ABSTRACT
Nonprescription ibuprofen is useful for managing minor aches and pains, reducing fever, and relieving symptoms of dysmenorrhea. For these indications, ibuprofen's effectiveness has been judged to be equal or superior to other available nonprescription analgesics. Ibuprofen is not recommended for self-treatment in children less than 12 years old.
Subject(s)
Ibuprofen , Drug Interactions , Humans , Ibuprofen/administration & dosage , Ibuprofen/adverse effects , Ibuprofen/therapeutic useABSTRACT
Annual vaccination programs against influenza are aimed at decreasing the morbidity and mortality associated with an infection. Recent epidemics have resulted in 40,000 excess deaths reported. The success of an immunization program depends both on the composition of the annual vaccine and the targeting efficacy of the program. National estimates of targeting efficacy are reported at 20%. An evaluation performed in the author's ambulatory care practice in the spring of 1984 yielded an overall efficacy of 24% in targeting activities. Efforts to improve the targeting practices included enhanced practitioner and patient education about the vaccine, flagging of medication records for patients at risk, and adoption of CDC guidelines for categorizing patients based on the degree of risk. A subsequent evaluation in 1986 showed a significant improvement in targeting efficacy (40%; P less than .001). Subgroup analysis indicated that the targeting efficacy of the program was greatest for the high-risk patients (P less than .025). An overall immunization rate of at least 80% of patients at risk is our desired goal.
Subject(s)
Ambulatory Care , Immunization/standards , Influenza, Human/prevention & control , Pharmaceutical Services/standards , Adolescent , Adult , Aged , Child , Child, Preschool , Evaluation Studies as Topic , Humans , Influenza, Human/drug therapy , Middle Aged , North Carolina , RiskABSTRACT
Recent clinical trials in hypertension suggest that thiazide diuretics may increase coronary heart deaths in selected patients, possibly through adverse effects on serum potassium, lipids, lipoproteins, and/or apolipoproteins. Administration of smaller doses of diuretics has been recommended to decrease this risk. We evaluated 12.5-mg and 112.5-mg daily doses of hydrochlorothiazide (HCTZ) administered for 1 month to nine postmenopausal black female hypertensives using a double-blind, randomized, crossover design. Both regimens produced significant reductions in sitting diastolic blood pressure, a mean of 11 mm Hg with the high dose and 8 mm Hg with the low dose. The high dose produced a mean 0.7 mEq/L reduction in serum potassium while the low dose caused no change. Both doses produced similar changes in serum lipoproteins. Statistically significant elevations were seen in total cholesterol (approximately 12%), LDL cholesterol (approximately 20%), cholesterol: HDL ratio (approximately 15%), and apolipoprotein B (approximately 20%). Apolipoprotein A1 was significantly reduced (approximately 6%). These results support the use of low doses of HCTZ in mild hypertension to avoid hypokalemia, but suggest that adverse changes in serum lipids will occur.
