See also Individual agents General information The major coagulation and fibrinolytic proteins are listed in Table 1 . Table 1 Proteins involved in coagulation and fibrinolysis Protein (synonym) Function Coagulation proteins Factor I (fibrinogen) Activated to fibrin Factor II a (prothrombin) Activated to thrombin Factor III (tissue thromboplastin) Extrinsic pathway Factor IV (calcium) Co-factor Factor V (Ac-globulin; proaccelerin) Converts prothrombin to thrombin Factor VI (unassigned) Factor…

General information The genera in the family of Clusiaceae ( Table 1 ) include St John’s wort and brindleberry (gamboge). Table 1 Genera of Clusiaceae Calophyllum (calophyllum) Hypericum (St John’s wort) Platonia (platonia) Clusia (attorney) Mammea (mammea) Triadenum (marsh St John’s wort) Garcinia (sap tree) Pentadesma (pentadesma) Garcinia gambogia (brindleberry, gamboge) Liver There have been many reports of hepatotoxicity associated with herbal products used for weight…

See also Neuroleptic drugs General information Clozapine is a dibenzodiazepine, an atypical neuroleptic drug with a high affinity for dopamine D4 receptors and a low affinity for other subtypes [ ]. It is also an antagonist at alpha-adrenoceptors, 5-HT2A receptors, muscarinic receptors, and histamine H1 receptors. Drug studies Observational studies Rates of hospitalization with clozapine have been analysed by Novartis, the manufacturers, based on two retrospective…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Cloximate is an oxime ether derivative non-steroidal anti-inflammatory drug (NSAID) [ ]. It was approved in only a few countries, and experience with it is limited. The usual adverse effects of NSAIDs (headache, insomnia, drowsiness, anorexia, gastrointestinal symptoms, a transient increase in blood urea, leukopenia, thrombocytopenia, and rashes) have been reported [ ]. You’re Reading a Preview Become…

See also Neuroleptic drugs General information Clotiapine is a dibenzothiazepine neuroleptic drug [ ]. 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 here

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General information Clopidogrel is a thienopyridine compound, structurally related to ticlopidine, which inhibits ADP-induced platelet aggregation [ ]. Its efficacy in stroke, myocardial infarction, and other vascular causes of death has been demonstrated in the CAPRIE Study [ ], a large trial in which 9599 patients were treated with clopidogrel. The most frequent adverse effects were gastrointestinal symptoms, although they were not significantly more frequent than…

General information The presynaptic α-adrenoceptor agonists, particularly methyldopa and clonidine, are agonists at presynaptic α 2 -adrenoceptors. Guanabenz, guanfacine, and tiamenidine appear to be qualitatively similar to clonidine; clear evidence of quantitative differences remains to be confirmed. The mechanism of action of these drugs depends on reducing sympathetic nervous outflow from the nervous system by interference with regulatory neurotransmitter systems in the brainstem. Because none of…

General information Clonazepam is a benzodiazepine that is used predominantly in epilepsy, panic disorder, and mania, and also appears to be effective in relieving antipsychotic drug-induced akathisia [ ]. The use of clonazepam in psychiatric disorders is complicated by significant drowsiness in a majority of patients, and additional behavioral problems in children [ ]. Although they are commonly used in the adjunctive management of chronic pain,…

See also Tricyclic antidepressants General information Clomipramine is the imipramine analogue of chlorpromazine. However, while the difference between chlorpromazine and promazine is large, adding a chloride atom to imipramine hardly affects its actions. Most trials have failed to show any superiority of the chlorinated compound over imipramine. The adverse reactions profile is similar [ ], but drowsiness, confusion, and “feeling awful” are commonly reported [ ].…

General information Clomiphene is a very weak non-steroidal estrogen; it blocks the feedback effect of endogenous estrogens on the pituitary, promoting the further secretion of gonadotropins. The primary use of clomiphene in women is in the induction of ovulation. In men, it has been used to treat infertility in view of its ability to increase endogenous production of testosterone [ ]. Drug studies In one large…

General information Clomethiazole is a sedative-hypnotic that has been used extensively in the treatment of alcohol withdrawal, as well as for inducing sedation and sleep in the elderly. In addition to GABA enhancement, which it shares with the benzodiazepines, clomethiazole also enhances the activity of another inhibitory amino acid, glycine. Whether this property is clinically important is uncertain. As well as the expected effects of sedation…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information The NSAID clometacin is an indometacin derivative. Because of the risk of long-term or repeated use of clometacin, the French authorities restricted its use to prescriptions for no more than 8 days. It should no longer be used. Organs and systems You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become…

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See also Antituberculosis drugs General information Clofazimine is weakly bactericidal against Mycobacterium leprae . It is active in chronic skin ulcers (Buruli ulcer) and partly against Mycobacterium avium intracellulare. The usual adult dosage is 50–100 mg At higher doses, its anti-inflammatory effect seems to prevent the development of acute reactions, such as erythema nodosum leprosum. Clofazimine is a strongly lipophilic dye and accumulates in tissues, especially…

General information Clofarabine (Clolar®) is a purine nucleoside analogue, which has been approved for the treatment of relapsed or refractory acute lymphoblastic leukemia in children after at least two prior regimens. The active 5′-triphosphate metabolite inhibits DNA synthesis by reducing cellular pools of deoxynucleotide triphosphate. In addition, drug-related inhibition of ribonucleotide reductase and termination of DNA chain elongation contribute to clofarabine’s antineoplastic activity. After intravenous administration…

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See also Benzodiazepines General information Clobazam, a 1,5-benzodiazepine, differs in its chemical structure from most other benzodiazepines. It has been claimed to have less sedative effects for its effective anticonvulsant and anti-anxiety effects [ ]. Whether because of tolerance or not, clobazam tends to be less sedative than clonazepam. Both the therapeutic and adverse effects of clobazam have been related to its major metabolite N-desmethylclobazam, the…

See also Anticholinergic drugs General information The anticholinergic drug clidinium is a component of Librax (chlordiazepoxide 5 mg plus clidinium bromide 2.5 mg); the dose used is sufficient to produce typical anticholinergic adverse effects. Since it is combined with a benzodiazepine, it is most unwise to allow patients taking Librax to drive motor vehicles or to ingest alcohol. Organs and systems You’re Reading a Preview Become…