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Drug and Therapeutics Bulletin (DTB): July–December 2014
Nicotine and health
Nicotine, an alkaloid derived from the leaves of tobacco plants (Nicotiana tabacum and Nicotiana rustica), is the primary addictive agent in tobacco products. There are different ways of administering the various products including smoking cigarettes, chewing tobacco, holding moist snuff in the mouth, inhaling dry snuff through the nose, inhaling smoke from a waterpipe and inhaling vapour from an electronic cigarette. It can be difficult to differentiate the effects of nicotine from the many other toxic substances these products also contain. We review the pharmacological effects of nicotine, but we will not review the well-known harmful effects of cigarettes, where it is primarily the toxins and carcinogens in tobacco smoke rather than the nicotine that cause illness and death. A future article will consider the use of electronic cigarettes (DTB 2014;52:78–81).
Zoely: a new combined oral contraceptive
Zoely is the second estradiol-containing oral contraceptive formulated as an ‘extended regimen’ (pill-free interval <7 days) to be licensed in the UK. However, unlike the quadraphasic estradiol-containing contraceptive Qlaira, it is a monophasic preparation. The company considers Zoely an option for women ‘who want a contraceptive with hormones similar to her own’, and claims that it has a high level of contraceptive efficacy, produces shorter, lighter periods compared with a 21-day regimen of drospirenone 3 mg/ethinylestradiol 30 µg (Yasmin) and that most women report no negative impact on weight and skin. In this article, we review the effectiveness and place of Zoely (DTB 2014;52:90–3).
Relvar Ellipta for asthma
Relvar Ellipta (GlaxoSmithKline) is a dry powder inhaler that contains a corticosteroid (fluticasone furoate) and a long-acting β2 agonist (vilanterol trifenatate). It is licensed for once-daily use as maintenance therapy for chronic obstructive pulmonary disease (COPD) and asthma. In a previous article, we considered its use in the management of COPD. In this article, we review the evidence for Relvar Ellipta in the treatment of patients with …