The Annals of pharmacotherapy
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To review the use of dextromethorphan for the treatment of painful diabetic neuropathy. ⋯ There are insufficient safety and efficacy data to justify the use of dextromethorphan for treating painful diabetic neuropathy. Further clinical trials are needed.
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To report a case of metabolic acidosis and coma in a severe acetaminophen overdose. ⋯ Severe acetaminophen overdoses can independently cause metabolic acidosis and coma in the absence of hepatotoxicity.
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To describe the development of coronary artery disease in childhood and review the available literature regarding the safety and efficacy of hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) when used during childhood and adolescence. ⋯ The addition of the HMG-CoA reductase inhibitors lovastatin, pravastatin, or simvastatin to diet therapy in children > or =10 years of age may be effective when diet therapy alone has failed to obtain the recommended maximum LDL-C concentration of 130 mg/dL. The use of statins during childhood and adolescence is generally safe, but large, long-term studies should be performed before statins are routinely prescribed to children with elevated cholesterol or lipoprotein concentrations.
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Comparative Study
Impact of osteoarthritis and analgesic treatment on quality of life of an elderly population.
To determine the quality of life of elderly patients with osteoarthritis (OA) compared with that of their peers with no chronic illnesses and to investigate the associations between analgesic use and quality of life. ⋯ Quality of life of elderly OA patients with and without additional comorbidities was significantly poorer than that of their healthy peers, particularly in the domains associated with physical status, but also affecting vitality, social functioning, and general health. Level of pain suffered and perceived effectiveness of analgesic medication in pain control were important factors associated with quality of life.
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To review the pharmacokinetics, efficacy, adverse effects, and cost of the newest antitubercular drug, rifapentine. ⋯ Rifapentine can be administered twice weekly during the intensive phase of tuberculosis treatment and then once weekly during the continuation phase of treatment. This may improve patient adherence over some other treatments and possibly reduce costs of treatment by preventing development of resistant tubercular strains due to nonadherence. Rifapentine is well tolerated, with most patients experiencing adverse effects at a similar rate as rifampin. Rifapentine induces cytochrome P450 somewhat less than rifampin, although few drug interaction studies have been done with rifapentine. Its efficacy at the currently approved dosage of 600 mg may be slightly lower than that of rifampin. Studies are needed to determine if equal or greater efficacy can be achieved with higher doses of rifapentine. Rifampin is less expensive than rifapentine. Further pharmacoeconomic studies are needed to evaluate costs of relapse and failure in patients receiving these agents.