Buspirone--frontrunner of a new genre of anxiolytics.

Buspirone (Buspar; Bristol) marks a departure from established concepts of anxiolysis. Differing substantially both in its mode of action and in the clinical expression of its action from agents such as barbiturates and benzodiazepines, it would seem to operate chiefly via the 5-HT1A subtype of serotonin receptor. Such receptor selectivity is likely to be responsible for the novel action of this anxiolytic in that sedation and psychomotor and cognitive dysfunction are minimal, and because dependence is unlikely. The slower onset of full therapeutic benefit further delineates the differences between buspirone and other anxiolytics. However, it is apparent that the benzodiazepines will not readily be displaced from all of their varied applications by buspirone. This review examines buspirone and provides some guidelines for its use.

Alprazolam--a new triazolobenzodiazepine.

The advent of another benzodiazepine, alprazolam (Xanor; Upjohn), is of interest because of the antidepressant properties which this agent seems to possess. A short résumé of the pharmacology of alprazolam is presented in an attempt to provide an early perspective on its place in therapeutics.

Erythromycin--three decades later.

This article reviews some of the more recent developments relating to the clinical usage of erythromycin. The bactericidal and tissue-penetrating properties of this antibiotic are described and the suggestion that erythromycin has a very useful spectrum of activity in respiratory tract infections is supported by a variety of studies. We examine the increasing application of erythromycin in an extending number of problems such as sexually acquired disorders, a variety of diseases produced by infection with Legionella species and the enteritides associted with Campylobacter and Shigella species. The influence of erythromycin in particular, and of antimicrobial agents in general, on the immune system of the host is discussed. The immunomodulatory capacity of the antibiotics used deserves more attention. The interactions of erythromycin with theophylines and with carbamazepine are noted and amplified, and the consequences of the binding of erythromycin to plasma alpha 1-glycoprotein are examined. After some 3 decades of use, this remarkably safe antibiotic continues to display activities which deserve the attention of the clinician.

Which benzodiazepine, why and how?

While no major differences with regard to psychopharmacological actions are to be found among the benzodiazepines, certain pharmacokinetic differences are known. These differences allow the benzodiazepines to be classified as cumulative or non-cumulative; the differences between these two groups are further dissected and evaluated, in an attempt to rationalize therapy with these agents.

Quantitation of chlordiazepoxide and its metabolites in biological fluids by thin-layer chromatography.

Chlordiazepoxide and its 4 major metabolites were assayed after separation by thin-layer chromatography following extraction from biological fluids. The compounds become intensely fluorescent in the presence of red, fuming nitric acid. The resulting compounds are quantitated with a spectrodensitometer with a fluorescent attachment. The sensitivity varies between 0.05 and 0.1 microgram. The coefficient of variation is 1.4% for assays in urine and 6.4% in serum.

Another look at erythromycin.

The erythromycins are broadly reviewed from a clinical viewpoint. The antimicrobial spectrum, clinical indications, pharmacokinetics and toxicity are dealt with. The usefulness of erythromycin for respiratory tract infections is stressed. New evidence to support bactericidal activity of this antibiotic is noted. There seems little reason to use the potentially hepatotoxic estolate form of erythromycin. The safety of the other forms of this antibiotic available in this country is emphasized.