Human alpha1-proteinase inhibitor (Prolastin Cutter), possibly better known as alpha1-antitypsin (ATT), is now available in the USA for replacement therapy in patients with emphysema who have a congential deficiency of the protein.

Recent advertisements for indapamide (Lozol - Rorer), an oral antihypertensive/diuretic (Medical Letter, 26:17, 1984), claim that the drug, unlike thiazide diuretics, does not significantly increase serum cholesterol and has a minimal impact on potassium. Indapamide has no thiazide ring but, like chlorthalidone (Hygroton; and others) and hydrochlorothiazide (HydroDiuril; and others), it does have a sulfamoyl benzamide moiety, which is probably responsible for its natriuretic and diuretic effects. Unlike the thiazides, it also has a methylindoline moiety, which apparently decreases...

The US Food and Drug Administration recently approved ''Treatment IND';'; (investigational new drug) protocols for Exosurf (Burroughs Wellcome) and Survanta (Ross), two preparations of surfactant used for prevention and treatment of the respiratory distress syndrome (RDS) in premature newborn infants. Consequently, these drugs will be available to virtually every level-ΙΙΙ neonatal intensive-care unit in the USA.

Adenosine (Adenocard - Fujisawa), an endogenous purine nucleoside, was recently approved by the US Food and Drug Administration for intravenous treatment of paroxysmal supraventricular tachycardia, including Wolff-Parkinson-White (WPW) syndrome. Adenosine is not approved for and has not been effective in treating atrial flutter, atrial fibrillation, or ventricular tachycardias.

Pegademase (Adagen - Enzon), bovine adenosine deaminase (ADA) conjugated with polyethylene glycol (PEG), was recently approved by the US Food and Drug Administration as an 'orphan drug' for treatment of severe combined immunodeficiency disease (SCID). SCID due to inherited deficiency of ADA occurs in less than one per million births; until recently, without extraordinary isolation measures, it was usually fatal before the age of two.

Isradipine (DynaCirc - Sandoz), a dihydropyridine calcium-channel blocker chemically related to nicardipine (Cardene) and nifedipine (Procardia, and others), was recently approved by the US Food and Drug Administration for oral treatment of hypertension.

(Ceredase - Genzyme) a modified form of the glycoprotein enzyme glucocerebrosidase prepared from human placenta, was recently approved by the US Food and Drug Administration as an 'orphan drug' for treatment of patients with the non-neurologic form of Gaucher's disease (Type 1).

Recent studies have caused concern about cardiomyopathy associated with doxorubicin (Adriamycin, and others), daunorubicin (Cerubidine, and others), idarubicin (Idamycin), mitoxantrone (Novantrone), and related anthracycline or anthraquinone anticancer drugs. Dexrazoxane (ADR-529, ICRF-187 - Adria), a piperazine derivative of ethylenediaminetetraacetic acid (EDTA), is now under investigation for prevention of this drug-induced cardiomyopathy.

Electronic reading machines that convert print into speech have become increasingly useful for blind, other visually impaired, or dyslexic patients. Some of these devices are available as components that can be added to a personal computer.

The Medical Letter continues to receive inquiries about the value of edetate disodium (EDTA) chelation therapy for cardiovascular disease. The last Medical Letter article on this subject was published in 1981 (volume 23, page 51). Some authors have estimated that more than 500,000 people receive this form of treatment each year (MT Grier and DG Meyers, Ann Pharmacother, 27:1504, Dec 1993).