ABSTRACT
The British National Formulary is a direct descendant of the National War Formulary, in which the titles of the preparations were in Latin and the doses in minims and grains. The British National Formulary was born in 1948, did a good job for about 20 years, but sickened and died in 1976. It was reborn in 1981. Parturition was painful with a very hostile reception from the media and the drug industry, but it survived and has grown in stature. The 25th edition was published in February. Wish it well for the next 25 issues!
Subject(s)
Formularies as Topic , United KingdomABSTRACT
This year we are celebrating the bicentenary of the publication, by William Withering, of An Account of the Foxglove and Some of its Medicinal Uses with Practical Remarks on Dropsy and Other Diseases (1). During these two hundred years digitalis has constantly been to the fore of medical thinking and it is appropriate that we should look back and examine the contributions which studies of this drug have made to medicine as we know it today. Some of the studies have been at the centre of fierce controversy and others have been of seminal importance in the development of new concepts.
Subject(s)
Digitalis , Digoxin/history , Plants, Medicinal , Plants, Toxic , Biological Availability , Cardiac Glycosides/pharmacology , Digitalis Glycosides/pharmacology , Digoxin/blood , Heart/drug effects , History, 18th Century , History, 19th Century , History, 20th Century , HumansSubject(s)
Digitalis , Plants, Medicinal , Plants, Toxic , Arrhythmia, Sinus/drug therapy , Digitalis Glycosides/adverse effects , Digitalis Glycosides/history , Digitalis Glycosides/metabolism , England , Heart Failure/drug therapy , History, 18th Century , History, 19th Century , History, 20th Century , Humans , Ion Channels/drug effects , Sodium/metabolismSubject(s)
Vivisection , Animals , Cats , Dogs , Legislation as Topic , Mice , Rats , Research , United KingdomABSTRACT
A random sample of 521 patients to whom prescriptions had been issued in an urban general practice were investigated to see how well they followed advice about taking medicines.Most factors that have been previously reported as affecting this did not appear to do so. A very high degree of compliance was achieved and it is suggested that the key factor in this is the relationship between doctor and patient.
Subject(s)
Family Practice , Patient Compliance , Adolescent , Adult , Aged , Child , Child, Preschool , Drug Prescriptions , Female , Humans , Infant , Male , Middle Aged , United KingdomSubject(s)
Drug Prescriptions , Hypnotics and Sedatives , England , Humans , Hypnotics and Sedatives/adverse effects , Northern Ireland , NorwayABSTRACT
A survey of one hundred patients submitted to autopsy has been carried out to assess the contribution of investigational procedures, surgery and drug therapy to death. In nineteen patients drug therapy, usually appropriate and necessary therapy, was thought to have contributed to death. In five patients failure to continue therapy properly contributed to death. The survey was not representative either of patients dying in hospital or in the community, but it suggests that a larger and more comprehensive survey should be undertaken.
Subject(s)
Autopsy , Drug-Related Side Effects and Adverse Reactions , Medical Audit , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
1 Pretreatment of the guinea-pig subcataneously three times daily with either 5 mug/kg isoprenaline or adrenaline reduced the response of the isolated perfused histamine-constricted lung when challenged with either the same or a different sympathomimetic bronchodilator. The longer the animals were pretreated and the higher the dose of bronchodilator the greater was the degree of tolerance developed. 2 Tolerance was developed to aminophline in the same preparation when the guinea-pig had been pretreated with aminophyline or isoprenaline. Cross-tolerance also developed adrenaline when the guinea-pig had been pretreated with aminophyline. 3 Tolerance was still persistent in guinea-pigs one and two weeks after pretreatment three times daily with either isoprenaline of adrenaline (5 mu/kg s.c.) for seven days in the same preparation. Only after three weeks was the tolerance diminished. 4 These results suggest that asthmatic patients who use bronchodilators excessively may become refractory to the bronchodilator effect of these drugs. They also support the hypothesis that induced cross-resistance to endogenous sympathetic stimulation could lead to a deterioration of the asthmatic state in patients using the sympathomimetic bronchodilators and that this may explain the increase in asthma mortality rate. 5 A mechanism of tolerance to sympathomimetic bronchodilators is postulated.
Subject(s)
Bronchodilator Agents/pharmacology , Lung/drug effects , Sympathomimetics/pharmacology , Airway Resistance/drug effects , Aminophylline/pharmacology , Animals , Ascorbic Acid/pharmacology , Drug Tolerance , Epinephrine/pharmacology , Female , Guinea Pigs , Histamine/pharmacology , In Vitro Techniques , Isoproterenol/pharmacology , Male , Terbutaline/pharmacology , Time FactorsABSTRACT
The consumption of insulin and oral antidiabetic drugs was measured at the gross sales level in Sweden and Norway and at the prescription level in Northern Ireland. ""Agreed daily doses'' were used as units of comparison, which defined as follows: insulin 40 I.U., tolbutamide 1 g, acetohexamide 500 mg etc. Consumption was expressed as the number of ""agreed daily doses'' per 1,000 inhabitants per day. This provided a rough estimate of the number of subjects for whom the drug had been prescribed per 1,000 population. The data were collected during the three months April-June 1971. Marked differences in the consumption of antidiabetic drugs were found between the three countries and also between areas within each country. The consumption of insulin was similar in Norway and Northern Ireland (3.5 and 3.9 agreed daily doses per 1,000 inhabitants per day), but almost twice as high in Sweden. In Norway much lower use was found in certain rural areas. The variation in the consumption of oral antidiabetic drugs was even more marked. Surprisingly, consumption was considerably higher in Sweden (15.8) than in the nearby Norway (7.3), and was even lower in Northern Ireland (4.3). The major use was of sulphonylureas, especially chlorpropamide. Within the countries there was marked regional variation in the choice of individual biguanides and sulphonylureas. The data are discussed in relation to such factors as the incidence of diabetes, the sole use of dietary treatment etc. It is concluded that studies in depth, which link the actual use of drugs by patients to diagnosis, diabetic symptoms and clinical outcome of treatment are necessary in order to explore the reasons behind the marked geographical differences and to define a rational drug policy. However, the methods described in the study may be used for early detection of gross national differences in drug utilization, the further investigation of which may reveal to be of great public health interest.
