Posts Tagged ‘calcium chloride’

pyrazinamide An antituberculous drug that is active against the intracellular and dividing forms of M. tuberculosis, and is most effective in the early stages of die disease. It penetrates the meninges, and is Of value in tuberculous meningitis. Dose: in combination with other drugs, 2 g 3 times a week. Side-effects include fever, jaundice and hepatotoxicity. Liver function tests should be carried out before and during treatment. (Zinamide). See page 170 and Table 31.
pyridostigmine An anticholinesterase similar to neostigmine. It has a slower and more prolonged action that is useful in some cases of myasthenia graves. Dose: 300–720 mg daily. The side-effect, are similar to those of neostigmine, but may be less severe. (Mestinon).
pyridoxine (vitamin B,) This vitamin plays an essential part in protein metabolism. Apart from its use in deficiency states, which are uncommon, pyridoxine has been used in isoniazid-induced neuropathy. Dose: 2,5-150 rig daily; in some sideroblastic anaemias, up to 400 rig daily.
pyrimethamine Ail antimalarial drug used with dapsone as Maloprint or with sulphadoxine as Fansidar in the prophylaxis of malaria. The use of these mixed products is not without risk, as they may have severe and sometimes fatal side-effects.
quetiapine A new ‘atypical’ antischizophrenic drug of the clozapine type with a high affinity for serotonin (5-HT) and dopamine DI and D2 receptors.
Dose: in schizophrenia, initilal doses of 25 rig twice a day, slowly increased up to 150-750 mg daily. Initial doses may cause hypotension. Care is necessary in cardiovascular disease. Side-effects include drowsiness and dizziness. The routine blood monitoring necessary with dozapine is not required. (Sew,jud). See page 108 and Table 30.
quinagolide A dopamine agonise used in
the treatment of hyperprolactinaemia.
I Rai
Dose: 25 jig at bedtime initially, increased at 3-day intervals to 75-100µg daily. Side-effects include hypotension, and the blood pressure should be monitored after a
change of dose. (Norprolac). See brornocriptine and cabergoline.
tquinalbarbitone sodium A short-acting barbiturate. Used in mild insoninia and anxiety states.
Dose: 50-100mg. (Seconal).
quinapril Ail ACE inhibitor with the actions, use and side-effects of that group of drugs. Dose: in hypertension, 5-10 mg daily initially, slowly increased to 20-40 mg as a single daily dose. (Accupro). See ACE inhibitors, page 148, and Table 21.
quinidine Ail alkaloid of cinchona, similar to quinine, that has been used in the preventive treatment of ventricular arrhydimias, but beta-blocking agents are now preferred.
Dose: (after a test dose of 200 rig) 200-400 mg 3-4 times a day. Side-effects are tinnitus, vertigo and confusion. Treatment should be stopped if response does not occur within 10 days.
quinine The principal alkaloid of cinchona bark. It was once used extensively in the treatment of malignant tertian malaria, and recently it has regained some of its value with the emergence of chloroquineresistant malaria.
Dose: 1.8 g daily for 7 days; in serious infections it is given by i.v. infusion in doses of 10 rig/kg for up to 3 doses, followed by oral therapy. Side-effects include tinnitus, nausea, rash and visual disturbances. See specialist literature.
rattitroxedV A selective enzyme inhibitor used in the palliative treatment of advanced colorectal cancer. It has advantages over fluorouracil, as treatment is less complicated and the incidence of leucopenia, mucositosis and other side-effects is less severe. Dose: 3 mg/ni! by slow i.v. injection, repeated at intervals of 3 weeks if tolerated. Blood counts and liver function tests are necessary. (Tomudex). See page 122 and Table 8.

ramipril An ACE inhibitor with the general properties of such drugs.
Dose: in mild hypertension, L25 ing daily, increased at intervals of 1-2 weeks tip to a maximum of 10 mg, given with food and adequate fluid. Prophylactic dose after myocardial infarction 5-10 ing daily. (Tritace). See page 148 and Table 21.
ranitidine A powerful and selective histamine H, antagonist of the cimetidine type, but with a longer action. It reduces the volume, acidity and pepsin content of gastric secretion, and is of value in peptic ulcer, reflux oesophagitis and similar conditions.
Dose: 300 nig daily for at least 4 weeks, maintenance (loses, 150 mg daily. In severe conditions, 50nig by i.ma or slow i.v. injection repeated at intervals of 6-8 hours. In suspected gastric ulcer, malignancy should be excluded before treatment is commenced. (Zantac). See cimetidine, page [62 and Table 27.
ranitidine bismuth citrateV It has the general action of ranitidine, but it also has a protective effect on the ulcerated area, and inhibits digestive action of pepsin on the gastric mucosa. It is given with amoxycillin and clarithromycin to promotethe elimination of Helicobacter pylori.
Dose: 800 mg daily. (Pylorid). See page 162.
razoxane A cytotoxic agent occasionally used in the treatment of leukaemias. Dose: 150-500 nighril daily for 3-5 clays, under laboratory control. Side electsare nausea and myleosuppression. (Razoxin).
Rif
Dose: by aerosol inhalation; 0.5-1 mg
( 1 -2 puffs), repeated up to 3 times a day. Side-effects include tremor an(] mild tachycardia. (Bronchodil). See page 118 and Table 6.
resorcinol A keratolytic agent used mainly as an ointment in acne, and as a hair lotion for removing dandruff. Myxoedema has been reported following the prolonged use of resorcin preparations.
reteplase A thrombolytic agent used in acute myocardial infarction.
Dose: 10 units by slow i.v. injection within 2 hours of the infarction. A second dose may be given 36 hours later, together with heparin, to reduce the risk of rethrombosis. Side-effects are arrhythmias an(] gastrointestinal bleeding. (Rapilysin). See page 156 and Table 24.
retinol See vitamin A.
riboflavine (vitamin B2) Part of the vitamin B complex, it is concerned with the oxidation of carbohydrates and amino acids. A deficiency causes several characteristic effects, including angular stomatitis and’burning feet’.
Dose: 1-10 mg in deficiency states associated with restricted diets or poor absorption.
rifabutinV A derivative of rifampicin used in the multi-drug treatment of pulmonary tuberculosis.
Dose: 150-450 mg daily. It is also used I,i,)I,Iiyl.iclically.ig,.iiii.%t opportunistic infection with Mycobacterium avium. (Mycobutin). See page 170 and Table 31.
reboxetineV An inhibitor of noradrenaline reuptake used in depression.
Dose: 4 ing twice a day, half-doses for the elderly. Side-effects are those of other antidepressants. Care in renal/hepatic impairment. (Fdronax). See page 128 and Table 11.
remifentanilV An analgesic of the fentanyl type used as an adjunct in doses of
0.5-1 fig/kg/min for the induction of anaesthesia. Its use reduces the amount of general anaesthetic required. (Ultiva).
reproterol A bronchodilator with the actions, uses and side-effects of salbutamol.
rifampicin An antibiotic now considered to be the first-choice drug in the treatment of tuberculosis, and given together with isoniazid and pyrazinamide.
Dose: 600 mg before breakfast. It is also used with dapsone and clofazimine in the initial treatment of severe leprosy. Combined therapy is also used in brucellosis, legionnaire’s disease and severe staphylococcal infections. Side-effects include gastrointestinal disturbances, rash, an influenza-likesyndrorne and hepatic reactions. Jaundice is a contraindication. Patients should be warned that rifampicin gives a red colour to the urine, sputum and tears, and to soft contact lenses. It may decrease the response to oral anticoagulants such as warfarin, and the failure of oral contraceptives has also been reported in patients receiving rifampicin. (Rifadin; Itiniaciane), See page 170 and Table 31.
riluzoleV A new drug used only for motor neurone disease (a myotrophic lateral sclerosis-ALS). ALS is a degenerative disease and may be due to the local accumulation of the neurotransmitter glutamate, with consequent neurone damage. Riluzole slows down the progressive nature of the disease, and improves the response to mechanical ventilation. Dose: 100 mg daily. See specialist liteiawre. Milutek).
rimiterol A bronchodilator similar in actions and uses to salbutamol, but with a shorter duration of effect. It is largely free from any cardiac stimulant activity. Rimiterol is used mainly for the relief of bronchospasm in bronchitis, bronchial asthma and similar conditions.
Dose: by aerosol inhalation, 200-600 pg ( 1-3 puffs) up to a maximum of 8 puffs daily. (Pulmadil). See page 118 and Table 6.
I sac
Lip to 350 pg/min. or 10 mg by i.m. injection and continued until the contractions have ceased; then orally up to 120 mg daily to prevent relapse. Side-effects include tremor, nausea and hyj)otension. (Yutopar).
rocuronlurn A muscle relaxant similar in actions and uses to vercuronium. Dose: 600 pg/kg initially, followed by 300-600 pglkglhrly as required.
(lisincron).
ropiniroleV A potent and selective
dopamine D,-receptor agonist used in the treatment of Parkinson’s disease, a condition basically due to a deficiency of dopamine in the brain. It is well absorbed orally, and reaches the central nervous system where it functions as dopamine replacement therapy.
Dose: first week 750µg daily with food; second week 13 ing daily, third week 2.25 mg daily, then 3 ing daily. Ropinirole may be given as monotherapy or together with levodopa. Side-effects are somnolence, hypotension, leg oedema and gastrointestinal disturbances. Caution in severe cardiac, renal and hepatic conditions. (Requip). See page 160 and Table 26.
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Ringer’s solution An electrolyte replacement solution containing sodium
chloride, potassium chloride and calcium chloride.
risperidone An antischizophrenic agent of the clozapine type, with a selective affinity for serotonin and dopamine receptors. It may relieve the aggressive symptoms of
schizophrenia as well as the negative aspects such as apathy.
Dose: 6-10 mg. daily. Side-effects are headache, dizziness and agitation. Agranulocytosis is uncommon, and the close blood monitoring required with clozapine is not necessary. (Risperdal). See page 168 and Table 30.
ritonavirV An HIV-protease inhibitor used in HIV infections in association with a nucleoside analogue.
Dose: 1.2 g daily with food. (Norvir). See page 144 and Table 19.
ritodrine A beta,-adrenoceptor stimulant with a relaxant action on uterine muscle, used to inhibit premature labour.
Dose: 5opg/niin initially by i.v. infusion (avoiding fluid overload), slowly increased
ropivacaine A local anaesthetic with the actions and uses of lignocaine. (Naropin).
Rose bengal A (lye used as eye drops (M) to stain and detect damaged conjunctival cells, and in the diagnosis of dry eye.
rubella vaccine A suspension of a live, attenuated strain of rubella virus. It is used for active immunization in girls of 10-14 years, and in seronegative women of childbearing age.
Dose: 0.5 nil by s.c. injection. It is contraindicated in pregnancy, and pregnancy within 3 months of vaccination should be avoided. A combined rneasles/mUnipsit-111101,a (MMR) vaccine is now recommended for all children.
saccharin A synthetic sweetening agent widely used as a non-calorific substitute for sugar. Has been used by rapid i.v. injection (2.5 g in 4 ml) for arm-tongue circulation time.

halothane A potent non-inflammable inhalation anaesthetic. It suppresses mucous and bronchial secretions, and reduces capillary bleeding. It has sonic muscle-relaxant properties, but in major surgery, supplementary treatment with a muscle relaxant is necessary. Halothane may cause some cardiac irregularities, but an occasional serious side-effect is severe hepatotoxicity, particularly after further exposure to the drug within periods of 441 weeks. Such susceptibility cannot yet be detected, so great care is necessary in any cases of liver dysfunction.
(Fluothane).
hamamelis An extract of witch hazel leaves referred to as harnarnelis or witch hazel water is used as a soothing application for bruises and sprains.
Hartmann’s solution An electrolyte-replacement solution containing sodium lactate, sodium chloride, potassium chloride and calcium chloride.
heparin The natural anticoagulant obtained front lung and liver tissue. It is widely used in deep-vein thrombosis and pulmonary embolism.
Dose: by i.v. injection 5000 units initially, followed by 1000-2000 units hourly by i.v. infusion, or 15000 units by s.c. injection 12-hourly under laboratory control. Prophylactic dose before surgery 5000 units, then 5000 units every 8-12 hours for 7 days. Overdosage call be controlled by the i.v. injection of prolamine sulphate. Treatment with heparin may be combined with that of oral anticoagulants such as phenindione or warfarin to provide immediate action before the slow-acting oral drugs begin to take effect. Occasional side-effects include hypersensitivity reactions and alopecia. Heparin is a complex polysaccharide, but certain fragments of that large molecule retain sonic anticoagulant activity, and are referred to as low molecular weight heparins. They are used mainly in the prophylaxis of venous thrombo-embolism, as they have a longer
action than standard heparin. They are given by once-daily s.c. injection, and laboratory control of the bleeding time is not necessary. The dose varies to some extent with the product used.
hepatitis A & 8 vaccines Inactivated hepatitis virus antigens for the protection of individuals highly exposed to the infections. Dose: see data sheets. (I iaverix A;
kncigix B; II–B–Vax).
theroin See diamorphine.
hetastarch A soluble modified starch that is used as a 6% solution with 0.9% sodium chloride as a plasma volume expander. Dose: 500-1500 nil daily by i.v. infusion, up to a maximum of 20 mltkg daily. It is excreted by the kidneys, and care must be taken to avoid circulatory overload. Not for use in congestive heart failure or renal insufficiency. Side-effects are vomiting, chills, fever and urticaria. (clol-IAES; Hespan).
hexachlorophene A slow-acting antiseptic used for skin sterilization, and present in sonic medicated soaps.
hexamine (methenamine) A formaldehyde derivative of low toxicity, occasionally used as a urinary antiseptic. Dose: 2 g daily. It is usually given as hexamine hippurate to ensure the necessary acidification ol’the urine. (Iliprex).
histamine A compound present in a bound form in all mammalian tissues; its release is probably the ultimate cause of many allergic conditions.
histamine H,-receptor antagonists See antihistamines. See page 110 and Table 2.
histamine Hz -receptor antagonists Drugs that (litter from conventional antihistamines in having a selective blocking action on receptors ill the gastric cells that secrete acid. They are widely used in the treatment of peptic ulcer and other conditions requiring a reduction in gastric acid secretion. See page 162 and Table 27.
homatropine An atropine derivative with a similar but more rapid mydriatic action (15-30 minutes), but a shorter duration of effect of about 24 hours. Eye drops
(1-2%) sometimes with cocaine.

hyaluronidase A ’spreading’ factor used to increase the absorption of large-volume s.c. injections. The injection of 1500 units of hyaluronidase, either into the injection site or mixed with the injection fluid, will promote the absorption of 500-1000 mL of electrolyte solution by s.c. drip infusion. (Hyalase).
hydralazine A vasodilator that is useful in the supplementary treatment of hypertension.
Dose: 50- 100 nig daily, usually with a IlliaUide diuretic or a beta-blocking agent. Also given in hypertensive crisis by slots, i.v. injection in doses of 5-10 mg; over-rapid injection may cause a marked fall in blood pressure. Side-effects are nausea, tachycardia and fluid retention (less likely with low doses), but a lupus erythematOSLIS- like syndromemay occur with extended high-dose therapy. (Apresoline). See page 148 and “Fable 21.
hydrochlorothiazide A thiazide diuretic that brings about it marked increase in the excretion of salts and water, and is of value in congestive heart failure and other oedematous conditions. It is also of value iii    as it reduces peripheral resistance, and potentiates the action of some other antihypertensive drugs.
Dose: 50-111(1 Ing daily initially in
oedenia; maintenance dose 25-50 mg daily or oil alternate days. III hypertension, 25-30 Ing daily according to need.
I lydrochlorolhiazidc, like other thiazid”, Increases the excretion of potassium as well as sodium, and in extended treatment supplementary treatment with potassium chloride or effervescent potassium tablets may be required. Side-effects include nausea, rash, dizziness and photosensitivity. (I lydroSaluric). See page 148
and ‘I able 21.
acute lyniphoblastic leukaemia and some lymphomas. In common with some other corticosteroids, hydrocortisone inhibits organ-transplant rejection and in high doses it is given to control incipient rejection.
Dose: varies considerably according to need: for replacement therapy, 20-30 mg daily: in shock, 100-300 mg or more by slow i.v. injection, repeated as required. Side-effects are numerous and include hypertension, oedema, mental disturbances, re-activation of peptic ulcer, muscle weakness and diabetes. Cushing’s syndrome may occur with high doses.
I I ydrocortisone, unlike cortisone, is active topically, in(] is used as eye drops 0.3% (usually with an antibiotic), ointment and cream (0.50/o and 11M, often with an antibiotic to control any secondary infection.
hydroflumethiazide A thiazide diuretic N,ith the actions, uses and side-effects of bendrofluazide.
Dose: 25- 100 nig daily in (lie morning; 25-50 Ing daily in hypertension.
ff lydrenox). See page 148.
hydrogen peroxide solution It contains 5-7% of H 02
, equivalent to about 20 volumes oJ oxygen. It has antiseptic and deodorizing properties, and is used mainly for cleaning wounds. It is also used as a mouthwash (diluted 1:7), and as ear drops (1:4 in water or 501% alcohol).
thydromorphone A potent opioid analgesic of the morphine type. Dose: in severe pain 1.3-2.6 Ing 4 t,-hourly. Walladone).
hydrotalcite Aluminium magnesium hydroxide carbonate. An antacid used in dyspepsia and related conditions.
Dose: I g as required.
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hydrocortisone The principal corticosteroid, also known as cortisol, that is secreted by the adrenal cortex. It plays a major role in the metabolism of glucose, protein and calcium, in maintaining the electrolyte balance, and in reducing inflammatory and allergic responses. It is used in all cases of adrenocortical insufficiency, including Addison’s disease and after adrenalectomy. It is also used in anaphylactic shock, asthma, rheumatoid disease and allergic states. It is valuable in
hydroxocobalamin A derivative of eydnu,obdlaniin, and now the preferred form of vitamin B,, as it has a more prolonged action.
Dose: in pernicious anaemia and other vitamin 13, deficiency states, I Ing initially ian. repeated 5 times at intervals of 2-3 days; maintenance dose 1 mg by I’ll’
by )CC- Lion every 3 months. It is also given
prophylactically after total gastrectonly. (Cobalin-H; NCO-Cytalliell). See
page 112.

hydroxyapatite A natural substance with a mineral composition somewhat similar to that of bone. It is used as a source of calcium and phosphorus in osteoporosis and other deficiency states. Tablets of 830 mg are available. (Ossopan).
hypermotility of the gastrointestinal tract, and may be useful in spasmodic dysmenorrhoea.
Dose: 40-80 mg daily; in acute spasm, .10 mg by injection. (Buscopan).
hydroxychloroquine An antimalarial with the actions, uses and side-effects of chloroquine. It is also useful in rheumatoid arthritis in doses of 200-400mg daily, and in lupus erythematosus, but side-effects are numerous, and treatment requires expert supervision. (Plaquenil). See page 165.
hypromellose A cellulose-derivative that dissolves in water to form a viscid, colloidal solution. Such a solution is used as a base for eye drops to extend the action of a dissolved ophthalmic drug; to lubricate contact lenses; and to act as a lubricant in chronic, sore eye conditions.
5-hydroxytryptamine See serotonin.
hydroxurea (hydrocarbamide) A cytotoxic agent sometimes used in chronic myeloid leukaemia.
Dose: 20- 30 mg/kg as a single dose daily or 80 nig/kg every third day. Side-effects are nausea, skin reactions and myelo- suppression. (Hydrea). See page 122 and Table 8.
hydroxyzine A mild tranquillizer with some sedative and antihistaminic properties. It is given in the short-term treatment of anxiety, and in pruritus and dermatoses complicated by emotional tension. Dose: 50-400 mg daily. It has the side-effects of the antihistamines, and is not recommended where some sedation is undesirable. (Atarax; Ucerax). See page 117 and Table 3.
hyoscine (scopolamine) An alkaloid obtained from plants of the belladonna group. It is a powerful hypnotic and is widely used together with papaveretum for premedication before anaesthesia in doses of 300-600 pg by s.c. or i.m. injection. It has some antiemetic properties, and is useful in travel sickness and vertigo. Dose: 300 mg 30 minutes before starting the iourney, followed by up to 3 doses 6-hourly. Scopoderm is a patch of 500 pg. Thc side-effects of mouth dryness and dizziness are those of the anticholinergic drugs generally. It is contraindicated in glaucoma. It is used occasionally in terminal care for bowel colic and excessive respiratory secretions. Dose: 600 pg-2.4 mg daily by s.c. infusion.
hyoscine butylbromide A derivative of hyoscine that differs in lacking any central action. It is given in spasm and
I
ibuprofen A non-steroidal anti-inflammatory agent (NSAID) widely used in rheumatoid and arthritic conditions. It is also given as an analgesic for mild to moderate pain, but not for acute gout. Dose: 1.8 g daily initially; lly; maintenance duos, 600 lllg-L2 daily after food. A 5% cream is available for local use. The sideeflicts are those of the NSAID& generally. (BrUlen; Feribid). See page 165.
ichthammol A thick, dark brown liquid with a characteristic odour, derived from certain bituminous oils. It is a mild antiseptic and is used mainly in chronic eczema as a 100A, ointment or zinc paste. A solution (10% in glycerin) has been used oil ulcers and inflamed areas.
idarubicin A potent cytotoxic agent similar in actions and uses to doxorubicin. It is given orally and i.v. in acute nonlymphocytic leukaemia, breast cancer, and as second-line therapy in acute lymphatic leukaemia. Dose is based on skin area. (Zavedos). See page 122 and Table 8.
idoxuridine An antiviral agent now virtually superseded by acyclovir and related drugs. Used occasionally in herpes zoster skin infection by local application of a 5% solution. See page 144 and Table 19.

fosfamide A derivative of cyclophosphamide with similar actions and uses. It is effective in lung, ovary, breast and soft-tissue tumours, as well as some malignant lymphomas.