Publication rates in U.S. schools and colleges of pharmacy, 1976-1992.

To establish publication rates of U.S. schools and colleges of pharmacy (SCOP) for 1976-1992, we obtained data from the Science Citation Index (SCI) Corporate Index. The SCI data base covers the top 4500 journals in the technical and scientific fields. Citations were counted without regard to publication type (letter, abstract, review, etc.). Duplicative publications were eliminated. Faculty counts were obtained from the American Association of Colleges of Pharmacy Roster of Faculty and Staff for the inclusive years. Total publications for all schools increased over 100% from 1976 to 1992, and the number of faculty members increased by 40% during that time. However, only 12 (16%) of the SCOP averaged 50 or more publications/year, whereas 43 (59%) averaged fewer than 20. Data were also normalized by full-time faculty members. Only 13 (18%) SCOP averaged 1.0 or more publication/faculty/year, and 38 (52%) averaged fewer than 0.5. Publication rates were greater for medical center-based than for nonmedical center-based SCOP (p < 0.05), and for public than for private SCOP (p < 0.05). These data suggest that over half of the existing SCOP are minimally productive, generating less than 20 publications/year or 0.5 publication/faculty/year.

Methotrexate for the treatment of chronic corticosteroid-dependent asthma.

The role and adverse effects of methotrexate in the treatment of chronic corticosteroid-dependent asthma are discussed. Methotrexate is a folic acid antagonist that has been used as an anti-inflammatory agent in the treatment of arthritis. It also appears to be effective in reducing the corticosteroid requirements in patients with chronic corticosteroid-dependent asthma, a use that was first reported in 1986. Studies of this use of methotrexate in adults support a trial of methotrexate in patients with severe asthma who have been unable to discontinue corticosteroid use despite aggressive management of their asthma and who are experiencing severe corticosteroid toxicity. Experience with methotrexate in children with asthma is limited to case series. Adverse effects associated with the use of methotrexate for treatment of corticosteroid-dependent asthma include nausea, elevated serum aminotransferase, diarrhea, and thinning of hair. While methotrexate appears to reduce corticosteroid requirements in patients with chronic corticosteroid-dependent asthma, its role in asthma therapy still needs to be clarified.

Clindamycin-induced lip and nasal passage swelling.

OBJECTIVE: To report a severe case of clindamycin-induced lip and nasal passage swelling. DESIGN: Single case report. SETTING: Six hundred eighty-four-bed community hospital. CASE SUMMARY: A 34-year-old, insulin-dependent diabetic white man with worsening cellulitis and osteomyelitis of the left great toe was admitted for treatment with intravenous antibiotics. Intravenous clindamycin was the first agent administered. Within 5 minutes after initiating the drug (600-mg dose) the patient began to sneeze and his eyes began to tear and itch. Within 10 minutes, his lips and nasal passages began to swell. By the end of the infusion (approximately 20 min), the patient's lips were severely swollen and his nasal passages were completely closed off secondary to the swelling. The patient did not have difficulty breathing through his mouth and denied any shortness of breath. He did not develop a rash. His vital signs remained stable and no pharmacologic agents were administered for this reaction. No subsequent doses of clindamycin were given and complete resolution of all symptoms occurred within 24 hours. CONCLUSIONS: Severe lip and nasal passage swelling is an uncommon adverse reaction associated with the use of intravenous clindamycin. We believe this to be the first published case of nasal passage swelling and only the second case reporting lip edema associated with the intravenous form of this agent. Clinicians should be aware of this uncommon but potentially severe reaction.

Mesalamine and olsalazine: 5-aminosalicylic acid agents for the treatment of inflammatory bowel disease.

The history, pharmacology, pharmacokinetics, clinical uses and efficacy, adverse effects, drug interactions, and dosage and administration of rectal mesalamine and oral olsalazine in the treatment of inflammatory bowel disease (IBD) are reviewed. The high incidence of toxicity associated with sulfasalazine led to the development of the nonsulfonamide 5-aminosalicylic acid products mesalamine and olsalazine. The exact mechanism of action of these agents in the treatment of IBD is unknown. In clinical trials, mesalamine was shown to be as effective as or more effective than sulfasalazine or corticosteroids in treating active ulcerative colitis, proctitis, and proctosigmoiditis. Mesalamine is effective in the maintenance of remission in patients with ulcerative colitis. Several studies have demonstrated the effectiveness of olsalazine in the treatment of active mild to moderate ulcerative colitis. Olsalazine is also effective in the maintenance of remission of ulcerative colitis. The most common adverse effect associated with mesalamine enemas is perianal irritation or trauma secondary to insertion. The most common adverse effects associated with olsalazine are dose-dependent watery diarrhea and gastrointestinal upset. The recommended dosage of the mesalamine enema for the treatment of active mild to moderate ulcerative colitis is one 4-g (60-mL) retention enema daily for three to six weeks. The dosage of mesalamine suppositories for the treatment of active ulcerative proctitis is one 500-mg suppository inserted rectally twice daily for three to six weeks. The dosage of olsalazine is 1 g daily in divided doses for the maintenance of remission of ulcerative colitis. Both rectal mesalamine and oral olsalazine provide clinicians with an effective therapeutic option for the treatment of ulcerative colitis, proctosigmoiditis, and proctitis in patients unresponsive to or intolerant of the effects of sulfasalazine or corticosteroids.