Dr. Best's interests covered the whole range of activities of the Canadian Diabetic Association. He participated in meetings of all kinds and was prepared to travel extensively to attend them. He made himself available for radio and television interviews and for films designed to illustrate the problems associated with diabetes, to help create a better understanding of these problems by the diabetic and the nondiabetic community. He had an almost paternal interest in the evolution of our association, particularly in the development of the clinical and scientific, and the professional health workers sections. M. SHLTLMAN. MD At the same time he recognized the 378 Roncesvalles Ave. need for diabetics to help themselves Toronto, Ont. and other diabetics, and for the association to hold that policy as its Tribute to Dr. Charles H. Best first principle, part of which is the To the editor: The recent death of need for research. To this end the Dr. Charles H. Best (Mar. 31, 1978) Charles H. Best Fund for Research, has made many people reconsider Education and Discovery was estaband review the impact of the life of lished by our association to finance this great man. We of the Canadian approved projects. Dr. Best supDiabetic Association have more ported all our fund-raising activities. cause than most to do so. It was the privilege of many memDr. Best cooperated with Dr. F.G. bers of our association to know this Banting in the discovery of insulin great Canadian. We shall always reand never forgot the people who member him as our very good friend needed the hormone. He was aware and benefactor. of the problems facing the diabetic FRCP[C] population, and was one of the lead- C. KENNETH GORMAN, MD, PH D,President ers instrumental in the creation of Canadian Diabetic Association Toronto, Ont. the Canadian Diabetic Association in 1953. We were most fortunate to have him as our honorary president CMARSP fund management during the first 25 years of the asso- to receive a shakeup (correction) ciation's existence. Contrary to a report at a recent CaDr. Best was interested in persons nadian Association Board of of all ages with diabetes. He did not DirectorsMedical meeting, mentioned by like the idea that insulin had to be D.A. Geekie in his article (Can Med injected, and kept hoping that a way Assoc 1 118: 1288, 1978), there are would be found of taking it by mouth. He encouraged investigation four physician members on the Govinto the hypoglycemic agents that ernment of British Columbia's advisory committee on medical mancould be taken orally when they first power. The committee is composed became available. He recognized the of W.D. chairman; Phyllis value of summer camps for diabetic Whittome, Black, vice-chairman; Dr. I. children and visited them when he Blake Thomson, Victoria, representhad the chance. ing the College of Physicians and One of Dr. Best's concerns was Surgeons of British Columbia; Dr. education of the person with diabetes, W. James Knickerbocker, Vancouand he supported the development of ver, representing the British Columspecial treatment centres where this bia Medical Association; Dr. R.B. could be achieved. He tried to help Kerr, Vancouver, chairman of the those who wrote to him about their Health Education Advisory Council; problems and guided them to the and Dr. D.M. Bolton, Victoria, Minnearest appropriate local resource. istry of Health representative. - Ed.
an increasing tendency by hospitals not to report dubious deaths. For example, a few weeks ago the press reported the death of a patient at Mount Sinai Hospital in Toronto. Apparently a group of nurses refused to tend the dying patient. The hospital did not report the death to the coroner's office, but even when the story came out in the newspapers no one at the coroner's office bestirred themselves to determine what had happened. Dr. Bennett is quite correct that coroner's investigations no longer provide headlines - the reason is simply that today's coroners take great care where they tread.
M.trin
(ibuprofen)
Action: Ibuprofen has demonstrated anti-inflammatory, analgesic, and antipyretic activity in special animal studies designed to specifically demonstrate these effects. Ibuprofen has no demonstrable glucocorticoid effect. Ibuprofen has been found to be less likely to cause gastro-intestinal bleeding in doses usually used than is acetylsalicylic acid. Clinical trials in man have shown the clinical activity of a dose of 1200-1800 mg of ibuprofen daily to be similar to that of 3600 mg of acetylsalicylic acid daily. Indications and Clinical Uses: Ibuprofen is indicated for the treatment of osteoarthritis and rheumatoid arthritis. Contraindications: Ibuprofen should not be used during pregnancy or in psediatric patients because its safety under these conditions has not been established. Ibuprofen should not be used in patients with a history of acetylsalicylic acidinduced bronchospasm. Precautions: Ibuprofen should be used with caution in patients with a history of gastrointestinal ulceration. Ibuprofen has been reported to be associated with toxic amblyopia. Therefore, precautions should be taken to ensure that patients on ibuprofen therapy report to their physicians for full ophthalmological examination if they experience any visual difficulty. Medication should be discontinued if there is any evidence of toxic amblyopia. Adverse Reactions: The following adverse reactions have been noted in patients treated with ibuprof en. Gastrointestinal: Nausea, vomiting, diarrhoea, constipation, dyspepsia, epigastric pain and guaiac positive stools have been noted. A few cases of gastric or duodenal ulceration, including some complicated by bleeding or perforation have occurred. Cenfraf Nervous System: Dizziness, light-headedness, headache, anxiety, mental confusion and depression were noted in some patients treated with ibuprofen. Ophthalmological: Blurred vision was noted in some patients and rarely a sensation of moving lights was observed following administration of ibuprofen. In addition there are three published cases of toxic amblyopia assoc;ated with the use of ibuprofen. Although a definite cause and effect relationship was not established, the attending physicians considered them to be drugrelated. The condition was characterised by reduced visual acuity and difficulty in colour discrimination. Defects (usually centrocaecal) were observed on visual field examination. Symptoms were reversible on discontinuation of treatment. Skin: Maculopapular rashes and generalised pruritus have been reported with ibuprofen therapy. Occasional cases of oedema have also been reported. Laboratory Tests: Sporadic abnormalities of liver function tests have occurred in patients on ibuprofen therapy (SGOT, serum bilirubin and alkaline phosphatase) but no definite trend was seen indicating toxicity. Similar abnormalities of white blood count and blood urea determinations were noted. A slight fall in haemoglobin and haematocrlf has been noted in some patients. Symptoms and Treatment of Overdosage: One case of overdosage has been reported. A oneyear-old child ingested 1200 mg ibuprofen and suffered no ill effects other than being drowsy the next day. Blood levels of ibuprofen reached 711 mcg/ml, which is considerably above the 90 mcg/ml previously recorded as the highest level seen in adults after a single oral dose of 800 mg. The SGPT level, nine days post-ingestion, was 72. No specific antidote is known. Standard measures to stop further absorption and maintain urine output should be implemented at once. The drug is excreted rapidly and excretion is almost complete in six hours. Dosage and Administration: To obtain rapid response at the start of treatment, particularly when transferring from other anti-inflammatory therapy, Motrin should be given at a dose of 1200 mg per day in four divided doses. Depending on the therapeutic response, the dose may be adjusted downward or upward keeping the four-times-a-day dosage schedule. The daily dose should not exceed 2400 mg. Maintenance therspy, once maximum response is obtained, will range from 800 to 1200 mg per day. Due to lack of clinical experience, ibuprofen is not indicated for use in children under 12 years of age. Supplied: 200 mg yellow coated tablets, 300 mg white coated tablets and 400 mg orange coated tablets in bottles of 100 and 1000. Product monograph available on request.
777
REGISTEREOTRADEMARK, MOTRIN
CE9223.2
TWF IIDIC.WM CflkAPAMY (.F CANADA
an increasing tendency by hospitals not to report dubious deaths. For example, a few weeks ago the press reported the death of a patient at Mount Sinai Hospital in Toronto. Apparently a group of nurses refused to tend the dying patient. The hospital did not report the death to the coroner's office, but even when the story came out in the newspapers no one at the coroner's office bestirred themselves to determine what had happened. Dr. Bennett is quite correct that coroner's investigations no longer provide headlines - the reason is simply that today's coroners take great care where they tread.
M.trin
(ibuprofen)
Action: Ibuprofen has demonstrated anti-inflammatory, analgesic, and antipyretic activity in special animal studies designed to specifically demonstrate these effects. Ibuprofen has no demonstrable glucocorticoid effect. Ibuprofen has been found to be less likely to cause gastro-intestinal bleeding in doses usually used than is acetylsalicylic acid. Clinical trials in man have shown the clinical activity of a dose of 1200-1800 mg of ibuprofen daily to be similar to that of 3600 mg of acetylsalicylic acid daily. Indications and Clinical Uses: Ibuprofen is indicated for the treatment of osteoarthritis and rheumatoid arthritis. Contraindications: Ibuprofen should not be used during pregnancy or in psediatric patients because its safety under these conditions has not been established. Ibuprofen should not be used in patients with a history of acetylsalicylic acidinduced bronchospasm. Precautions: Ibuprofen should be used with caution in patients with a history of gastrointestinal ulceration. Ibuprofen has been reported to be associated with toxic amblyopia. Therefore, precautions should be taken to ensure that patients on ibuprofen therapy report to their physicians for full ophthalmological examination if they experience any visual difficulty. Medication should be discontinued if there is any evidence of toxic amblyopia. Adverse Reactions: The following adverse reactions have been noted in patients treated with ibuprof en. Gastrointestinal: Nausea, vomiting, diarrhoea, constipation, dyspepsia, epigastric pain and guaiac positive stools have been noted. A few cases of gastric or duodenal ulceration, including some complicated by bleeding or perforation have occurred. Cenfraf Nervous System: Dizziness, light-headedness, headache, anxiety, mental confusion and depression were noted in some patients treated with ibuprofen. Ophthalmological: Blurred vision was noted in some patients and rarely a sensation of moving lights was observed following administration of ibuprofen. In addition there are three published cases of toxic amblyopia assoc;ated with the use of ibuprofen. Although a definite cause and effect relationship was not established, the attending physicians considered them to be drugrelated. The condition was characterised by reduced visual acuity and difficulty in colour discrimination. Defects (usually centrocaecal) were observed on visual field examination. Symptoms were reversible on discontinuation of treatment. Skin: Maculopapular rashes and generalised pruritus have been reported with ibuprofen therapy. Occasional cases of oedema have also been reported. Laboratory Tests: Sporadic abnormalities of liver function tests have occurred in patients on ibuprofen therapy (SGOT, serum bilirubin and alkaline phosphatase) but no definite trend was seen indicating toxicity. Similar abnormalities of white blood count and blood urea determinations were noted. A slight fall in haemoglobin and haematocrlf has been noted in some patients. Symptoms and Treatment of Overdosage: One case of overdosage has been reported. A oneyear-old child ingested 1200 mg ibuprofen and suffered no ill effects other than being drowsy the next day. Blood levels of ibuprofen reached 711 mcg/ml, which is considerably above the 90 mcg/ml previously recorded as the highest level seen in adults after a single oral dose of 800 mg. The SGPT level, nine days post-ingestion, was 72. No specific antidote is known. Standard measures to stop further absorption and maintain urine output should be implemented at once. The drug is excreted rapidly and excretion is almost complete in six hours. Dosage and Administration: To obtain rapid response at the start of treatment, particularly when transferring from other anti-inflammatory therapy, Motrin should be given at a dose of 1200 mg per day in four divided doses. Depending on the therapeutic response, the dose may be adjusted downward or upward keeping the four-times-a-day dosage schedule. The daily dose should not exceed 2400 mg. Maintenance therspy, once maximum response is obtained, will range from 800 to 1200 mg per day. Due to lack of clinical experience, ibuprofen is not indicated for use in children under 12 years of age. Supplied: 200 mg yellow coated tablets, 300 mg white coated tablets and 400 mg orange coated tablets in bottles of 100 and 1000. Product monograph available on request.
777
REGISTEREOTRADEMARK, MOTRIN
CE9223.2
TWF IIDIC.WM CflkAPAMY (.F CANADA
