Posts Tagged ‘gonadorelin’

triamcinolone A glucocorticosteroid with the actions, uses and side-effects of hydrocortisone, but differing by promoting sodium excretion, and so is of no value in adrenal cortex deficiency states. It is used in a wide range of inflammatory, allergic and respiratory states, and in inflammatory skin conditions.
Dose: 8-24 mg daily. It is also given as triamcinolone acetonide in doses of 40 ing by deep i.m. injection for a depot action. The acetonide is also given by iniraarticular injection in doses of 2.5-40 mg in local inflammation of the joints, and by intra-lesional injection in doses of 2-3 mg at any one site for the treatment of skin lesions. Triamcinolone actonide is also used as a 1% cream or ointment in severe inflammatory skin conditions. The side-effects are those of the corticosteroids (see hydrocortisone), but triamcinolone may also cause myopathy with high dose treatment. (Kenalog; Ledercort).
triamterene A potassium sparing diuretic, used mainly in association with more powerful drugs. It is indicated in oedematous conditions generally, and, as it causes some retention of potassium, its use avoids the need for supplementary potassium therapy.
Dose: 150-250 mg daily, with lower doses for the elderly and when given in association with other diuretics. Rash .ind gastrointestinal disturbances are ,ide-effects. (Dytac). See page 148 and Kahle 21.
tribavarin An inhibitor of viral replication used in severe viral bronchiolitis in infants.
Dose: by aerosol inhalation of a solution (20 ing/ml) for 12-18 hours daily liar 3-7 days, together with supportive therapy. (Viravid).
triclofos A derivative of chloral, with the sedative properties of the parent drug, but less irritant to the gastric mucosa.
Dose: I 2gdaily.
alternative to penicillamine in other conditions. The main side-effect is nausea.
trifluoperazine A powerful tranquillizing drug of the chlorpromazine type. It is used mainly in schizophrenia and similar psychoses, and in severe anxiety.
Dose: 10-20 nig or more daily according to need. In severe anxiety, 2-6 ing daily. In acute conditions, 1-3 mg daily by deep i.m. injection. As an antiemetic, it is given in doses of 2-4 mg or 1-3 ing by injection. The side-effects are similar to those of chlorpromazine, including extra-pyramidal symptoms, but the anticholinergic and sedative side-effects are less severe. (Stelayine). See page 168 and Table 30.
tri-iodothyronine See liothyronine.
trilostane An inhibitor of enzyme systems concerned with production of mineraloand glucocorticosteroids by the adrenal cortex, and so resembles metyrapone to some extent. It is used to control adrenal cortex hyperfunction and the excessive production of aldosterone.
Dose: 240 ing daily initially, adjusted tip to a maximum of 480 mg daily, according to the plasma corticosteroid levels. Care is necessary in liver and kidney dysfunction. (Modrenal).
trimeprazine A sedative antihistamine used in the treatment of pruritus and allergic itching conditions, and for premedication.
Dose: 30-100nig daily; pre-medication dose: 3 mg/kg. (Vallergan).
trimetaphan A short-acting ganglionic-blocking agent. It is used to produce a controllable reduction in blood pressure (luring neuro- and vascular surgery when a relatively bloodless field is necessary. Dose: by i.v. infusion, 3-4 nighnin initially, with subsequent doses carefully adjusted to the response. Side-effects are tachycardia and respiratory depression. Frequent determination of blood pressure during use is essential.
triclosan A chlorinated phenolic antiseptic, used mainly in surgical scrubs and similar preparations. (Manusept; Ster-Zac).
trientine A copper-chelating agent used in Wilson’s disease, but only for patients unable to tolerate penicillamine.
Dose: 1.2 -2.4 g daily. It is not an
trimethoprim An antibacterial agent similar in action to the sulphonamides. It is used in the prophylaxis and treatment of urinary tract and respiratory infections due to sensitive bacteria.
Dose: in chronic infections, 200-400 nig daily; prophylactic dose, 100mg daily. In severe infections, 130-250 mg twice daily by slow i.v. injection. Side-effects are nausea, vomiting,rash and pruritus, and possible bone marrow depression. (lpral;
Monotrim). See co-trimoxaole.
trimetrexateV An antibacterial agent used like atovaquone in AIDS patients with Pnettinocystis carinii pneumonia.
Dose: 45 ing/nidaily by i.v. infusion for 21 (lays, followed by calcium folinate 80 nighty daily for 28 days, orally or i.v. (Neutrexin).
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oral antidiabetic drugs by increasing the sensitivity to endogenous insulin, and so acts as an insulin enhancer.
Dose: 200 mg daily with breakfast, increased if required by 200 mg at intervals of 2-4 weeks up to 600 mg daily. Side-effects are diarrhoea, fatigue and malaise. (Romozin). See page 131 and Table 13.
tropicamide A short-acting mydriatic agent similar to homatropine. Used as 0.5% and I% solution.
trimipramine A sedative anti-depressant with the action and side-effects of amitriptyline. It is valuable in depression complicated by anxiety.
Dose: 75-300 mg daily. (Surmontil).
triple vaccine Diphtheria, tetanus and pertussis vaccine for the primary ininitinization ofchildren.
Dose: 0.5 ml by i.m. or deep s.c. injection.
triptorelin A synthetic form of gonadorelin, used in the treatment of advanced prostatic cancer. Such cancers are testosterone-dependent, and triptorelin acts by depressing pituitary function, and so indirectly reduces the plasma level of testosterone.
Dose: It has been formulated so that a single i.m. injection of 4.2 ing depresses testosterone production for 28 days. Initially there may be a temporary flare-up of symptoms, which can be prevented by giving an anti-androgen for 3 days before treatment, and continued for 2-3 weeks. Patients should be monitored for uleric obstruction and spinal cord compression during the first months of treatment. DecapepivI Sr). See page 122.
tropisetron A 5–HT.,-receptor antagonist, similar to ondansetron bill with a longer action. It is used to control the nausea and vomiting induced by cancer chemotherapy.
Dose: initially as a 5 mg dose i.v. shortly before such therapy, and followed 1)), oral doses of 5 mg daily, I hour before food, for 5 days. Side-effects are dizziness, headache and gastrointestinal disturbance. (Navoban). See page 122.
tryparsamide Used in late trypansomiasis when the CNS is involved.
Dose: 1-3 g by injection weekly, up to a maximum Lill) of 24 g. May damage optic nerves.
tryptophan\7 An amino acid involved in the biosynthesis of serotonin. It is used in specialist centres for the treatment of severe and prolonged depression resistant to other drugs, and where a deficiency of serotonin may be a factor. (Optimax). See page 128 and Table 11.
tuberculin A product obtained from cultures of Mycobacterium tuberculosis. It is used in the diagnosis of tuberculosis. See BGC vaccine.
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trisodium edetate A chelating or binding agent that is sometimes used in hypercalcaernia. The calcium complex so formed is excreted in the urine.
Dose: slow i.v. infusion tip to 70 rng1kg daily according to need and response, as shown by plasma calcium measurement. It is also used as a 0.4% solution for
ophthalmic use in lime burns of the eyes. Side-effects after injection are nausea, diarrhoea and cramp. Contraindicated in renal impairment. (Limclair).
troglitazone A new drug for non-insulin dependent diabetes. It differs from other
tulobuterol A selective beta,-adrenergic agonist of the salbutamol type, used in the prophylaxis and treatment of bronchospasm in asthma and related conditions. Dose: 4-6 mg daily. (Respacal). See page 118 and’fable 6.
tyrothricin A minor antibiotic used as
lozenges for mouth infections.

undecenoic acid An organic acid with useful antimycotic properties. It is used mainly as powder or ointment (5%), often with zinc undecenoate in the treatment of athlete’s foot and associated conditions.
urea An osmotic diuretic. It has been used orally in doses of 5-15 g. Applied locally as a 10% solution, it promotes granulation and reduces odour front•    foul ulcers.
urofollitrophin A preparation of human lollide-stimulating hormone (FSH) used with nienotrophin for the induction of ovulation. Dose and duration of treatment require careful control to avoid Over-stimulation. (Metrodin; Orgafol).
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allergen vaccines, used for desensitization to various allergens such as grass pollens, arc not true vaccines, but weak solutions of allergen extracts. They may precipitate allergic reactions in susceptible patients, and should be used only when emergency resuscitation measures are immediately available.
valaciclovirV A pro-drug of acyclovir used in herpes zoster. It is well absorbed orally, and quickly converted to the parent drug and promotes an improved response.
Dose: 3 g daily for 7 days, reduce([ in severe renal impairment. Dose in herpes simplex I g daily. Side-effects are headache and nausea. (Valtrcx). See page 144 and Table 19.
valproic acid (Convulex). See sodium valproate.
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urokinase A plasmin activator obtained from human urine. It is used mainly in the thrombolysis of blocked i.v. shunts, and in the lysis of blood clots in the eye. Dose: 5000-37 500 units, instilled into the shunt; similar doses are injected into the anterior chamber of the eye for the resolution ofl)l blood clots. (Ukidan).
ursodeoxycholic acid The acid appears to be a solvent of cholesterol, and is given orally to promote the dissolution of cholesterol-containing gall stones.
Dose: 8-12 mg/kg as a single daily dose, hut prolonged treatment is required, which should be continued after the dissolution of the stones to inhibit recurrence. The dissolution of calcium-containing or radio-opaque stones is unlikely to occur. (Destolit; Ursofalk).
valsartan An angiotensin II receptor antagonist used in hypertension. It has a more selective action than the ACE-inhibitors. Dose: 80 mg daily. Combined treatment with a potassium-sparing diuretic is not advisable. (Diovan). See page 148 and Table 21.
vancomycin An antibiotic used in severe antibiotic-associated staphylococcal colitis ( pseudomembranous colitis).
Dose: 0.5 g daily for i-10 days. It is also given by injection in resistant bacterial endocarditis; I g twice a day by slow i.v. infusion over 1-2 hours, as rapid injection may cause anaphylactic shock. Blood concentrations of the antibiotic should be monitored, as the many side-effects include renal damage, ototoxicity and ncutropenia. Pruritus and upper body flushing may occur, and tinnitus is an indication that the drug should be withdrawn. (Vancocin).
vaccines Bacterial vaccines are suspensions or extracts of dead bacteria, but sonic anti-viral vaccines are also available. They may be given by s.c. or i.m. injection, and are used mainly for prophylaxis against a particular infection. The most commonly used vaccines include those for typhoid, cholera, diphtheria, influenza, tetanus and polio. Protection against mumps, measles, pertussis, rubella, yellow fever and hepatitis can also be obtained. The so-called
vasoconstrictors Drugs such as noradrenaline that constrict the peripheral vessels, and so cause a temporary rise in blood pressure. They are useful in hypotensive conditions when the blood volume is still adequate, and in controlling the fall in blood pressure that occurs in spinal and general anaesthesia.

gelatin A protein obtained by the hydrolysis of animal tissues. Used orally as nutrient jellies, and specially refined solutions have been used as blood volume expanders (see dextran). (Gelofusine; Haemaccel).
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nephrotoxic side-effects, and dosage requires care when renal function is inadequate, and also in elderly patients. Gentarnicin is also used locally as cream or ointment (0.3%) and as eye drops (0.3%). (Cidomicin; Genticin).
gemcitabineV A cytotoxic agent related
to cytarabine, but with increased
potency and a longer action. It blocks cancer cell replication by inhibiting DNA synthesis, and may enhance the action of other agents. It is used mainly in the palliative treatment of non-small cell lung cancer.
Dose: 1000 mg/m-’ by slow i.v. infusion over 30 minutes, once a week for 3 weeks, repeated after a rest period. It is generally well tolerated, but a common side-effect is a transient influenza-like reaction. Myelosuppression is less severe than that of related cytotoxic agents. (Gemzar). See page 122 all(] Table 8.
gentian violet See crystal violet.
gestrinone An antiprogestogen used in ctidonictriosis that acts indirectly by suppressing gonadotrophin production. Dose: 2.5 ing twice weekly oil the same day,, each week for o months. Side-effects arc fluid retention, acne and voice changes. ( Dimetriose).
gestronel A synthetic progestogen used in the treatment of breast and endonietrial carcinoma and benign prostatic hypertrophy.
Dose: 200-400 ing i.m. once a week. (Depostat).
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gemeprost A synthetic prostaglandin used to dilate the cervix uteri in first trimester abortion.
Dose: I mg, as a pessary 3 hours before surgery. Side-effects are mild uterine pain and vaginal bleeding initially, nausea and di.11 I hoc.).
gernfibrozil A plasma lipid regulating agent, with the actions and uses of hez.afibrate and clofibrate.
Dose: 901) ing-1.3 mg daily, with regular checks oil plasma lipid levels. Treatment should be withdrawn after 3 months if the response is unsatisfactory. Gernfibrozil may potentiate the action of oral anticoagulants, the dose of which should be adjusted. Side-effects include nausea, diarrhoea, abdominal pain, rash and dizziness. (Lopid). See page 146 and Table 20.
gentamicin An aminoglycoside antibiotic, active against a wide range of Gram-negative organisms, including Pseudomonas aeruginiosa, as well as against many Gram-positive bacteria, although it is not very active against anaerobic organisms. It is of great value in septicaemia and meningitis, as well as in bacterial endocarditis.
Dose: 2-3 nig/kg daily by i.m. injection or i.v. infusion. In serious or undiagnosed infections, supplementary treatment with a penicillin or metronidazole may be require(]. In common with other arninoglycosides, goitarnicin has ototoxic and
glibenclarnide An orally active hypoglycaenfic agent similar to chlorpropamide. Dose: 5-15 nig daily, according to need and response. (Daonil; Euglucon). See
page 131 and’I'able 13.
gliciazide A sulphonylurea with the actions and uses of chlorpropamide and related drugs.
Dose: 40-320 mg orally. (Diarnicron). See page 131 and Table 13.
glimepiride A sulphonylurea used in non-ill Sidi 11 -dependent (Type 11) diabetes mellitus.
Dose: 2 mg after breakfast, increased ill, to .1 mg daily. Side-effects include
transient visual disturbances, rash and urticaria. (Amaryl). See page 131 and Table 13.
glipizide A sulphonylurea, used like chlorpropamide in diabetes, but effective in much lower doses.
Dose: 5 mg initially, maintenance dose 2.5-40 nig daily. (Glibenese; Minodiab). See page 131 and Table 13.
gliquidone An oral hypoglycaemic agent similar to chlorpropamide. Effective in maturity-onset diabetes.
Dose: I5 ing initially; maintenance dose 40-60 nig daily, but up to 180 mg daily have been given. (Glurenorni). See page 131 and Table 13.

glucagon A hormone of the alpha cells of the pancreas which raises the blood sugar level by mobilizing liver glycogen. Used in acute hypoglycaemia.
Dose: 0.5-1 mg by s.c., i.m. or i.v. iniection. (GlucaGen). Give i.v. glucose if there is no response within 10 minutes.
glucocorticoids Those corticostcroids with an anti-inflammatory action similar to hydrocortisone, as distinct from the mmerailocorticoids, such as fludrocortisone, used in Addison’s disease. Thel, differ in anti-inflammatory potency, and 0.75 mg of dexamethasone is considered equivalent to 20 mg of hydrocortisone. See Table 36.
glucose Also known as dextrose. A readily absorbed carbohydrate present in many
man
sweet fruits, but obtained commercially by the hydrolysis of starch. It is given orally as a dietary supplement; in acidosis; and to raise the glycogen reserves of the liver in hepatic damage. Given by i.v. infusion as a 5% solution, or as a glucose-saline infusion in dehydration and shock, and after surgery until fluids call be taken by mouth.
glutaraldehyde A disinfectant of the formaldehyde type, but with a more rapid and powerful action. Effective against a wide range of organisms, including
viruses. Used mainly for instrument sterilization as a 2% solution. Usually activated before use by the addition of a corrosion inhibitor. Such activated solutions are stable for about 2 weeks. It is also used as a 10% solution for the removal of plantar warts.
glycerin (glycerol) A clear syrupy liquid used as a sweetening agent in mixtures and linctuses. It promotes drainage when applied to inflamed areas, and is used as a paste with magnesium sulphate for boils. It is also used as suppositories for constipation.
Dose: sometimes given orally in doses of ]- 1.5 g/kg in glaucoma and before surgery to lower the intraocular pressure.
glyceryl trinitrate A powerful but short-acting vasodilator used in the control of angina pectoris. See page 114.
Dose: 300, 500 or 600 pg tablets which should be dissolved under the tongue for a rapid response. An aerosol spray (400g per
dose), as well as long-acting tablets are also available. Tolerance may occur with prolonged therapy. Side-effects are a throbbing headache, flushing and tachycardia. It is also used locally for all extended action, particularly at night, as ointment and medicated patches. Also given by i.v. infusion to control hypertension and ischaemia during cardiovascular surgery and in left ventricular failure. Dose: 10-200 pg/min in dextrose-saline. A new use of the drug is as an ointment (0.2%) to promote healing of anal Fissure. See page 1] 4 and Table 4.
glycopyrronium A synthetic atropine-like antispasmodic used for preoperative medication.
Dose: 200-400 pg by Lill. or i.v. injection. I i has the side-effects of anticholinergic drugs such as dryness of the mouth and blurred vision. Contraindicated in glaucoma. (Robinul).
GM-CSF Granulocyte-macrophage colony stimulating factor. See molgramostim. gold therapy See sodium aurothionialate.
gonadotrophins The follicle-stimulating hormone (FSH) and the luteinizing hormone (1-11) of the anterior pituitary gland. They stimulate ovarian development and the production of oestrogens; ill the male LH controls the formation of androgens. See gonadorclin.
gonadorefin A synthetic form of the gonadot roph in -releasing hormone of the pituitary gland (M-111-1). It is used to assess pituitary function.
Dose: 100 pg by i.v. injection normally
rise to a rapid rise in the plasma level of the luteinizingand follicle-stimulating hormones. In amenorrhoea and infertility due to gonadorelin insufficiency, it is given by pulsed s.c. infusion in doses of 1-20pg every 90 minutes, day and night. Treatment for up to 6 months may be required. Side-effects are uncommon. (Fertiloli Relefact). Sonic analogues of gonadorelin are used in remain cancers. See page 122.
goserelin A synthetic analogue of the hypothalamic hormone (LH-RH). It
suppresses the production of testosterone, d
anis used in the treatment of hormone-
dependent carcinoma of the prostate. It is also used in endometriosis and postmenopausal breast cancer.

Dose: 3.6 ing by s.c. injection every 28 days or as an implant. Side-effects include impotence, hot flushes, rash, breast swelling and tenderness. (Zoladex). See page 122 and ‘I able 8.
gramicidin A mixture of antibiotics effective against many Gram-positive organisms, but it is too toxic for syitenii, use. Used topically in infected skin conditions, usually in association with neomycin and hydrocortisone.
granisetron A scrotonin (5—HT) antagonist with a highly selective and powerful antiernetic action mediated by its effects on the 5-4-11′, receptors. It is used in the prevention and treatment of the severe nausea and vomiting induced by potent cytotoxic drugs such as cisplatin.
Dose: I mg I hour before treatment, then I ing twice daily, or by i.v. infusion in doses of 3 mg, repeated up to 3 times over 24 hours. For prophylaxis, a dose of 3 mg should be given before chemotherapy is commenced. Headache, rash and consti pation are common side-effects. (Kytril). See page 158.
griseofulvin An orally effective but slow
acting antifungal antibiotic that is
deposited selectively in the skin, hair and nails. It is used in the systemic treatment of ringworm and other dermatophyte infections of the keratin-containing tissues, but only when local treatment has failed.
Dose: 0.5-1 g daily, but prolonged therapy is required. Side-effects are headache, nausea, dizziness, rash and photosensitivity. 11 may also reduce the effects of oral contraceptives. (Fulcin; Grisovin).
growth hormone See soma(ropin.
guanethidine An anti-hypertensive drug that [)rings about a reduction in blood pressure by blocking transmission in adrenergic nerves, and preventing the release of noradrenaline. It has been used in the treatment of hypertension, often with a thiazide diuretic, but its use has declined as it may cause postural hypotension. Still used as part of combined therapy in resistant hypertension.
Dose: 20 mg daily, increased by 10 ing at weekly intervals according to response, up to 50 mg daily, although sometimes larger doses are required. Dose by i.m. injection,
10-20 nig as required. Diarrhoea, weakness, nasal congestion and bradycardia are common side-effects. (Ismelin). See page 148 and Table 21. Guanethidine is occasionally used as eye drops (1-3%) in glaucoma. (Ganda). See page 138 and Table 16.
guar gum A vegetable gum that, when taken with food, appears to retard the absorption of carbohydrates. It is used in the supplementary treatment of diabetes mellitus.
Dose: up to 15 g daily, usually sprinkled mi food. It is essential that a dose should he taken with an adequate fluid intake, and that the final dose is not taken at bedtime. Side-effects are flatulence and abdominal distension. (Guarem). See page 131 and Table 13.
halcinonide A powerful corticosteroid used iii severe inflammatory skin conditions not responding to other corticosteroids. It is applied sparingly as a 0.1% cream. (Halciderin).
halibut-liver oil A rich source of vitamins A ‘Ind 1).
Dose: 0.2-0.5 mi.
halofantrine An antimalarial, acting at the erythrocytic stage of the life cycle of plasmodium, and useful in chloroquine 01 MUlti-drug resistant malaria.
Dose: 500 nig 6-hourly for 3 doses between meals. Side-effects are nausea, vomiting and diarrhoea. It must not be given with or after mefloquine (risks of fatal arrhythmias). Contraindicated in pregnancy. 0 lalfan).
haloperidol A powerful tranquillizer used in schizophrenia, mania and psychoses. Dose: 5-20 ing daily, up to a maximum of 200 mg, reduced later according to
response. Dose by i.m. injection for rapid control of hyperactive psychotic patients, 5-30 mg initially, followed by 5 ing or more as required. For depot treatment, it is given as haloperidol decanoate, 50-300 mg by deep i.m. injection every 4 weeks. It is also given orally in doses of 500 g twice daily in severe anxiety. Doses of 1.5 nig