In a double-blind, placebo-controlled trial, recently reported in the New England Journal of Medicine*, the
administration of a single 200mg dose of doxycycline within 72 hours after a tick bite from Ixodes scapularis
was more effective than placebo in preventing the development of Lyme disease.
*Nadelman RB, et al. N Engl J Med 345(2):79 (2001 July 12)
Rapamune® (Sirolimus, Wyeth-Ayerst Laboratories), a transplant immunosuppressant, became available in
August 2001, as a 1mg tablet for the US market in addition to the oral solution. This product is indicated for
the prevention of acute organ rejection in kedney transplant patients and is recommended for use in a
regimen that includes cyclosporine and corticosteroids.
In an article published in the Journal of the American Medical Association*, Ang-Lee, et al, reviewed the
literature on commonly used herbal medications in the context of the perioperative period. The authors found
that complications can arise from direct effects, pharmacodynamic effects, and from pharmacokinetic
effects. Direct effects include bleeding (garlic, gingko, ginseng), cardiovascular instability (ephedra), and
hypoglycemia (ginseng). Pharmacodynamic herb-drug interactions include potentiation of the sedative effect
of anesthetics by kava and valerian and pharmacokinetic herb-drug interactions include increased
metabolism of many drugs used in the perioperative period by St. John’s wort. The authors conclude that
physicians should explicitly elicit and document a history of herbal medication use and be familiar with the
potential perioperative effects of these commonly used herbal medications.
*JAMA 286(2):208-16 (2001 Jul 11).