A-Z Principal Drugs (carbon dioxide - cephalosporins)
carbon dioxide A colourless, non-inflamniable gas. It has a stimulating effect on the respiratory centre, and a mixture of 5% of carbon dioxide in oxygen is used for respiratory depression. Solid carbon dioxide is used to destroy warts, naevi, etc.
carbonic anhydrase inhibitors These drugs, represented by acetazolamide and dichlorphenamide, have been used as diuretics as they inhibit the reabsorption of sodium and bicarbonate in the kidneys. Their use has declined as more effective diuretics have become available. They also reduce the formation of the aqueous humour and so bring about a reduction in the iruraticular pressure, and are used in the treatment of glaucoma. See page 138 and Table 16.
carboplatin An analogue of cisplatin but with generally reduced side-effects, although the myelodepression may be more severe. It is used mainly in ovarian and small-cell lung cancer.
Dose: 40 nighn’ i.v. as a single dose, repeated after 4 weeks. Blood tests during treatments are essential. Severe renal impairment is a contraindication. ( Pai aplatin). See page 122 and Table 8.
carboprost A prostaglandin with a selective action oil the myornetrium, and used in post-partum haemorrhage not responding to ergometrine.
Dose: 250 pg initially by deep i.m. injection, with subsequent doses according to need up to a total of 2 mg (not for i.v. injection). Care in asthma, epilepsy and hypertension. Nausea and vomiting are side effects. (Hemabate).
carisoprodol A muscle relaxant used in niusculoskeletal disorders and muscle spasm.
Dose: I g daily. (Carisomi).
carmustine A cytoxic agent similar to 1-viustine. It is used mainly in brain tumours, multiple myeloma and Hodgkin’s disease, often in association with other drugs.
Dose: 200 rnghii2 by slow i.v, injection, repeated at intervals of 6 weeks. Side-effects are nausea, vomiting and burning at the injection site. A delayed bone-marrow depression is often a dose-limiting factor. (BICNU). See page 122 and Table 8.
Cef
carteolof A beta-adrenaergic blocking agent used as eye drops (0.1-0.2%) in glaucoma. Some systemic absorption may occur from eye drops, and care is necessary in asthma and bradycardia. (Teoptic). See page 138.
carvedilol A non-cardiac selective betablocker with the actions and uses of propanolol.
Dose: in hypertension 12.5 mg initially, rising to 25-50 mg as a single daily dose. (hucardic). See page 148 and Table 21.
cascara A mild purgative.
Dose: dry extract 100-250 nig, liquid extract and elixir 2-5 nil.
castor oil A mild purgative.
Dose: 5-20 nil. The oil has emollient properties and is used together with zinc ointment for pressure sores and napkin rash.
catecholamines A term applied to the synipathornimetic drugs adrenaline, dopamine, noradrenaline, and related compounds, indicating that they are derivatives of catechol.
CCNU See lomustine.
cefaclor An orally active cephalosporin antibiotic used mainly in urinary and respiratory infections.
Dose: 750 ing or more, up to 4 g daily, with reduced doses in renal impairment. Nausea and diarrhoea are side-effects, but all allergic reaction indicating sensitivity may require withdrawal of the drug. (Distaclor). SeeTable 34,
cefadroxil An analogue of cephalexin. It is well absorbed orally and gives high blood levels.
Dose: 1-2 g daily, (Baran), See page 248 and Table 34.
cefatnandole See cephamandole.
cefixime A cephalosporin with the actions, uses and side-effects of the cephalosporins generally, but effective in single daily doses of 200-400 mg. (Suprax). See page 248 and Table 34.
cefodizine A cephalosporin used in lower respiratory tract infections and in urinary tract infections.
Dose: 2 g (laity by i.m. injection or i.v.
Cefotaxime A cephalosporin with an ink reased activity against many Gram-negative organisms.
Dose: 2 g daily by injection, increased in severe infections tip to 12 g daily. A single dose of 1 g is given in gonorrhoea. The side-effects are those of the cephalosporins generally. (Claforan). See page 248 and Table 34.
cefoxitin A cephaniycin with a wide range of activity and an increased potency against Gram-negative bacteria. It is of value in many infections, and is also used in surgical prophylaxis.
Dose: 3-12 g daily by Lin. or i.v. injection. (NIefoxin). See page 248 and Table 34.
cefp1ronve A beta -lactaniase- stable cephalosporin with a wide range of activity. Dose: 2 g daily i.v. (Cefrom). See
page 248 and Table 34.
cefuroxime A cephalosporin often effective against some organisms resistant to penicillin, and with increased activity
against Haemophilus inflidenzae. 27 Dose: 3-6 g daily by injection. For surgical prophylaxis and in gonorrhoea a single dose of 1.5 g. Side-effects include nausea, diarrhoea, urticaria, rash and hypersensitivity reactions. (Zinacef). cefuroxime-axetil is an orally active form. Dose: 500 mg- I g daily. (Zinnat). See page 248 and fable 34.
celiprolol A selective 0, receptor blocking agent, with some stimulating action oil receptors. The former occur mainly in the heart, the latter in the bronchi and peripheral vessels. It is used in mild hypertension, as it has a vasodilatory and cardioselective action with reduced side-effects.
Dose: 200 mg daily, at breakfast. Occasional side-effects are nausea, headache and dizziness. (Celectol). See page 148 and Table 21.
ceflaodoxime An oral cephalosporin for respiratory tract infections.
Dose: 200-400 mg daily with food. (Orelox). See page 248 and Table 34.
ceftazidime A cephalosporin resistant to most beta-lactamases, and active against a wide range of Gram-positive and Gram-negative organisms, including Pseudomonas aeruginosa, although it is less active against Staphylococcus aureus. Valuable in both single and mixed infections.
Dose: 1-6g daily by injection, reduced in cases of renal impairment. In pseudontonal lung infections associated with cystic fibrosis, 1(4-150nit
g/kg daily. Side-effects include abdominal disturbance and local reactions at the injection site. (FortUol; Ket”adirn). See page 248 and Table 34.
cettibuten An oral cephalosporin similar to cefaclor, but with a longer action. Dose: 400 nigas a single daily (lose. (Cedax t. See page 248 and Table 34.
ceftriaxone A cephalosporin of the cefaclor
Jtype given as a single daily dose of I g by eep i.m. or slow i.v. injection, doubled in severe infections. With high doses vary injection site. (Rocephin). See page 248 and Table 34.
cephalexin An orally active cephalosporin Of value in infections of the respiratory and urinary tracts, and in naso-oral and soft-tissue infections.
Dose: 1-2 g daily, but lower (loses are indicated in renal impairment. Cephalexin is usually well tolerated, but sonic gastrointestinal disturbances may occur. (Ceporex; Kellex). See page 248 and Table 34.
cephalosporins A group of antibiotics with properties similar to those of the penicillins, but having a wider range of activity. Some are active orally, others may have to be given by injection.
Cefotaxime, ceftazidime and ceftizoxime have an increased activity against Gram-negative bacteria, but are less potent against Staphylococcus aureus and Gram-positive organisms generally. Cefititoxin is active against bowel organisms. An indication of the range and dose is given in the table on page 248. The higher doses are given in severe infections; reduced doses should be given in renal impairment. The main side-effect of the cephalosporins is hypersensitivity, and cross- sensitivity to the penicillins is not uncommon. Sensitivity to one is likely to extend to all members of the group. The cephalosporins call affect blood-clotting mechanisms.