Potentially significant drug interactions of class III antiarrhythmic drugs.

Class III antiarrhythmic drugs, especially amiodarone (a broad-spectrum antiarrhythmic agent), have gained popularity for use in clinical practice in recent years. Other class III antiarrhythmic drugs include bretylium, dofetilide, ibutilide and sotalol. These agents are effective for the management of various types of cardiac arrhythmias both atrial and ventricular in origin.

What are the risks of long-term NSAIDs and COX-2 inhibitors?

This review presents an interesting new analysis of cyclo-oxygenase-2 (COX-2) inhibitor safety, concluding that long-term use results in more serious adverse events than traditional nonsteroidal anti-inflammatory drugs (NSAIDs). The nonsystematic and retrospective properties of this analysis limit its validity. However, the fact that an evaluation of long-term data found some small harm to COX-2 inhibitors relative to traditional NSAIDs (number needed to harm=78 over 9 months) should give clinicians pause.

Tiotropium: an inhaled, long-acting anticholinergic drug for chronic obstructive pulmonary disease.

Inhaled anticholinergic drugs are considered one of the principal bronchodilator treatments for chronic obstructive pulmonary disease (COPD). Ipratropium bromide is an anticholinergic drug frequently administered for the treatment of COPD. Unfortunately, ipratropium has a short duration of action, requiring administration every 6 hours; this regimen affects adherence to drug therapy.