Posts Tagged ‘sedative properties’

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).
I Tyr
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.
103
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).
I Vas
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.
104
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.

potassium permanganate Purple crystals, soluble in water. A powerful oxidizing and deodorizing agent used 1:1000 as lotion, 1:10000 to 1:5000 as mouthwash, douche, bladder washout and bath.
povidone-iodine A complex of iodine with an organic carrier. When applied to the skin it slowly releases iodine, and has an extended antiseptic action. Used for local application to the skin and mucous membranes as solution containing the equivalent of 0.75-1 % of iodine.
pralidoxime A reactivator of cholinesterase. Organophosphorus insecticides inhibit that enzyme, and poisoning by such insecticides is an occupational hazard. Their toxicity can be reversed in part by the injection of 2 mg atropine, but the enzyme can be reactivated and muscle power restored by pralidoxime (30 mglkg) given by slow i.v. injection, repeated as required. It is effective only if given within 24 hours of exposure to the insecticide.
pravastatin A blood lipid-lowering agent with the specific enzyme-inhibiting properties of simvastatin, and used in primary hypercholesterolaemia not responding to the other drugs.
Dose: 10 -40 mg daily as a single dose. Side-effects include myalgia, rash and gastrointestinal disturbances. (Lipostat). See page 146 and Table 20.
prazinquantel A schistosomicide of low toxicity, effective against Schistosonia hamratobium, S, mansoni and S. japonicum It is also active against tapeworm. Dose: 10-20nig/kg as a single oral dose. (Biltricide).
prazosin An alpha-adrenoceptor blocking agent and vasodilator used in the treatment of hypertension and congestive heart failure.
Dose: I mg daily initially, increased as required up to a maximum of 20 mg daily. The initial dose may cause marked hypotension, and it should be taken at night, in bed. prazosin is also given in benign prostatic hypertrophy in maintenance doses of 4 mg daily. Side-effects are drowsiness, nausea and postural hypotension. (Hypovase). See page 148 and Table 21.
prednisolone A glucocorticosteroid with the actions and uses of hydrocortisone, but effective in much lower doses. It is often the preferred drug for oral use, and is given in a wide range of conditions including asthma, severe allergic reactions, rheumatoid arthritis, collagen disorders and inflammatory skin conditions. prednisolone is also of value in leukaemia, ulcerative colitis, the nephrotic syndrome, pemphigus, sarcoidosis, myasthenia gravis, haemolytic anaemia, agranulocytosis and other blood dyscrasias. Large doses are given in the immunosuppressive control of transplant surgery. The dose varies with the nature and severity of the condition being treated, and in every case the lowest dose required to evoke an adequate response should be used, after which the dose should be reduced in stages. Dose: in rheumatoid arthritis, 7.5-10 ing daily initially; other conditions may require doses up to 100 mg daily. Dose by i.m. injection 25-100 ing once or twice a week. Asa retention enema, 20 mg to relieve the inflammation of colitis and Crohn’s disease; as eye drops and ear drops, 0.5% solution. The side-effects are those of the corticosteroids generally, and include salt and water retention, hypertension, muscle weakness and peptic ulcer.
prednisone A glucocorticosteroid that is converted to prednisolone in the body, and so has the actions and uses of that drug.
prilocaine A local anaesthetic with the actions, uses and side-effects of lignocaine. (Citanest).
primaquine An antimalarial drug used mainly to prevent a relapse of benign tertian malaria after treatment with chloroquine, as it kills the malarial parasites that may still be present in the liver. Dose: 13 mg daily, for 2-3 weeks after chloroquine treatment. Side-effects are nausea and abdominal pain.

primidone An anticonvulsant used in the treatment of grand mat and psychomotor epilepsy.
Dose: 125nig daily initially, slowly increased as required up to a maximum of 1.5 g daily. Side-effects include drowsiness, nausea, blurred vision and rash. (Mysoline). See page 136 and Table 15.
probenecid A uricosuric agent that
increases the excretion of uric acid, and so is useful in the treatment of gout and hv
I peruncacrina.
Dose: O.5-2 g daily. An adequate fluid intake and an alkaline urine are necessary for the best response. probenecid also delays the excretion of penicillin and sonic cephalosporins, and is given in doses of 2 g daily to raise the plasma level of those antibiotics. Side-effects include occasional nausea, flushing and dizziness. (Benernid). ,See page 140 and Table 17.
procainamide A procaine derivative occasionally of value in the treatment of ventricular arrhythmias.
Dose: till to 50 mg/kg daily. It is also given by slow i.v. injection under E’C.C, control in doses of 25-50 ing/tininute up to a maximum of I g. Side-effects are gastrointestinal disturbances, lever and rash. (Prones(vi).
severe nausea and vomiting, 20 mg orally, or 12.5 mg by deep i.m. injection. It is also used as suppositories of 25 ing. (Stemetil). See page 168 and Table 30.
procyclidine An anticholinergic drug similar to benzhexol, used mainly in the treatment of parkinsonism. Reduces rigidity more than tremor.
Dose: 73-30 mg daily. In acute states it is given by i.m. injection in (loses of-i-10 mg, or 5 mg doses i.v. (Arpicolin; Kernadrin). See page 160 and Table 26.
progesterone The hormone of the corpus luicum, responsible for the preparation of the uterus to receive a fertilized ovum. It is used in dysfunctional uterine bleeding and in the premenstrual syndrome. Dose: 200-400 nig daily per ragina on a cyclic basis. (Cyclogest). Also a constituent of sonic oral contraceptives. See dydrogesteronc and norethisterone.
proguanil hydrochloride A synthetic antimalarial of high potency and low toxicity, used in the prophylaxis and suppressive treatment of malaria, often in association with chloroquine.
Dose: 100-200 rig daily, and continued for 6 weeks after leaving the infected area. (PaILICIrinc).
85
procaine A local anaesthetic now largely replaced by lignocaine.
procaine penicillin An old long-acting loan of penicillin, given together with penicillin G to obtain a high initial blood level. It is now used mainly in early syphilis. Dose: 900 mg daily by Lin. injection for 10 days. (Ificillin).
procarbazine A cytotoxic drug used mainly as part of a multi-drug treatment of Hodgkin’s disease. It is also used to treat other lymphomas no longer responding to other therapy.
Dose: 50 ing initially, increasing to a maxiintini of 300 mg daily. Side-effects include nausea, anorexia and bone marrow depression. Alcohol may cause a disulfiram reaction. (Nitulan). See page 122 and Table 8.
prochlorperazine A tranquillizer with the actions, uses and side-effects of chlorpromazine.
Dose: in schizophrenia, 25-100 Tng daily; in severe anxiety, 15-20 mg daily. In
promazine A tranquillizer with the actions, uses and side-effects of chlorpromazine, but less potent. It is used mainly to
control agitation in the elderly, and in other minor conditions of psychiatric disturbance.
Dose: 50-800 ing daily, adjusted to need .111d response; by injection 25-50 mg. (Sparine).
promethazine A long-acting antihistamine with sedative properties. It is used for the relief of a wide range of allergic conditions, in mild insomnia and for preoperative sedation. It is also of value as an antiemetic in the prophylaxis and treatment of travel sickness, vertigo and drug-induced nausea.
Dose: 25-50 mg daily; 25-100 ing by deep i.m. injection. In anaphylaxis, sometimes given by slow i.v. injection in doses up to 100 mg to supplement previously injected adrenaline. The side-effects are those of the antihistamines generally. (Phenergan). See page 110 and Table 2.

propafenone An anti-arrhythmic agent of the lignocaine type, used in the prophylaxis and treatment ofventricular arrhythmias. Dose: under ECG control 450 ing daily initially, after food, increased at 3-day intervals up to a maximum of 900 mg daily. Side-effects are dizziness, gastrointestinal disturbances and postural hypotension. (Arythniol).
propantheline An anticholinergic agent used as a spasmolytic in gastrointestinal disorders, in urinary frequency associated with bladder neck weakness, and in nocturnal enuresis.
Dose: 45-120 mg daily at least I hour before food. Side-effects include dryness of the mouth and blurred vision. (Pro- Banthine). See page 174 and Table 33.
propofol A non-irritant short-acting i.v. anaesthetic for smooth induction and maintenance of general anaesthesia for up to I hour. Dose: 2-2.5 mgft initially, followed by Supplementary doses of 0.1-0.2
ing/kg1min as required but some local pain may occur. Side-effects include mild hypotension, transient apnoea an([ bradycardia. Recovery is normally rapid and uneventful but delayed recovery, convulsions and anaphylaxis have been reported. Care is necessary in cardiovascular, respiratory or renal impairment. (Diprivan).
propranolol A beta-adrenoceptor blocking agent that reduces the cardiac response to circulating adrenaline and noracircrialine. It reduces the load on the heart during
exercise and stress, and is used in the treatment of angina, coronary insufficiency, cardiac arrhythmias, hypertension, and after myocardial infarction. It also ameliorates the tremor and palpitation of transient anxiety and stress, and is useful ill the prophylactic treatment of migraine. Dose: 160-320 mg daily according to need. In arrhythmias and thyrotoxic crisis, propranolol is given by slow i.v. injection in doses of I ing, repeated up to a maximum of 10 ing. Side-effects are bradycardia, bronchospasni and gastrointestinal disturbances. Care is necessary in renal and hepatic deficiency, asthma is a contraindication. (Inderal). See page 146 and’I'able 21.
propylthiouracil A thyroid inhibitor occasionally used as an alternative to carbiniazole in hyperthyroidism. Dose: 300-450 ing daily.
prostacyclin See epoprostenol.
prostaglandin A generic term applied to a series of closely related hormone-like fatty acid derivatives, originally extracted front the prostate gland, but now prepared
synthetically. Prostaglandins are widely distributed in animal tissues, and have a complex and varying range of biological activity.’rhus they may have a smooth muscle stimulating or relaxant action, pressor, vasodilator, inflammatory or other properties. The anti-inflammatory action of aspirin and related drugs is due to an inhibition of prostaglandin synthesis. See alprostadil, carboprost, dinoprostone and genieprost.
protamine sulphate A simple protein obtained from fish sperm. It neutralizes the anticoagulant effect of heparin, and it is used in controlling the haemorrhage i hat may occur during heparin therapy. Dose: 1% solution i.v. according to need; ling will neutralize 80-100 units of heparin.
prothionamide A second-line antitubercular drug that has been used in resistant tuberculosis. See page 170 and Table 31. It has also been used in the treatment of leprosy.
protirelin The thyrotrophin- releasing hormone (TRH) of the hypothalamus. Dose: in the diagnosis of hyperthyroidism, as a single i.v. dose ol’200 pg. It normally induces a rapid rise in the plasma levels of thyrotrophin, but in thyrotoxicosis that rise does not occur. Side-effects include nausea, flushing, a strange taste and urinary urgency.
protriptyline A tricyclic antidepressant with actions and uses similar to amitriptyline. It is used in depression associated with apathy, as it has some stimulant action. Dose: 15-40 mg daily. Side-effects are cardiovascular distu&nce, rash and photosensitivity. (Concordia). See
page 128 and Table 11.
proxymetacaine A local anaesthetic used as 0.5% drops in ophthalmology. (Oplithaine).
pseudoephedrine A drug very closely related to ephedrine, but now used mainly as a respiratory decongestant. It has been used in nocturnal enuresis, but may cause hallucinations in sonic children.

clobazam A benzodiazepine tranquillizer with the actions and uses of diazepam, but with reduce(] sedative effects. It is used mainly in the short-term treatment of anxiety.
Dose: 20-30 mg as a single nightly dose. III severe anxiety larger but divided doses niav be given under medical control. It is also useful in the auxiliary treatment of epilepsy. (Frkiuni). See page [ 17 and'i'able.5.
clobetasol A potent corticosteroid used as a cream or ointment (0.05%) in the short-term treatment of severe inflammatory skin conditions not responding to less powerful drugs. The application should be used sparingly as absorption with systematic and local side-effects may occur with excessive or prolonged treatment. (Dermovate).
clobetasone A locally acting corticosteroid, used as a cream or ointment (0.05%) in eczema and inflammatory skin conditions not responding to less potent drugs. (Fumovate).
be withdrawn. Clofibrate may potentiate tile action of oral anticoagulants.
clomiphene An anti-oestrogen used to stimulate ovulation in some types of anovulatory sterility.
Dose: 50 mg daily for 5 days a month, repeated if ovulation does not occur, Its use has resulted in occasional multiple births. If pregnancy does not follow tip to 6 courses, further treatment is of little use. Side-effects are hot flushes, and abdominal discomfort; visual disturbances indicate that treatment should be withdrawn. Contraindicated in hepatic disease and ovarian neoplasm. (Cloinid; Scroplictic).
clomipramine A tricyclic antidepressant with the actions, uses and side-effects of inupramine and related drugs, but with reduced sedative properties.
Dose: 30-150 mg daily orally; up to
150 nog daily by im. injection. (Anafranil). See page 128 and Table 11.
clodronate sodium A bisphosphonate used like etidronate and pamidronate in the hypercalcaemia of malignancy.
Dose: 1.6-3.2 g daily as a single dose
I hour before or after food. May also be given i.v. by infusion as a single daily dose of 300 mg for 7-10 days. Long oral treatment is necessary, and serum calcium and phosphate levels should be checked. Side-effects are nausea and diarrhoea. (Hollefos; Loron).
clofazimine An antileprotic agent given in association with dapsone and rifampicin to prevent the incidence of resistance. Dose: 300 Ing monthly; in lepra reactions, 300 ing daily for 3 months. It may cause discoloration of the urine, skin and lesions. (Lunprcric).
clofibrate A plasma lipid-regulating agent used in hyperlipidaernia in conjunction with dietary measures, to reduce excessive plasma levels of cholesterol and
t riglycerides.
Dose: 2 g daily, with regular checks on plasma lipid levels. Side-effects are transient nausea and abdominal discomfort.
It increases the biliary excretion of cholesterol, and gall stones are a contraindication. A myosins-like reaction may occur in renal impairment, and the drug should
clonazepam A benzodiazepine with a marked anticonvulsant action of value in all types of epilepsy.
Dose: I mg daily initially, increased LIP to 8 nog daily according to need. fit status epilepticus, I mg by slow i.v. injection, but apnoea and hypotension, requiring prompt treatment, may occur. Side-effects include drowsiness, dizziness and irritability and occasionally, paradoxical aggression. (Rivotril). See page 136 and Table 15.
Clonidine A centrally acting antihypertensive pertensive agent, now used less frequently.
Dose: 150-300pg daily initially, increased it required up to 1.2 mg daily. Doses of 150-300 pg have been given by slow i.v. injection. Sudden withdrawal of the drug may provoke a I P
hy ertensive crisis.
(Catapres). Clonidine is also used in doses of 100 pg daily in the prophylaxis of migraine. (Dixarit). The side-effects include sedation, dry mouth, fluid retention and bradycardia. See pages 154 andTible 21.
clorazepate A benzodiazepine tranquillizer with the actions, uses and side-effects of diazepam. Used mainly in the short-term treatment of anxiety.
Dose: 7.5-22.5 mg daily, or it single dose of I  mg at night. (Tranxene). See page 117 and Table 5.

clotrimazole An antifungal agent used local]) in vaginal candidiasis.
Dose: 104-200 mg as vaginal tablets or pessaries for nightly insertion. Also used as a 1% cream, lotion or dusting powder for fungal infections of the skin and cars. Side-effecis are local irritation and erythema. (Canestall).
cloxacillin An acid-stable, semi-synthetic penicillin that is not broken down by the enzyme penicillinase, and so is effective in infections due to penicillin-resistant staphylococci.
Dose: 2 g daily before lbod. In severe infeL bons 250-500mg by injection 6-hourly. Now largely replaced by flucloxacillin. The side-coccus are those of the penicillins generally. (Orbenin).
antibacterial action, but when given with a penicillin the antibiotic is able to
penetrate into the cell without loss of
activity. The combination is of value in    33 infections due to penicillin-resistant penicillinase-producing bacteria, including most staphylococci.
Dose: as amoxycillin 750 mg daily, doubled in severe infections, or 3-4 g daily by slow i.v. injection. The side-effects, are similar to those of arnpicillin, but a posttreatment reaction is cholestatic jaundice. (Augmentin).
co-beneldopa tablets of levodopa and henzerazide. (Madopar). See levodopa.
cocaine A local anaesthetic. Still used occasionally in ophthalmology as a 2% solution, often with homatropine.
clozapine A potent but potentially toxic dopamine-receptor blocking agent used in schizophrenia resistant to other drugs.
Dose: 12.5-50 mg daily initially (with care -risk of hypotension), slowly increased to 300 mg daily according to need. A serious side-effect is neutropenia that may lead to agranulocytosis, and treatment must be
Linder hospital supervision with regular blood monitoring. Patient, doctor and hospital pharmacist must be registered with the Clozaril (clozapine) Patient
Monitoring Service to maintain the necessary strict control of treatment. (Clozaril).
coal tar Tile black viscous liquid obtained from the distillation ofcoal. It is used mainly as Zinc and Tar Paste in psoriasis and atophic eczema.
co-amilofruse tablets of the diuretics ainiloricle and frusemide. (Fruinil; Lasoride).
co-amilozide Tablets of the diuretics amiloride and hydrochlorothiazide. (Moduretic).
co-amoxicla A mixture of clavulinic acid and amoxycillin.The resistance to penicillin by staphylococci and other organisms is due to penicillinases such as beta-lactamase in the bacterial cell wall. Those enzymes inactivate penicillin before it call enter the cell and exert its antibacterial action. Such inactivation can be prevented by inhibitors of beta-lactamase such as clavidanic acid. That acid has no
co-careldopa Tablets of levodopa and carbidopa. (Sinemet). See levodopa.
co-codamol Tablets of codeine and paracetamol.
co-codaprin Tablets of codeine and aspirin.
co-darrthramer Tablets of danthron and poloxamer.
cod-liver oil A rich source of vitamins A and 1). It is used as a dietary supplement to improve general nutrition, promote calcification and prevent rickets.
Dose: 2-10 in[ daily.
codeine One of the alkaloids of opium. It depresses the cough centre and is used in the treatment of useless cough. It also reduces intestinal motility, and is useful in the symptomatic treatment of diarrhoea. It also has mild analgesic properties, and is present with aspirin in co-codaprin and similar preparations. In large doses the constipating action may be a disadvantage. Dose: 10 60 mg.
co-dergocrine A cerebral vasodilator, sometimes used in the treatment of senile dementia.
Dose: 1.5 mg daily, but the response is unreliable. Side-effects include nausea, rash and bradycardia. (Hydergine).
co-dydramol Tablets of dihydrocodeine and paracetamol.