A new CDC guideline for prescribing opioids for pain recently became available. Nonopioid drugs for pain were reviewed in a previous issue.

Anxiety disorders (generalized anxiety disorder, panic disorder, social anxiety disorder, and various phobias) are the most common form of psychiatric illness. They can be treated effectively with cognitive behavioral therapy (CBT) and/or pharmacotherapy.

The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.

Initial treatment of allergic rhinitis (AR) depends on the severity of symptoms and whether they are intermittent or persistent (see Table 1).

Attention-deficit/hyperactivity disorder (ADHD) is a common chronic neurodevelopmental disorder often diagnosed in school-age children that frequently persists into adulthood.Pharmacologic treatment of ADHD has been associated with reduced risks of substance abuse, criminal behavior, unintentional injuries, serious traffic accidents, and all-cause mortality. Drugs approved by the FDA for treatment of ADHD are listed in Table 1.

Acesulfame potassium (Sunette - Hoechst), an oxathiazinondioxide, was recently approved by the US Food and Drug Administration (FDA) for use as a non-caloric table-top sweetener and as an ingredient in chewing gum, powdered beverages, gelatins and puddings. The other non-caloric artificial sweeteners available in the USA are saccharin (Sweet 'N Low; and others) and aspartame (NutraSweet; Equal) (Medical Letter, 24:1, 1982).

The 1990 labeling for Norpramin, the Merrell Dow brand of the tricyclic antidepressant desipramine, reports the occurrence of sudden death in an eight-year-old child treated with the drug. Desipramine is also available as Pertofrane (Rorer) and generically.

Two new substitutes for fat will soon be available in supermarkets in the USA, not directly, but incorporated into low-fat foods. Simplesse (NutraSweet) has already been approved for use by the US Food and Drug Administration (FDA) and is commercially available in some areas, but only in an ice-cream-like product called Simple Pleasures. Trailblazer (Kraft General Foods) is expected to be approved soon.

Gamma hydroxy butyrate (GHB) sold in health food stores has recently caused outbreaks of gastrointestinal illness, central-nervous-system (CNS) depression, and seizures.

Breathe Right, an adhesive bandage device that pulls open the nostrils, has been approved by the US Food and Drug Administration and is being heavily promoted to the general public as a treatment for snoring and night-time nasal congestion. The manufacturer's suggested retail price is $4.99 for a box of 10 strips.