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…
General information Ajmaline and its derivatives, prajmalium bitartrate (rINN; N-propylajmaline), lorajmine (rINN; chloroacetylajmaline), detajmium bitartrate (rINN), and diethylaminohydroxypropylajmaline, are Rauwolfia alkaloids. Their use is restricted by serious adverse effects, such as neutropenia and cardiac dysrhythmias, which have been reviewed [ ]. Other adverse effects include dizziness, headache, and a sensation of warmth after intravenous injection. Organs and systems Cardiovascular Ajmaline occasionally causes cardiac dysrhythmias [ ].…
General information Subtypes of adrenoceptors were first described by Ahlquist in 1948 [ , ]. Adrenoceptor agonists evoke physiological responses similar to those produced by stimulation of adrenergic nerves or the physiological release of adrenaline (see Table 1 ). For many of these responses it is currently possible to conclude that only an alpha-adrenoceptor or a beta-adrenoceptor is involved, and in some cases one can distinguish…
See also Adrenoceptor agonists General information Note on nomenclature Although “epinephrine” is the recommended International Non-proprietary Name (rINN), there are good reasons why the name “adrenaline” should be preferred, based on usage, history, etymology, and, most importantly, risk of clinical errors [ ]. For these reasons, the name “adrenaline” is used in many pharmacopoeias, including the British and European Pharmacopoeias. Uses Adrenaline is a catecholamine with…
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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