Increasing access to nonprescription medicines: a global public health challenge and opportunity.

As escalating health-care costs continue to be a focus of public discourse, the populace has become increasingly attentive to its own health and lifestyle choices. Nonprescription (over-the-counter, OTC) medicines represent an important option in this evolving environment and, through novel "Rx-to-OTC" switch efforts, could expand beyond their traditional role in symptomatic relief of common conditions such as minor pain, coughs, colds, heartburn, and allergy. This is certainly not a new concept.

A Consumer Use Study of Over-The-Counter lovastatin (CUSTOM).

The Consumer Use Study of OTC Mevacor evaluated the ability of subjects to self-manage high levels of low-density lipoprotein (LDL) cholesterol by using a multifaceted cholesterol self-management program (the Mevacor Over-the-Counter Self-Management System; MOTC-SMS). This 26-week all-comers multicenter observational study was conducted in naturalistic storefront settings that used the fully functional MOTC-SMS to guide subjects' behavior. Of 3,316 subjects who evaluated the product (evaluators), 1,061 took >or=1 20-mg tablet of Mevacor OTC (users).

Comparison of slow response action potentials from normal and hypertrophied myocardium.

Previous studies have shown that papillary muscles from hypertrophied cat right ventricles (RVH) exhibit altered mechanical properties which may be associated with defects in the excitation-contraction coupling process. Since calcium influx [as slow inward current (Isi) during the cardiac action potential is thought to be a major determinant of contractile state, we compared Isi-mediated slow response action potentials ( SRAPs ) in papillary muscles from cats with RVH, induced by chronic pulmonary artery constriction, to SRAPs from sham-operated controls. The results show that 1) when depolarized by elevated extracellular potassium (K+o, 22 mM), RVH muscles became inexcitable (as defined here) significantly faster than control muscles; 2) inexcitable RVH muscles required significantly more isoproterenol than controls to restore slow response activity; 3) at all isoproterenol concentrations tested, SRAPs from RVH muscles were reduced in amplitude and duration compared with controls; 4) SRAPs evoked by long duration stimulus pulses in the absence of isoproterenol were also markedly reduced in RVH; and 5) the relationship between resting potential and K+o was the same in both groups.

Isolation and morphology of calcium-tolerant feline ventricular myocytes.

A technique has been developed for isolating a high yield of Ca2+-tolerant rod-shaped myocytes from the right and left ventricles of cat myocardial tissue. Myocytes were prepared by retrograde perfusion of the coronary arteries via the aorta with a nominally Ca2+-free (20-30 microM) modified Krebs-Henseleit buffer containing 0.12% collagenase.

Cardiovascular effects of indapamide on frog hearts and open-chest cats.

Unlike related diuretics indapamide has been found by some investigators to be associated with a mild reduction in heart rate during its use as an antihypertensive agent. This investigation concerns the attempt to duplicate this phenomenon in animals and to elucidate possible mechanisms. In isolated frog hearts, high concentrations (0.