Clinical review of histamine-2 receptor antagonists

Article Abstract:

Histamine is a natural substance that increases stomach secretion, dilates capillaries, or small blood vessels, and contracts the bronchi and bronchioles, the muscular tube-like structures branching from the trachea, or windpipe, to the lungs. Histamine specifically binds or attaches to protein sites on the cell membrane called histamine receptors. Although there are various types of histamine receptors, the receptor involved in many of histamine's cellular reactions is the histamine-2 or H2 receptor. Agents that block the H2 receptor are called H2 receptor antagonists, and have been shown to be clinically useful. H2 receptor antagonists are used to treat several conditions: ulcers of the stomach and duodenum, the first part of the small intestine; gastroesophageal reflux, the backflow of stomach contents from the stomach to the esophagus; and hypersecretory states, conditions of increased release of substances, such as acid from the stomach. The H2 receptor antagonists have also been used prophylactically to prevent stress-related ulcers and the recurrence of stomach and duodenal ulcers. The H2 receptor antagonists approved for clinical use include cimetidine, famotidine, ranitidine, and nizatidine; their effectiveness, adverse drug reactions, and interactions with other drugs are reviewed. Because these agents differ with respect to drug interactions and adverse effects, clinicians should consider these factors when choosing H2 receptor antagonists for their patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Histamine, Antihistamines, Histamine receptors, Antiulcer agents, Antiulcer drugs

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Is individual responsibility a sufficient basis for public confidence?

Article Abstract:

Health care workers infected with HIV, the virus that causes AIDS, pose a very small risk of transmission of the virus to their patients, but patients do have a right to be protected from infected providers. While no specific policy exists in organized medicine to address the issue of the HIV-positive health professional, the notion that such an individual should be guided by a sense of personal responsibility in his or her practice is recognized. The ethical notion of autonomy suggests that the private actions of an individual are his and his alone. However, an autonomous individual soon encounters his community, and thus, the concept of responsibility to that community comes into play; i.e. his actions affect those around him. Responsibility does not only refer to an individual, as it is always shared by him and his community. Shared responsibility is a sound basis from which to explore the rights and duties of the AIDS-infected health care worker. Thus far, the response of organized medicine to infected members has been lacking. Organized medicine would do well to offer both psychological and financial support to those whose practices are damaged by public awareness that they carry HIV. If a health care professional knew that professional and financial support would be available to him, he would be more forthcoming in revealing his HIV-positive status. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical personnel, Ethical aspects, HIV patients, Civil rights, HIV seropositivity, HIV positive, editorial

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