Evaluation of a non-Food and Drug Administration-approved use of cimetidine: treatment of pruritus resulting from epidural morphine analgesia.

The purpose of this study was to evaluate the efficacy of a frequently used treatment at our hospital, intravenous cimetidine hydrochloride for pruritus resulting from epidural morphine sulfate analgesia in cesarean-section patients. Fifty-two patients were randomly assigned to receive either placebo or cimetidine 300 mg i.v. Thirty-nine patients experienced itching. Thirty-three patients completed the study (17 in the cimetidine group, 16 in the placebo group). For pruritus unrelieved by the study drug, bolus doses of naloxone hydrochloride 0.2 mg i.v. were administered at 30-minute intervals, if needed. Pruritus was assessed by two subjective rating scales and the number of naloxone doses needed for unrelieved pruritus. Using independent Student's t-tests, we identified no significant differences between the two groups. The mean numbers of naloxone boluses administered were 1.9 for placebo and 2.5 for cimetidine (p = 0.49). Our study demonstrates the importance of objectively evaluating the use of drugs for non-Food and Drug Administration-approved indications.

Comparison of consumer-oriented books on medications.

Consumers increasingly want to be informed about the processes involved in their own health care. Health professionals may be called upon to recommend appropriate consumer-oriented sources of information. To assist the health professional in making a rational recommendation, 15 currently available consumer-oriented books on prescription medications were compared with respect to readability, number of drugs covered, completeness of drug monograph information, price, and other factors. Mean readability scores, reported as a reading grade level, ranged from 9.2 to 14.3. The number of drugs covered by these books ranged from 135 to 1,200. Monograph completeness scores were assigned by determining the percentage of information from a standard reference's drug monograph covered in each book. The lowest percentage completeness score was 21.4%, while the highest was 76.7%. Prices for the books ranged from $2.50 to $19.95. Regardless of the relative priorities placed on these factors, a consumer or health professional may use the objective and descriptive assessments of this study to make an informed decision when choosing among consumer-oriented sources of medication information.

Palatability comparison of oral potassium chloride solutions.

The palatability of various commercially available potassium chloride preparations was studies. Twenty potassium chloride samples were tested by 152 people from February 1975 to April 1975. Nine samples were placed into a "most preferred" group and divided into 36 possible pairs, each to be tested four times. Twenty-four volunteers tested six pairs of samples and chose the preferred sample in each pair. The three samples, which finished with the highest scores (K-Lyte/Cl Packets, Kato Powder Packets and Kaochlor 10%), although not significantly different from the rest of the subgroup of nine, were all highly flavored and among the most expensive. It is suggested that when selecting a potassium chloride preparation, cost, convenience, palatability, and most importantly, long-term compliance with the prescribed regimen, must be considered.