A variety of cancer chemotherapy drugs are used, mostly in combination, for treatment of locally advanced and metastatic esophageal, gastric and colorectal cancers. The mechanism of action, indications and adverse effects of some of these drugs are discussed in thei article.

Salmeterol xinafoate (Serevent - Allen & Hanburys), a long-acting β 2 -selective adrenergic agonist for inhalation, has been approved by the US Food and Drug Administration for maintenance treatment of asthma, with or without concurrent use of inhaled corticosteroids. Salmeterol is not recommended for acute treatment of bronchospasm.

Rofecoxib, a selective COX-2 inhibitor, has been approved by the FDA for treatment of osteoarthritis, acute pain and menstrual pain.

Ertapenem (er ta pen' em; Invanz - Merck), a carbapenem antibacterial with a narrower spectrum of activity than imipenem (Primaxin) or meropenem (Merrem), has been approved by the FDA for once-daily IV treatment of complicated intra-abdominal, urinary tract and skin and skin structure infections, acute pelvic infections, and community-acquired pneumonia.

Several new treatments are now available for actinic keratoses (AKs), scaly pink papules commonly found on sun-exposed areas of the face, scalp, forearms and dorsal surface of the hands, particularly in the elderly. Some AKs regress spontaneously, but a few may progress to squamous cell carcinoma; the risk of progression has been estimated to be about 0.25% to 1% per year (EWB Jeffes III and EH Tang, Am J Clin Dermatol 2000; 1:167).

Several recent case reports suggest that oral sildenafil may be effective for treatment of pulmonary arterial hypertension (PAH). Sildenafil is currently marketed as Viagra for treatment of erectile dysfunction (Medical Letter 1998; 40:51).

The US manufacturer of varicella zoster immune globulin (VZIG; Massachusetts Public Health Biologic Laboratories, Boston, MA) recently discontinued its production. A Canadian formulation, VariZIG (Varicella Zoster Immune Globulin [Human] - Cangene Corporation, Winnipeg) is now available in the US under an investigational new drug application expanded access protocol.

Several large European observational studies published on-line this summer have raised questions about whether use of insulin glargine increases the risk of cancer.

Misoprostol (Cytotec, and generics), a prostaglandin E₁ analog FDA-approved for prevention of NSAID-induced gastric ulcers and, when taken with mifepristone (Mifeprex), for termination of early intrauterine pregnancy, has also been used off-label for years for medical management of first-trimester spontaneous abortion (miscarriage).

The FDA has approved dupilumab (Dupixent – Sanofi/Regeneron), a subcutaneously-injected fully human monoclonal antibody, for treatment of adults with moderate to severe atopic dermatitis (eczema) that has not responded to topical therapies. It can be used with or without topical corticosteroids.