Journal of Pharmacy Technology

To discuss the use of etidronate, a biphosphonate, in the treatment of women with postmenopausal osteoporosis and to determine its place in therapy when compared with conventional therapies.

A MEDLINE search was conducted for clinical trials and review articles on biphosphonates in the treatment of osteoporosis.

Six clinical trials and four review articles were selected because they dealt specifically with a biphosphonate in the treatment of postmenopausal osteoporosis.

The studies provide a look at how the treatment evolved from continuous etidronate therapy to the more accepted intermittent cyclic therapy. The studies showed an increase in bone mass and a decrease in vertebral fractures in women receiving cyclic therapy with etidronate compared with those receiving placebo. In one study, however, a follow-up report one year later revealed that women taking etidronate experienced a 50 percent increase in vertebral fracture rate compared with those receiving placebo. This was a complete reversal from the data collected over the first two years of the study. This follow-up study is useful to point out a major potential concern associated with long-term use of etidronate—that etidronate therapy may cause mineralization defects, which could lead to alterations in bone integrity.

Etidronate therapy has shown benefit in preserving bone in postmenopausal women. Comparative trials with conventional therapies such as estrogens have not been completed, which makes it difficult to determine etidronate's place in therapy. Long-term trials also are necessary to assess etidronate's potential to cause mineralization defects.

To report a case of Staphylococcus haemolyticus bacteremia that appeared unresponsive to vancomycin therapy alone but was successfully treated with the addition of rifampin therapy.

Public, university, teaching hospital (University of Minnesota Hospital and Clinic, Minneapolis).

A man with a history of bladder cancer developed S. haemolyticus bacteremia postoperatively that was unresponsive to vancomycin alone. The addition of oral rifampin to the vancomycin regimen provided a synergistic effect (serum inhibitory titer and serum bactericidal titer both ⩾ 1:64). The 5. haemolyticus was eradicated as judged by negative blood cultures for coagulase-negative Staphylococcus and clinical recovery.

In the treatment of an S. haemolyticus bacteremia, the addition of rifampin to vancomycin therapy was effective in eliminating the organism.

To determine whether consumers are using nonprescription ibuprofen more predominantly to treat acute or chronic conditions, incidence of adverse effects, and whether a healthcare professional is providing patient information.

A questionnaire was developed and placed in 15 randomly selected community pharmacies in a major metropolitan area. Adult consumers who were purchasing an ibuprofen over-the-counter product or who had previously used an ibuprofen product were asked to complete a written questionnaire (n=190). The information collected included age, gender, prescription, and other over-the-counter drugs presently used, quantity, duration, present illnesses or conditions, both intended and past use of ibuprofen, and incidence of adverse reactions.

Most subjects who self-treated with ibuprofen were female (70.8 percent) with a mean age of 37 years. Consumers generally used ibuprofen for stress/tension headache (38.9 percent), menstrual cramps (34.2 percent), generalized pain (31.8 percent), or muscle strain/sprain (30.0 percent). Most (55.9 percent) took 400 mg when needed, and 42.2 percent used ibuprofen for a period of 24 hours. Counseling concerning ibuprofen use was provided by a physician (42.9 percent) or pharmacist (39.7 percent) in most cases. The label was read the majority of the time (75 percent), and everyone who read the label understood the printed information.

The findings indicate that this community sample of consumers was using nonprescription ibuprofen appropriately for acute or as needed conditions over a short period of time. They experienced few adverse reactions to ibuprofen. Both pharmacists and physicians were providing patient information about ibuprofen. Counseling is needed regarding prescription and nonprescription drugs with a potential to interact with ibuprofen.

To examine the relationship of the frequency of daily doses and medication compliance for hypertensive patients.

Retrospective study, nonrandomized control trial.

Rural, general community.

Convenience sample of 55 outpatients who were prescribed antihypertensive therapy exclusively and whose therapy had been consistent for at least 14 months.

Pharmacy records were accessed to determine the medication compliance of these participants.

Medication compliance differences between participants who were on a once-a-day antihypertensive regimen versus a two-or-more × a day regimen.

Patients in the once-a-day regimen group were significantly more compliant than those in the two-or-more × a day group.

Consideration must be given to simplification of medication regimens to improve compliance. J Pharm Technol 1994;10:115–7.