General information Almitrine is a respiratory stimulant that improves hypoxemia in about 80% of patients with severe chronic obstructive pulmonary disease [ ]. Oral almitrine bimesilate (100 mg/day) increased PaO 2 in patients with severe chronic obstructive pulmonary disease without altering mean pulmonary artery pressure [ ]. Adverse reactions were rarely observed and it was concluded that long-term treatment was safe. In other studies, respiratory, digestive,…

General information Allopurinol is an inhibitor of xanthine oxidase, used to lower serum uric acid concentrations in the long-term treatment of gout and in the prevention of acute gout in people who are susceptible to hyperuricemia. Allopurinol is itself metabolized to its active metabolite, oxipurinol, by xanthine oxidase. Comparisons with antimonials in leishmaniasis Allopurinol has an antileishmanial effect in vitro and in animals, its effect being…

See also Cytotoxic and immunosuppressant drugs General information Alkylating cytostatic drugs include: Nitrosoureas: carmustine, lomustine, nimustine, streptozocin. N -lost derivatives: bendamustine, chlormethine, cyclophosphamide, estramustine. Others: busulfan, chlorambucil, dacarbazine, ifosfamide, melphalan, mitobronitol, mitomycin, procarbazine, thiotepa, temozolomide, treosulfan. The first two groups (apart from cyclophosphamide) are covered in this monograph. Nitrosoureas Carmustine (BCNU) is used to treat myeloma, lymphomas, breast cancer, and brain tumors, topical carmustine has been…

General information Alizapride is a substituted benzamide related to some neuroleptic drugs. 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 Renin inhibitors, direct General information Aliskiren is an orally active, non-peptidic inhibitor of renin, and is the only direct renin inhibitor approved for the treatment of hypertension. Its potential adverse effects and a comparison with other renin–angiotensin blockers have been reviewed [ ]. Aliskiren is a novel compound that was developed by the use of X-ray crystallography of the active site of renin and…

General information The lower aliphatic alcohols (ethanol, isopropanol, 2-propanol, N -propanol, and 1-propanol) are widely used for skin antisepsis. In appropriate concentrations, these alcohols are bactericidal to most of the common pathogenic bacteria, but some rare species survive and can grow, especially since these alcohols are inactive against dried spores. Seven cases of gaseous edema were observed in the former German Democratic Republic (GDR) after intramuscular…

See also Antihistamines General information Alimemazine is a phenothiazine derivative with sedative antihistaminic and antimuscarinic effects. 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

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See also Alpha-adrenoceptor antagonists General information Alfuzosin is a uroselective alpha 1 -adrenoceptor antagonist used to relieve the symptoms of prostatic hyperplasia [ ]. Its safety has been investigated in a large prospective 3-year open trial in 3228 patients with benign prostatic hyperplasia. There were no unexpected adverse effects. Only 4.2% of the patients dropped out owing to adverse effects. In a large database of 7093…

See also Opioid analgesics General information Alfentanil is a potent short-acting opioid used in anesthesia. Beside its effects on opioid receptors, there is some evidence that it may affect acetylcholine, since intrathecal neostigmine produced a dose-dependent increase in the effect of alfentanil [ ]. Its rapid onset and short duration of action make alfentanil suitable for use in day care, although it is important to treat…

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See also Monoclonal antibodies General information Alemtuzumab (campath-1H) is a humanized monoclonal antibody specific for the CDw52 antigen, present on cell membranes of lymphocytes and monocytes. It has been used for treatment of patients with rheumatoid arthritis and vasculitis, is being investigated for the treatment of chronic lymphocytic leukemia, and has been used to deplete circulating lymphocytes in patients with multiple sclerosis [ ]. In 2001,…

General information Alefacept is a bioengineered fusion protein of soluble lymphocyte function antigen (LFA-3) with Fc fragments of IgG1. It blocks the LFA-3/CD2 interaction necessary for activation and proliferation of memory effector T cells by binding to CD2 expressed on the surface of T cells. It has been used in the treatment of psoriasis and psoriatic arthritis. There has also been a small pilot study of…

General information Aldose reductase inhibitors [ ] have been developed for the treatment of secondary complications in diabetes [ , ]. They include alrestatin, benurestat, epalrestat, fidarestat, imirestat, lidorestat, minalrestat, ponalrestat, ranirestat, risarestat, sorbinil, tolrestat, zenarestat, and zopolrestat. The aldose reductase inhibitors inhibit or reduce secondary complications induced by diabetes, specifically in tissues in which glucose uptake is not insulin-dependent (probably neural tissue, the lens, and…

General information Aldesleukin (interleukin-2, celmoleukin, proleukin, teceleukin) is produced by activated T lymphocytes and has pleiotropic immunological effects, including the proliferation of T lymphocytes. Non-glycosylated recombinant aldesleukin has been approved for the treatment of metastatic renal cell carcinoma [ ] and is also being investigated in other malignant neoplasms. Low-dose aldesleukin is a relatively safe treatment of HIV infection [ ]. The adverse effects of aldesleukin…

See also Neuromuscular blocking drugs, non-depolarizing General information Alcuronium is a synthetic derivative of toxiferine, an alkaloid of calabash curare, and is a non-depolarizing relaxant with properties and adverse effects similar to those of D-tubocurarine. It is about twice as potent as D-tubocurarine, 0.15–0.25 mg/kg usually being adequate for abdominal relaxation, and has a similar onset time and a slightly shorter duration of action. It is…

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General information Adverse reactions to human serum albumin are uncommon and usually mild, such as itching and urticaria. Serious reactions are rare. A patient who has reacted violently to albumin on one occasion may tolerate it well on another after being given an antihistamine such as diphenhydramine [ ]. Aggregates present in protein preparations may be the cause of some reactions. Another postulated cause may be…

See also Benzimidazoles General information The benzimidazole antihelminthic drugs albendazole and mebendazole (qv) are commonly used to treat soil-transmitted helminth infections, such as gastrointestinal roundworms, hydatid disease, neurocysticercosis, larva migrans cutanea, and strongyloidiasis [ ]. They bind to nematode β tubulin and inhibit parasite microtubule polymerization, which causes death of adult worms after a few days. Although both albendazole and mebendazole are broad-spectrum antihelminthic drugs, their…

See also Fluoroquinolones General information Alatrofloxacin is a fluoronaphthyridone that is hydrolysed to the active moiety, trovafloxacin, after intravenous administration. This fourth-generation broad-spectrum fluoroquinolone has activity against Gram-positive, Gram-negative, anerobic, and atypical respiratory pathogens. Because it has significant hepatotoxicity, the list of appropriate indications for trovafloxacin has been restricted. In a multicenter, double-blind, randomized comparison of trovafloxacin 200 mg and clarithromycin 500 mg bd in 176…