Drugs

Moyle, Graeme; Gazzard, Brian; Cooper, David; Gatell, José

doi: 10.2165/00003495-199855030-00005pmid: 9530544

In the absence of evidence that eradication of HIV from an infected individual is feasible, the established goal of antiretroviral therapy is to reduce viral load to as low as possible for as long as possible. Achieving this with the currently available antiretroviral agents involves appropriate selection of components of combination regimens to obtain an optimal antiviral response. In addition, consideration of a plan for a salvage or second-line regimen is required if initial therapy fails to achieve an optimal response or should loss of virological control occur despite effective initial therapy. Such a planned approach, based on consideration of the likely modes of therapeutic failure (viral resistance, cellular resistance, toxicity) could be called rational sequencing.

Gelder, Isabelle; Brügemann, Johan; Crijns, Harry

doi: 10.2165/00003495-199855030-00002pmid: 9530541

Over the past decade, various studies have demonstrated that class I antiarrhythmic drugs should be avoided in patients with heart failure, cardiac ischaemia or a previous myocardial infarction. In contrast, class II drugs (β-blockers) reduce morbidity and may even lower mortality in patients suffering from moderate to severe heart failure. In these patients, careful titration of the drug dosage, frequently during hospital admission, may be necessary.

Colleoni, Marco; Audisio, Riccardo; Brand, Filippo; Fazio, Nicolas; Martinelli, Giovanni; Goldhirsch, Aron

doi: 10.2165/00003495-199855030-00004pmid: 9530543

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. To date, curative treatment options include liver transplantation or resection. Unfortunately, most patients are detected with nonresectable or -transplantable HCC due to disease extension or comorbid factors, and are therefore candidates only for palliative treatments.

Piérard, Gérald

doi: 10.2165/00003495-199855030-00008pmid: N/A

McClellan, Karen; Wiseman, Lynda; McTavish, Donna

doi: 10.2165/00003495-199855030-00009pmid: 9530546

▴ Cerivastatin is a synthetic HMG-CoAreductase inhibitor with high liver selectivity, which lowers plasma cholesterol levels by inhibiting endogenous cholesterol synthesis. ▴ In vitro, the affinity of cerivastatin for HMG-CoA reductase was higher than that of lovastatin, simvastatin and pravastatin. This higher enzyme affinity was reflected in vivo, with a lower ED50 (dose causing 50% inhibition) for cerivastatin in rats and beagle dogs compared with lovastatin. ▴ Cerivastatin 0.2 mg/day significantly reduced low density lipoprotein (LDL)-cholesterol, total cholesterol and triglyceride levels, and increased high density lipoprotein (HDL)-cholesterol levels, in patients with type IIa hypercholesterolaemia. ▴ Available data indicate that cerivastatin has a tolerability profile similar to that of other HMG-CoA reductase inhibitors. ▴ No drug interactions were observed when cerivastatin was coadministered with digoxin, warfarin, cimetidine or the antacid magnesium/aluminium hydroxide.

Gopal Rao, G.

doi: 10.2165/00003495-199855030-00001pmid: 9530540

The emergence of antibiotic resistance is primarily due to excessive and often unnecessary use of antibiotics in humans and animals. Risk factors for the spread of resistant bacteria in hospitals and the community can be summarised as overcrowding, lapses in hygiene or poor infection control practices. Increasing antibiotic resistance in bacteria has been exacerbated by the slow pace in developing newer antibiotics.

Stein, A.

doi: 10.2165/00003495-199855030-00011pmid: N/A

Adkins, Julie; Noble, Stuart

doi: 10.2165/00003495-199855030-00013pmid: 9530548

Itoh, Masatoshi

doi: 10.2165/00003495-199855030-00007pmid: N/A

Corsini, Alberto

doi: 10.2165/00003495-199855030-00010pmid: N/A