High blood pressure advice given by natural health food stores.

AIM: Complimentary and alternative medicines are widely used but are not registered medicines. The aim of the study was to compare advice given by health food stores and pharmacists for hypertension. METHODS: Twenty-six health food stores and 26 pharmacies were visited by an individual for advise on a hypothetical problem of hypertension. RESULTS: Staff in 25 out of 26 health food stores did not refer the researcher to a medical practitioner; instead they recommended and sold a wide variety of compounds of unproven efficacy. CONCLUSIONS: We recommend the implementation of a formal training programme for health food stores staff and that complimentary and alternative medicines-use in New Zealand is regulated.

The pulmonary and extra-pulmonary effects of high-dose formoterol in COPD: a comparison with salbutamol.

OBJECTIVES: Formoterol, a beta(2) agonist with a rapid onset of effect and long duration of action, can be used as maintenance and reliever medication for asthma and COPD. We compared the pulmonary and extra-pulmonary effects of cumulative doses of formoterol and salbutamol in patients with COPD to assess efficacy and safety. METHODOLOGY: In a randomized, double-blind, cross-over study, 12 patients with moderate to severe COPD inhaled, via Turbuhaler, 10 doses of formoterol (total metered dose, 120 microg, equivalent to a 90- microg delivered dose), salbutamol (total metered dose 2000 microg) or placebo at 2-min intervals on separate days. The effects on lung function (FEV(1) and PEF), heart rate, blood pressure, oxygen saturation, corrected QT interval (QTc), T-wave height and plasma potassium were assessed before each dose, 15 min after each dose, and at half-hourly intervals for 3 h following the final dose. RESULTS: Inhalation of formoterol or salbutamol resulted in significant improvement in lung function (measured 30 min after the last dose) when compared with placebo. There were no clinically important or statistically significant changes in heart rate, QTc, T-wave height, plasma potassium, oxygen saturation, or systolic and diastolic blood pressures with formoterol or salbutamol. One patient developed ventricular trigeminy after both formoterol and salbutamol. She had had ventricular ectopics on her screening electrocardiogram. CONCLUSION: Formoterol and salbutamol both produced significant improvement in lung function and were similarly well tolerated in high doses, as might be taken by a patient for relief of COPD symptoms.

Do natural health food stores require regulation?

AIM: To compare advice provided by health food stores (HFS) and pharmacies in relation to medical conditions and assess the need for regulation of HFS. METHODS: We assessed the advice provided by 26 health food stores (HFS) and 26 pharmacies to an individual presenting with symptoms suggestive of moderate to severe asthma who had not seen a general practitioner. RESULTS: The advice provided by the two stores differed markedly. 22/26 pharmacy staff diagnosed asthma/probable asthma, whereas only 15/26 HFS staff reached the same conclusion. 92.3% of pharmacy staff compared to 34.6% of HFS staff referred the investigator to a doctor; 5 HFS advised the investigator against seeing a doctor. A wide variety of remedies were recommended by the HFS, none of which are known to be beneficial in the treatment of asthma. CONCLUSION: HFS promoting herbal products for medical conditions should be regulated in a similar fashion to shops that dispense pharmaceutical products.