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,…
General information Deferasirox (ICL670), a hydroxyphenyltriazole derivative, is a tridentate selective iron chelator and an N-substituted bis-hydroxyphenyltriazole compound for oral use, available as 125, 250, and 500 mg tablets and administered in a daily dose of 20–50 mg It is rapidly absorbed (about 70%), highly bound to albumin, has a plasma half-life of 11–19 hours, and probably undergoes enterohepatic recirculation [ ]. Two molecules of deferasirox…
General information Decitabine (5-aza-2′-deoxycytidine) is structurally very similar to azacitidine [ ]. Both drugs have promising activity against acute myeloblastic leukemia and myelodysplastic syndrome. In addition, decitabine has significant activity against chronic myeloid leukemia. It is rapidly metabolized in the liver by cytidine deaminase, which explains its short half-life of 8–30 minutes. In an intravenous dose of 100 mg/m 2 over 6 hours every 12 hours…
General information Decamethonium, a depolarizing neuromuscular blocker, is little used nowadays. A dose of 3 mg provides adequate relaxation for intra-abdominal surgery for about 15 minutes, supplements being required at intervals of 10–30 minutes. It is not as rapid in onset of action as suxamethonium. It is not hydrolysed by plasma cholinesterase, but is eliminated by the kidneys [ ]. Tachyphylaxis occurs and a phase II…
General information Dasatinib (BMS-354825), a thiazole carboximide derivative, is structurally related to imatinib. It targets src kinase and imatinib-resistant bcr–abl kinase and has impressive activity in patients with chronic myeloid leukemia or Philadelphia chromosome-positive acute lymphoblastic leukemia [ , ]. Although dasatinib has been approved for these indications in a dosage of 70 mg bd, the search for the optimal dose regimen continues [ ]. Preliminary…
General information Daptomycin is a novel lipopeptide antibiotic, an inhibitor of lipoteichoic acid synthesis, with potent bactericidal activity against most clinically important Gram-positive bacteria, including resistant strains [ , ], such as meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci and was the first inhibitor of lipoteichoic acid synthesis. Daptomycin was initially developed in the late 1980s and early 1990s [ ] but was ultimately shelved owing to…
General information Dapsone is 4,4-diaminodiphenylsulfone (DDS, avlosulfone, disulfone) [ ]. It is a bacteriostatic antileprosy drug with a sulfonamide-like structure. The dosage should be 50–100 mg/day in adults [ ]. In children aged 3–5 years, the dosage should be reduced according to weight to, for example, 25 mg/day [ ]. Studies of patients with borderline leprosy have suggested that dapsone has mild immunosuppressive effects [ ].…
General information Dantrolene, a hydantoin derivative, is well established in clinical practice, being of greatest value for the reduction of clonus and involuntary muscle spasms [ , ]. The recommended oral doses for the treatment of spastic conditions are 75–400 mg Dantrolene [ , ] is the agent of choice for treatment of malignant hyperthermia and greatly reduces the mortality to under 10% if given in…
General information Danazol is a weak androgen and can thus exert the adverse effects of androgens, but because it inhibits LH and FSH secretion it can also elicit menopausal-like symptoms. However, from time to time it has other types of adverse effect. It has been used with some success in the management of pelvic pain associated with endometriosis [ ], heavy menstrual bleeding [ ], and…
General information Danaparoid is a low molecular heparinoid consisting of a mixture of sulfated glycosaminoglycans (heparan, dermatan, and chondroitin sulfates). It has an antithrombotic effect via antithrombin III-mediated inhibition of factor Xa and to a lesser extent through inhibition of factor IIa. The ratio of antifactor Xa to antifactor IIa is over 20. Danaparoid is as effective as heparins in inhibiting the formation of thrombi. Its…