Common Drugs

Nonsteroidal Anti-inflammatory Drug (NSAID),
any of a large group of drugs that reduce pain and inflammation in muscles and joints.
NSAIDs work by blocking the production of prostaglandins, body chemicals that cause
inflammation and contribute to the brain’s perception of pain. NSAIDs are among the most
commonly used drugs in the world. In the United States alone, 33 million people regularly
take these drugs, spending $4 billion annually.
NSAIDs are available over the counter and by prescription, and inclu de aspirin, ibuprofen,
naproxen, indomethacin, oxaprozin, nabumetone, and many other similar drugs. A remarkably
versatile group of drugs, NSAIDs relieve a variety of minor, everyday aches and pains as well
as play an important role in the treatment of a n umber of chronic diseases, particularly
arthritis. As such, they may be incorporated into long-term treatment programs that require
the careful supervision of a qualified physician.
More recently scientists have been investigating possible new uses for NSAIDs in preventing
various diseases. For example, low doses of aspirin prevent blood from clotting and can help
ward off heart attacks and strokes, which are among the leading causes of death in the United
States. The American Heart Association now recomme nds that people with a personal or
family history of heart attack may benefit from taking one aspirin every other day as a
preventive measure. Preliminary studies show that certain NSAIDs, especially sulindac, a drug
used to treat arthritis, may prevent some forms of colorectal cancer. Other emerging data
suggest that different NSAIDs, particularly ibuprofen, may have a role in preventing
Alzheimer’s disease.
For all of their benefits, however, NSAIDs are not without risks, some of them severe. The
most common side effects from NSAID use affect the digestive system. In addition to their
role in pain perception and inflammation, prostaglandins help protect the lining of the
digestive tract from corrosive stomach acid. When NSAIDs inhibit prostaglandin production,
the digestive tract is left unprotected, resulting in problems ranging from minor discomfort,
such as upset stomach, to life -threatening ulcers and bleeding from the stomach or intestine.
NSAIDs can also cause problems with the kidneys, liver, brain, skin, and other organs.
Although only a small percentage of NSAID users develop serious side effects, NSAID side
effects pose a major health problem because the drugs are used by so many people. In the
United States, NSAIDs are responsible for over 100,000 hospitalizations and over 10,000
deaths each year, mostly due to bleeding from the stomach or intestine.
The risk of side effects is greatest in older people, in the disabled, in patients who are also
taking the anti-inflammatory steroid prednisone, and in those who take high doses of NSAIDs
for long periods of time to control arthritis or other chronic diseases. For those who must use
NSAIDs for extended periods, doctors may prescribe a synthetic prostaglandin called
misoprostol to help protect the stomach lining.
Scientists are working to develop safer NSAIDs by targeting inflammation more precisely.
NSAIDs block prostaglandin production by inhibiting an enzyme known as cyclooxygenase, or
COX. The enzyme has two forms, known as COX-1 and COX-2. COX-1 is involved in producing
the prostaglandins that protect the stomach lining, while COX-2 is involved in inflammation.
The next generation of NSAIDs will selectively target COX-2 while allowing the activity of COX-
1 to continue. Preliminary evidence suggests that these drugs will prove to be safer than most
current NSAIDs.
Like all drugs, NSAIDs can interact with other medications. The drugs inhibit blood clotting,
which can be dangerous in patients who are also taking other anticoagulant drugs. NSAIDS
can also cause fluid retention in patients who are taking certain medications for congestive
heart failure.
Microsoft® Encarta® Encyclopedia 2002. © 1993-2001 Microsoft Corporation. All rights

reserved.
Carisoprodol,
drug used to relieve muscle spasms and help with the healing of severe muscle strain. It
relaxes muscles by blocking the transmission of impulses along certain nerves in the brain
stem and the spinal cord.
Available by prescription only, tablets are usually taken four times a day in 350-mg doses. The
drug may be taken with or without food but should not be combined with alcoholic beverages.
It is usually effective within minutes. Although carisoprodol can provide considerable relief
from pain, patients taking this drug should follow a doctor’s recommendations to limit physical
exercise or receive physical therapy. Rest is usually considered an important part of treatment
with this drug.
Patients with porphyria (a blood disorder), liver or kidney problems, a history of drug
dependence, or a previous re action to this drug should use it with caution. Its safety for
children under the age of 12 or for pregnant women has not been established. It is known to
appear in breast milk.
Possible side effects may include depression, dizziness, fainting, headache, i rritability, nausea,
vomiting, tremors, rapid heartbeat, insomnia, or hiccups. Some patients experience an allergic
reaction to the drug, which may range from mild itching or skin rash to fever, asthmatic
attacks, low blood pressure, fluid retention, stinging of the eyes, muscle weakness, or shock.
Occasionally, the first dose of this drug brings on temporary symptoms such as disorientation,
vision or speech impairment, paralysis, or euphoria. Patients with a strong or disturbing
reaction to carisoprodol should contact a doctor.
This drug may react adversely with various antidepressants, sedatives, or tranquilizers. It may
cause withdrawal symptoms if the patient stops treatment suddenly, producing abdominal
cramps or nausea, headache, insomnia, or chills. A serious overdose of carisoprodol can be
fatal.
Brand Name: Soma

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Sulfa Drugs,
common name applied to a group of chemotherapeutic agents that are effective again st a
number of infectious diseases. In 1935 the German chemist, Gerhard Johannes Paul Domagk
discovered that an azo dye, Prontosil, cured streptococcal infections in mice. The active
principle in Prontosil was found to be paraaminobenzenesulfonamide, commo nly known as
sulfanilamide. Clinical trials with sulfanilamide proved effective in arresting various bacterial
diseases. Among the derivatives of sulfanilamide that have proved effective against such
conditions as puerperal fever, scarlet fever, erysipelas, meningitis, pneumonia, and
bacteremia are sulfapyridine, sulfathiazole, sulfadiazine, sulfaguanidine, sulfamerazine, and
sulfasuxidine. All the sulfa drugs are somewhat toxic, producing blood abnormalities and
kidney damage when indiscriminately used. Since the discovery of penicillin, which is as
effective as the sulfa drugs although far less toxic, the use of sulfa drugs has somewhat
declined. Because bacteria often develop resistance to a particular kind of treatment, however,
sulfa drugs are used when bacterial tolerance for penicillin has developed. See Antibiotic.

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Mifepristone, also RU-486,

drug that is used to induce abortions. Mifepristone is used as an alternative to surgical
abortions during the first seven weeks of pregnancy.
Mifepristone was developed in 1980 by French endocrinologist Etienne-Emile Baulieu, who was
then a consultant to the French pharmaceutical company Roussel Uclaf. The drug was initially
called RU-486 because it was the 486th in a series of compounds that the company tested. It
has been used in France to induce abortions since 1988. Mifepristone has subsequently been
marketed in many countries around the world, including the United Kingdom, Germany,
Sweden, and China. However, the United States Food and Drug Administration (FDA) did not
approve its use until September 2000. The delay in the United States was due primarily to
opposition by conservative religious political activists.
Roussel Uclaf relinquished its patent rights to mifepristone in many countries, including the
United States. It did so because of threats that people who oppose abortion would boycott the
company’s other products. In the United States the company gave the p atent rights to the
Population Council, a nonprofit, private research organization. The Population Council spent at
least $50 million to test the drug and get it approved by the FDA. Under the trade name
Mifeprex, the drug is distributed by Danco Laboratories, a company that was established
specifically for that purpose. Mifeprex is thought to be manufactured in bulk by a
pharmaceutical company in Shanghai, China. No company in the United States was willing to
manufacture the drug because of the controversy surrounding it. Mifeprex is not available in
pharmacies. Instead, it is shipped directly to physicians who use it. Most health insurance
agencies in the United States have expressed a willingness to pay for the drug.
II HOW MIFEPRISTONE WORKS
Mifepristone is used in conjunction with a drug called misoprostol, a prostaglandin marketed

under the trade name Cytotec. In the United States misoprostol is used primarily to prevent
stomach ulcers.
Mifepristone works by blocking the action of progesterone, a hormone necessary to sustain a

pregnancy. Without progesterone, the fertilized egg detaches from the uterine wall, the cervix
softens and opens, and the uterine lining breaks down. Misoprostol, given later, stimulates the
uterus to contract and expel the fertilized egg. Because of its progesterone-blocking activity,
mifepristone is being tested for a variety of other potential uses. These include inducing full-
term labor; treating breast and ovarian cancer, as well as certain other tumors; and as a
therapy for endometriosis.
In most cases a woman being treated with mifepristone visits her physician three times. On
the first visit the patient takes three pills containing 600 milligrams of mifepristone, which
starts the process. In the United States, the patient is required to sign an informed consent
form on the first visit to indicate that she understands the risks and requirements of the
procedure. Two days later, she returns and is given a pill containing 400 micrograms of
misoprostol, which starts contractions. Typically, the woman might wait in the physician’s
office or the clinic for up to four hours for the embryo to be expelled. At the third visit, two
weeks later, a pelvic examination or a sonogram is conducted to ensure that the pregnancy
has ended.
Nearly half the women in the U.S. studies experienced light or moderate bleeding after
receiving mifepristone, and 3 percent aborted immediately. The rest did not begin to bleed
until after they received misoprostol, and many suffered cramping. Most abortions are
complete within two weeks, but a few take longer. In about 8 percent of women who were
pregnant 49 days or less, surgery is necessary to complete the abortion.
The primary side effects of mifepristone include nausea, headache, weakness, and fatigue.
Those of misoprostol include nausea and vomiting and, in a small number of women, diarrhea.
III ADVANTAGES AND PRECAUTIONS
The principal advantages of a drug-induced abortion, also called a medical abortion or a

chemical abortion, are that anesthesia is not required, no medical instruments are used, and
the procedure is not invasive. Theoretically, medical abortions can be performed by any
physician in the physician’s office, whereas surgical abortions require a clinic or hospital.
However, medical abortion becomes progressively less effective after the seventh week of
pregnancy. In contrast, a surgical abortion requires only two visits, is over much more quickly,
and is more effective in the later stages of pregnancy.
Medical abortion is not appropriate f or all women. Women with an ectopic pregnancy—in which
the embryo is lodged outside the uterus—cannot have it because it will not end such
pregnancies. Women who have an intrauterine device (IUD) in place or who have been taking
steroid therapy for a long time should not have a medical abortion. It is also not
recommended for women who suffer bleeding disorders or who are taking blood-thinning
drugs, women who have genetic blood diseases called porphyrias, or women who are allergic
to prostaglandins.
IV CONTROVERSY
The ethical issues surrounding mifepristone are virtually identical to those surrounding
abortion itself—whether the process is moral. Antiabortion activists claim that abortion is the
murder of an innocent human being and that the new drug simp ly provides physicians with a
better weapon. Groups opposed to abortion argue that the ready availability of the drug will
lead to a sharp increase in the rate of abortions. However, in France, where the drug has been
in use since 1988, the annual number o f abortions increased by only about 6 percent from
1990 to 1998, according to the French government’s Directorate of Health. Mifepristone is
used in about one-third of the abortions performed in France.
Abortion foes in the United States began a campaign warning women that the drug is
dangerous for them because they could suffer excessive bleeding or hemorrhaging.
Antiabortion groups questioned the FDA’s highly unusual policy of keeping much information
about the drug secret, including the names of distrib ution company officials and the identities
of physicians who conducted clinical trials. The FDA responded that the secrecy was necessary
to protect the officials and physicians from violence.
Mifepristone proponents argue that the drug makes the abortion p rocess less invasive for
pregnant women. They also point out that, by making abortion potentially available in any
physician’s office, the drug eliminates the necessity for women to brave the picket lines and
boisterous demonstrations now found outside abortion clinics. Use of mifepristone could also
ease fears among abortion physicians, who are sometimes targeted by antiabortion activists
with guns. Proponents also argue that mifepristone will increase the pool of health-care
providers that include abortio n services in their practice and thus will expand access to
abortion.

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Thalidomide,
drug introduced in 1953, initially prescribed for its sedative properties and widely used by
women to alleviate the nausea and vomiting common in the early stages of pregnancy.
Thalidomide gained notoriety in 1961 when it was found to cause severe malformations in the
growing fetus such as stunted development or the complete absence of limbs. More than
10,000 children were born with these disabling abnormalities before the drug was taken off
the market. This disaster triggered more rigorous government regulations for drug testing.
Today thalidomide is used in the treatment of leprosy, and experimentally in bone-marrow
transplant patients and certain immune system disorders.
II HISTORY
Thalidomide was first produced by Chemie Grunenthal, a German pharmaceutical company. By

the late 1950s the drug was widely used as a tranquilizer in Germany, Britain, and other
countries. The drug was never sold in the United States because marketing was delayed when
the Food and Drug Administration’s (FDA) review of its application for approval revealed
evidence of nerve damage with long-term thalidomide use. During this delay, reports emerged
from Europe of severe birth defects in children born to women who took thalidomide while
pregnant. Eventually, the clear connection between thalidomide usage and birth defects was
firmly established and thalidomide was withdrawn from commercial distribution worldwide in
1961.
A single dose of thalidomide taken only 34 to 50 days after a woman’s last menstruation
before pregnancy is enough to hurt a developing fetus. This period is crucial for the
development of the fetus’s limbs and major organ systems. In addition to stunted or missing
limbs, other organs susceptible to malformation from thalidomide use during this sensitive
period include the ears, lip, palate, eyes, heart, spine, respiratory tract, gastrointestinal tract,
kidneys, and reproductive tract.
The mechanism of thalidomide’s negative effects has not been established, but some evidence
suggests it may be related to the drug’s ability to inhibit the formation of new blood vessels.
Growing tissue needs an adequate blood supply to furnish it with needed nutrients and
oxygen. Inadequate blood circulation would impair growth and development.
The thalidomide disaster mobilized American support for the Drug Amendments Act of 1962.
Among other issues, this legislation strengthened the FDA’s role in overseeing the drug
development process. The FDA began to require that pharmaceutical companies determine
that a new drug does not affect fetal development before the drug can be approved for sale in
the United States.
III RECENT USES
While its commercial distribution was halted, thalidomide continued to be used in experimental
studies for a variety of diseases. A series of studies beginning in the mid -1960s showed that
thalidomide was effective in treating a leprosy-related disorder, erythema nodosum leprosum
(ENL). A serious skin disorder, ENL usually develops in leprosy patients after they begin taking
antibiotics to combat the leprosy-causing bacterium Mycobacterium leprae. ENL is believed to
be caused by an abnormal immune reaction to the killed bacteria.
The FDA approved thalidomide for the treatment of ENL in July 1998, at the same time placing
unprecedented restrictions on the drug’s use. Under these restrictions, thalidomide can only
be obtained from selected doctors and pharmacies that have agreed to follow a strict protocol
designed to prevent birth defects from the drug. Both men and women taking the drug must
use birth control during sexual intercourse, and women must also agree to undergo periodic
pregnancy tests.
Thalidomide’s success in treating ENL, although not fully understood, triggered extensive
studies into the drug’s effects on the immune system. Some studies suggest that thalidomide
reduces the production of tumor necrosis factor-alpha (TNF-a), a protein made by immune
cells that may cause problems such as wasting, or chronic weight loss, when produced in
excessive amounts. Thalidomide has also been proven to heal painful canker sores in the
mouth of patients with acquired immunodeficiency syndrome (AIDS) or other patients with
impaired immune systems. Canker sores in these patients do not heal as readily as in people
with normal immune systems, and the sores make eating difficult.
Early evidence suggests that thalidomide effectively suppresses the body’s rejection of donor
bone marrow that sometimes occurs in bone-marrow transplant patients. Thalidomide is also
being studied as a possible treatment for various cancers and other diseases because of its
ability to inhibit growth of new blood vessels. This inhibition could slow or completely prevent
growth of cancerous tumors that require new blood vessels in order to thrive.
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Metoprolol,
drug used to treat h ypertension (high blood pressure) and angina pectoris (chest pain), and to
reduce the risk of a second heart attack. Metoprolol belongs to a group of drugs called beta
adrenergic blocking agents, more commonly known as beta blockers. It lowers blood pressure
by blocking nerve impulses that contribute to a high heart rate.
This drug is available by prescription only. It comes in 50-mg, 100-mg, and 200-mg tablets; in
50-mg and 100-mg prolonged action tablets; and in a liquid that is administered
intravenously. For treatment of hypertension or angina, the oral dosage in regular tablet form
ranges from 10 to 450 mg per day, either taken as a single dose or in divided doses; in
prolonged action tablets, the oral dosage is up to 400 mg once a day. For prevention o f heart
attacks, the typical, intravenous injected dosage is 5 mg every two minutes for a total of three
doses. For treatment after a heart attack, the typical oral dosage in regular tablets is 50 mg
every 6 hours, starting 15 minutes after the last intravenous dose followed by 100 mg twice a
day for three months to one year. This drug is effective within 2 hours when given orally, and
its effectiveness in lowering blood pressure is apparent after 10 to 14 days.
Tablets can be taken with meals or on an empty stomach. The regular tablet can be crushed,
but the prolonged action tablet should be taken whole. This drug should not be used by
persons with a previous allergic reaction to it; pregnant or breast-feeding women; persons
with congestive heart failure, a n abnormally slow heart rate, or disorders of heart impulse
transmission (such as patients with cardiac pacemakers); or persons taking a class of
antidepressants known as monoamine oxidase (MAO) inhibitors. It should be used with
caution by persons with re duced liver function or asthma and by people over the age of 60. Its
safety and effectiveness in children under the age of 12 have not been established. It may
have a negative effect on driving or other risk-related activities. Metoprolol should not be
discontinued abruptly but should be tapered off gradually over one to two weeks.
Common side effects of this drug include drowsiness, fatigue, cold hands and feet, slow heart
rate, lightheadedness, and decreased sexual desire. Possible risks of long-term use include
congestive heart failure in advanced heart disease, worsening angina in coronary heart
disease, and increased asthma attacks in asthmatic persons.
Exposure to heat can lower blood pressure and exaggerate the effects of metoprolol. Exposure
to cold can further reduce the diminished circulation in hands and feet that may occur with
this drug. Alcohol may exaggerate the drug’s ability to lower blood pressure and increase its
sedative effect. Smoking may reduce the drug’s potency. Excessive salt intake should be
avoided when using this drug.
Metoprolol can interact adversely with certain drugs including other antihypertensive drugs;
albuterol; aminophylline; amiodarone; aspirin; barbiturates such as phenobarbital; calcium
channel blockers; chlorpromazine; cimetidine; clonidine; digoxin; diltiazem; epinephrine;
fluoxetine; furosemide; hydralazine; indomethacin and possibly other aspirin substitutes or
nonsteroidal anti-inflammatory drugs; insulin; nifedipine; oral antidiabetic drugs; oral
hypoglycemic drugs; oral contraceptives (birth control pills); tranquilizers; reserpine;
theophyllinevenlafaxine; and verapamil.
Brand Names:Lopressor, Toprol

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Nabumetone,
nonste roidal anti-inflammatory drug used for relief of pain and inflammation associated with
osteoarthritis and rheumatoid arthritis. Nabumetone blocks the production of certain chemicals
in the body called prostaglandins that may trigger pain and inflammation.
This drug is available by prescription only. It comes in 500-mg and 700-mg tablets, taken
orally. The typical, initial adult dosage is 1000 mg per day. This dosage may be increased as
needed and tolerated to 1500 to 2000 mg per day, taken once a day or in divided doses.
Relief of symptoms may be felt within one hour, but it may take up to two weeks to feel the
full effect of the drug.
Nabumetone should be taken on a regular schedule, without missing doses. It should be taken
with food to increase absorption of the drug and to prevent stomach irritation. To minimize
adverse side effects, the lowest effective daily dose should be used. Nabumetone should not
be used by persons who have had a previous allergic reaction to this drug or an asthmatic
reaction to aspirin; pregnant or breast-feeding women; or persons with peptic ulcers or any
form of gastrointestinal ulceration or bleeding, bleeding or blood cell disorders, liver disease,
or severe impairment of kidney function. It should be used with caution by persons with
reduced liver or kidney function and persons taking drugs that reduce blood clotting. The
safety and efficacy of this drug for children under the age of 12 have not been established.
Reduced dosages are advised for persons over the age of 60 until their tolerance of
nabumetone has been determined. Driving or other risk-related activities should be restricted
if drowsiness, dizziness, or impaired vision occurs with use of this drug.
Certain mild side effects may occur with nabumetone that should disappear as the body
adapts to the drug. These include bloating, constipation, diarrhea, difficulty sleeping,
dizziness, drowsiness, headache, heartburn, indigestion, lightheadedness, loss of appetite,
nausea, nervousness, soreness of the mouth, sweating, or vomiting. More serious but
uncommon side effects include activation of peptic ulcer disease or ulcerative colitis, asthma
or difficulty breathing, bleeding in the stomach or duodenum, blurred vision, impairment of
normal blood clotting, and liver or kidney damage. This drug may also cause increased
sensitivity to sunlight.
Nabumetone may interact adversely with alcoholic beverages and with certain other drugs
including anticoagulants (blood thinners) such as warfarin; aspirin, other salicylates, and other
anti-inflammatory drugs; beta blockers; diuretics; and probenecid.
Brand Name:Relafen

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Astemizole,
antihistamine drug that is used to treat hay fever and recurring hives. It works by blocking the
action of histamine (a chemical released by the body during allergic reactions) that contributes
to swelling and itching of the nose, eyes, and skin.
Astemizole is available only by prescription. It comes in tablet form a nd is taken orally on an

empty stomach (one hour before or two hours after a meal). The typical dosage for adults and
children over age 12 is 10 mg once a day. It has not been proven safe for children under age
12. The drug starts to be effective within one hour of treatment.
Astemizole is often prescribed for use over several weeks. It helps control the appearance of
hives and hay fever symptoms but does not provide immediate relief. Patients should not take
more than a single, prescribed dose—even if symptoms are severe or a dose was missed—
because overdose reactions are severe and may include fainting, irregular heartbeat, seizures,
or cardiac arrest.
Possible side effects include drowsiness, dry mouth or throat, fatigue, headache, or increased
appetite. Less common are depression, diarrhea, dizziness, itching or tingling, joint or muscle
pain, nervousness, nausea, nosebleed, skin rash, or sore throat. Patients with asthma, liver
disease, or kidney disease should use this drug with caution. Astemizole may interact
adversely with certain types of drugs, including antibiotics, antifungal drugs (especially
ketoconazole), and drugs that affect heart rhythms. Its safety during pregnancy and nursing is
not known.
In 1998 the Food and Drug Administration (FDA) issued an alert warning that astemizole can
cause death due to irregular heart rhythms if taken with certain other drugs or used at higher
than recommended doses. The FDA cautioned that in addition to those drugs previously known
to have adverse interactions with astemizole, several other drugs should be avoided by those
taking astemizole. These include the antidepressants fluoxetine (marketed under the brand
name Prozac), fluvoxamine (Luvox), setraline (Zoloft), nefazodone (Serzone), and paroxetine
(Paxil); the AIDS drugs known as protease inhibitors; and the anti-asthma medication zileuton
(Zyflo). The FDA also warned against drinking grapefruit juice while taking astemizole,
because grapefruit juice slows down the metabolism of astemizole by the liver.
Brand Name: Hismanal

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Digoxin,
drug used to treat heart problems, such as congestive heart failure and irregular heartbeat. It
also helps heart function in patients with pacemakers, an artificial implant in the heart that
regulates the heart rate. Digoxin works by increasing the force of heart muscle contractions
and by regulating the electrical signal that controls heartbeat. It belongs to a group of drugs
known as cardiac glycosides.
Digoxin is available in capsule, tablet, and liquid form. All are taken orally, although one form
of the liquid is injected. This drug is usually taken once a day on an empty stomach. It may be
taken with food, if necessary, to avoid stomach upset but should not be combined with bran or
other high-fiber products. Dosages of this drug vary widely, ranging from 0.125 to 0.5 mg per
day. Some patients start treatment at a high dosage (1 to 1.5 mg) on the first day. Children
under age ten may take this drug, which is usually divided into two or more small doses. Its
safety for use by pregnant women is not known, and nursing mothers should be aware that it
does appear in breast milk.
Patients taking digoxin may be asked to check their pulse rate periodically as a way to help
determine the most effective dose. The use of this drug should not be halted abruptly, as it
may seriously affect heart function. Digoxin is usually effective after one to two weeks of use,
but treatment with it is often prescribed for many months or years.
Possible side effects include diarrhea, nausea, stomach pain, vomiting, blurred vision,
headache, skin rash, loss of appetite, or breast development in males. Overdose can be
caused by slight increases in dosage. Symptoms o f overdose include those listed above as well
as a very slow pulse and an irregular heartbeat.
Digoxin may interact adversely with a wide variety of drugs. These include but are not limited
to antibiotics, antacids, bronchodilators, diuretics, steroids, thyroid hormones, and blood
pressure drugs (including beta blockers and calcium channel blockers). Others include the
drugs alprazolam and rifampin. Because of these many drug interactions, patients taking
digoxin should alert caretakers of this fact during emergency treatment or medical or dental
procedures.
Brand Names:Lanoxin,Lanoxicaps

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Amitriptyline,
an antidepressantdrug. Typically used to treat mental depression, amitriptyline may also be
used to treat chronic pain, bulimia, migraine headaches, and certain symptoms of multiple
sclerosis. It works by restoring levels of neurotransmitters, chemicals in the brain that help
transmit nerve impulses.
Amitriptyline is available only by prescription. It is taken orally in tablet form, often once a day
at bedtime. Dosages generally begin at 50 or 75 mg and are then gradually increased to 150
or 200 mg, the maximum daily dosage for adults. Children over age 12 generally take about
30 mg per day. Children under age 12 should not take this drug. Benefits from amitriptyline
may not be seen for several weeks after first starting the medication.
Patients recovering from a heart attack should not take this drug, nor should people who are
taking monoamine oxidase inhibitors such as phenelzine, another type of antidepressant. Its
safety for use during pregnancy has not been adequately studied, but it is known to appear in
breast milk. Patients with certain medical conditions should avoid using amitriptyline unless
advised by a doctor; these include seizures, heart or circulatory disorders, liver ailments, and
eye disorders such as glaucoma. In addition, patients undergoing medical or dental procedures
should be aware that amitriptyline can react adversely with anesthetics and other drugs used
during these procedures.
Possible side effects of amitriptyline include a wide variety of ailments, including dry mouth,
dizziness, drowsiness, blurred vision, breast enlargement, headache, disorientation, diarrhea,
constipation, vomiting, fatigue, anxiety, high fever, heart attack, impotence, insomnia,
seizures, or stroke. This drug may also increase the skin’s sensitivity to sunlight. These side
effects are more likely to appear when the drug is first used and usually disappear after a few
days. Lowering the dosage or eliminating the drug can produce side effects as well; these may
include headache, nausea, irritability, or sleep disturbances. An overdose of amitriptyline can
be fatal.
This drug may interact adversely with a broad variety of drugs, including but not limited to
allergy and cold medications, barbiturates, antihistamines, tranquilizers, muscle relaxants, oral
contraceptives, painkillers, seizure medications, sleep medications, thyroid hormones, and
large doses of vitamin C. It should not be combined with alcohol.
Brand Names:Elavil, Endep, Triavil

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Alprazolam,
drug used to treat anxiety, panic attacks, and certain phobias. It has also been used to treat
depression, irritable bowel syndrome, premenstrual syndrome, and problems associated with
alcohol withdrawal. Alprazolam works by depressing the activity of the central nervous
system.
Alprazolam is a prescription drug available in tablet form that is taken orally, with or without
food, usually three times a day. Dosages may range from 0.25 mg to 10 mg, depending on
the severity of the patient’s condition. The drug takes effect after one or two hours. Because
drowsiness is a common side effect, patients taking this drug are advised not to drive, operate
dangerous machinery, or engage in other risk-related activities.
An overdose of this drug can cause sleepiness, confusion, coma, or even death, especially
when combined with alcoholic beverages. Alprazolam should not be used by pregnant or
nursing women, as it may harm the baby. No safe dosages have been established for children
under 18 years of age.
Possible side effects of alprazolam include blurred vision, stuffy nose, headache, drowsiness,
diarrhea, constipation, nausea, chest pains, fainting, muscular weakness, decreased sex drive,
irritability, or depression. Side effects are more likely to appear when the drug is first used or
when dosage is increased, but they may lessen or disappear with continued use of the drug.
Lowering the dosage or eliminating the drug can also produce side effects, especially after
prolonged use (more than four weeks). This set of side effects may include blurred vision,
diarrhea, loss of appetite, muscle cramps, twitching, or seizures.
Patients who are sensitive to or allergic to tranquilizers should not use alprazolam. In addition,
it should not be used by anyone with myasthenia gravis (chronic muscle weakness), or with
narrow-angle glaucoma, an eye disorder. This drug may interact adversely with a variety of
medications, including carbamazepine, cimetidine, digoxin, disulfiram, various antihistamines,
antidepressants, oral contraceptives (see Birth Control Pill), and other tranquilizers.
Brand Name:Xanax

reserved.
Cyclobenzaprine or Flexeril,
muscle-relaxing drug that is used to relieve muscle pain and stiffness associated with pulled
or sprained muscles. It works by affecting nerves that control muscles, but it does not
interfere with muscle function.
Cyclobenzaprine must be prescribed by a doctor. Available in tablet form, cyclobenzaprine is

taken orally, with or without food, usually three times a day. The typical daily dosage is 30
mg, with a maximum recommended dosage of 60 mg per day. When combined with rest and
physical therapy, this drug usually relieves symptoms within a week or two. It is typically
prescribed for no more than a three-week period.
Patients taking antidepressant drugs that act as monoamine oxidase (MAO) inhibitors (such as
phenelzine) should not take this drug, as serious or fatal reactions may result.
Cyclobenzaprine should not be combined with alcohol and it may interact adversely with
barbiturates, high blood-pressure drugs, antispasmodic drugs, and drugs that depress the
central nervous system.
In addition, patients with an overactive thyroid gland, an irregular heartbeat, or congestive

heart failure should not take this drug. Cyclobenzaprine should be used with caution by
patients with glaucoma or with difficulties urinating. Its safety for use in pregnant or nursing
women and in children under age 15 has not been established.
Dry mouth is a common side effect, which may be relieved by sucking on candy or ice or by
chewing gum. Other possible side effects include drowsiness and dizziness. Patients who
experience either symptom should not drive, operate dangerous machinery, or engage in
other risk-related activities while taking this drug. Less common side effects include anxiety,
disorientation, insomnia, constipation, diarrhea, indigestion, headache, skin rash, sweating,
facial swelling, blurred or double vision, abnormal heartbeat, or tremors.
Brand Name :Flexeril

reserved.
Methylphenidate,
drug classified as a stimulant and used chiefly in the treatment of narcolepsy in adults and
attention-deficit hyperactivity disorders (ADHD) in children. It is also used to treat mild to
moderate depression and manage social withdrawal in the elderly. Methylphenidate tends to
improve alertness and concentration and increases learning ability and attention span,
presumably by activating the brain stem.
This drug is available by prescription only and is taken orally. It comes in 5 -mg, 10-mg, and
20-mg regular tablets, and in 20-mg sustained release tablets. The typical adult dosage in
regular tablet form is 5 to 20 mg taken two or three times a day, preferably 30 to 45 minutes
before a meal. For sustained release tablets, the dosage is one 20-mg tablet one to three
times a day (every 8 hours), preferably on an empty stomach. Adults over the age of 60
usually begin with small doses. For ADHD in children 6 years old and older, the initial dosage
in regular tablets is 5 mg twice a day, taken before breakfast and lunch. This dosage may be
increased by 5 to 10 mg per week to a maximum dosage of 60 mg per day. For sustained
release tablets, the dosage is one 20-mg tablet one to three times a day. The effectiveness of
this drug can usually be determined in three to four weeks.
Methylphenidate can be taken with food or milk to prevent stomach upset. The regular tablet
can be crushed, but the sustained release tablet should be taken whole. This drug should not
be used by persons who have had a previous allergic reaction to it; pregnant or breast-feeding
women; persons with glaucoma, anxiety, nervous tension, severe depression, or Tourette’s
syndrome; or children with major psychiatric disorders or acute stress. It should be used with
caution by persons with reduced liver function. The safety and effectiveness of the drug in
children under the age of six have not been determined. Driving and other risk-related
activities may need to be restricted if alertness is impaired. This drug should not be
discontinued abruptly if used for an extended period but should be tapered off to avoid severe
depression and erratic behavior.
The most common side effects of methylphenidate are nervousness and insomnia. It may also
cause dizziness and drowsiness, headache, nausea, a dry mouth, loss of appetite, stomach
pain, and weight loss with long-term use. Long-term use has the potential for serious
psychological dependence and may interfere with normal growth in children.
Methylphenidate may interact adversely with foods and beverages containing large amounts of
tyramine, a chemical that raises blood pressure. Foods and beverages high in tyramine include
aged cheeses, avocado, bean curd, bologna, chocolate, canned fish, dried and salted fish,
pickled herring, liver, meat extracts, meat tenderizers, pepperoni, raisins, raspberries, salami,
sour cream, soy sauce, yeast extracts, unpasteurized beer, chianti, sherry, and vermouth.
Caffeine should not be taken in any form. Methylphenidate may also interact adversely with
certain drugs including tricyclic antidepressants such as amitriptyline, desipramine,
imipramine, and nortriptyline; other antidepressant drugs known as monoamin e oxidase
(MAO) inhibitors such as isocarboxazid, pargyline, phenelzine, and tranylcypromine; high
blood pressure medications (especially guanethidine); oral anticoagulants (blood thinners)
such as warfarin; anticonvulsants such as phenytoin, phenobarbital, and primidone; and the
nonsteroidal anti-inflammatory drug phenylbutazone.
Brand Names:Ritalin, Ritalin-SR

reserved.
Atenolol,
prescription drug used to treat heart and blood vessel (cardiovascular) problems, including
high blood pressure, angina, and heart attack. It is also sometimes used for migraine
headaches, anxiety, and symptoms of alcohol withdrawal. Atenolol belongs to a group of drugs
called beta blockers. It affects the autonomic nervous system, which controls the involuntary
muscles and glands of the body, slowing the heartbeat and decreasing the force of heart
contractions. These changes ease the strain on the heart and result in lower blood pressure.
Atenolol is taken orally in tablet form once a day, usually in 50 or 100 mg doses, with or
without food. Relief of high blood pressure or angina pain (caused by lack of oxygen to the
heart muscle) usually occurs one or two weeks after treatment begins. (An injectable, liquid
form of this drug—effective within 5 minutes—may be used to treat a heart attack.) Because
atenolol controls rather than cures cardiovascular problems, treatment should continue even
after symptoms disappear.
Patients with certain medical conditions should use this drug with caution or should avoid it
altogether. These conditions include severe congestive heart failure, heart blockage, asthma,
allergies, kidney disease, coronary artery disease, or a slow heartbeat. Diabetics should be
aware that atenolol may interfere with blood-sugar tests. This drug should not be used by
pregnant or nursing women. Its safety for use in children is not known.
Potential side effects include dizziness, fatigue, nausea, or slow heartbeat. Less common side
effects are diarrhea, drowsiness, headache, impotence, skin rash or itching, depression, hair
loss, and breathing difficulties. Patients ending treatment with this drug should do so over a
period of several weeks rather than stopping its use abruptly.
Atenolol is often prescribed in conjunction with other medications, such as diuretics
(medication that increases urination). However, it may interact adversely with certain drugs
including epinephrine, insulin, and other drugs used to treat diabetes, other blood pressure
medications, and antacids that contain calcium.
Brand Name:Tenormin

reserved.
Carbamazepine or Tegretol,
prescription drug used to treat seizures such as those associated with epilepsy. It also relieves
neuralgia, or pain along a sensory nerve, in the jaw, tongue, or throat. The drug is
occasionally prescribed for patients recovering from alcohol or cocaine addiction, for migraine
headaches, and for depression or other emotional disorders. It works by suppressing impulses
along nerve fibers in the brain, making seizures less frequent and less severe. It also prevents
the transmission of certain nerve impulses, thereby reducing pain.
Carbamazepine is taken orally and is available in tablet form, usually taken twice a day, or
liquid form, usually taken four times a day. Both forms should be taken with meals. Daily
dosages for control of seizures range from 800 to 1200 mg, the higher recommended dose for
adults and childre n over the age of 12. For neuralgia, doses of 400 to 800 mg per day are
usually effective. The drug is typically prescribed in small doses in the beginning, which are
increased daily or weekly until symptoms are relieved. This process may take three months or
more. Children six years and older may take this drug, although it is usually prescribed in
smaller amounts. The maximum children’s daily dosage is 1000 mg.
A variety of side effects have been associated with carbamazepine. They include muscle or
joint pain, abdominal pain, constipation, blurred vision, anemia, fainting, drowsiness, hair loss,
headache, dizziness, hallucinations, impotence, itching, breathing problems, low blood
pressure, sensitivity to light, and sweating. Side effects that include fever, sore throat, mouth
ulcers, bruises, or reddish spots on the skin may indicate a blood disorder, which requires
immediate medical treatment.
Patients with a sensitivity to certain antidepressant drugs (such as amitriptyline) or with

reduced bone-marrow function should not use carbamazepine. It should be used with caution
by patients with drug sensitivities and by those who have glaucoma, or impairment of heart,
liver, or kidney function. Pregnant or nursing women should avoid using this drug. Because of
the potential for dizziness or drowsiness, patients taking this drug should not drive, operate
dangerous machinery, or engage in other risk-related activities. Patients who take
carbamazepine to control seizures should not stop taking it abruptly, as severe, continuous
seizures may result.
Carbamazepine should not be combined with antidepressants known as MAO inhibitors. It may
also interact adversely with lithium, theophylline, doxycycline, haloperidol, as well as calcium
channel blockers, oral contraceptives (see Birth Control Pill), and other antiseizure
medications.
Brand Names:Tegretol, Atretol

reserved.
Cephalexin,
bacteria-fighting drug in a group known as cephalosporin antibiotics, used to treat infections of
the middle ear, urinary tract, reproductive system, skin, and bones. Cephalexin works by
interfering with the invading bacteria’s ability to multiply in the body.
This drug is available by prescription in table t, capsule, and liquid form, all of which are taken
orally. The typical adult dosage is 500 mg every 12 hours (sometimes prescribed as 250 mg
every 6 hours). Children should take the liquid form of this drug, which is usually prescribed in
two or four daily doses. The total daily dosage for children is determined by body weight and
the type of infection being treated.
Cephalexin works fastest when taken on an empty stomach, but it may be taken with food if it
causes stomach upset. The drug is effective within three to five days, but to prevent a
recurrence of infection, the entire course of medication should be taken. However, prolonged
use is not recommended as it may lead to a secondary infection. Patients with diabetes should
be aware that cephalexin may affect the accuracy of urine glucose monitoring tests. Patients
with drug allergies, kidney disorders, colitis (inflamed colon), or other gastrointestinal
problems should use this drug with caution. Its safety for use during pregnancy has not been
determined. It is known to appear in breast milk.
Diarrhea is this drug’s most common side effect. Less common side effects include indigestion,
abdominal pain, colitis, vomiting, dizziness, confusion, hallucinations, skin rash, hives, joint
pain, fluid retention, vaginitis, and yellowing of the eyes or skin. A severe allergic reaction to
cephalexin may occur in patients who are sensitive to both cephalosporin antibiotics and
penicillin. This drug may interact adversely with diarrhea medications and oral contraceptives.
Brand Names:Keflex,Biocef

reserved.
Chlorpromazine,
prescription tranquilizer drug used to treat moderate to severe mental illnesses such as
schizophrenia, manic-depressive illness (see Bipolar Disorder), and violent hyperactivity in
children. It is also used to treat porphyria (a blood disorder), tetanus, and uncontrollable
hiccups. In addition, chlorpromazine is used to relieve withdrawal symptoms associated with
drug addiction, anxiety before surgery, and to control vomiting following chemotherapy. It
works by suppressing the action of dopamine, a neurotransmitter in the brain, thereby
restoring normal nerve impulses and helping control psychotic behaviors.
Chlorpromazine is available in capsule, tablet, liquid, and suppository form. Dosages are
usually small (10 to 30 mg per day) at first, increased as necessary to dosages that range
from 300 to 800 mg per day. Oral forms of this drug are usually taken with meals t o prevent
stomach irritation. Children over six months of age may take chlorpromazine based on body
weight. Several weeks of treatment are usually needed before this drug’s effectiveness
becomes apparent.
Chlorpromazine should be used with caution by patie nts with asthma, emphysema, kidney or
liver diseases, glaucoma, respiratory infections, intestinal blockage, seizures, breast cancer, or
brain tumors. Its safety for use during pregnancy is not known; it does appear in breast milk.
Prolonged use of this drug can cause a condition known as tardive dyskinesia, characterized by
muscle spasms and twitches. Chlorpromazine may also cause neuroleptic malignant
syndrome, a sometimes fatal condition of rigid muscles, rapid heartbeat, and high fever.
Numerous other s ide effects are associated with this drug, including anemia, constipation,
headache, nasal congestion, fainting, insomnia, impotence, irregular heartbeat, hives, eye
problems such as blurred vision or fixed gaze, change in urine color, light sensitivity,
suppressed cough reflex, or nervousness.
Dizziness and drowsiness are also possible, so patients should not drive, use dangerous
machinery, or engage in other risk-related activities while taking chlorpromazine. Abruptly
stopping this drug can cause nausea, vomiting, tremors, or dizziness. An overdose of
chlorpromazine can be fatal.
This drug should never be combined with alcoholic beverages, narcotics, or barbiturates. It
can also interact adversely with anesthetics, antacids, anticonvulsants, diuretics,
antidepressants known as MAO inhibitors, blood-thinners, captopril, cimetidine, or
epinephrine.
Brand Name:Thorazine

reserved.
Clozapine,
drug used to treat schizophrenia, a mental illness characterized by severe disturbances in
thought, emotions, and behavior. Classified as an antipsychotic (see Psychoactive Drugs),
clozapine works by blocking the action of dopamine, a chemical in the brain associated with
emotions and behavior. Blocking dopamine tends to correct the abnormal nerve impulses that
cause schizophrenic behavior.
Clozapine is a prescription drug available in tablets that are taken orally with or without food.
Starting dosages usually range from 12.5 to 25 mg take n once or twice a day. The dosage is
gradually increased by the physician to a typical dosage of 600 mg per day. The maximum
recommended dosage is 900 mg per day. Effectiveness is usually apparent after two to four
weeks of treatment, although maximum benefits are typically not observed for about three
months.
Patients taking clozapine are monitored with a blood test each week for signs of
agranulocytosis, a serious blood disorder that can be brought on by this drug. Characterized
by a drop in the number of white blood cells, agranulocytosis causes fever, sore throat, and
muscle weakness, and can lead to death in some cases. Patients with existing blood disorders
should not take this drug. It should be used with caution by patients with heart or circulatory
problems (including high blood pressure), a history of seizures, impaired liver or kidney
function, an enlarged prostate gland, or narrow-angle glaucoma, an eye disorder. Clozapine
has not been proven safe for use in children under the age of 16 or in pregnant or nursing
women.
In addition to agranulocytosis, other possible side effects include seizures, drowsiness,

headache, dizziness, low blood pressure, nausea, constipation, fever, blurred vision, tremors,
rapid heartbeat, weight gain, or nightmares. Patients taking this drug should not drive,
operate dangerous machinery, or engage in other risk-related activities.
Clozapine may interact adversely with other antipsychotic drugs, epilepsy drugs (such as
carbamazepine or phenytoin), blood pressure medicatio ns, and antidepressants, as well as
cimetidine, digoxin, atropine, epinephrine, and warfarin. In addition, clozapine should not be
combined with alcoholic beverages.
Brand Name:Clozaril

reserved.
Diazepam,
mild tranquilizer drug, used to treat anxiety and nervous tension. It may also be used to treat
acute alcohol withdrawal, insomnia, muscle spasms, and certain types of seizures. Classified
as a benzodiazepine, diazepam works by blocking nerve activity in certain parts of the brain,
producing a calming effect.
Diazepam is available by prescription in tablet, capsule, and liquid form. With the exception of
one form of liquid made for injection, all are taken orally. Depending on the patient’s
condition, the prescribed dosage may range from 2 mg to 10 mg 2 to 4 times daily, with a
maximum recommended dosage per day of 60 mg. Diazepam may be taken with or without
food. Relief of symptoms is usually apparent within three to five days. Because this drug may
be addictive or habit -forming, prescribed treatment is typically no longer than three weeks.
Patients with mental illnesses or with acute narrow-angle glaucoma (an eye disorder) should
not take this drug. Diazepam should be u sed with caution by patients with impaired liver or
kidney function, severe depression, or epilepsy. It is not safe for use during pregnancy, while
breast-feeding, or in children under six months of age. It should not be combined with
alcoholic beverages.
Side effects of this drug may include drowsiness, lightheadedness, fatigue, or poor muscle
coordination. Patients who experience these symptoms should not drive, operate dangerous
machinery, or engage in other risk-related activities while taking diazepam. Other side effects
include blurred or double vision, confusion, depression, dizziness, headache, slurred speech,
nausea, constipation, skin rash, or low blood pressure. Patients taking diazepam for an
extended period (more than four weeks) may experience withdrawal symptoms if use is
stopped abruptly; these symptoms may include abdominal cramps, sweating, vomiting,
tremors, or convulsions. An overdose of this drug may cause sleepiness, confusion, or coma.
Diazepam may interact adversely with a wide variety of drugs. These include other
tranquilizers, anticonvulsant drugs, antidepressants (especially MAO inhibitors), barbiturates,
narcotics, and birth control pills. Other potentially adverse drug interactions include
cimetidine, digoxin, fluoxetine, ranitidine, and rifampin.
Brand Names:Valium, Valrelease,Dizac
Hydrocodone,
nonprescription drug used to relieve moderate to moderately severe pain and to control
coughing. It works by suppressing the brain’s perception of pain and dulling the cough reflex,
the n atural response to irritation of the lungs and air passages. A mild narcotic, hydrocodone
is similar to codeine.
A common ingredient in cough medicines, hydrocodone is also available in tablets coupled with
an analgesic (pain killer) such as acetaminophen. As a liquid cough remedy, the dosage is 5
mg every four to six hours. In tablet form the dosage is 5 to 10 mg taken no more frequently
than once every four hours. The drug is effective within 30 minutes and continues working for
3 to 6 hours. Taking the drug with or following food may help prevent stomach irritation or
nausea. To avoid tolerance or drug dependence, uninterrupted use should continue no longer
than five to seven days.
Side effects associated with hydrocodone include drowsiness, urinary retention, constipation,
dry mouth, skin rash, depression, blurred or double vision, nausea, vomiting, delirium,
impaired breathing, and a heightened awareness of pain after the drug wears off. Extended
use can cause chronic constipation.
Pregnant women should avoid using hydrocodone unless a physician specifically prescribes it.
It is not known whether the drug appears in breast milk. Patients who have previously reacted
poorly to any narcotic, who have a history of chemical dependency, impaired kidney or liver
function, or chronic lung disease should use this drug with caution.
Hydrocodone can increase the effects of sedative drugs taken at the same time. Alcohol often
interacts adversely with hydrocodone to cause depression, and hydrocodone can intensify
alcohol’s intoxicating effects.
Brand Names:Dimetane Expectorant-DC,Triaminic Expectorant DH,Vicodin

reserved.
Ketoconazole,
prescription drug used to treat fungal infections. It works by weakening fungal cell walls,
thereby either killing the fungus or stopping its growth. Ketoconazole is also used to treat
prostate cancer because it suppresses the production of testosterone, a hormone necessary
for prostate cancer cell survival.
Ketoconazole is available as a tablet, cream, or shampoo. Patients using the drug in tablet
form take 200 to 400 mg once a day for fungal infections and 400 mg three times a day for
prostate cancer. The drug should be taken with food for bette r absorption and to avoid
stomach irritation. It must be taken for two to four weeks before a physician can evaluate its
effectiveness as an antifungal agent. A cure may require many months of treatment.
Common side effects of ketoconazole include reduced testosterone production (which may
impair sexual function in males), skin irritation and rash, headache, nausea, diarrhea, and
liver problems. Pregnant and nursing women, patients with active liver disease, and patients
who have previously had an allergic reaction to the drug should not take ketoconazole.
Patients should exercise caution in taking the drug if they are allergic to related antifungal
drugs, take any other drugs, have liver disease or reduced liver function, have a history of
alcoholism, or have low levels of hydrochloric acid in their stomachs.
Ketoconazole enhances the blood-thinning effects of warfarin and minimizes the effects of
theophylline. Antacids may lessen ketoconazole’s effectiveness. Patients who consume alcohol
while taking this drug may experience dizziness, headaches, and nausea. Alcohol in
combination with ketoconazole can also contribute to liver problems.
Brand Name:Nizoral

reserved.
Mometasone Furoate,
drug used in the treatment of skin diseases such as eczema and psoriasis as well as allergic
rashes such as those caused by poison oak and poison ivy. Mometasone furoate belongs to a
group of drugs called synthetic corticoids, which are similar to hormones secreted naturally in
the body by the outer layer, or cortex, of the adrenal glands. The drug is absorbed through
the skin and reduces swelling and itching, although its exact mechanism is unknown.
Available by prescription only, mometasone furoate is available as a cream, ointment, or

lotion. A thin film of cream or ointment or a few drops of lotion should be applied to affected
areas of skin once daily. Some relief from itching and a decrease in redness and swelling is
typically apparent in a few days. Complete disappearance of symptoms depends on the extent
of the skin condition.
Mometasone furoate should be used only as specifically directed by a physician. It should not
be used on areas of the body other than those for which it was prescribed, and treated skin
should not be bandaged unless so ordered by a physician. Avoid direct contact with the eyes.
Breast-feeding women should not use the drug and pregnant women should not use it
indiscriminately or for prolonged periods. Its use in children should be limited to the least
amount effective.
The most frequent side effects of mometasone furoate are localized burning, itching, tingling,
stinging, or dry skin. If used in especially thin or sensitive skin areas, this drug may cause skin
damage. If used over large surface areas, in areas of broken skin, with bandages, or over a
long period, too much of the drug may be absorbed into the body, producing serious adverse
reactions such as suppression of the body’s normal production of certain hormones. Because
of their higher skin surface to body weight ratio, children are more susceptible to toxicity than
adults.
Mometasone furoate is not known to interact adversely with any foods or other drugs.
However, patients should exercise caution to prevent over-absorption of the drug if prescribed
along with oral corticoids.
Brand Name:Elocon

reserved.
Nortriptyline,
drug used to treat major mental depression. It is also used to treat chronic, severe pain and
attention-deficit hyperactivity disorder (ADHD) in adolescents. Nortriptyline relieves
depression by regulating production of the brain’s neurotransmitters, chemicals crucial to the
transmission of nerve impulses.
This drug is available by prescription only in capsules and as a liquid. The capsule is taken
orally in doses of 10 mg, 25 mg, 50 mg, and 75 mg. The initial adult dosage is 25 mg three to
four times a day. The usual maintenance dosage ranges from 5 0 to 100 mg per day. A
reduced dosage of 30 to 50 mg per day is recommended for adolescents and the elderly. It
may take two to three weeks for this drug to produce results.
Nortriptyline should not be used by persons who have had a previous allergic reaction to it;
pregnant or breast-feeding women; persons recovering from a recent heart attack or with
narrow-angle glaucoma; or persons who have taken a monoamine oxidase (MAO) inhibitor
drug within the past 14 days. Nortriptyline should be used with caution by persons with liver
damage or problems with urination. Its safety and effectiveness for children have not been
established. Exposure to excessive heat or cold should be avoided. Driving and other risk-
related activities should not be undertaken if drowsiness occurs. This drug should be
discontinued gradually rather than abruptly.
Common side effects of nortriptyline that should disappear as the body adjusts to the drug
include anxiety, drowsiness, blurred vision, confusion, constipation, a dry mouth, fa tigue,
headache, insomnia, lightheadedness, memory problems, nausea, peculiar tastes in the
mouth, decreased urination, and weight gain or loss. More serious but less common side
effects include aggravation of paranoid psychoses and schizophrenia; hallucin ations; irregular
heart rhythm; nightmares; seizures; and uncoordinated movements or balance problems.
Nortriptyline may cause sensitivity to sunlight and may activate latent diabetes, epilepsy, or
glaucoma.
Alcoholic beverages should be completely avoided while using this drug. Nortriptyline may also
interact adversely with other drugs including antiseizure medications; birth control pills;
antihistamines, barbiturates, tranquilizers, narcotics, and sleeping medications;
carbamazepine; cimetidine; epinephrine; fluconazole; fluoxetine; and monoamine oxidase
(MAO) inhibitors.
Brand Names:Aventyl, Pamelor

reserved.
Cefuroxime Axetil or Ceftin,

bacteria-fighting drug in a group known as cephalosporin antibiotics, used to treat mild or
moderate infections of the ears, throat, chest, urinary tract, and skin. It is also used to treat
gonorrhea. Cefuroxime axetil works by interfering with the invading bacteria’s ability to
multiply in the body.
Available by prescription only, this drug is taken orally in tablet form, and a liquid form is
administered intravenously. Depending on the severity of infection, the adult dosage may
range from 125 to 500 mg taken twice a day. A single d ose of 1 g is used to treat gonorrhea.
Children under the age of 12 may take this drug safely, usually in two daily doses of 125 or
250 mg per dose.
Cefuroxime axetil works fastest when taken on an empty stomach, but it may be taken with
food if it causes stomach upset. For children the tablets may be crushed and mixed with food.
The drug is effective within three to five days, but to prevent a recurrence of infection, the
entire course of medication should be taken. However, prolonged use is not recommended as
it may lead to a secondary infection.
Patients with diabetes should be aware that cefuroxime axetil may affect the accuracy of urine
glucose monitoring tests. Patients with colitis (inflamed colon) or other gastrointestinal
problems should use this drug with caution. Its safety for use during pregnancy has not been
determined, and it does appear in breast milk.
Common side effects may include diarrhea, nausea, vomiting, colitis, or skin problems such as
redness, itching, or rash. Other side effects sometimes observed are dizziness, headache,
seizures, vaginitis, or yeast infection. A severe allergic reaction to cefuroxime axetil may occur
in patients who are sensitive to both cephalosporin antibiotics and penicillin. This drug may
interact adversely with the drug probenecid and with diarrhea medications, prolonging the
diarrhea or making it more severe.
Brand Name: Ceftin

reserved.
Ciprofloxacin,
drug used to treat bacterial infections in the lower respiratory tract, urinary tract, bones,
joints, and skin. It is also used to treat serious ear infections, cholera, tuberculosis, infectious
diarrhea, and infections associated with acquired immunodeficiency syndrome (AIDS).
Ciprofloxacin works by blocking the action of gyrase, an enzyme needed by the invading
bacteria for cell reproduction, thereby slowing or completely stopping bacterial growth.
The drug is available by prescription in tablets, which are taken orally w ith or without food,
and in a liquid, which is used in the form of eyedrops. Depending on the severity of infection,
dosages for tablets range from 250 to 750 mg taken every 12 hours. Eyedrops are typically
prescribed as one or two drops every 2 to 4 hours . Patients taking this drug should drink
plenty of fluids but avoid excessive caffeine. Pregnant women, breast-feeding women, and
children under the age of 18 should not take this drug.
Possible side effects include abdominal pain, nausea, vomiting, headache, skin rash, sensitivity
to light, or restlessness. Serious side effects should be reported to a doctor, as allergic
reactions to this drug, while rare, can be fatal. Allergic symptoms may include facial swelling,
shortness of breath, tingling or itchin g, hives, or unconsciousness.
Patients with severe liver disease, impaired kidney function, or with epilepsy or other disorders
or injuries affecting the central nervous system should use this drug with caution. Those who
experience dizziness or lightheadedness with this medication should not drive, operate
dangerous machinery, or engage in other risk-related activities. Because of the possible risk of
tendon rupture, strenuous physical activity should be avoided or approved by a doctor.
Ciprofloxacin should not be combined with the drug theophylline, as serious or fatal reactions
can result. It may interact adversely with phenytoin and warfarin. Ciprofloxacin may be less
effective when used in combination with vitamin supplements containing zinc or iron o r with
antacids containing calcium, aluminum, or magnesium.
Brand Names:Cipro,Ciloxan

reserved.
Fluvastatin,
drug used to lower cholesterol levels. It is typically p rescribed when dietary changes, weight
loss, and exercise are not effective in lowering cholesterol. This drug works by interfering with
the body’s chemical pathways associated with cholesterol synthesis.
Capsules are taken with or without food, usually a t bedtime. Fluvastatin is usually prescribed
in combination with a cholesterol-lowering diet. The typical dosage ranges between 20 and 40
mg per day. Effectiveness of the drug is usually seen after three or four weeks.
This drug should not be taken by pre gnant or nursing women or by children under age 18.
Patients with liver or kidney problems, low blood pressure, or seizures should use this drug
with caution. Fluvastatin can cause damage to the liver or to muscle tissue, although problems
can usually be d etected early with laboratory tests.
Possible side effects of this drug include abdominal or back pain, muscle pain, fatigue,
headache, diarrhea, nausea, constipation, respiratory irritation or infection, skin rash,
insomnia, dizziness, or coughing. Fluva statin may interact adversely with the drugs cimetidine,
digoxin, erythromycin, gemfibrozil, ketoconazole, ranitidine, or rifampin.
Brand Name: Lescol

reserved.
Haloperidol,
drug used to treat the hallucinations that accompany certain mental illnesses such as
schizophrenia. It is also used to treat Tourette’s syndrome (a movement disorder) and for
short-term treatment of attention-deficit hyperactivity disorder in children. Haloperidol works
by interfering with the function of the neurotransmitter dopamine in the central nervous
system.
Haloperidol is available by prescription in tablet and liquid injectable form. Dosage depends on
the age and symptoms of the patient. The usual maximum dosage for an adult is 20 mg per
day. Treatment of mental illnesses and Tourette’s syndrome requires two or more daily doses.
If benefits are not apparent within six weeks, use of the drug should be discontinued.
Treatment should be tapered off unless the patient suffers a severe side effect from
haloperidol use, which may warrant abruptly ending treatment.
Pregnant women should not take haloperidol in their first trimester, and should use it only as
necessary in the second and third trimesters. The drug is present in breast milk, so the
nursing child should be carefully monitored for any adverse effects. Patients suffering from
depression, Parkinson disease, breast cancer, active liver disease, or a bone marrow or blood
cell disorder should not take this drug.
Common side effects of haloperidol include drowsiness, low blood pressure, constipation, dry
mouth, blurred vision, tremors, or muscle rigidity. Other side effects may include nausea, skin
rash, insomnia, urinary retention, depression, eye damage, diminished sexual function, and
increased heart rate. One possible consequence of long-term use is the onset of tardive
dyskinesia, a nervous system disorder that causes uncontrolled movements of the fingers,
neck, eyelids, jaws, lips, and tongue.
Haloperidol can increase the effects of sedative drugs. Some drugs decrease haloperidol’s
effects, including barbiturates and antacids with aluminum or magnesium. Haloperidol and
lithium together can cause toxic effects in the nervous system and brain. Alcoholic beverages
should not be consumed by patients using this drug.
Brand name: Haldol

reserved.
Lisinopril,
drug used to treat hypertension (high blood p ressure) and congestive heart failure (inability of
the heart to pump sufficient blood). Lisinopril relaxes blood vessel walls, thereby lowering
blood pressure and increasing the supply of blood and oxygen to the heart.
This drug is available by prescription only and is taken orally in tablet form. The typical dosage
for adults ranges from 10 to 40 mg taken once a day. The cumulative effect of this drug may
not be apparent for two to four weeks.
Lisinopril should not be taken by pregnant women. It should be used with caution by breast-
feeding women and people with diabetes mellitus, heart or blood vessel disease, heart attack,
stroke, kidney or liver disease, or systemic lupus erythematosus. Its safety for children has
not been established.
The side effects of taking lisinopril are relatively minimal. Dizziness and lightheadedness may
occur from lowered blood pressure. However, a rarely observed side effect includes swelling of
the face, extremities, eyes, lips, and tongue after the first dose, resulting in difficulty
swallowing or breathing and potential obstruction of the airway.
Certain foods and other drugs may interact adversely with lisinopril. Potassium supplements
and foods high in potassium should be avoided. The use of alcoholic beverages with this drug
may dramatically lower blood pressure. Diuretic drugs (those that increase the elimination of
urine) may lower blood pressure excessively, and potassium-sparing diuretics may increase
blood potassium. Indomethacin, a nonsteroidal, anti-inflammatory drug, may decrease the
effect of lisinopril.
Brand Names: Prinivil, Zestril

reserved.
Nitrofurantoin,
antibiotic drug used to treat bacterial infections of the bladder and kidneys. Nitrofurantoin
kills susceptible strains of Escherichia coli, Staphylococcus aureus, Enterobacter, and Klebsiella
bacteria by breaking down cell walls and interfering with the bacteria’s metabolism.
This drug is available by prescription only. It is taken orally in 25-mg, 50-mg, and 100-mg
tablets and as a liquid suspension of 25 mg per 5 -ml spoonful. The typical adult dosage for
treatment of infections ranges from 50 to 100 mg every six hours, day and night. For
prevention of recurrent in fections, the usual adult dosage is 50 to 100 mg taken at bedtime.
Dosages for children and infants over one month old are determined on the basis of age and
weight and given on a similar schedule. The drug begins to take effect within 20 to 30
minutes.
To prevent stomach irritation and increase the effectiveness of nitrofurantoin, it should be

taken with a meal or a glass of water or milk. The liquid should be shaken well before
measuring, and the dose may be diluted in water, milk, fruit juice, or baby f ormula. Although
nitrofurantoin may cause the symptoms of a urinary tract infection to disappear within a few
days, it should be taken for the length of time prescribed. If dizziness or drowsiness occurs,
driving and other risk-related activities should be avoided. Nitrofurantoin should not be used
by pregnant women, especially in the third trimester; by breast-feeding women; persons with
impaired kidney function; or infants less than one month old. It should be used with extreme
caution by persons with anemia, diabetes, electrolyte imbalances, vitamin-B deficiency, or any
debilitating disease.
Nitrofurantoin is a potentially toxic drug with many side effects. Stomach irritation is the most
common. Nitrofurantoin may also cause abdominal or stomach pain, diarrhea, loss of appetite,
nausea, or vomiting. A normal but harmless side effect is a change in the color of urine for the
duration of treatment. Occasionally this drug may have serious, adverse effects on the lungs
or liver. The elderly have an increased chance of experiencing side effects.
This drug may interact adversely with other drugs including acetazolamide, anticholinergic
medications, magnesium trisilicate, nalidixic acid, oral antacids, probenecid, sodium
bicarbonate, and sulfinpyrazone.
Brand Names:Furadantin, Macrobid, Macrodantin

reserved.
Omeprazole,
drug used to treat gastric (stomach) ulcers and ulcers in the duodenum, or upper part of the
small intestine. This drug is also used to treat gastroesophageal reflux, a condition in which
stomach acid backs up into the esophagus, causing heartburn. Omeprazole works by reducing
the amount of acid that the stomach secretes.
This drug is available by prescriptio n only and comes in delayed release capsules of 10 mg and
20 mg that are taken orally. The typical adult dosage for duodenal ulcer or gastroesophageal
reflux is 20 mg once a day for four to eight weeks. For gastric ulcer, the usual adult dosage
ranges from 20 to 40 mg once a day for four to eight weeks. For excessive stomach acid
conditions, the typical adult dosage is 60 mg taken once a day for as long as necessary. For
adults over the age of 60, the recommended daily dosage is 20 mg for all conditions.
Omeprazole takes effect within one hour, but several days may pass before it relieves stomach
pain. Two to three weeks of regular use determines the overall benefit.
Omeprazole should be taken with a glass of water on an empty stomach at least one hour
befo re a meal (preferably the morning meal) or two hours after a meal. The capsule should be
swallowed whole and may be taken with an antacid if needed. This drug should not be taken
by persons who have had a previous allergic reaction to it; pregnant or breast-feeding women;
or persons with active bone marrow or blood cell disorders. The safety and effectiveness of
omeprazole for children under the age of 12 have not been established. Driving and other risk-
related activities should be avoided if drowsiness and dizziness occur.
The most common side effects of this drug are abdominal or stomach pain. Less common side
effects are chest pain, constipation, diarrhea, dizziness, gas, headache, heartburn, muscle
pain, nausea and vomiting, skin rash or itching, and u nusual drowsiness or fatigue. Rare but
more serious effects include bone marrow depression, kidney or liver damage, urinary tract
infection, or yeast infection of the esophagus.
Drinking alcohol and smoking tobacco increase stomach acid secretion and should be avoided
while taking this drug. Omeprazole may interact adversely with certain drugs including
ampicillin, amoxicillin, warfarin, clonazepam and some other benzodiazepines, cyclosporine,
diazepam, digoxin, ketoconazole, and phenytoin.
Brand Name: Prilosec

reserved.
Paroxetine or Paxil,
drug known as an antidepressant that functions by promoting higher levels of the
neurotransmitter serotonin in the brain. Low le vels of serotonin are thought to be associated
with depression.
Paroxetine must be prescribed by a doctor. The drug is available in tablet form and is taken
orally. Patients take up to 50 mg of the drug per day in one dose, preferably in the morning.
Within ten days of regular use, the drug’s concentration reaches a constant level in the
bloodstream. Two to four weeks of use are necessary before the patient feels the drug’s
benefits.
Common side effects of paroxetine include dizziness, tremor, nervousness, insomnia, dry
mouth, nausea, constipation, diarrhea, decreased appetite, and impaired sexual function.
Rarer reactions include dizziness upon rising from a seated or prone position, anxiety, urinary
disorders, skin rashes, and muscle weakness.
Pregnant and nursing women should not use this drug. Patients with liver or kidney
impairment, a history of seizure disorders, or manic-depressive mental illness should exercise
caution when using the drug.
Paroxetine interacts harmfully with cimetidine, digoxin, monoamine oxidase inhibitors,

warfarin, and tryptophan. Because tryptophan also occurs naturally in many foods (including
turkey and milk), paroxetine patients must carefully regulate their diets. Alcohol should not be
consumed by patients using paroxetine.
Brand Name: Paxil

reserved.
Cefadroxil or Duricef,
bacteria-fighting drug in a group known as cephalosporin antibiotics. It is commonly used to
treat staphylococcu s infections, streptococcus infections, and infections caused by Eschericia
coli (E. coli) bacteria. Examples of conditions caused by these bacteria include strep throat,
pneumonia, tonsillitis (swollen and inflamed tonsils), urinary tract infections, and skin
infections. Cefadroxil works by interfering with the invading bacteria’s ability to multiply in the
body.
This drug is available by prescription in tablet, capsule, and liquid form, all of which are taken
orally, usually once or twice a day. The daily adult dosage is 1 to 2 g, depending on the
severity of infection. Children may safely take this drug. The total daily dose for children is
determined by body weight. Effectiveness is usually apparent after three to five days, but to
avoid a recurrence of infection, the entire course of medication should be taken. Prolonged use
of cefadroxil is not recommended, however, as it may lead to a secondary infection.
Patients with colitis (inflamed bowel) or other gastrointestinal problems, allergies, or drug
sensitivities should use this drug with caution. Its safety for use during pregnancy has not
been determined, although it is known to appear in breast milk.
The primary side effect of cefadroxil is diarrhea. Other side effects sometimes observed are
nausea, itching, skin rash or redness, vaginal inflammation, vomiting, or colitis. A severe
allergic reaction to cefadroxil may occur in patients who are sensitive to both cephalosporin
antibiotics and penicillin. This drug may be taken safely with most other medications.
Brand Name: Duricef

reserved.
Cefprozil or Cefzil,
treat mild or moderate infections of the throat, ear, and respiratory tract, including strep
throat, pneumonia, tonsillitis (swollen and inflamed tonsils), and bronchitis (inflammation of
the bronchi, the air passages that connect the windpipe to the lungs), as well as skin
infections. Cefprozil works by interfering with the invading bacteria’s ability to multiply in the
body.
Cefprozil must be prescribed by a doctor. It is available in tablet and liquid form, which are
both taken orally. The typical dosage for adult s and children over age 12 is 500 mg per day,
taken in one or two doses. The dose for children under age 12 is determined by body weight
and the infection being treated.
Cefprozil works fastest when taken on an empty stomach, but it may be taken with food if it
causes stomach upset. Effectiveness is usually seen after three to five days, but to avoid a
recurrence of infection, the entire course of medication should be taken. However, prolonged
use of this drug is not recommended, as it may lead to a secondary infection. Patients with
diabetes should be aware that cefprozil may affect the accuracy of urine glucose-monitoring
tests. Patients with kidney disorders or with colitis or other gastrointestinal problems should
use this drug with caution. Its safety for use during pregnancy has not been determined, and
nursing mothers should be aware that this drug may appear in breast milk.
Nausea is this drug’s most common side effect. Less common side effects include diarrhea,
hives, genital itching, skin rash (including diaper rash), abdominal pain, insomnia, dizziness,
confusion, headache, nervousness, drowsiness, vomiting, and yellowing of the eyes and skin.
A severe allergic reaction to cefprozil may occur in patients who are sensitive to both
cephalosporin antibiotics and penicillin. This drug may interact adversely with other antibiotics,
certain diuretics (medications that increase urination), diarrhea medications, and oral
contraceptives (see Birth Control Pill).
Brand Name:Cefzil

reserved.
Clotrimazole,
antifungal drug used to treat a variety of fungal infections, especially on the skin and in the
mouth and vagina. Examples include ringworm, athlete’s foot, jock itch, thrush, and vaginal
yeast infections. The drug works by damaging the cell walls of the invading fungus, thereby
inhibiting its growth.
Clotrimazole is available in a variety of forms: skin cream, lotion, liquid solution, lozenges,
vaginal cream, and vaginal tablet. Depending on the type of infection being treated, the drug
is applied to the infected area once or twice a day. It may be massaged into the skin or
inserted into the vagina with an applicator. The exception is lozenges, which are dissolved in
the mouth, usually five times a day. Symptoms generally start to improve within the first one
or two weeks of treatment.
Patients with abdominal pain, fever, or vaginal discharge should not use the vaginal forms of
this drug. In addition, sexual intercourse should be avoided unless a condom is used. The
vaginal medication can be used safely during menstruation, but clotrimazole’s safety during
pregnancy and while nursing has not been determined. Children under age 5 should not use
the lozenge form of this drug.
Possible side effects include fluid retention and skin irritation, such as itching, peeling,
stinging, blistering, or burning. Vaginal preparations may cause abdominal cramps, vaginal
burning or itching, headache, or discomfort during sexual intercourse, including irritation to
the patient’s sexual partner. An important safety precaution with this drug is that it should not
come in contact with the eyes. It can be combined safely with other medications.
Brand Names: Lotrimin, Mycelex, Lotrisone

reserved.
Estradiol,
drug used to relieve the discomforts associated with menopause such as hot flashes and night
sweats. It also is used to prevent osteoporosis (a bone-thinning disorder) and atrophy of
genital tissues following menopause. Estradiol may also be helpful in treating breast cancer
and prostate cancer. A synthetic form of the sex hormone estrogen, estradiol works by
replacing estrogen in the body, which is needed for normal cellular activity.
Estradiol is available by prescription in capsules and tablets, which are taken orally; in a
patch, which is applied to the skin; and in a cream, which is applied to vaginal tissues. Oral
forms of this drug are taken with or without food in dosages ranging from 0.5 to 309 mg per
day, depending on the disorder. The skin patch is usually prescribed in 0.05- or 0.1-mg doses,
while the vaginal cream is used in 2 - to 4-mg doses. Estradiol’s effectiveness is usually
apparent afte r 10 to 20 days of use, although long-term treatment (months to years) is
sometimes prescribed.
Patients who are pregnant or planning to become pregnant should not use estradiol. It also
should not be used by patients with liver disease, sickle cell disease, certain breast cancers, or
a history of heart problems or stroke. Patients who smoke or have migraine headaches,
epilepsy, asthma, high blood pressure, gallbladder disease, diabetes, endometriosis, or blood-
clotting disorders should use this drug with caution. Estradiol may be associated with
increased risk of breast cancer and cancer of the uterine lining, especially with long-term use.
Possible side effects of this drug may include abdominal cramps, breast tenderness or
enlargement, change in menstru al flow, change in sex drive, weight gain or loss, headache,
fluid retention, skin rash, nausea, vomiting, or benign uterine tumors. Other side effects
sometimes observed are light sensitivity, cardiovascular problems (including high blood
pressure), depre ssion, hair loss or excess growth, vaginal yeast infection, gallbladder disease,
or certain cancers.
Estradiol may interact adversely with blood thinners, epilepsy drugs, diabetes drugs,
barbiturates, certain antidepressants, carbamazepine, phenobarbital, phenytoin, primidone, or
rifampin.
Brand Names:Estraderm, Estracea
Fluconazole,
drug used to treat fungal infections, especially of the mouth and throat. It is also used for
pneumonia, peritonitis, meningitis, infections of the urinary tract, and vaginal yeast infections.
It is useful in treating fungal infections in organ transplant patients and those with acquired
immunodeficiency syndrome (AIDS). The drug works by damaging the cell walls of the
invading fungus, thereby inhibiting its growth.
Fluconazole must be prescribed by a doctor. It is available in tablet or liquid form, with one
liquid form made for injection. Dosages range from 100 to 400 mg per day, usually starting
with a high dose on the first day. It may be taken with or without food. Th e drug’s
effectiveness is usually seen after two to four weeks of treatment, although long-term use
(months to years) may be required for some patients.
Patients with impaired liver or kidney function should use this drug with caution. Its safety for
use during pregnancy or while nursing is not known. Its use in children under age 13 is not
clearly established, although some children have used it safely.
Possible side effects may include nausea, abdominal pain, vomiting, diarrhea, headache, or
skin rash. Additional symptoms such as hives, drop in blood pressure, swelling, or difficulty
breathing or swallowing may indicate an allergic reaction to this drug, which requires
immediate medical attention.
Fluconazole may interact adversely with certain antihistamines, drugs that treat diabetes,
anticoagulants (especially warfarin), ulcer medications, phenytoin, rifampin, or
hydrochlorothiazide.
Brand Name:Diflucan

reserved.
Glyburide,
also known as glibenclamide, drug used for the treatment of adult -onset (Type 2) diabetes
mellitus. Glyburide is typically prescribed in addition to diet and weight-control measures to
control this form of diabetes, and it is useful for patients whose conditions cannot be treated
with diet alone but do not require insulin therapy. Glyburide lowers blood-sugar levels in
diabetic patients by stimulating the pancreas to release insulin and by promoting sugar uptake
into cells.
The drug is available by prescription in tablet form. The usual dosage is from 1.25 to 20 mg
daily. Most effective on an empty stomach, glyburide is commonly taken just before breakfast.
The drug takes effect within two hours. At least one to two weeks of use are necessary to
determine its effectiveness. After an initially positive response with the drug, some patients
may find that it becomes ineffective. For this reason, as well as to watch for side effects,
patients who take this drug must monitor their blood sugar on a regular basis.
A common side effect of glyburide use is hypoglycemia, a condition of low blood sugar. Other
possible side effects include skin rash, itching, hives, headaches, drowsiness, dizziness,
fatigue, nausea, indigestion, and heartburn.
Patients with unstable diabetes, those unfamiliar with the signs and symptoms of
hypoglycemia, or those who have histories of congestive heart failure, peptic ulcer disease,
hypothyroidism, or porphyria (a blood disorder) should notify their physicians before taking
glyburide.
Pregnant women, patients who prove allergic to glyburide, and patients whose liver or kidney
function is impaired should not take the drug. Alcohol consumption while taking glyburide can
lead to headaches, abdominal cramps, nausea and vomiting.
Brand Names: DiaBeta, Micronase

reserved.
Hydrochlorothiazide,
prescription drug known as a diuretic. It removes excess water from the body in order to
reduce the effe cts of fluid retention. Hydrochlorothiazide is also used to treat mild to moderate
high blood pressure (hypertension), often by increasing the effectiveness of other
hypertensive drugs such as beta blockers.
Hydrochlorothiazide is available in tablet form, and the usual dosage ranges from 50 to 200
mg per day. Taking the drug with food or shortly after meals can help prevent stomach
irritation. The drug is commonly taken at breakfast to prevent nighttime urination. Two to
three weeks of use are necessary to determine its effectiveness.
Side effects of using the drug include dizziness, nausea, low blood pressure, and skin rashes.
Some men experience impaired sexual function. After long-term use, imbalances in water,
salt, and potassium levels in the body ma y result. Pregnant women are generally discouraged
from using hydrochlorothiazide but may do so with the close supervision of a physician. The
drug appears in breast milk, and nursing women should avoid using it. Patients with kidney or
liver disorders, diabetes, gout, or patients preparing to undergo surgery with general
anesthesia should be cautious about using hydrochlorothiazide.
Brand Names: Aldoril, Aprozide, Capozide, Chlorzide
Microsoft® Encarta® Encyclopedia 2002. © 1993-2001 Microsoft Corporatio n. All rights

reserved.
Lorazepam,
drug used to treat anxiety, insomnia, and epilepsy. It is also used to calm surgery patients
before anesthesia. Lorazepam belongs to the benzodiazepine class of tranquilizers and works
by depressing the activity of the central nervous system (the brain and spinal cord).
Available by prescription only, lorazepam is dispensed in tablets; oral solution; and as an
injectable liquid. For sedation and relief of anxiety in adults from 18 to 60 years old, therapy
begins with 1 mg per day orally divided in two to three doses. The usual maintenance dosage
is 2 to 6 mg daily in divided doses, with a maximum dosage of 10 mg per day. For insomnia,
the dosage is 2 to 4 mg at bedtime. For sedation and anxiety in persons over the age o f 60,
therapy begins with 0.5 to 1 mg per day in divided doses and the maintenance dosage should
not exceed 2 mg per day initially. For insomnia in people over 60 years old, the dosage is 0.5
to 1 mg at bedtime. The drug usually takes effect in 45 minutes. Intravenous and
intramuscular injections are given in dosages based on body weight.
Since lorazepam can reduce alertness and slow reactions, users of the drug should avoid
driving or other risk-related activities. Because this drug can cause psychologica l and physical
dependence when taken in large doses for an extended period, continuous use should be
limited to several weeks. However, it should not be stopped abruptly if used for more than
four weeks. Lorazepam should not be taken by people with a known sensitivity to
benzodiazepine tranquilizers; persons with acute narrow-angle glaucoma; or pregnant or
breast-feeding women. It should be used with caution by people with liver or kidney disease.
Its safety and effectiveness have not been established in ch ildren under the age of 18.
The most frequent side effects of this drug are drowsiness, dizziness, weakness, and
unsteadiness. Less frequent side effects are disorientation, depression, nausea, change in
appetite, headache, sleep disturbance, agitation, s kin problems, vision problems, and memory
impairment.
Lorazepam may interact adversely with other drugs including alcohol, sedatives,
antihistamines, barbiturates, narcotics, antidepressants, carbamazepine, levodopa, phenytoin,
cimetidine, isoniazid, and rifampin.
Brand Name:Ativan
reserved.
Mupirocin,
antibiotic drug used to treat skin infections such as impetigo, characterized by pus-filled
lesions covered with thick yellow crusts. Such lesions are caused by several bacteria including
Staphylococcus aureus, Streptococcus pyogenes, and other types of Streptococcus. Mupirocin
is also used to cure infections caused by Staphylococcus aureus bacteria in the nasal
passages. Whether on the skin or in the nostrils, mupirocin works by preventing bacteria from
making proteins necessary for reproduction.
This drug is available by prescription only. It is available as an ointment applied directly to

affected areas of the skin. For skin infections in adults and children 16 years and older, a thin
film of ointment is applied to the infection site three times a day for 5 to 14 days. For children
from 5 to 15 years old, a thin film of ointment is applied to the infection site three times a day
for 3 to 5 days. Special single -use tubes of ointment are prescribed for intranasal use. For
adults and children over the age of 12, half the contents of a single -use nasal tube is squeezed
into each nostril twice a day, morning and evening, fo r 5 days. The effects of this drug should
be apparent after several days of continual use.
Mupirocin should not be used by persons who have had a previous allergic reaction to this
drug; pregnant or breast-feeding women; or persons with extensive burns or open wounds. It
should not be applied to an area of skin larger than that prescribed by a physician. The safety
and efficacy of the regular ointment have not been established for children under the age of 5,
while the safety and efficacy of the nasal ointment have not been established for children
under the age of 12.
The most common side effects of this drug include burning, stinging, pain, or itching at the
infection site. Less common side effects are rash, nausea, reddening or dry skin, tenderness,
swelling, and hives. One of the ingredients in this ointment, polyethylene glycol, may be toxic
to the kidneys if it is applied over an extensive burn or wound.
Mupirocin may interact adversely with certain medications and should not be used with other
ointments or treatments unless prescribed. Other intranasal medications should not be used
with the intranasal form of this drug.
Brand Names:Bactroban, Bactroban Intranasal

reserved.
Ofloxacin,
antibiotic drug used to treat certain types of pneumonia, bronchitis, gonorrhea, chlamydia,
prostatitis (inflammation of the prostate gland), skin infections, and conjunctivitis(eye
inflammation). Ofloxacin kills the bacteria that cause these infections by interfering with an
enzyme in the bacteria needed for reproduction.
This drug is available by prescription only in tablets taken orally, in an injectable liquid, and
eyedrops. The usual adult dosage in tablet or injection form is 200 to 400 mg every 12 hours
for 7 to 14 days depending on the type of infection. Gonorrhea is usually treated with a single
oral dose of 400 mg. Prostatitis may require six weeks of treatment. Conjunctivitis is treated
with eyedrops only. The typical, in itial dosage is one to two drops in the affected eye every
two to four hours for the first two days followed by one to two drops four times a day for five
additional days. Ofloxacin begins to kill bacteria within one to two hours; however, the full
course of medication should be taken to prevent the recurrence of infection.
Ofloxacin tablets should be taken on an empty stomach, either one hour before or two hours
after eating. It should be taken on a regular schedule, without missing doses, in order to keep
a constant level of the drug in the blood or urine. Antacids containing aluminum or magnesium
and vitamin supplements containing iron or zinc should not be taken for two hours before or
two hours after a dose of ofloxacin. This drug should not be taken b y people who have had a
previous allergic reaction to it or to cinoxacin, ciprofloxacin, or norfloxacin; pregnant or
breast-feeding women; or persons under 18 years old (ofloxacin may impair normal bone
growth and development). It should be used with caution by persons with impaired liver or
kidney function or known or suspected disorders such as severe cerebral atherosclerosis,
epilepsy, or factors that predispose a person to seizures (convulsions). The safety and
effectiveness of the eyedrops have not been established in children under one year old.
Driving and other risk-related activities should be avoided if the user experiences drowsiness,
dizziness, or impaired vision.
Common minor side effects of ofloxacin may include abdominal or stomach pain or discomfort,
diarrhea, dizziness, drowsiness, headache, lightheadedness, nausea, vomiting, nervousness,
and insomnia. Rare but more serious side effects may include severe allergic reactions,
excessive confusion, hallucinations, drug-induced hepatitis, restle ssness, speech problems,
tremor, seizures, and tendon rupture as a result of heavy exertion. The eyedrops may cause
temporary burning or stinging, redness, itching, tearing, or dryness in the eye.
Ofloxacin may interact adversely with large amounts of caffeine and with other drugs including
antacids containing aluminum or magnesium, calcium supplements, iron salts, probenecid,
sucralfate, theophylline, warfarin, and zinc salts.
Brand Names: Floxin, Ocuflox

reserved.
Pentoxifylline,
drug prescribed to treat a lack of oxygen in the calf muscles that can cause pain and limping.
Pentoxifylline works in three ways to improve blood circulation to calf muscles so that more
oxygen is delivered there. It reduces blood levels of fibrinogen, a protein that increases blood
thickness; it makes red blood cells more flexible for better passage through the smallest blood
vessels; and it prevents blood from forming clots, obstructions that can block off blood
vessels.
Pentoxifylline must be prescribed by a doctor. It is available in tablets and is taken orally. The
standard dosage is 400 mg taken three times a day. Taking the drug with food can help
minimize stomach irritation. It takes two to four weeks of regular use for symptom relief to
begin, and two to three months of use for the drug to reach its full effectiveness.
Side effects are rare, and may include headache, dizziness, tremor, skin rash, indigestion,
nausea, vomiting, and, when used by a patient with coronary heart disease, development of
heart rhythm disorders or angina (intense chest pain).
Pregnant women should avoid pentoxifylline during the first trimester, and should take the
drug during the remainder of the pregnancy only if there is a great need for it. Because the
drug appears in breast milk, nursing women should not take pentoxifylline. Patients who suffer
from impaired liver function, who have a high risk of bleeding problems, low blood pressure,
or coronary arte ry disease should be cautious about using pentoxifylline.
The effects of drugs that prevent blood clots and that lower blood pressure may be increased
in the presence of pentoxifylline. Because nicotine narrows arteries, pentoxifylline is
significantly less effective if the patient uses tobacco. Alcohol should be used with caution
because it contributes to pentoxifylline’s blood pressure -lowering effect.
Brand Name: Trental

reserved.
Phenelzine,
drug used to treat depression, anxiety, or phobias. Phenelzine is known as a MAO inhibitor,
and it works by blocking the action of the enzyme, monoamine oxidase (MAO), which normally
breaks down certain chemicals known as neurotransmitters in the brain. Blocking the
breakdown of neurotransmitters permits these chemicals to become more highly concentrated,
producing a more stable emotional state in the patient.
Available by prescription only, phenelzine tablets are taken orally, with or without food,
usually three times a day. Total daily dosage may range from 15 to 90 mg. The benefits of
taking phenelzine are usually apparent after three to four weeks of treatment, and long-term
usage (months to years) may be prescribed.
Patie nts with a history of congestive heart failure, liver disease, or an adrenal gland tumor
should not take phenelzine. It should be used with caution by patients with diabetes, heart
disease, or epilepsy. In general, it is safe for children under the age of 16 or for pregnant or
nursing women. The use of phenelzine may complicate other medical treatment and all
patients should notify their physicians and dentists that they are using this drug. Patients
should also carry a medic-alert card or wear a bracelet t hat will alert medical personnel to the
patient’s use of the drug in an emergency.
Side effects of phenelzine may include constipation, dizziness, drowsiness or fatigue,

headache, fluid retention, dry mouth, muscle weakness, twitching or tremors, weight g ain, or
insomnia. It may detract from sexual performance in males. Abruptly ending treatment can
cause agitation, nightmares, or convulsions.
Phenelzine can cause serious reactions, including death, if combined with certain foods or
drugs, so it is important that patients taking phenelzine understand the dietary and medical
restrictions that the use of this drug demands. Among the foods to be avoided are those
containing tyramine, an amino acid contained in aged cheeses and meats, products that
contain yeast, alcoholic beverages, and bananas. Examples of drugs to avoid include cold and
cough remedies, sinus and hay-fever medications, nasal decongestants, appetite
suppressants, bronchodilator inhalants, amphetamines, and other antidepressants. Serious
complications can occur up to two weeks after phenelzine treatment ends.
Brand Name:Nardil

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Amoxicillin,
an antibiotic drug used to treat infection. It has many u ses, including the treatment of
respiratory, ear, and skin infections, as well as urinary or genital infections and gonorrhea.
Amoxicillin works by preventing invading bacteria from multiplying in the body.
Amoxicillin must be prescribed by a doctor. It is available in tablets, capsules, and liquid form,
all of which are taken orally. The typical adult dose is 259 mg taken every eight hours with or
without food. Larger doses are prescribed for certain infections, such as gonorrhea. Dosages
for children are determined by body weight, although children over 20 kg (44 lb) can take
adult dosages. The drug starts to work within one to two hours of treatment. Because some
infections can reappear in more harmful forms if not completely eliminated, this drug should
be taken for the full length of time prescribed by a doctor, even after symptoms disappear.
Amoxicillin should not be used by patients who are allergic to penicillin antibiotics. It also may
interfere with routine tests used to monitor diabetes. Patients with asthma, colitis, diabetes,
allergies (such as hay fever or hives), liver disease, or kidney disease should advise their
doctor of these conditions before taking this drug, in order to determine whether the benefits
of amoxicillin exceed any potential risk. This is also true for pregnant or nursing women.
Side effects of amoxicillin include anemia, anxiety or hyperactivity, confusion, diarrhea,

dizziness, hives, insomnia, nausea, skin rash, or vomiting. Indications of an allergic reaction to
amoxicillin may include fever, itching, joint pain, swollen lymph nodes, skin rash, genital
sores, or bruising. Amoxicillin interacts negatively with several common prescription drugs; a
doctor’s approval should be obtained before taking amoxicillin with other prescriptions.
Brand Names:Amoxil, Wymox, Augmentin
Cefixime,
bacteria-fighting drug in a group known as cephalosporin antibiotics. It is used to treat
bacterial infections in the ears, throat, chest, and urinary tract. It is also used to treat
gonorrhea. Cefixime works by interfering with the invading bacteria’s ability to multiply in the
body.
This drug is available by prescription in tablet and liquid form, which are both taken orally. The
typical dosage for adults and children over the age of 12 is 400 mg per day, taken in one or
two doses. Children over 6 months of age may take this drug safely, also in one or two daily
doses. The total daily dose for children is determined by body weight.
Cefixime works fastest when taken on an empty stomach, but it may be taken with food if it
otherwise causes stomach upset. Effectiveness is usually apparent after three to five days, but
to prevent a recurrence of infection, the entire course of medication should be taken.
However, prolonged use is not recommended, as it may lead to a secondary infection. Patients
with diabetes should be aware that cefixime may affect the accuracy of urine glucose-
monitoring tests. Patients with kidney disorders or with colitis (inflamed colon) or other
gastrointestinal problems should use this drug with caution. Its safety for use during
pregnancy has not been determined, although it is known to appear in breast milk.
Common side effects may include indigestion, mild diarrhea, gas, nausea, or vomiting. Other
side effects sometimes o bserved are dizziness, fever, headache, itching, skin rash, vaginitis
(inflammation of vaginal tissues), hives, severe diarrhea, stomach cramps, shock, or seizures.
A severe allergic reaction to cefixime may occur in patients who are sensitive to both
cephalosporin antibiotics and penicillin. This drug may interact with diarrhea medications,
prolonging the diarrhea or making it more severe.
Brand Name: Suprax

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Doxazosin Mesylate,
prescription drug used to treat high blood pressure. It is also sometimes used to treat
congestive heart failure and symptoms associated with enlargement of the prostate gland
(male organ located near the bladder that produces seminal fluid). Doxazosin mesylate works
by interfering with certain functions of the sympathetic nervous system, relaxing blood vessel
walls and the smooth muscles that control urine flow.
Tablets are taken orally, with or without food, usually once a day at bedtime. A starting dose
of 1 mg is often prescribed to determine the patient’s response to the drug. Dosages are then
increased as needed to a maximum of 16 mg a day. Effectiveness is usually apparent after six
to eight weeks of treatment. Because doxazosin mesylate controls, but does not cure, high
blood pressure, it should be taken as prescribed even after symptoms are relieved. Long-term
therapy (months to years) is not uncommon with this drug.
Patients with liver disease or untreated angina (severe chest pain) should not use doxazosin
mesylate. Its safety for children and pregnant or breast-feeding women has not been
established. Patients with impaired liver or kidney function, coronary artery disease, low
white -blood-cell count, mental depression, or a h istory of stroke should use this drug with
caution.
The most common side effects include fatigue and headache. Some patients experience light-
headedness or dizziness, especially when the dosage is increased, and as a result, should not
drive, operate dangerous machinery, or engage in other risk-related activities. Other possible
side effects include constipation, indigestion, nausea, muscle cramps or weakness, nosebleed,
skin rash, ringing in the ears, insomnia, eye pain, or depression. This drug can be co mbined
safely with most other medications.
Brand Name: Cardura
Indapamide or Lozol,
drug used to increase urine production, subsequently relieving edema, or swelling caused by
the buildup of water and salt in body tissues. Indapamide also causes the kidneys to decrease
the amount of blood circulating through the body, lowering blood pressure.
This drug is available by prescription in tablet form. To treat fluid retention, the dosage is 2.5
mg per day, which may be increased to 5 mg per day. To treat hypertension (high blood
pressure), the dosage is 1.25 mg per day, which may be increased to 2.5 mg per day. The
drug is best taken with or after food to prevent stomach irritation. To avoid nighttime
urination, the drug should be taken with breakfast.
Side effects associated with indapamide include lightheadedness, skin rashes, itching,
headaches, visual problems, nausea, diarrhea, weakness, and drowsiness. Some men may
experience problems with sexual performance. Long-term use can lead to diabetes in patients
who have a predisposition for the disease and sodium and potassium imbalances in the body.
Pregnant women and patients with kidney or liver disorders, diabetes, gout, or patients
preparing to undergo surgery with general anesthesia should be cautious using the drug.
Brand Name:Lozol
Loracarbef ,
antibiotic drug used in the treatment of illnesses including bronchitis, pneumonia, upper
respiratory tract infection, skin infection, urinary tract infection, and kidney infection—all of
which are caused by specific bacteria. Loracarbef prevents the cell division and growth of
bacteria by interfering with the formation of bacterial cell walls.
This drug is available by prescription in tablets and a dissolvable powder. The typical adult
dosage is 200 to 400 mg every 12 hours for seven days. A reduced dosage based on body
weight is prescribed for infants and children under the age of 12. The drug begins to take
effect in about one hour.
Loracarbef should be taken at least one hour prior to eating or two h ours after eating. Its use
should continue for the full seven-day course to prevent reinfection. It should not be taken by
persons with a known allergy to loracarbef or to cephalosporin -class antibiotics. It should be
used with caution, at a reduced dosage, by persons with impaired kidney function, a history of
colitis, penicillin allergies, and persons taking potent diuretics to increase the volume of urine
excreted. This drug has not been proven safe for pregnant or breast-feeding women or for
children under six months of age.
The most common side effects of loracarbef are diarrhea, abdominal pain, and skin rashes.
Less common side effects are colitis, nausea and vomiting, loss of appetite, headache,
sleepiness, nervousness, insomnia, and dizziness. Use o f loracarbef with potent diuretics
increases the risk of kidney disease. Use with probenecid, an antigout drug, increases the
levels of loracarbef in the bloodstream.
Brand Name: Lorabid

reserved.
Loratadine,
drug used to relieve symptoms of seasonal allergies and hives. Loratadine blocks the action of
histamine, a chemical released in the body during allergic reactions, thereby inhibiting the
development of symptoms such as sneezing, swelling mucous membranes, and itching eyes.
Available by prescription only, the typical dosage for adults and children over the age of 12 is
10 mg once a day. Loratadine should be taken on an empty stomach because food may delay
its absorption. People with impaired liver or kidney function and the elderly may need smaller
and less frequent doses. The drug is usually effective in one to three hours.
Loratadine may impair mental alertness, and activities requiring mechanical skills, such as
driving, should not be performed until the effects of the drug have been determined. The
safety and effectiveness of loratadine in children under the age of 12 are not understood, and
its effects during pregnancy have not been thoroughly studied. This d rug should not be used
by breast-feeding mothers or people undergoing skin tests for allergies.
The most common side effects of loratadine are skin rash, headache, drowsiness, or dizziness.
Less common side effects include heart rhythm disturbances and skin sensitivity to sunlight.
Extreme drowsiness may result if loratadine is used with other central nervous system
depressants such as alcohol, barbiturates, tranquilizers, muscle relaxants, narcotics, pain
medication, or tricyclic antidepressants. Monoamine oxidase (MAO) inhibitors, a class of
antidepressants, can increase the side effects of loratadine. Loratadine taken concurrently with
the antifungal drugs ketoconazole, itraconazole, or fluconazole may cause serious heart
rhythm disturbances. Antibiotics such as azithromycin, clarithromycin, or erythromycin may
have a toxic interaction with loratadine.
Brand Name:Claritin
Methadone,
also called methadon, synthetic pain -relieving drug often used to treat drug dependence. An
analgesic, methadone was d eveloped in 1943 in Germany to replace morphine and opium,
which were unavailable during World War II (1939-1945). In the late 1940s, researchers
discovered that methadone could reduce the withdrawal symptoms associated with heroin
addiction. In 1965 American researchers Vincent Dole and Marie Nyswander of The Rockefeller
University developed a program of treating heroin addiction using high doses of methadone.
Unlike heroin, methadone does not provide the user with a euphoric “high.” Taken in large
doses, it also blocks the euphoric effects of heroin and other narcotics, limiting their appeal to
the recovering addict. Methadone treatment has proven effective for heroin addicts who
voluntarily seek to end their addiction.
In typical methadone therapy, addicts receive gradually increasing doses of the drug until they
are receiving 100 to 120 milligrams a day. Many clinics require addicts to submit to drug tests
during treatment to insure they are not continuing their use of heroin or other illegal drugs.
Because methadone itself is addictive, some patients continue to be treated for many years.
Azithromycin,
antibiotic drug used to treat a variety of infections, such as tonsillitis (inflamed and swollen
tonsils), bronchitis, pneumonia, skin infections, and urinary tract infections. It works by
interfering with the formation of important proteins inside the invading bacteria, which kills
the bacteria.
Available in capsule form, azithromycin is taken orally and is available only by prescription. It
is typically prescribed for five days, with a 500-mg single dose the first day followed by 250-
mg doses each day thereafter. Improvement is often seen after three or four days of
treatment. Certain ailments, such as sexually transmitted diseases, may be treated with a
single dose of 1000 mg. Azithromycin should be taken on an empty stomach (one hour before
or two hours after a meal). This drug is not recommended for use by children under 16 and
should not be used by pregnant women or patients with liver problems, u nless approved by a
doctor. It is not known if the drug poses a risk for nursing mothers and their babies.
Potential common side effects include abdominal pain, diarrhea, nausea, or vomiting. Less
common are chest pain, dizziness, drowsiness, headache, in digestion, jaundice, light
sensitivity, hives, or yeast infection. Some serious but rare reactions have been reported.
These reactions include swelling of the face and neck, which interferes with breathing; a
severe form of diarrhea; and anaphylaxis, a potentially fatal allergic reaction. Patients who
suspect any of these conditions may need immediate medical help.
Azithromycin should not be combined with antacids containing aluminum or magnesium. The
drug may interact adversely with carbamazepine, cyclosporine, digoxin, hexobarbital,
lovastatin, phenytoin, triazolam, and warfarin. It also may interact with certain antihistamines
(especially astemizole).
Brand Name:Zithromax

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Benazepril,
drug used to control high blood pressure. It is one of a group of drugs known as ACE
inhibitors. Benazepril works by interfering with angiotensin -converting enzymes (ACE) in the
body, which influence salt and water retention. The result is relaxed artery walls and lower
blood pressure.
Benazepril must be prescribed by a doctor. Tablets or capsules are taken orally either once or
twice a day in dosages ranging from 20 to 40 mg per day. The maximum recommended daily
dosage is 80 mg. Benazepril may be taken with or without food, but must be taken regularly
to be effective, even after symptoms are relieved. This usually takes several weeks. Benazepril
may interact adversely with certain diuretics (medication that increases urinatio n), especially
those that help the body retain potassium; potassium supplements (including salt substitutes
that contain potassium); and lithium.
Patients with certain medical conditions, such as congestive heart failure or kidney disorder,
should use this drug with caution. This drug should not be taken by pregnant women,
especially in the second and third trimesters. It also is known to appear in breast milk.
Benazepril has not been proven safe for use in children under age 12.
Possible side effects include coughing, dizziness, headache, fatigue, nausea, excessive thirst,
irregular heartbeat, or muscle cramps. Less common are chest pain, constipation, fluid
retention, impotence, itching, joint pain, skin rash, sweating, urinary infection, or vomiting.
Brand Names:Lotensin
Cefaclor or Ceclor ,
treat staphylococcus infections, streptococcus infections, and infections caused by Escherichia
coli (E. coli) bacteria. Examples of ailments caused by these bacteria include strep throat,
pneumonia, tonsillitis (swollen and inflamed tonsils), urinary tract infections, and skin
infections. Cefaclor works by interfering with the invading bacteria’s ability to multiply in the
body.
This drug is available by prescription in tablet and liquid form, which are both taken orally,
usually every eight hours. Each adult dose typically is 250 mg. Children may take this drug,
also every eight hours, although the total daily dose is determined by body weight.
Cefaclor should be taken on an empty stomach unless it causes stomach upset. Effectiveness
is usually apparent after three to five days, but to avoid a recurrence of infection, the entire
course of medication should be taken. Patients with diabetes should be aware that cefaclor
may affect the accuracy of urine glucose-monitoring tests. Patients with colitis (inflamed
bowel) or other gastrointestinal problems should avoid using this drug. Its safety for use
during pregnancy has not been determined, although it is known to appear in breast milk.
Common side effects include diarrhea, hives, and itching. Other side effects sometimes
observed are nausea, skin rash, joint pain, vomiting, vaginal inflammation, liver disorders, or
blood disorders. A severe allergic reaction to cefaclor may occur in patients who are sensitive
to both cephalosporin antibiotics, certain diuretics, diarrhea medications, and oral
contraceptives (see Birth Control Pill).
Brand Name: Ceclor
Doxycycline,
antibiotic drug used to treat various types of bacterial infections including urinary tract
infections, traveler’s diarrhea, Rocky Mountain spotted fever, trachoma (a chronic eye
infection), and syphilis. It is also sometimes used to treat early Lyme disease and to prevent
the spread of malaria. Doxycycline belongs to a group of antibiotics known as tetracyclines. It
works by interfering with the invading bacteria’s ability to form essential proteins, thereby
halting their growth.
This drug is available by prescription in capsules, tablets, and liquid forms, which are taken
orally, although one form of liquid is made for injection. Typical dosages range from 100 to
200 mg per day, taken in one or two doses, with a recommended maximum dose of 300 mg a
day. Unless this drug causes stomach upset, it should be taken on an empty stomach (one
hour before or two hours after a meal) with a full glass of water. Doxycycline usually relieves
symptoms after 48 hours of treatment, but it should be taken for the entire prescribed length
of time to avoid recurrence of infection.
Patients with liver disease and pregnant or breast-feeding women should not use this drug. It
may be taken by children over the age of eight at a dosage based on body weight. Possible
side effects include diarrhea, nausea, vomiting, skin rash, itching, light sensitivity, headache,
facial swelling, chest pain, difficulty swallowing, or bulging forehead (in infants). Children may
develop discolored teeth, especially with long-term use.
Doxycyline may interact adversely with antacids and other common gastrointestinal
medications, birth control pills, barbiturates, blood-thinners, penicillin, phenytoin, sodium
bicarbonate, and carbamazepine.
Brand Names:Doryx, Vibramycin, Vibra-Tabs, Bio-Tab

reserved.
Prednisone,
drug used to treat a variety of ailments including arthritis, asthma, tuberculosis, ulcerative
colitis (inflamed colon), certain cancers, multiple sclerosis, skin diseases, and severe allergic
reactions. Prednisone is also used to prevent rejection of transplanted organs. An anti-
inflammatory drug known as a steroid, prednisone works by suppressing the action of certain
white blood cells in the immune system.
Prednisone is available only by prescription. It is taken orally in tablet or liquid form, usually
with food to avoid stomach upset. Dosages vary from 5 to 60 mg per day, although some
acute conditions may be treated with up to 200 mg per day. Prednisone’s effectiveness is
usually apparent after four to ten days of treatment. It is usually discontinued gradually, with
smaller and smaller doses until the end of treatment.
Patients with widespread fungus infections, peptic ulcer disease, active tuberculosis, or an eye
infection caused by the herpes simplex virus should not take this drug. It should be used with
caution by patients with glaucoma, diabetes, high blood pressure, osteoporosis, myasthenia
gravis (chronic muscle weakness), gastrointestinal disorders , impaired thyroid function, or a
history of tuberculosis. Patients taking prednisone should avoid exposure to chicken pox and
measles and should not be vaccinated during treatment. Children may take this drug, but
long-term use is not recommended as it ma y stunt growth. Pregnant and breast-feeding
women should avoid prednisone.
Possible side effects may include insomnia, depression, mood swings, headache, dizziness,
muscle cramps, skin rash, acne, high blood pressure, weight gain, or fluid retention. Long-
term use may cause various eye problems or Cushing’s syndrome, a hormonal disorder
characterized by obesity, muscle weakness, brittle bones, and purplish, thick skin.
Prednisone may interact adversely with cyclosporine, carbamazepine, ketoconazole,

amphotericin B, phenytoin, rifampin, birth control pills, diabetes medications, estrogen
supplements, and certain diuretics.
Brand Names: Deltasone, Liquid Pred, Prednicen-M, Sterapred

reserved.
Buspirone,
mild tranquilizer drug used to treat various forms of anxiety and nervous tension. It works by
interacting with the neurotransmitter serotonin to produce a calming effect.
Tablets are taken orally, usually three times p er day, with or without food. Total daily dosages
range from 15 mg to 60 mg, depending on the patient’s condition. Buspirone’s effectiveness
may not be evident until one to two weeks after beginning treatment.
Patients with impaired kidney or liver function should not take this drug. Its safety for use by
pregnant women and children under age 18 has not been determined, and it is not known
whether it appears in breast milk. Alcohol should be avoided during treatment with buspirone,
and certain drugs may in teract adversely with it. These include antidepressants that act as
monoamine oxidase (MAO) inhibitors such as phenelzine, narcotics, haloperidol, trazodone,
warfarin, and fluoxetine.
Unlike many tranquilizers, buspirone has minimal sedative effects. It i s not addictive and does
not usually cause withdrawal symptoms when treatment is stopped. Possible side effects
include dizziness, dry mouth, headache, fatigue, nausea, or nervousness. Also possible are
blurred vision, bone or muscle pain, constipation, diarrhea, rapid heartbeat, skin rash, upset
stomach, sweating, or vomiting. Patients taking buspirone should not drive, operate
dangerous machinery, or engage in other risk-related activities.
Brand Name:Buspar
Guaifenesin,
expectorant (medication that helps in coughing up mucus) available over-the-counter in syrup,
capsule, and tablet form, usually found in combination with antihistamines, cough
suppressants, or decongestants. The drug acts by loosening fluids that are produced in the
nasal passages and lungs. The fluids are then more easily expelled from the air passages by
coughing.
Physician-prescribed dosages for adults and juveniles 12 years and older range from 200 to
400 mg every four hours, with a maximum of 2400 mg per day. Children between the ages of
6 and 11 are given 100 to 200 mg every four hours, with a maximum dosage of 1200 mg per
day, and children between 2 and 5 are given 50 to 100 mg every four hours, with a maximum
dosage of 600 mg a day. Children under the age of two receive individ ualized dosage
instructions from their physicians. Although guaifenesin is most effective when taken on an
empty stomach, the patient should drink a glass of water when taking the drug to assist in
loosening mucus.
Possible side effects of guaifenesin use include drowsiness, stomach pain, nausea, vomiting,
and diarrhea. Guaifenesin can increase the effects of heparin, a drug that prevents blood from
clotting, and patients taking both of these medications may increase their risk of bleeding
problems. There is some evidence that use by pregnant women may have negative effects on
the unborn child, and it has not yet been determined if use by nursing mothers is safe.
Brand Names: Cheracol D, Comtrex Cold Formula, Contac Cough and Chest Cold, Dimacol
Caplets, Triaminic Expectorant, Vicks Children’s Cough Syrup.
Medroxyprogesterone
Acetate or Depo-Provera, injectable form of the female sex hormone progesterone that
prevents pregnancy by stopping ovulation, the monthly release of an egg from the ovary. It
also thickens the mucus of the cervix (small organ that connects the uterus to the vagina),
making it difficult for sperm to pass into the uterus. A woman who receives an injection of
medroxyprogesterone acetate every three months does not have to take pills o r use any other
contraceptive device to prevent pregnancy. This drug is highly effective, preventing pregnancy
99.7 percent of the time. It does not protect against sexually transmitted diseases.
In the United States, medroxyprogesterone acetate has been prescribed as a contraceptive

since 1992. However, it has been available in New Zealand since 1969. Prior to 1992 the drug
was prescribed in the United States to treat cancers of the endometrium (lining of the uterus)
and the kidney. It has been used by at least 30 million women in 90 countries.
Beginning six weeks after giving birth, medroxyprogesterone acetate is a safe contraceptive
method for women who are breast-feeding. Studies show that it decreases the risk of
endometrial cancer (cancer of the uterine lining).
The most common side effect of medroxyprogesterone acetate is irregular bleeding for the
first few months of use. About half of all women who use this contraceptive stop menstruating
(a condition known as amenorrhea), sometimes for a year or more. This side effect has not
been shown to cause health problems. Other possible side effects include weight gain,
headaches, mood changes, and abdominal pain. In many cases, side effects clear up as a
woman continues to use the contraceptive. Women who choose to discontinue using this drug
because of bothersome side effects must wait for three months—until the medication is no
longer effective—for side effects to disappear. Also, it may take from six months to a year
after the last injection for a woman to conceive.
Brand Name: Depo-Provera
Zidovudine or AZT,
antiviral drug used in the treatment of acquired immunodeficiency syndrome (AIDS). It is not
a cure for the disease but prolongs the lives of people suffering from the symptoms of AIDS.
Zidovudine was developed in the mid -1980s and approved for use in 1987. Taken every four
hours, night and day, it reduces the risk of infection and relieves many neurological
complications associated with AIDS. However, frequent blood monitoring is required to co ntrol
anemia, a potentially life-threatening side effect of zidovudine. Blood transfusions are often
necessary, and the drug must be withdrawn if bone-marrow function is severely affected.
A research study on zidovudine in 1994 showed that the drug does p rovide some protection to
babies whose mothers are infected by the human immunodeficiency virus (HIV). The number
of babies infected was reduced by two-thirds when mothers received zidovudine during
pregnancy.
Barbiturate,
any of an important group of drugs that depress brain function; they are derived from
barbituric acid (C4H4N2O3), a combination of urea and malonic acid. Depending on the
dosage or formulation, barbiturates have a sedative (tranquilizing), hypnotic (sleep-inducing),
anticonvulsant, or anesthetic effect. Very short-acting barbiturates such as thiopental are
injected intravenously to induce rapid anesthesia before surgery. Phenobarbital, a long-acting
barbiturate, is prescribed with other medications to prevent epileptic seizures. Other
barbituric-acid derivatives, such as secobarbital, were used as antianxiety medications until
the development of the tranquilizer; they are still in use for the short-term treatment of
insomnia, although tranquilizers are more suitable sleep inducers. Barb iturates are common
drugs of abuse. Taken orally or intravenously, they produce symptoms similar to drunkenness:
loss of inhibition, boisterous or violent behavior, muscle incoordination, depression, and
sedation. They are physically addicting and produce severe withdrawal symptoms; overdoses
can cause profound shock, coma, or death. See Drug Dependence

reserved.
Ampicillin,
drug used to treat bacterial infections of the skin, gastrointestinal tract, urinary tract, and
respiratory tract. An antibiotic like penicillin, ampicillin interferes with the invading bacteria’s
ability to multiply in the body.
Available by prescription in liquid and capsule form, ampicillin is usually taken orally with a full
glass of water either one hour before a meal or two hours after. Another liquid form is
administered by injection. Doses range from 200 to 1000 mg every six hours, with a
maximum dosage of 6000 mg per day.
Signs of infection usually disappear after several days of treatment, but an entire course of
medication, usually a seven- to ten-day course, should be taken to avoid any recurrence of
infection. Children may take ampicillin, but they should be monitored for such side effect s as
diarrhea or skin rash.
Patients who are allergic to penicillin or cephalosporin antibiotics should not take this drug. Its
safety for use in pregnant women has not been determined. Diabetic patients should be aware
that ampicillin may affect the accuracy of urine glucose monitoring tests.
Possible side effects may include nausea, vomiting, mouth irritation, diarrhea, colitis (inflamed
bowel), fever, skin rash, hives, or anemia. Ampicillin may interact adversely with other
antibiotics, particularly tetracycline and erythromycin, oral contraceptives, allopurinol,
atenolol, mefloquine, and probenecid.
Brand Name: Omnipen
Trypanosomiasis,
also sleeping sickness, endemic, and sometimes epidemic, chronic disease caused by a
protozoan blood parasite, genus Trypanosoma. In cattle and other animals, which serve as the
reservoir for the protozoa, the disease is called nagana. Two variations of the disease occur in
central and western Africa, both of them transmitted in the salivary glands of infected tsetse
flies. The most common is caused by T. brucei gambiense, whereas a more local version is
caused by T. brucei rhodesiense. In South America, another version of the protozoan, T. cruzi,
is transmitted by the triatoma bug and is called Chagas' disease.
African sleeping sickness begins with a chancre at the site of the insect bite, an accelerated
heartbeat, an enlargement of the spleen, and rash and fever. Over the next few months the
nervous system is attacked, with accompanying mood changes, sleepiness, lack of appetite,
eventual coma, and, frequently, death. Chagas' disease, which more frequently attacks
children, also involves fever and damage to the spleen and nervous system, as well as to the
liver and the heart muscles. It is also sometimes fatal. In early stages, African sleeping
sickness can be alleviated by the administration of various antiparasitic drugs; treatment in
later stages with arsenic-containing drugs is less likely to be effective.
Encephalitis is also sometimes called sleeping sickness.
Allopurinol,
drug mainly prescribed for the treatment of chronic gout (a disease caused by buildup of uric
acid and marked by painful inflammation of the joints). Allopurinol is an isomer (chemical
variation) of hypexanthine C5H4N4O, and acts by reducing levels of uric acid in the blood.
Discovered accidentally in the early 1960s in the search for new immunosuppressives (drugs
that repress the body’s immune system), it has no effects on acute gout attacks, and may
even provoke them in the first stages of therapy. In the long term, it prevents the deposit of
urates (salts of uric acid) in the joints and the formation of kidney stones.

reserved.
Ephedrine,
drug that act s like adrenaline on the sympathetic nervous system (sympathomimetic). Once
used to relieve bronchospasm in asthma, it has been superseded by safer, more specific
drugs. It is contained in some cold remedies as a decongestant. Side effects include rapid
heartbeat, tremor, dry mouth, and anxiety.
Ephedrine is an alkaloid, C10H15NO, derived from Asian gymnosperms (genus Ephedra) or

synthesized. It is sometimes misused, and excess leads to mental confusion and increased
confidence in one's own capabilities as they actually decline.

reserved.
Steroids,
large group of naturally occurring and synthetic lipids, or fat-soluble chemicals, with a great
diversity of physiological activity. Included among the steroids are certain alcohols (sterols),
bile acids, many important hormones, some natural drugs, and the poisons found in the skin
of some toads (see Digitalis; Hormone). Various sterols found in the skin of human beings are
transformed into vitamin D when they are exposed to the ultraviolet rays of the sun (see
Vitamin: Vitamin D). Cholesterol, a major contributor to arteriosclerosis, is a sterol. Steroid
hormones, which are similar to but not identical with sterols, include the adrenal cortical
steroids hydrocortisone, cortisone, aldosterone, and progesterone; and the female and male
sex hormones (see Estrogen; Testosterone). Most oral contraceptives are synthetic steroids
consisting of female sex hormones that inhibit ovulation (see Birth Control). Perhaps the most
widely used steroids in medicine are cortisone and various synthetic derivatives of this
substance. Such steroids are prescription drugs used for a variety of skin ailments, rheumatoid
arthritis, asthma and allergies, and various eye diseases, and in cases of adrenal insufficiency,
or the malfunctioning of the adrenal cortex (see Adrenal Gland; Endocrine System).
Anabolic steroids induce weight gain and increased muscle mass. Originally developed to help
cancer patients and victims of starvation, they are derived from the male sex hormone
testosterone. In recent decades steroids have been abused by many athletes hoping to
improve performance. Besides the unfairness their use introduces into competition, steroids
can have serious psychological and physiological side effects, including increased aggressive
behavior and cancer of the liver. The International Olympics Committee banned the use of
steroids in 1974, after gas chromatography testing for their presence became possible. A
number of athletes have been disqualified in competitions. See also Sports Medicine.
related articles
see also Nonsteroidal Antiinflammatory Drug
Streptomycin,
antibiotic agent produced by a filamentous (thready) soil bacterium, Streptomyces griseus. It
was first described in 1944 by the American soil microbiologist Selman Waksman and his
collaborators. Microorganisms that cause many serious diseases, such as tuberculosis, leprosy,
and cholera, are susceptible to streptomycin. The first d rug effective against tuberculosis, it is
still used for this condition, although it has been replaced for most purposes by newer, more
effective antibiotics of the same chemical family, the aminoglycosides. These include
gentamicin, tobramycin, amikacin, and kanamycin.
An important drawback to the use of streptomycin is the development of resistance to the

drug by certain bacteria. Resistance may be delayed by supplementing streptomycin with
para -aminosalicylic acid or isoniazid. Streptomycin occasionally causes damage to the
vestibular or auditory division of the eighth cranial nerve. Aminoglycosides may also damage
the kidney.
Acetaminophen,
nonprescription drug used for the relief of minor pain, such as headaches and structural
muscle aches, and for the reduction of fever. Like the other common analgesic drugs aspirin
and ibuprofen, acetaminophen relieves pain by inhibiting the synthesis of prostaglandins in the
body. It does not reduce inflammation as do those other two analgesics, but it also does not
irritate the stomach lining, as aspirin tends to do for some users. A large overdose of
acetaminophen may cause severe liver damage.

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Fluoxetine,
type of drug known as an antidepressant, prescribed for the treatment of depression,
particularly depression lasting longer than two weeks and interfering with daily functioning.
Fluoxetine works by regulating serotonin levels in the brain. Serotonin is a neurotransmitter, a
chemical in the body’s nervous system associated with maintaining a general sense of well-
being. An insufficient amount of serotonin in the brain may contribute to depression.
Fluoxetine may also be prescribed for treatment of other conditions related to insufficient
levels of serotonin including eating disorders (obesity and bulimia), obsessive -compulsive
disorder, and premenstrual syndrome.
Fluoxetine, available by prescription only, is taken orally in tablet form. The effectiveness of
fluoxetine is not altered by food, so the medication can be taken on an empty or full stomach.
When fluoxetine is prescribed to treat depression, the usual dose ranges from 20 to 60 mg per
day. It usually requires three to four weeks for the patient to feel the effects. After the
medication begins to take effect, the dose may be lowered. A lower dose may be sufficient for
treatment of conditions other than depression.
Fluoxetine should not be taken in combination with other types of antidepressants known as
monoamine oxidase (MAO) inhibitors. Taking these medications at the same time or even
within a month of one another has serious, sometimes fatal results. At least five weeks must
be allowed between the last dose of fluoxetine and the first dose of a MAO inhib itor. Fluoxetine
is not recommended for people recovering from heart attack, or for those with kidney or liver
disease, diabetes, or a history of seizures. Women who are pregnant or breast-feeding are
advised not to take fluoxetine, and people taking it should not consume alcohol.
Common adverse side effects of fluoxetine include anxiety, insomnia, headaches, dizziness,
changes in appetite, weight loss, nausea, and diarrhea.
Brand Name: Prozac
Glycerol or Glycerin,
colorless, odorless, sweet-tasting a lcohol, C3H8O3, with a specific gravity of 1.26. It boils at
290° C (554° F) and melts at 18° C (64.4° F). Liquid glycerol resists freezing but may
crystallize at low temperatures. It forms a solution with water in any proportion, and dissolves
in alcohol in all proportions, but is insoluble in ether and many other organic solvents. The
term glycerol refers specifically to the compound, the formula of which is given above,
whereas glycerin may also refer to glycerite (glycerol in solution) or other solutions of or
preparations made from glycerol.
Simple fats and oils are esters of fatty acids and glycerol. Obtained as a by-product of soap
manufacture, after fats and oils have been treated with alkali to form the soap, crude glycerol
is purified by distillation. Of the annual glycerol production in the U.S. about 40 percent comes
from soapmaking. The rest is synthesized from the petroleum products allyl alcohol, C3H6O,
or propylene, C3H6, or by the catalytic action of hydrogen on sugar at high temperature and
pressure.
The most common use for glycerol is in the making of alkyd resins (see Plastics). Other
important applications are in the preparation of drugs and toilet articles, including
toothpastes; as a plasticizer in cellophane; and as a moistening agent in tobacco products.
Because cheaper products are now available, only 5 percent of the production of industrial
glycerol goes into the making of nitroglycerol explosives. Because of its affinity for water and
its high viscosity, glycerol is a valuable constituent in stamp pad inks. Pumps for petroleum
products are lubricated by glycerin because it resists dissolving in petroleum liquids. Because
of its high viscosity and its nonpoisonous character, glycerin is a suitable lubricant for food-
processing machinery.
Coal Tar,
viscous black liquid produced in the destructive distillation of coal to make coke and gas. Coal
tar is a complex mixture of organic compounds, mostly hydrocarbons. Its composition varies
with the coal, the temperature at which it is fo rmed, and the equipment used.
When formed at temperatures below 600° C (1112° F), coal tar consists of hydrocarbons of
the paraffin and olefin types, together with alcohols, phenols, and water. Coke is usually
produced at about 1000° C (about 1832° F), and coal tar formed in that temperature range
consists mostly of aromatic hydrocarbons plus phenols and some compounds containing
nitrogen, sulfur, and oxygen. The variation in composition means that most of the compounds
in coal tar are formed during the co king process and are not present as such in the original
coal. Some 300 distinct compounds have been identified in coal tar, of which about 50 are
separated and used commercially. Some of the constituents are carcinogens, that is, they
incite cancerous gro wths.
Separation of coal tar into its constituent compounds or groups of compounds is achieved by
extraction and distillation. The phenols, which are acidic, can be extracted by alkali solutions,
from which they are released later by acidification. The nitrogen compounds react with and
dissolve in acidic solutions and are freed later by alkalizing. Distillation produces benzene,
toluene, naphthalene, xylene, anthracene, phenanthrene, and other valuable products. The
processing may be varied to give differe nt proportions. Left after distillation are residues of
pitch, used in making roads, in roofing mixtures, and in electrodes for the production of
aluminum.
Coal tar was once regarded as a useless nuisance. Since then, however, it has led to a whole
new field of chemistry , and its compounds are indispensable to a vast number of products,
including dyes, drugs, explosives, food flavorings, perfumes, artificial sweeteners, paints,
preservatives, stains, insecticides, and resins. Coal tar is also the chief source of cresols, a
group of chemicals used in antiseptics, creosote oil, paint removers, and plastics.
Aspirin,
synthetic chemical compound, acetylsalicylic acid. It is made from salicylic acid, found in the
bark of the willow tree, which was used by the ancient Greeks and Native Americans, among
others, to counter fever and pain. Salicylic acid is bitter, however, and irritates the stomach.
The German chemist Felix Hoffman synthesized the acetyl derivative of salicylic acid in 1893 in
response to the urging of his father, who took salicylic acid for rheumatism. Aspirin is
currently the first-choice drug for fever, mild to moderate pain, and inflammation due to
arthritis or injury. It is a more effective analgesic than codeine. Aspirin causes insignificant
gastrointestinal bleeding that can over time, however, cause iron deficiency; gastric ulcers
may also occur with long-term use. Complications can be avoided by using enteric-coated
aspirin, which does not dissolve until reaching the intestine. Aspirin should not be given to
children who have chicken pox or influenza, because it increases the risk of contracting the
rare and frequently fatal Reye's syndrome, a disease of the brain and some abdominal organs.
Aspirin is thought to act by interfering with synthesis of prostaglandins, which are implicated
in inflammation and fever. Studies of aspirin's anticlotting activities suggest that half an
aspirin tablet per day may reduce the risk of heart attack and stroke in some persons.
Ibuprofen,
drug used to reduce inflammation, fever, and the sensation of pain. In prescription form,
ibuprofen is usually taken to relieve the more severe symptoms associated with arthritis. The
nonprescription form available over the counter is taken for low-intensity pain, inflammation,
or fever.
Ibuprofen works by inhibiting the action of prostaglandins (chemicals that cause inflammation
and contribute to the brain’s perception of pain). Ibuprofen reduces fever by blocking
prostaglandin synthesis in the hypothalamus, a structure in the brain that regulates body
temperature. Ibuprofen also acts as an anticoagulant, suppressing the formation of blood
clots.
In adults, the dosage of ibuprofen commonly prescribed for arthritis is 1200 to 3200 mg per
day, usually divided into 3 or 4 doses. For mild to moderate pain in nonprescription uses, the
dosage is generally 400 mg taken every 4 to 6 hours as necessary. Because ibuprofen can
cause stomach upset, pills should be swallowed with a full glass of water, and may be taken
with food. Ibuprofen is not recommended for use by pregnant women.
Prolonged use of ibuprofen can result in ulcers and internal bleeding because it blocks the
production of the stomach lining’s protective mucous barrier.
Ibuprofen prevents the body from excreting salt and water properly, and it should be used
with caution by people who suffer from kidney disease, liver disease, or high blood pressure.
The anticoagulant effect of ibuprofen can also result in excessive bleeding when taken prior to
tooth extraction or m inor surgery. When taken in excessive amounts, ibuprofen can produce a
potentially fatal overdose syndrome, which usually involves vomiting, diarrhea, rapid
breathing, or rapid heartbeat. Alcoholic beverages should be avoided while taking this
medication.
Brand Names: Advil, Motrin, Nuprin

Hydrocortisone,
also cortisol, common names for 17-hydroxy-corticosterone, the principal hormone secreted
by the outer layer, or cortex, of the adrenal gland. Hydrocortisone affects the metabolism of
carbohydrate, protein, and fat; the maturation of white blood cells; the retention of salt and
water in the body; the activity of the nervous system; and the regulation of blood pressure.
Secretion of hydrocortisone from the adrenal cortex is stimulated by the pituitary h ormone
ACTH.
Because of their widespread effects, hydrocortisone and related compounds, called

corticosteroids, or corticoids, are employed for many medical purposes. They are used to treat
a deficiency of adrenal cortical hormones, a condition called congenital adrenal hyperplasia,
rheumatoid disease that is not helped by milder drugs, and to counter severe non-infectious
inflammations. Corticosteroids suppress the immune response, so they are used to increase
acceptance of transplants (Transplantation, Medical).
Other conditions for which they are helpful are asthma, collagen diseases, and eye
inflammations. Because corticosteroids affect so many body processes, they must be used
carefully. Corticosteroids dispose persons to infection and can lead to swelling of the face and
limbs, muscle weakness, weight gain, high blood pressure, and diabetes.
Another naturally occurring corticosteroid hormone, called cortisone, was the first
corticosteroid to be isolated, in 1935. It was synthesized in 1944 and subsequently became
available for widespread medical use. Cortisone is rapidly converted to hydrocortisone in the
body. Synthetic corticosteroids with more specific activity have now been made and are
preferred in many situations.
Melatonin,
naturally occurring hormone that is released into the bloodstream during the hours of
darkness. While scientists continue to study the function of melatonin in humans, they believe
the hormone plays a role in the body’s circadian rhythm. This rhythm regulates the
physiological functions that occur in the body within a 24-hour period, such as sleep-wake
cycles, fluctuations in body temperature, heart rate, and blood pressure (see Biological
Clocks). More recently melatonin has become a popular nonprescription dietary supple ment
with the alleged ability to combat a variety of health problems.
Melatonin is produced by the pineal body, a cone-shaped gland about the size of a pea that is
situated near the center of the brain. The release of melatonin from the pineal body into t he
bloodstream is orchestrated by the hypothalamus, a region of the brain that governs the
body’s internal environment to maintain temperature, water balance, and hormone balance.
The hypothalamus receives cues about the amount of sunlight that is absorbed by the eye —
darkness causes the hypothalamus to stimulate melatonin release while light suppresses its
release.
Scientists theorize that because melatonin levels are low during the day and high at night,
melatonin may instruct the body when it is day or n ight, enabling the body to adapt and meet
the demands of its changing environment. Melatonin may also provide seasonal cues by, for
instance, informing the body about the longer nights that occur in winter and the shorter
nights in summer.
In animals it is clear that conveying information about day, night, or time of year is critical for
mating and reproduction so that offspring are born at the best time of year, usually in the
milder spring rather than the harsher winter. It is less clear how this role ma y affect humans.
Some studies suggest that melatonin helps regulate sleep-wake cycles and is an effective
treatment for some forms of insomnia, jet lag, or shift work.
Other studies have found that melatonin levels in the body decline with age in humans,
leading some researchers to speculate that melatonin acts as an antiaging hormone by
alleviating some of the adverse effects of aging such as heart disease. However, the levels of
most hormones decline with advancing age and there is little evidence to indicate that
melatonin supplements can slow the aging process.
Melatonin is the subject of active research as scientists try to determine its exact function in
the body and how it may be used to enhance human health. Melatonin is also subject to
sensational claims that link it with enhanced sexual performance and the prevention of serious
diseases such as acquired immunodeficiency syndrome (AIDS), Alzheimer’s disease, Parkinson
disease, arthritis, epilepsy, and hypertension. These claims are not supported by scientific
studies and consumers should therefore use melatonin cautiously. Although it is easily
available over the counter, it is not regulated by the Food and Drug Administration (FDA).
Effective dosages have not yet been determined and potential side effects are poorly
understood.

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Epinephrine,
hormone secreted by the adrenal gland. The pure compound, first isolated by the Japanese
chemist Jokichi Takamine, is also known as adrenaline. It was formerly prepared from adrenal
glands, but it is now made synthetically.
Epinephrine normally is present in the bloodstream in minute quantities. In times of

excitement or emotional stress, however, large additional quantities are secreted, exerting a
marked effect on body structures in preparation for physical exertion. For example,
epinephrine stimulates the heart, constricts the small blood vessels, raises the blood pressure,
liberates sugar stored in the liver, and relaxes certain involuntary muscles while contracting
others. It is widely used as a drug to stimulate the heart in cases of shock, to prevent
bleeding, and to expand lung bronchioles in acute asthma attacks.
The adrenal gland also secretes a substance chemically related to epinephrine, called
norepinephrine, noradrenaline, or levoarterenol. In general, the function of norepinephrine
seems to be the maintenance of normal blood circulation. It is also the chemical agent
responsible for transmission of n erve impulses in the autonomic nervous system. Large
amounts of epinephrine and norepinephrine are produced by some tumors of the adrenal
glands, resulting in a great increase in blood pressure.
Dicyclomine
Dicyclomine, drug used to treat irritable bowel syndrome, recurring symptoms of
abdominal pain, diarrhea, or constipation. An antispasmodic drug, it works by relieving
smooth muscle spasms in the digestive tract, reducing or eliminating abdominal
discomfort.
Dicyclomine must be prescribed by a doctor. It is available in capsule, tablet, and

liquid form, and is taken orally four times a day, with or without meals. The typical
starting dosage is 80 mg per day, which is increased to 160 mg per day when
satisfactory tolerance of the drug has been established. One to two weeks of
treatment may be needed before this drug’s effectiveness is seen.
Patients should not take dicyclomine if they suffer from gastrointestinal blockage,
urinary tract blockage, severe colitis, severe heartburn, glaucoma, or myasthenia
gravis. This drug should be used with caution by those with liver or kidney disease,
high blood pressure, heart disease, irregular heartbeat, hyperthyroidism, hiatal hernia
(protrusion of stomach tissue into the diaphragm), enlarged prostate gland, or a nerve
condition known as automatic neuropathy. It has not been proven safe for pregnant or
nursing women or for children.
Side effects are not uncommon with this drug. They may include blurred vision, light-
headedness, dizziness, drowsiness, dry mouth, nausea, muscular weakness, or
nervousness. Because of this, risk-related activities such as driving or operating
machinery are not recommended. Other side effects sometimes seen are
disorientation, fainting, headache, impotence, insomnia, nasal congestion, tingling, or
short-term memory loss. This drug can also decrease sweating, leading to fever and
heatstroke in hot weather.
Dicyclomine may interact adversely with a wide variety of medications. These include
but are not limited to antacids, antihistamines, corticoids, digoxin, and other heart
medications (including nitroglycerin), certain antidepressants (especially MAO
inhibitors and tricyclic drugs), narcotic pain relievers, antipsychotic drugs, and
bronchodilators.
Brand Name:Bentyl
Microsoft ® Encarta ® Encyclopedia 2002. © 1993-2001 Microsoft Corporation. All

rights reserved.
Nizatidine
Nizatidine, drug used to treat peptic ulcer disease and heartburn. It is also used to
reduce the secretion of stomach acid and prevent the return of peptic ulcers.
Nizatidine blocks the effects of histamine in the stomach, thereby reducing the
concentration of stomach acid.
This drug is available over the counter in 75-mg tablets for the treatment of
heartburn, and by prescription in capsules of 150 and 300 mg for the treatme nt of
peptic ulcers and excessive stomach acid. The typical oral dosage for heartburn in
persons over the age of 16 is one 75-mg tablet taken one to two times per day. The
typical oral dosage for treatment of peptic ulcers and excessive stomach acid in
persons over 16 years old is 300 mg taken at bedtime or 150 mg taken twice a day for
up to eight weeks. The usual maintenance dosage is 150 mg per day. Its effectiveness
in healing peptic ulcer disease can usually be determined in four to six weeks.
Nizatidine can be taken on an empty stomach or with food or milk. Since antacids can
block absorption of this drug, they should not be taken within an hour of taking
nizatidine. This drug should not be used by persons who have had a previous allergic
reaction to it or by pregnant or breast-feeding women. It should be used with caution
by persons with reduced kidney function. The safety and efficacy for children under
the age of 16 have not been determined. Driving and other risk-related activities
should be avoided if dizziness or confusion occurs. This drug should not be stopped
abruptly when being used to treat peptic ulcers. The over-the-counter form should be
used to treat heartburn only.
Mild side effects may occur with use of nizatidine including constipation, diarrhea,
dizziness, fatigue, headache, itching, nausea, stomach upset, and sweating. More
serious effects include confusion, decreased sexual ability, excessive fatigue, fever,
increased heart rate, unusual bleeding or bruising, and weakness. Confusion and
dizziness are especially likely to occur in adults over 60 years old. Most side effects
should disappear as the body adjusts to nizatidine.
Alcoholic beverages, citrus fruit, garlic, onions, protein-rich foods, and tomatoes
increase stomach acid secretio n and should be avoided while taking this drug.
Nizatidine may also interact adversely with other drugs including amoxicillin, high-
dose aspirin, pentoxiylline, and theophylline.
Brand Name:Axid

rights reserved.
Nifedipine
Nifedipine, calcium channel blocker drug used in the treatment of angina pectoris
(chest pain) and hypertension (high blood pressure). By blocking the passage of
calcium into cells of the heart and blood vessels, nifedipine relaxes blood vessels,
thereby lowering blood pressure and increasing the supply of blood and oxygen to the
heart. These combined effects reduce the workload of the heart during exertion and
help prevent angina.
This drug is available by p rescription only. It is taken orally and comes in 10-mg and
20-mg regular capsules and in 30-mg, 60-mg, and 90-mg extended release tablets.
For treatment of angina, the initial adult dosage is either one 10-mg regular capsule
taken three times a day, or one 30-mg or 60-mg extended release tablet taken once a
day. The typical maintenance dosage is either one 10-mg or 20-mg regular capsule
taken three times per day or one 60-mg or 90-mg extended release tablet taken once
a day. Only extended release tablets a re used in the treatment of hypertension. The
initial dosage for hypertension is one 30-mg extended release tablet taken once a day.
The typical maintenance dosage is one 30-mg or 60-mg extended release tablet taken
once a day. The tablets or capsules should be taken whole, not crushed, on an empty
stomach either one hour before or two hours after a meal; however, if stomach
irritation is a problem, doses may be taken with food. The effects of this drug are
apparent within 30 to 60 minutes, although overall benefits may not be determined for
two to four weeks.
Nifedipine should not be used by persons who have had a previous allergic reaction to
this drug; pregnant or breast-feeding women; or persons with low blood pressure,
reduced liver or kidney function, or a significant narrowing of the aorta. Hot
environments can exaggerate the effects of this drug, dropping blood pressure to
undesirably low levels. Driving and other risk-related activities should be restricted if
dizziness and drowsiness occur with use of nifedipine. The safety and effectiveness of
this drug have not been determined for children under the age of 12. The regular
capsules should not be used by persons over 71 years old. Nifedipine should not be
stopped abruptly but should be tapered off under a physician’s supervision.
Common side effects of this drug include dizziness, flushing, headache,

lightheadedness, low blood pressure, nausea, swelling of the feet and ankles, and
weakness. Rarely, nifedipine may increase angina, especially in persons who have
stopped taking beta blocker drugs. There is an increased chance of side effects in
persons over the age of 60.
Nifedipine may interact adversely with alcoholic beverages, grapefruit juice, cigarette
smoking, and certain drugs including amiodarone, cimetidine, cyclosporine, digitalis,
digoxin, diltiazem, insulin, magnesium, oral hypoglycemic drugs, phenytoin,
theophylline, and ranitidine.
Brand Names:Adalat, Procardia

rights reserved.
Neomycin
Neomycin, antibiotic drug most commonly used in combination-drug preparations to
treat skin, eye, and ear infections. Neomycin alters the chemical activity in bacteria
that causes such infections, thereby preventing the production of proteins needed by
the bacteria to multiply and survive.
This drug is available in over-the-counter preparations in combination with polymyxin

B sulfate and either bacitracin zinc or pramoxine hydrochloride as a first aid antibiotic
and pain -relieving o intment or cream. These combinations, along with hydrocortisone,,
are also available by prescription for inflammatory conditions that require a corticoid
drug in addition to an antibiotic. The prescription preparations come as skin ointments
or creams, ophthalmic (eye) ointments or drops, and otic (ear) drops.
For skin conditions, a thin film of ointment or cream is applied to the affected area two
to four times per day for up to one week. For eye infections, a thin coating of the eye
ointment or one to two eyedrops are put into the affected eye every three to four
hours for seven to ten days. Adult ear infections are treated with four eardrops three
to four times per day; infants and children should be given three eardrops three to
four times per day.
These preparations should not be used by persons who have had a previous allergic
reaction to any of these drugs. The skin ointment or cream should not be used over
large areas of the body or for more than one week and should not be used in the eye
or the ear. The eardrops should not be used for herpes simplex, smallpox, and chicken
pox infections.
Neomycin occasionally causes the skin to redden and become sensitive. Rarely, kidney
or ear damage may occur. Prolonged use may cause secondary bacterial or fungal
infections. Preparations containing hydrocortisone may cause burning, itching,
irritation, or dryness. Use of neomycin on large areas of the body or for extended
periods of time may cause stretch marks and more serious systemic damage. None of
the neomycin preparations are known to have adverse reactions with other drugs.
Brand Names:Corticosporin, Neosporin

rights reserved.
Nabumetone
Nabumetone, nonsteroidal anti-inflammatory drug used for relief of pain and
inflammation associated with osteoarthritis and rheumatoid arthritis. Nabumetone
blocks the production of certain chemicals in the body called prostaglandins that may
trigger pain and inflammation.
This drug is available b y prescription only. It comes in 500-mg and 700-mg tablets,
taken orally. The typical, initial adult dosage is 1000 mg per day. This dosage may be
increased as needed and tolerated to 1500 to 2000 mg per day, taken once a day or in
divided doses. Relief of symptoms may be felt within one hour, but it may take up to
two weeks to feel the full effect of the drug.
Nabumetone should be taken on a regular schedule, without missing doses. It should

be taken with food to increase absorption of the drug and to prevent stomach
irritation. To minimize adverse side effects, the lowest effective daily dose should be
used. Nabumetone should not be used by persons who have had a previous allergic
reaction to this drug or an asthmatic reaction to aspirin; pregnant or breast-feeding
women; or persons with peptic ulcers or any form of gastrointestinal ulceration or
bleeding, bleeding or blood cell disorders, liver disease, or severe impairment of
kidney function. It should be used with caution by persons with reduced liver or kidney
function and persons taking drugs that reduce blood clotting. The safety and efficacy
of this drug for children under the age of 12 have not been established. Reduced
dosages are advised for persons over the age of 60 until their tolerance of
nabumetone has been determined. Driving or other risk-related activities should be
restricted if drowsiness, dizziness, or impaired vision occurs with use of this drug.
Certain mild side effects may occur with nabumetone that should disappear as the
body adapts to the drug. These include bloating, constipation, diarrhea, difficulty
sleeping, dizziness, drowsiness, headache, heartburn, indigestion, lightheadedness,
loss of appetite, nausea, nervousness, soreness of the mouth, sweating, or vomiting.
More serious b ut uncommon side effects include activation of peptic ulcer disease or
ulcerative colitis, asthma or difficulty breathing, bleeding in the stomach or duodenum,
blurred vision, impairment of normal blood clotting, and liver or kidney damage. This
drug may also cause increased sensitivity to sunlight.
Nabumetone may interact adversely with alcoholic beverages and with certain other
drugs including anticoagulants (blood thinners) such as warfarin; aspirin, other
salicylates, and other anti-inflammatory drugs; beta blockers; diuretics; and
probenecid.
Brand Name:Relafen
Norgestrel/Ethinyl Estradiol
Norgestrel/Ethinyl Estradiol, combination drug used as birth control pill by women to
prevent pregnancy. Norgestrel and ethinyl estradiol are synthetic hormones similar to
the natural female sex hormones progesterone and estrogen, respectively. This
combination drug suppresses the release of eggs from the ovaries (ovulation);
thickens the mucus of the cervix, making it more difficult for the sperm to enter the
uterus; and causes changes in the lining of the uterus that prevent a fertilized egg
from implanting.
This drug is available by prescription only. One tablet is taken orally each day for 21
days, beginning on the first Sunday following the beginning of the menstrual period.
The tablets are then discontinued for seven days, after which the same dosage cycle is
repeated each month.
Norgestrel and ethinyl estradiol are considered effective in contraception after seven
consecutive days, and the chance of becoming pregnant is less than 1 percent per
year when no tablets are missed. This drug is most effective if the tablets are taken no
more than 24 hours apart. If tablets are missed, an additional method of birth control
must be used until the tablets have again been taken for seven consecutive days.
This drug should not be used by women who have had heart attacks, strokes, or
angina pectoris (chest pain); blood clots in the legs, lungs, or eyes; known or
suspected breast cancer or cancer of the uterine lining, cervix, or vagina; liver tumors;
unexplained vaginal bleeding; yellowing of the whites of the eyes or skin during
pregnancy or previous use of the pill; or known or suspected pregnancy. The risks
associated with the drug are increased significantly in women who have these
conditions, smoke, or have high blood pressure, diabetes, or high cholesterol. The
drug should not be used by breast-feeding mothers. Because of the risk of blood clots,
it should be discontinued three to four weeks before surgery and for two weeks after
surgery.
The most common side effects of this drug are nausea, vomiting, bleeding between
menstrual periods, weight gain, fluid retention, breast tenderness, difficulty wearing
contact lenses, and brown, blotchy spots on exposed skin. Other side effects may
include changes in appetite, headache, nervousness, depression, dizziness, loss of
scalp hair, rash, and vaginal infections. Uncommon—but serious and potentially fatal—
side effects are blood clots and blockage of blood vessels. There is at present no
confirmed evidence that oral contraceptives increase the risk of cancer of the
reproductive organs, and several studies have found no overall increase in the risk of
developing breast cancer. Some studies have found an increase in the incidence of
cervical cancer.
Certain drugs may interact with oral contraceptives to make them less effective in
preventing pregnancy or cause an increase in breakthrough bleeding. These include
rifampin; drugs used for epilepsy such as barbiturates and phenytoin;
phenylbutazone; and certain antibiotics.
Brand Names: Lo/Ovral, Ovral-28

rights reserved.
Gemfibrozil
Gemfibrozil, prescription drug used to reduce blood cholesterol, a fatty substance both
manufactured in the body and consumed in the diet. In lowering blood cholesterol,
gemfibrozil decreases the risk of coronary heart disease as well as pancreatitis
(inflammation of the pancreas).
Tablets are taken orally twice a day about 30 minutes before a meal. Dosages range
from 1200 to 1600 mg per day. Effectiveness is usually apparent after four to eight
weeks of treatment. Patients taking this drug are usually advised to follow a special
diet, exercise, and lose weight as part of their treatment.
Taking gemfibrozil may lead to or worsen symptoms of myositis (a muscle disease),

liver disorders, gallbladder disease, or other abdominal problems. Patients with
diabetes, thyroid problems, or impaired liver or kidney function should use gemfibrozil
with caution. This drug has not been proven safe for use in children under the age of
12 or in pregnant or breast-feeding women.
Possible side effects include constipation, diarrhea, headache, nausea, indigestion,

vomiting, skin rash, or abdominal pain (including appendicitis). Other side effects
sometimes observed are anemia, dizziness, fainting, impotence, blurred vision,
confusion, irregular heartbeat, muscle or joint pain, itching, or sleepiness. Gemfibrozil
may interact adversely with glyburide, lovastatin, or various blood-thinning drugs.
Brand Name:Lopid
Furosemide
Furosemide, drug used to help the body remove excess fluid by increasing urine flow,
also known as a diuretic. This is useful in the treatment of high blood pressure,
congestive heart failure, kidney disease, and liver disease. It reduces water and salt in
the body, relieving pressure on the circulatory system and various organs.
Furosemide must be prescribed by a doctor. Available in tablet and liquid form, it is

usually taken twice a day in dosages starting at 20 to 80 mg. This is increased as
needed to a maximum daily dosage of 600 mg. The drug may be taken with food to
minimize stomach irritation. Effectiveness is usually apparent after two to three
weeks, although long-term treatment (months to years) is not uncommon with this
drug. Potassium supplements or a potassium-rich diet is needed in some patients to
prevent excess potassium loss.
Patients with liver or kidney disease, diabetes, gout, lupus erythematosus, or an

allergy to sulfa d rugs should use furosemide with caution. Its safety for use during
pregnancy is not known, but it does appear in breast milk. Children may take this
drug, with dosage based on body weight.
Possible side effects may include constipation, diarrhea, nausea, h eadache, fever,
dizziness, excessive thirst, skin rash, hives, impotence, ringing in the ears, light-
sensitivity, or blurred vision. Furosemide may interact adversely with aspirin,
barbiturates, narcotics, and other muscle -relaxing drugs.
Brand Name: Lasix

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Famotidine
Famotidine, drug used in the treatment of stomach and intestinal ulcers. It is also
used to treat reflux disease (a condition in which stomach acids back up into the
esophagus, causing heartburn) and to prevent upper abdominal bleeding.
Famotidine blocks the action of histamine, a chemical in the body that stimulates acid
secretions in the stomach, among other effects. When histamine action is blocked,
stomach acid decreases, allowing ulcers and other gastrointestinal ailments to heal.
This drug must be prescribed by a doctor. It is available in tablet and liquid form, both
taken orally, and also in a liquid form that is injected. The typical dosage is 20 to 40
mg taken in a single dose at bedtime. Relief of symptoms may take several days.
Long-term use (months to years) is sometimes prescribed for prevention of
symptoms.
Patients taking famotidine should avoid antacids within one to two hours of a
famotidine dose. This drug has not been proven safe for pregnant or nursing women
or for children under age 16. It should be used with caution by patients with impaired
liver or kidney function.
Headache is the most common side effect of this drug. Less common are diarrhea,
dizziness, hair loss, impotence, joint or muscle pain, skin rash or itching, rapid or slow
heartbeat, anxiety, or sleepiness. Overdosage can cause confusion, drowsiness,
seizures, or cardiac arrest. Famotidine may interact adversely wit h the drugs
itraconazole, ketoconazole, pancrelipase, pentoxifylline, or probenecid.
Brand Name: Pepcid

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Diltiazem
Diltiazem, drug used to treat angina (sharp chest pain caused by reduced oxygen to
the heart muscle) and high blood pressure. It is also sometimes used to treat
congestive heart failure and abnormal heart rhythms. The drug works by dilating, or
opening, blood vessels and slowing the heart, thereby reducing blood pressure. This
also relieves the chest pains associated with angina. Diltiazem belongs to a group of
medications called calcium channel blockers.
Diltiazem must be prescribed by a doctor. Available in tablet and capsule form, this
drug is usually prescribed in dosages ranging from 180 to 360 mg per day. These are
divided into three or four smaller doses, which are typically taken before meals and at
bedtime. An extended-release form of this drug is taken once a day. Effectiveness of
this drug may not be seen for two to four weeks. It is important to remember that
diltiazem only controls cardiovascular problems (it does not cure them), so it should
be taken as prescribed even after symptoms are relieved. Long-term therapy for
months to years is not uncommon with this drug.
Patients with low blood pressure or certain types of irregular heartbeat should not use
diltiazem. Those with an impaired liver or with congestive heart failure should use this
drug with caution. Its safety for use during pre gnancy or in children under age 12 has
not been determined, and nursing mothers should be aware that it does appear in
breast milk.
Possible side effects include dizziness or light-headedness, fluid retention, headache,

nausea, skin rash, muscular weakness, or abnormally slow heartbeat. Also sometimes
seen are constipation, diarrhea, dry mouth, hair loss, ringing in the ears, light
sensitivity, sleeplessness, or vision changes. An increase in angina attacks can occur if
this medication is stopped abruptly. Diltiazem may interact adversely with beta blocker
drugs, aspirin, carbamazepine, cimetidine, digoxin, and ranitidine.
Brand Names:Cardizem, Dilacor XR

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Diclofenac Sodium
Diclofenac Sodium, drug used to treat various forms of arthritis. It is also sometimes
used to relieve menstrual pain (see Menstruation). An anti-inflammatory analgesic,
this drug works by reducing concentrations of certain chemicals in tissue that produce
inflammation and pain, thereby relieving the swelling and stiffness commonly
associated with arthritis.
Diclofenac sodium must be prescribed by a doctor. Tablets are taken orally two to five
times per day. The total daily dosage usually ranges from 100 to 200 mg, with 225 mg
being the recommended maximum. Tablets should be taken with a full glass of water
and, if stomach upset occurs, with food. Not lying down for 20 to 30 minutes after
taking the drug can also help prevent stomach upset. Effectiveness of this drug may
not be seen for one to two weeks after beginning treatment.
Patients who experience allergic reactions to aspirin or related medications should not
take diclofenac sodium. Patients with kidney or liver problems, ulcers, heart disease,
or high blood pressure should use this drug with caution. Its safety for use during
pregnancy is not known, but it is known to appear in breast milk. Children under the
age of 12 should not use this drug.
Ulcers or internal bleeding are sometimes ca used by this medication. Other possible
side effects include abdominal pain, indigestion, nausea, constipation, diarrhea,
headache, or dizziness. Occasionally seen are fluid retention, skin rash, ringing in the
ears, blurred or double vision, hair loss, in somnia, light sensitivity, facial swelling, or
vomiting. An overdose of diclofenac sodium can cause acute kidney failure, lung
inflammation, drowsiness, or loss of consciousness.
This drug may interact adversely with aspirin, blood-thinning medications, diuretics,
heart medications containing digitalis, insulin and certain other diabetes drugs,
cyclosporine, lithium, methotrexate, and carteolol.
Brand Name:Voltaren

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Cromolyn Sodium
Cromolyn Sodium or Intal, drug used to treat respiratory problems such as hay fever
and asthma. Classified as an antiasthmatic, it works by interfering with the chemical
reactions that constrict muscles in the bronchi, the two branch es that connect the
trachea or windpipe to the lungs. It also prevents the swelling and itching associated
with allergic reactions.
Cromolyn sodium is available only by prescription. It comes in several forms, including

capsules (taken orally), liquid (inhaled orally or sprayed into the nose), or powder,
which is packaged in capsules or cartridges for inhalation or spraying into the nose.
Dosages vary widely depending on the form prescribed, although most are taken four
to six times per day.
Unlike asthma medications that provide immediate relief from respiratory difficulties,
cromolyn sodium helps to control and prevent symptoms. Effectiveness in preventing
asthma attacks is usually achieved after four to six weeks of treatment.
Patients with impaired liver or kidney function should avoid taking this drug or should
use it with caution. Its safety for use during pregnancy or while nursing is not known.
Cromolyn sodium may be especially effective for controlling asthma in young patients.
Children over age five can safely take most forms of this drug.
Possible side effects include coughing, nasal congestion, sneezing, throat irritation,
nausea, or wheezing. Sometimes seen are facial swelling, difficulty swallowing,
headache, dizziness, joint pain, nosebleed, skin rash, frequent urination, or swollen
glands. Cromolyn sodium may be taken safely with most other drugs, including
bronchodilators used to provide immediate relief from asthma attacks.
Brand Names:Intal, Nasalcrom, Gastrorom

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Clarithromycin
Clarithromycin, antibiotic drug used to treat respiratory tract and skin infections such
as pneumonia, tonsillitis (swollen and inflamed tonsils), and bronchitis. The drug
works by interfering with the formation of proteins in the invading bacteria, thereby
preventing their growth and multiplication.
Available by prescription only, tablets are taken orally, usually in 250- to 500-mg
doses every 12 hours. They may be taken w ith or without food. Effectiveness in
controlling infection is usually apparent after 4 to 6 days, although the complete,
prescribed treatment (usually 7 to 14 days) should be taken even if symptoms have
subsided to prevent a recurring infection. Patients with kidney disease or a sensitivity
to erythromycin or similar antibiotics should avoid this drug or use it with caution.
Clarithromycin has not been proven safe for children under the age of 12 or for
pregnant women. Breast-feeding mothers should be aware that the drug may appear
in breast milk.
The drug’s side effects are usually minimal, but may include nausea, indigestion,
diarrhea, headache, or an altered sense of taste. Severe diarrhea, sometimes caused
by the drug’s effect on the intestine, requires immediate medical attention.
Clarithromycin may interact adversely with blood-thinning drugs such as warfarin, as

well as with the drugs carbamazepine, theophylline, astemizole, digoxin, and
phenytoin.
Brand Name:Biaxin
Butalbital
Butalbital, sedative b arbiturate drug. It is typically combined with other ingredients
(such as aspirin, acetaminophen, caffeine, or codeine) to create a medication used to
relieve headaches or muscle pain in the neck and shoulders. It works by decreasing
the activity of the central nervous system.
A medication containing butalbital must be prescribed by a doctor. It is taken in tablet

or capsule form, usually one or two tablets every four hours. (One capsule or tablet
typically contains 50 mg of butalbital combined with various other active ingredients.)
The maximum recommended dosage is six tablets per day. It should be taken with
food or a large drink of water and should not be combined with alcohol. Butalbital’s
safety for use by children and pregnant women has not been established; nursing
women should be aware that it does appear in breast milk.
Dependency on this drug can occur, especially with long-term use. Dosages should not
be increased without a doctor’s approval. Patients taking this drug should avoid
driving, operating dangerous machinery, or other risk-related activities. Patients with
porphyria, a medical condition affecting the liver or bone marrow, should not take this
drug.
Potential side effects include drowsiness, dizziness, light-headedness, nausea, and
vomiting. Symptoms of butalbital overdose are confusion, low blood pressure,
breathing difficulties, shock, or coma. Numerous drugs may combine adversely with
medications containing butalbital. These include antidepressants; antihistamines;
certain drugs for hig h blood pressure, such as beta blockers; insulin and other drugs
for diabetes; oral contraceptives; steroids; warfarin; and theophylline.
Brand Names:Fioricet, Fiorinal, Phrenilin, Sedapap
Microsoft ® Encarta ® Encyclopedia 2002. © 1993-2001 Microsoft Corp oration. All

rights reserved.
Amlodipine
Amlodipine, drug used to treat angina and high blood pressure. It works by dilating
blood vessels and slowing the heart, thereby reducing blood pressure. Amlodipine also
relieves the chest pains associated with a ngina that occur when clogged arteries
prevent sufficient oxygen from reaching the heart muscle. Amlodipine belongs to a
group of medications called calcium channel blockers.
Amlodipine is available only by prescription. Tablets or capsules are taken orally once
a day, usually in 5- or 10-mg doses. The drug’s full effectiveness is not achieved until
seven or eight days of treatment is completed. The drug may be taken with or without
food. Amlodipine controls but does not cure cardiovascular problems, so it may be
combined with most other blood pressure or angina medications. However, patients
with low blood pressure, liver disease, or severe heart disease should take smaller
doses or avoid this drug altogether. Its safety for use in children under age 12 or in
pregnant or nursing women has not been determined.
A few common side effects are associated with this drug, including dizziness, fatigue,
flushing, fluid retention or swelling, headache, and heart palpitations. Uncommon side
effects may include nausea, sleepiness, back or chest pain, constipation, diarrhea,
fainting, itching, anxiety, migraine, twitching, or vomiting. Amlodipine may be taken
safely with most other drugs.
Brand Names:Norvasc, Lotrel

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Albuterol
Albuterol, drug generally used for the treatment of asthma. It relieves and can prevent
bronchial spasms, sudden episodes of breathlessness and wheezing that make
breathing difficult. Albuterol can also relieve bronchial spasms that occur in some
people after exercising.
Albuterol is a bronchodilator. It works by relaxing the constricted muscles of the lung’s

bronchi (the two branches at the end of the trachea that provide air passage to the
lungs). The drug expands the passageways for air to move in and out of the lungs,
restoring comfortable breathing.
Albuterol must be prescribed by a doctor. It is available in aerosol, tablet, syrup, and

capsule form, all of which are taken orally. Inhalation of the aerosol form provides the
most immediate relief, usually within 15 minutes. Two inhalations every four to six
hours is the usual dosage for adults and children over age 12. (Safe dosages for
younger children depend on the form of albuterol taken.) When used to prevent
bronchial spasm, the dosage is slightly less: two inhalations four times a day. For
prevention of a spasm caused by exercise, two inhalations about 15 minutes before
exercising are recommended. Extended-release tablets should be swallowed whole
without crushing or chewing.
Increasing the dosage of this drug without a doctor’s approval is strongly discouraged
and, in fact, can make symptoms worse. People with high blood pressure, an irregular
heartbeat, cardiovascular problems, liver disease, an overactive thyroid gland, or
diabetes should consult a doctor before using albuterol. This drug’s safety for use
during pregnancy and while nursing have not been adequately studied.
A large variety of side effects have been associated with albuterol. Some of the more
common ones include agitation, diarrhea, dizziness, headache, increased blood
pressure, indigestion, muscle cramps, nausea, nosebleeds, rapid heartbeat, ringing in
the ears, sleeplessness, tooth discoloration, and vomiting. Albuterol should not be
combined with antidepressants or beta blockers unless approved by a doctor. The
aerosol form should not be combined with other inhaled drugs without a doctor’s
approval.
Brand Names:Proventil, Ventolin, Volmax

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Propoxyphene
Propoxyphene, drug used to treat mild to moderate pain. It is often combined with
other ingredients such as aspirin, caffeine, or acetaminophen to form combination
medications. Propoxyphene is a narcotic that works by depressing the activity of the
central nervous system to create an anesthetic, or pain -killing, effect.
Medications containing propoxyphene must be prescribed by a doctor. They are taken

in tablet or capsule form, usually one or two tablets of 65 mg every four hours, as
needed, for pain relief. Propoxyphene may be taken with or without food, but it should
not be combined with alcoholic beverages. Pain relief begins within one to two hours.
This drug should not be used by ch ildren, pregnant women, or nursing women.
Patients taking propoxyphene can become dependent on it, especially after long-term
use at high dosages. Propoxyphene preparations that contain aspirin should be used
cautiously by patients with liver or kidney dis orders, ulcers, blood-clotting problems,
chickenpox, asthma, or influenza.
Possible side effects include nausea, vomiting, constipation, headache, mood changes,
kidney or liver problems, skin rash, muscle weakness, or jaundice. Drowsiness and
dizziness are also associated with propoxyphene, so patients should avoid driving,
operating dangerous machinery, or engaging in other risk-related activities.
Propoxyphene should not be taken with most tranquilizers, antidepressants, sleep

aids, antihistamines, muscle relaxants, anticonvulsant drugs (especially
carbamazepine), anticoagulants, or other narcotic pain relievers.
Brand Names:Darvon,Darvocet-N

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Pravastatin
Pravastatin , drug used to lower cholesterol levels in the bloodstream in cases when
dietary changes, weight loss, and exercise are ineffective in lowering cholesterol.
Pravastatin works by blocking the liver enzyme that controls the manufacture of
cholesterol. It is primarily effective against low-density lipoproteins (LDL), the form of
cholesterol associated with increased risk of heart disease.
Available only by prescription, tablets of pravastatin are taken with or without food,
usually at bedtime. The typical dosage ranges between 10 and 40 mg per day.
Typically, cholesterol levels begin falling four to six weeks after the medication is
started. Pravastatin is often prescribed in combination with a cholesterol-lowering diet.
Pregnant or nursing women, or children under the age of 18, should not take
pravastatin. Patients with liver or kidney disease, muscular disorders, cataracts, or a
history of alcohol abuse should use this drug with caution. Pravastatin can cause
damage to the liver or muscle tissue, although problems can usually be detected early
using well-established laboratory tests.
Possible side effects of this drug include dizziness, headache, skin rash, itchiness,
stomach pain, nausea, diarrhea, constipation, gas, muscle cramps, or flulike
symptoms. Pravastatin may be contraindicated for patients who are also taking the
following drugs: cholestyramine, cimetidine, colestipol, cyclosporine, erythromycin,
gemfibrozil, ketoconazole, niacin, warfarin, and immunosuppressive drugs.
Brand Name: Pravachol

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Promethazine
Promethazine, drug used mainly to treat allergies. It is also prescribed to control
motion sickness, fight insomnia, and minimize pain and vomiting after surgery.
Sometimes it is prescribed as a sedative. Promethazine works by blocking the action of
histamine, a natural chemical released by body tissues during allergic reactions.
Available by prescription in tablet, syrup, injectable liquid, and suppository form,

promethazine is usually prescribed in 25-mg doses taken once or twice daily. It may
be taken with or without food. Promethazine works quickly, usually within 20 minutes.
Children may take this drug, with dosages based on body weight. Promethazine’s
safety for use during pregnancy and breast-feeding has not been determined.
Patients with disorders affecting breathing, including asthma and sleep apnea, should
not take promethazine. It should be used with caution by patients with seizure
disorders, heart disease, liver conditions, peptic ulcers, high blood pressure, prostate
enlargement, or narrow-angle glaucoma. Promethazine may affect the accuracy of a
pregnancy test.
Patients who experience drowsiness should not drive, operate dangerous machin ery,
or engage in other risk-related activities. Other possible side effects include dizziness,
blurred vision, nausea, vomiting, skin rash, jaundice, blood pressure changes,
disorientation, or light sensitivity. An overdose of promethazine can cause a slo wer
heart rate, breathing difficulties, or loss of consciousness.
Promethazine may cause health problems if taken with certain narcotic pain relievers,
sedatives, tranquilizers, and antidepressant drugs. This drug should not be taken with
Brand Names: Phenergan, Mepergan

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Erythromycin
Erythromycin, antibiotic drug used to treat a wide variety of bacterial infections. These
infections include respiratory tract infections such as pneumonia, urinary tract
infections, ear and skin infections, gonorrhea, syphilis, rheumatic fever, whooping
cough, and diphtheria. The drug is also used in a form applied directly to the skin to
treat acne. It works b y interfering with the formation of essential proteins in the
invading bacteria, preventing their multiplication and growth.
Erythromycin is available by prescription in capsules, tablets, ointment, gel, and

various liquids. Dependingon the site of the infection, the drug is taken orally or
applied directly to the infected area. Dosages range from 250 to 1000 mg taken every
six hours. Children may take most forms of this drug, with dosages determined by
body weight. Some forms of this drug should be taken o n an empty stomach (one
hour before or two hours after a meal). Erythromycin’s effectiveness is usually
apparent after three to five days. However, the entire prescribed course of treatment
should be completed to avoid recurrence of infection.
Patients wit h liver disease should not take this drug. It should be used with caution by
patients with a history of allergies, impaired kidney function, or abnormal heart
rhythm. It is generally safe for use during pregnancy (except in the form known as
erythromycin estolate); however, breast-feeding mothers should be aware that this
drug appears in breast milk.
Possible side effects include abdominal pain, nausea, vomiting, loss of appetite, or
diarrhea. Also seen are skin rash, hives, eye irritation, yellowing of the eyes or skin,
dizziness, rapid heartbeat, or temporary hearing loss.
Erythromycin can react adversely with a variety of drugs. These include other
antibiotics (including penicillin), blood-thinners, carbamazepine, digoxin, lovastatin,
phenytoin, and theophylline. Erythromycin should never be combined with astemizole.
Brand Names: Erythrocin,Ilosone, Emgel,Benzamycin,Theramycin

Z,Erygel,Erymax,Pediazole

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Methylprednisolone
Methylprednisolone, steroid drug used in the treatment of various inflammatory and
allergic disorders. It reduces swelling, redness, itching, and allergic reactions by
blocking some of the body’s normal immune system defenses. It is most commonly
used to manage serious skin disorders such as dermatitis, eczema, and psoriasis; and
to treat asthma; inflammation of the small intestine (enteritis); multiple sclerosis;
lupus erythematous; ulcerative colitis; and major rheumatic disorders like bursitis,
tendinitis, and most forms of arthritis. It is also used to treat anemia, chronic
obstructive pulmonary disease (COPD), acute nonlymphoblastic leukemia,
Pneumocystis carinii pneumonia in people with acquired immunodeficiency syndrome
(AIDS), bone cysts in children, croup, and severe vomiting caused by chemotherapy.
This drug is available by prescription only. It comes in a tablet, an injectable liquid, an

ointment, and an enema. For tablets, the usual adult dosage is 4 to 48 mg daily, taken
orally as a single dose or in divided doses; a reduced tablet dosage is prescribed for
children and may be prescribed for adults over the age of 60. The usual adult dosage
for injections into a muscle or joint is 10 to 120 mg at intervals ranging from once a
week to once every four weeks; the injection dosage for children is prescribed
according to body weight. The usual adult dosage for enemas is 40 mg three to seven
times per week, preferably right after a bowel movement; the enema dosage for
children is determined individually by a physician. The effect of methylprednisolone
should be felt in two to four days. For acute disorders, it is usually taken for four to
ten days. For chronic disorders, this drug should be taken only as long as needed to
stabilize the chronic condition and permit a gradual withdrawal.
Methylprednisolone can be taken with food or milk to prevent stomach irritation. It

should not be used by persons who have had an allergic reaction to it in the past or by
pregnant or breast-feeding women. It should also be avoided by persons with active
tuberculosis, peptic ulcer disease, eye infections caused by the herpes simplex virus,
or recent surgical joining of two bowel segments. It should be used with caution by
persons with reduced kidney function a nd people over the age of 60. Prolonged use in
infants and children should be avoided. Methylprednisolone should be discontinued 72
hours before vaccination against measles, rabies, smallpox, or yellow fever and should
not be resumed for at least 14 days a fter vaccination. This drug should not be stopped
abruptly after long-term treatment but should be tapered off in decreasing dosages.
Common side effects of methylprednisolone include increased appetite, weight gain,

retention of salt and water, and elimin ation of potassium in the urine. Prolonged use of
the oral form is associated with serious side effects such as mood alterations,
increased blood sugar, possible diabetes, osteoporosis (loss of bone strength),
hypertension (high blood pressure), arrhythmia (abnormal heartbeat), peptic ulcer,
cataracts, glaucoma, reactivation of latent tuberculosis, retarded growth and
development in children, and increased susceptibility to infection.
Methylprednisolone may interact adversely with certain drugs including amphotericin

B; antacids; antihypertensive (high blood pressure) drugs; aspirin; barbiturates ;
carbamazepine; cyclosporine; digoxin; ephedrine; drugs containing estrogen; insulin;
ketoconazole; nonsteroidal anti-inflammatory drugs such as ibuprofen, indomethacin,
ketoprofen, and naproxen; oral anticoagulants (blood thinners); oral antidiabetic
drugs; oral contraceptives (birth control pills); phenytoin; and certain vaccines. Heavy
smoking may add to the effects of methylprednisolone, and drinking alcoholic
beverages can increase the risk of peptic ulcers in persons taking this drug orally.
Brand Names:Duralone, Medrol, Meprolone

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Naproxen
Naproxen, nonsteroidal anti-inflammatory drug used for relief of pain and
inflammation associated with adult and adolescent rheumatoid arthritis, osteoarthritis,
ankylosing spondylitis (chronic inflammation of the spine), bursitis, tendinitis, and
gout. It is also used in treating headaches and menstrual cramps. Naproxen is an
effective painkiller after childbirth, orthopedic surgery, dental treatment, and for
strains and sprains. It blocks the production of certain chemicals called prostaglandins
that may trigger pain and infla mmation.
This drug may be purchased over the counter in tablets of 225 mg. It is available in
larger dosages—by prescription only—in tablets of 250 mg, 375 mg, and 500 mg; in
sustained-release tablets of 375 mg and 500 mg; and as a liquid, administered ora lly
in 125 mg per 5-ml spoonful. The typical adult oral dosage for rheumatoid arthritis,
osteoarthritis, and ankylosing spondylitis is 200 to 500 mg twice a day. For gout, the
initial adult dosage is 750 mg followed by 250 mg every eight hours until symptoms
disappear. For bursitis, tendinitis, menstrual cramps, and other pain, the initial adult
dosage is 500 mg followed by 250 mg every six to eight hours. The total daily dosage
should not exceed 1250 mg. For children with rheumatoid arthritis, the dosage is
determined on the basis of body weight. Pain relief should begin within one hour,
although the full anti-inflammatory effect of this drug may not be apparent for two to
four weeks after continuous use.
Naproxen should be taken on a regular schedule, without missing doses. If possible, it

should be taken on an empty stomach 30 to 60 minutes before meals or 2 hours after
meals. If stomach irritation occurs, it may be taken with food or antacids. To minimize
adverse side effects, the lowest effective daily d ose should be used. Naproxen should
not be used by persons who have had a previous allergic reaction to this drug or an
asthmatic reaction to aspirin; pregnant or breast-feeding women; or persons with
peptic ulcers or any form of gastrointestinal ulceratio n or bleeding, bleeding or blood
cell disorders, liver disease, or severe impairment of kidney function. It should be used
with caution by persons with reduced liver or kidney function. The safety and efficacy
of this drug for children under the age of two have not been established. Reduced
dosages are advised for persons over the age of 60 until their tolerance of naproxen
has been determined. Driving or other risk-related activities should be restricted if
drowsiness or dizziness occur with the use of this drug.
Certain mild side effects may occur with naproxen that should disappear as the body
adapts to the drug. These include bloating, constipation, diarrhea, difficulty sleeping,
dizziness, drowsiness, headache, heartburn, indigestion, lightheadedness, loss of
appetite, nausea, nervousness, soreness of the mouth, sweating, or vomiting. More
serious but uncommon adverse effects include activation of peptic ulcer disease or
ulcerative colitis, bleeding in the stomach or bowel, difficulty breathing, changes in
menstruation, and liver or kidney damage. This drug may also cause increased
sensitivity to sunlight.
Naproxen may interact adversely with alcoholic beverages and certain other drugs
including anticoagulants (blood thinners) such as warfarin; aspirin, salicylates, or
other anti-inflammatory drugs; lithium; methotrexate; beta blockers such as
acebutolol, atenolol, metoprolol, and timolol; furosemide and thiazide-type diuretics;
and probenecid.
Brand Names:Aleve, Naprosyn

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Metoprolol
Metoprolol, drug used to treat hypertension (high blood pressure) and angina pectoris
(chest pain), and to reduce the risk of a second heart attack. Metoprolol belongs to a
group of drugs called beta adrenergic blocking agents, more commonly known as beta
blockers. It lowers blood pressure by blocking nerve impulses that contribute to a high
heart rate.
This drug is available by prescription only. It comes in 50-mg, 100-mg, and 200-mg
tablets; in 50-mg and 100-mg prolonged action tablets; and in a liquid that is
administered intravenously. For treatment of hypertension or angina, the oral dosage
in regular tablet form ranges from 10 to 450 mg per day, either taken as a single dose
or in divided doses; in prolonged action tablets, the oral dosage is up to 400 mg once
a day. For prevention of heart attacks, the typical, intravenous injected dosage is 5
mg every two minutes for a total of three doses. For treatment after a heart attack,
the typical oral dosage in regular tablets is 50 mg every 6 hours, starting 15 minutes
after the last intravenous dose followed by 100 mg twice a day for three months to
one year. This drug is effective within 2 hours when given orally, and its effective ness
in lowering blood pressure is apparent after 10 to 14 days.
Tablets can be taken with meals or on an empty stomach. The regular tablet can be
crushed, but the prolonged action tablet should be taken whole. This drug should not
be used by persons with a previous allergic reaction to it; pregnant or breast-feeding
women; persons with congestive heart failure, an abnormally slow heart rate, or
disorders of heart impulse transmission (such as patients with cardiac pacemakers); or
persons taking a class of antidepressants known as monoamine oxidase (MAO)
inhibitors. It should be used with caution by persons with reduced liver function or
asthma and by people over the age of 60. Its safety and effectiveness in children
under the age of 12 have not been established. It may have a negative effect on
driving or other risk-related activities. Metoprolol should not be discontinued abruptly
but should be tapered off gradually over one to two weeks.
Common side effects of this drug include drowsiness, fatigue, cold h ands and feet,
slow heart rate, lightheadedness, and decreased sexual desire. Possible risks of long-
term use include congestive heart failure in advanced heart disease, worsening angina
in coronary heart disease, and increased asthma attacks in asthmatic persons.
Exposure to heat can lower blood pressure and exaggerate the effects of metoprolol.
Exposure to cold can further reduce the diminished circulation in hands and feet that
may occur with this drug. Alcohol may exaggerate the drug’s ability to lower blood
pressure and increase its sedative effect. Smoking may reduce the drug’s potency.
Excessive salt intake should be avoided when using this drug.
Metoprolol can interact adversely with certain drugs including other antihypertensive
drugs; albuterol; aminophylline; amiodarone; aspirin; barbiturates such as
phenobarbital; calcium channel blockers; chlorpromazine; cimetidine; clonidine;
digoxin; diltiazem; epinephrine; fluoxetine; furosemide; hydralazine; indomethacin
and possibly other aspirin substitutes or nonsteroidal anti-inflammatory drugs; insulin;
nifedipine; oral antidiabetic drugs; oral hypoglycemic drugs; oral contraceptives (birth
control pills); tranquilizers; reserpine; theophyllinevenlafaxine; and verapamil.
Brand Names:Lopressor, Toprol

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Oxaprozin
Oxaprozin , drug used for relief of pain and inflammation associated with rheumatoid
arthritis, osteoarthritis, gout, and tendinitis. Oxaprozin blocks the production of
chemicals called prostaglandins, which may trigger pain and inflammation.
This drug is available by prescription only and comes in 600-mg caplets that are taken
orally. The typical adult dosage is 1200 mg per day determined individually on the
basis of weight and health. Pain is usually relieved after a single dose, but reduction of
inflammation may require regular doses for several days. One to two weeks of
continual usage determines the general effectiveness of the drug, although the full
effect may not be apparent during the first six weeks of regular use.
Oxaprozin should be taken with a full glass of water or milk, with meals, or with a
prescribed antacid. To avoid adverse side effects, the lowest effective daily dose
should be taken. Persons who have had a previous allergic reaction to oxaprozin or to
any other nonsteroidal anti-inflammatory drug, such as aspirin, should not take this
drug. It should be avoided by pregnant or breast-feeding women, and by persons with
bleeding or blood cell disorders, or a severe impairment of kidney function. It should
be used with caution by persons with reduced liver or kidney function. The safety and
effectiveness of this drug for children under the age of 12 have not been established.
Small doses are advisable for persons over the age of 60 until tolerance is determined.
Driving and other risk-related activities should be restricted if drowsiness or dizziness
occurs.
Possible side effects of oxaprozin may include altered or blurred vision, constipation,
depression, diarrhea, dizziness, headache, hives, indigestion, itching, mouth sores,
nausea, ringing in the ears, skin rash, increased skin sensitivity to sunlight, sleep
disturbances, and vomiting. Rare but serious side effects include kidney damage and
gastrointestinal pain, ulceration, and bleeding.
Drinking alcoholic beverages with this drug may increase the risk of stomach
ulceration or bleeding. Oxaprozin may interact adversely with other drugs including
acetaminophen; anticoagulants; aspirin; b eta blockers; diuretics such as
hydrochlorothiazide and furosemide; enoxaparin; indomethacin; lithium;
methotrexate; sulfinpyrazone; valproic acid; and warfarin.
Brand Name:Daypro

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Etodolac
Etodolac, drug used to treat osteoarthritis. Etodolac is a nonsteroid, mild analgesic
that works by reducing concentrations of certain chemicals in bodily tissues that
produce inflammation and pain, relieving swelling and stiffness.
Etodolac is available only by prescription. Capsules or tablets of etodolac are taken

orally every six to eight hours, usually in 200 to 400 mg doses. The total daily dosage
should not exceed 1200 mg. Capsules should be taken with food and a fu ll glass of
water. (Not lying down for 20 to 30 minutes after taking the drug can help avoid
stomach upset.) Effectiveness of this drug may not been seen for one to two weeks
after beginning treatment.
Patients who experience allergic reactions to aspirin or related medications should not
take etodolac. Patients with kidney or liver problems, peptic ulcer, heart disease, or
high blood pressure should use this drug with caution. Its safety for use during
pregnancy is not known, and it may appear in breast milk. Children under age 12
should not use this drug.
Ulcers or internal bleeding are sometimes caused by this medication. Other possible
side effects include abdominal pain, indigestion, nausea, constipation, diarrhea, fever,
dizziness, ringing in the ears, or muscle weakness. Occasionally seen are fluid
retention, sweating, anemia, fainting, insomnia, rapid heartbeat, skin rash, or
yellowing of the skin or eyes.
This drug may interact adversely with aspirin, blood-thinning medications, diuretics,
and digoxin.
Brand Name: Lodine

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Ketoprofen
Ketoprofen, drug used to reduce the inflammation, fever, and pain associated with
such diseases as arthritis, bursitis, tendinitis, and menstrual cramps. Ketoprofen is
believed to work by preventing prostaglandins (chemicals that cause inflammation and
contribute to the brain’s perception of pain) from concentrating in body tissues.
Ketoprofen is available by prescription in capsule, tablet, and suppository form. The

drug is taken daily in 3 or 4 doses for a total of 150 to 300 mg. It is most effectively
absorbed if taken on an empty stomach, but it can be taken with food, milk, or an
antacid to prevent stomach irritation. The patient must take ketoprofen for one to
three weeks before physicians can evaluate its effectiveness.
Possible side effects include drowsiness, fluid retention, skin rash, headache,
depression, indigestion, and nausea. Men may experience problems with s exual
performance and breast enlargement. Women may find their menstrual cycles
affected, with increased blood flow during menstruation.
Pregnant women should not use ketoprofen in the third trimester of pregnancy.
Breast-feeding women, patients with allergies to the drug, those who suffer asthma
with aspirin use, and patients with ulcers, bleeding disorders, impaired kidney
function, or liver disease should not take ketoprofen.
Ketoprofen may have negative effects when taken with other anti-inflammatory drugs,
steroids, aspirin, insulin, phenytoin, verapamil, nifedipine, lithium, and diuretics.
Alcoholic beverages can increase the risk of ulcers or bleeding in the stomach.
Brand Name: Orudis

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Nitroglycerin (drug)
Nitroglycerin (drug), drug used in the treatment and prevention of angina pectoris
(chest pain). Nitroglycerin relaxes the muscles of blood vessel walls, thereby dilating
arteries and veins and lowering blood pressure. As a result, blood supply to the heart
muscle improves, workload on the heart is reduced, and chest pain is alleviated.
Nitroglycerin is available by prescription only. It comes in immediate-release forms

used either for fast relief of an angina attack or taken immediately before engaging in
strenuous activity that may cause an attack. Nitroglycerin is also prescribed in
sustained-release forms used to prevent angina on a long-term basis.
For relief of pain following an acute (sudden) a ngina attack, the typical dosage is one
tablet of 0.15 to 0.6 mg taken sublingually (under the tongue) and allowed to dissolve,
or one metered dose of 0.4 mg from a spray container, applied on or under the
tongue. If necessary, the dosage may be repeated e very 5 minutes for a maximum of
three tablets or three metered sprays within 15 minutes. For prevention of angina, one
tablet is placed under the tongue or one metered spray is taken 5 to 10 minutes
before activities that may precipitate an attack. These immediate-release forms of
nitroglycerin take effect within 1 to 3 minutes.
For long-term prevention of angina, typical dosages of the sustained-release forms of

nitroglycerin are one 2.5 -mg sustained-release tablet or capsule taken orally every 6
to 8 hours, one 1 - to 2 -mg sustained-release buccal tablet placed between the cheek
and gum every 4 to 5 hours and allowed to dissolve, one transdermal patch applied to
a hairless area of the skin every 24 hours and left on for 12 to 14 hours, or a 0.5 -inch
(7.5-mg) strip of ointment applied in a thin, even layer to hairless skin every 3 to 4
hours. These sustained-release forms of nitroglycerin take effect within 30 to 60
minutes.
The body usually develops a tolerance to the sustained-release forms after 24 hours.
To maintain its effectiveness, the drug should not be taken for 10 to 12 hours out of
every 24 hours. It should not be stopped abruptly after long-term use; rather, the
dosage should be gradually reduced over a period of six weeks.
Nitroglycerin should not be taken by persons who have had a previous allergic reaction
to the drug or persons with severe anemia, recent head trauma, increased heart rate
or increased blood pressure following a heart attack, abnormal growth of heart muscle
in response to vascular disease, hyperthyroidism, or glaucoma (excess pressure within
the eyeball). It should be used with caution by pregnant or breast-feeding women.
Driving or other risk-related activities should be restricted if dizziness or faintness

occur. Nitroglycerin taken in hot environments can cause excessively low blood
pressure, and cold environments can increase the amount needed for full
effectiveness.
The most common side effects of taking nitroglycerin are facial flushing, headache,
sudden drop in blood pressure , rapid heart rate, and heart palpitations. Diarrhea and
fainting may also occur.
Alcoholic beverages should be completely avoided while using this drug, and smoking
cigarettes can reduce its effectiveness. Nitroglycerin can also interact adversely with
other drugs including many over-the-counter products for allergies, colds, and coughs;
acetylcysteine; antihypertensive drugs; aspirin; dihydroergotamine or similar ergot
medicines; diltiazem, heparin; and isosorbide dinitrate or mononitrate.
Brand Names: Nitro-Bid, Nitrocap TD, Nitrocine Transdermal, Nitro-Dur

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Warfarin
Warfarin, prescription blood-thinning drug used to treat or prevent blood clots.
Classified as an anticoagulant, warfarin works by interfering with the action of vitamin
K, which plays an essential role in blood thickening and clot production.
Available in tablets taken orally on an empty stomach and in an injectable liquid form,
warfarin is usually prescribed in an initial dose of 10 to 15 mg per day. After the first
two to three days, the dosage is adjusted according to changes in the patient’s blood-
clotting capacity as determined by laboratory tests. Effectiveness is usually apparent
after three to five days of treatment. Patients with peptic ulcers, ulcerative colitis, an
aneurysm, a heart-related infection, a blood disorder, or recent surgery should not use
this drug. It should be used with caution by patients preparing to undergo surgery o r
invasive dental procedures, or patients with high blood pressure, impaired liver or
kidney function, severe allergies, diabetes, any infectious disease, or intestinal
problems. This drug should not be used by children under the age of 18 or by
pregnant o r breast-feeding women.
Possible side effects of warfarin include hemorrhage (severe bleeding), chest pain,
joint pain, headache, difficulty breathing, difficulty swallowing, or swelling. Other side
effects may include diarrhea, nausea, fever, hair loss, s kin inflammation, discolored
(purplish) toes, or gangrene. Excessive bleeding from a nosebleed, cut, puncture, or
unusual menstrual flow should be checked by a doctor.
Warfarin may react adversely with dozens of medications including over-the-counter

drugs such as aspirin, acetaminophen (Tylenol), and ibuprofen (Advil, Motrin). For this
reason, patients taking warfarin are usually advised to carry a drug identification card.
Foods that may diminish warfarin’s effectiveness are those rich in vitamin K such a s
leafy green vegetables, cauliflower, asparagus, fish, beef liver, and bacon. Patients
taking this drug should also avoid alcoholic beverages.
Brand Name:Coumadin

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Verapamil
Verapamil, prescription drug used to treat heart and circulatory conditions such as
angina pectoris, some forms of irregular heartbeat, and hypertension (high blood
pressure). It is also sometimes used to treat migraine headache. Verapamil works by
dilating blood vessels and slowing the heart rate, thereby reducing blood pressure and
relieving the chest pain associated with angina. Verapamil belongs to a group of
medications called calcium channel blockers.
Available in tablet and capsule form, this drug is usually prescribed in dosages ranging
from 180 to 480 mg per day, taken in three or four doses, with meals and at bedtime
with food. An extended-release form of verapamil is taken once a day; an injectable
solution is also available. E ffectiveness may not be apparent for two to four weeks.
Verapamil controls—but does not cure —cardiovascular problems, and it should be

taken as prescribed even after symptoms are relieved. Long-term therapy (months to
years) is not uncommon with this drug.
Patients with low blood pressure or irregular heartbeats should not use verapamil.
Patients with impaired liver or kidney function, congestive heart failure, or a history of
stroke should use this drug with caution. Its safety for use during pregnancy or in
children under the age of 12 has not been determined, and it does appear in breast
milk.
Possible side effects include dizziness or lightheadedness, fluid retention, constipation,

headache, nausea, skin rash, fatigue, abnormally low blood pressure, or s low
heartbeat. Other side effects sometimes observed are diarrhea, dry mouth, hair loss,
ringing in the ears, light sensitivity, sleepiness, impotence, or congestive heart failure.
An increase in angina attacks can occur if this medication is stopped abruptly.
Verapamil may interact adversely with a variety of drugs. These include other blood
pressure drugs (especially beta blockers and ACE inhibitors), aspirin, carbamazepine,
cimetidine, cyclosporine, digoxin, lithium, phenobarbital, phenytoin, rifampin,
theophylline, and various diuretics.
Brand Names:Calan, Isoptin, Verelan

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Terazosin
Terazosin , prescription drug used to treat high blood pressure, and in me n, prostate
gland enlargement. Terazosin dilates blood vessels, thereby lowering blood pressure.
It alleviates prostate problems by relaxing muscles in the urinary tract to relieve
problems of urine flow, which may include a frequent urge to urinate, painful
urination, and urinary tract infections.
Capsules are taken orally with or without food. The usual starting dose is 1 mg at
bedtime, which a doctor may increase to 5 or 10 mg if needed. The maximum daily
dose is 20 mg. Terazosin starts to work within one or two hours after taking it, but
initial effectiveness in controlling symptoms may not be apparent for several weeks.
Because terazosin controls rather than cures blood pressure, it should be taken
regularly, even when symptoms are relieved.
Patients with depression or untreated angina should not take this drug. It should be
used with caution by patients with impaired liver or kidney function, coronary artery
disease, or a history of stroke. Terazosin has not been proven safe for use in children
under the age of 12 or in pregnant or breast-feeding women.
Possible side effects include lightheadedness (especially upon standing), dizziness,

fainting, headache, stuffy nose, difficulty breathing, heart palpitations, nausea, muscle
weakness, fatigue, sweating, numbness, fluid retention, or blurred vision. Dizziness is
most likely to occur at the start of treatment or when the dosage is increased. At
these times, patients should avoid driving, operating dangerous machinery, or
engaging in other risk-related activities.
Terazosin may interact adversely with other blood pressure medications, especially
beta blockers, estrogens, and certain non-steroidal anti-inflammatory drugs such as
aspirin. Patients should also avoid alcohol use and tobacco smoking while taking t his
drug.
Brand Name:Hytrin

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Ramipril
Ramipril, drug used to control high blood pressure. It works by interfering with
angiotensin -converting enzymes (ACE) in the body, which influence salt and water
retention, to dilate arteries, reduce blood volume, and lower blood pressure.
Available by prescription in capsule form, ramipril works best when taken on an empty
stomach. Dosages range from 2.5 to 20 mg per day, taken in one or two doses.
Positive results are usually apparent after several weeks. Because ramipril controls
rather than cures high blood pressure, it must be taken regularly to be effective. Long-
term treatment over months or years is common.
Patients with liver disease or a history of severe allergic reactions should not take this
drug. It should be used with caution by patients with diabetes, impaired liver or kidney
function, heart disease, scleroderma, systemic lupus erythematosus, high potassium
levels, or low white blood cell levels. This drug should not be taken by pregnant
women, as it can harm the fetus, especially in the second and third trimesters. It is
also known to appear in breast milk. Ramipril has not been proven safe for use in
children.
Side effects may include headache, coughing, fatigue, nausea, vomiting,

lightheadedness, muscle pain, or light sensitivity. An allergic reaction to this drug,
characterized by facial swelling and difficulty swallowing or breathing, requires
immediate medical attention, as does any sore throat or fever that develops during
treatment.
Although ramipril may be prescribed in combination with certain diuretics, it can react
adversely with such drugs. It also may react with aspirin, lithium, cyclosporine, and
potassium supplements, including salt substitutes containing potassium. Ramipril
should not be combined with alcoholic beverages unless approved by a doctor.
Brand Name:Altace

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Phenytoin
Phenytoin or Dilantin, drug used to treat the seizures, or violent muscle contractions,
caused by epilepsy. The drug can also control seizures associated with surgery of the
brain or spinal cord. Phenytoin influences the m ovement of sodium along nerve fibers,
preventing or minimizing the abnormal electrical impulses that cause seizures.
Phenytoin is available by prescription in tablet, capsule, and liquid form. Taken orally,
except for one liquid form made for injection, the drug is usually prescribed in 100-mg
doses taken once a day. The maximum recommended daily dosage is 600 mg. To
avoid stomach irritation, oral phenytoin should be taken with food. The drug’s
effectiveness is usually apparent after two to three weeks of treatment.
Patients with impaired liver function, diabetes, or heart disease should use this drug
with caution. Although long-term use of phenytoin is common, it may be associated
with the development of cancers in the lymphatic system or the bone marrow
(leukemia). Pregnant women or those nursing an infant should not take this drug.
Children who take it should be monitored with particular care.
Possible side effects include decreased coordination, mental confusion, or slurred

speech. Other observed side effects include nausea, headache, fever, dizziness,
twitching, involuntary eye movement, joint pain, insomnia, impotence, bedwetting,
abnormal hair growth, skin rash, or change in urine color. An overdose of phenytoin
can be fatal. Abruptly stopping treatment can cause uninterrupted seizures that may
also be fatal.
Phenytoin may interact adversely with a variety of medications. These include, but are
not limited to, aspirin, certain tranquilizers, steroids, blood thinners, ulcer
medications, oral contraceptive s, estrogens, and antacids. Also included are the drugs
felbamate, furosemide, methylphenidate, phenobarbital, carbamazepine, diazepam,
doxycycline, sodium valproate, theophylline, and valproic acid. Users of phenytoin
should not drink alcoholic beverages.
Brand Name:Dilantin

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Ketorolac
Ketorolac, non-steroidal anti-inflammatory drug used in the short-term management
of severe, acute pain, as well as for the short-term treatment of itchy eyes caused by
seasonal allergies. Ketorolac relieves pain and reduces fever and inflammation by
blocking the production of prostaglandins (fatty acids in the body that regulate cell
activities). It is sometimes used with a n arcotic to provide better pain relief than either
drug alone can offer.
This drug is available by prescription only as an injectable liquid, in 10-mg tablets that
are taken orally, and as eyedrops. The initial, injectable dose is typically 30 mg or 60
mg, followed by 15-mg or 30-mg doses four times a day, four to six hours apart. The
injection is given within a muscle, with a maximum daily dose of 150 mg the first day
and 120 mg every day thereafter for no more than five days. Tablets are usually given
in doses of 10 mg every four to six hours, with a maximum daily dose of 40 mg for no
more than five days. The usual eyedrop dose is one drop (0.25 mg) four times a day
for up to a week. The effectiveness of all forms is usually apparent in 30 to 60
minutes.
Ketorolac should be used with caution by patients with known bleeding disorders or
sensitivities to other non-steroidal anti-inflammatory drugs as well as by patients with
a history of alcohol abuse, diabetes mellitus, edema, kidney or liver disease, lupus
erythematosus, asthma, colitis, heart disease, or high blood pressure. The safety of
this drug for pregnant or breast-feeding women or for children has not been
determined. The eyedrop solution should not be used by patients wearing contact
lenses. Abdominal or stomach pain, bruising at the site of injection, drowsiness,
indigestion, and nausea are the most common side effects of both the oral and
injected forms of the drug. Less common side effects are bloating or gas, burning or
pain at the injection site, constipation, diarrhea, dizziness, a feeling of fullness in the
abdominal or stomach area, headache, increased sweating, vomiting, edema, decrease
in urine output, renal failure, and gastrointestinal bleeding, ulceration, and perforation.
A temporary stinging and burning sensation in the eye is the most common side effect
of the eyedrop solution. Less common side effects are eye irritation, allergic reactions,
superficial eye infections, and superficial inflammation of the eye’s cornea.
Ketorolac may interact adversely with aspirin, acetaminophen, and other non-steroidal
anti-inflammatory agents, as well as with lithium, methotrexate, probenecid,
ketoprofen, nabumetone, naproxen, and oxaprozin. Use of ketorolac with blood-
thinning drugs, cefamandole, cefoperazone, cefotetan, heparin, moxalactam,
plicamycin, or valproic acid may increase risk of bleeding.
Brand Names:Acular, Toradol

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Glipizide
Glipizide, prescription drug used to treat diabetes in patients who are not dependent
on insulin injections. It is usually prescribed in conjunction with a specialized diet and
an exercise plan. Glipizide works by stimulating the pancreas to secrete more insulin
and by helping body tissues to use the insulin more effectively.
Tablets are taken orally with a morning meal. The starting dose is 5 mg, but
depending on the patient’s response, a physician may slowly increase the dosage to as
much as 40 mg a day. Effectiveness is usually apparent after one to two weeks of
treatment. With long-term use (months to years), the drug’s effectiveness may
diminish.
Patients with heart disorders, impaired kidney or liver function, or peptic ulcer should
use glipizide with caution. It should not be used by patients with diabetic ketoacidosis
(an excessive level of acid in the blood). Glipizide has not been proven safe for use in
children or in pregnant or nursing women.
Potential side effects may include headache, dizziness, light sensitivity, nausea,
stomach pain, skin rash, anemia, drowsiness, or low blood sugar (hypoglycemia).
Patients taking glipizide should be aware that the symptoms of hypoglycemia include
blurred vision, rapid heartbeat, shallow breathing, sweating, disorientation, or
seizures, and that severe hypoglycemia requires immediate medical care.
Glipizide can interact adversely with a variety of drugs. These include, but are not
limited to, aspirin, antacids, certain heart medications (beta blockers and calcium
channel blocke rs), tranquilizers, thyroid medications, birth control pills, estrogens,
sulfa drugs, corticoids, and antidepressants known as MAO inhibitors. Patients taking
glipizide should avoid alcoholic beverages.
Brand Name:Glucotrol

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Enalapril
Enalapril, prescription drug used to control high blood pressure and sometimes to treat
congestive heart failure, an inability of the heart to pump sufficient blood. Enalapril is
classified with a group of drugs known as ACE inhibitors that work by interfering with
angiotensin -converting enzymes (ACE) in the body, which control salt and water
retention. The result is relaxed arterial walls and lower blood pressure.
Tablets are taken orally, with or without food, in dosages ranging from 2.5 to 40 mg
per day, in one or two doses. Effectiveness is usually apparent after several weeks of
treatment. Long-term treatment with this drug (months or years) is common.
Patients with kidney d isease or impaired kidney function should use enalapril with
caution. Combining enalapril with exercise or exposure to excessive heat may cause
dehydration. This drug should not be taken by pregnant women as it can harm the
fetus, especially in the second and third trimesters. It is also known to appear in
breast milk. It has not been proven safe for use in children.
Enalapril can cause a wide variety of side effects, including an allergic reaction known
as angiodema (facial swelling with difficulty in swallowing or breathing). It also may
cause chest pain, abdominal pain, nausea, blurred vision, dizziness, headache, hair
loss, excessive sweating, skin rash or itching, hives, rapid heartbeat, sensitivity to
light, muscle cramps or weakness, breast enlargement (in males), impotence, dry
mouth or eyes, loss of appetite, depression, or abnormally low blood pressure.
Although enalapril may be prescribed in combination with certain diuretics (drugs that
remove excess water from the body), it may react adversely with such drugs. It may
also react adversely with aspirin and with potassium supplements, including salt
substitutes that contain potassium.
Brand Names:Vasotec, Vaseretic

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Cimetidine
Cimetidine, drug used in the treatment of stomach and intestinal ulcers. It is used to
treat reflux disease, a condition in which stomach acids back up into the esophagus
causing heartburn, and to prevent upper abdominal bleeding. Cimetidine is also used
to treat chronic hives, acne, herpes infections (including shingles), excessive hair
growth in women, and an overactive parathyroid gland.
Cimetidine blocks the action of histamine, a chemical in the body that stimulates acid
secretions in the stomach. When histamine action is blocked, secretion of stomach
acid decreases, allowing ulcers and other gastrointestinal ailments to heal.
This drug is available by prescription in tablet and liquid form, both taken orally, and
in a liquid form that is injected. Depending on the condition being treated, typical
dosages range from 800 to 1200 mg per day. Cimetidine may be taken in a single
dose at bedtime or divided into two or four smaller doses, usually taken immediately
after a meal. Relief of symptoms may take several days. Recurrence of ulcers after
cimetidine treatment ends may be slightly higher than with other forms of treatment.
Patients taking this drug should avoid alcohol, cigarette smoking, and excessive
caffeine. Patients should refrain from taking antacids within one to two hours of a
cimetidine dose. This drug has not been proven safe for pregnant or nursing women or
for children under the age of 16. It should be used with caution by patients with
impaired liver or kidney function. It should not be stopped abruptly by patients taking
it for peptic ulcer disease.
Breast development in men and headaches are the two most common side effects of
this drug. Less common side effects are diarrhea, dizziness, anemia, hair loss,
impotence, joint or muscle pain, skin rash or inflammation, rapid or slow heartbeat,
and sleepiness. With prolonged use (one month or more), some patients experience
anxiety, confusion, depression, or hallucinations. These reactions are more likely to
occur in elderly or severely ill patients, but they are temporary and subside several
days after drug treatment ends.
Cimetidine may interact adversely with a variety of drugs, including medications for
diabetes, heart palpitations, and fungal infections as well as blood pressure drugs
(both beta blockers and calcium blockers), benzodiazepine tranquilizers (such as
diazepam), narcotic pain relievers, nicotine, and aspirin. Other drugs that may interact
adversely include chlorpromazine, cyclosporine, digoxin, metoclopramide,
metronidazole, paroxetine, pentoxifylline, phenytoin, quinine, sucralfate, theophylline,
and warfarin.
Brand Name:Tagamet

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Divalproex
Divalproex, also known as valproic acid, drug used to treat seizures, such as those
associated with epilepsy. It is also sometimes used to treat migraine headaches.
Divalproex works by increasing the availability of certain chemicals needed for nerve
transmission, suppressing the abnormal electrical discharges that cause seizures.
Available in tablet form, this drug is prescribed in amounts based on body weight. The
typical starting dose is 15 mg per kg (2.2 lb), which is increased as needed (to a
maximum of 60 mg per kg) to control symptoms. The usual daily dosage ranges from
1000 to 1600 mg, which is divided into several smaller doses. The drug should be
taken one hour before a meal but may be taken with food to avoid stomach upset.
Effectiveness in controlling seizures is usually seen within two weeks of treatment.
Patients with impaired liver function or a bleeding disorder should not take divalproex.
This drug can cause liver damage, especially when used in children under the age of
two. (Symptoms of liver impairment may include dizziness, drowsiness, facial swelling,
muscle weakness, loss of appetite, vomiting, yellowing skin or eyes, and loss of
seizure control.) Pregnant or nursing women should not use this drug. Divalproex
should not be stopped abruptly, as continuous seizures may result. This drug slows
blood clotting, which may result in excessive bleeding during injury, surgery, or dental
procedures.
Possible side effects include indigestion, nausea, and vomiting. Some patients
experience drowsiness and, as a result , should not drive, operate dangerous
machinery, or engage in other risk-related activities. Other possible side effects
include abdominal cramps, fever, double vision, constipation, behavior changes,
itching, fluid retention, skin rash, tremors, or weight gain.
Divalproex may interact adversely with aspirin, antihistamines, sleep aids,

tranquilizers, blood thinners, and birth control pills. It also may interact with
erythromycin, isoniazid, and other seizure medications, such as carbamazepine and
phenytoin . Divalproex should not be combined with alcohol.
Brand Name: Depatoke

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Captopril
Captopril, drug typically used to control high blood pressure. It is also used to treat
congestive heart failure, heart attacks, and kidney disease in diabetic patients.
Captopril is classified as an ACE inhibitor. It works by interfering with angiotensin -
converting enzymes (ACE) in the body, which influence salt and water rete ntion. The
result is relaxed artery walls and lowered blood pressure.
Captopril should be taken one hour before a meal. Tablets are taken orally two or
three times a day in doses ranging from 25 to 150 mg. Patients are often started on a
small dosage, which is increased as needed. Captopril must be taken regularly to be
effective, even after symptoms are relieved, which usually takes several weeks. Long-
term use of this drug for months or years is not uncommon.
Patients with kidney disease or impaired kidney function should use captopril with
caution. Exercise or other physical activity should be approved by a doctor. This drug
should not be taken by pregnant women, as it can harm the fetus, especially in the
second and third trimesters. Breast-feeding women should be aware that captopril is
known to appear in breast milk. Captopril has not been proven safe for children.
Possible side effects include itching, skin rash, loss of taste, and extremely low blood
pressure. Less common side effects include blurred vision, confusion, light-
headedness, constipation, depression, fatigue, muscle pain or weakness, light
sensitivity, nausea, peptic ulcer, sleepiness, fainting, wheezing stroke, or heart failure.
A reaction that includes chest pain, sweating, vomiting, diarrhea, or swelling of the
arms, legs, mouth, or throat (including difficulty swallowing) requires immediate
medical attention. Yellowing of the skin or eyes may indicate a liver problem, which
also requires immediate medical care.
Although captopril may be prescribed in combination with a diuretic or digitalis (found

in the drug digoxin), it can react adversely with these drugs. It also may react
adversely with aspirin, certain blood pressure medications such as beta blockers,
lithium, nitroglycerin, anti-inflammatory medications, and potassium supplements
(including salt substitutes that contain potassium).
Brand Names:Capoten, Capozide

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Lovastatin
Lovastatin , drug used to reduce high blood cholesterol levels and slow the progression
of coronary atherosclerosis, or hardening of the heart’s arteries. Lovastatin interferes
with an enzyme in the liver responsible for making cholesterol, a fatlike substance that
can both harden and clog the arteries. This drug reduces low-density lipoproteins
(LDL), the type of cholesterol that increases the risk of coronary heart disease, and
increases high-density lipoproteins (HDL), the type of cholesterol thought to reduce
the risk of heart disease.
Available by prescription only, this drug is dispensed in 10-mg, 20-mg, and 40-mg
tablets, which are taken orally. The initial adult dosage is 20 mg taken once a day,
after which the dosage may be increased up to 40 mg twice a day. The maximum
dosage should not exceed 80 mg daily. Effectiveness should be apparent within two
weeks.
This drug should be taken with food, preferably with evening meals. It should not be
used by persons who have had an allergic reaction to lovastatin; persons with active
liver disease or active peptic ulcers; or pregnant or breast-feeding women. It should
be used with caution by persons with reduced liver function and habitual users of
alcohol. The safety and effectiveness of lovastatin for people under the a ge of 20 have
not been established. Driving and other risk-related activities should be restricted if
dizziness and blurred vision occur while taking this drug.
Common side effects of lovastatin include constipation, diarrhea, dizziness, gas,

headache, heartburn, nausea, skin rash, and stomach pain. Less common side effects
are blurred vision, fever, muscle aches or cramps, severe stomach pain, and unusual
tiredness or weakness. Long-term use of this drug may result in abnormal liver
function tests.
Lovasta tin may interact adversely with certain drugs including clofibrate, cyclosporine,
erythromycin and other macrolide antibiotics such as asithromycin and clarithromycin,
gemfibrozil, niacin, and warfarin.
Brand Name:Mevacor

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Simvastatin
Simvastatin, drug used to lower cholesterol levels. It is typically prescribed by a
physician when dietary changes, weight loss, and exercise are not effective in reducing
cholesterol. Simvastatin works by blocking the liver enzyme that controls the
production of cholesterol. It is primarily effective against low-density lipoproteins
(LDL), the form of cholesterol associated with increased risk of coronary heart disease.
Tablets are taken with or without food, usually at bedtime. The typical dosage ranges
between 5 and 40 mg per day. Effectiveness is usually apparent after four to six
weeks of treatment. Simvastatin is usually prescribed in combination with a
cholesterol-lowering diet.
This drug should not be taken by patients with liver disease, by pregnant or nursing
women, or by young people under the age of 20. Patients with impaired liver function,
muscular disorders, cataracts, or a history of alcohol abuse should use this d rug with
caution.
Possible side effects of this drug include headache, stomach pain, nausea, diarrhea,
constipation, gas, muscle weakness, or lowered blood pressure. Other side effects
sometimes observed are muscle pain, skin rash, impaired vision, or hepatitis.
Simvastatin may interact adversely with the drugs cholestyramine, cimetidine,
clofibrate, cyclosporine, erythromycin, gemfibrozil, digoxin, ketoconazole, nicotinic
acid, warfarin, and spironolactone.
Brand Name:Zocor

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Levothyroxine
Levothyroxine, drug used in the treatment of thyroid deficiency. It is also used to treat
an enlarged thyroid gland (goiter) and thyroid cancer. Levothyroxine is a synthetic
thyroid hormone that increases the body’s metabolism (rate at which the body burns
calories and runs vital processes).
This drug is available by prescription only, in tablets and an injectable liquid. The
typical oral dosage for adults is 50 to 100 micro grams (one millionth of a gram) taken
once a day and continued for life. Children often require a higher dosage and adults
over 60 years old a lower dosage. The drug is effective within 48 hours, although full
effects may not be felt for several weeks. Injections are used for adults suffering from
myxedema coma, a condition that results from thyroid deficiency, and for infants with
cretinism, a condition marked by arrested physical and mental development due to
insufficient thyroid secretions.
Levothyroxine should be used with caution by patients with cardiovascular disease,

including high blood pressure, and diabetes. It should not be used by patients
suffering from heart attack, or thyrotoxicosis, a condition caused by excessive
amounts of the natural thyroid hormone. Levothyroxine may be used during
pregnancy but should be used with caution by breast-feeding mothers. Patients
sensitive to lactose may not tolerate this drug because lactose is used in its
manufacture.
Side effects from levothyroxine are rare and usually due to overdosage, which causes
thyroid overactivity. Symptoms of overdose include anxiety, agitation, diarrhea,
weight loss or gain, sweating, flushed skin, tiredness, heart palpitations, or chest pain.
Levothyroxine may increase the effect o f oral blood-thinning drugs and may increase
the requirements for insulin or oral antidiabetic drugs. Its absorption may be reduced
by cholestyramine and colestipol.
In 1996 the Wall Street Journal exposed a controversy surrounding Synthroid, a

brand-name version of levothyroxine. This controversy culminated in a class-action
lawsuit brought against the manufacturers of Synthroid by users of the drug. The
drug’s users charged the manufacturer with suppressing research indicating that less
expensive generic versions of levothyroxine are biologically equivalent to the brand-
name versions. In August 1997 the manufacturer agreed to pay participants in the
class-action lawsuit $98 million, but never admitted any wrongdoing.
Brand Names: Levothroid, Levoxine, Synthroid

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Astemizole
Astemizole, antihistamine drug that is used to treat hay fever and recurring hives. It
works by blocking the action of histamine (a chemical released by the body during
allergic reactions) that contributes to swelling and itching of the nose, eyes, and skin.
Astemizole is available only by prescription. It comes in tablet form and is taken orally
on an empty stomach (one hour before or two hours after a meal). The typical dosage
for adults and children over age 12 is 10 mg once a day. It has not been proven safe
for children under age 12. The drug starts to be effective within one hour of treatment.
Astemizole is often prescribed for use over several weeks. It helps control the
appearance of hives and hay fever symptoms but does not provide immediate relief.
Patients should not take more than a single, prescribed dose—even if symptoms are
severe or a dose was missed—because overdose reactions are severe and may include
fainting, irregular heartbeat, seizures, or cardiac arrest.
Possible side effects include drowsiness, dry mouth or throat, fatigue, headache, or
increased appetite. Less common are depression, diarrhea, dizziness, itching or
tingling, joint or muscle pain, nervousness, nausea, nosebleed, skin rash, or sore
throat. Patients with asthma, liver disease, or kidney disease should use this drug with
caution. Astemizole may interact adversely with certain types of drugs, including
antibiotics, antifungal drugs (especially ketoconazole), and drugs that affect heart
rhythms. Its safety during pregnancy and nursing is not known.
In 1998 the Food and Drug Administration (FDA) issued an alert warning that
astemizole can cause death due to irregular heart rhythms if taken with certain other
drugs or used at higher than recommended doses. The FDA cautioned that in addition
to those drugs previously known to have adverse interactions with astemizole, several
other drugs should be avoided by those taking astemizole. These include the
antidepressants fluoxetine (marketed under the brand name Prozac), fluvoxamine
(Luvox), setraline (Zoloft), nefazodone (Serzone), and paroxetine (Paxil); the AIDS
drugs known as protease inhibitors; and the anti-asthma medication zileuton (Zyflo).
The FDA also warned against drinking grapefruit juice while taking astemizole,
because grapefruit juice slows down the metabolism of astemizole by the liver.
Brand Name: Hismanal

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Cromolyn Sodium
Cromolyn Sodium or Intal, drug used to treat respiratory problems such as hay fever
and asthma. Classified as an antiasthmatic, it works by interfering with the chemical
reactions that constrict muscles in the bronchi, the two branches that connect the
trachea or windpipe to the lungs. It also prevents the swelling and itching associated
with allergic reactions.
Cromolyn sodium is available only by prescription. It comes in several forms, including

capsules (taken orally), liquid (inhaled orally or sprayed into the nose), or powder,
which is packaged in capsules or cartridges for inhalation or spraying into the nose.
Dosages vary widely depending on the form prescribed, although most are taken four
to six times per day.
Unlike asthma medications that provide immediate relief from respiratory difficulties,
cromolyn sodium helps to control and prevent symptoms. Effectiveness in preventing
asthma attacks is usually achieved after four to six weeks of treatment.
Patients with impaired liver or kidney function should avoid taking this drug or should
use it with caution. Its safety for use during pregnancy or while nursing is not known.
Cromolyn sodium may be especially effective for controlling asthma in young patients.
Children over age five can safely take most forms of this drug.
Possible side effects include coughing, nasal congestion, sneezing, throat irritation,
nausea, or wheezing. Sometimes seen are facial swelling, difficulty swallowin g,
headache, dizziness, joint pain, nosebleed, skin rash, frequent urination, or swollen
glands. Cromolyn sodium may be taken safely with most other drugs, including
bronchodilators used to provide immediate relief from asthma attacks.
Brand Names:Intal, Nasalcrom, Gastrorom

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Clonazepam
Clonazepam or Klonopin, anticonvulsant drug used to treat epilepsy. It is also
sometimes used for panic disorders, Tourette’s syndrome (a movement disorder), and
depression. Classified in a group of drugs known as benzodiazepines, clonazepam
works by increasing the action of certain chemicals needed for nerve transmission,
which has the effect of blocking seizures.
Clonazepam must be prescribed by a doctor. Available in tablet form, clonazepam is

taken orally three times a day, with or without food. Starting adult doses range from
0.5 to 1.5 mg, which may be increased, as needed, under a doctor’s supervision. The
maximum daily dosage is 20 mg. Children may safely take this drug, although dosages
are determined by body weight. Effectiveness of this drug may not be seen for several
weeks, and dosage adjustments for optimum effectiveness may require several
months.
Side effects may include drowsiness, behavior changes, or lack of coordination. Also
sometimes seen are anemia, constipation, diarrhea, double vision, hair loss, fever,
insomnia, appetite changes, memory loss, confusion, difficult urination, skin rash,
twitching, or weig ht gain. If treatment with this drug is stopped suddenly (which is not
recommended), withdrawal symptoms may include muscle cramps, restlessness,
tremors, convulsions, or hallucinations.
Patients with severe liver disease or with acute narrow-angle glaucoma, an eye
disorder, should not take this drug. Its safety for use during pregnancy has not been
adequately studied, but it is known to appear in breast milk. Patients who experience
drowsiness with this drug should not drive, operate dangerous machinery, o r engage
in other risk-related behavior. Clonazepam should not be combined with alcohol. It
may also interact adversely with various kinds of drugs, including antidepressants,
tranquilizers, sedatives, narcotic pain relievers, barbiturates, antianxiety dru gs, and
other anticonvulsants. In addition, it may become habit -forming and may lose its
effectiveness over time.
Brand Name:Klonopin

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Zolpidem
Zolpidem, prescription drug used to treat insomnia. Zolpidem works by affecting
certain brain sites that influence sleep patterns and control the onset of sleep.
Tablets are taken orally, without food, at bedtime. The usual dosage is 10 mg each
night for up to ten nights. Longer treatment is not usually recommended because the
drug becomes less effective over time and can cause the patient to become dependent
on ever-increasing doses. Zolpidem begins to work within one hour of ingestion to
induce sleep.
Patients with impaired liver or kidney function, depression, or a history of excessive

alcohol or drug use should take zolpidem with caution. It should not be used by
children under the age of 18 or by pregnant or breast-feeding women. When
treatment is discontinued, some patients experience a recurrence of insomnia.
Dizziness or drowsiness the day after taking zolpidem are possible side effects,
especially when beginning treatment. Patients who experience a loss of mental clarity
should avoid driving, operating dangerous machinery, or engaging in other risk-related
activities. Other possible side effects may include nausea, diarrhea, blurred vision, skin
rash, tremors, memory loss, or abnormal thoughts or behavior. Withdrawal symptoms,
such as vomiting or cramps, may occur if treatment is stopped abruptly.
Zolpidem may interact adversely with drugs that affect the central nervous system
such as narcotics, tranquilizers, and antidepressants. It should not be combined with
Brand Name:Ambien

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Venlafaxine
Venlafaxine, prescription drug used to treat mental depression. Classified as a
antidepressant, it works by interfering with the action of serotonin and dopamine,
chemicals associated with nerve impulse transmission in the central nervous system.
Tablets are taken orally, with or without food, in dosages starting at 75 mg per day,
usually divided into several small doses. If necessary, a doctor may prescribe a d osage
as high as 225 mg per day. Effectiveness is usually apparent within two weeks of
beginning treatment.
Patients with impaired liver or kidney function, high blood pressure, heart disease, or a
history of seizures should use this drug with caution. Children under the age of 18
should not use venlafaxine. Its safety for pregnant or breast-feeding women is not
known.
A variety of possible side effects are associated with venlafaxine, including nausea,
diarrhea, dry mouth, sweating, dizziness, blurred vision, weight loss, sleepiness, or
increased blood pressure.
Venlafaxine may have serious, sometimes fatal, interactions with another group of
antidepressants known as monoamine oxidase (MAO) inhibitors. These drugs, such as
phenelzine and tranylcypromine, should be discontinued at least two weeks before
starting treatment with venlafaxine. Other drug groups that may have adverse
interactions with venlafaxine include tranquilizers, narcotic pain relievers, sleep aids,
and cimetidine
Brand Name:Effexor

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Trimethoprim
Trimethoprim, antibacterial drug used to treat infections, especially of the urinary tract
and eye. It is also available in combination with sulfamethoxazole to treat ear
infections, pneumonia, bronchitis, and traveler’s diarrhea. Trimethoprim works by
interfering with protein formation in the invading bacteria, thereby limiting their ability
to grow and multiply.
Available by prescription only, this drug is taken orally in tablet form, with or without
food. The usual oral dosage is 100 mg every 12 hours and the maximum
recommended dosage is 640 mg per day. One liquid form is made for injection and
another for eyedrops. Eyedrops are applied as a single drop every three hours up to
six drops per day. Effectiveness is usually apparent after one week, although the
prescribed treatment typically lasts 10 to 14 days.
Patients with anemia, impaired liver or kidney function, or folic acid deficiency should
avoid this drug or use it with caution. Pregnant or breast-feeding women should also
avoid using this drug. Trimethoprim can be used for children and infants over two
months old, with dosages based on body weight.
Possible side effects may include skin rash or itching, headache, sore mouth, loss of
appetite, nausea, diarrhea, vomiting, abdominal cramps, or increased blood
potassium. Some infections can develop resistance to this drug and may require other
forms of treatment. Trimethoprim can interact adversely with amantadine,
cyclosporine, dapsone, phenytoin, procainamide, rifampin, and cholestyramine.
Brand Names:Bactrim, Septra

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Tramadol
Tramadol, prescription drug used to treat moderate to severe pain including pain
following surgery or dental procedures, back or joint pain, or pain associated with
cancer. Tramadol is classified as an analgesic. It produces a pain -killing effect by
interfering with the action of chemicals called neurotransmitters that are vital for
nerve transmission.
Tablets are taken orally as needed for pain. They may be taken with or without food in
doses ranging from 50 to 100 mg. The maximum recommended dosage is 400 mg per
day. Effectiveness is usually apparent within one hour.
People with seizure disorders or impaired liver or kidney function should use this drug
with caution. Its safety for children under the age of 16, or for pregnant or breast-
feeding women has not been determined.
Possible side effects include dizziness or drowsiness. For this reason, people taking
this drug should not drive, operate dangerous machinery, or engage in other risk-
related activities. Other possible side effects include nausea, constipation, vomiting,
sweating, diarrhea, or dry mouth. An overdose can cause breathing difficulties or
seizures.
Tramadol may interact adversely with carbamazepine, quinidine, and drugs that
depress the central nervous system such as tranquilizers, sedatives, and monoamine
oxidase (MAD) inhibitors. In addition, tramadol should not be combined with alcoholic
beverages.
Brand Name:Ultram

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Triamcinolone
Triamcinolone, steroid drug used to treat breathing problems associated with such
disorders as hay fever and asthma. Triamcinolone works by keeping open the
bronchial tubes (the two divisions of the windpipe leading into the lungs) and reducing
inflammation in the mucous tissues of the respiratory tract. It is also effective in
treating inflamed areas of the skin as well as growths (polyps) inside the nose.
This drug is available by prescription only in several forms, including an oral inhalant,
tablets, cream and ointment forms applied topically, and a liquid form that is injected.
Triamcinolone is usually prescribed for adults in 2 inhalations, two to three times a
day, with a maximum of 16 inhalations per day. The tablet dosage ranges from 4 to
48 mg per day. Tablets may be taken with food to avoid stomach upset. Children 6 to
12 years old can use this drug, although prescribed dosages are usually smaller.
Effectiveness is typically apparent within one to two weeks of treatment.
Triamcinolone does not provide immediate relief from respiratory difficulties, but helps
alleviate symptoms. Long-term treatment with this drug (months to years) is
sometimes prescribed to control asthma.
Possible side effects may include a dry mouth or throat, fluid retention, hoarseness,
wheezing, skin rash, headache, memory loss, weight loss, nasal irritation or
congestion, nosebleed, sneezing, or fungal infections in the mouth or throat.
Patients with bronchitis or a systemic fungal infection should not use this drug. It
should be used with caution by patients with diabetes, glaucoma (an eye disorder),
peptic ulcer, myasthenia gravis (muscle weakness), or a history of tuberculosis. Its
safety for pregnant or breast-feeding women has not been adequately studied.
Unvaccinated patients taking triamcinolone should avoid exposure to chicken pox and
measles.
This drug may interact adversely with bronchodilators (both inhaled and tablet forms),
warfarin, diabetes drugs (including insulin), digoxin, phenytoin, carbamazepine, and
primidone. Treatment with triamcinolone should not be stopped abruptly because it
may trigger a dangerous imbalance in the body’s endocrine system.
Brand Names:Azmacort, Nasacort

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Tretinoin
Tretinoin, prescription drug used to treat moderate acne and sun-damaged skin. A
naturally occurring derivative of vitamin A, tretinoin works by interfering with the
ability of skin cells to form pimples. It also speeds the growth of new skin cells, which
aids in healing acne and reduces sun-related conditions like fine wrinkling and rough,
mottled skin.
Tretinoin is also the first in a new class of cancer drugs known as differentiating
agents. It is taken in oral form as a chemotherapeutic agent against acute
promyelocytic leukemia (cancer of the blood-forming tissues). Taken orally, it has also
shown promise improving AIDS-related Kaposi’s sarcoma, a cancer that begins on the
skin and spreads to the internal organs.
Tretinoin is available in a gel, cream, and solution. It is applied to the skin, usually
once a day at bedtime. About 20 to 30 minutes before application the skin should be
cleansed with a mild soap and patted dry. Hands should be washed immediately after
application. Effectiveness is usually apparent after two to three weeks of treatment,
although maximum improvement may take several months.
Patients with sensitive skin or eczema (inflamed, crusty skin) should use this drug with
caution. It should not come in contact with the eyes, mouth, or mucous me mbranes of
the nose. The gel form of this drug is flammable and should be kept away from heat or
open flames.
Possible side effects may include sun sensitivity, excessive redness or peeling of the
skin, temporary worsening of acne, darkening or lightening of skin color, or a
sensation of heat or stinging when the drug is applied.
Tretinoin may interact adversely with other skin medications, especially those
containing sulfur, salicylic acid, or resorcinol, as well as with medicated soaps,
astringents, and s kin products containing alcohol, citrus scents, or spices.
Brand Names:Retin-A, Renoval, Vesanoid

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Timolol Maleate
Timolol Maleate, prescription drug used to treat glaucoma, an eye disorder
characterized by pressure within and hardening of the eyeball. It is also used to treat
migraine headaches and certain heart conditions. Timolol maleate interacts with the
sympathetic nervous system to reduce the formatio n of excess fluid in the eyeball. It
also slows the heart rate and relaxes blood vessel walls.
This drug is available in liquid form, administered as one eyedrop every 12 to 24

hours. The tablet form is taken orally, preferably an hour before meals, and the typical
dosage is 10 to 20 mg twice a day. Effectiveness is usually apparent after one to two
weeks, although maximum improvement may take one to two months. Long-term
treatment with this drug (months to years) is not uncommon, but periodic evaluations
by a doctor are recommended.
Patients with asthma, lung disease, or certain heart disorders should not use this drug.
It should be used with caution by patients with diabetes, hay fever or other allergies,
impaired liver or kidney function, low blood sugar, an overactive thyroid gland,
myasthenia gravis (muscle weakness), or emphysema (lung disease characterized by
labored breathing). Timolol maleate has not been proven safe for children under the
age of 12 or pregnant women. It is known to appear in breast milk and may adversely
affect a nursing infant.
Possible side effects may include headache, dizziness, diarrhea, nausea, vomiting,
shortness of breath, hair loss, muscle weakness, tingling or numbness, chest pain, or
impotence. Symptoms of an overdose may include wheezing, low blood pressure, or
heart failure.
This drug may interact adversely with various heart medications, as well as
epinephrine, monoamine oxidase (MAO) inhibitors, insulin and other diabetes drugs,
chlorpromazine, cimetidine, theophylline, and nonprescription nasal decongestants.
Treatment with this drug should not be stopped abruptly, especially in patients with
heart disorders.
Brand Names: Timoptic, Blocadren, Timolide

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Theophylline
Theophylline, prescription drug used to treat asthma, a chronic disease of the
respiratory system. It is also used to treat asthmalike symptoms in patients with
emphysema, chronic bronchitis, and pulmonary (lung) disease. Theophylline is
sometimes used to treat breathing problems in infants at risk for sudden infant death
syndrome (SIDS). As a bronchodilator, the drug works by relaxing constricted muscles
of the lung’s bronchi, the two branches of the trachea (w indpipe) that lead to the
lungs. It also opens blood vessels in the lungs, improving circulation.
Theophylline is available in capsule, tablet, and liquid form. All are taken orally,
usually with food to prevent stomach irritation. Dosage in children under the age of 16
is based on body weight. Adult dosages usually start at 200 mg taken twice a day,
which may be increased if needed. The maximum adult dose is 900 mg per day.
Effectiveness is usually apparent within 48 to 72 hours.
Patients with peptic ulcers, seizure disorders, impaired liver or kidney function, high
blood pressure, irregular heartbeat, or heart disease should use this drug with caution.
Theophylline should not be used by breast-feeding women and should be avoided
during pregnancy.
Side effects may include nausea or restlessness, especially when starting treatment
with theophylline. Other possible side effects are diarrhea, headache, increased
urination, insomnia, low blood pressure, or skin rash. Changes in heart rate, another
possible side effect, should be checked by a doctor. Symptoms of overdose can include
the side effects described above or more severe effects including high fever,
convulsions, or coma.
Theophylline may interact adversely with the medication in a flu shot. It also may
interact with cimetidine, ciprofloxacin, clarithromycin, doxycycline, erythromycin,
phenytoin, propanolol, and birth control pills.
Brand Names:Slo-bid, Theo-dur

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Tetracycline
Tetracycline, drug used to treat various bacterial infections, including urinary tract
infections, Rocky Mountain spotted fever, trachoma (a chronic eye infection), and
gonorrhea. Tetracycline is also sometimes used to treat early stages of Lyme disease,
acne, gum disease, and certain gastrointestinal ulcers. It works by interfering with the
invading bacteria’s ability to form essential proteins, thereby halting their growth.
Tetracycline is available by prescription in capsule form, taken orally, and in a

reconstituted powder solution, applied topically. Typical capsule dosages range from 1
to 2 g per day, taken in one to four doses, with a recommended maximum of 4 g per
day. Unless this drug causes stomach upset, it should be taken on a n empty stomach
(one hour before or two hours after a meal) with a full glass of water. It should not be
combined with milk or other dairy products. Tetracycline usually relieves symptoms
after 48 hours of treatment, but it should be taken for the prescrib ed length of time to
avoid recurrence of infection.
Patients with severe liver disease or pregnant or breast-feeding women should not
take this drug. Patients with impaired liver or kidney function or with systemic lupus
erythematosus should use tetracycline with caution.
Possible side effects include diarrhea, nausea, vomiting, skin rash, itching, light
sensitivity, facial swelling, headache, blurred vision, chest pain, sore throat, difficulty
swallowing, or in infants, a bulging soft spot on the head. Children may develop
discolored teeth with long-term use.
Tetracycline may interact adversely with antacids and other common gastrointestinal
medications, oral contraceptives, blood thinners, lithium, penicillin, isotretinoin,
cholestyramine, and sucralfate.
Brand Names:Achromycin V, Topicycline.

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Fexofenadine
Fexofenadine, prescription drug used primarily to treat hay fever, also effective
against hives and cold symptoms.
As an antihistamine, fexofenadine works by blocking the action of histamine, a

chemical released during allergic reactions that contributes to swelling and itching of
mucous membranes in the nose, eyes, and throat. Tablets of fexofenadine are ta ken
orally, preferably with food to avoid stomach irritation. The typical dose is 60 mg
taken twice a day. Effectiveness is usually apparent within one hour.
Fexofenadine should be used with caution in patients with hypertension, diabetes

mellitus, ischemic heart disease, increased intraocular pressure, hyperthyroidism,
renal impairment, or prostatic hypertrophy. This drug should not be used by breast-
feeding women or children under the age of 12. Its safety for use during pregnancy
has not been determined.
Possible side effects include headache, insomnia, cold or flu, nausea, fatigue,
indigestion, and menstrual pain. Unlike many other antihistamines, fexofenadine
causes little or no drowsiness. Symptoms of overdose may include fainting, confusion,
irregular heartbeat, or seizures.
Brand Name:Allegra
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Terconazole
Terconazole or Terazol 3 , prescription drug used to eliminate fungus infections of the
vulva and vagina caused by candida, a yeastlike fungus. Terconazole works by altering
the cell membranes of the invading fungus, preventing its reproduction and growth.
This drug is available as a cream or in a suppository form inserted into the vagina with
a reusable applicator. The dose is generally 5 g (one suppository or one applicator full
of cream) at bedtime for 3 consecutive nights. Treatment can continue during a
menstrual period, although patients should not use tampons until treatment ends.
Patients should avoid sexual intercourse during treatment or use birth control that
does not involve latex products such as diaphragms or latex condoms, which can
interact with terconazole. A non-latex condom will help reduce the chance of
reinfection. This drug has not b een proven safe for use in children or in pregnant or
breast-feeding women.
Possible side effects may include genital pain and burning sensations, body pain,
headache, fever, or chills. Terconazole is generally considered safe in combination with
other medications.
Brand Name:Terazol 3

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Temazepam
Temazepam, drug used to treat insomnia. Temazepam works by increasing the action
of certain neurotransmitters, brain chemicals needed for nerve transmission. As a
result, nerve activity to certain parts of the brain is blocked, producing a calming
effect. Temazepam also tends to relax muscles as it helps the patient go to sleep.
Available only by prescription, temazepam is taken orally in capsule form at bedtime,
usually in a 15-mg dose. Effectiveness is usually apparent within one hour. Treatment
with this drug is usually short-term (a few days or weeks). Persistent insomnia may
require other forms of treatment.
Patients with impaired liver or kidney function or with severe depression should use
this drug with caution. Temazepam should not be used by pregnant or breast-feeding
women, or by young people under the age of 18. With long-term use (more than a few
weeks), temazepam can both lose its effectiveness and become addictive. When
treatment is stopped, some patients experience a recurrence of insomnia that lasts for
one or two nights.
Dizziness or drowsiness the next day are two possible side effects of temazepam,
especially when starting treatment. Patients who experience a lack of mental clarity
should avoid driving, operating dangerous machinery, or engaging in risk-related
activities. Other possible side effects include fatigue, headache, nervousness, or
nausea. Also observed in some patients are sweating, blurred vision, depression,
diarrhea, increased dreaming, restlessness, tremors, or hallucinations. Abruptly
stopping treatment can cause muscle cramps, convulsions, tremors, or vomiting. An
overdose can cause l ow blood pressure, difficulty in breathing, confusion, seizures, or
coma.
Temazepam may interact adversely with various drugs, including antidepressants,

antihistamines, tranquilizers, narcotics, barbiturates, and oral contraceptives. In
addition, it should not be combined with alcoholic beverages.
Brand Name:Restoril

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Sumatriptan
Sumatriptan or Imitrex, drug used to treat severe migraine headaches. It works b y
shrinking swollen blood vessels in the brain that are believed to cause migraines.
This drug is available by prescription in tablet form and as a liquid administered by

self-injection in a 6-mg dose just below the skin. Tablets are taken orally in doses
ranging from 25 to 100 mg. A dose of the drug is taken as soon as migraine
symptoms appear. If needed, a second dose may be taken one hour after the first.
The maximum dosage in a 24-hour period is two injections or 300 mg of tablets.
Effectiveness is usually apparent within one to two hours.
Patients with heart disease, especially angina, irregular heartbeat, uncontrolled high
blood pressure, or a history of heart attack should not take this drug. It should be
used with caution by patients with liver or kidney disease, Raynaud’s syndrome, or
allergies. Its safety for young people under the age of 18 and pregnant or breast-
feeding women has not been determined.
Possible side effects may include dizziness, stiff neck, muscle weakness, sore throat,
tingling, or skin rash. Irregular heartbeat, change in blood pressure, tightness in the
chest or throat, difficulty breathing, or fainting are sometimes observed. Sumatriptan
may react adversely with medications containing ergotamine, a drug commonly found
in other migraine preparations.
Brand Name:Imitrex

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Sucralfate
Sucralfate, drug used to treat ulcers. It works by forming a protective coating over
irritated tissues a nd stimulating tissues to heal. It is primarily used for duodenal
ulcers, or ulcers that form in the uppermost 25 cm (10 in) of the small intestine.
Sucralfate can also help heal ulcers or similar irritations in the mouth, esophagus,
digestive tract, or va gina. It is sometimes used to soothe throat pain after a
tonsillectomy.
Prescribed in either tablet or liquid form, sucralfate is taken orally, preferably with
water, on an empty stomach one hour before or two hours after a meal. The typical
dosage is 1 g four times a day. Sucralfate is often effective after one to two weeks,
although treatment typically lasts from four to eight weeks. This drug heals existing
ulcers, but does not stop new ulcers from forming.
Patients with kidney failure should use sucralfate with caution. Its safety for children,
or pregnant or breast-feeding women, has not been determined. Possible side effects
may include constipation, dizziness, drowsiness, nausea, diarrhea, or a dry mouth.
Sucralfate may interact adversely with antacid s, antispasmodic drugs, certain
antibiotics, and blood-thinners, as well as cimetidine, digoxin, ketoconazole,
phenytoin, quinidine, ranitidine, tetracycline, and theophylline.
Brand Name:Carafate
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Simvastatin
Simvastatin, drug used to lower cholesterol levels. It is typically prescribed by a
physician when dietary changes, weight loss, and exercise are not effective in reducing
cholesterol. Simvastatin works by blocking the liver enzyme that controls the
production of cholesterol. It is primarily effective against low-density lipoproteins
(LDL), the form of cholesterol associated with increased risk of coronary heart disease.
Tablets are taken with or without food, usually at bedtime. The typical dosage ranges
between 5 and 40 mg per day. Effectiveness is usually apparent after four to six
weeks of treatment. Simvastatin is usually prescribed in combination with a
cholesterol-lowering diet.
This drug should not be taken by patients with liver disease, by pregnant or nursing
women, or by young people under the age of 20. Patients with impaired liver function,
muscular disorders, cataracts, or a history of alcohol abuse should use this drug with
caution.
Possible side effects of this drug include headache, stomach pain, nausea, diarrhea,
constipation, gas, muscle weakness, or lowered blood pressure. Other side effects
sometimes observed are muscle pain, skin rash, impaired vision, or hepatitis.
Simvastatin may interact adversely with the drugs cholestyramine, cimetidine,
clofibrate, cyclosporine, erythromycin, gemfibrozil, digoxin, ketoconazole, nicotinic
acid, warfarin, and spironolactone.
Brand Name:Zocor

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Sertraline
Sertraline, drug used to treat depression and, less often, obsessive -compulsive
disorders, which are characterized by persistent ideas (obsessions) that trigger
repetitive acts (compulsions). Sertraline works by adjusting brain levels of the
neurotransmitter serotonin
Available only by prescription, tablets are taken once a day with or without food. The
starting dose is 50 mg, which a doctor may slowly increase, if needed, to a maximum
daily dose of 200 mg. Effectiveness is usually apparent after four to eight weeks of
treatment.
Patients with impaired liver or kidney function, Parkinson disease, seizures, or a recent
heart attack should use sertraline with caution. Its safety for children under the age of
12 or pregnant or breast-feeding women has not been determined.
A variety of possible side effects are associated with sertraline, including headache,
agitation, fatigue, insomnia, sleepiness, constipation, diarrhea, vomiting, a dry mouth,
sweating, irregular heartbeat, tremors, or problems with male sexual performance.
Less common side effects are abnormal hair growth, breast enlargement (in both
females and males), difficulty breathing or swallowing, sensitivity to bright light,
weight loss, or behaviora l changes.
Sertraline may interact adversely with diazepam, digitoxin, warfarin, tolbutamide,

cimetidine, lithium, various diabetes medications including insulin, and monamine
oxidase (MAO) inhibitors. This drug should not be combined with alcoholic bevera ges.
Brand Name:Zoloft

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Salmeterol
Salmeterol, drug used for the treatment of asthma. It relieves and helps prevent
spasms in the bronchial tubes, the two b ranches of the trachea (windpipe) that lead
into the lungs. Such spasms make it difficult for asthma-sufferers to breathe or take
deep breaths. Salmeterol can also relieve the bronchial spasms that occur in some
people after exercising. Salmeterol is a bro nchodilator that works by relaxing
constricted muscles in the bronchial tubes, thereby expanding the passageways for air
to move in and out of the lungs.
Available only by prescription, salmeterol enters the respiratory system through the
mouth with the use of an inhaler. The typical dose is 42 mg, or two inhalations, twice
daily. When salmeterol is used to prevent exercise-induced spasms, the recommended
dose is two inhalations within 30 to 60 minutes before exercising. Additional doses
should not be taken within a 12-hour period. Salmeterol starts to work within one
hour, but its effectiveness in preventing asthma takes four to six weeks of treatment.
Patients with an irregular heartbeat should not use this drug. It should be used with
caution by patients who have high blood pressure, diabetes, liver disease, or
overactive thyroid gland. Salmeterol’s safety for use in children under the age of 12 or
in pregnant or nursing mothers has not been adequately studied.
Possible side effects may include a dry mouth or throat, dizziness, nervousness,
fatigue, headaches, or skin rashes. An overdose can cause irregular heartbeat, heart
attack, or muscle cramps. Salmeterol may interact adversely with certain
antidepressants, especially MAO inhibitors and tricyclic antid epressants, as well as
theophylline and caffeine.
Brand Name:Serevent

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Ranitidine
Ranitidine, drug used in the treatment of ulcers of the stomach and intestines. It is
also used to prevent upper abdominal bleeding and treat gastroesophageal reflux
disease, a condition in which stomach acids back up into the esophagus, causing
chronic heartburn. Ranitidine reduces gastrointestinal irritation and helps heal ulcers
by blocking the action of histamine, a chemical in the body that stimulates acid
secretions in the stomach.
This drug is available by prescription in tablet, capsule, and liquid form, all taken
orally. It is also available as an injectable liquid. The typ ical oral dosage is 150 mg or
10 ml, which may be prescribed in a single dose at bedtime or divided into two smaller
doses usually taken immediately after meals. Effectiveness is usually apparent after
four to six weeks. To treat milder acid indigestion and stomach upset, an over-the-
counter form is available in tablets of 75 mg.
Ranitidine should not be used within two hours of drinking alcoholic beverages,
smoking cigarettes, or taking antacids. This drug has not been proven safe for
pregnant or breast-feeding women or for children under the age of 16. It should be
used with caution by patients with impaired liver or kidney function. Patients who take
it for ulcers of the stomach and small intestine should not stop treatment abruptly.
Headache is the most common side effect of this drug. Less common side effects are
diarrhea, dizziness, anemia, hair loss, joint or muscle pain, skin rash, rapid or slow
heartbeat, and drowsiness.
Ranitidine may interact adversely with blood-thinning drugs such as warfarin, as well
as with diazepam, glipizide, enoxacin, itraconazole, ketoconazole, midazolam,
procainamide, sucralfate, theophylline, and triamterene.
Brand Name:Zantac

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Quinapril
Quinapril, drug used to control high blood pressure and sometimes to treat congestive
heart failure, a condition in which the heart’s ability to pump blood is impaired.
Quinapril works by interfering with angiotensin -converting enzymes (ACE) in the body,
which influence salt and water retention. The drug relaxes arterial walls, reduces blood
volume, thereby reducing blood pressure.
Available by prescription, quinapril is taken orally in tablet form with or without food.
Dosages range from 10 to 80 mg per day. Positive results are usually apparent after
several weeks. Because quinapril controls rather than cures high blood pressure, it
must be taken regularly to be effective. Long-term treatment lasting months or years
is common.
Patients with a blood cell or bone marrow disorder should not use quinapril. It should
be used with caution by patients with liver or kidney disease, heart disease,
scleroderma, systemic lupus erythematous, high potassium levels, or low white blood
cell counts. This drug should not be taken by pregnant women, as it can harm the
fetus, especially in the second and third trimesters. Breast-feeding mothers should be
aware that this drug is known to appear in breast milk. Quinapril has not been proven
safe for use in children under the age of 12.
Possible side effects include dizziness, lightheadedness, fatigue, nausea, chest or

abdominal pain, muscle pain, coughing, or vomiting. An allergic reaction to this drug,
characterized by such symptoms as facial swelling and difficult y swallowing or
breathing, requires immediate medical attention, as does any sore throat or fever that
develops during treatment.
Although quinapril may be prescribed in combination with certain diuretics, it can react
adversely with these drugs. It also may react with lithium, tetracycline, cyclosporine,
and potassium supplements, including salt substitutes containing potassium. It should
not be combined with alcoholic beverages unless approved by a doctor.
Brand Name: Accupril

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Common Drugs

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Nonsteroidal Anti-inflammatory Drug (NSAID),

Microsoft® Encarta® Encyclopedia 2002. © 1993-2001 Microsoft Corporation. All rights

Brand Name: Soma

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Mifepristone, also RU-486,

II HOW MIFEPRISTONE WORKS

Mifepristone is used in conjunction with a drug called misoprostol, a prostaglandin marketed

Mifepristone works by blocking the action of progesterone, a hormone necessary to sustain a

III ADVANTAGES AND PRECAUTIONS

The principal advantages of a drug-induced abortion, also called a medical abortion or a

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Thalidomide was first produced by Chemie Grunenthal, a German pharmaceutical company. By

III RECENT USES

Brand Names:Lopressor, Toprol

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Astemizole is available only by prescription. It comes in tablet form a nd is taken orally on an

Brand Name: Hismanal

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Brand Names:Elavil, Endep, Triavil

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Cyclobenzaprine must be prescribed by a doctor. Available in tablet form, cyclobenzaprine is

In addition, patients with an overactive thyroid gland, an irregular heartbeat, or congestive

Brand Name :Flexeril

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Brand Names:Ritalin, Ritalin-SR

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Patients with a sensitivity to certain antidepressant drugs (such as amitriptyline) or with

Brand Names:Tegretol, Atretol

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In addition to agranulocytosis, other possible side effects include seizures, drowsiness,

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Brand Names:Valium, Valrelease,Dizac

Brand Names:Dimetane Expectorant-DC,Triaminic Expectorant DH,Vicodin

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Available by prescription only, mometasone furoate is available as a cream, ointment, or

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Brand Names:Aventyl, Pamelor

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Cefuroxime Axetil or Ceftin,

Brand Name: Ceftin

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Brand Name: Lescol

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Brand Names: Prinivil, Zestril

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To prevent stomach irritation and increase the effectiveness of nitrofurantoin, it should be

Brand Names:Furadantin, Macrobid, Macrodantin

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Brand Name: Prilosec

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Paroxetine interacts harmfully with cimetidine, digoxin, monoamine oxidase inhibitors,

Brand Name: Paxil

Brand Name: Duricef

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