Julian Melamed

Efficacy and safety of nedocromil sodium 2% ophthalmic solution b.i.d. in the treatment of ragweed seasonal allergic conjunctivitis.

The efficacy and safety of twice-daily nedocromil sodium 2% ophthalmic solution and vehicle were compared in the treatment of ragweed seasonal allergic conjunctivitis. Two separate multicenter, randomized, double-masked, placebo-controlled studies were subjected to a combined analysis. Following a one-week baseline period during the beginning of the ragweed pollen season, 189 patients with seasonal allergic conjunctivitis received either nedocromil sodium or vehicle b.i.d. for eight weeks. Efficacy was evaluated by patient diary cards and clinical eye examinations. Safety was assessed by reports of adverse events. Compared with vehicle, nedocromil sodium produced significantly greater decreases in summary symptom score (p = 0.005), itch (p = 0.005), tearing (p = 0.004), overall eye condition (p = 0.001), and clinician-evaluated conjunctival edema (p = 0.018), and significantly better (p = 0.001), and patient (p = 0.001) opinions of treatment effectiveness at the peak pollen period. Additionally, the superiority of nedocromil sodium compared to vehicle approached statistical significance in redness reduction (p = 0.087) and clinician-evaluated conjunctival injection (p = 0.087). There were no serious treatment-related adverse events in either treatment group. In summary, nedocromil sodium 2% ophthalmic solution b.i.d. was found to be effective and to have a favorable safety profile in the treatment of seasonal allergic conjunctivitis.

Tilarin in combination with astemizole

Bukstein D. A., Biondi R. M., Blumenthal M. M., Dockhorn R. J., Filley W I!, Fink J., Goldstein S., Graft D. E, Hirsch S. R., Joos T. H., Melamed J., Rowe M. S., Townley R. G. Tilarin in combination with astemizole.

The use of inhaled medications in school by students with asthma

Students with asthma frequently have the sudden onset of asthma symptoms from a variety of causes, including exercise. In most cases, asthma can be prevented or treated by inhaled medications. For many students with asthma to function normally at school, these prescribed medications must be readily accessible to the individual. Students whose parents and physician judge that they have sufficient maturity to control the use of these inhaled medications should be allowed to retain these inhalers in their possession. School policies that require inhalers to be kept in school official’s or nurse’s offices result in an interference in the medical needs of the patient and may seriously delay treatment. Most students will not properly use their medications under these circumstances, School officials should discuss with parents or physicians of students with asthma any problems regarding appropriateness and responsibility of use of these medications. Otherwise, schools should cooperate in the best interest of the patient by permitting the student to have possession of their inhaled medication. There is no indication that these medications have any potential for abuse by students without asthma. Therefore, it should not be argued that this policy presents any danger to other students. It is reasonable to expect that the student requiring inhaled medication to be sufficiently responsible and discreet in its use to avoid drawing attention to treatment. Therefore, we recommend that students with asthma be permitted to have in their possession inhaled medications for the treatment and the prevention of asthma symptoms when they are prescribed by that student’s physician.