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In Brief: A New OTC Naloxone Nasal Spray (RiVive)

The Medical Letter on Drugs and Therapeutics • March 18, 2024; (Issue 1698)

The FDA has approved RiVive (Harm Reduction Therapeutics), a 3-mg naloxone nasal spray, as an over-the-counter (OTC) product for emergency treatment of opioid overdose. Two 4-mg naloxone nasal spray...

The FDA has approved RiVive (Harm Reduction Therapeutics), a 3-mg naloxone nasal spray, as an over-the-counter (OTC) product for emergency treatment of opioid overdose. Two 4-mg naloxone nasal spray formulations, Narcan and one of its generics, were approved for OTC sale in 2023.

Med Lett Drugs Ther. 2024 Mar 18;66(1698):47-8 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Drugs for Maintenance Treatment of Opioid Use Disorder (online only)

The Medical Letter on Drugs and Therapeutics • September 4, 2023; (Issue 1684)

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View Comparison Table: Some Drugs for Maintenance Treatment of Opioid Use Disorder

Med Lett Drugs Ther. 2023 Sep 4;65(1684):e144-5 | Show Full Introduction Hide Full Introduction

Drugs for Opioid Use Disorder

The Medical Letter on Drugs and Therapeutics • September 4, 2023; (Issue 1684)

Opioid use disorder is a chronic, relapsing disease with physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of blood-borne infections such as HIV and viral hepatitis, adverse pregnancy outcomes, and increased mortality. According to the NIH, there were 80,411 deaths involving an opioid in the US in 2021, more than in any previous year. Several guidelines on the management of opioid use disorder are available; all recommend maintenance pharmacotherapy as the standard of care.

Med Lett Drugs Ther. 2023 Sep 4;65(1684):137-44 | Show Full Introduction Hide Full Introduction

In Brief: Over-the-Counter Narcan Nasal Spray

The Medical Letter on Drugs and Therapeutics • May 1, 2023; (Issue 1675)

The FDA has approved the over-the-counter (OTC) sale of Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone. Narcan nasal spray has been available by prescription since...

The FDA has approved the over-the-counter (OTC) sale of Narcan (Emergent), a nasal spray that delivers 4 mg of the opioid antagonist naloxone. Narcan nasal spray has been available by prescription since 2015 for emergency treatment of opioid overdose. Generic formulations of Narcan have also been approved; the manufacturers of these products will be required to switch them to OTC status and amend their labeling accordingly. Kloxxado, an 8-mg naloxone nasal spray, remains available only by prescription.

Med Lett Drugs Ther. 2023 May 1;65(1675):72 | Show Full Introduction Hide Full Introduction

Opioids for Pain

The Medical Letter on Drugs and Therapeutics • December 12, 2022; (Issue 1665)

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

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

Med Lett Drugs Ther. 2022 Dec 12;64(1665):193-200 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Oral/Transdermal Opioid Analgesics (online only)

The Medical Letter on Drugs and Therapeutics • December 12, 2022; (Issue 1665)

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View the Comparison Table: Some Oral/Transdermal Opioid Analgesics

Med Lett Drugs Ther. 2022 Dec 12;64(1665):e199-202 | Show Full Introduction Hide Full Introduction

Management of Opioid Withdrawal Symptoms

The Medical Letter on Drugs and Therapeutics • August 27, 2018; (Issue 1554)

Pharmacologic management of opioid withdrawal symptoms can reduce the intensity of drug craving and improve treatment retention in patients with opioid use disorder who will receive maintenance...

Pharmacologic management of opioid withdrawal symptoms can reduce the intensity of drug craving and improve treatment retention in patients with opioid use disorder who will receive maintenance treatment. Withdrawal management without subsequent maintenance treatment is associated with high rates of relapse, overdose death, and HIV and/or hepatitis C virus infection. Several guidelines on management of opioid withdrawal are available. Maintenance treatment of opioid use disorder was reviewed in a previous issue.

Med Lett Drugs Ther. 2018 Aug 27;60(1554):137-42 | Show Full Introduction Hide Full Introduction

Expanded Table: Some Drugs for Management of Opioid Withdrawal Symptoms (online only)

The Medical Letter on Drugs and Therapeutics • August 27, 2018; (Issue 1554)

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View Expanded Table: Some Drugs for Management of Opioid Withdrawal Symptoms

Med Lett Drugs Ther. 2018 Aug 27;60(1554):e144-6 | Show Full Introduction Hide Full Introduction

Lofexidine (Lucemyra) for Opioid Withdrawal

The Medical Letter on Drugs and Therapeutics • July 16, 2018; (Issue 1551)

The FDA has approved lofexidine (Lucemyra – US WorldMeds/Salix), a centrally acting alpha2 receptor agonist, to manage withdrawal symptoms in adults abruptly stopping opioid use. Available in the UK...

The FDA has approved lofexidine (Lucemyra – US WorldMeds/Salix), a centrally acting alpha₂ receptor agonist, to manage withdrawal symptoms in adults abruptly stopping opioid use. Available in the UK since 1992, lofexidine is the first nonopioid to be approved in the US for management of opioid withdrawal symptoms. Clonidine (Catapres, and generics), another central alpha₂ receptor agonist, has been used off-label for this indication for many years.

Med Lett Drugs Ther. 2018 Jul 16;60(1551):115-7 | Show Full Introduction Hide Full Introduction

Opioids for Pain

The Medical Letter on Drugs and Therapeutics • April 9, 2018; (Issue 1544)

Use of nonopioid drugs for pain was reviewed in a previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations of full opioid agonists should generally be used for acute pain that is severe enough to require treatment with an opioid. Use of extended-release or long-acting opioid formulations initially and treatment durations >1 week have been associated with an increased risk of unintended long-term use.

Med Lett Drugs Ther. 2018 Apr 9;60(1544):57-64 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Oral/Topical Opioid Analgesics (online only)

The Medical Letter on Drugs and Therapeutics • April 9, 2018; (Issue 1544)

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View the Comparison Table: Some Oral/Topical Opioid Analgesics

Med Lett Drugs Ther. 2018 Apr 9;60(1544):e64-7 | Show Full Introduction Hide Full Introduction

Drugs for Opioid Use Disorder

The Medical Letter on Drugs and Therapeutics • June 5, 2017; (Issue 1522)

Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of...

Opioid use disorder is a chronic, relapsing disease with both physical and psychiatric components. It is associated with economic hardship, social isolation, incarceration, increased rates of blood-borne infections such as HIV and viral hepatitis, adverse pregnancy outcomes, and increased mortality. According to the CDC, there were 33,091 deaths related to opioid overdose in the US in 2015, more than in any previous year. Several guidelines on the management of opioid use disorder have recently been published.

Med Lett Drugs Ther. 2017 Jun 5;59(1522):89-96 | Show Full Introduction Hide Full Introduction

Comparison Table: Some Drugs for Maintenance Treatment of Opioid Use Disorder (online only)

The Medical Letter on Drugs and Therapeutics • June 5, 2017; (Issue 1522)

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View Comparison Table: Some Drugs for Maintenance Treatment of Opioid Use Disorder

Med Lett Drugs Ther. 2017 Jun 5;59(1522):e96-7 | Show Full Introduction Hide Full Introduction

Buprenorphine Implants (Probuphine) for Opioid Dependence

The Medical Letter on Drugs and Therapeutics • July 18, 2016; (Issue 1499)

The FDA has approved subdermal implants of the partial opioid agonist buprenorphine (Probuphine – Titan) for maintenance treatment of opioid dependence in patients stabilized on low to moderate doses of...

The FDA has approved subdermal implants of the partial opioid agonist buprenorphine (Probuphine – Titan) for maintenance treatment of opioid dependence in patients stabilized on low to moderate doses of transmucosal buprenorphine. Probuphine was designed to provide continuous low levels of buprenorphine for 6 months and to safeguard against illicit use of the drug.

Med Lett Drugs Ther. 2016 Jul 18;58(1499):94-5 | Show Full Introduction Hide Full Introduction

Naloxone (Narcan) Nasal Spray for Opioid Overdose

The Medical Letter on Drugs and Therapeutics • January 4, 2016; (Issue 1485)

The recent increase in deaths due to overdose of heroin and prescription opioids in the US has renewed interest in the opioid antagonist naloxone, particularly in making it available to first responders and to relatives and close friends of persons using heroin or taking prescription opioids. IV or IM administration by healthcare professionals is preferred, but peripheral venous access may be difficult to obtain in IV drug abusers, and exposure to their blood may be hazardous.

Med Lett Drugs Ther. 2016 Jan 4;58(1485):1-2 | Show Full Introduction Hide Full Introduction

Bunavail: Another Buprenorphine/Naloxone Formulation for Opioid Dependence

The Medical Letter on Drugs and Therapeutics • February 2, 2015; (Issue 1461)

The FDA has approved a buccal film formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Bunavail – BioDelivery Sciences) for maintenance treatment of...

The FDA has approved a buccal film formulation of the partial opioid agonist buprenorphine combined with the opioid antagonist naloxone (Bunavail – BioDelivery Sciences) for maintenance treatment of opioid dependence. Sublingual tablet and film formulations of the same combination were approved earlier. The manufacturer of Bunavail claims that the new product is superior to sublingual formulations because of the convenience of buccal administration and better absorption into the blood, permitting use of lower doses.

Med Lett Drugs Ther. 2015 Feb 2;57(1461):19-20 | Show Full Introduction Hide Full Introduction

Drugs for Parkinson's Disease

The Medical Letter on Drugs and Therapeutics • November 1, 2013; (Issue 135)

The motor symptoms of Parkinson's disease (PD) are caused primarily by progressive degeneration of dopaminergic neurons in the substantia nigra. The non-motor symptoms of the disease are thought to be...

Treat Guidel Med Lett. 2013 Nov;11(135):101-6 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2013; (Issue 128)

Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids and is often treated with adjuvant drugs such as antidepressants and antiepileptics. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2013 Apr;11(128):31-42 | Show Full Introduction Hide Full Introduction

Quetiapine (Seroquel) and QT-Interval Prolongation

The Medical Letter on Drugs and Therapeutics • October 3, 2011; (Issue 1374)

The FDA has required the manufacturer of the secondgeneration antipsychotic quetiapine (Seroquel) to add a warning to the labeling saying that use of the drug should be avoided in combination with other...

The FDA has required the manufacturer of the secondgeneration antipsychotic quetiapine (Seroquel) to add a warning to the labeling saying that use of the drug should be avoided in combination with other drugs that prolong the electrocardiographic QTc interval (Table 1). The warning is based only on postmarketing reports of QT-interval prolongation in patients who overdosed on the drug, had concomitant illness, or were taking other drugs known to cause electrolyte imbalances or increase the QT interval. QT prolongation can lead to torsades de pointes, a potentially fatal cardiac arrhythmia.

Med Lett Drugs Ther. 2011 Oct 3;53(1374):79-80 | Show Full Introduction Hide Full Introduction

Drugs for Parkinson's Disease

The Medical Letter on Drugs and Therapeutics • January 1, 2011; (Issue 101)

Parkinson’s disease (PD) is caused primarily by progressive degeneration of dopamine-containing neurons in the substantia nigra. Dopamine itself cannot be used to treat PD because it does not cross the...

Treat Guidel Med Lett. 2011 Jan;9(101):1-6 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2010; (Issue 92)

Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids; adjuvant medicines such as antidepressants and anticonvulsants are often used to treat neuropathic pain. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2010 Apr;8(92):25-34 | Show Full Introduction Hide Full Introduction

Dronedarone (Multaq) for Atrial Fibrillation

The Medical Letter on Drugs and Therapeutics • October 5, 2009; (Issue 1322)

Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but...

Dronedarone (Multaq - Sanofi-Aventis) has been approved by the FDA for oral treatment of atrial fibrillation and flutter. Amiodarone (Cordarone, and others) is the most effective drug for this indication, but has considerable toxicity.

Med Lett Drugs Ther. 2009 Oct 5;51(1322):78-80 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • April 1, 2007; (Issue 56)

Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants and anticonvulsants have been used to treat neuropathic pain. Combining two different types of analgesics may nprovide an additive analgesic effect without increasing adverse effects.

Treat Guidel Med Lett. 2007 Apr;5(56):23-32 | Show Full Introduction Hide Full Introduction

Tipranavir (Aptivus) for HIV

The Medical Letter on Drugs and Therapeutics • October 10, 2005; (Issue 1219)

Tipranavir (Aptivus - Boehringer Ingelheim), a new protease inhibitor, has received accelerated approval from the FDA. It must be given with ritonavir (Norvir). The combination is indicated for use with other...

Tipranavir (Aptivus - Boehringer Ingelheim), a new protease inhibitor, has received accelerated approval from the FDA. It must be given with ritonavir (Norvir). The combination is indicated for use with other antiretrovirals to treat HIV infection in highly treatment-experienced adults who have ongoing viral replication or in those with HIV strains known to be resistant to multiple protease inhibitors.

Med Lett Drugs Ther. 2005 Oct 10;47(1219):83-4 | Show Full Introduction Hide Full Introduction

Drugs for Tuberculosis

The Medical Letter on Drugs and Therapeutics • December 1, 2004; (Issue 28)

Tuberculosis (TB) is still a problem in the United States, even though the incidence continues to decline in most of the country (MMWR Morbid Mortal Wkly Rep 2004; 53:209). Treatment of TB can be divided into treatment of latent infection diagnosed by a positive PPD and treatment of active clinical TB. Guidelines with detailed management recommendations are available from the US Centers for Disease Control and Prevention (CDC) (MMWR Morbid Mortal Wkly Rep 2003; 52RR-11:1).

Treat Guidel Med Lett. 2004 Dec;2(28):83-2 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • July 1, 2004; (Issue 23)

Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of as analgesics, such as antidepressants, which can act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Combining two different types of analgesics may provide an additive analgesic effect without necessarily increasing adverse effects.

Treat Guidel Med Lett. 2004 Jul;2(23):47-54 | Show Full Introduction Hide Full Introduction

Buprenorphine: An alternative to Methadone

The Medical Letter on Drugs and Therapeutics • February 17, 2003; (Issue 1150)

The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only...

The FDA has approved the marketing of buprenorphine in sublingual tablets (Reckitt Benckiser) both alone (Subutex) and with naloxone (Suboxone) for treatment of opioid dependence. Previously available only for parenteral use in treatment of pain (Buprenex, and others), it offers an alternative to methadone (Dolophine, and others), which is now often abused (New York Times, February 9, 2003; page 1). As a schedule III narcotic, buprenorphine will be subject to fewer prescribing restrictions than a schedule II drug such as methadone (MJ Kreek and FJ Vocci, J Subst Abuse Treat 2002; 23:93).w1150a

Med Lett Drugs Ther. 2003 Feb 17;45(1150):13-5 | Show Full Introduction Hide Full Introduction

Acute Reactions to Drugs of Abuse

The Medical Letter on Drugs and Therapeutics • March 4, 2002; (Issue 1125)

Acute toxic reactions to drugs of abuse continue to be important problems. Some patients may have mixed intoxications with complex combinations of signs and...

Acute toxic reactions to drugs of abuse continue to be important problems. Some patients may have mixed intoxications with complex combinations of signs and symptoms.

Med Lett Drugs Ther. 2002 Mar 4;44(1125):21-4 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • August 21, 2000; (Issue 1085)

Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Non-opioids can be given concurrently with opioids for an additive analgesic effect.

Med Lett Drugs Ther. 2000 Aug 21;42(1085):73-8 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • August 14, 1998; (Issue 1033)

Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, some drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain.

Med Lett Drugs Ther. 1998 Aug 14;40(1033):79-84 | Show Full Introduction Hide Full Introduction

Acute Reactions to Drugs of Abuse

The Medical Letter on Drugs and Therapeutics • May 10, 1996; (Issue 974)

Acute toxic reactions to drugs of abuse continue to be important problems. Since the last Medical Letter article on this subject (volume 32, page 92, 1990), new reactions and new approaches to treating them...

Med Lett Drugs Ther. 1996 May 10;38(974):43-6 | Show Full Introduction Hide Full Introduction

Nalmefene - Long-Acting Injectable Opioid Antagonist

The Medical Letter on Drugs and Therapeutics • October 27, 1995; (Issue 960)

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...

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 use.

Med Lett Drugs Ther. 1995 Oct 27;37(960):97-8 | Show Full Introduction Hide Full Introduction

Drugs For Tuberculosis

The Medical Letter on Drugs and Therapeutics • August 4, 1995; (Issue 954)

Tuberculosis (TB) continues to be a major problem in the United States, particularly in areas where drug resistance is common (Morbid Mortal Weekly Rep, 44:387, May 26, 1995). Since poor compliance is the most important cause of treatment failure and is associated with emergence of drug resistence, some experts now recommend that all patients take drugs for TB under direct observation (SE Weis et al, N Engl J Med, 330:1179, 1994; R Bayer and D Wilkinson, Lancet, 345:1545, June 17, 1995).

Med Lett Drugs Ther. 1995 Aug 4;37(954):67-70 | Show Full Introduction Hide Full Introduction

Naltrexone For Alcohol Dependence

The Medical Letter on Drugs and Therapeutics • July 21, 1995; (Issue 953)

Naltrexone (ReVia -DuPont Pharma), a long-acting oral opioid antagonist previously marketed for treatment of opioid dependence under the trade name Trexan, was recently approved by the US Food and Drug...

Naltrexone (ReVia -DuPont Pharma), a long-acting oral opioid antagonist previously marketed for treatment of opioid dependence under the trade name Trexan, was recently approved by the US Food and Drug Administration (FDA) for treatment of alcohol dependence. The new trade name will now also be used for the old indication.

Med Lett Drugs Ther. 1995 Jul 21;37(953):64-6 | Show Full Introduction Hide Full Introduction

Drugs for Migraine

The Medical Letter on Drugs and Therapeutics • March 3, 1995; (Issue 943)

Drugs are used both to prevent and treat migraine symptoms. The effectiveness of such use can be difficult to evaluate, even with double-blind controlled trials, because migraine is episodic, response to placebo is frequent, and patients vary in response to a given agent (KMA Welch, N Engl J Med, 329:1476, 1993; SD Silberstein and RB Lipton, Neurology, 44 suppl 7:S6, Oct 1994).

Med Lett Drugs Ther. 1995 Mar 3;37(943):17-20 | Show Full Introduction Hide Full Introduction

Fluvoxamine for Obsessive-Compulsive Disorder

The Medical Letter on Drugs and Therapeutics • February 17, 1995; (Issue 942)

Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine...

Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine (Prozac), another SSRI antidepressant, and clomipramine (Anafranil), a tricyclic antidepressant that also inhibits serotonin reuptake, are the only other drugs available for this indication in the USA. Antidepressants that do not inhibit serotonin reuptake have not been effective for treatment of this condition.

Med Lett Drugs Ther. 1995 Feb 17;37(942):13-4 | Show Full Introduction Hide Full Introduction

LAAM - Long-Acting Methadone for Treatment of Heroin Addiction

The Medical Letter on Drugs and Therapeutics • June 10, 1994; (Issue 924)

Methadone, an opioid agonist that can be taken orally, has been used for maintenance treatment for many years in the USA (DM Novick et al, Drug Alcohol Depend, 33:235, 1993). Last year, the US Food and Drug Administration approved the distribution and use of L-alpha-acetyl-methadol (LAAM; ORLAAM - Bio Development Corporation, McLean, VA), a long-acting congener of methadone. LAAM, like methadone, will be available for this indication only through federal and state-regulated treatment programs.

Med Lett Drugs Ther. 1994 Jun 10;36(924):52 | Show Full Introduction Hide Full Introduction

Butorphanol Nasal Spray for Pain

The Medical Letter on Drugs and Therapeutics • November 12, 1993; (Issue 909)

Butorphanol tartrate, a synthetic opioid agonist-antagonist analgesic previously available for injection, is now being marketed as a nasal spray (Stadol-NS - Mead Johnson). The spray was approved by the US...

Butorphanol tartrate, a synthetic opioid agonist-antagonist analgesic previously available for injection, is now being marketed as a nasal spray (Stadol-NS - Mead Johnson). The spray was approved by the US Food and Drug Administration (FDA) for any type of pain for which an opioid analgesic is appropriate, but the manufacturer is emphasizing use for treatment of migraine headache and postoperative pain. Drugs for pain were reviewed in the Medical Letter, volume 35, page 1, January 8, 1993.

Med Lett Drugs Ther. 1993 Nov 12;35(909):105-6 | Show Full Introduction Hide Full Introduction

Drugs for Tuberculosis

The Medical Letter on Drugs and Therapeutics • October 29, 1993; (Issue 908)

The rising incidence of tuberculosis (TB) has been accompanied by a dramatic increase in drug resistance in some areas of the USA (TR Frieden et al, N Engl J Med, 328:521, 1993). Since poor compliance is the most important cause of treatment failure and associated with emergence of drug resistance, some experts now recommend that patients with TB take their drugs under direct obeservation (MD Iseman et al, N Engl J Med, 329:576, 1993).

Med Lett Drugs Ther. 1993 Oct 29;35(908):99-102 | Show Full Introduction Hide Full Introduction

Drugs for Pain

The Medical Letter on Drugs and Therapeutics • January 8, 1993; (Issue 887)

Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. (American Pain Society, Principles of analgesic Use, 3rd ed, Skokie, illinois: American pain society, 1992).

Med Lett Drugs Ther. 1993 Jan 8;35(887):1-6 | Show Full Introduction Hide Full Introduction

Acute Reactions to Drugs of Abuse

The Medical Letter on Drugs and Therapeutics • October 5, 1990; (Issue 828)

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Med Lett Drugs Ther. 1990 Oct 5;32(828):92-4 | Show Full Introduction Hide Full Introduction

Drugs That Cause Pulmonary Toxicity

The Medical Letter on Drugs and Therapeutics • September 21, 1990; (Issue 827)

Some commonly used systemic drugs that may cause pulmonary toxicity are listed in the table below. These adverse effects may sometimes be difficult to distinguish from the underlying disease (JAD Cooper, Jr et al, Am Rev Respir Dis, 133:321, 488, 1986). Pulmonary effects that are part of a generalized reaction or are indirect effects of drugs - on respiratory muscles, for example, or on the immune system - are not included here.

Med Lett Drugs Ther. 1990 Sep 21;32(827):88-90 | Show Full Introduction Hide Full Introduction