Posts Tagged ‘neostigmine’

dimethicone Activated dimethicone is an antifoaming agent, said to reduce flatulence and protect mucous
membranes. It is a constituent of many antacid preparations. It is also present in some water-repellent skin creams.
dipipanana A rapidly acting morphine-like analgesic of value in the sever rain 4 to -1 dk–
Dose: 30-3450 mg (fail),, but it is usually• given in association with cyclizine as Diconal. The side-effects are similar to those of morphine.
dipivefrine A pro-drug that is converted into adrenaline after absorption. It is used
in chronic open angled- glaucoma as eye
drops (0.1%). (Propine). See page 138 and Table 16.
dimethylsulphoxide (DMSO) An organic liquid, it has been used for the symptomatic relief of interstitial cystitis
(Hunner’s ulcer) by the bladder instillation of 50 ml of a 50% solution. (Rimso-50).
dinoprost Prostaglandin F,.. It has actions and uses similar to dinoprostone.
(Prostin 112).
dinoprostone A synthetic form of prostaglandin E,. It has been used to initiate contractions of the pregnant uterus. Dose: 500 pg orally to induce labour, repeated if necessary at hourly intervals; as vaginal tablets or gel, 3 mg. Side-effects are nausea, diarrhoea, shivering and dizziness. (Prostin E2; Prepidil).
dioctyl sodium sulphosuccinate See dOCUSalC.
diodone injection A solution of a complex organic iodine compound, used as a contrast agent in X-ray examination of kidneys and ureters.
diphenhydramine One of the early antihistamines, with a more sedative action, and use(] in the temporary relief of insomnia. Dose: 10-25 trig. (Medinex. Nytol). It is also present in some cough preparations and nasal decongestants.
diphenoxylate A derivative that resembles codeine III reducing intestinal activity. It is used for the symptomatic relief of diarrhoea, and is usually given with a small dose of atropine to discourage excessive dosage and to reduce the risk of dependence. Dose: 10 mg initially, then 5 nig every 6 hours as required. (Lomotil;’Fropergen).
diphenylpyraline An antihistamine used as .I decongestant in colds and sinusitis. Present in Eskornadc.
dipyridamole An inhibitor of thrombus formation by reducing the adhesiveness of blood platelets in the arterial circulation. Dose: 300-600 mg daily before food. s I
ide-effects include nausea, diarrhoea and headache. (Persantill).
disodium cromoglycate See sodium cromoglycatc.
disodium etidronate See etidronate. disodium pamidronate See pamidronate.
disopyramide A quinidine-like drug used in the treatment of cardiac arrhythmias especially after myocardial infarction. Dose: 300-800 mg daily; dose by slow i.v. injection under ECG cover, 2 nig/kg up to 150 mg, followed by oral therapy as soon as possible. By its anticholinergic action care is necessary in glaucoma and prostatic enlargement. Contraindicated in heart block. (Dirythmin; Rythmodan). See page 1;6 and “fable 24.
distigmine An inhibitor of cholinesterase similar to neostigmine but with a longer action.
Dose: in the control of myasthenia gravis 5-20 mg as a single morning dose before breakfast; in urinary retention after surgery, 5 trig daily. It is sometimes used in neurogenic bladder disorders. Side-effects are nausea, abdominal cramp, diarrhoea and weakness. (Ubretid).
disulfiram When taken with even small amounts of alcohol, disulfiram permits the accumulation of acetaldehyde in the body, with side-effects such a flushing, giddiness, vomiting and headache that may be severe. Distilfiram is used in chronic alcoholism, but prolonged treatment and co-operation of the patient are essential.

Dose: after at least 24 alcohol free hours: 800 nig on the first day, falling over 5 days to 100-200 mg daily. Acute confusion may occur if given at the same time as tucLro-
llidazole. (Antabuse).
dithranol Synthetic compound used locally in the treatment of psoriasis. It is a powerful irritant, and treatment should be commenced with a simple ointment or zinc paste containing 0.1% ofdithranol, gradually increased to 1% if well tolerated. Higher concentrations are sometimes used in ’short -contact -time’ therapy.
Dose: 100 mg/m’ by i.v. infusion over
I hour. Rapid and severe hypersensitivity reactions (hypotension, bronchospasm) may occur, and treatment must be irrnediat4y available. Reaction risks may be reduced by premedication with jexalnetha&one given the day before treatment and continued for 5 days. Rash, pruritus and neutropenia may occur, and blood counts and liver function tests are necessary. (Taxotere). See page 122 and Table 8.
docusate A surface-active agent used as a faeces -softening laxative.
Dose: ill, to 500 nig daily. (Dioctyl).
diuretics The most widely used group of diuretics is the thiazides, represented by bendrofluazide (see page 14I ). They act mainly by increasing the excretion of
sodium by inhibiting its re-absorption by the distal tubule of the kidney, and evoke a rapid response which may persist over 12-24 hours, although some, such as chlorthalidone, have a still longer action. They are given in mild cardiac failure, oedema and in hypertension, but in more severe conditions, and in pulmonary occlema, the more powerful ‘loop’ diuretics, such as frusemide, which act at a different point, are preferred. A side-effect of some thiazides is an increase in the excretion of potassium which may require the use of potassium supplements or a change to a potassium sparing diuretic such as trianiterene. Spironolactone, an aldosterone antagonist, is a more powerful diuretic, of value in resistant oedema. Osmotic diuretics such as mannitol are used mainly in cerebral oedema. Simple diuretics such as potas slum citrate arc mainly used to alkalize the urine and promote diuresis in cystitis and similar conditions. See page 141 and Table 18.
dobutamine A sympathomimetic agent similar to isoprenaline, but with a more selective stimulant action on the beta, receptors in the heart. It increases cardiac contractility but is less likely to cause tachycardia. Useful in acute heart failure and cardiogenic and septic shock. Dose: 2.5-5 pg/kg/min by i.v, infusion, carefully adjusted to need. (Dobutr= Posiject). See page 141 and Table 18.
docetaxel A potent cytotoxic agent derived from the Pacific Yew. Used in advanced breast cancer resistant to other therapy.
domperidone An antiemetic that functions as a dopamine antagonist, as it prevents dopamine from reaching the receptors in the chemoreceptor trigger zone (see antiemetics). It is mainly of value in the severe nausea and vomiting caused by cytotoxic drugs, and is also useful in fum clonal dyspepsia. It is of little value in postoperative and travel sickness.
Dose: 10-20 mg 4-8-hourly; 30-60 nig by suppository. Sedative side-effects are infrequent, as domperidone does not cross the blood-brain barrier. (Motilium). See page 77.
donepezil A reversible inhibitor of anti-cholinesterase. Alzheimer’s disease is linked with a deficiency of acetylcholine in the brain, and donepezil may relieve sonic of the symptoms of that disease by increasing brain acetylcholine.
Dose: 5-10 mg at night. Diarrhoea and muscle cramps are side-effects. (Aricept ).
dopamine A sympathomimetic agent with actions and uses similar to dobutamine. Dose: 2.5-10 pg/kg/min by slow i.v. infusion. Careful control ofdose is essential, as dopamine may cause vasoconstriction with higher doses and increase the risk of heart failure. (Intropin). Dopamine is also a central neurotransinifter, and a deficiency is associated with parkinsonism. See levodopa, page 141 and “table 18.
dopexamine A short-acting drug of the dopamine type but with a more powerful action on the 0,-receptors. It is used in heart failure during cardiac surgery.

atenolol A long-acting beta-adrenoceptor blocking agent of the propranolol type, but with a more cardioselective action. Used mainly in hypertension pertension and angina.
Dose: 50-100 mgdaily. Also given by slow 6. injection in arrhythmias in doses ill, to 10 mg. The side-effects are similar to propranolol, although atenolol may cause fewer sleep disturbances. (”Fenormin). See pages 114 & 148, and Tables 4 & 21.
atorvastatin A lipid-lowering agent with an enzyme-inhibitory action on cholesterol synthesis used in hyperlipidaemia. Dose: 10 mg daily initially, up to a maximum of 80 ing daily. Liver function tests are necessary before and during treatment. (Lipitor). See page 146 and Table 20.
atovaquone An antibacterial agent used in Prietintocyslis carinii pneumonia resistant to co-trimoxazole.
Dose: 750 ing daily with food for 21 days. Side-effects are rash, nausea and diarrhoea. (Welivolle).
atracurium A non-depolarizing muscle relaxant of the gallamine type, but causing less histamine release.
Dose: 30f1-600 pglkg i.v. initially followed by doses of 100-200 µg/kg at intervals as required. Its action can be reversed, if nec- essary, with neostiginine. Arninoglycoside antibiotics may increase the response and require all adjustment of dose. (Tracrium).
atropine An alkaloid with anticholinergic properties obtained from belladonna, hyoscymus and other plants. It is often given in doses of 300-600 pg by injection with morphine for preoperative sedation and to reduce bronchial secretion. Is also of value in gastrointestinal smooth muscle spasm.
Dose: 0.23-2 mg daily. It is used as eye drops (Vyl)) to dilate the pupil, but such use in the elderly requires care, as the long action may precipitate glaucoma. It is also used with neostigmine in doses of 600 pg-1.2 ing to reverse the action of the vecuronium-type muscle-relaxants. Side-effects include dryness of the mouth, disturbed vision, an(] bradycardia followed by tachycardia. Care is necessary in prostatic enlargement and urinary disturbances, and glaucoma is a contraindication.
augmentin See co-amoxiclay.
auranofin An orally active gold compound used in the treatment of active rheumatoid arthritis not relieved by non-steroidal anti-inflammatory drugs (NSAIDs).
Dose: 6 nig daily, increased if necessary .titer 6 months to 9 ing daily. It should be withdrawn if the response is inadequate after 9 months. Side-effects are nausea and diarrhoea. See sodium aurothiomalate for the systemic side-effects of gold therapy. (Ridaura). See page 165 and Table 29.
avomine Derivative of promethazine used in travel sickness, nausea and vomiting. Dose: 25-150 mg daily.
azapropazone A non-steroidal anti-inflammatory agent (NSAID) with actions and uses similar to those of naproxen and used when other NSAIDs are unsuitable. Dose: 1.2 g daily, but in acute gout an initial, divided, dose of 1.8 g is given. Side-effects include rash and occasional photosensitivity, and care is necessary in peptic ulcer. Azapropazone may potentiate the action of warfarin and phenytoin, and require all adjustment of dose
(Rheuniox). See page 165 and *]’able 29.
azatadine An antihistamine with the actions and uses of promethazine.
Dose: 1-2 ing twice daily. (Optimise). See page 110 and Table 2.
azathioprine An immunosuppressive agent mainly used to inhibit rejection after organ transplant surgery. It has also been used in some auto-immune conditions and in
resistant ulcerative colitis.
Dose: 1-5 niglkg daily, but (lose and duration vary according to need and response. Side-effects include depression of bone marrow function, gastrointestinal disturbances, hepatotoxicity and rash. Severe secondary infections may occur as a result of the inunlU1lOSllppreS!aOu, and the use of the drug requires close control. (Az,aniinc).
azoolic acid An organic acid with some antibacterial properties. Used as 20% cream for acne vulgaris. (Skinoren).
azelastine An antihistamine used as a nasal spray 0.1% in allergic rhinitis. (Rhinolast).
azidothymidine See zidovudine.

azithromycin A macrolide antibiotic with a longer action than erythromycin or clarithromycin, used chiefly in respiratory tract infections.
Dose: 500 mg daily for 3 days, I hour before or 2 hours after food or antacids. Side-effects include nausea, abdominal discomfort and diarrhoea. Not to be given with astemizole or terfenadine ( risk of arrhythmias). Vithrornax).
azlocillln A broad-spectrum antibiotic with exceptional activity against Pseudomonas. Of value in respiratory and urinary infections, and in septicaemia.
Dose: in life-threatening infections, 5 g by i.x. infusion 8-hourly. Doses of 2 g 8-hourly may be given in less severe infer lions. III patients with impaired renal function, doses should be given 12-hourly. Allergy to penicillins or cephalosporins is a contraindication. (Securopen).
AZT See zidovudine.
aztreonam An antibiotic that is exceptional in being resistant to breakdown by beta-lactamases. It has a selective action against Gram-negative aerobes, and it is given in urinary, respiratory, bone and other infections caused by susceptible bacteria. When given in association with an aminoglycoside, the activity of aztreonam against Pseudomonas aeruginosa may be increased.
Dose: 4 g daily by i.m. injection and up to 8 e daily i.v. in severe infections. Reduced doses are indicated in renal impairment. Side-effects are skin reactions, nausea, jaundice, blood disorders, and malaise. (Azactam).
is given by intrathecal injection in small doses via an implantable pump, but treatment requires specialist supervision. (Lioresal).
BAL See dimercaprol.
balsalazide A melsalazine complex used in ulcerative colitis. It reaches the colon unchanged, where it is broken down to release active melsalazine.
Dose: 9g daily until remission or for 12 weeks. Side-effects are those of melsalazine. See page 172 and Table 32.
bambuterol A prodrug of terbutaline, with .I similar but more prolonged bronchodilator action.
Dose: 10-20 mg at night. (Bambec). See page 118 and Table 6.
barbiturates A group of hypnotic drugs exemplified by butobarbitone. Once widely used, but their value has declined sharply and safer drugs such as nitrazepam are now preferred.
barium sulphate A very insoluble powder, given orally or rectally as an aqueous suspension as contrast agent for X-ray examination of the alimentary system.
BCG vaccine A preparation of the Calniette-Guerin strain of Mycobacterium tuberculosis. It is used for active immunization against tuberculosis. particularly for individuals likely to be exposed to
infection.
Dose: 0.1 111[. by int radermal injection. A product obtained from an isoniazidresistant strain of the organism is also used for the immunization of individuals receiving prophylactic treatment with isoniazid.
baclofen A muscle relaxant that acts on the spinal end of some motor neurones. Useful in multiple sclerosis and muscle spasms caused by spinal lesions.
Dose: 15 nig daily initially gradL1.111), increased, as required, up to a maximum of 100 mg daily. Side-effects include nausea, fatigue and hypotension. Care is necessary in epilepsy and psychiatric disorders. Withdrawal of treatment is slow over 1-2 weeks to avoid serioius side-effects. In severe spasticity and spinal injury, baclofen
beclomethasone A potent corticosteroid used in the control of asthma and bronchospasin not responding to other drugs. Dose: by oral aerosol inhalation, too pg (two puffs) repeated up to 4 times a day according to need and response. Dose: by powder inhalation 800 pg daily. Hoarseness may develop as a side-effect, and oral candidiasis may occur with high doses. Beclornethasone is also used as a cream or ointment (0.025%) in severe inflammatory skin conditions not responding to less Potent corticosteroids. (Becotide; Propaderm).