See also Anesthetics, local General information Chloroprocaine is a local anesthetic, an aminoester of para-aminobenzoic acid. Its systemic toxicity is low, owing to rapid hydrolysis by plasma pseudocholinesterases [ ]. Drug studies Comparative studies Chloroprocaine was compared with lidocaine in a double-blind, randomized, crossover study [ ]. Eight healthy volunteers each received two spinal anesthetics, one with 2% lidocaine (40 mg) and the other with 2%…

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General information Chlormezanone is a tranquillizer with central muscle relaxant effects. In reaction to some case reports of serious, sometimes fatal, cutaneous toxicity and after intervention by drug regulatory authorities in some European countries, all major manufacturers have stopped production of chlormezanone. It may still be available in combination products in some Asian countries. For the most part chlormezanone causes only minor adverse effects, such as…

General information Chlorhexidine (1,1′-hexamethylene- bis [5-( p -chlorophenyl)biguanide]) is a widely used antibacterial agent with activity against Gram-positive bacteria, Gram-negative bacteria (less against Pseudomonas species), and yeasts. It was introduced as an antiseptic in the early 1950s. It has been primarily used for topical antisepsis, for example in preoperative skin disinfection, and for disinfection of materials, mainly in combination with cetrimide. Long-term experience has shown a…

See also Benzodiazepines General information Chlordiazepoxide, which has a long duration of action (half-life = 10–25 hours), is useful for the management of alcohol withdrawal and is arguably better tolerated than other benzodiazepines when used for this indication. As with diazepam, loading doses are possible and simplify clinical management. Organs and systems Metabolism A San Francisco woman with a history of diabetes and high blood pressure…

See also Thiamphenicol General information Chloramphenicol is one of the older broad-spectrum antibiotics. It was introduced in 1948 and grew in popularity because of its high antimicrobial activity against a wide range of Gram-positive and Gram-negative bacteria, Rickettsiae , Chlamydia , and Mycoplasma species. It is particularly useful in infections caused by Salmonella typhi and Haemophilus influenzae . It is mainly bacteriostatic. It readily crosses tissue…

See also Dichloralphenazone General information Chloral hydrate, which was synthesized by Justus Liebig in 1832, continues to be used for sleep disorders and for sedation before surgery or radiology, especially in children [ ]. As an alternative to the benzodiazepines, it has essentially similar properties and problems, but is associated with perhaps rather more frequent gastrointestinal disturbances, up to 7% in one large sample of children.…

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General information Cetrimonium bromide and cetrimide are quaternary ammonium antiseptics, trimethylammonium derivatives, with similar structures. Cetrimonium bromide is hexadecyltrimethylammonium. Cetrimide is a mixture of tetradecyltrimethylammonium (mostly), dodecyltrimethylammonium, and hexadecyltrimethylammonium. They dissociate in aqueous solution, forming a relatively large and complex cation, which is responsible for their surface activity, and a smaller inactive anion. They are emulsifiers and detergents and have bactericidal activity against Gram-positive and, at…

See also Antihistamines General information Cetirizine is a non-sedating metabolite of hydroxyzine [ ]. There is only minor hepatic metabolism of cetirizine [ ], which is excreted unchanged in the urine. It has not been associated with dysrhythmias. Skin reactions have been reported, and the anticoagulant activity of acenocoumarol may be potentiated [ ]. Seasonal allergic rhinitis affects about 10% of school-age children, and there is…

General information Cesium is a silver-white soft alkaline metallic element (symbol Cs, atomic number 55). It is used industrially in photoelectric cells and as a catalyst for the hydrogenation of some organic compounds. The natural resonance frequency of excited caesium atoms forms the basis of the measurement of time in atomic clocks, and the international definition of a second is the interval occupied by a specific…

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See also HMG coenzyme-A reductase inhibitors General information Weight for weight, cerivastatin is the most potent statin. Like other statins, the chance of rhabdomyolysis increases when cerivastatin is taken together with certain other drugs [ ]. Although cerivastatin is degraded by two different isoforms of P450 in the liver, and therefore should be less likely to take part in drug interactions than most of the other…

General information The cephalosporins represent a family of beta-lactam antibiotics originally derived from the naturally occurring cephalosporin C. Isolation of the cephalosporin C nucleus, 7-aminocephalosporanic acid, made it possible to introduce new groups into this molecule to obtain the current variety of compounds [ ]. Cephalosporins vary widely in their antibacterial properties, beta-lactamase stability, and pharmacokinetic behavior, but there is as yet no unequivocal classification […

See also Beta-adrenoceptor antagonists General information Celiprolol is a beta 1 -selective antagonist with partial beta 2 -agonist activity. In healthy volunteers it caused “particularly unpleasant” subjective adverse reactions, including headache, sleepiness, and feeling cold and generally unwell [ ]. However, it has beneficial effects on lipids, reducing total cholesterol by 6% and low-density lipoproteins by 10% [ ]. Whether this translates into clinical benefit is…

See also COX-2 inhibitors (coxibs) General information Celecoxib is a selective COX-2 inhibitor. Organs and systems Cardiovascular The risk of cardiovascular events with celecoxib has been studied in a systematic review and meta-analysis of randomized double-blind trials of at least 6 weeks' duration with data on serious thromboembolic events [ ]. Four placebo-controlled trials in 4422 patients were analysed. The odds ratio for myocardial infarction with…

General information The genera in the family of Celastraceae ( Table 1 ) include bittersweet and khat. Table 1 Genera of Celastraceae Canotia (canotia) Gyminda (false box) Pristimera (pristimera) Cassine (cassine) Lophopyxis Salacia Catha (khat) Maytenus (mayten) Schaefferia (schaefferia) Celastrus (bittersweet) Mortonia (saddlebush) Torralbasia (torralbasia) Crossopetalum (crossopetalum) Pachystima (pachystima) Tripterygium Euonymus (spindle tree) Paxistima (paxistima) Perrottetia (perrottetia) Catha edulis Khat, or qat, is a stimulant commonly…

See also Cephalosporins Organs and systems Nervous system Pseudotumor cerebri has been attributed to ceftriaxone [ ]. Metabolism Although possible interference with the metabolism of carnitine by pivaloylmethyl-esterified beta-lactams is a matter of concern [ ], new similar prodrug derivatives of cephalosporins continue to be marketed, as do reports that they can be given to healthy volunteers without concern [ ]. However, taking a closer look…

General information Adverse effects can arise from physical effects of catheters used for intravenous, intra-arterial, urinary, or spinal access. Adverse reactions can also occur from the latex that some catheters contain or from the antiseptics with which they are sometimes combined. Central venous catheters are reluctantly used as blood access for hemodialysis because of safety concerns and frequent complications, for example sepsis, thrombosis, and vessel stenosis.…

General information Caspofungin is approved in patients over 18 years of age for second-line therapy of definite or probable invasive aspergillosis, for primary therapy in non-neutropenic patients with invasive Candida infections, and for empirical antifungal therapy in granulocytopenic patients with persistent fever. Drug studies Observational studies Caspofungin has been investigated in a non-comparative phase II clinical study in 90 patients with invasive aspergillosis [ ]. Two…