Posts Tagged ‘polysaccharide’

halothane A potent non-inflammable inhalation anaesthetic. It suppresses mucous and bronchial secretions, and reduces capillary bleeding. It has sonic muscle-relaxant properties, but in major surgery, supplementary treatment with a muscle relaxant is necessary. Halothane may cause some cardiac irregularities, but an occasional serious side-effect is severe hepatotoxicity, particularly after further exposure to the drug within periods of 441 weeks. Such susceptibility cannot yet be detected, so great care is necessary in any cases of liver dysfunction.
(Fluothane).
hamamelis An extract of witch hazel leaves referred to as harnarnelis or witch hazel water is used as a soothing application for bruises and sprains.
Hartmann’s solution An electrolyte-replacement solution containing sodium lactate, sodium chloride, potassium chloride and calcium chloride.
heparin The natural anticoagulant obtained front lung and liver tissue. It is widely used in deep-vein thrombosis and pulmonary embolism.
Dose: by i.v. injection 5000 units initially, followed by 1000-2000 units hourly by i.v. infusion, or 15000 units by s.c. injection 12-hourly under laboratory control. Prophylactic dose before surgery 5000 units, then 5000 units every 8-12 hours for 7 days. Overdosage call be controlled by the i.v. injection of prolamine sulphate. Treatment with heparin may be combined with that of oral anticoagulants such as phenindione or warfarin to provide immediate action before the slow-acting oral drugs begin to take effect. Occasional side-effects include hypersensitivity reactions and alopecia. Heparin is a complex polysaccharide, but certain fragments of that large molecule retain sonic anticoagulant activity, and are referred to as low molecular weight heparins. They are used mainly in the prophylaxis of venous thrombo-embolism, as they have a longer
action than standard heparin. They are given by once-daily s.c. injection, and laboratory control of the bleeding time is not necessary. The dose varies to some extent with the product used.
hepatitis A & 8 vaccines Inactivated hepatitis virus antigens for the protection of individuals highly exposed to the infections. Dose: see data sheets. (I iaverix A;
kncigix B; II–B–Vax).
theroin See diamorphine.
hetastarch A soluble modified starch that is used as a 6% solution with 0.9% sodium chloride as a plasma volume expander. Dose: 500-1500 nil daily by i.v. infusion, up to a maximum of 20 mltkg daily. It is excreted by the kidneys, and care must be taken to avoid circulatory overload. Not for use in congestive heart failure or renal insufficiency. Side-effects are vomiting, chills, fever and urticaria. (clol-IAES; Hespan).
hexachlorophene A slow-acting antiseptic used for skin sterilization, and present in sonic medicated soaps.
hexamine (methenamine) A formaldehyde derivative of low toxicity, occasionally used as a urinary antiseptic. Dose: 2 g daily. It is usually given as hexamine hippurate to ensure the necessary acidification ol’the urine. (Iliprex).
histamine A compound present in a bound form in all mammalian tissues; its release is probably the ultimate cause of many allergic conditions.
histamine H,-receptor antagonists See antihistamines. See page 110 and Table 2.
histamine Hz -receptor antagonists Drugs that (litter from conventional antihistamines in having a selective blocking action on receptors ill the gastric cells that secrete acid. They are widely used in the treatment of peptic ulcer and other conditions requiring a reduction in gastric acid secretion. See page 162 and Table 27.
homatropine An atropine derivative with a similar but more rapid mydriatic action (15-30 minutes), but a shorter duration of effect of about 24 hours. Eye drops
(1-2%) sometimes with cocaine.

hyaluronidase A ’spreading’ factor used to increase the absorption of large-volume s.c. injections. The injection of 1500 units of hyaluronidase, either into the injection site or mixed with the injection fluid, will promote the absorption of 500-1000 mL of electrolyte solution by s.c. drip infusion. (Hyalase).
hydralazine A vasodilator that is useful in the supplementary treatment of hypertension.
Dose: 50- 100 nig daily, usually with a IlliaUide diuretic or a beta-blocking agent. Also given in hypertensive crisis by slots, i.v. injection in doses of 5-10 mg; over-rapid injection may cause a marked fall in blood pressure. Side-effects are nausea, tachycardia and fluid retention (less likely with low doses), but a lupus erythematOSLIS- like syndromemay occur with extended high-dose therapy. (Apresoline). See page 148 and “Fable 21.
hydrochlorothiazide A thiazide diuretic that brings about it marked increase in the excretion of salts and water, and is of value in congestive heart failure and other oedematous conditions. It is also of value iii    as it reduces peripheral resistance, and potentiates the action of some other antihypertensive drugs.
Dose: 50-111(1 Ing daily initially in
oedenia; maintenance dose 25-50 mg daily or oil alternate days. III hypertension, 25-30 Ing daily according to need.
I lydrochlorolhiazidc, like other thiazid”, Increases the excretion of potassium as well as sodium, and in extended treatment supplementary treatment with potassium chloride or effervescent potassium tablets may be required. Side-effects include nausea, rash, dizziness and photosensitivity. (I lydroSaluric). See page 148
and ‘I able 21.
acute lyniphoblastic leukaemia and some lymphomas. In common with some other corticosteroids, hydrocortisone inhibits organ-transplant rejection and in high doses it is given to control incipient rejection.
Dose: varies considerably according to need: for replacement therapy, 20-30 mg daily: in shock, 100-300 mg or more by slow i.v. injection, repeated as required. Side-effects are numerous and include hypertension, oedema, mental disturbances, re-activation of peptic ulcer, muscle weakness and diabetes. Cushing’s syndrome may occur with high doses.
I I ydrocortisone, unlike cortisone, is active topically, in(] is used as eye drops 0.3% (usually with an antibiotic), ointment and cream (0.50/o and 11M, often with an antibiotic to control any secondary infection.
hydroflumethiazide A thiazide diuretic N,ith the actions, uses and side-effects of bendrofluazide.
Dose: 25- 100 nig daily in (lie morning; 25-50 Ing daily in hypertension.
ff lydrenox). See page 148.
hydrogen peroxide solution It contains 5-7% of H 02
, equivalent to about 20 volumes oJ oxygen. It has antiseptic and deodorizing properties, and is used mainly for cleaning wounds. It is also used as a mouthwash (diluted 1:7), and as ear drops (1:4 in water or 501% alcohol).
thydromorphone A potent opioid analgesic of the morphine type. Dose: in severe pain 1.3-2.6 Ing 4 t,-hourly. Walladone).
hydrotalcite Aluminium magnesium hydroxide carbonate. An antacid used in dyspepsia and related conditions.
Dose: I g as required.
55
hydrocortisone The principal corticosteroid, also known as cortisol, that is secreted by the adrenal cortex. It plays a major role in the metabolism of glucose, protein and calcium, in maintaining the electrolyte balance, and in reducing inflammatory and allergic responses. It is used in all cases of adrenocortical insufficiency, including Addison’s disease and after adrenalectomy. It is also used in anaphylactic shock, asthma, rheumatoid disease and allergic states. It is valuable in
hydroxocobalamin A derivative of eydnu,obdlaniin, and now the preferred form of vitamin B,, as it has a more prolonged action.
Dose: in pernicious anaemia and other vitamin 13, deficiency states, I Ing initially ian. repeated 5 times at intervals of 2-3 days; maintenance dose 1 mg by I’ll’
by )CC- Lion every 3 months. It is also given
prophylactically after total gastrectonly. (Cobalin-H; NCO-Cytalliell). See
page 112.

hydroxyapatite A natural substance with a mineral composition somewhat similar to that of bone. It is used as a source of calcium and phosphorus in osteoporosis and other deficiency states. Tablets of 830 mg are available. (Ossopan).
hypermotility of the gastrointestinal tract, and may be useful in spasmodic dysmenorrhoea.
Dose: 40-80 mg daily; in acute spasm, .10 mg by injection. (Buscopan).
hydroxychloroquine An antimalarial with the actions, uses and side-effects of chloroquine. It is also useful in rheumatoid arthritis in doses of 200-400mg daily, and in lupus erythematosus, but side-effects are numerous, and treatment requires expert supervision. (Plaquenil). See page 165.
hypromellose A cellulose-derivative that dissolves in water to form a viscid, colloidal solution. Such a solution is used as a base for eye drops to extend the action of a dissolved ophthalmic drug; to lubricate contact lenses; and to act as a lubricant in chronic, sore eye conditions.
5-hydroxytryptamine See serotonin.
hydroxurea (hydrocarbamide) A cytotoxic agent sometimes used in chronic myeloid leukaemia.
Dose: 20- 30 mg/kg as a single dose daily or 80 nig/kg every third day. Side-effects are nausea, skin reactions and myelo- suppression. (Hydrea). See page 122 and Table 8.
hydroxyzine A mild tranquillizer with some sedative and antihistaminic properties. It is given in the short-term treatment of anxiety, and in pruritus and dermatoses complicated by emotional tension. Dose: 50-400 mg daily. It has the side-effects of the antihistamines, and is not recommended where some sedation is undesirable. (Atarax; Ucerax). See page 117 and Table 3.
hyoscine (scopolamine) An alkaloid obtained from plants of the belladonna group. It is a powerful hypnotic and is widely used together with papaveretum for premedication before anaesthesia in doses of 300-600 pg by s.c. or i.m. injection. It has some antiemetic properties, and is useful in travel sickness and vertigo. Dose: 300 mg 30 minutes before starting the iourney, followed by up to 3 doses 6-hourly. Scopoderm is a patch of 500 pg. Thc side-effects of mouth dryness and dizziness are those of the anticholinergic drugs generally. It is contraindicated in glaucoma. It is used occasionally in terminal care for bowel colic and excessive respiratory secretions. Dose: 600 pg-2.4 mg daily by s.c. infusion.
hyoscine butylbromide A derivative of hyoscine that differs in lacking any central action. It is given in spasm and
I
ibuprofen A non-steroidal anti-inflammatory agent (NSAID) widely used in rheumatoid and arthritic conditions. It is also given as an analgesic for mild to moderate pain, but not for acute gout. Dose: 1.8 g daily initially; lly; maintenance duos, 600 lllg-L2 daily after food. A 5% cream is available for local use. The sideeflicts are those of the NSAID& generally. (BrUlen; Feribid). See page 165.
ichthammol A thick, dark brown liquid with a characteristic odour, derived from certain bituminous oils. It is a mild antiseptic and is used mainly in chronic eczema as a 100A, ointment or zinc paste. A solution (10% in glycerin) has been used oil ulcers and inflamed areas.
idarubicin A potent cytotoxic agent similar in actions and uses to doxorubicin. It is given orally and i.v. in acute nonlymphocytic leukaemia, breast cancer, and as second-line therapy in acute lymphatic leukaemia. Dose is based on skin area. (Zavedos). See page 122 and Table 8.
idoxuridine An antiviral agent now virtually superseded by acyclovir and related drugs. Used occasionally in herpes zoster skin infection by local application of a 5% solution. See page 144 and Table 19.

fosfamide A derivative of cyclophosphamide with similar actions and uses. It is effective in lung, ovary, breast and soft-tissue tumours, as well as some malignant lymphomas.

If you or your child are allergic to your pet, you should really find it another home. But a survey in the United States showed that more than a third of people with cat allergy still keep their cat - so there is detailed advice below for those who want to keep the pet, as well as those who decide to part company.
Often people with severe allergies find that, although they miss their pet badly at first, the vast improvement in their symptoms makes that difficult decision seem like a good one in the long run. Finding a home for an adult pet is often difficult, as most people want kittens or puppies, but try advertising locally, and explaining in your ad exactly why the pet needs a new home. Family and friends may be happy to help by offering your pet a home. Ask around among your older neighbours too – they may value having a mature pet that is calmer and already house-trained.
Cats
You can’t see cat allergen – many people wrongly assume that it is cat fur that is allergenic, or flakes of skin. The main allergen is a protein found in the sweat and saliva of the cat, which wafts about in the air in microscopic specks. These lightweight allergen particles are carried throughout the house.
So small are these particles that they remain airborne for six hours or more, however still the air. If they do finally settle, they are easily made airborne again by the least little breeze. Simply walking around a room is enough to disturb them.
Parting with the cat
After your cat has gone, there will be allergens everywhere – on and in the armchairs, sofas and cushions, on shelves and lampshades, in the carpets and even stuck to the walls and curtains. They will also be inside the mattress if the cat once slept on the bed, and will shoot out every time you lie down.
Once the cat has gone, air the house very thoroughly to shift all the allergen that is just hanging in the air. Wait a couple of
weeks, and see how much your symptoms improve, before going further. If you still have troublesome symptoms that are worse at home, then you need to:
• Buy a high-suction vacuum cleaner that retains allergen particles (these are marketed for dust mites – make sure it is a good one) so that you can vacuum your furnishings without redistributing the allergen everywhere.
• Wash anything that can be washed: duvets, sheets, curtains, loose covers, cushions and their covers, duvet covers, pillow cases, bedspreads etc. Cat allergen is not affected by heat, so a cool wash is as good as a hot one – but you must wash all the allergen away, so run the rinse cycle twice. No one knows if dry-cleaning removes cat allergen.
• If the cat ever slept on your bed, then consider buying new pillows and duvet. Covers designed for dust-mite avoidance (see p. 115) are an alternative option. They will keep some of the cat allergen from escaping into the air, but not the very smallest particles.
• The seat cushions of sofas and armchairs can be sprayed with tannic acid or a polysaccharide (see box on p. 116) to deactivate the allergens. Vacuum clean very thoroughly first to remove as much allergen as possible, then spray repeatedly for a few weeks or months.
A clean getaway
The allergic individual should go out while this work is done, and stay out for at least six hours afterwards (see p. 109).
The size of the allergen particles
Cat allergen is the tiniest allergen - most of the particles are less than 2.5 microns, and the smallest may be only 0.05 microns. (A micron is a thousandth of a millimetre.) You would need a really good dust mask or HEPA air filter (see pp. 108-9) for these particles. It probably won’t remove the very smallest particles, but will certainly reduce the allergen load.
Even after the cat has gone, and you have cleaned up meticulously, you may still sometimes have symptoms. Unfortunately, cat allergen is carried about on the clothes of cat-owners and gets into schools, cinemas, buses, banks and even the padded seats in hospital waiting rooms. However, only the most highly sensitised people are affected by these low levels of allergen.
Keeping the cat
Bear in mind that keeping the pet will result in significant continued exposure however hard you try with the methods described.
• Improve the ventilation in your house as this will reduce the amount of allergen in the air. If your house is tightly sealed against draughts at the moment, this will actually make a huge difference. Air the house regularly. Always keep a window slightly open whenever the cat and/or the allergic person is indoors. You could use a HEPA filter to clean the air, instead. These work fairly well for cat allergens because these are very small lightweight particles which easily become airborne, so there is quite a lot of allergen in the air most of the time. Of course, an air filter cannot do anything to protect you from a cat sitting on your lap (though advertisements have sometimes implied that they can!).
• Put the cat outdoors when it begins washing itself, as this generates a lot of airborne allergen. Provide the cat with a shelter outside where it can sleep and wash, to reduce the amount of allergen in the house. Make it as warm and comfortable as possible, feed the cat there, and provide a little catnip to make it more attractive.
• If your cat is still allowed indoors, remove all soft furnishings and fitted carpets. Buy leather- or vinyl-covered armchairs which can be wiped clean of cat allergen.
• Keep the cat out of the bedroom entirely. If it has been in the habit of sleeping there, wash all the bedding and buy new pillows. The mattress and duvet should be replaced or covered with anti-mite covers (see p. 124).
• If you have an un-neutered tom, consider having him neutered: the amount of allergen produced declines when male cats are neutered.
The following measures are sometimes recommended, but in fact they don’t work:
• treating the cat with acepromazine, an animal tranquilliser
• using a spray called Allerpet-C, which, so it is claimed, reduces the amount of allergen released. Scientific trials by a research group in Detroit have shown that it does not work.
• giving the cat a shower - i.e. drenching it in water. After a cat has had such a shower, the washing water contains a lot of cat allergen, so everyone assumed that this meant less cat allergen in the air. New research shows that the amount of allergen in the air around a cat after showering is no less than before. However, actually immersing the cat for three minutes followed by rinsing in clean warm water does reduce the allergen level in the air considerably. Unfortunately, the cat probably renews its stocks of allergen very fast, as a washed dog does (see below), so you need to repeat the wash at least once a week to reduce the allergen level in the air.
Dogs
Most of the advice given above, for cats, applies to dogs too because their allergens are also small and lightweight. Dogs produce less allergen than cats, and it seems to be less potent. However, you would still need to clean up thoroughly after the dog has gone, assuming you decide to find it another home.
If you decide to keep your dog, HEPA filters can be very useful, although you need also to take other measures, such as excluding the dog from bedrooms and keeping it outside for more (or most) of the time. Washing dogs thoroughly in a bath, using dog shampoo, reduces the amount of allergen in the air, but it builds up again to its former level within three days. You would need to wash the dog twice a week to achieve a useful reduction in allergen levels.
Other pets and domestic animals
Horses produce very powerful allergens, and those with allergies to horses are often so sensitive that even clothing that has been worn while riding and then brought indoors can elicit symptoms. Old furniture or mattresses stuffed with horsehair can sometimes cause problems too.
In the case of small mammals, such as mice and guinea pigs, it is usually the urine that causes allergic reactions. Proteins in the urine become airborne, and are carried around the house. You may be able to keep the pet if it is in a well-ventilated utility room or caged outside.
With snakes, lizards and other reptiles the allergens are found in tiny skin particles that float in the air. The same is true of stick insects and other insect pets.