In the United States, it can be purchased either as a generic medicine, or as Questran or Questran Light (Bristol-Myers Squibb). Dosage
A typical dose is 4 to 8 g once or twice daily, with a maximum dose of 24 g/d. Side effects
These side effects have been noted:
Most frequent: constipation
Increased plasma triglyceridesIntestinal obstruction has been reported in patients with previous bowel surgery who should use colestyramine cautiously. Cholestyramine-induced hyperchloremic metabolic acidosis has also been reported rarely.Patients with hypothyroidism, diabetes, nephrotic syndrome, dysproteinemia, obstructive liver disease, kidney disease, or alcoholism should consult their doctor before taking this medication. Other drugs should be taken at least one hour before or four to six hours after colestyramine to reduce possible interference with absorption. Patients with phenylketonuria should consult with a physician before taking Questran Light because that product contains phenylalanine. Drug interactions
Interactions with these drugs have been noted:
Digitalis
Estrogens and progestins
Oral diabetes drugs
Penicillin G
Phenobarbital
Spironolactone
Tetracycline
Thiazide-type diuretic pills
Thyroid medication
Warfarin
LeflunomideMost interactions are due to the risk of decreased absorption of these drugs. The duration of treatment is not limited, but the prescribing physician should reassess at regular intervals if continued treatment is still necessary. The principal overdose risk is blockage of intestine or stomach. Colestyramine may interfere in the absorption of fat-soluble vitamins such as vitamins A, D, E, and K. No special considerations regarding alcohol consumption are made. Notes and references
The Merck Index (12 ed.). p. 2257. External links
U.S. National Library of Medicine: Drug Information Portal - Cholestyramine
Cefprozil is a second-generation cephalosporin antibiotic. Originally discovered in 1983, and approved in 1992, it was sold under the tradename Cefzil by Bristol Meyers Squibb until 2010 when the brand name version was discontinued. It continues to be available from various companies in its generic form. It is used in the treatment of pharyngitis, tonsillitis, ear infections, acute sinusitis, bacterial exacerbation of chronic bronchitis, and skin and skin structure infections. It is currently available as a tablet and as a liquid suspension. Adverse Effects
Although there is a widely quoted cross-allergy risk of 10% between cephalosporins and penicillin, research has shown no increased risk for cross-allergy for cefprozil and several other second-generation or later cephalosporins. The most common side effects were increased hepatic lab values (including AST and ALGT), dizziness, eosinophilia, diaper rash and superinfection, genital pruritus, vaginitis, diarrhea, nausea, vomiting, and abdominal pain. Spectrum of bacterial susceptibility and resistance
Currently bacteria like Enterobacter aerogenes, Morganella morganii and Pseudomonas aeruginosa are resistant to cefprozil, while Salmonella enterica serotype Agona and streptococci are susceptible to cefprozil. Some bacteria like Brucella abortus, Moraxella catarrhalis and Streptococcus pneumoniae have developed resistance towards cefprozil in varying degrees. Detailed minimum inhibition concentration information is given by the Cefprozil Susceptibility and Resistance Data sheet. Synthesis
This is not a direct copy of Lednicer book like at first glance, but is sourced from the primary reference material. Displacement of the allylic chloride in intermediate (1) with triphenylphosphine gives the phosphonium salt (2).