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It seems unlikely that these agents would have significant order 960mg bactrim with amex antimicrobial mold cleaner, if any generic bactrim 960mg visa bacterial sinus infection, terato- genic risks. Fluconazole Fluconazole is an azole antifungal similar to ketoconazole and is utilized for both local and systemic fungal infections (Hollier and Cox, 1995). It is useful in the treatment of vaginal, oral, and systemic candidiasis, as well as for prophylaxis and treatment of cryp- tococcal infections in immunocompromised patients (i. Among 239 women who took single low doses of fluconazole, 60 took it during the first trimester of pregnancy. Antifungals 37 However, four cases of craniosynostosis with radial-humeral bowing and tetrology of Fallot have occurred following repeated high-dose fluconazole for cocci meningitis (Aleck and Bartley, 1996; Lee et al. In one study of 226 pregnancies exposed to fluconazole during the first trimester, the frequency of congenital anomalies was not increased (Mastroiacovo et al. Maternal side effects may include headache, dizziness, or gastroin- testinal upset. Ciclopirox This is a relatively new, topical antifungal agent effective against various dermatophytes such as Trichophyton species and Candida albicans. There is little, if any, information regarding its use during pregnancy but, according to its manufacturer, it was not terato- genic in various animal studies. Tolnaftate, undecylenic, and terbinafine Both tolnaftate (Tinactin) and undecylenic acid (Desenex) are utilized for dermatophyte infections such as tinea pedis and tinea corporis, but are not effective against yeast (Davis, 1995). There are no reports of these agents being teratogenic, and it would seem reasonable to classify them as category B agents at the present time. Amphotericin B Amphotericin B is an antifungal agent that is used primarily to treat systemic mycotic infections. However, in a review of case reports by Ismail and Lerner (1982), there was no evidence of teratogenicity of amphotericin B. Griseofulvin Griseofulvin is an antifungal agent used primarily to treat mycotic infections of the skin, nails, and hair. It is incorporated in the keratin of the epidermis and nails and is fungista- tic (Davis, 1995). There are no adequately controlled studies of this antifungal agent during pregnancy. However, Rosa and associates (1987b) reported two cases of con- joined twins born to mothers who took griseofulvin during early pregnancy. A variety of central nervous system malformations and skeletal anomalies have been observed in the offspring of animals treated with several times the human dose of griseofulvin dur- ing pregnancy (Klein and Beall, 1972; Scott et al. Because of these reports, grise- ofulvin is not recommended for use during pregnancy. Acyclovir and valacyclovir Acyclovir is an antiviral agent used primarily in the treatment and prophylaxis of her- pes simplex infections. The active metabolite of valacyclovir is acyclovir, and the use of valacyclovir during pregnancy will have risks similar to those of acyclovir. It has also been used in the treatment of other herpes infections, including varicella. However, in one review of seven women who received acyclovir during the second half of pregnancy, there were no congenital abnormalities detected (Leen et al.

It is indicated in feeble or aged patients with persistent dragging or weight across the kidneys buy cheap bactrim 960mg bacteria 1 in urine. It will quickly relieve many cases of simple renal hyperemia purchase 480 mg bactrim free shipping infection 5 weeks after c-section, preventing the development of structural change, or the advancement of nephritis. After acute nephritis, whether from direct causes, or subsequent to scarlet fever, diphtheria, or other severe disease, when active inflammation has subsided, it will restore the secretory power of the Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 270 epithelium of the renal tubules and readjust the secretory function to the blood pressure, restoring normal action. It is useful in strangury, and in some dropsies where there is absence of acute inflammation. It may be applied directly, but is quite severe upon an irritable or sensitive surface. It is a useful agent in psoriasis, and as a parasiticide it will destroy psora and cure favus. It was at one time in common use as an application to skin diseases and parasites in domestic animals. Physiological Action—In Kalmia we have a remedy acting in a manner somewhat like veratrum viride, both in controlling fevers and in inflammations, as well as in its influence as an alterative, it having been successfully used both in primary and secondary syphilis. Like veratrum it has also been employed hypodermically in the treatment of neuralgia of the face, and sciatica. The patient at the time I saw him had several chancres; the surface of the body and head was covered with small red pimples, elevated above a jaundiced skin, and be was in a very debilitated condition. I administered a saturated tincture of the leaves of Kalmia, and touched the chancre with tincture of muriate of iron, and effected a cure in four weeks, removing the jaundice at the same time. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 271 If Kalmia would relieve other cases of syphilis as it did this one, we may safely say that we have no other alterative in our materia medica equal to it. It has not been extensively used, but it is without doubt beneficial in glandular disorders, scrofula, and in mild cases of secondary syphilis. Kalmia exercises a sedative influence over the heart, controls the pulse beat without depression. It is markedly alterative but must not be pushed because of this slowing influence. Homeopathists give it in cardiac hypertrophy, and for painful rheumatic affections, for facial neuralgia, for tobacco heart, and it will probably act well in rheumatic endocarditis. It will be found of service in inflammatory diseases, also in hypertrophy of the heart with palpitation, diarrhea and dysentery, rheumatism, chronic inflammations, with atonicity, neuralgia, active hemorrhages, threatened abortion from syphilitic taint, active menorrhagia, pain in the limbs and back during menstruation, jaundice, and also in scleritis, with pain in turning the eyes, and in ophthalmia. Specific Symptomatology—This agent is positive in suppressed lochia from any cause, amenorrhea from cold; dysmenorrhea, with morbid nervous excitability, and hysteria. John King regarded motherwort as superior to all other remedies in suppression of the lochia, giving it internally and applying a fomentation of the herb over the lower abdominal region. Therapy—It is prescribed in the above conditions, also in delirium tre- mens, typhoid state in fevers, chronic diseases with wakefulness, restlessness, disturbed sleep, spinal irritation, neuralgia of the stomach Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 272 and head, feeble digestion, general debility, chorea, convulsions, nervousness fr om irregular menstruation, palpitation of the heart, associated with uterine disease, amenorrhea, with chlorosis, cachexia and an irritable, excitable, enfeebled state of the nervous system, spasms and harrassing bearing down pains, and morbid sensibility from uterine disease, pain in the pelvic and lumbar regions in females. It is a simple heart tonic, promoting normal action, probably very mild in its influence. It would work well combined with cactus or crataegus or both, especially in the presence of nux vomica or collinsonia. Motherwort is tonic and laxative, a diaphoretic somewhat like asclepias, an emmenagogue like cimicifuga and a nervine like scutellaria.

Ellingwood’s American Materia Medica cheap 960mg bactrim with mastercard antimicrobial natural products, Therapeutics and Pharmacognosy - Page 357 It causes a sensation of acridity in the throat when a moderate dose is swallowed order bactrim 960 mg antibiotics for sinus infection, and may be employed in chronic pharyngitis, as a local stimulant, where the mucous membrane is relaxed and the secretion abundant. Specific Symptomatology—The agent is indicated in typhoid pneumonitis, capillary bronchitis, in aged and debilitated subjects, chronic bronchitis with profuse secretion, in the declining stages of pneumonitis, bronchitis and croup, when the inflammatory condition has passed off, chronic bronchitis with pain and soreness in the chest and asthma. Therapy—The agent is in use in the treatment of dropsy from obstruction and glandular enlargement, also in rheumatism, syphilis, squamous skin diseases and in amenorrhea. Senega has been employed as a stimulating expectorant in chronic bronchitis, in aged and debilitated subjects, where a stimulating medicine is demanded and in the later stages of pneumonia and catarrhal inflammations. In these cases, given in small doses, it improves secretion, removes abnormal deposits and restores the strength. It is an energetic stimulant to the mucous membranes of the air passages: and, when given before the inflammation has subsided, aggravates the cough and does harm. Given in small doses, it also acts as an alterative, and may thus be given in dropsy from obstruction, in syphilis, and in squamous skin diseases. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 358 Therapy—In suppression of the menses from cold, thirty drops in hot water may be drunk every two hours. It may be begun two weeks before the menses should next appear, if one period has passed, and given every four hours in cold water, until a day or two before the expected time, when it can again be given in hot water. More recently, I have used it in conjunction with one or two of the other uterine remedies, carefully selected, in all forms of menstrual suppression, except in feeble and anemic patients, and have, found it efficient and readily controllable. It acts promptly upon the skin and kidneys and seems to be to a certain extent antispasmodic, as in hystero-epilepsy, or epilepsy depending upon suppression of the menses, it relieves the paroxysms and reduces the number of the attacks. Goss recommended it when there was urinary suppression from cold and in retention with lack of power in the bladder. In certain forms of flatulent colic, when the pains are sharp and lancinating, intermittent, and of a severe griping character, it is curative. Physiological Action—Given in large doses polymnia acts as an emeto- cathartic, producing painful evacuations, with severe emesis, and if pushed produces gastro-intestinal inflammation, dizziness, convulsions and even death. Specific Symptomatology—It is indicated in conditions of inactivity of the organs, with passive fullness of the circulation of the parts, or of surrounding tissues which may be of a sodden inelastic character. Ellingwood’s American Materia Medica, Therapeutics and Pharmacognosy - Page 359 Inactive engorgements, or stagnations of the circulation, are general conditions pointing to the use of this agent. Scudder gave as its indications full, flabby, sallow tissues, impaired circulation, glandular enlargement and other impaired functions from lack of tone. Therapy—The older writers of our school lauded this remedy as of much importance in rheumatism. Others spoke of it favorably in the same class of cases in which phytolacca is used. Pruitt used it in the form of an ointment, in inflammation of the mammary glands, and other glandular inflammations, especially if abscesses had formed. The specific influence of the remedy, however, as agreed by all writers, is upon enlargement of the spleen. This gland is influenced in chronic malarial conditions, in scrofulous diseases and in tubercular difficulties. It is upon the malarial form of splenic enlargement that it acts to the best advantage. It should be used freely internally, and externally the hot infusion must be applied. A chronically enlarged inactive engorged liver, with tenderness on pressure, is quickly and satisfactorily cured by it. A womb enlarged from subinvolution or other hypertrophy, yields satisfactorily to its influence. It has been used in mastitis or “caked breast” so-called, to excellent advantage, but its prolonged use may suppress the secretion of milk.