Permethrin 5% (Elimite Cream - Herbert), a synthetic pyrethroid previously available in a 1% concentration (Nix) for treatment of head lice (Medical Letter, 28:89, 1986) and as an aerosol clothing spray (Permanone) for protection against mosquitoes and ticks (Medical Letter, 31:45, 1989), was recently approved by the US Food and Drug Administration for single-application treatment of infestation with Sarcoptes scabiei (scabies).

Human rabies continues to be rare in the USA, but animal rabies is becoming more common. An animal epizootic in the mid-Atlantic states, involving especially raccoons, has recently spread into the northeastern states.

Cardiac arrest may be due to tachyarrhythmias, bradyarrhythmias, or asystole. Without treatment, permanent damage to the cerebral cortex usually begins within five minutes and is complete in ten. After cardiopulmonary resuscitation (CPR) has been started and electrical defibrillation, when indicated, has been applied, drugs may help promote recovery.

Use of alendronate (Fosamax), estrogen and other drugs for prevention and treatment of osteoporosis (Medical Letter, 38:1, 1996) has been accompanied by widespread availability of bone density screening tests, not only in doctors offices and hospitals, but even in retail stores. Bone densitometry provides a quantitative measurement of bone mineralization that can be used to predict the risk of osteoporotic fractures.

Sibutramine hydrochlorid monohydreate (Meridia - Knoll), which is structurally related to amphetamine, has been approved by the FDA for treatment of obesity. It is classified by the Drug Enforcement Agency (DEA) as a schedule IV controlled substance.

Doconsanol 10% cream, a long-chain saturated alcohol, has been approved by the FDA for over-the-counter treatment of herpes labialis.

The FDA has approved incobotulinumtoxinA (Xeomin – Merz) for treatment of cervical dystonia and blepharospasm in adults. It has been commercially available in Germany since 2005. Several formulations of botulinum toxin type A (Botox; Dysport) and type B (Myobloc) are already marketed for treatment of cervical dystonia. Botox is also approved for treatment of blepharospasm.

The FDA has approved the antiprogestin mifepristone (Korlym – Corcept Therapeutics) for control of hyperglycemia secondary to hypercortisolism in adults with endogenous Cushing’s syndrome who have type 2 diabetes/ glucose intolerance and have not responded to, or are not candidates for, surgery. Formerly known as RU 486, mifepristone is also available in a lower strength as Mifeprex for use in terminating an early intrauterine pregnancy.

Anascorp (Rare Disease Therapeutics), an intravenously administered antivenom derived from horse serum, has been approved by the FDA for treatment of clinical signs of scorpion envenomation.

Renal sympathetic denervation is under investigation as a therapeutic option for hypertension that has not responded to ≥3 antihypertensive drugs (resistant hypertension).