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General information To date, four subtypes of adenosine receptor, A 1 , A 2A , A 2B , and A 3 , have been described [ ]. Stimulation of specific cell-surface A 1 receptors shortens the duration, depresses the amplitude, and reduces the rate of rise of the action potential in the atrioventricular node, slowing conduction; this is the mechanism by which adenosine terminates re-entrant supraventricular…

General information Adenosine and adenosine triphosphate (ATP), its phosphorylated derivative, have been used to treat acute paroxysmal supraventricular tachycardias and adenosine has also been used in the diagnosis of narrow-and broad-complex tachycardias [ ]. Several reviews of the clinical pharmacology, actions, therapeutic uses, and adverse reactions and interactions of adenosine and ATP have appeared [ ]. After intravenous administration adenosine enters cells, disappearing from the blood…

General information Ademetionine ( S -adenosylmethionine) has anti-inflammatory and analgesic effects in animals. Convincing evidence of these effects in man is still lacking. 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 Adefovir is an adenine analogue reverse transcriptase inhibitor. While it has activity against both HIV and hepatitis B, its use in HIV infection is limited by nephrotoxicity due to the high doses needed [ ]. The dose used for treatment of hepatitis B is about one-tenth that needed to treat HIV infection, so patients with hepatitis B must have co-infection with HIV ruled out…

See also Monoclonal antibodies General information Adalimumab, a fully human monoclonal antibody, is the third commercially available TNF alfa antagonist for patients with rheumatoid arthritis for whom previous treatment with disease-modifying antirheumatic drugs has failed. Adalimumab has been approved alone or in combination with methotrexate for the treatment of rheumatoid arthritis in the EU and USA; approval for the treatment of psoriasis, psoriatic arthritis, and ankylosing…

General information Activated charcoal is a standard therapy for gut decontamination after self-poisoning. It has two uses. If given within an hour or two after acute self-poisoning it can adsorb the drug and prevent it from being absorbed; in this case a single dose of activated charcoal 50 g is sufficient. However, some drugs are secreted into the gut after absorption and can be adsorbed by…

General information Local biocompatibility Although polymerized polymethylmethacrylate is a biocompatible material, it is not biocompatible during the brief time it takes to set, during which it releases 130 calories/gram and can cause a rise in temperature up to 120 °C. This temperature rise can be reduced by various techniques, although the thermal tolerance of the tissues affected is low (56 °C and 72 °C for coagulation…

See also Antihistamines General information Acrivastine is a second-generation antihistamine that has not been the subject of recent studies; earlier work was insufficient to substantiate statements that it was non-sedating. 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 Disinfectants and antiseptics General information Acrisorcin (aminoacridine 4-hexylresorcinolate) has been used in the treatment of tinea versicolor [ ] and for induction of abortion in mid-trimester pregnancies. 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 Herbal medicines General information Acorus calamus was originally classified as a member of the arum family (Araceae), but is now designated as belonging to its own family, the Acoraceae, of which it is the only member. 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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General information Acipimox (S-methylpyrazine-2-carboxylic acid 4-oxide) is structurally related to nicotinic acid. There were flushing and gastrointestinal disturbances in 7137 patients, of whom 15% stopped taking the drug because of adverse effects; there were no adverse effects on blood glucose or uric acid [ ]. Of 32 patients with hypertriglyceridemia, excessive hypertriglyceridemia, and combined hyperlipidemia, acipimox had to be withdrawn in 10 cases, because of adverse…

General information Aciclovir is an acyclic purine nucleoside. Its antiviral activity depends upon intracellular phosphorylation to its triphosphate derivative. Because of its higher affinity for viral thymidine kinase, aciclovir is phosphorylated at a much higher rate by the viral enzyme. Thus, it is almost exclusively active in infected cells, fulfilling one of the selectivity principles of antiviral drugs. In addition, aciclovir triphosphate serves as a better…

See also Benorilate ; Diflunisal ; Lysine acetylsalicylate ; Salicylates, topical ; Salsalate General information Over a century after its introduction, acetylsalicylic acid (aspirin) is by far the most commonly used analgesic, sharing its leading position with the relative newcomer paracetamol (acetaminophen), and notwithstanding the fact that other widely used anti-inflammatory drugs, like ibuprofen and naproxen, have in recent years been introduced in over-the-counter versions. Both…

General information Acetylcysteine (N-acetylcysteine) is used as a mucolytic and to treat paracetamol overdose. Acetylcysteine splits disulfide bonds in mucoproteins and thus lowers mucus viscosity, resulting in a larger volume of sputum. It is normally administered by inhalation as a nebulized solution or aerosol, although it can also be taken orally. Acetylcysteine is also an antioxidant and may protect the lung from free radicals generated by…

General information Cholinesterase inhibitors increase parasympathetic nervous system (cholinergic) activity indirectly by inhibiting acetylcholinesterase, thereby preventing the breakdown of acetylcholine. They are only effective in the presence of acetylcholine. They are listed in Table 1 . Table 1 Acetylcholinesterase inhibitors Ambenonium Diisopropyl fluorophosphate (Diflos) Distigmine Donepezil Ecothiopate Edrophonium Eserine Methoxytacrine Metrifonate Neostigmine Physostigmine Prostigmine Pyridostigmine Rivastigmine Tacrine and 7-methoxytacrine The cholinesterase inhibitors are used in the…

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See also Non-steroidal anti-inflammatory drugs (NSAIDs) General information Despite claims that aceclofenac is a COX-2 selective inhibitor, experience shows that its adverse effects profile is similar to that of the non-selective NSAIDs. 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

See also Antidysrhythmic drugs General information Acecainide (N-acetylprocainamide) is the main metabolite of procainamide, and it has antidysrhythmic activity [ ]. However, in contrast to procainamide, which has Class Ib activity, the main action of acecainide is that of Class III. Apart from the lupus-like syndrome, the adverse effects of acecainide are as common as those of procainamide. The commonest affect the gastrointestinal tract and the…