Category: Drugs

Description of Streptokinase Streptokinase is a nonenzymatic protein produced by group C beta-hemolytic streptococci. Clinically, it is used as a parenteral thrombolytic agent in the management of acute myocardial infarction, pulmonary embolism, deep vein thrombosis, occluded arteriovenous cannulae, and acute arterial thrombosis and embolism. Streptokinase is not recommended in patients with acute ischemic stroke due to lack of benefit and an increased risk of intracranial hemorrhage and mortality. Unlike urokinase, repeated administration of streptokinase can result in tolerance and/or hypersensitivity. Streptokinase is considerably less expensive than other thrombolytics. Streptokinase is…

Description of Phentolamine Phentolamine is an alpha-adrenergic receptor antagonist. Phentolamine is similar in action to phenoxybenzamine but is administered parenterally and has a shorter duration of action. Approved uses of phentolamine include diagnosis of pheochromocytoma and treatment of hypertension in pheochromocytoma, prevention of tissue necrosis after norepinephrine extravasation, and reversal of soft tissue anesthesia. Phentolamine also has been used to treat hypertensive crisis associated with monoamine oxidase inhibitor (MAOI) therapy and in combination with papaverine to treat erectile dysfunction (ED). According to ED treatment guidelines, oral phosphodiesterase type 5 (PDE5) inhibitors…

Description of Cefepime  Cefepime is a parenteral cephalosporin with pharmacokinetics and spectrum of activity similar to ceftazidime, a ‘third-generation’ cephalosporin. Because cefepime may be active against some organisms resistant to ceftazidime, some consider cefepime a ‘fourth-generation’ cephalosporin. Cefepime is comparable to ceftazidime in its coverage of Pseudomonas aeruginosa, and it may be more active than ceftazidime against Enterobacter sp. due to enhanced stability against beta-lactamases. Clinical uses of cefepime are similar to those of the third-generation cephalosporins. Cefepime was approved in January 1996. It was approved for the treatment of febrile neutropenia…

Description of Physostigmine  Physostigmine is a parenteral and ophthalmic cholinesterase inhibitor. Physostigmine is similar to neostigmine except that it is a tertiary amine while neostigmine is a quaternary amine. This difference may explain the increased activity of physostigmine in the CNS. Physostigmine most commonly is used as an ophthalmic agent in the treatment of open-angle glaucoma. It has also been used to counteract toxic anticholinergic effects (both central and peripheral) of other drugs which cause anticholinergic toxicity, particularly in overdose situations. Until recently, physostigmine was used to treat tricyclic antidepressant…

Description of Alvimopan (entereg) Alvimopan is the first oral, gastrointestinal-specific mu-opioid receptor antagonist and is indicated to accelerate the time to upper and lower gastrointestinal recovery following partial large or small bowel resection surgery with primary anastomosis (i.e., prevention of postoperative ileus). The efficacy of alvimopan in the management of postoperative ileus was evaluated in 6 multicenter, randomized, double-blind, parallel-group, placebo-controlled studies. Primary approval was supported by trials in patients undergoing bowel resection for benign or malignant colorectal or small bowel disease; expanded approval was supported by a Phase IV…

Description of Trospium Trospium is an oral non-specific antimuscarinic agent. Trospium is indicated for the treatment of overactive bladder (OAB) in adults. Trospium decreases the frequency of bladder contractions, resulting in a reduction in urinary frequency, urgency and incontinence. Trospium is effective in patients with idiopathic or neurogenic detrusor overactivity, with symptoms of overactive bladder improving as early as 1 week following drug initiation.Trospium has been shown to be as effective as oxybutynin for OAB, but with better tolerability in clinical trials (e.g., less dry mouth).The most commonly reported adverse…

Description of Sufentanil  Sufentanil is an injectable and sublingual opioid agonist of the phenylpiperidine class. Injectable sufentanil is indicated as a primary anesthetic agent for the induction and maintenance of anesthesia with 100% oxygen in patients undergoing major surgical procedures to provide favorable myocardial and cerebral oxygen balance or when extended postoperative ventilation is required, as an analgesic adjunct in the maintenance of balanced anesthesia, and for epidural anesthesia with low dose bupivacaine during labor and delivery. Sufentanil sublingual tablets are indicated for the management of acute severe pain that…

Description of Cevimeline  Cevimeline is a quinuclidine derivative of acetylcholine and acts as a cholinergic agonist. Cevimeline improves the symptoms of dry mouth (xerostomia) in patients with Sjogren’s syndrome. Prior to the approval of cevimeline, pilocarpine was the only other agent approved for this indication; however, significant advantages of cevimeline over pilocarpine have yet to be determined. In studies comparing cevimeline at various dosages per day, there was no difference between the 180 mg/day and 90 mg/day dosages; however, the 90 mg/day dosage was preferred by patients over the 45…

Description of Apomorphine Apomorphine, a non-narcotic derivative of morphine, is approved as a sublingual film for the treatment of acute, intermittent ‘off’ episodes associated with Parkinson’s disease and as a subcutaneous injection for use in patients with advanced Parkinson’s disease. Apomorphine has also been used as a diagnostic test for dopaminergic responsiveness in parkinsonian syndromes to determine whether a patient will respond or is still responsive to levodopa therapy. Apomorphine has a quick onset of action, a significant effect on parkinsonian hypomobility (‘off’ episodes) unresponsive to oral medications, and a…

Description of Pethidine/Meperidine Meperidine hydrochloride (known as pethidine outside the US) is a synthetic opiate agonist belonging to the phenylpiperidine class. Other members of this group include alfentanil, diphenoxylate, fentanyl, loperamide, and sufentanil. The chemical structure of meperidine is similar to local anesthetics. Meperidine is a second-line agent for the treatment of moderate to severe acute pain and has the unique ability to interrupt postoperative shivering and shaking chills induced by amphotericin B. Meperidine has also been used for peripheral nerve blocks and intraarticular, epidural, and spinal analgesia. A high…