Risperidone (Risperdal - Janssen), a benzisoxazole derivative, is now available in the USA for treatment of schizophrenia and other psychotic disorders.

Recombinant human deoxyribonuclease I (rhDNase; dornase alfa; Pulmozyme - Genentech), an enzyme that hydrolyzes extracellular DNA, is now available as a purified solution to decrease the viscosity of sputum in patients with cystic fibrosis. It requires a nebulizer to produce an aerosol mist for inhalation.

A 0.05% ophthalmic solution of levocabastine hydrochloride (Livostin - Iolab), a histamine H 1 -receptor antagonist, has been approved by the US Food and Drug Administration for treatment of seasonal allergic conjunctivitis. The new drug is a cyclohexylpiperidine derivative with no structural relationship to any other antihistamine.

Aprotinin (Trasylol - Miles), an inhibitor of fibrinolysis first identified in 1930, was recently approved by the US Food and Drug Administration for intravenous use in high-risk coronary artery bypass graft (CABG) surgery to decrease bleeding and the need for transfusion. Inhibitors of fibrinolysis previously available in the USA include aminocaproic acid (Amicar, and others) and tranexamic acid (Cyklokapron - Medical Letter, 29:89, 1987).

The US Food and Drug Administration has approved use of the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten) for patients with left ventricular dysfunction after a myocardial infarction. ACE inhibitors, widely used for treatment of hypertension, in recent years have also been used for treatment of heart failure (Medical Letter, 35:40, 1993).

Rocuronium bromide (Zemuron - Organon), a new short-onset, intermediate-acting, nondepolarizing neuromuscular blocking drug, is now available in the USA for intravenous use. It is being promoted particularly for use in rapid endotracheal intubation.

Yohimbine hydrochloride, a presynaptic 2 -adrenergic receptor antagonist available by prescription in the USA (Yocon, Yohimex, and others), is advertised for treatment of impotence and has been used as an aphrodisiac. A pre-1938 drug, yohimbine has never been approved for marketing by the US Food and Drug Administration.

As the weather becomes warmer, physicians may see more photosensitivity reactions due to systemic or topical drugs, perfumes, cosmetics or sunscreens. Even brief exposure to sunlight in warm or cold weather can cause intense cutaneous reactions in patients with drug-induced photosensitivity, and some patients may continue to be sensitive to sunlight long after stopping use of the offending agent.

High-dose chemotherapy, with or without total body radiation, followed by bone marrow transplantation to restore bone marrow function has been used widely in the treatment of malignant diseases in recent years (Medical Letter, 34:79, 1992; 37:25, 1995). Now, however, instead of using bone marrow itself to restore function destroyed by chemotherapy and radiation, many centers infuse hematopoietic stem cells harvested from peripheral blood. Most stem cell transplants have been autologous; allogeneic stem cells have been tried in a small number of patients (WI Bensinger et al, Blood,...

Mycophenolate mofetil (CellCept - Roche) has been approved by the US Food and Drug Administration for oral use in preventing organ rejection in patients receiving allogeneic renal transplants. It is being promoted as an improvement over azathioprine (Imuran) for concurrent use with cyclosporine (Sandimmune; Neoral) and corticosteroids.