Ofloxacin
Article Abstract:
Ofloxacin is a new oral antibiotic in the fluoroquinolone group. Like ciprofloxacin (another drug in this group), ofloxacin has been approved for treatment of a variety of infections. It is effective against bacteria in both gram-positive and gram-negative classes, and is especially effective against organisms that can cause gonorrhea, meningitis, and intestinal infections. This antibiotic is rapidly absorbed and reaches high blood levels. Ofloxacin has been generally effective against pneumonia and bronchiolitis, but some pneumococcal infections have been resistant. Patients with cystic fibrosis, who are susceptible to infections, have been effectively treated for Pseudomonas aeruginosa lung infections with the drug. Infections of skin, soft tissue, bone marrow, and the genitourinary tract have also been successfully treated. This drug may be similar to other fluoroquinolones in that bacterial resistance to the medication may occur. Adverse effects include nausea, diarrhea, insomnia, headache, and dizziness. Hypersensitivity, rash and itching, visual problems, vaginitis, anorexia (lack of appetite), and nervousness have also been reported. Vasculitis (inflammation of blood vessels), psychosis, and effects on blood cell production and glucose metabolism have been infrequently reported. The action of warfarin, an inhibitor of clotting, may be increased by ofloxacin. Drugs and antacids that contain metals, such as calcium, iron, aluminum, magnesium, or zinc, may interfere with ofloxacin absorption. The drug appears to be as useful as ciprofloxacin in treating a variety of infections. It is the only quinolone antibiotic that may be used to treat uncomplicated gonorrhea and can also be used for chlamydial infections. Overuse leading to bacterial resistance is a problem with ofloxacin. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Alglucerase for Gaucher's disease
Article Abstract:
Alglucerase is an altered form of an enzyme obtained from human placental tissue. It was approved for use as an orphan drug, that is, a drug that is effective, but not very profitable because few people suffer from the disease being treated. The unaltered parent of alglucerase, glucocerebrosidase, is needed to break down a glycolipid (a compound containing sugar and fat) that is prevalent in the brain and nerves. Glucocerebrosidase is deficient in patients with Gaucher's disease, so that unmetabolized glycolipid accumulates in cells, especially scavenger cells, of the liver, spleen, and bone marrow, and displaces normal cells. Bone deformity, anemia, enlarged liver and spleen, and low levels of white blood cells and platelets then occur. Alglucerase is modified so that it is preferentially taken up by glycolipid-containing scavenger cells; the glycolipid can then be metabolized. Hemoglobin (oxygen-transporting protein in red blood cells) levels increased and spleen size decreased in 12 patients with Gaucher's disease who were treated with alglucerase for up to 12 months. Some of the patients also experienced skeletal improvement and increased platelet levels. Chills, fever, and digestive disturbances occurred in a few patients. The techniques used in preparing alglucerase are thought to render it free of viruses such as HIV (the cause of AIDS), but further study is needed to verify this theory. If patients respond favorably, the drug must be continued indefinitely. Another treatment for Gaucher's disease is bone marrow transplantation, which is as effective as the new drug but much riskier. Future treatment may be transfer of the normal gene. Although experience with alglucerase is limited, the drug is apparently safe and effective in the treatment of Gaucher's disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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Doxacurium
Article Abstract:
Doxacurium is a newly available agent that acts to block the junctions between muscles and the nerves controlling these junctions so that stimulation of muscle contraction does not occur. These types of drugs are highly useful in relaxing skeletal muscles during general anesthesia and when placing endotracheal tubes in patients. Although drugs that act in a similar manner may have significant side effects, doxacurium tends to cause only small decreases in heart rate and blood pressure, even in doses up to three times the usual level. Doxacurium's activity strongly resembles that of pipecuronium, including prolonging muscle block in patients with kidney failure. The drug is excreted by the kidneys. General anesthetics such as halothane, enflurane, and isoflurane increase the activity of doxacurium. However, prior administration of succinylcholine, another muscle blocker important in anesthesia, does not potentiate doxacurium's effect, a common occurrence with other drugs of doxacurium's class. Phenytoin (Dilantin) and carbamazepine (Tegretol) may shorten the duration of muscle block by doxacurium. Drugs in this class should not be used in patients who are receiving prolonged mechanical ventilation (breathing assistance), as occurs in intensive care units, because they should not be paralyzed while awake. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1991
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