[Problems with the availability of drugs in The Netherlands]. / Beschikbasrheidsproblemen van geneesmiddelen in Nederland.

The withdrawal ofa license to trade can result in problems with the availability of drugs. The reasons for withdrawal can be ofan economic nature, but the balance between effectiveness and side effects of a drug can also, after a period of time, prove disappointing and the drug can, as a result, be withdrawn from sale. A scarcity of basic materials, too, can play a role in availability, as can the inability of the manufacturer to meet the standards of the relevant authority.

[Medication and comedication in COVID-19 patients]. / Geneesmiddelen bij COVID-19.

This paper discusses the possible effects of comedication on COVID-19 and the current treatment options for this infection. It is very doubtful that comedication has a disadvantageous effect on the course of the disease. NSAIDs should be avoided in any patient with a possible severe disease, because of potential side effects. Inhibitors of the renin-angiotensin aldosterone system should be continued when there is a solid indication, and stopped in case of hemodynamic problems. There is no preference for either ACE inhibitors or angiotensin II receptor inhibitors. Currently, chloroquine and remdesivir are possible treatment options. There is no sound evidence for either treatment. Chloroquine has side effects (nausea, QT prolongation) and there are several drug interactions. The treatment should be reconsidered in the event of side effects and when inferior medication for comorbidity must be prescribed because of possible interactions. Lopinavir/ritonavir is not effective. Supportive care is at present the mainstay of the treatment.

[Utilization of euthanatic agents; experience of physicians with 227 patients, 1998-2000]. / Toepassing van euthanatica; ervaringen van artsen bij 227 patiënten, 1998-2000.

OBJECTIVE: To determine the experiences of physicians in the application of euthanatics. DESIGN: Descriptive. METHOD: The report 'Toepassing en bereiding van euthanatica' [Use and Preparation of Euthanatics] prepared by the national pharmacists' association contains a questionnaire for physicians regarding the condition of the patient, the method followed and time till death. The report was sent on request 723 times. From August 1998 until May 2000, 227 questionnaires were returned by general practitioners. These questionnaires were analysed. RESULTS: In 73.1% of the cases the euthanatic substance was given intravenously, in 26.4% orally. Time until death varied from 0 to 30 min when applied intravenously and 8 minutes to 7 hours when applied orally. On 51 questionnaires problems were registered which may occur when euthanatics are applied: difficult intravenous injection, too large volume of solute for the thiopental, deposit in the syringe, too little time between the intravenous administration and decease, unpleasant taste of euthanatic drink, too large volume of euthanatic drink, and too much time between the oral intake of the drink and decease.