See also Anesthetics, local General information Articaine is an aminoamide that also contains an ester group, which is rapidly hydrolysed by plasma esterases. It is 4-methyl-3([2-(propylamino)propionamido)]-2-thiophenecarboxylic acid, methyl ester hydrochloride. The thiophene group increases its lipid solubility while the ester group enables it to undergo plasma esterase hydrolysis as well as hepatic enzyme metabolism. Articaine is formulated as a 4% solution with adrenaline. It is the…

General information The herb Qinghaosu ( Artemisia annua ) has been known to Chinese medicine for centuries and was used in the treatment of fevers, in particular malaria fever; it is not clear why it did not become more widely used elsewhere. The plant can be grown in locations other than China, and field studies in propagating and growing the plant are being carried out in…

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General information Arsenic is a metallic element (symbol As; atomic no. 33), which exists in several allotropic forms. Various ores contain crystalline forms of arsenic salts: cobaltite contains cobalt arsenic sulfide; mispickel (arsenopyrite) iron arsenic sulfide; orpiment arsenic trisulfide; proustite (ruby silver ore) silver arsenic sulfide; realgar arsenic sulfide; and tennantite copper arsenic sulfide. Arsenic has a long history of medicinal uses. Thomas Fowler introduced it…

General information The development of newer antiestrogens continues in the hope of attaining a better benefit to harm balance, particularly in the adjuvant treatment of early breast cancer after the menopause [ , ]. The third-generation aromatase inhibitors inhibit the production of estrogen [ ]. Anastrozole and letrozole are non-steroids, and exemestane (a steroid with some androgenic activity) is a derivative of the androgen androstenedione, the…

See also Herbal medicines General information The family of Aristolochiaceae contains two genera: 1. Aristolochia (dutchman’s pipe). 2. Asarum (wild ginger). Hexastylis (heartleaf), previously categorized as a separate genus, is now classed as a subgenus of Asarum . Aristolochia species Plants belonging to the genus of Aristolochia are rich in aristolochic acids and aristolactams. In the UK, the long-term (2 and 6 years) use of Aristolochia…

See also Neuroleptic drugs General information Aripiprazole (Abilify®), an antipsychotic drug, has been said to be the prototype of a new third generation, the so-called “dopamine–serotonin system stabilizers” [ ]. Its mechanism of action differs from previous typical and atypical antipsychotic drugs; it is a partial agonist at D 2 receptors, with properties of an agonist and antagonist in animal models of dopaminergic hypoactivity and hyperactivity…

General information l -Arginine is an amino acid that is commonly used to sustain and promote healthy heart function. According to Health Canada, patients who have previously had a heart attack should not use arginine supplements, because of recent evidence that there is an increased risk of death in these circumstances [ ]. Drug studies Placebo-controlled studies In a randomized, double-blind, placebo-controlled study, 153 patients were…

See also Direct thrombin inhibitors General information Argatroban is a direct thrombin inhibitor that has been used to treat thrombosis in patients with heparin-induced thrombocytopenia [ ] or heparin allergy [ ]. However, in some patients overanticoagulation has occurred and care with dosage is clearly required [ ]. Its effects can be monitored using the activated partial thromboplastin time for low doses and the activated clotting…

See also Herbal medicines General information Genera in the family of Arecaceae ( Table 1 ), also known as Palmaceae, include various types of palm. Table 1 Genera of Arecaceae Acoelorraphe (palm) Cocos (coconut palm) Pritchardia (pritchardia) Acrocomia (acrocomia) Copernicia (carnauba wax palm) Pseudophoenix (pseudophoenix) Aiphanes (aiphanes) Corypha (talipot palm) Ptychosperma (ptychosperma) Archontophoenix (archontophoenix) Dypsis (butterfly palm) Raphia (raffia palm) Areca (areca) Elaeis (oil palm) Rhapidophyllum…

See also Herbal medicines General information Genera in the family of Araliaceae ( Table 1 ) include aralia, ginseng, and ivy. Table 1 Genera of Araliaceae Aralia (spikenard, angelica) Kalopanax (castor aralia) Pseudopanax (pseudopanax) Cheirodendron (cheirodendron) Meryta (meryta) Reynoldsia (reynoldsia) Dendropanax (dendropanax) Munroidendron (munroidendron) Schefflera (schefflera) Eleutherococcus (ginseng) Oplopanax (oplopanax) Tetraplasandra (tetraplasandra) Fatsia (fatsia) Polyscias (aralia) Tetrapanax (tetrapanax) Hedera (ivy) Panax (ginseng) You’re Reading a Preview…

General information Because of increased mortality (see Death below), aprotinin was temporarily withdrawn worldwide in 2007, after consultation with the German Federal Institute for Drugs and Medical Devices (BfArM), the US Food and Drug Administration (FDA), Health Canada, and other health authorities, pending the final results from the Canadian BART trial; it was permanently withdrawn in May 2008 [ , ]. Aprotinin is a fibrinolytic agent,…

See also Antidysrhythmic drugs General information The pharmacology, clinical pharmacology, clinical uses, efficacy, and adverse effects of aprindine have been extensively reviewed [ ]. The adverse effects of aprindine most commonly affect the central nervous system. However, other less common but serious and potentially fatal adverse effects (neutropenia and liver damage) occur, and these limit its usefulness. Aprindine is metabolized by CYP2D6, and one would therefore…

General information Aprepitant is a neurokinin-1 (NK 1 ) receptor antagonist. Substance P, a regulatory peptide that is the preferred endogenous ligand at NK 1 receptors, is found in the gastrointestinal tract (vagal afferents) and areas of the central nervous system thought to be involved in the vomiting reflex (including the nucleus tractus solitarius and area postrema). Aprepitant is a substrate and a weak inhibitor of…

General information Apomorphine, a very potent non-selective dopamine agonist, which acts on both D1 and D2 receptors, has been used with some success in Parkinson’s disease, particularly in patients with severe long-term adverse effects of levodopa. Because of first-pass metabolism it has to be used subcutaneously, sublingually, or intranasally. Its adverse effects resemble those of levodopa. Yawning, somnolence, nausea, and vomiting can all result from the…

See also Herbal medicines General information Genera in the family of Apocynaceae ( Table 1 ) include dogbane, oleander, and periwinkle. Table 1 Genera of Apocynaceae Adenium (desert rose) Landolphia (landolphia) Allamanda (allamanda) Lepinia Alstonia (alstonia) Macrosiphonia (rock trumpet) Alyxia (alyxia) Nerium (oleander) Amsonia (blue star) Ochrosia (yellow wood) Anechites (anechites) Pentalinon (pentalinon) Angadenia (pineland golden trumpet) Plumeria (plumeria) Apocynum (dogbane) Prestonia (prestonia) Carissa (carissa) Pteralyxia…

See also Factor Xa inhibitors, direct General information Apixaban is a follow-up compound with high oral systemic availability (50–85%) and a half-life of about 12 hours. Apixaban is cleared through renal (25%) and fecal routes and is given twice daily. It has been tested in the prevention and treatment of venous thromboembolism, for the prevention of stroke or systemic embolism in patients with atrial fibrillation, and…

See also Herbal medicines General information There are about 100 genera in the family of Apiaceae (formerly Umbelliferae), including a variety of spices and vegetables, such as angelica, anise, carrot, celery, chervil, coriander, cumin, dill, fennel, parsley, and parsnip ( Table 1 ). Table 1 The genera of Apiaceae Aciphylla (fierce Spaniard) Aegopodium (goutweed) Aethusa (aethusa) Aletes (Indian parsley) Ammi (ammi) Ammoselinum (sand parsley) Anethum (dill)…

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See also Hymenoptera venoms General information Antivenoms (also called antivenins) have been developed against a variety of venomous creatures, including rattlesnakes, scorpions, and snakes. Scorpion antivenom There are over 1700 species of scorpions worldwide, of which those in the Buthidae family are the most dangerous. Scorpion venoms contain many toxins with different pharmacological actions, and antitoxins to the whole venoms are required rather than antidotes to…