Posts Tagged ‘dapsone’

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.
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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.
89
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.

cytarabine A cytotoxic agent that prevents cell development by inhibiting the formation of nucleic acid. It is used mainly in the control of acute mycloblastic leukaemia.
Dose: 0.5-3 mg/kg daily by i.v. or s.c. injection. Close haematological control is essential as the drug is a powerful myclodepressant. Other side-effects are those of the cytotoxic drugs, generally, but fever, myalgia and bone pain may also occur. Alexan; Cv cos: r).
Dose:    nig/kg, daily for 10 days, repeated after 4 weeks. Side-effects are severe nausea, bone marrow depression and an influenza-like syndrome. The drug should be handled with care, as it is a tissue irritant. (DTIC).
dactinomycin See actinomycin D.
dalteparin A low-molecular weight heparin given by s.c. injection for pre- and postoperative thrombo-embolic prophylaxis. Dose: 2500 units daily for 5 (lays. (Fragmin). See enoxaprin and tinzaparin.
cytotoxic drugs A term applied to drugs that can kill cancer cells. In practice, many factors influence their therapeutic value. They are rarely selective, and therapeutic doses usually have a toxic effect on sonic normal cells. They may attack cancer cells at different stages of development, as actively dividing cells are more susceptible than resting cells. They may not reach the cancer cells in adequate concentration, or resistance to the drug may develop. The dose may also depend to some extent on the patient’s tolerance of the drug, and combined treatment with two or more drugs may have the advantages of increased potency with reduced toxicity. All cytotoxic drugs, with the exception of bleomycin and vincristine, bring about a depression of the bone marrow, which may be severe, and some degree of hair loss, which is usually reversible. Severe nausea and vomiting are also common, and early use of powerful antiemetics is essential. Many cytotoxic agents are tissue irritants, and with i.v. treatment great care must be taken to avoid extravasation, as severe local tissue damage can occur. See alkylating agents and antimetabolites. See page 122.
clacarbazine A cytotoxic drug that appears to depress purine metabolism and the formation of DNA. It is used mainly in malignant melanoma, and in combination with other agents it is of value in other malignant conditions.
clanazol A derivative of ethisterone that inhibits the release of pituitary gonadotrophins. Used in conditions such as endometriosis and gynaecomastia. Dose: 200-800 ing daily, starting during menstruation. Side-effects are nausea, dizziness, rash, flushing and hair loss. Care is necessary in cardiac, renal or hepatic impairment, and in epilepsy and diabetes. (Danol).
danthron A synthetic anthraquinone laxative used mainly for constipation in the aged, and in drug-induced constipation in the terminally ill. Not suitable for routine use by other patients.
Dose: given in doses of 25–25 mg as codanthramer, and acts within 6-12 hours. the urine may be coloured red.
dantrolene A skeletal muscle relaxant that acts on the muscle fibre, and not at the myoneural junction. The action may be linked with an interference with the movement of calcium ions. It is used in the severe and chronic spastic states that occur after stroke, spinal cord injury, and in multiple sclerosis.
Dose: 21 ing daily initially, increased at weekly intervals up to a maximum of 400 mg daily, as the response is slow and May be inadequate. The side-effects of weakness and Gangue are mild, and often transient, but liver function tests during treatment are essential. Dantrolene is also of value in malignant hyperthermia, a rare but serious complication of anaesthesia, and is given in doses of I mg/kg by i.v. injection as soon as the condition is diagnosed,

dapsone A sulphone compound used in the ti,atnient of leprosy.
Dose: 25-400 mg orally twice weekly and continued for some years. Resistance to dapsone may occur, and combined treatment with clofazimitic and rifarnpicin may lie necessary. Dapsone is sometimes given with pyrimetharnine in chlotoquine-resistaut malaria. Side-effects are nausea, rash, neuropathy and myelodepression.
duration of action. Used in the diagnosis and control of diabetes insipidus, and in the treatment of nocturnal eneuresis. Dose: 10-20pg intranasally once or twice
a day; 1-4 pg daily by injection. IMAM.
desoxymethasone A corticosteroid, for local application in acute inflammatory and allergic skin conditions. Used as oily cream 0.25%. (Stiedex).
daunorubicin See doxorubicin.
debrisoquine An adrenergic neurone blocking agent with the actions, uses and side-effects of guanethidine, except that it is less likely to cause diarrhoea. It is used mainly in resistant hypertension, in association with other drugs. (Declinax).
See page 148 and Table 21.
deflazacort A glucocorticoid with the actions and uses of related drugs, and comparable in activity with prednisolone. Dose: initially in acute conditions up to 120 mg daily; maintenance dose 3-18 mg daily. (Calcort). See hydrocortisone, page 55 and Table 36.
demeclocycline An antibiotic with the actions, uses and side-effects of tetracycline, but more likely to cause photo-allergic reactions.
Dose: 600 mg daily. Used occasionally in hyponatraemia due to overactivity of the antidiuretic hormone. (Ledermycin).
desferrioxamine A chelating agent that combines with iron salts to form a soluble non-toxic complex. Of great value in acute ferrous sulphate poisoning in children. Dose: 2 g immediately by i.m. injection, together with gastric lavage (2 g of desferrioxamine/1) followed by a single oral dose of 10 g. It may also be given by continuous i.v. infusion, 15 mg/kg hourly up to a maximum of 80 mg/kg. It may cause hypotension if the infusion is given too rapidly. It is also useful in the treatment of iron-overload caused by repeated blood transfusions, and for aluminium overload in patients On dialysis. (Desferal).
desflurane An inhalation anaesthetic
similar to CuflUrane. (Suprane).
desmopressin A derivative of vasopressin, with increased potency and longer
dexamethasone A potent synthetic corticosteroid, with reduced salt-retaining properties. Useful in all conditions requiring systemic corticosteroid therapy (except Addison’s disease), including inflammatory and allergic disorders, shock, cerebral oedema and adrenal hyperplasia.
Dose: 0.5-2 mg daily up to a MaXiMUM Of’ 15 mg daily; in shock, 5-20 mg by slow i.v. injection or infusion; in cerebral oedema, 10 ing initially by i.v. injection, followed by 4 mg i.m. 6-hourly. Dexamethasone is also given by infra-articular injection for local inflammation of joints in doses of
0.4-4 mg. It is also used as eye drops (0.1%)
in uveitis, but care is necessary with prolonged treatment as with some patients a ’steroid glaucoma’ may be precipitated. (Decadron). See page M and Table 36.
dexamphetamine sulphate A central nervous system stimulant. It is used in the treatment of narcolepsy and, paradoxically, it is sometimes useful in hyperkinesia in children.
Dose: in narcolepsy, 20-60 mg daily; in hyperkinesia 2.5 mg initially, slowly increased up to a maximunl’of 20 mg daily. Side-effects are insomnia, anorexia and agitation. Dependence and tolerance may occur early. (Dexedrine).
dextran A blood-plasma substitute
obtained from sucrose solutions by bacterial action, and used as solutions of varying molecular weight (dextran 40, 70). Dextran 70 is used as a blood volume expander by i.v. injection in some cases of shock; dextran 40 is used mainly to improve postoperative peripheral circulation, reduce blood viscosity, and to prevent thrombo-embolism. Care must be taken to adjust dose to avoid overloading the circulation. Any blood-matching should be carried out before giving dextran. (Gentran; Macrodex; Rheomacroclex).