Transdermal nitroglycerin products commercially available in the USA are listed in the table below. These patches, which look like adhesive bandages, are often applied over the precordium, but they can be attached to any hairless area of the skin, except distal parts of the extremities. Individual patients vary in their absorption of nitroglycerin from the skin; the amounts delivered (the doses) are average figures.

Octreotide acetate (Sandostatin - Sandoz), a synthetic octapeptide that mimics the actions of somatostatin, was recently approved by the US Food and Drug Administration for symptomatic treatment of patients with metastatic carcinoid or VIPomas (vasoactive intestinal peptide-secreting tumors).

Three nicotine-releasing adhesive patches for the skin (Habitrol - Ciba-Geigy; Nicoderm - Marion Merrell Dow; and PROSTEP - Lederle) have been approved by the US Food and Drug Administration to aid withdrawal from smoking. Nicotrol (Parke-Davis) may also be approved soon. All the manufacturers recommend using the patches in conjunction with a behavioral modification program.

Flumazenil (Mazicon - Roche), a benzodiazepine receptor antagonist, has been approved by the US Food and Drug Administration to reverse the sedative effects of benzodiazepines after anesthesia, sedation for brief surgical or diagnostic procedures, or after benzodiazepine overdosage. The drug does not antagonize opioids, non-benzodiazepine sedatives, or anesthetic drugs.

Desogen (Organon) and Ortho-Cept (Ortho), two oral contraceptives each containing a low dose (30 mcg) of the estrogen ethinyl estradiol plus 150 mcg of the progestin desogestrel, were recently approved by the US Food and Drug Administration for marketing in the USA. They are the first US oral contraceptives to contain desogestrel, which is widely used in oral contraceptive combination products in other countries. Desogestrel is one of three new progestins (norgestimate and gestodene are the others) considered less androgenic than previously available progestins (L Speroff et al, Obstet...

Implanted devices that monitor cardiac rhythm and can recognize and treat ventricular tachycardia or ventricular fibrillation are now widely used in the USA and other countries. Implantable cardioverter/defibrillators (ICDs) marketed here include the Ventak P and PRX (Cardiac Pacemakers, Inc., St. Paul, MN), the PCD (Medtronic, Minneapolis, MN), and the Cadence (Ventritex, Sunnyvale, CA) (JG Porterfield et al, Am J Cardiol, 72:301, 1993).

Dorzolamide hydrochloride (Trusopt - Merck), a thienothio-pyran-2-sulfonamide carbonic anhydrase inhibitor, was recently approved by the US Food and Drug Administration in a 2% ophthalmic solution for treatment of elevated intraocular pressure in patients with ocular hypertension or open-angle glaucoma.

An aqueous formulation of alprostadil (prostaglandin E 1 ; - Upjohn) has been approved by the US Food and Drug Administration (FDA) for injection into the corpus cavernosum to treat erectile dysfunction. The drug is also marketed as Prostin VR, an alcohol-containing formulation, for intravenous use in newborns with congenital heart disease to maintain the patency of the ductus arteriosus.

Nalmefene (Revex - Ohmeda), an i methylene analog of naltrexone (Trexan), is a long-acting opioid antagonist that has been approved by the US Food and Drug Administration for reversal of postoperative opioid drug effects, including respiratory depression, sedation and hypotension and for management of known or suspected opioid overdose in the emergency department. The only other opioid antagonists available in the USA are naloxone (Narcan), which is also injectable but has a short duration of action, and naltrexone, which has a long duration of action but is marketed only for oral...

Valsartan (Diovan - Novartis), a non-peptide tetrazole, is the second angiotensin II receptor antagonist approved for oral treatment of hypertension by the US Food and Drug Administration. The first was losartan (Cozaar - Medical Letter, 37:57, 1995).