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The article mentions that poisoning caused due to intake of paracetamol could be fatal and talks about several other side effects that are associated with it such as acute liver failure and liver injury. It discusses the metabolism of paracetamol in the body, the damage caused by it to the liver and several factors that could aggravate the impact of the damage such as malnourishment and alcoholism. It mentions several symptoms associated with paracetamol poisoning which are visible within a few hours of its intake. It informs about the diagnostic methods which should adopted to determine the level of the poisoning and the type of subsequent and supportive courses of treatment that should be prescribed. It also mentions situations where the patient succumbs to the poisoning.

The authors reflect on legislative proposals which have been developed which would increase people's access to over the counter medicines. They suggest that the risks of increasing access may outweigh the benefits. They argue that given the concerns that are associated with potential problems with over the counter medications it would be wise to avoid a rush to increase their availability.

Presents an editorial on the monitoring of drug treatments. Value of monitoring treatment to anticipate or detect adverse reactions to drugs before they become inevitable or irreversible; Monitoring tests which should be safe, simple, precise and validated; Actions to take in response to positive tests; Monitoring strategy.

The authors reflect on the potential medical and health benefits of biosimilar medicines. Topics covered include the fundamental definitions and examples of biological products and biosimilars, how England's National Health Service (NHS) can benefit in prescribing cheaper biosimilars, and the problems and challenges encountered in naming and prescribing biosimilars. The authors also provide recommendations with regards to prescribing biosimilars.

The authors ponder on the problems surrounding orphan drugs, or the drugs developed for life threatening or chronically debilitating rare disorders. They cite the aim of the orphan drug legislation in the U.S. and Europe, along with the unintended consequences of such legislation. They explain how prescribing expensive licensed drugs, despite the availability of cheaper ones, affects medical care costs. They also emphasize the significance of incentives to drug manufacturers.

Presents an editorial about regulating herbal medicines in England. Lack of evidence on the effectiveness of herbal medicine; Difficulty of judging whether such medicines are safe; Description of regulations in the United States for supplements, which is what herbal medicines are regarded as; Efforts of the European Union in regulating herbal products.

Discusses the medical concept of concordance, in which the physician and patient come together to make a decision regarding the prescribed medical treatment for the patient's condition. Importance of dialogue between a physician and patient in optimizing the potential benefits of medical care; Difficulty in assessing the risks and benefits in the taking of prescribed medicines; Behavioral aspects of taking prescribed medicines.

Editorial. Comments on the Audit Commission report, 'A Spoonful of Sugar,' which indicates a fivefold increase in ten years of medication errors or adverse reactions to medicines in Great Britain. Discussion of the Audit Commission's failure to distinguish between medication errors, inevitable adverse reactions, and potentially preventable adverse reactions; Factors that contribute to medication errors; View that those who prescribe and give drugs should be better educated and tested on competency in patient safety.

The author discusses whether the mefloquine drug should still be used for chemoprophylaxis by the British military personnel. Topics discussed include the three options for chemoprophylaxis against chloroquine resistant Plasmodium falciparum malaria, two forms of mefoquine-induced neuropsychiatric reaction, and nomination of a first-line treatment and reservation of another drug for second-line use.

The authors discuss criminal prosecution of physicians that committed medical errors associated with patient mortality. They report increase in number of cases focusing on negligent acts of physicians from 1990 to 2005. They cite various factors which could bring change in the link between medicine and criminal law in England and Wales. Brief details about the implementation of the Corporate Manslaughter and Corporate Homicide Act of 2007 in Great Britain are also presented.

A letter to the editor is presented in response to the article "How long should treatments be continued?," by J. C. Craig et al, published in the August 19, 2010 issue.

We report the case of a 27-year-old, UK-born, Asian woman who suffered a rare recurrence of Kikuchi-Fujimoto disease. She presented with tender lymphadenopathy of the neck, fever and a prodrome of flu-like symptoms. She had a past medical history of biopsy-proven Kikuchi-Fujimoto disease of her right axilla 2 years earlier, which required no treatment. Following her repeat admission, a cervical lymph node biopsy confirmed a diagnosis of recurrent Kikuchi-Fujimoto disease. She did not improve despite treatment with paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs). She was started on high-dose prednisolone and her symptoms, pyrexia, and inflammatory markers settled within 24 h. She continually improved and the prednisolone was slowly reduced over 9 months. Kikuchi-Fujimoto is a rare, benign, self-limiting disease that presents with lymphadenopathy and fever. It rarely reoccurs. The severity, recurrence and the different body site make this an unusual case. [ABSTRACT FROM AUTHOR]

This letter to the editor is in response to the article "A Prescription for Better Prescribing," written by J. K. Aronson, G. Henderson, D. J. Webb and M. D. Rawlins in the September 2, 2006 issue of the "British Medical Journal."

Competing Interests: Competing interests: JKA has published articles and edited textbooks on adverse drug reactions and interactions, for which he has sometimes received royalties, and has often given medicolegal advice, including appearances as an expert witness in coroners’ courts, for which he has received fees. He is an associate editor of BMJ Evidence-Based Medicine and was a coauthor of the editorial that introduced the Coroners’ Concerns to Prevent Harms Series in the journal. GCR was financially supported by the National Institute for Health Research School for Primary Care Research, the Naji Foundation, and the Rotary Foundation to study for a doctor of philosophy (2017-2020), but no longer has any financial conflicts of interest; she is an associate editor of BMJ Evidence-Based Medicine, was lead author of the editorial that introduced the Coroners’ Concerns to Prevent Harms Series, and is developing (https://preventabledeathstracker.net/) a programme of research on preventable deaths.

Background: Enzyme-inducing antibacterial drugs can impair the efficacy of hormonal contraceptives. Suspicion that other antibiotics might do likewise led to advice that extra contraceptive precautions should be taken during a course of antibiotics. However, current advice is that the purported interaction does not occur, based on small studies observing few pregnancies, assuming that all women are susceptible, and without measuring unbound hormone concentrations., Objective: To test the null hypothesis that antibiotics do not impair the effectiveness of oral contraceptives., Design: A database review of Yellow Card reports to the UK's Medicines and Healthcare products Regulatory Agency., Data: Spontaneous reports of suspected adverse drug reactions in people taking antibacterial drugs (n=74 623), enzyme-inducing medicines (n=32 872), or control medicines (n=65 578)., Main Outcome Measures: Reports of the primary outcome-unintended pregnancies; reports of cardiac arrhythmias and headaches (control events); reports of congenital abnormalities (positive control events); and reports of diarrhoea (a possible confounding factor)., Results: Compared with control medicines, unintended pregnancies were seven times more commonly reported with antibiotics and 13 times more commonly reported with enzyme inducers (the positive controls). Congenital abnormalities were reported seven times more often with enzyme inducers but were not more common with antibiotics. Diarrhoea was not a confounding factor., Conclusion: This study provides a signal that antibacterial drugs may reduce the efficacy of hormonal contraceptives. Women taking hormonal contraceptives should be warned that antibiotics may impair their effectiveness. Extra precautions can be taken during a course of antibiotics; an unintended pregnancy is a life-changing event., Competing Interests: Competing interests: JKA and REF have both written widely about adverse drug reactions and interactions and have from time to time received fees for legal reports, payments for articles, and royalties on books that they have written on the subject., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)