Summary:A questionnaire on the pattern of drug taking was completed by 185 patients with chronic airflow obstruction. Of these, 49% admitted to taking their prescribed therapy regularly and 33% could be regarded as being fully compliant. The use ofincreasing numbers ofdrugs was not accompanied by a fall in compliance. Regular drug taking was better in patients (particularly females) with asthma than in patients with chronic bronchitis and emphysema. During acute exacerbations of airflow obstruction, excessive use of bronchodilators beyond the recommended increase in medication was rare; indeed, underuse of therapy in this situation was commoner. These conclusions must be regarded as tentative since the questionnaire was not validated by repeat interviewing or measurement of drug usage.

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Twenty patients who had taken overdoses of paracetamol were treated with acetylcysteine between 12 and 24 hours after the incident. Although 19 patients had plasma paracetamol concentrations greater than those associated with a 90% risk of moderate to severe liver damage, this complication occurred in only seven (35%) individuals. No patient developed hepatic encephalopathy or acute renal failure and all recovered without sequelae. We conclude that acetylcysteine administration up to 24 hours following paracetamol overdose is not dangerous and may prevent further liver damage.

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[4, 5]. The trait is inherited in an autosomal dominant fashion and a mutation of the receptor site shared by meal and enema, and CT of the thorax, abdomen and pelvis, bronchoscopy and brushings also failed to reveal any abnormality.warfarin and vitamin K is postulated, although the locus of the mutation is unknown. He was commenced on full-dose ( porcine mucosal) heparin for 10 days and the warfarin dose was increased to 15 mg daily untilMeasurement of the plasma warfarin concentration may be helpful in all these circumstances, since at steady state, his INR had risen to 4.0, when his plasma warfarin concentration was measured at 3.1 mg l −1 . the reference range is 0.8 to 2.4 mg l −1 [6]. The reference range for warfarin clearance (calculated by dividing the daily Patients vary markedly in their requirement for warfarin, warfarin dose by the steady-state plasma concentration) is but 95% of subjects need more than 1 and less than 2.5 to 8.7 l day −1

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