Herbal therapies are widely used, but there are few data on their interactions with conventional medications. This study evaluated the effect of garlic supplements on the pharmacokinetics of saquinavir. Ten healthy volunteers received 10 doses of saquinavir (Fortovase) at a dosage of 1200 mg 3 times daily with meals for 4 days on study days 1-4, 22-25, and 36-39, and they received a total of 41 doses of garlic caplets taken 2 times daily on study days 5-25. Blood samples were obtained on study days 4, 25, and 39 for determination of saquinavir plasma pharmacokinetic parameters. In the presence of garlic, the mean saquinavir area under the curve (AUC) during the 8-h dosing interval decreased by 51%, trough levels at 8 h after dosing decreased by 49%, and the mean maximum concentrations (Cmax) decreased by 54%. After the 10-day washout period, the AUC, trough, and Cmax values returned to 60%-70% of their values at baseline. Patients should use caution when combining garlic supplements with saquinavir when it is used as a sole protease inhibitor.

Lifting patients under the axilla has been found to be physically stressful for nurses and uncomfortable for patients. The goals of this study were to find out: how often educators teach this method and observe it in the clinical field; which assistive devices are used in teaching; and what authors of textbooks teach about the under-axilla method. A questionnaire was sent to 546 baccalaureate (BS) and associate (AD) degree programs; 358 educators responded and 337 responses were analyzed. Eighty-three percent of the educators teach the under-axilla method for in- and out-of-bed transfers; 94% observe it used in the clinical field. For lifting up in bed, 56% teach the under-axilla method; 86% observe it in the clinical field. When assistive devices are included in teaching, the hydraulic lift and gait belt are taught most often; less stressful and more comfortable devices are not taught or observed by most respondents. None of the authors of the 3 most frequently used textbooks describe the use of the under-axilla method; authors of 2 textbooks state patients should not have pressure placed on the axilla area.