Posts Tagged ‘cisplatin’

chymotrypsin A proteolytic enzyme of the pancreas used in ophthalmology to facilitate intracapsular lens extraction. (Zonulysin).
cidofovir An antiviral agent used in cytomegalovirus retinitis resistant to ganciclivir.
Dose: 5 nig/kg by i.v. infusion every 2 weeks. (Vistide). See page 144 and ‘['able 19.
cilastatin See imipenem.
chlorthalidone A diuretic similar in action and uses to bendrofluazide, but with a longer duration of activity that permits a single morning dose. It is also useful in diabetes insipidus.
Dose: as diuretic 50-100 mg daily or on .illci nale days; in hypertension 25-50 mg; up to 350 mg daily in diabetes insipidus. (I lygrolon ). See page 148 and Table 21.
cholecalciferol See vitamin D.
cholestyramine An exchange resin that binds with bile acids in the intestines and prevents their absorption. Such acids are essential for cholesterol synthesis, and resin-binding leads indirectly to a lowering of plasma cholesterol levels.
Dose: in hyperlipidaemia: 12-24 g daily, wilh water; similar doses in the diarrhoea of Crohn's disease. It is also used in doses of 4-8 g daily to relieve the pruritus
associated with biliary obstruction. Side-effects are rash and gastrointestinal disturbances. Cholestyramine and related agents may interfere with the absorption of anticoagulants and other drugs. iQuestrari). See page 146 and Table 20.
choline theophyllinate A bronchodilator ,ilh the actions, uses and side-effects of anlinophyllille.
Dose: 400-1600 mg daily, after food. (C'I ioledyl). See page 118 and Table 6.
chorionic gonadotrophin A gonad-stimulating hormone prepared from the Urine of pregnancy. It has bten used in anovulalory sterility, metropathia haernorrhagica, habitual abortion and undescended testis.
cilazapril A long-acting ACE inhibitor with the actions, uses and side-effects of that group of drugs.
Dose: in essential hypertension 1 mg daily initially, increased up to 5 mg daily according to need. In renovascular hypertension 0.25-0.5 mg daily. (Vascace). See page 148 and'I'able 21.
cimitidine A selective histamine H, receptor antagonist. Unlike ordinary antihistamines, it inhibits gastric secretion, and is used in the treatment of peptic ulcer and other conditions of gastric hyperacidity. Dose: 8(m) nig daily for at least 4 weeks, doubled in severe conditions. Dose by i.m. or slow i.v. injection 200 mg 4-4-hourly. The dose should be reduce(] in renal impairment. The drug may increase the effects of oral anticoagulants and phenytoi ii. Side-effects include diarrhoea, rash and dizziness. It has some anti-androgen activity, and gynaecomastia is all occasional side-effect with high closes. (Dysparneu Tagarnet; Zila). See page 162 and Table 27.
cinchor-aine A local anaesthetic used as
ointment 1% in haemorrhoids and
pruritus. (Nupercainal).
cinnarizine An antihistamine, chiefly of value in Wniere’s disease, although it is also used in travel sickness and in peripheral vascular disorders.
Dose: 45-90 ing daily. Drowsiness and gastrointestinal disturbances are side-effects. (Stugeron).
cinoxacin A quinolone derivative with actions, uses and side-effects similar to i hose of nalidixic acid.

Dose: in urinary tract infections,  daily; prophylaxis 500mg daily. Contraindicated in severe renal impairment. (Cinobac).
ciprofbrate A blood-lipid lowering agent used in diet-resistant hyperlipidaemia as a single daily dose of 100-200 mg. (Modalim). See page 146 and Table 20.
ciprofloxacin A quinolone with a wide range of activity against both Gram-positive and Gram-negative bacteria, including Pseudomonas and Fronts. It is effective in many systemic infections, as well as in bone, joint and urinary infections, and in gonorrhoea, but is indicated mainly in infections resistant to other antibacterial agents. Dose: 500 mg -1.5 g daily for 5-7 days; in gonorrhoea, a single dose of 250 mg is given. In severe infections 200-400 mg daily by i.v, infusion for 5-7 days. Side-effects include nausea, dizziness, headache, rash and pruritus. plasma levels of theophylline may be increased and should be closely controlled. Care is necessary in convulsive disorders. (Ciproxin).
cisapride A gastrointestinal stimulant given to relieve gastro-oesophageal reflex and delayed gastric emptying.
Dose: .10-40 mg daily before meals, and at night, for some weeks. Side-effects are abdominal pain and diarrhoea. Drugs that delay the excretion of cisapride and may cause arrhythmias are erythromycin and clarithromycin-antigungal agents of the ketoconazole type should also be avoided. Unlike metoclopramide, it has no central antiemetic properties. (Alimix; Prepulsin).
cisatracurium A non-depolarizing neuromuscular blocking agent with an intermediate duration of activity. It is used as a muscle- relaxing adjunct in general anaesthesia, and to facilitate tracheal ininhation. (Nimbly).
cisplatin A cytotoxic agent containing platinum bound in an organic complex. The action is linked with drug-induced changes in DNA structure that inhibit cell development. It is used in ovarian, testicular and other solid tumours, and in resistant malignant conditions, sometimes in association with other antineoplastic agents.
Dose: by i.v.  for 5 days a month, or 15-120 mgIm’ monthly. Blood tests are essential
throughout treatment. Side-effects, which may be severe, include nausea, vomiting, and oto-, nephro- anti
citalopram A selective serotoninreuptake inhibitor (SSRI).
Dose: used in depression in single daily doses of 20 ing, increased up to 40 mg daily. Treatment for at least 6 months necessary to avoid relapse. (Cipraruil). See page 128 and Table 11.
cladribine A new agent used by specialists in hairy cell leukaemia. (Leustat).
clarithronlycin A macrolide antibiotic similar to erythromycin, but with better absorption and reduced gastrointestinal side-effects.
Dose: 250 rug twice a day for 7 days, doubled in severe infections. Care in hepatic an([ renal impairment. It may potentiate the effects of warfarin and digoxin. Should not be given with astemizole or terfenadine (risk of arrhythinias). (Khricid).
clavulanic acid An inhibitor of betalactanlase. Many penicillin-resistant organisms contain that enzyme in the cell wall, which inactivates the penicillin before it call enter the cell and exert its bacterial action. clavulanic acid inhibits such enzyme activity, and so facilitates the penetration of the antibiotic into the bacterial cell. It is used in association with amoxycillin as coamoxiclav (Augmentin) and with ticarcillin as Tinientin, in the treatment of infections due to amoxycillin-resistant bacteria.
clemastine An antihistamine used in allergic rhinitis, urticaria and allergic derniatoses.
Dose: I mg twice a day. In common with other antihistamines, it may cause drowsiness, and anticholinergic side-effects such as dryness of the mouth. H avegil). See
page 110 and Table 2.
clindamycin An antibiotic used mainly in staphylococcal bone and joint infections not responding to other drugs. It is also useful in anaerobic abdominal infections.  A serious side-effect is a potentially fatal pseudomernbranous colitis, and the drug should be withdrawn immediately if diarrhoea occurs. See vancomycin and nietronidazole.

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.