Primary hypothyroidism is usually the result of Hashimoto's thyroiditis, thyroidectomy for hyperthyroidism, goiter or cancer, or radioactive iodine therapy for hyperthyroidism.

The angiotensin-converting enzyme (ACE) inhibitors captopril (Capoten - Squibb) and enalapril (Vasotec - Merck) are now widely used to treat chronic congestive heart failure that has not responded adequately to digitalis and diuretics (Medical Letter, 30:13, Jan 29, 1988). Recently, some cardiologists have debated whether ACE inhibitors should also be used as first-line agents for treatment of this condition (WW Parmley et al, J Am Coll Cardiol, 12:265, July 1988).

Liquid diets for weight reduction, once discredited because of their adverse effects, are becoming popular again. Now, formula diets are available through physicians or hospitals as part of a packaged weight-reduction program that includes nutrition education and modification of eating and exercise habits. Three widely used programs are Optifast (Sandoz), Medifast (Nutrition Institute of Maryland, 1840 York Road, Timonium, MD 21093) and HMR (Health Management Resources, 59 Temple Place, Boston, MA 02111).

Levamisole (Janssen), an old antiparasitic drug widely used for treatment of ascariasis in animals, is now available from the National Cancer Institute (NCI) for investigational use with fluorouracil (5-FU; Adrucil; and others) as an adjuvant for treatment of resectable colon cancer that has metastasized to regional lymph nodes (Dukes stage C).

Since the implication of aspirin in Reye's syndrome, acetaminophen (Tylenol; and others) has become the standard drug for symptomatic treatment of fever and pain in children. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) available for many years in tables (Mortin; Advil; and others), has now become available in a suspension. The suspension will be sold by presecription for treatment of fever or arthritis in children.

Pentostatin (2'-deoxycoformycin; DCF; - Parke-Davis), a purine analog, was recently approved by the US Food and Drug Administration (FDA) for treatment of hairy-cell leukemia resistant to interferon alfa (Intron A; Roferon-A). is a rare (500 cases/year in the USA) form of chronic lymphocytic leukemia. Acutely ill patients may respond rapidly to interferon, but the drug is rarely curative. Another purine analog, 2-chlorodeoxyadenosine (CdA; Leustatin - Ortho Biotech), may also be approved soon for treatment of hairy-cell leukemia (JD Piro, Blood, 79:843, 1992). Fludarabine (Fludara...

Calcipotriene ointment 0.005% (calcipotriol; Dovonex - Westwood Squibb), a synthetic vitamin D 3 analog previously available in Europe and Canada, has now been approved by the US Food and Drug Administration (FDA) for treatment of moderate plaque psoriasis, the most common form of the disease.

Patients may be asking their physicians about use of histamine H2-receptor antagonists for treatment and prevention of heartburn. Cimetidine and famotidine have recently been released for over-the-counter sale and are being heavily advertised on television and in the print media.

Dirithromycin (Dynabac - manufactured by Lilly, distributed by Bock), an oral macrolide antibiotic chemically similar to erythromycin, clarithromycin (Biaxin) and azithromycin (Zithromax), has been approved for marketing by the US Food and Drug Administration (FDA).

The Prostatron, a microwave device manufactured by EDAP Technomed in Cambridge, MA, has been approved by the US Food and Drug Administration for treating symptoms of benign prostatic hyperplasia (BPH).