Rosalie Sagraves

Estrogen Therapy for Postmenopausal Symptoms and Prevention of Osteoporosis

Menopausal symptoms are noted as estrogen deficiency affects target tissues during the climacteric and after menopause. With estrogen replacement therapy (ERT), clinical signs, such as vasomotor symptoms and genitourinary atrophy, abate. Estrogen replacement therapy protects against the development of osteoporosis and is used in its treatment. In addition, ERT has a positive effect on serum lipids and appears to he protective against coronary heart disease. More than 75% of all women experience troublesome vasomotor symptoms during the climacteric years, and osteoporosis is a major cause of morbidity and mortality in postmenopausal women. In the United States, the current annual cost of treating patients with osteoporosis is

Therapy of Acute Otitis Media

10 billion dollars. With the aging of the baby boom generation, it is estimated that osteoporosis‐associated costs may double in the next 30 years if interventions are not undertaken to reduce the incidence of osteoporosis. It is therefore important for pharmacists and other health care practitioners to educate women about ERT after menopause to reduce the risks of vasomotor symptoms, osteoporosis, and other problems. The incidence, etiology, symptoms, and therapeutic measures used to reduce vasomotor symptoms are discussed, and updates on pathophysiology, risk factors, prevention, and treatment of osteoporosis, with an emphasis on ERT, are reviewed.

Pediatric pain management (Part I)

Acute otitis media is a common health problem worldwide that accoun!s for significant morbidity, primarily among pre-school-age children. for which antirnicrobiallhcrapy is currently the treatment of choice. Approximately 25% of all prescriptions wri tten in the US for children under the age of 10 years are for children diagnosed as having acute otitis media. Until adequately designed studies with appropriate patient populations are conducted. clinicians must base their decisions to treat acute otitis media with antimicrobial therapy. and their choice of drug, on local susceptibility patterns (if known), in vitro and in vivo studies. adverse effect profiles, tolerability, and affordability. Such studies will hopefully answer questions about selecting an antimicrobial for acute otitis media and address the comprehensive cost of using various antimicrobials for the condition. Because of the human and economic costs associated with acute otitis media, healthcare practitioners should also be aware of the epidemiology, pathophysiology and various treatment options for children with acute otitis media.

Varicella-zoster virus: recent therapeutic advances.

Abstract This article is the first in a two-part series on pediatric pain management. It contains primarily a general discussion of pediatric pain, myths and misconceptions about pediatric pain, and the use of nonnarcotic analgesics for pain control. In the second article, the use of narcotic analgesics for the pediatric population will be discussed.

Colony-stimulating factors: Use in the pediatric population (Part I)

Summary Chickenpox is a common childhood problem. In otherwise healthy children, the disease is usually benign, although secondary complications can occur. Symptomatic therapy has long been the mainstay of treatment. Acyclovir use in such cases remains controversial secondary to the marginal benefit in relation to the additional cost incurred by an already costly disease. Advancements in the form of prevention have been made in an attempt to decrease the current hardship of VZV infection. The Oka strain of varicella vaccine should soon be available in the United States. Varicella vaccine has been shown to be immunogenic and well tolerated in healthy children. Lifetime follow-up is needed to determine the true duration of immunity and any effect on the epidemiology of adult varicella or recurrent zoster compared to natural infection. With the development of immunization, it is hoped that the varicella vaccine will become the next addition to the childhood vaccination schedule, possibly as a “quadrivalent” product with measles, mumps, and rubella. Widescale use of the varicella vaccine may render this once common childhood disease obsolete.

Growth hormone therapy for short stature.

This two-part article is intended to review the pharmacology, indications, clinical use, dosage and administration, and adverse effects of several promising colony-stimulating factors. Granulocyte-macrophage colony-stimulating factor and granulocyte colony-stimulating factor will be reviewed in part I, and erythropoietin and interleukin-3 will be reviewed in part II.