Drugs

Brogden, R.; Heel, R.; Speight, T.; Avery, G.

doi: 10.2165/00003495-197918040-00001pmid: 387372

Synopsis: Naproxen1 is a propionic acid derivative with analgesic and anti-inflammatory activity which has been widely used in the treatment of rheumatic diseases. Naproxen has been well studied in rheumatoid arthritis and is as effective as aspirin but better tolerated, thus enabling more patients to continue with treatment. For this reason some clinicians now prefer to try propionic acid derivatives, such as naproxen, before aspirin in arthritic patients. In comparative studies with other non-steroidal anti-inflammatory drugs, such as indomethacin, ibuprofen, fenoprofen and others, all drugs were usually of similar overall efficacy although naproxen was sometimes preferred: but as with other non-steroidal anti-inflammatory agents, not all patients will respond to naproxen and in such cases other agents should also be tried until the most satisfactory drug is found for each patient.

Ovesen, Lars

doi: 10.2165/00003495-197918040-00002pmid: 387373

During the past 10 to 20 years it has become increasingly clear that a certain number of drugs may lead to increased vitamin requirements. However, it is unusual for symptomatic avitaminosis to develop, and then only when circumstances are present which in themselves increase the risk of vitamin deficiency.

Linnoila, M.; Mattila, M.; Kitchell, B.

doi: 10.2165/00003495-197918040-00003pmid: 387374

Ethanol and drugs can affect each other’s absorption, distribution, metabolism, and excretion. When ingested together, ethanol can increase drug absorption by enhancing the gastric solubility of drugs and by increasing gastrointestinal blood flow. However, high concentrations of ethanol induce gastric irritation causing a pyloric spasm which in turn may delay drug absorption and/or reduce bioavailability. The ‘quality’ of the alcoholic beverage, independent of its ethanol content, can contribute to altered absorption of a drug.

Walker, J.; Beevers, D.

doi: 10.2165/00003495-197918040-00004pmid: 387375

In the second half of this century, morbidity and mortality from cardiovascular disease has reached epidemic proportions. The major risk factor associated with cardiovascular disease has been found, from various epidemiological studies, to be elevated blood pressure. Therefore, a lot of energy has been expended in prospective therapeutic trials in attempting to detect whether treatment of high blood pressure is beneficial. In severe hypertension, where the risk to the individual is considerable, this benefit has been demonstrated with relative ease. However, it has not yet proven possible to show conclusive benefit of treatment in the mild group of hypertensives, which form the vast majority of patients seen in general practice. A different approach has been advocated where account is taken of other coincidental cardiovascular risk factors; their presence or absence should help the clinician decide whether to treat or not to treat in the individual case.

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doi: 10.2165/00003495-197918040-00005pmid: N/A