti-tumor antibiotic spergualin. It contains the polyamine spermidine as part of its structure and has similar properties and mechanisms of action to ciclosporin and the calcineurin inhibitors. It has been used as an immunosuppressant in preventing and treating graft rejection [ ], in vasculitis [ , ] proliferative glomerulonephritis [ ] and systemic lupus erythematosus […

General information Denileukin diftitox is a genetically engineered fusion protein combining the enzymatically active domains of diphtheria toxin and the full-length sequence for interleukin-2 (IL-2). It targets lymphoma cells that express the high-affinity IL-2 receptor. In vitro, the retinoid X receptor retinoid bexarotene upregulated both the p55 and p75 subunits of the IL-2 receptor and enhanced five- to ten-fold the susceptibility of T cell leukemia cells…

See also Non-nucleoside reverse transcriptase inhibitors (NNRTIs) General information Delavirdine is a non-nucleoside reverse transcriptase inhibitor, which is dosed three times daily. No food restrictions apply. It is metabolized mainly by CYP3A, and so interactions with other drugs that use this metabolic pathway can occur. Organs and systems Skin The most frequent adverse effect of delavirdine is a rash, which usually occurs during the first 3…

General information Defibrotide is a polydeoxyribonucleotide extracted from mammalian organ [ ]. Its antithrombotic activity is partly ascribed to enhancement of eicosanoid metabolism, in particular increased release of prostacyclin, with ensuing vasodilatation and inhibition of platelet aggregation. An additional mechanism is activation of the fibrinolytic system, primarily increased activation of tissue plasminogen in the vessel wall. The antithrombotic potential of defibrotide has been reported in patients…

General information Deferoxamine is a polyhydroxamine acid with specific affinity for iron and, less strongly, aluminium. It is a naturally occurring siderophore produced by Streptomyces pilosus. Uses Deferoxamine is used in the treatment of acute iron poisoning and in iron storage diseases, notably beta-thalassemia [ ]. The usual regimen is 40 mg/kg/day as a subcutaneous infusion over 10–12 hours, starting at an early age (3 years).…

General information Deferiprone is an alpha-ketohydroxypyridine compound with metal-chelating properties [ ]. It is absorbed within minutes after oral administration and reaches maximum blood concentrations within 1 hour. It has a half-life of 1–2 hours, and is almost completely undetectable in blood within 5–7 hours after a single dose. Deferiprone is mostly metabolized to a glucuronide conjugate that reaches maximum blood concentrations within 1.0–1.5 hours. Deferiprone,…