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See also Antidysrhythmic drugs General information Amiodarone is highly effective in treating both ventricular and supraventricular dysrhythmias [ ]. Its pharmacology, therapeutic uses, and adverse effects and interactions have been extensively reviewed [ ]. General adverse effects and reactions Amiodarone prolongs the QT interval and can therefore cause dysrhythmias; there have also been reports of conduction disturbances. Abnormalities of thyroid function tests can occur without thyroid…

General information The aminosalicylates that are currently available are: mesalazine (5-aminosalicylic; acid mesalamine); sulfasalazine, a compound of mesalazine and sulfapyridine, the two compounds being linked by a diazo bond that is hydrolysed by intestinal bacteria; mesalazine is therapeutically effective in inflammatory bowel disease and sulfapyridine causes adverse effects and reactions; olsalazine, a compound of two molecules of mesalazine, linked by a diazo bond that is hydrolysed…

See also Anorectic drugs General information Aminorex is an amfetamine analogue that was used as an anorectic agent, but was withdrawn from the market over 20 years ago because of its association with pulmonary hypertension, which sometimes proved fatal. Its adverse effects have been attributed predominantly to the release of noradrenaline and other catecholamines. You’re Reading a Preview Become a Clinical Tree membership for Full access…

General information Aminophenazone (amidopyrine) is the most toxic and most dangerous anti-inflammatory analgesic. Blood dyscrasias have been documented beyond any doubt, perhaps due to a hypersensitivity mechanism. The Committee on the Safety of Drugs of the Japanese Pharmaceutical Affairs Bureau has ordered its withdrawal because of its serious adverse effects [ ] and it has been withdrawn in most developed countries. However, aminophenazone is still used…

General information Aminolevulinic acid (5-aminolevulinic acid, δ-aminolevulinic acid, 5ALA, δ-ALA) is the first compound in the porphyrin synthesis pathway, which leads to heme in mammals and chlorophyll in plants. It has been used as a component of photodynamic therapy in the management of a range of skin disorders, including acne vulgaris [ , ], actinic keratosis [ ], Bowen’s disease [ ], leukoplakia [ ], and…

See also individual agents General information The aminoglycosides that have been, or are still, important in medical practice are amikacin, gentamicin (pINN), isepamicin, kanamycin, neomycin, netilmicin, paromomycin, sisomicin, streptomycin and dihydrostreptomycin, and tobramycin. Being chemically similar, the aminoglycosides have many features in common, in particular their mechanism of antibacterial action, a broad antibacterial spectrum, partial or complete cross-resistance, bactericidal action in a slightly alkaline environment, poor…

General information During normal fibrinolysis, inactive circulating plasminogen binds to fibrin through an active site that binds lysine. The bound plasminogen is then converted to plasmin by activators (such as tissue plasminogen activator, t-PA) and converted to plasmin, which breaks down the fibrin. Aminocaproic acid (ε-aminocaproic acid, EACA, 6-aminohexanoic acid, Amicar) and tranexamic acid (Cyklokapron) are structural analogues of lysine, which bind irreversibly to the lysine-binding…

See also Tricyclic antidepressants General information Amineptine is a tricyclic antidepressant that selectively reduces the dopamine reuptake without affecting the uptake of noradrenaline or serotonin (5-HT) [ ]. In vivo, it increases striatal homovanillic acid concentrations without affecting the concentrations of other metabolites of dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC) and 3-methoxytyramine. However, high doses of amineptine reduced the extracellular DOPAC concentration in the nucleus accumbens but not…

General information Amiloride is a potassium-sparing diuretic that acts in the distal convoluted tubule independently of the action of aldosterone, inhibiting sodium channels. It is a relatively safe drug with few reported adverse effects. Patients with congenital nephrogenic diabetes insipidus are often treated with a combination of a thiazide and a potassium-sparing diuretic, without consensus on the preferred potassium-sparing diuretic. A Japanese adult was systematically studied…

See also Aminoglycoside antibiotics General information Amikacin is a semisynthetic derivative of kanamycin with similar pharmacokinetic properties and dosages. It is resistant to many of the bacterial R factor-mediated enzymes that inactivate kanamycin and gentamicin. Noteworthy is its effect against Pseudomonas aeruginosa and against most Gram-negative aerobes that are resistant to gentamicin and tobramycin. There are strains of Staphylococcus aureus that inactivate amikacin by phosphorylation and…

See also Anorectic drugs General information Reports on the frequency of adverse reactions to amfepramone are not entirely consistent. The number of adverse effects reported by patients taking amfepramone closely paralleled the number in those taking placebo in one study in 90 obese individuals. In another 16-week controlled study in 95 subjects who took amfepramone 25 mg tds, the main adverse effect was nervousness. In 121…

See also Endothelin receptor antagonists General information Ambrisentan is an endothelin receptor antagonist that has been investigated in the treatment of idiopathic and secondary pulmonary hypertension [ ]. It is a propionic acid-based selective antagonist at endothelin type A (ET A ) receptors. It is licensed for the treatment of some types of pulmonary hypertension under specialist supervision. Raised liver enzymes have been seen with bosentan…

See also Herbal medicines Genera in the family of Amaryllidaceae ( Table 1 ) include the lily genus ( Allium ). This family includes genera that previously belonged to the family of Alliaceae. Table 1 Genera of Amaryllidaceae Allium (lily, onion, garlic) Milula (milula) Speea (speea) Gilliesia (gilliesia) Nothoscordum (false garlic) Trichlora (trichlora) Ipheion (starflower) Prototulbaghia (prototulbaghia) Tristagma (springstar) Latace (latace) Schickendantziella (schickendantziella) Tulbaghia (society garlic)…

See also Herbal medicines General information Genera in the family of amaranthaceae ( Table 1 ) include cotton flower and rockwort. Table 1 Genera of amaranthaceae Achyranthes (chaff flower) Cyathula (cyathula) Lithophila (lithophila) Aerva (aerva) Froelichia (snake cotton) Nototrichium (rockwort) Alternanthera (joyweed) Gomphrena (globe amaranth) Pfaffia (pfaffia) Amaranthus (pigweed) Gossypianthus (cotton flower) Philoxerus (philoxerus) Blutaparon (blutaparon) Guilleminea (matweed) Tidestromia (honeysweet) Celosia (cock's comb) Hermbstaedtia (hermbstaedtia) Chamissoa…

General information Amantadine is a symmetrical C10 tricyclic amine with an unusual structure (1-adamantanamine hydrochloride). It interferes with virus uncoating [ ] by blocking the M2 ion channel, which is needed to affect a pH change that helps to initiate the uncoating process. Most consistent antiviral activity has been observed against influenza A virus, but amantadine has little or no activity against influenza B virus […

General information Alverine is a smooth muscle relaxant that is used to treat spasmodic conditions of the bowel [ ]. 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 Aluminium is a metallic element (symbol Al; atomic no. 13), a light, silver-colored, malleable metal. Aluminium is the most abundant of all metals and is obtained from bauxite ores by the production of alumina, which is then smelted to produce aluminium. Its abundance is demonstrated by the vast number of minerals and precious stones that contain aluminium, which include: albite, analcime, anorthite, beryl, chabazite,…

General information Alprostadil is PGE 1 available for exogenous administration. Alprostadil is widely used in neonates with cyanotic congenital heart disease to maintain the patency of the ductus arteriosus. Reported adverse effects include fever, apnea, flushing, bradycardia, and hyperostosis. Continuous chronic infusion of alprostadil via a portable pump and neuromuscular electrical stimulation help to improve the quality of life in patients with severe chronic heart failure…

General information Alprazolam, a triazolobenzodiazepine, has been marketed as an anxiolytic with additional antidepressant properties; an analogue, adinazolam, also has partial antidepressant activity [ ] and is useful in panic disorder. Like other benzodiazepines, alprazolam is effective in acute and generalized anxiety; its efficacy in panic disorder [ , ], premenstrual syndrome [ ], and chronic pain [ ] is complicated by high rates of adverse…