Effect of concomitant antacid administration on plasma cimetidine concentrations during repetitive dosing.

Previous research has suggested that concurrent administration of antacid and cimetidine results in lower than expected plasma levels of cimetidine. Because these studies were all of single-dose design, this study was undertaken to determine the nature of the interaction after repeated administration of both drugs. There was no statistically significant difference demonstrated for any of the pharmacokinetic parameters evaluated in the study. Based on these findings, the previous recommendation that administration of antacid and cimetidine be separated in time may not be necessary.

P & T Committee roundtable discussion: Eastern region Pt. II.

A series of regional roundtable discussions regarding the successful operation of Pharmacy and Therapeutics (P & T) Committees has been conducted by Hospital Formulary. Representatives from private hospitals; university and teaching hospitals, as well as Veterans Administration medical centers have participated to ensure that different aspects of P & T Committee performance are demonstrated. issues regarding committee profile, constituency, function, and mechanics are discussed, as are criteria for establishing a successful formulary within an institution. The sessions were taped, and the edited transcription is provided in the following article.

Effect of antacids on predicted steady-state cimetidine concentrations.

The purpose of this study was to evaluate effects of antacids on predicted steady-state concentrations of cimetidine. Ten healthy volunteers received in random order one week apart, cimetidine and cimetidine and antacid suspension. Blood was obtained at specified times and analyzed for cimetidine. Bioavailability was assessed by comparison of peak concentration, time to peak concentration, area under the curve, and time spent over 0.5 micrograms/ml. Single-dose data were extrapolated to steady-state using computer simulation. Concurrent administration of antacid suspension reduced parameters of bioavailability approximately 30%. When steady-state conditions were simulated, concentrations of cimetidine greater than or equal to 0.5 micrograms/ml were maintained for the entire dosing interval in seven of 10 subjects. These data suggest that temporal separation of cimetidine and antacid suspension may be unnecessary.

P & T Committee roundtable discussion: Eastern region. Part I.

A series of regional roundtable discussions regarding the successful operation of Pharmacy and Therapeutics (P & T) Committees has been conducted by Hospital Formulary. Representatives from private hospitals, university and teaching hospitals, as well as Veterans Administration medical centers discuss committee profile, constituency, function, mechanics, and criteria for establishing a successful formulary within an institution. The sessions were taped, and the edited transcription is provided in the following article.

Antibodies to herpes simplex type 1 in patients with active duodenal ulcer.

One hundred seventy-two patients requiring upper gastrointestinal tract endoscopy were examined prospectively for evidence of herpes simplex virus type 1 (HSV-1) infection. No viruses were recovered from active ulcers (11 with duodenal and eight with gastric ulcers). Using both enzyme-linked immunosorbent assay (ELISA) and standard complement fixation methods, patients with endoscopically proved active duodenal ulcer had significantly higher mean serum antibody levels to HSV-1 (but not to cytomegalovirus) than those without evidence of peptic ulcer. Neither patients with a history of or evidence of past peptic ulcer nor those with active gastric ulcer had higher serum antibody levels to HSV-1 compared with subjects without ulcers. These data provide support for an association between active duodenal ulcer and HSV-1 infection, the nature of which is not defined by these studies.