Posts Tagged ‘enoxaparin’

tiaprofenic acid A non-steroidal analgesic and anti-inflammatory agent with the actions, uses and side-effects of related NSAIDs such as naproxen.
Dose: 600-800 nig daily. Mild oedema may occur with extended treatment. Peptic ulcer and asthma are contraindications. Severe cystitis is an occasional side-effect. It should not be given to patients with urinary tract disorders, and should he withdrawn at once if any
urinary symptoms develop. (Surgarn). See Page 165 and Table 29.
t1bolone A compound described as an gonadomimetic steroid as it has oestrogenic and progestogenic properties. It is used to control the vasomotor symptoms of the menopause, including those surgically induced as well as those occurring naturally.
Dose: 2.5 ing daily for some months. Similar doses in the prophylaxis of osteoporosis. Side-effects are headache, dizziness and vaginal bleeding. Treatment should be withdrawn if any thromboembolic symptoms or jaundice appear. (1,ivial).
Dose: 400 nig as a single daily dose for 12 weeks, to be taken with water at least 2 hours before or 2 hours after meals. Antacids and milk should be avoided. The improvement in serum alkaline phosphatase activity may persist, and a second course needed only after an interval of at least 6 months. Gastrointestinal side-effects are common, but renal function should be monitored regularly. (Skelid).
timolol A beta-andrenergic blocking agent of the propranolol type, used in the control of angina and hypertension. Dose: 10-60nigdaily. In the prophylactic t i catment of migraine, 10-20 ing daily. (,’are is necessary in bradycardia, cardiac insufficiency and bronchial disease. It is also of value as eye drops (0.25%-0.5%) in simple chronic glaucoma, as it reduces infra-ocular pressure by reducing the formation of the aqueous humour. (Betim; Blocadren; Timoptol). See pages 148 & 154, and Table 21.
tinidazole A drug similar to metronidazole, and used mainly in the prophylaxis and treatment of anaerobic infections and anioebiasis.
Dose: 2 g initially, followed by I g daily for 5 days. A single oral (lose of 2 g is given 12 hours before abdominal surgery, and a similar single dose is given in amoebiasis and giardiasis. Side-effects are nausea, vomiting and diarrhoea. A disulfiram-like -like reaction may occur if alcohol is taken. ( Fasigyn).
99
ticarcillin An antibiotic with an increased activity against Pseudomonas aeruginosa. In pseudomonal septicaemia, combined treatment with an aminoglycoside anti biotic such as gentamicin may evoke an increased response.
Dose: 15-20 g daily by slow i.v. injection or infusion in systemic infections; 3-4 g daily by i.m. injection in urinary infections. (Ticar). It is sometimes given together with clavulanic acid as Timentin, but it delayed post-treatment reaction with Tinientin is cholestatic jaundice, thought to be due to clavulanic acid.
tiludronic acid A bisphosphonate that inhibit., (fie [)one resorbing activity of osteoclasts, and so reduces the excessive demineralization of bone that occurs in Paget’s disease.
tinzaparin A low-molecular weight heparin ti,cd in the prevention ofthromboembolism.
Dose: by s.c. injection 2500-3000 units daily for 7-10 days. It is also used to prevent clotting in haemodialysis apparatus. (Innohep; Logiparin). See dalteparin and enoxaparin. With these products laboratory control is not necessary.
tioconazole An antifungal agent used in
tines infections of the nails by the
extended application of a 289/6 solution. Treatment for 6 months or more may be necessary. (Trosyl).
titanium dioxide A metallic oxide, similar to zinc oxide, with mild astringent properties. It is present in some sunburn protection preparations.

tizanidine A central alpha, receptor agonist use([ in the spasticity associated with multiple sclerosis and spinal injury. Dose: 2 ing weekly, increased according to response up to 24 ing daily. Monitor liver function monthly for 4 months. (Zaiiallex).
tobramycin An aminoglycoside antibiotic with the actions, uses and side-effects of gentamicin, but considered to be more active against Pseudomonas aerugi . nosa. Dose: 3-5 nig1kg daily by i.m. injection or i.v. infusion. It may be given together with a penicillin or nictroniclazole in serious mixed infections. Care is necessary to avoid the ototoxic and nephrotoxic effects of aminoglycosides. (Nebcin).
tocainide An anti-arrhythmic agent similar in action to lignocaine. It is a powerful drug, and may cause severe blood dis(urhances, and its use is largely restricted to the control of life-threatening arrhythmias not responding to other drugs.
Dose: 1.2-2.4 g daily. Blood counts during treatment are essential. Side-effects include bradycardia, hypotension, rash, tremor and aplastic anaemia. (Tonocard).
tocopherol A synthetic form of vitamin E.
tolazamide An oral hypoglycaemic agent related to tolbutamide, with similar actions, uses and side-effects.
Dose: 100-250 mg daily, increased if necessary up to a maximum dose of I g daily. (Tolanase). See page 131 and Table 13.
tolbutamide A sulphonylurea used like Jilorproparnicle in the treatment of maturity-onset diabetes, but it has a shorter action, and twice-daily doses are usually necessary. It is effective only when some insulin-secreting cells of the pancreas are still functioning, and a return to insulin therapy may be necessary during illness and infection. Tolbutarnide is not suitable for the treatment of juvenile or severe diabetes.
Dose: 0.5-2 g daily. Side-effects include hypoglycaemia, poglycaernia. rash, Jaundice and blood dyscrasias, but are uncommon with low doses. (Rastinoo). See page 131 and
Table 13.
tolcapone An inhibitor of the enzyme concerned with the biosynthesis of dopamine. It is used with other drugs in the
treatment of parkinsonism in initial doses of 100 mg 3 times a day. Side-effects are dyskinesia, nausea and sleep disturbances. (Tasmar). See page 160 and Table 26.
tolfenamic acid A non-steroidal anti-inflammatory drug (NSAID) but exceptional in being used in the treatment of migraine, on the basis that prostaglandins are involved in the pathology of migraine. Dose: 200 mg at the onset of an attack, repeated once after 2-3 hours if necessary. Close monitoring is required if anticoagulants also given; caution in peptic ulcer. (Clotani). See page 154 and Table 23.
tolmetin An anti-inflammatory analgesic agent used in rheumatoid and mUSCUIOskeletal conditions. As with related non-steroidal anti-inflammatory drugs
(NSAIDs) it may cause gastrointestinal disturbances in some patients, and should be taken after food. Hypersensitivity reactions may occur occasionally.
Dose: 0.6-1.8 g daily. (Tolectin). See page 163 and -Fable 29.
topiramateV A new anti-epileptic that differs chemically from related drugs. It is used as adjunctive therapy in partial seizure patients not adequately controlled by standard treatment.
Dose: initial (lose 100 nig daily, slowly increased at weekly intervals as required up to 800 mg daily. Patients receiving digoxin should be monitored. Not recommended for children. (Topaniax). See page 136 and Table 15.
topotecanV A new advance in cancer chemotherapy is the use of topoisomerase inhibitors. Topoisomerase I is necessary for DNA replication, and topotican acts by binding with super-coiled DNA and so preventing further DNA development. Dose: 1.5 mg/n’ by i.v. infusion daily for 5 days under expert supervision. Side-effects are myelosuppression and severe neutropenia. (Hycamptin). See page 122 and Table 8.
torasemide A loop diuretic of the
IrLISCII)i(IC type.
Dose: in oedema, 5-20 ing once daily; in pulmonary oedema 10-20 mg daily by slow i.v, injection but much larger doses are sometimes necessary. In hypertension. 5-20 mg daily. (Torero). See page 148 and Table 21.

toremitene’v” An anti-oestrogen used in h0i 11 im ie- dependent metastatic breast cancer.
Dose: 60 mg as a single daily dose. Side- effects are linked with the mode of action
aninclude hot flushes, dizziness and
sweating. Care is necessary in severe hepatic deficiency, angina and cardiac weakness. (Fareston). See page 122 and Table 8.
trannadoW An analgesic used in the short-tan) treatment of moderate to severe pain. It has reduced affinity for opioid receptors, and the action may be mediated by inhibiting the neuronal re-uptake of noradrenaline and related amines. Dose: 300-400nig; in severe pain it may he given by i.m. injection or i.v. injection/infusion in closes of 50- 100 ing 4-6-hourly. (Tramake; Zamadol; Zydol).
trandolapril An ACE inhibitor used in mild io moderate hypertension.
Dose: 500 jig daily initially, increased at intervals of 2-3 weeks up to 1-21ng once daily. If hypotension occurs, reduce supportive therapy before lowering the trandolopril dose. Prophylactic dose after myocardial infarction 500 Vg-4 mg daily. Diuretic therapy should be stopped before starting with trandolapril, to reduce the risks of initial hypotensive side-effects. (’are with monitoring in patients with renal and hepatic impairment. (Gopten; Odrik). See page 148 and Table 21.
tranexamic acid An antifibrinolytic agent used to check haemorrhage after prostactectomy, in surgery generally and in the control of menorrhagia.
Dose: 2-8 g daily; 3 g daily by slow i.v. infection. Side-effects are nausea, diarrhoea and dizziness. (Cyklokapron).
tranquillizers These drugs were once Separated into the major tranquillizers, represented by chlorpromazine, and the minor tranquillizers exemplified by diazepam, but are now often referred to as antipsychotic drugs and anxiolytics respectively. The antipsychotics are used mainly in the control of disturbed patients, and in schizophrenia, although they have some anti-anxiety properties, and long-term treatment is often necessary. The anxiolytic drugs are intended mainly for the short-term treatment of acute anxiety states, as extended use may
cause dependence. See pages H 7 & 168, and Tables 5 & 30.
Transiderm-Nitro A medicated patch containing glyceryl trinitrate designed to have an action over 24 hours in the prophylaxis of angina.
tranylcypromine A monoamine oxidase inhibitor (MACI), of use in severe depression not responding to other drugs. Dose: 20 nig daily initially, increased to .50 ing daily or more according to need. The use of tranylcypromine requires care, as the drug has a stimulant action that may complicate therapy, and phenelzine may be preferred. Side-effects are dizziness, dry mouth and insomnia. Liver damage may also occur, and a hypertensive crisis with throbbing headache requires withdrawal of the drug. Hyperthyroidism is a contraindication. (Parnate). See page 128 and Table 11.
trazodone An antidepressant chemically distinct from other drugs with a similar action, and with reduced anticholinergic and cardiovascular side-effects. It is
indicated mainly in depression associated with anxiety when a sedative action is also required.
Dose: 150-300mgd;iily.’['Iieside-effects are those of the tricyclic antidepressants such as amitriptyline. (Molipaxin). See page 128 and’I'able 11.
treosuffan A cytotoxic agent related to busulphan, but used mainly in ovarian cancer.
Dose: I g daily for 28 days, repeated after a 4-week rest period; 5-15g by i.v. injection at intervals of 1-3 weeks. In all cases the (lose is adjusted according to the
degree of bone marrow depression that occurs. Other side-effects are those of cytotoxic drugs generally. Extravasation causes pain and local tissue damage. See page 122 and Table 8.
tretinoin A derivative of vitamin A. It is used locally for acne (Retin-A) and also for the treatment of photodamage to the skin (Retinova). A new use is the induction of remission in acute promyelocytic leukaemia.
Dose: 22.5 trig/m2 twice daily with food. Combined therapy may reduce the risk of relapse (Vesanoid).

dornase alfa A recombinant form of human deoxyribonuclease (rhDNase) used in cystic fibrosis. The viscous purulent airways secretion of that disease is due to the presence of large amounts of extra-cellular DNA from degenerating leucocytes. Dornase alfa breaks down the DNA and reduces the sputum viscosity. Dose: 2500 units daily by inhalation from it jet nebulizer. Daily treatment is necessary to maintain the response. (Ptilillozvme).
dorzolamide An inhibitor of carbonic anhydrase that reduces the amount of sodium bicarbonate in the aqueous humour of the eye. It is used as eye drops (2%) 2 or 3 times a day as adjunctive therapy in ocular hypertension when beta-blockers are unsuitable or ineffective. (Trusopt). See page 138 and Table 16.
dothiepin (dosulepin) A tricyclic antidepressant with the uses and side-effects of antitriptyline. It is used in the treatment of depression when a sedative action is also indicated.
Dose: 75-150 mg daily. It may also be given as a single nightly dose to reduce daytime drowsiness. (Prothiaden). See page 128 and Table 11.
doxapram A respiratory stimulant useful in postoperative respiratory failure under expert control.
Dose: by i.v. injection 1-1.5 nig1kg according to need. It is also given by i.v. infusion in doses controlled by arterial food gas studies. Side-effects include hypertension, Ypertension, bronchospasin and tachycardia. (Dopram).
doxepin An antidepressant with the actions, uses and side-effects of dothiepin.
Dose: 30–300 nig daily; a single dose of I Ito mg is sometimes given at night. (Sinequan). See page 128 and Table 11.
doxorubicin A cytotoxic antibiotic widely used in leukaemia, lymphosarcoma, breast and lung cancer.
Dose: by fast i.v. infusion 60-75 nigIm’ at intervals of 3 weeks, or 20-25 mg/m’ daily for 3 days. It is also used by bladder installation (50 mg in 50 nil of saline solution) for superficial bladder tumours. Side-effects include bone marrow depression, cardiac damage, alopecia, buccal ulceration and nausea. Doxorubicin is it skin irritant, and should he handled with care. See page 122 and Table 8.
doxycycline A long-acting tetracycline. Dose: 200 mg initially, followed by 100 ing its a single daily (lose. In acne, a dose of 50 mg daily is given for some weeks. It should be taken with adequate fluid, with the patient in a sitting or standing position. (Nordox; Vibramycin).
droperidol A tranquillizer with unusual properties. It is given in severe psychotic conditions such as mania, in drug-induced nausea and vomiting and for preoperative sedation. It is also given with fentanyl to produce a state of detachment (neuroleptanalgesia).
Dose: 20-120 ing daily; 5-10 ing by injection; in cancer therapy induced vomiting (loses of 1-3 nig/hr have been given by continuous i.v. infusion. Side-effects are those of chlorpromazine and haloperidol. (Droleptan).
doxazocin An alpha-adrenoceptor blocking agent of the prazosin type, but with a longer action that permits a single daily dose.
Dose: in hypertension I mg initially, slowly increased after 7-14 days to 2 mg daily, up to a daily maximum of 16 ing, usually in association with other amihypertensive drugs. It is also used in Iliesymptcunitic treatment ofbenign prostatic . P
hy erplasia. Side-effects are
dydrogesterone An orally active progestogen that is virtually free from
any oestrogenic or androgenic side-effects. It is used in amenorrhoea, endometriosis, functional uterine bleeding, and threatened abortion.
Dose: 10-30 mg daily. (Ouphastort).

econazole An antifungal agent similar in actions and uses to clotrimazole. (Ecostatin; Pcvaryl).
ecothiopate A potent and long-acting iniotic that has been used in glaucoma as eye drops of 0.03-0.25%. It may cause cataract; its availability is strictly limited.
edrophonium A very short-acting drug of the neostigniine type. It is used in the diagnosis of myasthenia gravis.
Dose: 2-10 nig by i.v. injection, which causes a marked but transient increase in muscle power if myasthenia gravis is present.
eformoterol A selective P2 stimulant (agonist) with a rapid initial action, used as supplementary treatment in patients receiving other bronchodilator therapy for reversible airway obstruction.
Dose: by inhalation: 12µg twice daily, doubled if necessary. (.are is necessary in ischaernic heart disease and diabetes. Not to be used for acute attacks. (Foradil). Sec page 118 and Table 6.
enalapril An ACE inhibitor used in the treatment of all types of hypertension, and in congestic heart failure, often together with a diuretic.
Dose: i ing daily initially, increase(] as required up to 40 mg daily, and often given as a single dose. Dizziness, hypotension and loss of taste are some side-effects. ! I imov.i, :. See page 148 and Table 21.
enflurane An inhalation anaesthetic with the actions and uses of halothane, but less potent.
epoetin alfa and beta Recombinant fornis of human erythropoietin. (Eprex; Recormon). See erythropoietin.
epoprostenol A prostaglandin present in the walls of blood vessels that inhibits platelet aggregation. It is used to prevent platelet aggregation during cardiopulmonary bypass and charcoal haemoperfusion, and as an alternative to heparin in renal dialysis.
Dose: 10-20 ng1kShnin by continuous i.v. infusion. Smaller doses in renal dialysis. It is also a vasodilator, and side-effects are flushing and hypotension. (Flolan).
enoxaparin A low-molecular weight and longer acting form of heparin. It has the general properties of heparin, but with less effect on blood platelet activity. It is used in the prevention of venous thrombosis. Dose: 20 mg by sx. injection once daily ( I hour before surgery) for 7-10 days. (Clexane). See certoparin, dalteparin and tinzaparin.
enoximone An inhibitor of the enzyme phosphodiesterase. It has a digoxin-like action on the myocardium and is used in
eptacog alfa See Factor VIIa.
ergocalciferol See calciferol.
ergometrine The principal alkaloid of ergot. It promotes uterine contraction and is used for the rapid control of postpartum haemorrhage. Dangerous in the early stages of labour.
Dose: 05-1 nig orally; or 200-500 jig by injection. It is often used together with oxycytocin as Syntometrine. Side-effects are nausea and transient hypertension.

ergot A fungus that develops in rye and replaces the normal grain. The active principles include ergometrine and ergotamine. Chronic toxic effects characterized by gangrene of the extremities have followed the use of ergot-contaminated rye bread.
ergotamine Air alkaloid of ergot that constricts the cranial arteries, and is used solely for the relief of migraine not responding to analgesic therapy. Early treatment evokes the best response.
Dose: 2 mg initially up to 6 ing during an attack, not to be repeated until after an interval of some days.”I oral dose in I week: 10– 12 mg. It is also given by oral inhalation in doses of 360pg ( I puff), repeated after 5 minutes, up to a maximum of 6 puffs daily. Side-effects include headache and nausea, and the drug should be withdrawn if tingling of the extremities occurs.
trot suitable for prophylaxis because of the risks of toxicity. (Lingriine). Sec page 154
erythromycin Air antibiotic, resembling penicillin in its general range of activity, with the advantage of being active orally. It is useful in streptococcal and respiratory infections and in penicillin-resistant staphylococcal infections. Erythromycin is also of value in penicillin-sensitive patients. It is also given as a prophylactic before dental surgery. Dose: up to 4 g daily; in severe infections it may lie given by slow i.v. infusion in closes of 50 mg/kg daily. Side-effects include nausea and vomiting, and diarrhoea may occur after high doses. Gore is necessary in hepatic impairment. Preparations of erythromycin estolate are contraindicated in liver disease. Erythromycin may potentiate the action of warfarin. It should not be given with aslenii/.ole or terfenadine.
erythropoietin (epoetin) A renal hormone that regulates blood cell production in the bone marrow. Patients with renal failure maintained by haemodialysis do not
produce epoetin, and so become anaemic. A recombinant form of erythropoietin is available for replacement therapy.
Dose: 20-50 units/kg 3 times a week by s.c. or i.v. injection under haematological control. Side-effects include headache and hypertension, but a sudden migraine-like pain may indicate air impending hypertensive crisis. (Eprex; Itecormon).
eserine See physotiginine.
esmolol A very short-acting betaadrenoceptor blocker used in the emergency treatment of supra-ventricular arrhythmias, tachycardia and perioperative hypertension.
Dose: by i.v. infusion 50-200pg/kg/rniri under close control. (Brevibloc).
estramustine A compound of oestradiol and inustine, designed to release mustinc at oestrogen-receptor sites. It has a more localized action and so causes less myelodepression. It is used mainly in prostatic carcinoma, especially when resistant to other therapy.
Dose: 0.56-1.4 g daily. It should not be taken with food or milk products. Side-effects include gastrointestinal disturbances, nausea and gynaccomastia. (Fstracyt). See page 122 and Table 8.
ethacrynic acid A loop diuretic with a rapid and intense action used mainly in oliguria due to renal failure.
Dose: 50 ing daily initially, increased as required up to a maximum of400rng daily or on alternate days. Ethacrynic acid is also given by slow i.v. iniection in doses of 50-100 mg in acute or refractory conditions. Side-effects include nausea, diarrhoea and deafness. Some hypotension may occur initially. (Edecrin).
ethambutol An antitubercular drug.
Dose: 15 mg/kg daily, together with i i lo i i ipic in or isoniazid. Lower doses should be given in renal damage. It may cause visual disturbances with loss of acuity, but recovery is usually complete on withdrawal of the drug. (Myarnbutol). See page 170 and Table 31.
ethamsylate A haemostatic used in the prophylaxis and treatment of periventricular haemorrhage in low birth-weight infants.
Dose: 12.5 mg/kg by injection 6-hourly within 2 hours of birth and continued for 4 days. It is also used orally in menorrhagia. Dose: 2g daily. (Dicynene).
ethanolamine oleate A sclerosing agent used for varicose veins and bleeding oesophageal varices.
Dose: by local i.v. injection, 2-5 nil.
ether A colourless inflammable liquid, once widely used as a general anaesthetic but now replaced by halothane.

cephamandole A cephalosporin more resistant to inactivation by penicillinases. It is of value in serious infections resistant to other antibiotics.
Dose: 2-12 g daily by i.m. or i.v. injection. : Kellidol). See page 248 and Table 34.
cephazolin A cephalosporin with the
general properties of the group.
Dose: 1-12 g daily by injection. (Kefzol). See page 248 and Table 34.
cephradine A cephalosporin active orally as well as by injection.
Dose: 1-2 g orally daily; in severe infeclions 2–8g daily by injection. (Velosef). See page 248 .
certoparin A low molecular weight form of heparin. Used in prophylaxis of venous thromboembolism.
Dose: 3000 units once a day by s.c. injection (1-2 hours before surgery) for 7-10 days. (Alphaparin). See enoxaparin.
cetirizine A slower-acting antihistamine with reduced sedative effects, as it does not pass the blood-brain barrier to any extent. The anti-cholinergic side-effects are also reduced.
Dose: 10 nigat night. (’Lirtels). See page 110 and Table 2.
cetrinnide A detergent with some antiseptic properties. It is used chiefly in association with chlorhexidine.
charcoal Activated charcoal is a powerful adsorbent, and is used in the treatment of overdose or poisoning by many toxic drugs by preventing further absorption. Dose: 50g orally. It is also used in the charcoal - haenioperfusion system to promote elimination from the circulation of sonic already absorbed poisons. Charcoal has also been used as impregnated dressings to deodorize foul smelling wounds and ulcers,
chenodeoxycholic acid A bile acid
derivative that has it solvent action on cholesterol-containing gallstones, and it is useful when surgical removal of the stones is contraindicated.
Dose: I g once daily, but prolonged treatment is necessary. Side-effects are diarrhoea and pruritus, and ursodcoxycholic acid, which has fewer side-effects, is often preferred. Chenodeoxycholic acid is not suitable for the dissolution of radio-opaque gallstones. (Chendol; Chenofalk).
chloral hydrate A water-soluble hypnotic with a rapid action that is useful in the treatment of insomnia in children and the elderly.
Dose:    g. It must be given well-diluted to reduce the gastric irritant side-effects, and is contraindicated in gastritis, and severe renal, hepatic and cardiac disease. (Notre). Chloral betaine (Well-dorm) is a less irritant alternative. See page 152 and Table 22.
chlorambucil An orally active cytotoxic drug used mainly in the treatment of lymphomas and chronic lymphocytic leukaemia.
Dose: 100-200 pgfkg daily for 4-8 weeks. It k sometimes used as an immunosuppressant in the treatment of rheumatoid arthritis in doses of 2.5-7.5 mg daily. Chloranibucil is generally well tolerated, [)of [)one marrow depression may occur, and haematological control during treatment is essential. (Leukeran). See page 122 and Table 8.
chloramphenicol A wide-range, orally active antibiotic but now used only in life-threatening infections where other drugs arc unsuitable.
Dose: 2g daily orally, but in severe infections, -So niglkg daily by i.v. injection. Care is necessary when giving chloramphenicolo infants as it may cause so-called ‘grey syndrome’. Side-effects include nausea, neuritis and aplastic anaemia. Chloromycetin is also used locally in skin, eye and ear infections. (Chloromycetin; Kcinicetine).
chlordiazepoxide A benzodiazepinc used mainly in [tic short-term treatment of anxiety and alcoholism.
Dose: 30 mg daily, increased in severe anxiety up to 100 mg daily, with half closes fix elderly patients. Withdrawal of treatment should be gradual to avoid rebound effects. Side-effects include dizziness, drowsiness and ataxia. Prolonged use carries the risk of dependence. (Librium).

chlorhexidine An antiseptic of high potency and a wide range of activity, although it is ineffective against spores and viruses. For preoperative skin preparation, a 0.5% solution in alcohol is often used; an aqueous solution (0.05%) is for general topical application. Chlorhexidine is also used as a  solution for bladder irrigation. A general purpose cream and an obstetric cream are also available. Solutions of chlorhexidine may become contaminated with Pseudomonas, and all aqueous solutions should he sterilized. (1-libitane).
irreversible retinal damage. Other side-effects are gastrointestinal disturbances, rash and prutiros. (Axioclor,). Swe page 16.3.
chlorothiazide The first of the thiazide diuretics, now largely replaced by bendrofluazide and similar drugs. Dose: 1 -2 g daily in oedematous states; 0.i-1 g daily in hypertension. Potassium supplements may be necessary with extended treatment. (Saltiric). See page 148 and Table 21.
29
chlormethiazole A sedative with anticonvul’ant properties.
Dose: in severe insomnia in the elderly, 200-400nigorally; in alcohol withdrawal conditions, 400-800 mg initially, reduced and withdrawn over a 9-day period. It may also be given by i.v. infusion as a 0.8% solution. Chlonnethiazole has also been given by injection in status epilepticus and the toxaemia of pregnancy in doses according to need and response. Side-effects are sneezing, gastrointestinal disturbances and headache. (Heminevrit) See page 136 and Table Ii.
chloroform Once widely used as a general anaesthetic, but now obsolete. Used as chloroform -water in mixtures as a preservative and flavouring agent, and for its carminative effects.
chloroquine An antimalarial drug used for both prophylaxis and treatment of benign and malignant tertian malaria. It should be noted that chloroquine- resistant strains of Plasmodiunifialciparurn are becoming increasingly common, and a return to treatment with quinine may be necessary. Dose: adult prophylaxis, 300nig once a week; (Or treatment of an attack of malaria, oWnig initially followed by 300mg daily for 2-3 days. Seriously ill or vomiting patients should be given 2(XI-300 ing by Lin. or slow i.v. injection, repeated once ifncccssary L)cfi)rc oral treatment can be tolerated. Other dosage schemes are also in use, and for details reference should be made to standard works on the treatment of malaria. It has also been used in hepatic anioebiasis, but nietronidazole is now often preferred. Chloroquinc also has an action in rheumatoid inflammatory conditions similar to that of penicillamine, dose: 150 mg daily after food. Such use requires care, as extended therapy is necessary, and the drug may cause corneal opacity and
chloroxylenol A general purpose antiseptic present in some popular products. Of no value against Pseudornonas. aeruginosa or Proteus.
chlorpheniramine An antihistamine with the action, uses and side-effects of the group, including drowsiness.
Dose: 16-24 mg daily: 10-20 mg by Lin. or .c. injection as required. (Piriton). See page 110 and Table 2.
chlorpromazine A powerful tranquillizer or antipsycholic agent with a wide range of activity on the central nervous system. It is widely used in the treatment of schizophrenia and other psychoses, in agitation and tension, and the management of refractory patients. It is also effective as an antienietic in terminal illness; in the short-term treatment of severe anxiety; and for the control of intractable hiccup.
Dose: initially 75 mg orally daily, slowly increased as required. In psychotic states, Lip to I g daily. Single doses of 25-50 mg may be given by deep imi. injection in acute conditions. Suppositories of 100 mg are also available. Side-effects include extrapyramidal and anticholinergic symptoms, drowsiness, hypotension, weight gain, rash, jaundice and haemolytic anaemia. prolonged use may cause pigmentation of the skin and eyes. Care is necessary in hepatic and renal dysfunction. Skin sensitization may occur after Contact With solutions of chlorpromazine. Margactil). See page 168 and’I'able 30.
chlorpropamide A long-acting hypoglycaemic agent of the sulphonylurea type. It is effective only if some insulin-secreting cells are still functional. It is used mainly in mild diabetes mellitus occurring in middle-aged patients not responding to dietary control. Its long action makes it unsuitable for elderly diabetics.