Archive for June, 2009
An antifungal drug that is particularly effective in treating candidiasis (thrush). Since it is not absorbed from the gastrointestinal tract, it is particularly useful for treating candidiasis of the mouth, throat, and gut, as well as the genital area. As it is too toxic to be administered intravenously, it is not suitable for treating systemic (generalized) infections.
Nystatin is available, on prescription only, in a variety of formulations, including tablets, a suspension, pastilles, and a mouthwash for oral administration, pessaries, creams, a gel, and an ointment.
Side effects: high doses may cause nausea, vomiting, and diarrhoea. Oral preparations may cause local irritation and (rarely) allergic reactions, and a rash may rarely occur after topical application.
Precautions: nystatin should be used with caution by women who are pregnant or breastfeeding.
Proprietary preparations:
Infestat; Nystamont; Nystan; DERMOVATE-NN (combined with clobetasol and neomycin); FLAGYL COMPAK
(packaged with metronidazole); GREGODERM (combined with neomycin, polymyxin B, and hydrocortisone); NYSTADERMAL (combined with triamcinolone acetonide); NYSTAFORM (combined with chlorhexidine); NYSTAFORM-HC (combined with chlorhexidine and hydrocortisone);
TERRA-CORTRIL NYSTATIN (combined with oxytetracycline and hydrocortisone); TIMODINE (combined with hydrocortisone, benzalkonium chloride and dimethicone
TRI-ADCORTYL OTIC (combined with triamcinolone acetonide, neomycin, and gramicidin); TRIMOVATE (combined with clobetasone butyrate and oxytetracycline).
A long-acting analogue of somatostatin, a hormone that is produced in the brain, gastrointestinal tract, and pancreas and inhibits the release of growth hormone. It is used for the short-term treatment of patients awaiting surgery for acromegaly (a condition due to excessive secretion of growth hormone by a tumour of the pituitary gland) and for the long-term treatment of acromegaly that does not respond to surgery, Mopamine receptor antagonists, or radiotherapy. It can also be used as an interim treatment until radiotherapy has been effective in reducing concentrations of growth hormone. Lanreotide is also used
to inhibit the secretions (and thus relieve the symptoms) of hormone-secreting tumours of the gastrointestinal tract. It is available as an injection on prescription only.
Side effects: include pain, stinging, and swelling at the injection site, loss of appetite, nausea, vomiting, and abdominal pain; gallstones may develop with long-term treatment.
Precautions: lanreotide should not be given to women who are pregnant or breastfeeding. Diabetic patients may need to reduce their dosage of insulin or oral antidiabetic drugs. Gall-bladder function should be
monitored. Lanreotide should be withdrawn gradually at the end of treatment.
Interactions with other drugs:
Antidiabetic drugs: doses of these may need to be reduced.
Cyclosporin: lanreotide reduces the absorption of cyclosporin.
Proprietary preparation: Somatuline LA.
Used for the treatment of ankylosing spondylitis (a type of arthritis affecting the spine) when this has not
responded to other drugs. It is used only under supervision in hospital because it occasionally causes severe side effects. Phenylbutazone is available as tablets on prescription only.
Side effects of phenylbutazone may include inflammation of the lining of the mouth and salivary glands,
enlargement of the thyroid gland (goitre), hepatitis, and blood disorders.
Anyone taking phenylbutazone who develops a sore throat, mouth ulcers, bruising, fever, malaise, or a rash should inform a doctor immediately.
Interactions with other drugs:
Phenytoin: its effects are enhanced by phenylbutazone.
Warfarin: should not be taken with phenylbutazone, as phenylbutazone greatly increases its anticoagulant effects.
Proprietary preparation: Butacote.
A group of phosphate salts used as osmotic laxatives to evacuate the bowel before abdominal X-ray examinations or before investigative procedures or surgery of the bowel. They are also used to relieve postoperative constipation and in obstetrics.
The common phosphate laxatives are sodium acid phosphate and sodium phosphate which are available as enemas or suppositories and can be obtained without a prescription, but only from pharmacies. Sodium dihydrogen phosphate dihydrate and disodium phosphate dodecahydrate are ingredients in bowel-cleansing solutions.
Side effects: there may be local irritation.
Precautions: phosphates should be used with caution in elderly people and should not be used in patients with acute gastrointestinal disorders.
An alpha blocker used for the treatment of episodes of hypertension in phaeochrornocytoma, a tumour of the adrenal gland that can release large amounts of noradrenaline
Proprietary preparation: Rogitine.
An NSAID used for the treatment of pain and mild inflammation in rheumatoid arthritis and other disorders of muscles or joints.
It is also used to relieve period pains, acute gout, sciatica, and pain occurring after orthopaedic surgery. It is available, on prescription only, as capsules, modified-release capsules, suppositories, an injection, and a gel for topical application (some gel formulations are also available without a prescription).
Suppositories may cause local irritation: there may be pain at the site of the injection.
Proprietary preparations: Boots Muscular Pain Relief Gel; Fenoket (modified-release capsules); Jomethid XL (modified-release capsules); Ketil CR (modified-release capsules); Ketocid (modified-release capsules); Ketoprofen CR (modified-release capsules); Ketotard 200 XL (modified-release capsules); Ketovail (modified-release capsules); Ketozip XL (modified-release capsules); Larafen CR (modified-release capsules); Orudis (capsules and suppositories); Oruvail (modified-release capsules, gel, and injection);
Powergel (gel); Solpaflex Gel.
Naratriptan used to treat acute attacks of migraine. A single dose can relieve a migraine headache at any stage of the attack. Naratriptan is available as tablets on prescription only.
Side effects: include sensations of tingling, heat, heaviness, pressure, or tightness; if tightness in the chest or throat is severe, treatment should be discontinued.
Other side effects may include a slow or fast heart rate, disturbed vision, flushing, dizziness, and weakness.
Precautions: naratriptan should not be taken by people with certain heart conditions, uncontrolled high blood pressure, or disease of the peripheral blood vessels or by those who have previously had a heart attack.
It should be used with caution by women who are pregnant or breastfeeding and by people with impaired liver or kidney function.
Proprietary preparation: Naramig.
A leukotriene receptor antagonist used as an adjunct for the treatment of mild to moderate asthma that is not adequately controlled by the usual combination of an inhaled corticosteroid and a beta stimulant (such as saibutamol). It can also be used to prevent an attack of asthma being brought on by exercise, but it should not be used to treat acute attacks. Montelukast is available as tablets or chewable tablets on prescription only.
Side effects: include abdominal pain, headache, diarrhoea, and dizziness.
Precautions: the chewable tablets contain aspartame and should be used with caution by people who have phenylketonuria.
Montelukast should be used with caution by women who are pregnant or breastfeeding.
Interactions with other drugs:
Fhenobarbitone (phenobarbital): can reduce the effectiveness of
montelukast.
Proprietary preparation: Singulair.
An antibiotic used for the treatment of urinary-tract infections and to prevent infection during surgery of the genitourinary tract. It is especially useful for treating kidney infections that are resistant to other antibiotics. It is available, on prescription only, as tablets, capsules, modified-release capsules, or a suspension.
Side effects: include gastrointestinal upset, breathing difficulties, rash,
and itching. Rare side effects are jaundice, inflammation of the liver, and
blood disorders. The drug should be withdrawn if signs of breathing
problems, jaundice, or liver problems occur.
Precautions: nitrofurantoin should not be taken by people with impaired
kidney function or by women at the end of pregnancy or who are breastfeeding.
Interactions with other drugs:
Magnesium trisilicate: reduces absorption of nitrofurantoin.
Probenecid: increases the potential toxicity of nitrofurantoin.
Proprietary preparations: Furadantin; Macrobid; Macrodantin.
A broad-spectrum antibiotic that is not related to any of the other antibiotics. It is used for treating bacterial skin infections and is especially useful for nasal infections, since it is active against methicillin-
resistant Staphylococcus aureus (MRSA), a bacterium that is resistant to many antibiotics and may be carried in the nostrils. Mupirocin is available, on prescription only, as an ointment to be applied to the skin
or nostrils.
Side effects: the ointment may cause stinging on application; contact
with the eyes should be avoided.
Precautions: mupirocin should be used with caution by people with
kidney disease.
Proprietary preparations: Bactroban; Bactroban Nasal.
