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Because the simultaneous use of more than one form of topical corticosteroid involves higher cumulative doses and, therefore, more potential for absorption, this study was concerned primarily with effect on adrenal function. Seventeen adults whose asthma symptoms had been stable for at least three months on 100-400 microgram/day of beclomethasone dipropionate aerosol received flunisolide intranasal solution (200 microgram/day) combined with its intrabronchial form (1 mg/day) or with beclomethasone dipropionate bronchial aerosol (400 microgram/day). Utilizing a physician-blind, crossover design, each medication combination was administered for one month. Patient and physician evaluations revealed no significant differences in efficacy, adverse effects (complaints) or effect on adrenal function between the two combinations. Thus, the addition of intranasal flunisolide to intrabronchial flunisolide or beclomethasone did not appear to result in significant systemic absorption of corticosteroid above that which might have occurred as a result of the bronchial inhalation of corticosteroid medication alone during the pretrial period.

This study tested the effectiveness of flunisolide in the treatment of children with seasonal allergic rhinitis. Thirty-five children between the ages of 5 and 14 years used an intransal preparation of either flunisolide (200 micrograms/day) or placebo for a 6-week double-blind parallel trial consisting of a 2-week baseline phase and a 4-week treatment phase, conducted during a period of 'high' pollen counts in Adelaide, South Australia. Flunisolide was effective in reducing four symptoms of hay fever: sneezing, stuffy nose, runny nose and eye itch. Sixty-four percent of the flunisolide-treated group and 33% of the placebo-treated group noted substantial or total control of their hay fever symptoms (P < 0.05). The effect of the intranasal administration of flunisolide on the pituitary-adrenal axis was monitored by performing plasma cortisol measurements (a.m. and p.m.) and 24-hr urinary free cortisol excretion studies for each patient. The data confirmed that 200 micrograms/day intranasal flunisolide does not suppress the pituitary-adrenal-axis in this young patient population.

A total of 20 patients with a diagnosis of chronic idiopathic urticaria were entered into a fully randomized, double-blind, crossover study to investigate the efficacy of 8 mg acrivastine versus 4 mg chlorpheniramine three times daily. Data from 16 patients were available for analysis. Both acrivastine and chlorpheniramine were found to be effective in relieving the signs and symptoms of urticaria. There were no significant differences between the two treatments, although efficacy trends were generally in favour of acrivastine over chlorpheniramine throughout the study.

Five cases of stings by native bees are reported. The reactions were various and include a fatality as a result of the sting of a presumed Lasioglossum sp. (Halictidae). The effects of stings from Lasioglossum spp., Homalictus dotatus (Cockerell) (Halictidae), and Euryglossa cf adelaidae Cockerell (Colletidae) are described. The rarity of severe allergic reactions to native bees and the rarity of stings by the same species makes a programme of immunotherapy inappropriate.