Angiotensin Receptor Blockers Effect on Serum Uric Acid-A Class Effect?

PURPOSE: To provide a comprehensive review to determine whether there is a class effect among angiotensin receptor blockers (ARBs) in relation to serum uric acid. SUMMARY: A literature search was conducted and 8 articles were identified for inclusion in this review. In the studies reviewed, candesartan and valsartan were shown to have either a neutral or negative effect on serum uric acid. Azilsartan was shown to have a negative impact on serum uric acid while eprosartan appeared to have no impact on serum uric acid levels. Irbesartan demonstrated either a neutral or positive effect on serum uric acid while losartan exhibited a positive effect. CONCLUSION: The available data indicate that the reduction of serum uric acid is not a class effect of ARBs. Of the available agents, only losartan has clear evidence of its ability to lower serum uric acid. For patients with high blood pressure and elevated serum uric acid, losartan should be considered as a first-line agent with irbesartan as an alternative when appropriate.

Evaluation of Over-the-Counter Medication Knowledge and Literacy in Adolescent Students.

OBJECTIVE: To 1) assess and compare knowledge and literacy of over-the-counter (OTC) medications among middle school (MS) and high school (HS) students, and 2) to assess student self-identified lack of knowledge regarding OTC medications. METHODS: A convenience sample of suburban adolescent students completed a 2-part survey about OTC medications: part 1 included demographics and baseline knowledge of OTCs, and part 2 included medication label interpretation (literacy). Descriptive statistics and chi-square test were used to summarize and compare responses among MS and HS students. RESULTS: Students (n = 309) were in MS (46.2%) and HS (53.8%), with a mean age of 14 ± 1.8 years, 61.4% male, 81.2% white, and 84.3% non-Hispanic. A majority of students (68.5%) agreed that they always speak with an adult before taking medication. Students responded correctly to 19% of brand versus generic knowledge questions; conversely, 65% selected "I don't know." Similar trends were seen for questions about medication indications (26% correct, 59% didn't know), side-effects (8% correct, 67% didn't know), and combining medications (21% correct, 63% didn't know). When students referenced a medication label, 55% answered label interpretation questions correctly and 30% reported "I don't know." HS students answered more questions correctly and were less likely to report "I don't know" to questions about common OTC medications (eg, ibuprofen, Tylenol, etc) compared with MS students (P < .05). DISCUSSION: Overall, baseline knowledge of OTC medications was low; however, students were better at interpretation of drug labels. MS students self-reported less knowledge about common OTC medications compared with HS students. This study provides an important foundation for future OTC medication educational programs for adolescents.