Drug and therapeutics bulletin
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In the UK, mefloquine (Lariam-Roche) has been marketed since 1990 for both malaria prophylaxis and for acute treatment of falciparum malaria. In 1991, we concluded that prophylaxis with mefloquine was appropriate for those travelling to areas where strains of Plasmodium falciparum resistant to chloroquine and proguanil are common. ⋯ Recently, mefloquine's use as a prophylactic has been questioned because of reports of neuropsychiatric unwanted effects. This article discusses the place of f2p4oquine in malaria prophylaxis in light of these concerns.
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Three years ago we reviewed paclitaxel (Taxol-Bristol-Myers Squibb), the first taxoid cytotoxic drug to be marketed. At that time it was licensed for the treatment of women with metastatic ovarian cancer resistant to standard platinum-containing therapy; we concluded that any benefits of paclitaxel were unproven. Since then the licence has been extended to include first-line treatment (in combination with cisplatin) of advanced ovarian cancer and treatment of metastatic carcinoma of the breast in patients who have failed, or are not candidates for, standard anthracycline-containing therapy. ⋯ It is licensed for the treatment of patients with breast cancer that is locally advanced or metastatic, and which is either resistant to, or has recurred after, cytotoxic therapy, or has relapsed during adjuvant cytotoxic therapy. In each case, the previous cytotoxic therapy should have included an anthracycline drug (such as doxorubicin). Here we review the place of the two taxoids in the treatment of ovarian and breast cancer.
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Glaucoma is one of the commonest causes of blindness in the world. In the UK, about 7% of people over the age of 75 years have primary open angle glaucoma, the most common type of glaucoma and the cause of visual impairment in about 13% of those registered blind. ⋯ However, half of all patients with primary open angle glaucoma in the UK do not present until vision has begun to deteriorate. Here we consider ways of improving detection and management.