General information Bithionol is a chlorinated bisphenol with antihelminthic properties. It is active against most trematodes and has been recommended as preferable to praziquantel in fascioliasis and paragonimiasis, proving both effective and well tolerated. Bithionol also has antibacterial properties and was for this reason included for a time in cosmetic formulations. However, when given topically it caused photosensitivity reactions, and this form of application has been…

General information The development of bisphosphonates for clinical purposes began with the discovery that inorganic pyrophosphate is present in blood and urine and inhibits the precipitation of calcium and phosphate [ ]. Derivatives of pyrophosphate had been widely used for industrial purposes, because they inhibit the precipitation of calcium carbonate. Their principal use was as antiscaling additives in washing powders, water, and oil brines, to prevent…

See also Beta-adrenoceptor antagonists General information Bisoprolol is a highly selective β 1 -adrenoceptor antagonist. Its adverse effects profile is similar to that of atenolol [ ], and despite theoretical benefits there is no convincing clinical evidence that bisoprolol has an advantage [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

General information Bismuth is a brittle reddish-white metallic element (symbol Bi; atomic no. 83). It enjoyed great popularity up to the early 20th century, and thereafter continued to be used in the form of insoluble bismuth compounds, used for their supposed effects on the gastric wall as antacids, protective coatings, or inhibitors of proteolytic activity. The use of bismuth was particularly heavy in Australia, where bismuth…

See also Anticholinergic drugs General information Biperiden is given orally in doses rising from 2 to 6 mg/day, more being given in individual cases. Of the anticholinergic effects that biperiden can cause, drowsiness seems to be one of the most prominent; biperiden should not be given to patients who have to drive motor vehicles. A dose of 12 mg has been reported to precipitate involuntary movements…

See also Vitamins General information Biotin is a water-soluble vitamin of the B complex (vitamin B 10 , also called vitamin H), and is found in many foods, especially eggs and liver. Biotin is involved in the action of four carboxylases: acetyl-CoA carboxylase, which catalyses the binding of bicarbonate to acetyl-CoA to form malonyl-CoA in the synthesis of fatty acids; pyruvate carboxylase, which is involved in…

See also Prostaglandins General information Bimatoprost is an analogue of PGF 2α , used to treat glaucoma. It is believed to lower intraocular pressure by increasing the outflow of aqueous humor through both the trabecular meshwork and uveoscleral routes. Drug studies 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…

General information The bile acids are used in the long-term treatment of cholesterol gallstones. Ursodeoxycholic acid is the 7-epimer of chenodeoxycholic acid. Tauroursodeoxycholic acid is a derivative of ursodeoxycholic acid. Drug studies Observational studies In a retrospective review of medical records over 12 months, ursodeoxycholic acid (20 mg/kg/day) reduced serum bilirubin concentrations in four of five children with cholestasis and hyperbilirubinemia [ ]. No adverse reactions…

General information Metformin (rINN) is the only biguanide commonly used; buformin (rINN) and phenformin (rINN) have been withdrawn in many countries [ ] because of dangerous adverse effects. However, they are still available in a few countries, and with increasing travel, adverse effects of drugs no longer available in one country can occur if the drug is obtained elsewhere. Biguanides as a group [ ] and…

See also Antiandrogens General information Mason has reviewed the role of antiandrogens in the treatment of prostate cancer, arguing that with earlier initiation of therapy the long-term adverse effects of castration need to provide the standard by which the acceptability of drugs such as bicalutamide is judged [ ]. There is now evidence that bicalutamide confers significant overall survival benefit when used as an adjuvant to…

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General information Bevacizumab is an anti-angiogenic agent that has been rationally designed to target vascular endothelial growth factor (VEGF), a key mediator in angiogenesis. It was approved by the FDA in February 2004 for the first-line treatment of metastatic colorectal cancer in combination with 5-fluorouracil-based chemotherapy, and is the first approved agent to target angiogenesis [ ]. The principal adverse events seen in clinical trials are…

General information Bethanechol is a quaternary ammonium compound that shares both the muscarinic and nicotinic actions of acetylcholine but it is much more slowly deactivated. It has been used to treat clomipramine-induced orgasmic dysfunction [ ], as well as decrease the duration of urethral catheterization in patients who underwent type III radical hysterectomy [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full…

General information Beta-lactamases are genetically and structurally closely related to penicillin-binding proteins. Their production by bacteria is a major mechanism of resistance to the action of beta-lactam antibiotics. Drugs have therefore been developed that inhibit beta-lactamase, as a way of overcoming this resistance [ ]. They are beta-lactam compounds with particularly high affinities for beta-lactamases [ , ], which therefore act as competitive inhibitors of beta-lactamases.…

General information The beta-lactam antibiotics still comprise roughly half of the antibiotic market worldwide. The common structure that defines the whole family of beta-lactam antibiotics is the four-membered, highly reactive beta-lactam ring, which is essential for antimicrobial activity [ ]. The following simplifying classification is practical: 1. penicillins; 2. cephalosporins; 3. monobactams (containing no second ring system besides the beta-lactam ring); 4. carbapenems. In addition, beta-lactamase…

General information Many beta-adrenoceptor antagonists (beta-blockers) have been developed, and their adverse effects have been comprehensively reviewed [ ]. The spectrum of adverse effects is broadly similar for all beta-blockers, despite differences in their pharmacological properties, notably cardioselectivity, partial agonist activity, membrane-stabilizing activity, and lipid solubility (see Table 1 ). The influence of these properties is mentioned in the general discussion when appropriate and is summarized…

See also individual agents General information Beta 2 -adrenoceptor agonists are widely used in asthma and have inevitably been associated with a number of problems. Some of these are attributable to the drugs themselves, others to the formulations in which they are given. Combination therapy Asthma guidelines recommend adding long acting β 2 -adrenoceptor agonists (LABAs) to inhaled glucocorticoids at step 3 in adults and adolescents…

See also Herbal medicines General information The genera in the family of Berberidaceae ( Table 1 ) include lychee and soapberry. Table 1 Genera of Berberidaceae Achlys (achlys) Epimedium (epimedium) Podophyllum (may apple) Berberis (barberry) Jeffersonia (jeffersonia) Vancouveria (insideout flower) Caulophyllum (cohosh) Mahonia (barberry) Diphylleia (umbrellaleaf) Nandina (nandina) Berberis vulgaris Barberry (pipperidge bush) is a vernacular name for Berberis vulgaris (the European barberry), but it can…

See also Prostaglandins General information Beraprost is a stable, orally active analogue of PGI 2 . It has been tested in patients with intermittent claudication in a randomized, placebo-controlled trial [ ]. Beraprost improved walking distance more often than placebo. It also reduced the incidence of critical cardiovascular events, but the trial was not powered for statistical validation of this effect. As with iloprost, headache and…

See also Calcium channel blockers General information Bepridil is an antidysrhythmic drug with unusual pharmacological properties in that it belongs to both class I and class IV. In other words, it blocks both the fast inward sodium current and the slow outward calcium current in excitable cardiac cells [ , ]. It was withdrawn because of its serious prodysrhythmic effects. Bepridil has been the subject of…