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General: In vie ' ofthe biliaz-v and renal routes ofexcretion for cromolvn sodium, consideration should be given to decreasing the dosage or discontinuing the administration ofthe drug in patients with impaired renal or hepatic function. Ifeosinophilic pneumonia pulmonary infiltrates with eosinophilia ; ccurs during the course oflntal Nebulizer Solution therap drug should be the discontinued. Occasionally patients may experience cough and or bronchospasm following cromolvn sodium inhalation. At times, patients with cromolyn sodium induced bronchospasm mas' not be able to continue its administration despite prior bronchodilator administration. Rarely ver 'severe bronchospasm has been encountered. Symptoms ofasthma may recur iflntal Nebulizer Solution is reduced below the recommended dosage, or discontinued. Psychosocial support is critical to restoring well-being; some patients receive adequate support from monthly 5-minute discussions with their primary care provider, while others need more in-depth attention from a mental health professional, for example, side effects of cromolyn.
In accordance with the freedom of information provisions of 21 cfr part 20 and 51 11 e ; summary of safety and effectiveness data and information submitted to support this approval may be seen in the dockets management branch hfa-305 ; , food and drug administration, 5630 fishers lane, rm. ANGIOTENSIN CONVERTING ENZYME INHIBITORS ANGIOTENSIN CONVERTING ENZYME INHIBITORS ANTIACNE DRUGS ANTIACNE DRUGS OTHER ANTIHYPERTENSIVES OTHER ANTIHYPERTENSIVES OTHER ANTIHYPERTENSIVES TOPICAL CORTICOSTEROID DRUGS TOPICAL CORTICOSTEROID DRUGS SALICYLATES AND RELATED DRUGS DRUGS AFFECTING THE EAR OTHER ANTIVIRAL DRUGS OTHER ANTIVIRAL DRUGS OTHER ANTIVIRAL DRUGS OTHER ANTIVIRAL DRUGS SMOKING CESSATION PRODUCTS DRUGS TO PREVENT AND TREAT GOUT DRUGS TO PREVENT AND TREAT GOUT ORAL DERMATOLOGICAL DRUGS ANTIPSYCHOTICS LEUKOTRIENE MODIFIERS LEUKOTRIENE MODIFIERS ANTIHISTAMINE DECONGESTANT COMBINATIONS BETA-2 ADRENERGICS BETA-2 ADRENERGICS TOPICAL DERMATOLOGICAL DRUGS TOPICAL DERMATOLOGICAL DRUGS ELECTROLYTES, IRRIGATING SOLUTIONS, ETC. ANGIOTENSIN CONVERTING ENZYME INHIBITORS ANGIOTENSIN CONVERTING ENZYME INHIBITORS ANGIOTENSIN CONVERTING ENZYME INHIBITORS OB GYN TOPICAL ANTIINFECTIVES PROTON PUMP INHIBITORS TOPICAL CORTICOSTEROID DRUGS OTHER ENDOCRINE DRUGS OTHER ENDOCRINE DRUGS CLASS II NARCOTICS CLASS II NARCOTICS CLASS II NARCOTICS CLASS II NARCOTICS CLASS II NARCOTICS CLASS II NARCOTICS, for example, cromolyn sodium inhalation solution. Like other h 1 -antagonists, promethazine does not prevent the release of histamine, as do cromolyn and nedocromil, but competes with free histamine for binding at h 1 -receptor sites.
Impaired glucose tolerance IGT ; 1 is a condition associated with elevations in the plasma glucose concentration above 7.8 mmol liter 120 min after ingestion of a 75-g glucose load standard oral glucose tolerance test ; . Although greater than norAddress correspondence to Kenneth Polonsky, M.D., University of Chicago, Department of Medicine, 5841 S. Maryland Ave., MC 1027, Chicago, IL 60637. Phone: 773-702-6217; FAX: 773-834-0846; E-mail: polonsky medicine.bsd.uchicago Received for publication 6 February 1997 and accepted in revised form 22 April 1997. J. Clin. Invest. The American Society for Clinical Investigation, Inc. 0021-9738 97 08 $2.00 Volume 100, Number 3, August 1997, 530537 : jci 530 Cavaghan et al and danocrine. The participants were asked to answer a questionnaire about their medical history, smoking habits and regular medication. All subjects were investigated in the morning after an overnight fast. No medication or smoking was allowed after midnight. After recordings of height, weight, abdominal and hip circumference, an arterial cannula was inserted in the. Be sure to inform your physician of all your medical conditions before you begin taking a medication and ddavp, for example, cromolyn solution. Nilanthi de Silva Department of Parasitology, Faculty of Medicine, University of Kelaniya, P.O. Box 6, Ragama SRI LANKA. E-mail: nrdes sltnet.lk Simon Brooker Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, UK WC1E 7HT. Peter Hotez Dept. Microbiology and Tropical Medicine, The George Washington University, 2300 Eye St. NW, Washington DC 20037, USA. Antonio Montresor Dirk Engels Lorenzo Savioli Strategy Development and Monitoring for Parasitic Diseases and Vector Control, Communicable Diseases Control, Prevention and Eradication, World Health Organization, CH-1211 Geneva 27, Switzerland.

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The questions below are based on the article "Recommendations for Participation in Sport Activities and Exercise for Persons with Exercise-Induced Bronchospasm, " which begins on page 23 of this issue. Choose the single best answer for each question. 1. During a routine physical examination, a 9-year-old boy reports experiencing breathlessness and chest tightness during soccer practice. His uncle has allergic rhinitis. How can a diagnosis of exercise induced bronchospasm EIB ; be supported? A ; Document airflow obstruction by showing a maximal voluntary ventilation MVV ; of less than 85% of that predicted for age and height after 6 to 8 minutes of moderate exercise B ; Document a 10% to 15% decrease in forced expiratory volume in 1 second FEV1 ; from the resting baseline value after 6 to 8 minutes of strenuous exercise C ; Document that the ratio of FEV1 to forced vital capacity is below the lower limit of normal after 6 to 8 minutes of moderate exercise D ; Establish reversibility by showing a decrease in FEV1 of 10% or more following inhalation of a long-acting 2-agonist after 6 to 8 minutes of moderate exercise Evidence from the canine airway model of leukotriene blockade attenuating EIB supports which of the following theories of EIB's initial stimulus? A ; -Adrenergic blockade theory B ; Airway-drying theory C ; Rebound hyperemia theory D ; Thermal exchange theory E ; Vagal reflex bronchoconstriction theory An 11-year-old girl with mild persistent EIB seeks advice about safe participation in a summer swim program. She competes in the 200-meter freestyle event. What advice should be given? A ; Avoid participation B ; Enroll in an inspiratory-muscle training program for 8 weeks before participating C ; Inhale a high-dose corticosteroid 1 to 2 hours before competing D ; Inhale 2 puffs of cromolyn via a pressurized metered-dose inhaler 5 to 60 minutes before competing E ; Inhale 2 to 4 puffs of sustained-release theophylline 1 to 2 hours before competing 4. Which of the following best describes the physiologic adaptations in persons with EIB after they participate in an exercise-training program? A ; Effects of aerobic training in persons with EIB are similar to those in persons without EIB B ; Fewer episodes of EIB occur in physically trained persons, most likely because of a change in the underlying disease pathophysiology C ; Fewer episodes of EIB occur in physically trained persons, most likely because of decreased minute ventilation at higher workloads and, thus, decreased stimulus for the disease D ; Physically trained persons can achieve a higher maximum heart rate HR ; and, thus, a higher double product ie, HR systolic blood pressure ; than untrained persons E ; Physically trained persons experience breathlessness during exercise at the same level of intensity as untrained persons and stimate.
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Swallow the coated tablet, delayed-release tablet, or delayed-release capsule whole and decadron. Substance abuse disorders among pathological gamblers ranged from 25-63 percent. The connection of both of these together with suicide has, however, not been clearly investigated. Beautrais et al 1996 ; determined in their study that the risk of a suicide attempt increased with increasing psychiatric morbidity, and that subjects with two or more disorders had odds of serious suicide attempts that were 89.7 times the odds of those with no psychiatric disorder. Pathological gambling, a diagnosable psychiatric disorder under DSM-IV in itself, is often seen with other psychiatric disorders, notably depression and substance misuse. This indicates therefore that this is a group of clients who are significantly at risk. Blaszczynski and Farrell 1998 ; comment that given that the variables of major depression, alcohol and substance abuse, and marital dysfunction which are considered risk factors for suicide in both the general population and among psychiatric patients, it is surprising that only a few studies have investigated risk factors associated with suicide in populations of pathological gamblers. The Gaps While there has been research undertaken as outlined previously, attempting to understand the connection between problem gambling and suicidality this has not been from the perspective of identifying problem gambling as a factor in either those who have attempted suicide or those who have completed. Further, while there has been a considerable body of work on the connection between alcohol and suicidality, problem gambling has never been taken in to account as a part of the equation that may contribute to a suicide attempt and particularly the seriousness of a suicide attempt. THE PRESENT STUDY The Aims 1. To investigate the incidence of gambling problems in a population who have presented to hospital following an episode of deliberate self-harm. 2. To compare the prevalence rate of problem gambling identified in the study to the general population using currently available statistics in sub-groups of age, gender and ethnicity. 3. To investigate the affect of alcohol and gambling on the seriousness of suicide attempts. The Process Participants in a survey to investigate the aims will be drawn from patients who present at Auckland and North Shore hospitals following an episode of deliberate self-harm. The gambling eight early intervention gambling health test ; screen Sullivan, 1999 ; used to identify problem gamblers will be administered along with the CAGE alcohol screen and the Beck Suicidal Intent Scale Beck et al, 1974 ; . This information will be collected along with demographics including the preferred form of gambling. Conclusion The information accessed in this survey will enable the prevalence of gambling problems within the population of those who present to hospital following self-harm to be identified. Further to this, it will be possible to establish whether an alcohol problem has been a contributing factor in association with this. The Beck Suicidal Intent scale will also allow for the investigation of the relationship between the seriousness of the attempt and whether a gambling problem has been identified. It is expected from anecdotal evidence from counselling within the problem gambling field that this will be the case. It could in fact be deduced that those who complete suicide, match well the profile of problem gamblers who present for treatment, indicating that problem gambling does indeed impact upon the seriousness of the attempt. The association of this in connection with more recent suicide statistics as they become available will require further investigation. Alison Penfold, Director, Abacus Counselling and Training Services Ltd References Beautrais, A., Joyce, P., Mulder, R., Fergusson, D., Deavoll, B. and Nightingale, S. 1996 ; . Prevalence of Comorbidity of mental Disorders in Persons Making Serious Suicide Attempts: A Case-Control Study. J Psychiatry 153 : 8 Beck, A., Schuyler, D. and Herman, J. 1974 ; . Development of Suicidal -5, for example, cromolyn drops.

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I.B. Kremer2, R. Abbas1, E. Arbit1, J.J. van Lier2, F.A.E. Sollie2, M.J.J.F. Willemsen2, B. Oosterhuis2 and A.A. van Vliet2 1Emisphere Technologies, Inc., Tarrytown, New York, USA 2Pharma Bio-Research, Zuidlaren, The Netherlands Introduction Croolyn cromoglycate ; sodium is used by inhalation as a prophylactic agent in the treatment of mild to moderate asthma and as a nasal inhaler to treat seasonal allergic rhinitis. Cromolyn, when given orally, is poorly absorbed from the gastrointestinal tract. SNAC is an acetylated amino acid molecule that facilitates the oral absorption of macro ; molecules. In a sheep model of allergic asthma, orally delivered cromolyn SNAC was successful in mitigating the early and late phase responses of the allergic reaction. Aims To evaluate the safety, tolerability, pharmacokinetics PK ; and pharmacodynamics PD ; of cromolyn when given as capsules twice daily for 10 days in combination with SNAC. Methods Double-blind, randomised, placebo-controlled, multiple dose study with oral administration of cromolyn SNAC twice daily for 10 days in two groups of 24 male subjects, Group 1: 12 healthy subjects 8 subjects cromolyn 80 mg SNAC 600 mg, 2 subjects cromolyn. The present studies demonstrated that acute and chronic treatment with CAP and ENA reduced thrombus weight in the venous thrombosis model in young normotensive rats. Both drugs administered chronically significantly inhibited the frequency of thrombosis. This effect was weaker after single-dose administration of both drugs. The antithrombotic effect of the studied ACE-Is seems to involve the activation of fibrinolytic pathway. As suspected, CAP and ENA also decreased arterial blood pressure. Although ACE-Is have been broadly applied in hypertension therapy in adults, there are still few records of their effectiveness in children, especially and divalproex. Demonstration that a doubling of healing rates can be achieved through enhancing the natural, wound-generated EF pharmacologically may promote this and indeed stimulate efforts to use EFs in conjunction with current growth factorbased therapies. The direction of nerve growth is regulated by the endogenous EF at a wound With respect to the directed neuronal growth and turning responses, at least two well-recognised guidance cues are likely to be present at corneal wounds and may induce or contribute to these effects. First, a host of growth factors and cytokines are released upon wounding and these could give rise to chemical gradient effects. Second, a healing epithelial sheet may induce tension within trailing tissues that could orient nerve sprouts. When the EF was modulated pharmacologically, faster epithelial closure rates were frequently correlated with the extent of perpendicular nerve sprouting, suggesting a causal link. In this scenario, wound-directed nerve sprouting could be secondary to epithelial movement-induced tensions and not a primary response to the EF. Three observations indicate that the EF induced. Table adapted from Osteoporos Int 2005 16: pp. 239254, with permission from Springer International.20 All rights reserved.NA: No evidence available and tolterodine. Page Colyte Colyte-Flavored Combipres Compazine Compound 65 Compro Condylox Constilac Constulose Cor-Oticin Cordarone Cordran Corgard Cormax Corphed Cort-Dome Cortenema CORTICOTROPIN Cortisporin ophthalmic ointment Cortisporin ophthalmic suspension Cortisporin otic solution Cortisporin otic suspension Cortisporin topical ointment Cortril Cotrim Cotrim DS Cotrim Pediatric Coumadin Crolom CROMOLYN SODIUM Cromoptic CROTAMITON Crotan Cryselle CYANOCOBALAMIN CYCLACILLIN Cyclapen W CYCLOBENZAPRINE HYDROCHLORIDE Cyclocort Cyclogyl Cyclopar CYCLOPENTOLATE HYDROCHLORIDE CYCLOPHOSPHAMIDE CYCLOSPORINE Cycrin Cylert CYPROHEPTADINE HYDROCHLORIDE CYTARABINE Cytomel Cytosar-U Cytotec Cytoxan 167 50 DACARBAZINE Dalmane DANAZOL Danocrine Dapex-37.5 Darvocet-N 50 Darvocet-N 100 Darvon Darvon Compound-65 DAUNORUBICIN HYDROCHLORIDE Daypro DDAVP Deapril-ST Decadron Deca-Durabolin Decapryn Delacort Delalutin Deladumone Deladumone-OB Delatestryl Delaxin Delestrogen Delflex w Dextrose Delflex w Dextrose low magnesium Delflex w Dextrose low magnesium low calcium Deltalin Deltasone Del-Vi-A Demadex Demerol Demulen 1 35 Demulen 1 50 Dendrid Depakene Depo-Estradiol Depo-Testadiol Depo-Testosterone Dermabet Dermacomb Dermacort Dermatol HC DESIPRAMINE HYDROCHLORIDE DESMOPRESSIN ACETATE Desmopressin Acetate Preservative-Free Desogen DESOGESTREL; ETHINYL ESTRADIOL DESONIDE DesOwen DESOXIMETASONE Desoxyn Desquam X 2.5.

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1. Hepatitis C Section, Community Acquired Infections Division and the Departmental Program Evaluation Division. Hepatitis C Prevention, Support and Research Program Health Canada: mid-term evaluation report. Ottawa: Health Canada; 2003. Available: : phac-aspc.gc hepc hepatitis c pdf hepcMidterm accessed 2005 Oct 15 and gliclazide and cromolyn, for instance, cormolyn sodium nasal solution.

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No No Overuse Overuse Underuse Underuse No. of patients 868 5158 1523 Demographics Age, y 18-34 24.7 27.9 Sex M 34.4 29.1 33.0 F 65.6 70.9 67.0 Race White 84.6 81.5 90.0 Nonwhite 15.4 18.5 10.0 Asthma impact Symptoms 2-3 times wk ; Cough 67.9 51.9 60.4 Sputum 62.0 45.2 55.2 Chest tightness 79.2 52.1 66.5 Wheezing 77.8 53.0 62.5 Shortness of breath 85.3 58.8 73.6 Night awakening 74.1 44.5 59.4 Asthma Symptom Index 3.54 2.70 3.12 score, mean range, 1-5 ; Attacks 1-2 wk ; 69.9 42.2 56.6 Canceled activities because 92.7 77.0 87.1 of asthma Emotional problems from 68.4 45.7 57.9 asthma Symptoms most of the time 25.5 7.3 18.8 between attacks Control of asthma rated very 24.4 45.3 37.4 good or excellent Treatment indicators PFM Has PFM 40.2 24.4 44.4 Taught to use PFM 98.0 94.0 96.1 Knows action to take at 81.7 76.7 79.2 low reading Knowledge Managing flare-ups 54.8 52.8 62.0 Recognizing triggers 55.3 52.3 53.5 Adjusting medications 53.3 49.7 58.2 Fromolyn sodium 17.4 10.8 17.3 Corticosteroid MDI any ; 83.9 66.0 100.0 Corticosteroid MDI used 54.6 29.9 91.9 daily Corticosteroid MDI 4 34.6 6.2 puffs d -Agonist MDI any ; 100.0 98.0 -Agonist MDI 8 puffs d 30.5 10.6 Theophylline 59.0 38.2 54.5 Oral -agonist 42.7 26.8 35.4 Oral corticosteroids 39.6 17.2 34.6 Anticholinergics 21.5 8.7 17.8 Comorbidity Heartburn 40.9 32.1 39.0 Sinusitis 48.2 45.2 49.3 Chronic bronchitis 34.8 24.6 29.3 Emphysema 12.8 4.4 8.4 Utilization ED visits for asthma 15.4 6.5 10.6 in past year ; Office visits for asthma 4 in past 6 mo ; Telephone calls to physician about asthma 4 in past 6 mo ; Hospital admissions for asthma 1 in past year ; Access excellent or very good rating ; Time to get appointment Ease of reaching physician by telephone Ease of getting urgent care Quality of communication Skill of physician Payment for asthma care and dibenzyline. Diagnosing lyme disease depends more on medical judgment based on the patient's symptoms and history than on a definitive laboratory test. A small volume nebulizer a7003, a7004, a7005 ; , related compressor e0570, e0571 ; , and fda-approved inhalation solutions of the drugs listed below are covered when: a ; it is medically necessary to administer albuterol j7611, j7613 ; , budesonide j7626 ; , vromolyn j7631 ; , ipratropium j7644 ; , levalbuterol j7612, j7614 ; , or metaproterenol j7669 ; for the management of obstructive pulmonary disease icd-9 diagnosis codes 49 050 9 ; , or b ; medically necessary to administer dornase alpha j7639 ; to a patient with cystic fibrosis icd-9 diagnosis code 27 02 ; or medically necessary to administer tobramycin j7682 ; to a patient with cystic fibrosis or bronchiectasis icd-9 diagnosis code 27 02, 49 0, 49 1, 74 ; or medically necessary to administer pentamidine j2545 ; to a patient with hiv icd-9 diagnosis code 042 ; , pneumocystosis icd-9 diagnosis code 13 3 ; , or complications of organ transplants icd-9 diagnosis codes 99 80-99 89 ; , or e ; it medically necessary to administer acetylcysteine j7608 ; for persistent thick or tenacious pulmonary secretions icd-9 diagnosis codes 48 0-50 9, 78 4. GASTROINTESTINAL AGENTS Accolate Accuneb Advair Diskus Aerobid Aerobid-M Alupent Azmacort Brethine Combivent Cromopyn Sodium Duoneb Flovent Flovent Rotadisk Foradil Intal Ipratropium Bromide Maxair Proventil Proventil HFA Pulmicort Pulmicort Respules Pulmicort Turbohaler Quibron-T SR Qvar Serevent Serevent Diskus Singulair Terbutaline Theo-24 Uniphyl Ventolin Ventolin HFA Volmax Vospire ER Xopenex HEART HIGH BLOOD PRESSURE MEDICATIONS Acebutolol 200mg - 30 Lanoxicaps 50mcg - 30 Atenolol 25mg - 30 doses doses doses Accupril Atenolol Chlorthalidone Lanoxicaps 100mcg - 30 Atenolol 50mg - 30 doses 100-25mg - 30 doses doses Accuretic Captopril HCTZ 25-15mg - Lanoxicaps 200mcg - 30 Atenolol 100mg - 30 doses 30 doses doses Aceon Atenolol Chlorthalidone 50- Captopril HCTZ 25-25mg - Lanoxin 125mcg - 30 25mg - 30 doses 30 doses doses Adalat Captopril 12.5mg - 60 Captopril HCTZ 50-25mg - Lanoxin 250mcg - 30 doses 30 doses doses Altace Captopril 25mg - 60 doses Clonidine 0.2mg - 60 doses Antabuse Captopril 50mg - 60 doses Clonidine 0.3mg - 90 doses Atacand Clonidine 0.1mg - 60 Digoxin 50mcg ml elixir doses 60ml Atacand HCT Diltiazem 60mg tablets - 90 Digoxin 125mcg - 30 doses doses Avalide Digoxin 250mcg - 30 Diltiazem 90mg tablets - 60 doses doses Avapro Diltiazem 30mg tablets Diltiazem 120mg tablets 60 doses 60 doses Benicar Hydralazine tabs - 90 Enalapril 2.5mg tablets - 30 doses doses Betapace Metoprolol Tartrate 50mg - Enalapril 5mg tablets - 30 60 doses doses Betaxolol Metoprolol Tartrate 100mg Guanfacine HCl 1mg - 30 Bisoprolol Fu- 60 doses doses marate Propranolol 10mg tab - 60 Hydralazine w HCTZ 25-25 Bisoprolol Fudoses - 90 doses marate HCTZ Propranolol 20mg tab - 60 Isoxsuprine 10mg - 90 doses doses Calan Propranolol 40mg tab - 60 Labetalol 100mg - 60 doses doses Calan SR Propranolol HCTZ - 30 doses Lisinopril 2.5mg - 30 doses Cardizem Lisinopril 5mg - 30 doses Cardizem CD Methyldopa 250mg - 60 doses Cartia XT Methyldopa 500mg - 60 doses Catapres Methyldopa HCTZ - 30 doses Catapres-TTS Minoxidil 2.5mg tab - 30 doses Clorpres Nadolol 20mg - 30 doses Coreg Nadolol 40mg - 30 doses Corgard Labetalol 200 & 300mg Levatol Lexxel Lisinopril 10, 20, 40mg Lisinopril HCTZ Lopressor Lopressor HCT Lotensin Lotensin HCT Lotrel Mavik Micardis Micardis HCT Moxexipril Monopril Monopril HCT Nifedipine ER Norvasc Plendil Prinivil Prinzide Procardia XL Sectral Sotalol Sular Allopurinol 100mg tab - 30 doses Allopurinol 300mg tab - 30 doses Propantheline Bromide 15mg - 30 doses Ranitidine 150mg tabs - 30 doses Ranitidine 300mg tabs - 30 doses Sucrafalate 1gm - 30 doses Nizatidine Zelnorm. The facility must provide adequate and comfortable lighting levels in all areas, for example, cromolgn asthma. Pretreatment with the mast cell stabilizers cromolyn and nedocromil have also proven effective in limiting episodes of EIB. The effect of this class has been demonstrated when used between 0 and 10 minutes prior to exercise.1 These drugs may be considered as an alternative for long-term pre-treatment of athletes with exerciserelated bronchospasm. The benefit of long-term inhaled corticosteroid use to minimize FEV1 reduction among athletes with exerciseinduced asthma has been known for over a decade.0 Although the groundwork for this recommendation relied on several weeks of therapy, there may be a rapid onset of clinical action. A single dose of fluticasone, administered hours before exercise was effective in preserving FEV1 in a substantial proportion of a study population of children with EIB.1 Leukotriene antagonists are another valuable tool in the treatment of EIB. Several studies have shown the effectiveness of montelukast and zafirlukast in preventing airway obstruction in the affected athlete.19, 22 Whether these drugs have clinical usefulness as monotherapy is not yet certain. Successful diagnosis, prevention and treatment of EIB often requires a comprehensive approach that goes beyond the clinician's office. The treating primary care physician or asthma consultant should be aware of the variable pathology causing activity-induced airway obstruction. This understanding will allow for appropriately customized single-drug or combination therapy. Attention in the training room and on the field is also crucial for effective management. The National Athletic Trainers' Association recommends several actions among trainers and other health care professionals to mitigate the risk of an acute asthmatic event. 3 These guidelines are also largely relevant for coaches and physical educators.24 They may be summarized as follows: Be aware of the major signs and symptoms of asthma, such as coughing, wheezing, tightness in the chest, shortness of breath, and breathing difficulty at night, upon awakening in the morning, and when exposed to certain allergens or irritants. Devise an asthma action plan for managing and referring athletes who may experience significant or lifethreatening attacks or breathing difficulties. Have pulmonary function measuring devices, such as peak expiratory flow meters, at all athletic venues, and be familiar with how to use them. Encourage well-controlled asthmatics to engage in exercise to strengthen muscles, improve respiratory health and enhance endurance and overall well-being. Refer athletes with atypical symptoms, such as those that occur despite proper therapy; or other complications that can exacerbate asthma such as severe rhinitis or GERD ; , for full medical evaluation. Consider providing alternative practice sites for athletes with asthma, such as indoor practice cont. on p. 5 and danocrine. Computerization is one solution that has been shown to minimize prescribing errors in hospitals and health systems. One study showed an institution's serious medication errors dropped 55% after a computerized order system was implemented.60 NCC MERP offers a series of recommendations aimed at improving error-prone aspects of prescription writing61.

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