Posts Tagged ‘hodgkin s disease’

mupirocin An antibacterial agent that is effective against most of the pathogens responsible for skin infections. It is used as a 2% ointment in impetigo, folliculitis and similar conditions. It should not be used for longer than 10 days to avoid the development of resistance. (Bactroban).
mustine A cytotoxic drug used mainly in the treatment of Hodgkin’s disease and related conditions.
Dose: 0.1 mg/kg daily for 3 days as a fast-running i.v. infusion, or as a single dose of oA ing/kg. The solution is highly irritant, and extra venous injection causes very severe local necrosis. Side-effects include severe vomiting, bone marrow depression and alopecia. Close haematologicalcontrol during treatment is essential. Now in less frequent use. See page 122 and Tabl’. 8.
nabumetone A non-acidic anti-inflammatory agent of the naproxen type. It is effective in rheumatoid and osteoarthritis and has reduced gastric irritant properties. Dose: I g at night. Reduced closes are necessary in renal impairment, and the dose of any oral anticoagulant or hypoglycaemic agent may require adjustment. (Relifex). See page 165 and Table 29.
nadolol A beta-blocking agent with the
actions and uses of propranolol.
Dose: in angina, 40 mg daily, or more; in hypertension, 80 mg daily, increased slowly as required; in the prophylaxis and treatment of migraine, 80-160 mg daily. Maximum daily dose 240 mg. (Corgard). See pages 114 & 148, and Tables 4 & 21.
nafarelin A synthetic suppressant of steroid production by the gonads, and used in the treatment of endometriosis.
Dose: given as it once-only course of treatment by nasal spray in doses of 200 pg twice a day, starting between 2 and 4 days of the menstrual cycle, and continued for up to 6 months. Side-effects are numerous and of the menopausal type. (Synarel). See buserelin, goserelin and leuprorelin.
mycophenolate mofetil An immunosuppressant used together with cyclosporin and corticosteroids to prevent acute renal transplant rejection. It acts on a specific enzyme concerned with”]’- and B-lymphocyte proliferation, as well as inhibiting antibody formation.
Dose: 2 g daily, starting within 24 hours (d transplantation. Blood counts are necessary during treatment, and, as with other immunosuppressants, there is an increased risk of opportunistic infection. (CellCept).
nabilone A cannabinoid antiemetic used in the treatment of nausea and vomiting associated with cancer chemotherapy. Dose: 2-4 ing daily, beginning the day before cytotoxic treatment is commenced, and continued for a day after the end of the course. Side-effects are drowsiness, confusion and tremor. Care is necessary in liver dysfunction or any history of psychotic illness. See page 158.
naftidrofuryl A peripheral and cerebral vasodilator. Claimed to be of value in cerebrovascular disorders.
Dose: 300-600 ing daily. (Praxilene).
nalbuphine An opioid analgesic, comparable with morphine in potency, but with reduced side-effects and a reduced dependence potential.
Dose: by injection, 10-20 ingas required. It may cause nausea and dizziness, and care is necessary in respiratory, renal or hepatic dysfunction. (Nubain).
nalidixic acid A quinolone antibacterial agent used in cystitis and infections of the lower urinary tract, especially those due to Gram-negative bacteria (except Pseudornoricts). It is not suitable for systemic infections as the blood levels reached with nalidixic acid are too low to be effective.
Dose: 4 g daily for 7 days, with subsequent doses of 2 g daily. Side-effects arc nausea, visual disturbance, rash, jaundice and phototoxicity. Exposure to sunlight should be avoided; epilepsy is a contraindication. (Mictral; Negrain). See ciprotloxacin and norfloxacin.

naloxone A powerful and rapidly acting opioid narcotics antagonist. It is used immediately after operation to reduce any narcotic-induced respiratory depression. Dose: 100-200µg i.v. initially, followed by 100 µg at 2- minute intervals, as required. For neonates, 10 pglkg by iniection are given. In narcotic analgesic overdose, 800 lig-2 nig may be given, 111, to a total dose of 1 0 ing. (Narcan).
naltrexone A long-acting narcotic antagonist used only to prevent relapse and maintain recovery after treatment for opioid addiction. It prevents re-addiction only whilst the drug is being taken. Dose: 25 ing initially, later up to 50 mg daily. It must not be given to patients who are still opioid-dependent as an acute withdrawal syndrome may be precipitated. (Nalorex).
nandrolone An anabolic steroid related to testosterone, with markedly reduced virilizing properties. It has anabolic or tissue-building properties and has been used in postoperative convalescence, osteoporosis and wasting diseases but the response is poor. It is sometimes effective in aplastic anaemia.
Dose: 50 ing by deep Lin. injection every 3 weeks. (Deca-Durabolin).
the prophylactic treatment of asthma, but it is not effective in an established attack. Dose: by aerosol inhalation, 8 mg (4 pulls) daily. Side-effects are transient nausea and headache. (Tiladc). See page 118. It is also used as eye drops in allergic conjunctivitis. (Rapitil). See page 118 and Table 2.
nefazodoneV A new antidepressant of the selective serotonin-re-uptake inhibitor (SSRI) type.
Dose: 200-600 mg daily. (Dutonin).
nefopam An analgesic for moderate, acute and chronic pain before using more potent drugs. Dose: 90-270 ing daily; 20 mg by i.m. injection. Side-effects include drowsiness, headache and tachycardia. Care is necessary in hepatic or renal disease. (Acupan).
neomycin An antibiotic with a wide range of activity against Gram-positive and Gram-negative bacteria, but it is too toxic for systemic use. It is used mainly as an
ointment or cream (0.5%), often with an anti-inflammatory steroid, in infected skin conditions. It is also used locally for ear and eye infections as drops (0.5%), and it is occasionally given orally in doses of 6 g daily before bowel surgery. Extended local use may cause allergic reactions, and occasionally ototoxicity. (Mycifradin; Nivemycin).
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naproxen A widely used non-steroidal anti-inflammatory agent (NSAID) for the relief of rheumatic and musculoskeletal
disorders and acute gout.
Dose: 10-1 g daily, increased up to 2g daily in severe conditions. Suppositories of 500 ing are useful at night to reduce morning stiffness. Side-effects include headache, dizziness, and dyspepsia with occasional bleeding. Blurred vision may also occur, as well as I p hy ersensitivity reactions such as rash and bronchospasm. Care is necessary in renal and hepatic impairment; peptic ulcer is a contraindication. (Naprosyn; Syntlex). See page 165 and Table 29.
naratriptanVA serotonin (5-H’I',) receptor agonist for the treatment of acute migraine. Dose: 2.5 mg. A second dose may be given after at least 4 hours if the symptoms recur. (Nararnig). See page 154 and Table 23.
nedocromil An inhibitor of the release of inflammatory mediators in the respiratory tract. It is used like sodium cromoglycate in
neostigmine An inhibitor of cholinesterase which thus indirectly prolongs the action of acetylcholine released at nerve endings. It is used mainly in the treatment of myasthenia gravis.
Dose: 75-300 mg daily; 1-23 mg by injection. Side-effects are nausea, salivation, diarrhoea and abdominal cramp, and supplementary treatment with an anticholinergic drug may be required. It is also used postoperatively to antagonize the residual effects of muscle relaxants. Dose: 1-5 mg i.v., after a preliminary iniection of 0.3-1 nig of atropine. It is contraindicated in urinary or intestinal obstruction. (Prostiginio).
netilmidn An aminoglycoside antibiotic, less toxic than related drugs. Used mainly in severe infections of the urinary and respiratory tracts that are resistant to gentamicin. Dose: 4-6 mg1kg daily by i.v. injection; in urinary tract infections a single oral daily dose of 150 mg is given for 5 days. Side-’ effects are dizziness, vertigo, malaise and rash; ototoxicity may also occur. (Netillin).

neuromuscular blocking agents Drugs used to induce adequate muscle relaxation under a light plane of anaesthesia to facilitate surgery. The non-depolarizing agents such as vercuronium compete with acetylcholine at the neuromuscular receptor site, and have a relatively long action that can be reversed by neostigmine. The depolarizing relaxants, such as suxamethonium, have an acetylcholine-like action oil the receptor site, but as they are broken down less rapidly than acetylcholine, they delay the return of the ability of the muscle to contract again. The action of suxamethonium cannot be reversed by neostigmine.
niacin See nicotinic acid.
nicardipine A calcium channel blocking agent with it coronary vasodilator action similar to that ofverapaiiiii, but with reduced anti-arrhythmic activity. It is used mainly in angina and hypertension, and unlike verapamil it may be given to patients already receiving beta-blockers. Dose: 60-120 ing daily. Side-effects arc dizziness, flushing, nausea and palpita-
tions. If chest pain occurs early, the drugshould be withdrawn. Marked aortic
stenosis is a contraindication. (Cardene). See page I H and ‘]’able 4.
niclosamide A synthetic anthelmintic of value in the elimination of tapeworm. Dose: after lasting 2 g followed 2 hours later by a purge. The tablets should be chewed or crushed, and taken with a glass of water. Side-effects are nausea and abdominal pain, and occasionally pruritus. (Yoniesan).
nicorandil A cardiac drug that has an action mediated by the activation of potassium channels. It reduces the excitability of cardiac muscle and promotes coronary circulation, and is used in the prophylaxis and treatment of angina.
Dose: 5 10ing twice daily initially, rising to a maxintuin of6onig daily. Side-effects are initial headache, palpitations, dizziness. (lkorel). See page 114 and Table 4.
nicotinarnide A compound derived from nicotinic acid, possessing similar properties, but differing in that it has little vasodilator action. It is useful in
deficiency states as well as in pellagra when the vasodilator action of nicotinic
acid limits the dose. It is also used locally as a 4% gel (Papulex) for the treatment of inflammatory acne vulgaris.
nicotinic acid An essential food factor, occurring in yeast, liver, etc., but now prepared synthetically. It is a specific in the treatment of pellagra. It causes vasodilation, and has been used in Wni&e’s disease and chilblains, but with variable results. In large doses it reduces the plasma levels of some lipoproteins. Dose: 10-30 mg daily for prophylaxis; therapeutic dose in pellagra, 250-500 mg daily. In hyperlipidacinia up to 6 g daily have been given. Side-effects include flushing, dizziness and pruritus, which may sometimes lie reduced by taking aspirin 75 mg half an hour before a dose. See page 146,
nicotinyl alcohol A derivative with the vasodilator properties of nicotinic acid, but they are less intense. Useful in peripheral circulatory disturbances such as Raynaud’s disease and acrocyanosis. Dose: 100-200 mg daily. (Ronicol).
nicournalone A synthetic anti-coagulant similar to warfarin, and used mainly in the treatment of deep-vein thrombosis. Dose: 8-12 ing initially; subsequent doses are based on the response, as shown by determination of the blood prothrombin time, expressed as the International Normalized Ratio (INR). Haemorrhage is a potential side-effect. (Sinthrome).
nifedipine A calcium channel blocking agent similar to verapamil, but with a more powerful peripheral and coronary vasodilator action. It is used in the treatment of angina, hypertension and Raynatid’s disease, and may be given if required in association with a beta-blocking agent.
Dose: in angina, 15-60 mg daily; in hypertension 40-80 mg daily. Side-effects are flushing and headache, which are usually transient, and some ankle oedema may occur. It should be withdrawn if anginal pain develops. Severe aortic stenosis is a contraindication. (Adalat• Coracten; Nifensar). See pages 114 & 148, and “fables 4 & 21.
nimodipine A calcium channel blocking agent that acts preferentially on the cerebral vessels. It is used in subarachnoid haemorrhage to prevent ischaemic sequelae.

lithium succinate Lithium succinate appears to have sonic antifungal and anti-inflammatory properties, and is used as an 8% ointment for seborrhoeic dermatitis. (Ftalith).
lodoxamide A mast cell stabilizer similar to sodium cromoglycate. Used as eye drops (0.1%) in allergic conjunctivitis. (Alomide).
Dose: in acute diarrhoea, 4 mg initially, followed by 2 nig as required, up to a maximum of 16 ing daily. In chronic diarrhoea, 4-8 nig daily, but care is necessary in the elderly to avoid faecal impaction. Loperamide is not suitable for children under 4 years of age, nor in patients with liver disease, as it may cause undesirable sedation. (Iniodium).
loprazolam A benzodiazepine hypnotic used mainly in the short-term treatment of insomnia and nocturnal arousal. Dose: 1-2 nig at bedtime. Side-effects include drowsiness, dizziness, dry mouth and headache. See page 152 and Table 22.
loratadine An antihistamine with the general action of that group of drugs, but with reduced sedative side-effects.
Dose: 10 nig dailv. (Clarityn). See page I 10 and Table 2.
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lofepramine An antidepressant of the irnipramine group, with similar actions and uses, but reduced sedative and anticholinergic side-effects.
Dose: 140-210 nig daily. (Gamanil). See page 128 and Table 11.
lofexidine A narcotic antagonist. It has a selective blocking action on brain nor-adrenaline, and is used for the rapid relief of opioid withdrawal symptoms associated with central sympathetic activity.
Dose: 200 pg twice a day, slowly increased as required over 7-10 days, before withdrawal over 2-4 days. Care is necessary in cardiac insufficiency and bradycardia. (Britl.olex).
lomotil A preparation of diphenoxylate with atropine, for the rapid control of diarrhoea. Dose: 2 tablets 6-hourly.
lomustine A slow-acting cytotoxic agent used in Hodgkin’s disease and solid tumours.
Dose: 130 ing/ni’body surface at intervals of (> 8 weeks. Side-effects, include anorexia. nausea, liver damage and niyelodeprm ion. Dosage should not be repeated until white cell and platelet counts have returned to an acceptable level. Reduced doses are given
when lomustine forms part of a multi-drug dosage scheme. (CCNU). See page 122 and Table 8.
loperamide A synthetic inhibitor of peristalsis.
lorazepam A short-acting anxiolytic/ hypnotic similar to diazepam, but less likely to cause next-day drowsiness. Dose: 1-4 mgdaily. It is also given in similar oral closes or by slow i.v. injection in doses of 50 pglkg for preoperative sedation and anuiesia. Occasionally used i.v. in status epilepticus in doses of 4 nig, but apnoea and hypotension are side-effects that may require resuscitation. fAtivan). See page 152 and Table 22.
lormetazepam A short-acting benzodiazepine hypnotic. It is useful in the treatment of insomnia in the elderly, but is less suitable for insomnia associated with early awakening.
Dose: 500 fig I nig at night. See page 152 and ‘]’able 22.
losartanV An angiotensin 11 receptor antagonist used in the treatment of hypertension.
Dose: 50ing daily The use of potassium-sparing diuretics should be avoided with losartan. It has the advantage of not causing the persistent dry cough associated with ACE inhibitors. (Cozaar). See page 148 and Table 21.
low molecular weight heparins See heparin.
loxapine Antipsychotic agent with the actions and uses of chlorpromazine. Dose: in acute and chronic psychoses, 25-50 mg daily, slowly increased as required. Maintenance doses range from 20-100111g daily. Side-effects are those of other anti-psychotic agents. but loxapine may cause nausea, vomiting and weight changes. f .oxapac). See page 168 and Table 30.
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magnesium hydroxide A mild antacid laxative, usually given in aqueous suspension as Cream of Magnesia, although tablet forms are also available. Cream of Magnesia is a useful antidote in mineral acid poisoning.
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Lugol’s solution An aqueous solution of iodine 5% and potassium iodide 10%. Used in the preoperative treatment of t hyrotoxicosis.
Dose: 0.3-1 ml.
lymecycline A soluble complex of tetracycline and lysine. It has the action and uses and side-effects of tetracycline, but is absorbed more readily.
Dose: 800 mg daily. (Tetralysal).
typressin An analogue of vasopressin used to control the polyuria of pituitary diabetes insipidus.
Dose: 2.5-10 units several times a day by nasal spray. Side-effects include nausea and abdominal pain. I.ypressin has some vasoconstrictor properties, and desmopressin is sometimes prellcrred. (Syntopressin).
lysuride (lisuride) A bromocriptine-like drug for the treatment of parkinsonism. II acts by stimulating any surviving dopamine receptors in the brain.
Dose: 200 pg at night with food,
irk ceased at weekly intervals according to response up to a maximum of 5 mg daily. Side-effects include nausea, dizziness and initial hypotensive reactions which may affect driving ability. (Revanil). See
page 160 and Table 26.
magnesium sulphate Epsom salts. A powerful saline aperient, producing loose stools by preventing the reabsorption of water.
Dose: 5- 15 g before breakfast. Used externally for the treatment of boils and carbuncles as a paste with glycerin. A marked loss of plasma magnesium may occur after severe diarrhoea or drug-induced diuresis, and may require the i.v. infection of magnesium sulphate in doses based on the degree of hypoinagnesacmia. It has also been given i.v. in a dose of 8 mmol in the emergency treatment of severe;U’rhythinias associated with hypokalaemia.
magnesium trisilicate A white insoluble powder, with mild but prolonged antacid effects. It was formerly widely used in the symptomatic treatment of peptic ulcer;
now used chiefly for dyspepsia.
Dose: 0.3-2 g.
malathion An organophosphorus insecticide. Used as a lotion 0.5% for lice and scabies as alternative to lindane or carbaryl.
mannitol A sugar that is not metabolized, and is used mainly as an osmotic diuretic. Dose: (after a test dose of 200 mg/kg) 50-200 g by slow i.v. infusion over 24 hours. Mannitol has also been used by i.v. infusion as a short-term ocular hypotensive agent in the treatment of glaucoma. It is also useful in cerebral oedema, given by rapid i.v. injection in a dose of I g/kg as a 2044, solution.
macrolides A group of antibiotics that differ chemically from the penicillins, yet have a similar pattern of activity. They are active orally and are useful in the treatment of penicillin-sensitive patients. Erythromycin is the most widely used member of the group, with clarithromycin and azithromycin as more recent introductions.
magnesium carbonate A white, insoluble powder with antacid and laxative properties.
Dose: 0J-4 g daily.
maprotiline A sedative antidepressant with a general action similar to that of the tricyclic drugs represented by amitriptyline. Dose: 25-150 mg daily. If given at night as a single dose, the sedative action may reduce the need for other drugs. It has milder anticholinergic side-effects than some related compounds, although skin rash is more common. (I udionlil). See page 128 and Table 11.
mebendazole An anthelmintic effective against most intestinal worms.

Dose: 100 mg once for threadworm, and 100 mg twice daily for 2 days against other infestations. Generally well tolerated, but it should not be given to children under 2 years of age. (Verniox).
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in oedematous states. A potassium supplement may be required. Care is necessary in renal and hepatic deficiency.
(KiYcaron). See page 148 and Table 21.
mebeverine An antispasmodic agent which, unlike the anticholinergic drugs, appears to have a direct action on the intestinal smooth muscle. It is useful in the treatment of gastrointestinal spasm and in the irritable bowel syndrome. Dose: .100 mg daily, before food. As with other antispasmodics, mebeverine should not be used in paralytic ileus. (Colofac).
medroxyprogesterone A synthetic progestogen.
Dose: in endometriosis 30 mg daily for 90 days; in dysfunctional uterine bleeding and secondary amenorrhoea: 2.3-10 mg daily for 5-10 days, starling on l6th-2 Ist day of cycle and repeated for 2-3 cycles. Large doses of 400 mg-1.5 g daily are given in breast, endometrial, prostate and other hormone-dependent cancers, or 250mg– I g weekly by deep i.m. inJection. (Farlutal; proves). Depot-proves is a long-acting product used by i.m. injection is a contraceptive. but only after fit][ counselling.
megestrol An orally active progestogen. It is used in oestrogen-dependent breast cancer, and acts by suppressing the uptake of oestrogens by the cancer cells.
Dose: 160 mg daily. Nausea and fluid retention with weight gain are occasional side-effects. (Megace). See page 122.
meloxicarn A recently introduced non-steroidal anti-inflammatory drug (NSAID) indicated in the short-term treatment of acute osteo-arthritis and the longer-term treatment of rheumatoid conditions. Dose: 7.5-15 mg once daily with food; half doses for the elderly. Suppositories of 15 mg are also available. The side-effects are basically those of the NSAI Ds in general. Meloxicam has a more selective action on cyclo-oxygenase, the enzyme involved in the biosynthesis of prostaglandins, and is less likely to cause gastrointestinal disturbance, but it has no cytoprotective action, and is not suitable for patients with peptic ulcer. (Niobic). See page 165 and Table 29.
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mefenamic acid A non-steroidal anti-inflammatory analgesic agent used to relieve moderate pain in arthritic and rheumatoid conditions, and other states requiring mild analgesic therapy such as dysmenorrhoea. Dose: 1.5 g daily after food. Side-effects are drowsiness an(] haemolytic anaemia. Diarrhoea is an indication that the drug should be withdrawn. (Ponstan). See page 165 and Table 29.
rnefloquine A drug for the prophylaxis and treatment ofchloroquine-resistant malaria. Dose: lot- short -term prophylaxis 250 mg weekly, starting 1 week before exposure and for 4 weeks after return. Doses for treatment require specialist advice. Side-effects include gastrointestinal disturbances, dizziness and weakness. It is contraindicated in patients with a history of neu ro- psych iatric disturbance, and is not suitable for use in severe renal or hepatic impairment. (Lirium). See halofantrine.
mefruside A diuretic useful in the treatment of hypertension and oedema. Dose: 25-50 mg daily in the morning, according to need and response; 25-100 mg
melphalan An alkylating agent of the mustine type. Used mainly in myelomas, lymphomas and some solid tumours. Dose: 150-300 gg/kg daily for 4-6 days, repeated after 1-2 months. In myeloma it is also given by regional perfusion. The injection solution is highly irritant and contact should be avoided. Side-effects include myelo-depression, nausea, rash and pruritus. (Alkeran). See page 122 and ‘rabic 8.
menadiol A water-soluble form of vitamin K. Dose: 10 ing daily. (Synkavit) Phytorneii,dionc i.% now preferred.
menotrophin Human menopausal gonadotrophin containing follicle-stimulating hormone and luteinizing hormone. It is used in the treatment of anovulatory sterility. The dose depends on individual hormone assays and response. The use of the drug has resulted in multiple births. It is also given to males to stimulate spermatogenesis. (Humegon; Normegon).
menthol Colourless crystals obtained from oil of peppermint. Used as spray or drops for nasopharyngeal inflammation.

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.