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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…

See also Beta-adrenoceptor antagonists General information Carvedilol is a highly lipophilic non-selective beta-adrenoceptor antagonist with alpha1-blocking action, promoting peripheral vasodilatation. It also has free radical scavenging and antimitogenic effects. The safety and tolerability profile of carvedilol in heart failure appears to be reassuring [ ]. In trials in patients with congestive heart failure, carvedilol was withdrawn in only about 5% [ ]. The most common adverse…

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General information Carnitine Carnitine is a quaternary ammonium compound that is essential in transporting fatty acids from the cytosol into the mitochondria during lipid catabolism. It is found in high concentrations in red meat and dairy products. Other sources include nuts and seeds (for example, pumpkin, sunflower, and sesame seeds), legumes or pulses (beans, peas, lentils, peanuts), vegetables (artichokes, asparagus, beet greens, broccoli, Brussels sprouts, garlic,…

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General information Carisoprodol is a precursor of meprobamate, an oral anxiolytic with similarities to benzodiazepines. The spasmolytic effect of carisoprodol is thought to be due to interruption of neuronal communication within the reticular formation and spinal cord. Major adverse effects are sedation and drowsiness. Because of an increased risk of abuse and addiction [ , ] carisoprodol was withdrawn from many countries in 2008. However, in…

General information Many aspects of the pharmacology, clinical pharmacology, and adverse effects, adverse reactions, and interactions of cardiac glycosides have been reviewed [ ]. Note on nomenclature The most commonly used cardiac glycosides, digoxin and digitoxin, are derived from foxgloves, respectively Digitalis lanata and Digitalis purpurea . For this reason they are generally known as “digitalis.” Most other cardiac glycosides, such as ouabain and proscillaridin, do…

General information Carboxypeptidases are regulatory peptide-processing enzymes that are secreted by human cells [ ]. Carboxypeptidase G2, which is produced by Pseudomonas strain RS-16, hydrolyses the glutamate residue from methotrexate and other folate analogues [ ] and rapidly hydrolyses methotrexate to the inactive metabolite DAMPA (4-[[2,4-diamino-6-(pteridinyl)methyl]-methylamino]-benzoic acid) and glutamate. It has been used when unexpected toxicity or renal insufficiency occurs during high-dose methotrexate therapy [ ],…

See also Prostaglandins General information Carboprost is a 15-methylated analogue of PGF 2α . It is used in termination of pregnancy, in the management of labor, and to treat postpartum hemorrhage and uterine atony. 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

General information The carbonic anhydrase inhibitors, of which acetazolamide, a non-competitive inhibitor, is the prototype, are not suitable for normal diuretic use, because tolerance soon develops. However, they are well suited to brief intermittent use, particularly in the relief of glaucoma and in the prevention of acute mountain sickness. Acetazolamide and methazolamide should be used with caution in the long-term control of glaucoma because of its…

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