General information Batanopride is a substituted benzamide with 5-HT 3 receptor antagonist activity. It is claimed to be free of dopaminergic properties. Clinical studies have concentrated on its use in patients suffering severe vomiting as a result of cytostatic therapy, but have run into problems because of poor tolerance at effective doses. The most important dose-limiting adverse effect is severe hypotension [ ], but diarrhea and…

See also Monoclonal antibodies General information Basiliximab is a chimeric (human/mouse) anti-interleukin-2 receptor monoclonal antibody used in the prophylaxis of acute renal transplant rejection. It acts by binding the alpha chain of interleukin-2 receptors on activated T lymphocytes. Initially positive results in phase III trials have not been generally confirmed [ , ]. Compared with placebo, basiliximab was not associated with any specific adverse effects in…

General information Basidiomycetes are fungi that include mushrooms, puffballs, and bracket fungi. 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 Calcium channel blockers General information Barnidipine is a dihydropyridine with antihypertensive activity and tolerability similar to that of other calcium antagonists of the same class. The most frequent adverse events are edema, headache, and flushing, but barnidipine does not cause reflex tachycardia [ ]. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you…

General information Oral barium sulfate is theoretically non-toxic, but constipation and abdominal pain are not uncommon after barium meals or barium enemas [ ]. The main risk is that collections of barium will remain in the colon; they can persist for 6 weeks or longer in elderly patients or cases of colonic obstruction; barium fecoliths may even have to be removed surgically. Prolonged stasis of barium…

See also Methohexital ; Phenobarbital ; Primidone ; Thiopental sodium General information Barbituric acid was synthesized by Adolph von Baeyer in 1864, and a derivative, 5,5-diethylbarbituric acid was used as a hypnotic by Josef von Mering in 1885, following experiments with the related compound diethylacetylurea [ ]. Many analogues were subsequently synthesized, and a short list is given in Table 1 . Others include allobarbital (diallylbarbitone),…

See also Beta 2 -adrenoceptor agonists General information The efficacy of long-acting β 2 -adrenoceptor agonists in patients with chronic obstructive pulmonary disease remains unclear, but their role in treatment regimens, particularly in comparison with oral theophylline, has been reviewed [ ]. Bambuterol is a β 2 -adrenoceptor agonist, a biscarbamate ester prodrug of terbutaline [ , ]. It is available as the hydrochloride salt in…

General information Baclofen is a chlorophenyl derivative of gamma-aminobutyric acid (GABA), a naturally occurring inhibitory neurotransmitter in the brain and spinal cord. It is of proven therapeutic value in reducing the severity of flexor or extensor spasms resulting from spinal cord injury or disease. The recommended oral dose is 5 mg tds, which can be carefully increased; however, the total daily dose should not exceed 80…

General information Bacitracin has mostly dermatological uses. It can cause allergic reactions of the delayed type. A shock-like picture after local application has occurred in a hypersensitive individual [ ]. Since bacitracin is nephrotoxic, it should not be given intraperitoneally to patients with renal impairment. Drug studies Observational studies In a randomized study of the effects of a triple antibiotic ointment (polymyxin B + bacitracin +…

See also Vaccines General information Bacille Calmette–Guérin (BCG) vaccine is a suspension of living tubercle bacilli of the Calmette–Guérin strain. It is used mainly prophylactically against tuberculosis, but also as a means of stimulating the immune response in malignant disease. There are variations in the characteristics of BCG vaccines, depending on the strain of BCG derived from the original BCG strain and employed for vaccine production.…

See also Macrolide antibiotics General information The overall adverse reactions rate for azithromycin is 0.7% [ ]. Only diarrhea, nausea, and abdominal pain occurred in over 1% of patients. Other adverse effects that were reported from clinical trials in adults are palpitation, angina, dyspepsia, flatus, vomiting, melena, jaundice, vaginal candidiasis, vaginitis, nephritis, dizziness, headache, vertigo, somnolence, and fatigue. Azithromycin has also been reported to cause angioedema…

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See also Antihistamines General information Azelastine is a second-generation antihistamine, a phthalazinone compound with antiallergic and bronchodilator properties [ ]. It is available as a nasal spray and in oral form for the treatment of allergic rhinitis and asthma as well as dermatoses. It reduces rhinorrhea, sneezing, and nasal congestion. Azelastine is effective against exercise-induced asthma and allergen challenge in patients with extrinsic asthma. It can…

See also Tioguanine General information Azathioprine, 6-mercaptopurine, and 6-thioguanine are thiopurines. Azathioprine is a prodrug of mercaptopurine and thioguanine is an active metabolite. Thioguanine is covered in a separate monograph. Azathioprine, 6-(1-methyl-4-nitroimidazole-5-yl)-thiopurine, is converted non-enzymatically to mercaptopurine ( Figure 1 ) and subsequently to thioguanine nucleotides. It is therefore not unexpected for patients who have experienced adverse reactions to azathioprine to have similar reactions to the…

See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Azapropazone is structurally related to phenylbutazone and probably shares the same adverse effects: gastrotoxicity, skin reactions, headache, vertigo, edema, and renal impairment. A review of a very large series described azapropazone adverse effects in 1724 patients (18%), causing withdrawal in 3.7%. Surprisingly, however, there were no phenylbutazone-type blood dyscrasias [ ]. Azapropazone should be prescribed only for patients…

General information Azacitidine has been approved for the treatment of myelodysplastic syndrome. It inhibits DNA methyltransferase, resulting in hypomethylation of DNA and direct cytotoxicity in abnormal hemopoietic cells in the bone marrow. The recommended dosage is 75 mg/m 2 /day given subcutaneously for 7 days every 4 weeks [ ]. The absolute systemic availability after subcutaneous administration is about 89%. After intravenous and subcutaneous administration the…

General information Avoparcin is a glycopeptide antibiotic (see also teicoplanin and vancomycin), a large molecule that is produced by a variety of environmental micro-organisms, which may therefore contain genes that code for antimicrobial drug resistance. It is mostly active against Gram-positive bacteria, such as enterococci and staphylococci. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If…

See also Anticholinergic drugs General information Atropine is an anticholinergic drug that is mainly used today in premedication and occasionally to treat bradycardia in the acute phase of myocardial infarction. Organs and systems Cardiovascular In a classic study, more than a generation ago, of patients given atropine sulfate intravenously as premedication in a total dose of 1 mg, dysrhythmias occurred in over one-third of the subjects,…

See also Neuromuscular blocking agents General information Atracurium is a muscle relaxant with approximately one-fifth the potency of pancuronium (initial doses of 0.3–0.6 mg/kg and maintenance doses of 0.2 mg/kg being commonly used), an onset of action of 1.2–4 minutes (depending on the dose and the investigator), a medium duration of effect similar to (or slightly longer than) vecuronium, a rapid spontaneous recovery (slightly longer than…

General information Atovaquone is a hydroxynaphthaquinone that is effective in the prevention and treatment of murine Pneumocystis jirovecii pneumonitis. It also has effects against Toxoplasma gondii and Plasmodium falciparum . Food increases its absorption. The maximum serum concentration is dose-dependent, but absorption is reduced at doses above 750 mg. The maximum concentration occurs after 4–6 hours, with a second peak 24–96 hours later, suggesting enterohepatic cycling.…