See also HMG coenzyme-A reductase inhibitors General information Atorvastatin is an HMG Co-A reductase inhibitor. Pooled data from 21 completed and 23 continuing trials representing 3000 patient-years have shown that constipation, flatulence, dyspepsia, abdominal pain, headache, and myalgia occur in 1–3% of patients. Under 2% of atorvastatin-treated patients discontinued treatment because of an adverse event [ ]. Serious events in this review amounted to one patient…

General information Atomoxetine is a non-stimulant noradrenaline reuptake inhibitor that is efficacious in the treatment of ADHD [ ]. Sudden deaths of children and adolescents taking Adderall XR® have led to the need to screen children for risks of heart defect before beginning this stimulant medication. The label for atomoxetine has been altered to include a boxed warning and additional warning statements regarding an increased risk…

See also Beta-adrenoceptor antagonists General information Although atenolol, a hydrophilic cardioselective beta-adrenoceptor antagonist with no partial agonist activity, is generally regarded as one of the safest beta-blockers, severe adverse effects are occasionally reported. These include profound hypotension after a single oral dose [ ], organic brain syndrome [ ], cholestasis [ ], and cutaneous vasculitis [ ]. Organs and systems You’re Reading a Preview Become a…

General information Atazanavir is an inhibitor of HIV protease. It is used once daily in a dose of 400 mg or in combination with ritonavir as atazanavir + ritonavir 300 + 100 mg/day [ ]. Organs and systems Metabolism In an analysis of a randomized comparison of atazanavir and nelfinavir in 467 patients cardiovascular risk modelling was used to estimate the impact of dyslipidemia [ ].…

See also Herbal medicines General information There are about 600 genera in the family of Asteraceae (formerly Compositae), including various types of asters (daisies), arnica, chamomile, goldeneye, marigold, snakeroot, tansy, thistle, and wormwood. Delayed hypersensitivity reactions to the Asteraceae (Compositae) can arise from sesquiterpene lactones. To detect contact allergy to sesquiterpene lactones, a mixture of lactones (alantolactone, costunolide, and dehydrocostus lactone) is used. However, Compositae contain…

See also Antihistamines General information Astemizole is a second-generation antihistamine that has been withdrawn from the market because of the association with life-threatening cardiac arrhythmias. 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 Asparaginase is an enzyme that acts by breaking down the amino acid L-asparagine to aspartic acid and ammonia. It interferes with the growth of malignant cells that cannot synthesize L-asparagine. Its action is reportedly specific for the G1 phase of the cell cycle. It is used mainly for the induction of remissions in acute lymphoblastic leukemia. Nomenclature Colaspase and crisantaspase are the British Approved…

Genera in the family of Asparagaceae ( Table 1 ) include asparagus, aspidistra, and hyacinth. Table 1 Genera of Asparagaceae Acanthocarpus (popcornflower) Drimiopsis (drimiopsis) Parsonsia (silkpod) Agave (century plants) Eriospermum (eriospermum) Peliosanthes (tropical lily of the valley) Albuca (slime lilies) Eustrephus (wombat berry) Polygonatum (King Solomon's-seal) Asparagus (asparagus) Fusifilum (fusifilum) Rohdea (sacred lily) Aspidistra (aspidistra) Hosta hosta Romnalda (romnalda) Bowiea (climbing onion) Hyacinthoides (hyacinth) Ruscus (broom)…

General information The Average Daily Requirement of ascorbic acid is 30 mg. The Population Reference Intake is 45 mg/day for adults. The Lowest Threshold Intake, for which considerable evidence exists, is 12 mg/day [ ]. These estimates have been supported by the relevant committee of the European Union. A communication from the US National Academy of Sciences, as part of the revision of US Dietary Reference…

See also Clusiaceae ; Herbal medicines General information Genera in the family of Asclepiadaceae ( Table 1 ) include milkweed and periploca. Many of them contain cardiac glycosides. Table 1 Genera of Asclepiadaceae Araujia (araujia) Asclepias (milkweed) Calotropis (calotropis) Cryptostegia (rubbervine) Cynanchum (swallow-wort) Funastrum (twinevine) Gonolobus (gonolobus) Hoya (hoya) Marsdenia (marsdenia) Matelea (milkvine) Metaplexis (metaplexis) Morrenia (morrenia) Xysmalobium You’re Reading a Preview Become a Clinical Tree…

General information Acesulfame Acesulfame is an artificial sweetener derived from aceto-acetic acid. It is used in a wide range of non-medicinal products [ ]. Aspartame Aspartame is a dipeptide that is used as an artificial sweetener. It is completely hydrolysed in the gastrointestinal tract to methanol, aspartic acid, and phenylalanine [ ]. Aspartame appears to be a safe sweetener, and despite numerous studies of its safety…

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…