The US Food and Drug Administration recently approved the marketing of G-CSF (recombinant human granulocyte colony-stimulating factor, generic name filgrastim, Neupogen - Amgen) and GM-CSF (recombinant human granulocyte-macrophage colony-stimulating factor, generic name sargramostim, Leukine - Immunex, Prokine - Hoechst-Roussel). G-CSF is approved for use after cancer chemotherapy in patients with non-myeloid malignancies to decrease the incidence of infection. GM-CSF is approved for acceleration of myeloid recovery after autologous bone marrow transplantation in non-Hodgkin's lymphoma,...

Idarubicin hydrochloride (Idamycin - Adria), an anthracycline structurally related to daunorubicin (Cerubidine, and others) and doxorubicin (Adriamycin, and others), was recently approved in the USA for treatment of acute myelogenous leukemia (AML) in adults.

Accidental needlesticks can lead to infection with hepatitis viruses, human immunodeficiency virus, and other blood-borne bacterial, viral, and fungal pathogens (DK Henderson et al, Ann Intern Med, 113:740, 1990). Re-capping used needles is the most frequent cause of needlestick injuries (J Jagger et al, N Engl J Med, 319:284, 1988; MH Becker et al, Am J Infect Control, 18:232, 1990).

Because of concerns about the possibility of bioterrorism involving smallpox, the US government is reinstituting smallpox vaccination (https://www.cdc.gov/smallpox/; www.idsociety.org/bt/toc.htm). Vaccination is currently expected to proceed in three phases: the military and hospital smallpox response teams first, other health care workers, police and firefighters second, and the general public in the third phase. Except for the military, vaccination will be...

The FDA has approved ThermaClear (Therative), a battery-powered, handheld device, to treat individual acne lesions with heat. ThermaClear is indicated only for use on mild to moderate inflammatory acne, not severe nodular or severe cystic acne, and it is not meant to be used on blackheads and whiteheads. Two similar devices are already on the market: Zeno, another handheld device that delivers heat to acne lesions, and the Radiancy Clear Touch Lite Acne Clearance System, a larger heat-delivery device.

FK 506 (Fujisawa), an immunosuppressant similar in activity to cyclosporine (Sandimmune - Medical Letter 25:77, 1983), is currently under investigation in the USA, Europe, and Japan for prevention of organ transplant rejection.

Gastrointestinal gas may cause symptoms when excessive amounts become trapped in the stomach and intestinal tract. Simethicone (Gas-X, Maalox Anti-Gas, Mylanta Gas Relief, Mylicon, Phazyme), sold over-the-counter in capsules, tablets and infant drop formulations, is being heavily advertised to the public for symptomatic treatment of flatulence and gastric bloating. According to a recent press release, 'Phazyme works fast so people can continue living active lives and eating the foods they love without fear of embarrassment.' Products that combine one or more antacids with simethicone...

Dolasetron (Anzemet - Hoechst Marion Roussel), a selective serotonin (5-HT3) receptor antagonist similar to ondansetron (Zofran) and granisetron (Kytril - Medical Letter, 36:61, 1994) is now available for both oral and intravenous use in prevention of nausea and vomiting due to cancer chemotherapy. A 5-HT3 antagonist plus dexamethasone (Decadron, and others) is the most effective regimen for prevention of acute vomiting caused by cancer chemotherapy. Dolasetron has also been approved by the FDA for prevention and treatment of postoperative nausea and...

Patients may be asking about reports in the lay press that exenatide (Byetta - Med Lett Drugs Ther 2005; 47:45), a synthetic peptide that stimulates release of insulin from pancreatic beta cells, has been used by diabetics and non-diabetics to lose weight. Approved by the FDA to improve glycemic control in patients with type 2 diabetes not controlled by metformin, a sulfonylurea or both, it is given by subcutaneous injection before the morning and evening meals. In clinical trials, some diabetic patients treated with the drug lost weight. No data are available on use in non-diabetics....

The FDA has approved glucarpidase (Voraxaze – BTG International) for treatment of toxic plasma methotrexate concentrations (>1 micromole per liter) in patients with delayed methotrexate clearance due to impaired renal function. Glucarpidase has been available in the US since 2007 under a compassionate use open-label treatment protocol (Clinical Trials and Consulting Services, 1-877-398-9829), which will remain in effect until the drug becomes commercially available later this year. There is currently a shortage of IV methotrexate in the US.