Meperidine - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

MEPERIDINE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N...

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MEPERIDINE A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Meperidine: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00717-7 1. Meperidine-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on meperidine. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON MEPERIDINE .............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Meperidine .................................................................................... 4 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND MEPERIDINE .................................................................................... 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Meperidine................................................................................... 53 Federal Resources on Nutrition ................................................................................................... 54 Additional Web Resources ........................................................................................................... 55 CHAPTER 3. ALTERNATIVE MEDICINE AND MEPERIDINE.............................................................. 57 Overview...................................................................................................................................... 57 National Center for Complementary and Alternative Medicine.................................................. 57 Additional Web Resources ........................................................................................................... 60 General References ....................................................................................................................... 61 CHAPTER 4. DISSERTATIONS ON MEPERIDINE................................................................................ 63 Overview...................................................................................................................................... 63 Dissertations on Meperidine........................................................................................................ 63 Keeping Current .......................................................................................................................... 63 CHAPTER 5. PATENTS ON MEPERIDINE .......................................................................................... 65 Overview...................................................................................................................................... 65 Patents on Meperidine ................................................................................................................. 65 Patent Applications on Meperidine ............................................................................................. 66 Keeping Current .......................................................................................................................... 67 CHAPTER 6. PERIODICALS AND NEWS ON MEPERIDINE ................................................................ 69 Overview...................................................................................................................................... 69 News Services and Press Releases................................................................................................ 69 Academic Periodicals covering Meperidine ................................................................................. 71 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 73 Overview...................................................................................................................................... 73 U.S. Pharmacopeia....................................................................................................................... 73 Commercial Databases ................................................................................................................. 74 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 79 Overview...................................................................................................................................... 79 NIH Guidelines............................................................................................................................ 79 NIH Databases............................................................................................................................. 81 Other Commercial Databases....................................................................................................... 83 APPENDIX B. PATIENT RESOURCES ................................................................................................. 85 Overview...................................................................................................................................... 85 Patient Guideline Sources............................................................................................................ 85 Finding Associations.................................................................................................................... 87 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 89 Overview...................................................................................................................................... 89 Preparation................................................................................................................................... 89 Finding a Local Medical Library.................................................................................................. 89 Medical Libraries in the U.S. and Canada ................................................................................... 89 ONLINE GLOSSARIES.................................................................................................................. 95 Online Dictionary Directories ..................................................................................................... 97

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MEPERIDINE DICTIONARY ....................................................................................................... 99 INDEX .............................................................................................................................................. 135

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with meperidine is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about meperidine, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to meperidine, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on meperidine. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to meperidine, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on meperidine. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON MEPERIDINE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on meperidine.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and meperidine, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “meperidine” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Assessment of the Success of Meperidine and Promethazine Sedation in Medically Compromised Children Source: Journal of Dentistry for Children. 60(4-5): 288-294. July-October 1993. Summary: Meperidine and promethazine have been used for many years in children who are mentally and physically compromised in the dental clinics of two children's hospitals in Dallas, Texas. This article reports on a retrospective study that reviewed the data from the sedation logs of these patients over the past 2.5 years. The study attempted to determine the success rate and safety of this regimen in modifying the children's behavior; to determine the relationship of the child's mental or physical status and previous hospital experience to the success of the sedation; to analyze the significance of the medical diagnosis on the success of the technique; and to determine the effect of multiple sedations and different operators on outcome. The results support

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the concept that development of specific criteria, based upon individual analysis of the patient's status, will increase the chances for a successful status. The neurologicallyinvolved patient taking centrally-acting medications would be the least likely candidate for a successful sedation. 5 tables. 8 references.

Federally Funded Research on Meperidine The U.S. Government supports a variety of research studies relating to meperidine. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to meperidine. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore meperidine. The following is typical of the type of information found when searching the CRISP database for meperidine: •

Project Title: BEHAVIORAL EFFECTS OF OPIOIDS IN VOLUNTEERS Principal Investigator & Institution: Zacny, James P.; Associate Anesthesiology; University of Chicago 5801 S Ellis Ave Chicago, Il 60637

Professor;

Timing: Fiscal Year 2002; Project Start 15-MAR-1995; Project End 29-FEB-2004 Summary: Until recently, little attention had been paid to characterizing behavioral effects of opioids in normal volunteers (i.e., volunteers with no history of drug or alcohol dependence) using the rigorous testing methodologies that had been employed in the studies with abusers. For the past three years, we have employed an abuse liability/behavioral toxicology testing methodology to examine the effects of a number of different opioids that are typically given to patients for postoperative pain. This application will have four series of studies that are logical continuations of studies from the previous grant period. In the first series of studies, we will focus on opioids that are typically given to patients who are recovering from outpatient surgery. These patients might be at home or at work, engaging in different activities that may or may not be adversely affected by the opioids. It is vitally important to understand the behavioral toxicology of these opioids, yet rigorous toxicology studies (employing multiple measures of behavior and examining a range of doses that might be used by patients) have not been conducted to date. Therefore, we plan to continue our opioid characterization studies in normal volunteers, focusing on four oral drugs commonly used in outpatient settings: hydrocodone, oxycodone, propoxyphene, and tramadol. In the second series of studies, we will follow up on a study from the previous granting period in which some of morphine's subjective effects were attenuated by a painful stimulus. In four studies, we will use a cumulative dosing procedure recently developed 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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in our laboratory to examine the degree to which a painful stimulus modulates the subjective and psychomotor effects of morphine, meperidine, butorphanol and nalbuphine. We will study different opioids at different doses and at different levels of painful stimulation in order to better understand how pain, which frequently accompanies opioid administration in patients, modulates behavioral effects of opioids. In the third series of studies, we will again follow up on a previous study from our laboratory in which we demonstrated that a painful stimulus modulated the reinforcing effects of an opioid, fentanyl. We propose to utilize a patient controlled analgesia (PCA) methodology to examine the degree to which four different opioids- morphine, meperidine, nalbuphine and butorphanol- maintain self-administration, and the degree to which self-administration is modulated by a painful stimulus. In the fourth series of studies, the effects of psychomotor stimulants alone and in combination with an opioid will be examined. Psychomotor stimulants are often given as adjuncts to opioids in patients suffering from chronic malignant pain to offset the sedating and impairing effects of high-dose opioid therapy. We will study buprenorphine in combination with three psychomotor stimulants- d-amphetamine, methylphenidate, and pemoline- to determine the relative pharmacodynamic profiles and which combination(s) produces the most analgesia with the least degree of troublesome side effects (including marked sedation and psychomotor/cognitive impairment). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MODULATION OF G PROTEIN COUPLED RECEPTOR FUNCTION Principal Investigator & Institution: Childers, Steven R.; Professor; Wake Forest University 1834 Wake Forest Road Winston-Salem, Nc 27106 Timing: Fiscal Year 2002; Project Start 15-FEB-2002; Project End 31-JAN-2007 Summary: Opioid agonists like morphine, codeine and meperidine remain the most commonly used and effective treatment for chronic pain conditions. Despite the fact that chronic opioid treatment can produce high levels of tolerance and physical dependence. Mechanisms of tolerance and dependence for in brain are not well understood, but it is clear that chronic opioid treatment produces significant receptor desensitization in specific brain regions. Moreover, pain itself, as well as concurrent treatment with drugs like adenosine and alpha2- adrenergic agonists, alter the sensitivity of patients to opioid treatment. Opioid receptors (including mu, delta and kappa types), as well as adenosine A1 and alpha2-adrenergic receptors, are G-protein-coupled receptors, and their ability to activate signal transduction systems can be determined by the ability of agonists to stimulate [35S]GTPgammaS binding in both membranes and section autoradiography. This project will examine regulation of several receptor/G-protein interactions in rat spinal cord, using models of drug treatment, self-administration and chronic pain developed by other Center components. First, after determining the acute efficacies of opioid and adenosine A1 agonists in activating G-proteins in spinal cord, the ability of chronic drug exposure to produce receptor desensitization will be examined in both spinal cord membranes and by autoradiography. These treatments will include chronic intrathecal opioid administration to desensitize opioid receptor-activated G-proteins, and chronic intrathecal administration of adenosine and clonidine to desensitize agonist-stimulated incorporation of [32P]AAGTP into specific G-protein subunits. Second, various receptor-activated G-protein activities will be determined in both brains ans spinal cords from spinal nerve ligated rats to determine whether chronic pain and hypersensitivity affect receptor/G-protein coupling. These studies will also determine how chronic pain states modulate basal levels and activities of G-proteins in spinal cord. Third, the ability of NMDA antagonists and protein kinase C inhibitors to modulate

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receptor desensitization will be tested after chronic intrathecal administration of drugs. Information from this project will help design studies in the Clinical Core to test the use of opioid agonists of differing efficacies in treating chronic pain. Moreover, these studies will provide information to minimize tolerance in long-term drug treatment of chronic pain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NOVEL CERAMIDE-BASED CHEMOTHERAPY FOR ACUTE LEUKEMIA Principal Investigator & Institution: Maurer, Barry J.; Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles, Ca 900276062 Timing: Fiscal Year 2004; Project Start 10-AUG-2004; Project End 31-JUL-2008 Summary: (provided by applicant): Our goal is to establish a p53-independent chemotherapy for ALL leukemias based upon the intracellular generation and manipulation of the pro-death lipid, ceramide. We reported that fenretinide (4-HPR) increased de novo ceramide synthesis in cancer cell lines in vitro, and inhibitors of ceramide catabolism, such as safingol and PPMP, synergistically increased 4-HPR cytotoxicity. We have developed formulations 4-HPR and safingol for clinical testing. We hypothesize that combinations of 4-HPR, safingol, and PPMP, will have antileukemia activity with tolerable systemic toxicity in vivo, and that defining the mechanisms of 4-HPR synergy in ALL cell lines will facilitate clinical development. AIM 1. Define the molecular mechanisms of 4-HPR cytotoxicity. A) Determine the dependence of 4-HPR cytotoxicity and synergy upon de novo ceramide by abrogating de novo ceramide synthesis using antisense and siRNA to the LCB1 subunit of SPT. B) Determine the molecular ordering of 4-HPR cytotoxicity by measuring ceramide, ROS, mitochondrial membrane potential (psi/m), cytochrome c release, and caspase activation, in parental and mitochondrial DNA-deficient (Rho) cell derivatives. AIM 2. Determine the active metabolite of safingol and its effect on 4-HPR-induced de novo ceramide catabolism. Determine the kinetics of 3H-safingol and catabolites, and effects on ceramide, sphingosine, and sphingosine kinase. Determine if L-threodihydroceramides or L-threo-ceramides reproduce the effects of safingol. AIM 3. Determine the effect of inhibiting acylceramide synthase (ACS) and glucosylceramide synthase (GCS) on 4-HPR cytotoxicity. Identify a preferred stereoisomer of PPMP. ACS and GCS catabolize de novo ceramide to nontoxic products. Determine the effect on 4HPR cytotoxicity of selectively inhibiting ACS and GCS with antisense and/or siRNA. Identify an isomer of PPMP to inhibit both ACS and GCS. AIM 4. Establish the pharmacokinetic and pharmacodynamic interactions of 4-HPR, safingol, and PPMP in an ALL cells xenograft model. Correlate fenretinide and PPMP levels assayed by HPLC with ceramide levels assayed by mass spectroscopy in xenografts. Use drug and ceramide levels, xenograft response, and animal systemic toxicity to optimize delivery of 4-HPR, safingol, and PPMP. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: ROLE OF ENVIRONMENT IN NEUROPROTECTION Principal Investigator & Institution: Smeyne, Richard J.; Associate Member; St. Jude Children's Research Hospital Memphis, Tn 381052794 Timing: Fiscal Year 2004; Project Start 01-MAR-2004; Project End 28-FEB-2006 Summary: (provided by applicant): PD is a debilitating neurological disorder that strikes 20 per 100,000 persons greater than 50 years of age. The cause of >90% of all PD

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cases are unknown. However, the discovery of the meperidine by-product 1-methyl-4phenyl-1,2,3,6-tetrahydropyridine (MPTP) has provided a useful model of Parkinsonism that appears to recapitulate the pathology of the disease seen in man. Exposure to this prototypical "environmental toxin" causes a selective loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc). MPTP is a lipophillic molecule that rapidly enters the brain and is metabolized to MPP+ through a series of intermediates to MPP+ by the enzyme MAO-B. MPP + is a substrate for dopamine uptake mechanisms and it accumulates intraneuronally and interferes with complex I of the electron transport chain. We have recently shown that the glial cell is the critical cell for conferring protection or susceptibility to this toxin. Since PD is progressive, both in terms of cell loss and symptomotology, it would be of tremendous clinical value if there were cell biological, pharmacological or non-pharmacological methods that could attenuate cell loss; with or without interruption of the disease triggers. Alternatively, at the least, it would be important to slow the progression of cell loss once symptoms arose. There is a significant literature, dating back to the late 1700's that altering an animals' environment can lead to neurological changes. These changes are manifested as increased brain size, increased learning, and recently it has been shown that environment can increase neurogenesis. Recently, we have preliminary data to suggest that mice raised in an "Enriched Environment" (EE) are protected from MPTP toxicity. In this application, we will study and further establish the EE model. In addition, we will examine if the components (exercise, alterations in environmental complexity and/or social interactions) of the EE can confer neuroprotection. In addition, we will examine the role of the neurotrophin BDNF in EE-dependent neuroprotection. The work proposed and subsequent results generated in the application will be used as pilot data. We believe that the EE model may provide a new approach to prevention of PD symptomatology as well as other neurodegenerative disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: SYNTHESIS OF POTENTIAL COCAINE THERAPEUTICS Principal Investigator & Institution: Trudell, Mark L.; Professor; Chemistry; Louisiana State Univ-Univ of New Orleans New Orleans, La 70148 Timing: Fiscal Year 2003; Project Start 30-SEP-1997; Project End 30-JUN-2008 Summary: (provided by applicant): The primary goal of this project is to develop compounds that have potential utility as therapeutic agents for cocaine addiction. The primary objectives are to synthesize and evaluate the pre-clinical biological and behavioral effects of novel compounds targeted for the dopamine transporter. These compounds are designed to elucidate the mechanism of action of the dopamine transporter (DAT). As such, a better understanding of the mechanisms of action of dopamine uptake inhibition may provide leads toward the development of a cocaine therapeutic agent. The specific aims of the proposed research are focused on the study of the SAR of novel analogues of tropane/GBR 12909 hybrids. Lead compounds identified in the previous granting period (alkylidenyttropane/GBR 12909 hybrid analogues and 2-(diarylmethoxymethyt)-3a-aryltropanes) will be studied further in vitro and in vivo. These compounds will also serve as templates for new SAR studies aimed at the development of more potent and selective DAT ligands. In addition, the search for less lipophilic GBR 12909 analogues will continue with the aim to provide novel pharmacological probes to explore the relationship between the onset of activity and abuse liability. A secondary objective is to synthesize novel meperidine analogues to be employed in a limited SAR study to identify potential compounds that may be useful to explore the heterogeneous character of the dopamine transporter (a high affinity site

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and a low affinity site). Studies have suggested that the high affinity sites plays a role in the abuse liability of cocaine; however, these studies are far from conclusive and are hampered by the lack of pharmacological tools to selectively affect either of these sites. The 3',4"-dichloromeperidine (SAL-V-11) identified in the previous granting period will serve as a template for studies aimed at the identification of a site-selective DAT ligand. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with meperidine, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “meperidine” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for meperidine (hyperlinks lead to article summaries): •

A comparative study of midazolam to meperidine/promethazine as an IM sedative technique for the pediatric dental patient. Author(s): Downs AT, Dembo J, Ferretti G, Lyons TD, Pelphery A. Source: Asdc J Dent Child. 1997 May-June; 64(3): 197-200, 165, 228. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9262801

•

A comparison among nalbuphine, meperidine, and placebo for treating postanesthetic shivering. Author(s): Wang JJ, Ho ST, Lee SC, Liu YC. Source: Anesthesia and Analgesia. 1999 March; 88(3): 686-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10072029

•

A comparison between lidocaine alone and lidocaine with meperidine for continuous spinal anesthesia. Author(s): Maurette P, Bonada G, Djiane V, Erny P. Source: Reg Anesth. 1993 September-October; 18(5): 290-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8268117

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PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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•

A comparison between meperidine, clonidine and urapidil in the treatment of postanesthetic shivering. Author(s): Schwarzkopf KR, Hoff H, Hartmann M, Fritz HG. Source: Anesthesia and Analgesia. 2001 January; 92(1): 257-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11133640

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A comparison between topical and infiltrative bupivacaine and intravenous meperidine for postoperative analgesia after inguinal herniorrhaphy. Author(s): Waechter FL, Sampaio JA, Pinto RD, Alvares-Da-Silva MR, Pereira-Lima L. Source: The American Surgeon. 2001 May; 67(5): 447-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11379646

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A comparison of intranasal sufentanil and midazolam to intramuscular meperidine, promethazine, and chlorpromazine for conscious sedation in children. Author(s): Bates BA, Schutzman SA, Fleisher GR. Source: Annals of Emergency Medicine. 1994 October; 24(4): 646-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8092591

•

A comparison of meperidine and lidocaine for spinal anesthesia for postpartum tubal ligation. Author(s): Norris MC, Honet JE, Leighton BL, Arkoosh VA. Source: Reg Anesth. 1996 March-April; 21(2): 84-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8829417

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A comparison of oral diazepam versus midazolam, administered with intravenous meperidine, as premedication to sedation for pediatric endoscopy. Author(s): Martinez JL, Sutters KA, Waite S, Davis J, Medina E, Montano N, Merzel D, Marquez C. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 July; 35(1): 51-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12142810

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A comparison of the effects of epidural and meperidine analgesia during labor on fetal heart rate. Author(s): Hill JB, Alexander JM, Sharma SK, McIntire DD, Leveno KJ. Source: Obstetrics and Gynecology. 2003 August; 102(2): 333-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12907109

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A comparison of the haemodynamic effects of intrathecal meperidine, meperidinebupivacaine mixture and hyperbaric bupivacaine. Author(s): Conway F, Critchley LA, Stuart JC, Freebairn RC. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1996 January; 43(1): 23-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8665630

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Meperidine

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A comparison of tramadol, amitriptyline, and meperidine for postepidural anesthetic shivering in parturients. Author(s): Tsai YC, Chu KS. Source: Anesthesia and Analgesia. 2001 November; 93(5): 1288-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11682416

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A comparison of urapidil, clonidine, meperidine and placebo in preventing postanesthetic shivering. Author(s): Piper SN, Maleck WH, Boldt J, Suttner SW, Schmidt CC, Reich DG. Source: Anesthesia and Analgesia. 2000 April; 90(4): 954-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10735806

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A dose of 1 mg.kg(-1) meperidine causes muscle rigidity in infants? Author(s): Baris S, Karakaya D, Sarihasan B. Source: Paediatric Anaesthesia. 2000; 10(6): 684. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11119208

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A dose-range study of intrathecal meperidine combined with bupivacaine. Author(s): Thi TV, Orliaguet G, Liu N, Delaunay L, Bonnet F. Source: Acta Anaesthesiologica Scandinavica. 1992 August; 36(6): 516-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1514334

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A dose-response study of intravenous regional anesthesia with meperidine. Author(s): Reuben SS, Steinberg RB, Lurie SD, Gibson CS. Source: Anesthesia and Analgesia. 1999 April; 88(4): 831-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195533

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A prospective study comparing i.m. ketorolac with i.m. meperidine in the treatment of acute biliary colic. Author(s): Dula DJ, Anderson R, Wood GC. Source: The Journal of Emergency Medicine. 2001 February; 20(2): 121-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11207404

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A quality improvement approach to reducing use of meperidine. Author(s): Gordon DB, Jones HD, Goshman LM, Foley DK, Bland SE. Source: Jt Comm J Qual Improv. 2000 December; 26(12): 686-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11143208

Studies

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A randomized study of combined spinal-epidural analgesia versus intravenous meperidine during labor: impact on cesarean delivery rate. Author(s): Gambling DR, Sharma SK, Ramin SM, Lucas MJ, Leveno KJ, Wiley J, Sidawi JE. Source: Anesthesiology. 1998 December; 89(6): 1336-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9856707

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A retrospective study of chloral hydrate, meperidine, hydroxyzine, and midazolam regimens used to sedate children for dental care. Author(s): Wilson S, Easton J, Lamb K, Orchardson R, Casamassimo P. Source: Pediatr Dent. 2000 March-April; 22(2): 107-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10769854

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Acute neurotoxicity of meperidine in an infant. Author(s): Saneto RP, Fitch JA, Cohen BH. Source: Pediatric Neurology. 1996 May; 14(4): 339-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8962593

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Adding low dose meperidine to spinal lidocaine prolongs postoperative analgesia. Author(s): Murto K, Lui AC, Cicutti N. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1999 April; 46(4): 327-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10232715

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Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section. Author(s): Yu SC, Ngan Kee WD, Kwan AS. Source: British Journal of Anaesthesia. 2002 March; 88(3): 379-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990270

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Administering meperidine to patients with cancer. Author(s): Hoyer KA. Source: Clinical Journal of Oncology Nursing. 2002 September-October; 6(5): 292. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12240492

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Altering meperidine prescribing patterns in a university teaching hospital. Author(s): Stevenson JG, Pearlman M, Green CR, Newland S, Grondin L, Thompson M, Golembiewski J, Campbell D. Source: Jt Comm J Qual Saf. 2004 May; 30(5): 277-81, 233. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15154319

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Meperidine

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An assessment of the value of intraperitoneal meperidine for analgesia postlaparoscopic tubal ligation. Author(s): Colbert ST, Moran K, O'Hanlon DM, Chambers F, Moriarty DC, Blunnie WP. Source: Anesthesia and Analgesia. 2000 September; 91(3): 667-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10960397

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Analgesic and urodynamic effects of epidural meperidine and pentazocine--a comparative study. Author(s): Mohan VK, Batra YK, Vaidyanathan S, Puri GD. Source: Int J Clin Pharmacol Ther. 1995 January; 33(1): 34-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7711990

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Another explanation for reduced meperidine consumption in the immediate postoperative period. Author(s): Kissin I, Tverskoy M. Source: Anesthesia and Analgesia. 1995 January; 80(1): 214. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7802295

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Another explanation for reduced meperidine consumption in the immediate postoperative period. Author(s): Rozner MA. Source: Anesthesia and Analgesia. 1994 October; 79(4): 810-1. Corrected and Republished In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7802846

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Binding and hydrolysis of meperidine by human liver carboxylesterase hCE-1. Author(s): Zhang J, Burnell JC, Dumaual N, Bosron WF. Source: The Journal of Pharmacology and Experimental Therapeutics. 1999 July; 290(1): 314-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10381793

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Bupivacaine decreases epidural meperidine requirements after abdominal surgery. Author(s): St-Onge S, Fugere F, Girard M. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 April; 44(4): 360-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9104516

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Buspirone and meperidine synergistically reduce the shivering threshold. Author(s): Mokhtarani M, Mahgoub AN, Morioka N, Doufas AG, Dae M, Shaughnessy TE, Bjorksten AR, Sessler DI. Source: Anesthesia and Analgesia. 2001 November; 93(5): 1233-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11682404

Studies

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Butorphanol and meperidine compared in patients with acute ureteral colic. Author(s): Elliott JP, Evans JW, Gordon JO, Platt LO. Source: The Journal of Urology. 1979 October; 122(4): 455-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=384024

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Butorphanol tartrate (Stadol) relieves postanesthesia shaking more effectively than meperidine (Demerol) or morphine. Author(s): Vogelsang J, Hayes SR. Source: J Post Anesth Nurs. 1992 April; 7(2): 94-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1578400

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Butorphanol/diazepam compared to meperidine/diazepam for sedation in oral maxillofacial surgery: a double-blind evaluation. Author(s): Zallen RD, Cobetto GA, Bohmfalk C, Steffen K. Source: Oral Surg Oral Med Oral Pathol. 1987 October; 64(4): 395-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3309781

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Central nervous system toxicity associated with meperidine use in hepatic disease. Author(s): Danziger LH, Martin SJ, Blum RA. Source: Pharmacotherapy. 1994 March-April; 14(2): 235-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8197046

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Cesarean delivery: a randomized trial of epidural analgesia versus intravenous meperidine analgesia during labor in nulliparous women. Author(s): Sharma SK, Alexander JM, Messick G, Bloom SL, McIntire DD, Wiley J, Leveno KJ. Source: Anesthesiology. 2002 March; 96(3): 546-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11873026

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Cesarean delivery: a randomized trial of epidural versus patient-controlled meperidine analgesia during labor. Author(s): Sharma SK, Sidawi JE, Ramin SM, Lucas MJ, Leveno KJ, Cunningham FG. Source: Anesthesiology. 1997 September; 87(3): 487-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9316951

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Change in pain threshold by meperidine, naproxen sodium, and acetaminophen as determined by electric pulp testing. Author(s): Carnes PL, Cook B, Eleazer PD, Scheetz JP. Source: Anesthesia Progress. 1998 Fall; 45(4): 139-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10483385

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Meperidine

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Clinical and pharmacokinetic aspects of the combination of meperidine and prilocaine for spinal anaesthesia. Author(s): Tauzin-Fin P, Maurette P, Vincon G, Hecquet D, Houdek MC, Bonnet F. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 September; 39(7): 655-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1382879

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Clinical significance of methohexital, meperidine, and diazepam in breast milk. Author(s): Borgatta L, Jenny RW, Gruss L, Ong C, Barad D. Source: Journal of Clinical Pharmacology. 1997 March; 37(3): 186-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9089420

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Comparative study of intra-articular lidocaine and intravenous meperidine/diazepam for shoulder dislocations. Author(s): Orlinsky M, Shon S, Chiang C, Chan L, Carter P. Source: The Journal of Emergency Medicine. 2002 April; 22(3): 241-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11932085

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Comparison among intrathecal fentanyl, meperidine, and sufentanil for labor analgesia. Author(s): Honet JE, Arkoosh VA, Norris MC, Huffnagle HJ, Silverman NS, Leighton BL. Source: Anesthesia and Analgesia. 1992 November; 75(5): 734-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1416127

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Comparison of a chloral hydrate/hydroxyzine combination with and without meperidine in the sedation of pediatric dental patients. Author(s): Poorman TL, Farrington FH, Mourino AP. Source: Pediatr Dent. 1990 September-October; 12(5): 288-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2095539

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Comparison of dihydroergotamine with metoclopramide versus meperidine with promethazine in the treatment of acute migraine. Author(s): Scherl ER, Wilson JF. Source: Headache. 1995 May; 35(5): 256-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7775186

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Comparison of fentanyl versus meperidine for analgesia in pediatric gastrointestinal endoscopy. Author(s): Ali S, Davidson DL, Gremse DA. Source: Digestive Diseases and Sciences. 2004 May; 49(5): 888-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15259516

Studies

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Comparison of hydromorphone and meperidine for ureteral colic. Author(s): Jasani NB, O'Conner RE, Bouzoukis JK. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1994 November-December; 1(6): 539-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7541310

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Comparison of intrathecal meperidine and lidocaine in endoscopic urological procedures. Author(s): Patel D, Janardhan Y, Merai B, Robalino J, Shevde K. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1990 July; 37(5): 567-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2197005

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Comparison of intravenous ketorolac and meperidine in the treatment of biliary colic. Author(s): Henderson SO, Swadron S, Newton E. Source: The Journal of Emergency Medicine. 2002 October; 23(3): 237-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12426013

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Comparison of intravenous ketorolac, meperidine, and both (balanced analgesia) for renal colic. Author(s): Cordell WH, Wright SW, Wolfson AB, Timerding BL, Maneatis TJ, Lewis RH, Bynum L, Nelson DR. Source: Annals of Emergency Medicine. 1996 August; 28(2): 151-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8759578

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Comparison of ketorolac-chlorpromazine with meperidine-promethazine for treatment of exacerbations of chronic pain. Author(s): Mehl-Madrona LE. Source: The Journal of the American Board of Family Practice / American Board of Family Practice. 1999 May-June; 12(3): 188-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10395414

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Comparison of meperidine and pancuronium for the treatment of shivering after cardiac surgery. Author(s): Cruise C, MacKinnon J, Tough J, Houston P. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 July; 39(6): 563-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1643679

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Comparison of oral chloral hydrate with intramuscular ketamine, meperidine, and promethazine for pediatric sedation--preliminary report. Author(s): Campbell RL, Ross GA, Campbell JR, Mourino AP. Source: Anesthesia Progress. 1998 Spring; 45(2): 46-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10356431

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Comparison of oral transmucosal fentanyl citrate and intramuscular meperidine, promethazine, and chlorpromazine for conscious sedation of children undergoing laceration repair. Author(s): Schutzman SA, Liebelt E, Wisk M, Burg J. Source: Annals of Emergency Medicine. 1996 October; 28(4): 385-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8839521

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Comparison of subcutaneous hydromorphone with intramuscular meperidine for immediate postoperative analgesia. Author(s): Chan WH, Lin CJ, Sun WZ, Tsai SP, Tsai SK, Hsieh CY. Source: Kaohsiung J Med Sci. 1999 July; 15(7): 419-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10465924

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Comparison of the effect of orally versus submucosally administered meperidine on the behavior of pediatric dental patients: a retrospective study. Author(s): Song YU, Webb MD. Source: Anesthesia Progress. 2003; 50(3): 129-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14558588

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Comparison of the effects of meperidine and nalbuphine on intrapartum fetal heart rate tracings. Author(s): Dawes GS. Source: Obstetrics and Gynecology. 1996 January; 87(1): 158-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8532255

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Comparison of the effects of meperidine and nalbuphine on intrapartum fetal heart rate tracings. Author(s): Giannina G, Guzman ER, Lai YL, Lake MF, Cernadas M, Vintzileos AM. Source: Obstetrics and Gynecology. 1995 September; 86(3): 441-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7651658

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Comparison of the efficacy of oral midazolam alone versus midazolam and meperidine in the pediatric dental patient. Author(s): Musial KM, Wilson S, Preisch J, Weaver J. Source: Pediatr Dent. 2003 September-October; 25(5): 468-74. Erratum In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649610

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Comparison of the sedation and recovery profiles of Ro 48-6791, a new benzodiazepine, and midazolam in combination with meperidine for outpatient endoscopic procedures. Author(s): Tang J, Wang B, White PF, Gold M, Gold J. Source: Anesthesia and Analgesia. 1999 October; 89(4): 893-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10512261

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Comparison of vecuronium and meperidine on the clinical and metabolic effects of shivering after hypothermic cardiopulmonary bypass. Author(s): Sladen RN, Berend JZ, Fassero JS, Zehnder EB. Source: Journal of Cardiothoracic and Vascular Anesthesia. 1995 April; 9(2): 147-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7780069

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Compatibility of ketamine hydrochloride and meperidine hydrochloride. Author(s): Ambados F. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1997 January 15; 54(2): 205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9117812

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Compatibility of ondansetron hydrochloride with meperidine hydrochloride for combined administration. Author(s): Xu QA, Trissel LA, Fox JL. Source: The Annals of Pharmacotherapy. 1995 November; 29(11): 1106-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8573953

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Conscious sedation of pediatric dental patients: an investigation of chloral hydrate, hydroxyzine pamoate, and meperidine vs. chloral hydrate and hydroxyzine pamoate. Author(s): Hasty MF, Vann WF Jr, Dilley DC, Anderson JA. Source: Pediatr Dent. 1991 January-February; 13(1): 10-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1945978

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Continuous intrathecal meperidine via an implantable infusion pump for chronic, nonmalignant pain. Author(s): Harvey SC, O'Neil MG, Pope CA, Cuddy BG, Duc TA. Source: The Annals of Pharmacotherapy. 1997 November; 31(11): 1306-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9391683

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Detecting the dangers of meperidine. Author(s): Hinnant D. Source: Nursing. 1995 June; 25(6): 28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7624069

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Determination of meperidine blood to plasma concentration ratio (lambda) - effect of temperature and pH. Author(s): Jackson AJ. Source: Res Commun Chem Pathol Pharmacol. 1981 May; 32(2): 365-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7244369

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Determination of therapeutic serum concentrations of oral and parenteral meperidine by liquid chromatography. Author(s): Shih AP, Robinson K, Au WY. Source: European Journal of Clinical Pharmacology. 1976 March 22; 09(5-6): 451-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=786668

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Dexmedetomidine and meperidine additively reduce the shivering threshold in humans. Author(s): Doufas AG, Lin CM, Suleman MI, Liem EB, Lenhardt R, Morioka N, Akca O, Shah YM, Bjorksten AR, Sessler DI. Source: Stroke; a Journal of Cerebral Circulation. 2003 May; 34(5): 1218-23. Epub 2003 April 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12690216

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Diazepam (Valium) as preoperative medication in oral surgery. Comparative study with meperidine-promethazine. Author(s): Khosla VM, Boren W. Source: Oral Surg Oral Med Oral Pathol. 1969 November; 28(5): 671-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5259451

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Diazepam and meperidine on arterial blood gases in healthy volunteers. Author(s): Zsigmond EK, Flynn K, Martinez OA. Source: Journal of Clinical Pharmacology. 1974 July; 14(7): 377-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4602600

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Diazepam and meperidine on arterial blood gases in patients with chronic obstructive pulmonary disease. Author(s): Zsigmond EK, Shively JG, Flynn K. Source: Journal of Clinical Pharmacology. 1975 May-June; 15(5-6): 464-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=237017

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Diffuse myopathy related to meperidine addiction in a mother and daughter. Author(s): Aberfeld DC, Bienenstock H, Shapiro MS, Namba T, Grob D. Source: Archives of Neurology. 1968 October; 19(4): 384-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5677188

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Direct stimulation of urokinase, plasmin, and collagenase by meperidine: a possible mechanism for the ability of meperidine to enhance cervical effacement and dilation. Author(s): Milwidsky A, Finci-Yeheskel Z, Mayer M. Source: American Journal of Perinatology. 1993 March; 10(2): 130-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8476475

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Disposition of meperidine and normeperidine following multiple doses during labor. I. Mother. Author(s): Kuhnert BR, Philipson EH, Kuhnert PM, Syracuse CD. Source: American Journal of Obstetrics and Gynecology. 1985 February 1; 151(3): 406-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3970109

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Disposition of meperidine and normeperidine following multiple doses during labor. II. Fetus and neonate. Author(s): Kuhnert BR, Kuhnert PM, Philipson EH, Syracuse CD. Source: American Journal of Obstetrics and Gynecology. 1985 February 1; 151(3): 410-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3970110

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Disposition of meperidine in pregnancy. Author(s): Morgan D, Moore G, Thomas J, Triggs E. Source: Clinical Pharmacology and Therapeutics. 1978 March; 23(3): 288-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=627134

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Does localized flare reaction to intravenous meperidine reduce sedation and pain control during conscious sedation for endoscopy? Author(s): Fitzhugh G, Epstein B, Kankaria AG. Source: The American Journal of Gastroenterology. 1995 February; 90(2): 330-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7847318

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Dosage-side-effect relationships of morphine and meperidine. Author(s): Galway JE, Morrison JD, Dundee JW. Source: Anesthesia and Analgesia. 1973 July-August; 52(4): 536-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4577695

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Dose-responsive characteristics of meperidine sedation in preschool children. Author(s): McKee KC, Nazif MM, Jackson DL, Barnhart DC, Close J, Moore PA. Source: Pediatr Dent. 1990 July-August; 12(4): 222-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2077497

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Double-blind comparison of butorphanol and meperidine in the treatment of postsurgical pain. Author(s): Stehling LC, Zauder HL. Source: J Int Med Res. 1978; 6(4): 306-11. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=357232

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Double-blind comparison of butorphanol tartrate and meperidine hydrochloride in balanced anaesthesia. Author(s): Stehling LC, Zauder HL. Source: J Int Med Res. 1978; 6(5): 384-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=359382

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Double-blind comparison of intravenously injected butorphanol and meperidine in parturients. Author(s): Quilligan EJ, Keegan KA, Donahue MJ. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1980; 18(5): 363-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6110584

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Double-blind comparison of maternal analgesia and neonatal neurobehaviour following intravenous butorphanol and meperidine. Author(s): Hodgkinson R, Huff RW, Hayashi RH, Husain FJ. Source: J Int Med Res. 1979; 7(3): 224-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=378732

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Double-blind comparison of nalbuphine and meperidine in combination with diazepam for intravenous conscious sedation in oral surgery outpatients. Author(s): Dolan EA, Murray WJ, Ruddy MP. Source: Oral Surg Oral Med Oral Pathol. 1988 November; 66(5): 536-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3200556

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Double-blind comparison of oral transmucosal fentanyl citrate with oral meperidine, diazepam, and atropine as preanesthetic medication in children with congenital heart disease. Author(s): Goldstein-Dresner MC, Davis PJ, Kretchman E, Siewers RD, Certo N, Cook DR. Source: Anesthesiology. 1991 January; 74(1): 28-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1986659

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Double-blind comparison of the neurobehaviour of neonates following the administration of different doses of meperidine to the mother. Author(s): Hodgkinson R, Bhatt M, Wang CN. Source: Can Anaesth Soc J. 1978 September; 25(5): 405-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=359110

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Double-blind evaluation of butorphanol and meperidine given intramuscularly before anesthesia. Author(s): Delpizzo A. Source: Curr Ther Res Clin Exp. 1976 December; 20(6): 763-71. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=827423

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Double-blind study of methotrimeprazine, morphine, and meperidine for preanesthetic medication. Author(s): Dobkin AB, Israel JS, Byles PH. Source: Anesthesia and Analgesia. 1965 September-October; 44(5): 510-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5318665

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Double-blind, multicenter trial to compare the efficacy of intramuscular dihydroergotamine plus hydroxyzine versus intramuscular meperidine plus hydroxyzine for the emergency department treatment of acute migraine headache. Author(s): Carleton SC, Shesser RF, Pietrzak MP, Chudnofsky CR, Starkman S, Morris DL, Johnson G, Rhee KJ, Barton CW, Chelly JE, Rosenberg J, Van Valen MK. Source: Annals of Emergency Medicine. 1998 August; 32(2): 129-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9701293

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Doxapram antagonism of meperidine-induced respiratory depression. Author(s): Ramamurthy S, Steen SN, Winnie AP. Source: Anesthesia and Analgesia. 1975 May-June; 54(3): 352-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1169024

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Drug interaction: meperidine and chlorpromazine, a toxic combination. Author(s): Stambaugh JE Jr, Wainer IW. Source: Journal of Clinical Pharmacology. 1981 April; 21(4): 140-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7240435

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Early respiratory depression during caesarean section following epidural meperidine. Author(s): Rosaeg OP, Suderman V, Yarnell RW. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 January; 39(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1733538

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Effect of ketorolac on bleeding time and postoperative pain in children: a doubleblind, placebo-controlled comparison with meperidine. Author(s): Bean-Lijewski JD, Hunt RD. Source: Journal of Clinical Anesthesia. 1996 February; 8(1): 25-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8695075

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Effectiveness of intravenous meperidine for pain relief in the first stage of labour. Author(s): Soontrapa S, Somboonporn W, Komwilaisak R, Sookpanya S. Source: J Med Assoc Thai. 2002 November; 85(11): 1169-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12546313

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Effects of meperidine on the pancreatic and biliary sphincter. Author(s): Sherman S, Gottlieb K, Uzer MF, Smith MT, Khusro QE, Earle DT, Brunelle RL, Hawes RH, Lehman GA. Source: Gastrointestinal Endoscopy. 1996 September; 44(3): 239-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8885340

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Effects of subarachnoid lidocaine, meperidine and fentanyl on somatosensory and motor evoked responses in awake humans. Author(s): Fernandez-Galinski SM, Monells J, Espadaler JM, Pol O, Puig MM. Source: Acta Anaesthesiologica Scandinavica. 1996 January; 40(1): 39-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8904258

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Effects of thoracic epidural meperidine on arterial oxygenation during one-lung ventilation in thoracic surgery. Author(s): Garutti I, Cruz P, Olmedilla L, Barrio JM, Cruz A, Fernandez C, Perez-Pena JM. Source: Journal of Cardiothoracic and Vascular Anesthesia. 2003 June; 17(3): 302-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12827575

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Effects of tramadol and meperidine on respiration, plasma catecholamine concentrations, and hemodynamics. Author(s): Mildh LH, Leino KA, Kirvela OA. Source: Journal of Clinical Anesthesia. 1999 June; 11(4): 310-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10470633

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Efficacy and safety of a diazepam and meperidine combination for pediatric gastrointestinal procedures. Author(s): Nahata MC, Murray RD, Zingarelli J, Li BU, McClung HJ, Lininger B. Source: Journal of Pediatric Gastroenterology and Nutrition. 1990 April; 10(3): 335-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2324894

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Efficacy and safety of combined meperidine and midazolam for EGD sedation compared with midazolam alone. Author(s): Diab FH, King PD, Barthel JS, Marshall JB. Source: The American Journal of Gastroenterology. 1996 June; 91(6): 1120-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8651156

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Efficacy and safety of single doses of intramuscular ketorolac tromethamine compared with meperidine for postoperative pain. Author(s): Stanski DR, Cherry C, Bradley R, Sarnquist FH, Yee JP. Source: Pharmacotherapy. 1990; 10(6 ( Pt 2)): 40S-44S. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2082312

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Efficacy of ketorolac tromethamine versus meperidine in the ED treatment of acute renal colic. Author(s): Larkin GL, Peacock WF 4th, Pearl SM, Blair GA, D'Amico F. Source: The American Journal of Emergency Medicine. 1999 January; 17(1): 6-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9928687

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Efficacy of subarachnoid meperidine for labor analgesia. Author(s): Swayze CR, Skerman JH, Walker EB, Sholte FG. Source: Reg Anesth. 1991 November-December; 16(6): 309-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1772812

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Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy. Author(s): Pediatr Dent. 2004 Jan-Feb;26(1):4. [correction of serious dosage error] Source: European Journal of Anaesthesiology. 2003 November; 20(11): 920-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15080350

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Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour. Author(s): Loughnan BA, Carli F, Romney M, Dore CJ, Gordon H. Source: British Journal of Anaesthesia. 2002 September; 89(3): 466-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12402727

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Epidural meperidine after cesarean section. A dose-response study. Author(s): Ngan Kee WD, Lam KK, Chen PP, Gin T. Source: Anesthesiology. 1996 August; 85(2): 289-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8712444

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Epidural meperidine after cesarean section: the effect of diluent volume. Author(s): Ngan Kee WD, Lam KK, Chen PP, Gin T. Source: Anesthesia and Analgesia. 1997 August; 85(2): 380-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9249117

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Epidural meperidine does not cause hemodynamic changes in the term parturient. Author(s): Khaw KS, Kee WD, Critchley LA. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2000 February; 47(2): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10674510

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Epidural meperidine provides surgical anesthesia for critically ill patients undergoing major surgery. Author(s): Kaza R, Lawlor M, Allen W, Ranella L, Johnson C. Source: Anesthesia and Analgesia. 1993 November; 77(5): 1084. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8214721

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Epidural opioid analgesia after caesarean section: a comparison of patient-controlled analgesia with meperidine and single bolus injection of morphine. Author(s): Rosaeg OP, Lindsay MP. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1994 November; 41(11): 1063-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7828253

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Evaluation of morphine as compared to meperidine when administered to the moderately anxious pediatric dental patient. Author(s): Roberts SM, Wilson CF, Seale NS, McWhorter AG. Source: Pediatr Dent. 1992 September-October; 14(5): 306-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1303534

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Failure of meperidine to anesthetize human median nerve. A blinded comparison with lidocaine and saline. Author(s): Flanagan MT, Walker FO, Butterworth J. Source: Reg Anesth. 1997 January-February; 22(1): 73-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9010950

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Failure of meperidine wound infiltration to reduce pain after laparoscopic tubal ligation. Author(s): Forgach L, Ong BY. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 December; 42(12): 1085-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8595682

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Fetal distress due to intravenous administration of pethidine (meperidine) with promethazine during labour. Author(s): Bergman A, Eckstein N, Yedwab G, David MP. Source: The Australian & New Zealand Journal of Obstetrics & Gynaecology. 1982 November; 22(4): 215-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6963160

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Fetal heart rate decelerations following the administration of meperidinepromethazine during labor. Author(s): Ron M, Menashe M, Scherer D, Palti Z. Source: International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics. 1982 August; 20(4): 301-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6127263

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Fetal heart rate responses to meperidine alone and in combination with propiomazine. Author(s): Barrett JM, Boehm FH. Source: Southern Medical Journal. 1983 December; 76(12): 1480-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6139879

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First pass uptake of fentanyl, meperidine, and morphine in the human lung. Author(s): Roerig DL, Kotrly KJ, Vucins EJ, Ahlf SB, Dawson CA, Kampine JP. Source: Anesthesiology. 1987 October; 67(4): 466-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3310739

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Function of each lung during mechanical ventilation with ZEEP and with PEEP in man anesthetized with thiopental-meperidine. Author(s): Rehder K, Wenthe FM, Sessler AD. Source: Anesthesiology. 1973 December; 39(6): 597-606. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4586604

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Function of each lung in spontaneously breathing man anesthetized with thiopentalmeperidine. Author(s): Rehder K, Sessler AD. Source: Anesthesiology. 1973 April; 38(4): 320-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4707577

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Gas chromatographic analysis of meperidine and normeperidine: determination in blood after a single dose of meperidine. Author(s): Jacob P 3rd, Rigod JF, Pond SM, Benowitz NL. Source: Journal of Pharmaceutical Sciences. 1982 February; 71(2): 166-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7062237

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Gastric and biliary excretion of meperidine in man. Author(s): Dunkerley R, Johnson R, Schenker S, Wilkinson GR. Source: Clinical Pharmacology and Therapeutics. 1976 November; 20(5): 546-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=975725

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Gastric excretion of intravenously administered meperidine in surgical patients. Author(s): Trudnowski RJ, Gessner T. Source: Anesthesia and Analgesia. 1979 March-April; 58(2): 88-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=35041

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Gastroenterologist-administered propofol versus meperidine and midazolam for advanced upper endoscopy: a prospective, randomized trial. Author(s): Vargo JJ, Zuccaro G Jr, Dumot JA, Shermock KM, Morrow JB, Conwell DL, Trolli PA, Maurer WG. Source: Gastroenterology. 2002 July; 123(1): 8-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12105827

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Giving meperidine for pain: should it be so mechanical? Author(s): McCaffery M. Source: Nursing. 1987 April; 17(4): 60-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2882452

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GLC determination of meperidine in blood plasma. Author(s): Goehl TJ, Davison C. Source: Journal of Pharmaceutical Sciences. 1973 June; 62(6): 907-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4712622

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Hazards of high-dose meperidine. Author(s): Morisy L, Platt D. Source: Jama : the Journal of the American Medical Association. 1986 January 24-31; 255(4): 467-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3941530

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Hepatotoxicity of the opioids morphine, heroin, meperidine, and methadone to cultured human hepatocytes. Author(s): Gomez-Lechon MJ, Ponsoda X, Jover R, Fabra R, Trullenque R, Castell JV. Source: Mol Toxicol. 1987-88 Fall; 1(4): 453-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3509697

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High-dose meperidine in anesthesia. Author(s): Kang L, Wang JJ, Tsai SK, Lee TY. Source: Ma Zui Xue Za Zhi. 1986 March; 24(1): 56-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3784809

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Home use of Demerol for migraine. Author(s): Rubsamen DS. Source: Headache. 1999 June; 39(6): 450. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11279928

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Human fetal oxygenation (tcPo2), heart rate variability and uterine activity following maternal administration of meperidine. Author(s): Baxi LV, Petrie RH, James LS. Source: Journal of Perinatal Medicine. 1988; 16(1): 23-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3404377

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Hypersensitivity to meperidine. Author(s): Waisbren BA. Source: Jama : the Journal of the American Medical Association. 1978 April 3; 239(14): 1395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=633540

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Hypertension after epidural meperidine. Author(s): Robinson RJ, Metcalf IR. Source: Can Anaesth Soc J. 1985 November; 32(6): 658-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4075217

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Hypertensive crisis following meperidine administration and chemoembolization of a carcinoid tumor. Author(s): Balestrero LM, Beaver CR, Rigas JR. Source: Archives of Internal Medicine. 2000 August 14-28; 160(15): 2394-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10927742

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Iatrogenic cardiopulmonary arrest during pediatric sedation with meperidine, promethazine, and chlorpromazine. Author(s): Brown ET, Corbett SW, Green SM. Source: Pediatric Emergency Care. 2001 October; 17(5): 351-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11673713

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Influence of meperidine on fetal movements and heart rate beat-to-beat variability in the active phase of labor. Author(s): Petrie RH. Source: American Journal of Perinatology. 1988 July; 5(3): 306. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3382492

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Influence of meperidine on fetal movements and heart rate beat-to-beat variability in the active phase of labor. Author(s): Zimmer EZ, Divon MY, Vadasz A. Source: American Journal of Perinatology. 1988 July; 5(3): 197-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3382477

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Intramuscular ketamine is superior to meperidine, promethazine, and chlorpromazine for pediatric emergency department sedation. Author(s): Petrack EM, Marx CM, Wright MS. Source: Archives of Pediatrics & Adolescent Medicine. 1996 July; 150(7): 676-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8673189

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Intramuscular meperidine, promethazine, and chlorpromazine: analysis of use and complications in 487 pediatric emergency department patients. Author(s): Terndrup TE, Cantor RM, Madden CM. Source: Annals of Emergency Medicine. 1989 May; 18(5): 528-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2719364

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Intramuscular pethidine (meperidine) during labor associated with metabolic acidosis in the newborn. Author(s): Kariniemi V, Rosti J. Source: Journal of Perinatal Medicine. 1986; 14(2): 131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3735046

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Intrathecal fentanyl/meperidine combined with low-dose epidural bupivacaine for Cesarean section in a patient with advanced Krukenberg tumors. Author(s): Okutomi T, Hoshino Y, Amano K, Okamoto H, Hoka S. Source: Acta Anaesthesiologica Scandinavica. 2002 November; 46(10): 1272-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12421201

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Intrathecal meperidine as the sole agent for cesarean section. Author(s): Cheun JK, Kim AR. Source: Journal of Korean Medical Science. 1989 September; 4(3): 135-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2631746

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Intrathecal meperidine decreases shivering during cesarean delivery under spinal anesthesia. Author(s): Roy JD, Girard M, Drolet P. Source: Anesthesia and Analgesia. 2004 January; 98(1): 230-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14693625

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Intrathecal meperidine. Author(s): Fassoulaki A, Sarantopoulos C. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1999 November; 46(11): 1096-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10566938

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Intravenous ketorolac tromethamine versus meperidine for adjunctive sedation in upper gastrointestinal endoscopy: a pilot study. Author(s): Dies DF, Clarkston WK, Schratz CL. Source: Gastrointestinal Endoscopy. 1996 January; 43(1): 6-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8903809

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Intravenous meperidine during labor: a randomized comparison between nursingand patient-controlled administration. Author(s): Rayburn W, Leuschen MP, Earl R, Woods M, Lorkovic M, Gaston-Johansson F. Source: Obstetrics and Gynecology. 1989 November; 74(5): 702-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2682412

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Intravenous meperidine for control of shivering during caesarean section under epidural anaesthesia. Author(s): Casey WF, Smith CE, Katz JM, O'Loughlin K, Weeks SK. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1988 March; 35(2): 128-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3356050

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Intravenous regional anesthesia with meperidine. Author(s): Acalovschi I, Cristea T. Source: Anesthesia and Analgesia. 1995 September; 81(3): 539-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7653819

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Intravenous single-dose tramadol versus meperidine for pain relief in renal colic. Author(s): Eray O, Cete Y, Oktay C, Karsli B, Akca S, Cete N, Ersoy F. Source: European Journal of Anaesthesiology. 2002 May; 19(5): 368-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12095018

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Intravenous, deltoid, or gluteus administration of meperidine during labor? Author(s): Lazebnik N, Kuhnert BR, Carr PC, Brashear WT, Syracuse CD, Mann LI. Source: American Journal of Obstetrics and Gynecology. 1989 May; 160(5 Pt 1): 1184-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2729393

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Investigation of meperidine and its metabolites in urine of an addict by gas chromatography-flame ionization detection and gas chromatography-mass spectrometry. Author(s): Anesth Analg. 1995 Jan;80(1):214 Source: Journal of Chromatography. B, Biomedical Applications. 1994 August 19; 658(2): 375-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7802295

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Is there a place for meperidine in intravenous regional anesthesia? Author(s): Reuben SS, Steinberg RB, Lurie SD. Source: Anesthesia and Analgesia. 1998 November; 87(5): 1215-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9806722

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Is there a place for meperidine in intravenous regional anesthesia? Author(s): Zetlaoui PJ. Source: Anesthesia and Analgesia. 1998 April; 86(4): 918. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9539632

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Ketamine infusion for postoperative analgesia in asthmatics: a comparison with intermittent meperidine. Author(s): Jahangir SM, Islam F, Aziz L. Source: Anesthesia and Analgesia. 1993 January; 76(1): 45-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8418739

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Ketamine-midazolam versus meperidine-midazolam for painful procedures in pediatric oncology patients. Author(s): Marx CM, Stein J, Tyler MK, Nieder ML, Shurin SB, Blumer JL. Source: Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 1997 January; 15(1): 94-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8996129

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Ketorolac versus meperidine and hydroxyzine in the treatment of acute migraine headache: a randomized, prospective, double-blind trial. Author(s): Duarte C, Dunaway F, Turner L, Aldag J, Frederick R. Source: Annals of Emergency Medicine. 1992 September; 21(9): 1116-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1514724

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Ketorolac versus meperidine for pain relief after orthopaedic surgery. Author(s): DeAndrade JR, Maslanka M, Reines HD, Howe D, Rasmussen GL, Cardea J, Brown J, Bynum L, Shefrin A, Chang YL, Maneatis T. Source: Clinical Orthopaedics and Related Research. 1996 April; (325): 301-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8998891

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Ketorolac versus meperidine: ED treatment of severe musculoskeletal low back pain. Author(s): Veenema KR, Leahey N, Schneider S. Source: The American Journal of Emergency Medicine. 2000 July; 18(4): 404-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10919528

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Ketorolac versus meperidine-plus-promethazine treatment of migraine headache: evaluations by patients. Author(s): Davis CP, Torre PR, Williams C, Gray C, Barrett K, Krucke G, Peake D, Bass B Jr. Source: The American Journal of Emergency Medicine. 1995 March; 13(2): 146-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7893296

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Ketorolac vs meperidine for the management of pain in the emergency department. Author(s): Koenig KL, Hodgson L, Kozak R, Jordan K, Sexton TR, Leiken AM. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1994 November-December; 1(6): 544-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7600401

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Letter. Meperidine and combination oral contraceptives. Author(s): Hansten PD. Source: Journal of Clinical Pharmacology. 1975 August-September; 15(8-9): 640. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1150914

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Letter: Meperidine dosage. Author(s): Haase PS. Source: Am J Hosp Pharm. 1975 June; 32(6): 562. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1155465

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Letter: Meperidine vs morphine. Author(s): Westring DW, Fribourg E. Source: Jama : the Journal of the American Medical Association. 1974 December 16; 230(11): 1512. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4479657

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Meperidine

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Letter: Metabolites of meperidine. Author(s): Clark RB, Flacke WE. Source: American Journal of Obstetrics and Gynecology. 1974 February 15; 118(4): 57881. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4812584

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Letter: Pharmacokinetics of meperidine in man. Author(s): Moore G, Nation R. Source: Clinical Pharmacology and Therapeutics. 1976 April; 19(4): 486-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1269197

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Letter: pharmacokinetics of meperidine in man. Author(s): Moore G, Nation R. Source: Clinical Pharmacology and Therapeutics. 1976 February; 19(2): 246-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1261160

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Letter: Psychotic symptoms due to meperidine intoxication. Author(s): MacVicar AA. Source: Can Med Assoc J. 1974 June 8; 110(11): 1237. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4834427

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Levallorphan and meperidine mixtures. A dose-response study of the ventilatory sensitivity to carbon dioxide. Author(s): Rouge JC. Source: Acta Anaesthesiologica Scandinavica. 1969; 13(2): 87-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5367473

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Localisation of human speech by the newborn baby and the effects of pethidine ('meperidine'). Author(s): Turner S, Macfarlane A. Source: Developmental Medicine and Child Neurology. 1978 December; 20(6): 727-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=729925

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Low frequency of meperidine-associated seizures in sickle cell disease. Author(s): Nadvi SZ, Sarnaik S, Ravindranath Y. Source: Clinical Pediatrics. 1999 August; 38(8): 459-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10456240

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Low-dose intrathecal-meperidine for lower limb orthopaedic surgery. Author(s): Kavuri S, Robalino J, Janardhan Y, Shevde K. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1990 November; 37(8): 947-8. Erratum In: Can J Anaesth 1991 March; 38(2): 263. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2253305

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Meperidine addiction or treatment frustration? Author(s): Hung CI, Liu CY, Chen CY, Yang CH, Yeh EK. Source: General Hospital Psychiatry. 2001 January-February; 23(1): 31-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11226555

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Meperidine and alfentanil do not reduce the gain or maximum intensity of shivering. Author(s): Ikeda T, Sessler DI, Tayefeh F, Negishi C, Turakhia M, Marder D, Bjorksten AR, Larson MD. Source: Anesthesiology. 1998 April; 88(4): 858-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9579492

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Meperidine as a potential cause of serotonin syndrome in the emergency department. Author(s): Weiner AL. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1999 February; 6(2): 156-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10051909

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Meperidine associated mental status changes in a patient with chronic renal failure. Author(s): Stock SL, Catalano G, Catalano MC. Source: J Fla Med Assoc. 1996 May; 83(5): 315-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8666967

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Meperidine attenuates the secretion but not the transcription of interleukin 1 beta in human mononuclear leukocytes. Author(s): McCarthy DO, Murray S, Galagan D, Gern JE, Hutson PR. Source: Nursing Research. 1998 January-February; 47(1): 19-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9478180

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Meperidine decreases the shivering threshold twice as much as the vasoconstriction threshold. Author(s): Kurz A, Ikeda T, Sessler DI, Larson MD, Bjorksten AR, Dechert M, Christensen R. Source: Anesthesiology. 1997 May; 86(5): 1046-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9158353

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Meperidine

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Meperidine in forearm intravenous regional anesthesia? Author(s): Coleman MM, Chan VW. Source: Anesthesia and Analgesia. 1999 November; 89(5): 1329. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10553869

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Meperidine misuse in a patient with sphincter of Oddi dysfunction. Author(s): Hubbard GP, Wolfe KR. Source: The Annals of Pharmacotherapy. 2003 April; 37(4): 534-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12659611

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Meperidine or morphine for treatment of pancreatic pain? Author(s): Paulson C. Source: Rn. 2002 May; 65(5): 10; Author Reply 10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12046176

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Meperidine or morphine in acute pancreatitis? Author(s): Spiegel B. Source: American Family Physician. 2001 July 15; 64(2): 219-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11476269

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Meperidine utilization and compliance with Agency for Health Care Policy and Research guidelines in a tertiary care hospital. Author(s): Pellegrini JE, Paice J, Faut-Callahan M. Source: Crna. 1999 November; 10(4): 174-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10723296

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Meperidine vs morphine in pancreatitis and cholecystitis. Author(s): Lee F, Cundiff D. Source: Archives of Internal Medicine. 1998 November 23; 158(21): 2399. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9827794

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Meperidine: a critical review. Author(s): Latta KS, Ginsberg B, Barkin RL. Source: American Journal of Therapeutics. 2002 January-February; 9(1): 53-68. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11782820

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Meperidine: second-line agent with first-line prescribing practices. Author(s): Wacker MS, Moniz CJ. Source: Medicine and Health, Rhode Island. 2001 January; 84(1): 10-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11210282

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Meperidine: therapeutic use and toxicity. Author(s): Clark RF, Wei EM, Anderson PO. Source: The Journal of Emergency Medicine. 1995 November-December; 13(6): 797-802. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8747629

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Meperidine--a liability. Author(s): Waitman J, McCaffery M. Source: The American Journal of Nursing. 2001 January; 101(1): 57-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11211689

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Meperidine-induced generalized seizures with normal renal function. Author(s): Marinella MA. Source: Southern Medical Journal. 1997 May; 90(5): 556-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9160082

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Minimizing meperidine use. Author(s): Hinnant DC. Source: The American Journal of Nursing. 1996 August; 96(8): 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8712233

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Morphine patient-controlled analgesia is superior to meperidine patient-controlled analgesia for postoperative pain. Author(s): Plummer JL, Owen H, Ilsley AH, Inglis S. Source: Anesthesia and Analgesia. 1997 April; 84(4): 794-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9085960

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Multifaceted approach to medication use policy development: the restriction of meperidine. Author(s): Vermeulen LC, Bollinger KA, Antonopoulos J, Meek PD, Goshman LM, Ploetz PA. Source: Pharmacy Practice Management Quarterly. 1997 January; 16(4): 66-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10164161

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N-(2-Cyanoethyl) derivatives of meperidine, ketobemidone, and a potent 6,7benzomorphan. Author(s): Uwaydah IM, Waddle MK, Rogers ME. Source: Journal of Medicinal Chemistry. 1979 July; 22(7): 889-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=109618

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Nalbuphine versus meperidine for post-operative analgesia: a double-blind comparison using the patient controlled analgesic technique. Author(s): Sprigge JS, Otton PE. Source: Can Anaesth Soc J. 1983 September; 30(5): 517-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6354386

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Nalbuphine vs. meperidine in sickle cell anemia. Author(s): Leikin JB, Ehrenpreis ED, Barkin RL, Harper-Brown D, Koshy M. Source: Dicp. 1990 July-August; 24(7-8): 781-2. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2375146

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Naloxone, meperidine, and shivering. Author(s): Kurz M, Belani KG, Sessler DI, Kurz A, Larson MD, Schroeder M, Blanchard D. Source: Anesthesiology. 1993 December; 79(6): 1193-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8267194

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Nasal oxygen alleviates hypoxemia in colonoscopy patients sedated with midazolam and meperidine. Author(s): Gross JB, Long WB. Source: Gastrointestinal Endoscopy. 1990 January-February; 36(1): 26-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2311881

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Neonatal effects of the administration of meperidine and promethazine to the mother in labor. Double blind study. Author(s): Busacca M, Gementi P, Gambini E, Lenti C, Meschi F, Vignali M. Source: Journal of Perinatal Medicine. 1982; 10(1): 48-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7062233

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Neonatal neurobehavior in the first 48 hours of life: effect of the administration of meperidine with and without naloxone in the mother. Author(s): Hodgkinson R, Bhatt M, Grewal G, Marx GF. Source: Pediatrics. 1978 September; 62(3): 294-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=704198

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Neonatal pattern of breathing during active and quiet sleep after maternal administration of meperidine. Author(s): Hamza J, Benlabed M, Orhant E, Escourrou P, Curzi-Dascalova L, Gaultier C. Source: Pediatric Research. 1992 October; 32(4): 412-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1437393

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Neurologic abnormalities in sickle cell disease: role of meperidine. Author(s): Walson PD. Source: The Journal of Pediatrics. 1992 November; 121(5 Pt 1): 838. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1432448

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Neurotoxicity of meperidine. Author(s): Goetting MG, Thirman MJ. Source: Annals of Emergency Medicine. 1985 October; 14(10): 1007-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4037466

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Non-human primate species as metabolic models for the human situation: comparative studies on meperidine metabolism. Author(s): Caldwell J, Notarianni LJ, Smith RL, Fafunso MA, French MR, Dawson P, Bassir O. Source: Toxicology and Applied Pharmacology. 1979 April; 48(2): 273-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=112716

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Nurse-administered propofol versus midazolam and meperidine for upper endoscopy in cirrhotic patients. Author(s): Weston BR, Chadalawada V, Chalasani N, Kwo P, Overley CA, Symms M, Strahl E, Rex DK. Source: The American Journal of Gastroenterology. 2003 November; 98(11): 2440-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14638346

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Objectively measured perinatal exposure to meperidine and benzodiazepines in Finland. Author(s): Bardy AH, Lillsunde P, Hiilesmaa VK, Seppala T. Source: Clinical Pharmacology and Therapeutics. 1994 April; 55(4): 471-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8162674

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Obstetric analgesia. A consideration of labor pain and a patient-controlled technique for its relief with meperidine. Author(s): Scott JS. Source: American Journal of Obstetrics and Gynecology. 1970 April 1; 106(7): 959-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5435661

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Obstetric analgesia. Pentazocine and meperidine in normal primiparous labor. Author(s): Levy DL. Source: Obstetrics and Gynecology. 1971 December; 38(6): 907-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5125442

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Obstetric meperidine usage and assessment of neonatal status. Author(s): Brackbill Y, Kane J, Manniello RL, Abramson D. Source: Anesthesiology. 1974 February; 40(2): 116-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4812708

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Obstetrical medication and the newborn infant. II: The influence of meperidine (pethidine) on visual behaviour. Author(s): Adams RJ. Source: Developmental Medicine and Child Neurology. 1992 March; 34(3): 247-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1559604

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Oral ketamine/midazolam is superior to intramuscular meperidine, promethazine, and chlorpromazine for pediatric cardiac catheterization. Author(s): Auden SM, Sobczyk WL, Solinger RE, Goldsmith LJ. Source: Anesthesia and Analgesia. 2000 February; 90(2): 299-305. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10648310

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Oral meperidine, atropine, and pentobarbital for pediatric conscious sedation. Author(s): Winn CW, Porter AG, Vincent RN. Source: Pediatric Nursing. 2000 September-October; 26(5): 500-2, 509. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026339

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Oral midazolam versus meperidine, atropine, and diazepam: a comparison of premedicants in pediatric outpatients. Author(s): Pywell CA, Hung YJ, Nagelhout J. Source: Aana Journal. 1995 April; 63(2): 124-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7740908

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Oral midazolam versus midazolam and meperidine in the pediatric patient. Author(s): Wilson S. Source: Pediatr Dent. 2004 January-February; 26(1): 4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15080350

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Oral midazolam with and without meperidine for management of the difficult young pediatric dental patient: a retrospective study. Author(s): Nathan JE, Vargas KG. Source: Pediatr Dent. 2002 March-April; 24(2): 129-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11991315

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Oral morphine versus injected meperidine (Demerol) for pain relief in children after orthopedic surgery. Author(s): O'Hara M, McGrath PJ, D'Astous J, Vair CA. Source: Journal of Pediatric Orthopedics. 1987 January-February; 7(1): 78-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3793916

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Oxyhemoglobin saturation following cesarean section in patients receiving epidural morphine, PCA, or im meperidine analgesia. Author(s): Brose WG, Cohen SE. Source: Anesthesiology. 1989 June; 70(6): 948-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2729636

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Paraplegia after continuous subdural meperidine infusion. Author(s): Hilgenhurst G, Sukiennik AW, Anderson ML, Wurm WH. Source: Anesthesiology. 1994 February; 80(2): 462-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8311327

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Patient-controlled analgesia with epidural meperidine after elective cesarean section. Author(s): Yarnell RW, Polis T, Reid GN, Murphy IL, Penning JP. Source: Reg Anesth. 1992 November-December; 17(6): 329-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1286054

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Patient-controlled epidural analgesia after caesarean section using meperidine. Author(s): Ngan Kee WD, Khaw KS, Ma ML. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1997 July; 44(7): 702-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9232297

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Patient-controlled epidural analgesia after thoracotomy: a comparison of meperidine with and without bupivacaine. Author(s): Etches RC, Gammer TL, Cornish R. Source: Anesthesia and Analgesia. 1996 July; 83(1): 81-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8659770

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Pediatric patient-controlled analgesia with morphine versus meperidine. Author(s): Vetter TR. Source: Journal of Pain and Symptom Management. 1992 May; 7(4): 204-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1517642

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Pharmacokinetics and local responses to submucosal meperidine compared with other routes of administration. Author(s): Schmitt M, Nazif MM, McKee KC, Zullo T, Venkataramanan R, Burckart G, Habucky K. Source: Pediatr Dent. 1994 May-June; 16(3): 190-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8058542

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Pharmacokinetics and pharmacodynamics of intravenous meperidine in neonates and infants. Author(s): Pokela ML, Olkkola KT, Koivisto M, Ryhanen P. Source: Clinical Pharmacology and Therapeutics. 1992 October; 52(4): 342-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1424407

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Pharmacokinetics of meperidine in healthy volunteers after short- and long-term exposure to high altitude. Author(s): Ritschel WA, Paulos C, Arancibia A, Pezzani M, Agrawal MA, Wetzelsberger KM, Lucker PW. Source: Journal of Clinical Pharmacology. 1996 July; 36(7): 610-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8844443

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Pharmacokinetics of meperidine in sickle cell patients. Author(s): Yang YM, Hoff C, Hamm C, Mankad V, Boerth RC, Friedrich L. Source: American Journal of Hematology. 1995 August; 49(4): 357-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7639287

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Physiologic response and adverse reactions in pediatric dental patients sedated with promethazine and chloral hydrate or meperidine. Author(s): Sams DR, Russell CM. Source: Pediatr Dent. 1993 November-December; 15(6): 422-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8153006

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Physostigmine prevents postanesthetic shivering as does meperidine or clonidine. Author(s): Horn EP, Standl T, Sessler DI, von Knobelsdorff G, Buchs C, Schulte am Esch J. Source: Anesthesiology. 1998 January; 88(1): 108-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9447863

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Postoperative nausea and vomiting: comparison of the effect of postoperative meperidine or morphine in gynecologic surgery patients. Author(s): Ezri T, Lurie S, Stein A, Evron S, Geva D. Source: Journal of Clinical Anesthesia. 2002 June; 14(4): 262-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12088808

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Postthoracotomy pulmonary function: a comparison of epidural versus intravenous meperidine infusions. Author(s): Slinger P, Shennib H, Wilson S. Source: Journal of Cardiothoracic and Vascular Anesthesia. 1995 April; 9(2): 128-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7780067

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Potential for nonnarcotic analgesics to save personnel costs associated with controlling injectable morphine and meperidine. Author(s): Koffer H, Hildebrand JR 3rd, Connell ML. Source: Am J Hosp Pharm. 1990 May; 47(5): 1084-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2337099

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Probable meperidine-induced serotonin syndrome in a patient with a history of fluoxetine use. Author(s): Tissot TA. Source: Anesthesiology. 2003 June; 98(6): 1511-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12766667

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Procainamide and quinidine inhibition of the human hepatic degradation of meperidine in vitro. Author(s): Bailey DN, Briggs JR. Source: Journal of Analytical Toxicology. 2003 April; 27(3): 142-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12731654

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Prolonged parenteral meperidine analgesia during pregnancy for pain from an abdominal wall mesh graft. Author(s): Aaen V, Cowan L, Sakala EP, Small ML. Source: Obstetrics and Gynecology. 1993 October; 82(4 Pt 2 Suppl): 721-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8378026

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Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy. Author(s): Koshy G, Nair S, Norkus EP, Hertan HI, Pitchumoni CS. Source: The American Journal of Gastroenterology. 2000 June; 95(6): 1476-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10894582

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Propofol versus midazolam plus meperidine for sedation during ambulatory esophagogastroduodenoscopy. Author(s): Khoshoo V, Thoppil D, Landry L, Brown S, Ross G. Source: Journal of Pediatric Gastroenterology and Nutrition. 2003 August; 37(2): 146-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12883300

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Propofol versus midazolam/meperidine for outpatient colonoscopy: administration by nurses supervised by endoscopists. Author(s): Sipe BW, Rex DK, Latinovich D, Overley C, Kinser K, Bratcher L, Kareken D. Source: Gastrointestinal Endoscopy. 2002 June; 55(7): 815-25. Erratum In: Gastrointest Endosc 2002 August; 56(2): 324. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12024134

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Randomized comparison of meperidine and fentanyl during labor. Author(s): Goodlin RC. Source: Obstetrics and Gynecology. 1990 February; 75(2): 308. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2300361

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Randomized comparison of meperidine and fentanyl during labor. Author(s): Rayburn WF, Smith CV, Parriott JE, Woods RE. Source: Obstetrics and Gynecology. 1989 October; 74(4): 604-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2797637

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Re: Koshy et al.--Propofol versus midazolam and meperidine for conscious sedation in GI endoscopy. Author(s): Jackson FW. Source: The American Journal of Gastroenterology. 2001 August; 96(8): 2523. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11513218

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Rectal thiopental compared with intramuscular meperidine, promethazine, and chlorpromazine for pediatric sedation. Author(s): O'Brien JF, Falk JL, Carey BE, Malone LC. Source: Annals of Emergency Medicine. 1991 June; 20(6): 644-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2039103

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Relationship between blood meperidine concentrations and analgesic response: a preliminary report. Author(s): Austin KL, Stapleton JV, Mather LE. Source: Anesthesiology. 1980 December; 53(6): 460-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7457961

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Relationship to plasma meperidine levels to changes in anxiety and hostility. Author(s): Elliott HW, Gottschalk LA, Uliana RL. Source: Comprehensive Psychiatry. 1974 May-June; 15(3): 249-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4596772

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Relative potencies and durations of action with respect to respiratory depression of intravenous meperidine, fentanyl and alphaprodine in man. Author(s): Kaufman RD, Aqleh KA, Bellville JW. Source: The Journal of Pharmacology and Experimental Therapeutics. 1979 January; 208(1): 73-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=759617

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Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour. Author(s): Thurlow JA, Laxton CH, Dick A, Waterhouse P, Sherman L, Goodman NW. Source: British Journal of Anaesthesia. 2002 March; 88(3): 374-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11990269

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Remifentanil versus meperidine for monitored anesthesia care: a comparison study in older patients undergoing ambulatory colonoscopy. Author(s): Greilich PE, Virella CD, Rich JM, Kurada M, Roberts K, Warren JF, Harford WV. Source: Anesthesia and Analgesia. 2001 January; 92(1): 80-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11133605

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Removing meperidine from the health-system formulary--frequently asked questions. Author(s): Beckwith MC, Fox ER, Chandramouli J. Source: Journal of Pain & Palliative Care Pharmacotherapy. 2002; 16(3): 45-59. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14640355

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Respiratory and analgesic effects of meperidine and tramadol in patients undergoing orthopedic surgery. Author(s): Tarradell R, Pol O, Farre M, Barrera E, Puig MM. Source: Methods Find Exp Clin Pharmacol. 1996 April; 18(3): 211-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8738073

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Respiratory and circulatory effects of pentazocine and meperidine on anesthetized patients. Author(s): Davie IT. Source: The Mount Sinai Journal of Medicine, New York. 1972 March-April; 39(2): 14657. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4536794

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Respiratory depression associated with meperidine spinal anaesthesia. Author(s): Ong B, Segstro R. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1994 August; 41(8): 725-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7923521

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Respiratory depression in a child following meperidine, promethazine, and chlorpromazine premedication: report of a case. Author(s): Album MM. Source: Asdc J Dent Child. 1979 May-June; 46(3): 258-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=285954

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Respiratory depression in a child following meperidine, promethazine, and chlorpromazine premedication: report of case. Author(s): Benusis KP, Kapaun D, Furnam LJ. Source: Asdc J Dent Child. 1979 January-February; 46(1): 50-3. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=283080

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Reversal of the OKT3-related shivering and chest tightness by intravenous meperidine. Author(s): Abdallah KA, David-Neto E, Centeno JR, Nahas WC, Arap S. Source: Transplantation. 1996 July 15; 62(1): 145-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8693536

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Reversible parkinsonism related to meperidine. Author(s): Lieberman AN, Goldstein M. Source: The New England Journal of Medicine. 1985 February 21; 312(8): 509. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3969111

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Safety concerns with meperidine. Author(s): Golembiewski J. Source: Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses / American Society of Perianesthesia Nurses. 2002 April; 17(2): 123-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11925585

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Safety of patient-controlled intravenous meperidine. Author(s): Wilson D, Douglas MJ. Source: Anesthesiology. 1998 June; 88(6): 1688-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9637672

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Sedation for upper gastrointestinal endoscopy: a comparison of alfentanil-midazolam and meperidine-diazepam. Author(s): Donnelly MB, Scott WA, Daly DS. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1994 December; 41(12): 1161-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7867109

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Sedation with meperidine and midazolam in pediatric patients undergoing endoscopy. Author(s): Bahal-O'Mara N, Nahata MC, Murray RD, Linscheid TR, Fishbein M, Heitlinger LA, Li BU, McClung HJ, Potter C, Lininger B. Source: European Journal of Clinical Pharmacology. 1994; 47(4): 319-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7875182

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Self-administered intranasal meperidine for postoperative pain management. Author(s): Striebel HW, Bonillo B, Schwagmeier R, Dopjans D, Spies C. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1995 April; 42(4): 287-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7788825

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Serotonin syndrome induced by amitriptyline, meperidine, and venlafaxine. Author(s): Dougherty JA, Young H, Shafi T. Source: The Annals of Pharmacotherapy. 2002 October; 36(10): 1647-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12243617

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Serum concentrations of meperidine in patients with sickle cell crisis. Author(s): Abbuhl S, Jacobson S, Murphy JG, Gibson G. Source: Annals of Emergency Medicine. 1986 April; 15(4): 433-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3954178

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Severe hypotension from epidural meperidine in a high-risk patient after thoracotomy. Author(s): Balaban M, Slinger P. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1989 July; 36(4): 450-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2758544

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Side effects of morphine patient-controlled analgesia and meperidine patientcontrolled analgesia: a follow-up of 500 patients. Author(s): McKenzie R, Rudy T, Ponter-Hammill M. Source: Aana Journal. 1992 June; 60(3): 282-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1632156

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Simultaneous determination of pethidine (meperidine), phenoperidine, and norpethidine (normeperidine), their common metabolite, by gas chromatography with selective nitrogen detection. Author(s): Kintz P, Godelar B, Mangin P, Lugnier AA, Chaumont AJ. Source: Forensic Science International. 1989 December; 43(3): 267-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2613140

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Single bolus of midazolam versus bolus midazolam plus meperidine for colonoscopy: a prospective, randomized, double-blind trial. Author(s): Radaelli F, Meucci G, Terruzzi V, Spinzi G, Imperiali G, Strocchi E, Lenoci N, Terreni N, Mandelli G, Minoli G. Source: Gastrointestinal Endoscopy. 2003 March; 57(3): 329-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12612511

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Site-specific pharmacokinetics and pharmacodynamics of intramuscular meperidine in elderly postoperative patients. Author(s): Erstad BL, Meeks ML, Chow HH, Rappaport WD, Levinson ML. Source: The Annals of Pharmacotherapy. 1997 January; 31(1): 23-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8997460

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Species differences in the hydrolysis of meperidine and its inhibition by organophosphate compounds. Author(s): Luttrell WE, Castle MC. Source: Fundamental and Applied Toxicology : Official Journal of the Society of Toxicology. 1988 August; 11(2): 323-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3220210

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Spectral analysis of sudden bradycardia during intrathecal meperidine anesthesia. Author(s): Critchley LA, Chan S, Tam YH. Source: Regional Anesthesia and Pain Medicine. 1998 September-October; 23(5): 506-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9773706

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Spinal anesthesia with low dose meperidine for knee arthroscopy in ambulatory surgical patients. Author(s): Trivedi NS, Halpern M, Robalino J, Shevde K. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1990 May; 37(4 Pt 2): S46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2361293

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Spinal anesthesia with meperidine as the sole agent for cesarean delivery. Author(s): Nguyen Thi TV, Orliaguet G, Ngu TH, Bonnet F. Source: Reg Anesth. 1994 November-December; 19(6): 386-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7848947

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Spinal anesthesia with meperidine. Effects of added alpha-adrenergic agonists: epinephrine versus clonidine. Author(s): Acalovschi I, Bodolea C, Manoiu C. Source: Anesthesia and Analgesia. 1997 June; 84(6): 1333-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174316

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Spinal anesthesia with meperidine: will epinephrine prolong its duration? Author(s): Bostrom MA, Pakiz AM, Melnyk DL, Benke G, Cohen S. Source: Aana Journal. 1994 June; 62(3): 267-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7725867

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Subarachnoid meperidine (Pethidine) causes significant nausea and vomiting during labor. The Duke Women's Anesthesia Research Group. Author(s): Booth JV, Lindsay DR, Olufolabi AJ, El-Moalem HE, Penning DH, Reynolds JD. Source: Anesthesiology. 2000 August; 93(2): 418-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10910491

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Subarachnoid meperidine-morphine combination. An effective perioperative analgesic adjunct for cesarean delivery. Author(s): Chung JH, Sinatra RS, Sevarino FB, Fermo L. Source: Reg Anesth. 1997 March-April; 22(2): 119-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9089852

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The analgesic effect of fentanyl, morphine, meperidine, and lidocaine in the peripheral veins: a comparative study. Author(s): Pang WW, Mok MS, Huang S, Hwang MH. Source: Anesthesia and Analgesia. 1998 February; 86(2): 382-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9459253

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The clinical relevance of the drug displacement interaction between meperidine and bupivacaine. Author(s): Denson DD, Myers JA, Coyle DE. Source: Res Commun Chem Pathol Pharmacol. 1984 September; 45(3): 323-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6505376

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The comparison of midazolam and topical lidocaine spray versus the combination of midazolam, meperidine, and topical lidocaine spray to sedate patients for upper endoscopy. Author(s): Laluna L, Allen ML, Dimarino AJ Jr. Source: Gastrointestinal Endoscopy. 2001 March; 53(3): 289-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11231385

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The duration of effect of maternally administered meperidine on neonatal neurobehavior. Author(s): Hodgkinson R, Husain FJ. Source: Anesthesiology. 1982 January; 56(1): 51-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7053671

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The effect of meperidine and promethazine on fetal heart rate indices during the active phase of labor. Author(s): Solt I, Ganadry S, Weiner Z. Source: Isr Med Assoc J. 2002 March; 4(3): 178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11908257

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The effect of opioids on thermoregulatory responses in humans and the special antishivering action of meperidine. Author(s): Ikeda T, Kurz A, Sessler DI, Go J, Kurz M, Belani K, Larson M, Bjorksten AR, Dechert M, Christensen R. Source: Annals of the New York Academy of Sciences. 1997 March 15; 813: 792-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9100971

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The effect of ritonavir on the pharmacokinetics of meperidine and normeperidine. Author(s): Piscitelli SC, Kress DR, Bertz RJ, Pau A, Davey R. Source: Pharmacotherapy. 2000 May; 20(5): 549-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10809341

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The effects of intravenous lorazepam alone and with meperidine on ventilation in man. Author(s): Paulson BA, Becker LD, Way WL. Source: Acta Anaesthesiologica Scandinavica. 1983 October; 27(5): 400-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6637367

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The effects of meperidine and sufentanil on the shivering threshold in postoperative patients. [email protected]. Author(s): Alfonsi P, Sessler DI, Du Manoir B, Levron JC, Le Moing JP, Chauvin M. Source: Anesthesiology. 1998 July; 89(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9667292

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The effects of three graded doses of meperidine for spinal anesthesia in African men. Author(s): Hansen D, Hansen S. Source: Anesthesia and Analgesia. 1999 April; 88(4): 827-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195532

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The efficacy of oral vs. IM meperidine. Author(s): Todd B. Source: The American Journal of Nursing. 1984 March; 84(3): 302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6560983

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The peripheral analgesic effect of meperidine in reducing propofol injection pain is not naloxone-reversible. Author(s): Pang WW, Mok MS, Huang S, Chung YT, Hwang MH. Source: Regional Anesthesia and Pain Medicine. 1998 March-April; 23(2): 197-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9570610

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The pharmacokinetics of meperidine in acute trauma patients. Author(s): Kirkwood CF, Edwards DJ, Lalka D, Lasezkay G, Hassett JM, Slaughter RL. Source: The Journal of Trauma. 1986 December; 26(12): 1090-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3795304

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The placebo effect in acute headache management: ketorolac, meperidine, and saline in the emergency department. Author(s): Harden RN, Gracely RH, Carter T, Warner G. Source: Headache. 1996 June; 36(6): 352-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8707552

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The suppressive effect of meperidine on PHA-stimulated transformation of human lymphocytes. Author(s): Saito K, Kumagai K. Source: The Tohoku Journal of Experimental Medicine. 1981 July; 134(3): 337-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7314109

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The use of clonidine for the treatment of meperidine withdrawal in a multidisciplinary pain program setting. A case presentation. Author(s): Jimenez AC, Gusmorino P, Pinter I, Snow B. Source: Bull Hosp Jt Dis Orthop Inst. 1987 Spring; 47(1): 72-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3038230

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Toxicity secondary to meperidine in patients on monoamine oxidase inhibitors: a case report and critical review. Author(s): Meyer D, Halfin V. Source: Journal of Clinical Psychopharmacology. 1981 September; 1(5): 319-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7334144

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Tramadol versus meperidine in the treatment of shivering during spinal anaesthesia. Author(s): Kaya M, Sariyildiz O, Karakus D, Ozalp G, Kadiogullari DN. Source: European Journal of Anaesthesiology. 2003 April; 20(4): 332-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12703840

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Transient neurological symptoms after subarachnoid meperidine. Author(s): Lewis WR, Perrino AC Jr. Source: Anesthesia and Analgesia. 2002 January; 94(1): 213-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11772831

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Treating headache in the emergency ward: avoiding the migraine-meperidine trap. Author(s): Gupta R, Gernsheimer J. Source: Annals of Emergency Medicine. 2003 July; 42(1): 161; Author Reply 161-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12852415

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Urinary excretion of meperidine and normeperidine in man upon acute and chronic exposure to high altitude. Author(s): Ritschel WA, Paulos C, Arancibia A, Pezzani M, Agrawal M, Wetzelsberger K, Lucker PW. Source: Methods Find Exp Clin Pharmacol. 1996 January-February; 18(1): 49-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8721256

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Urticaria induced by meperidine allergy. Author(s): Anibarro B, Vila C, Seoane FJ. Source: Allergy. 2000 March; 55(3): 305-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10753031

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Use of meperidine for obstetric analgesia. Author(s): Vaugn R, Perkett E. Source: The Journal of Pediatrics. 1978 January; 92(1): 171-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=619072

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Use of meperidine in patient-controlled analgesia and the development of a normeperidine toxic reaction. Author(s): Simopoulos TT, Smith HS, Peeters-Asdourian C, Stevens DS. Source: Archives of Surgery (Chicago, Ill. : 1960). 2002 January; 137(1): 84-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11772223

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Ventilatory arrest after meperidine. Author(s): Stoelting RK. Source: Anesthesia and Analgesia. 1977 September-October; 56(5): 727-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=562103

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Visual compatibility of morphine sulfate and meperidine hydrochloride with other injectable drugs during simulated Y-site injection. Author(s): Pugh CB, Pabis DJ, Rodriguez C. Source: Am J Hosp Pharm. 1991 January; 48(1): 123-5. No Abstract Available. Erratum In: Am J Hosp Pharm 1991 May; 48(5): 946. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2000871

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What's so bad about meperidine? Author(s): Kettelman K. Source: Nursing. 2000 October; 30(10): 20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11096965

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CHAPTER 2. NUTRITION AND MEPERIDINE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and meperidine.

Finding Nutrition Studies on Meperidine The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “meperidine” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “meperidine” (or a synonym): •

A comparison of nalbuphine and meperidine in treatment of postoperative pain. Author(s): Department of Anaesthesia, Mount Sinai Hospital, Toronto, Ontario. Source: Hew, E Foster, K Gordon, R Hew Sang, E Can-J-Anaesth. 1987 September; 34(5): 462-5 0832-610X

•

A double-blind comparison of nalbuphine and meperidine hydrochloride as intravenous analgesics in combination with diazepam for oral surgery outpatients. Source: Scott, R F J-Oral-Maxillofac-Surg. 1987 June; 45(6): 473-6 0278-2391

•

Antagonism of the response rate-decreasing effects of meperidine and morphine by beta-funaltrexamine and naltrexone in squirrel monkeys. Author(s): Department of Psychology, University of North Carolina, Chapel Hill 275993270, USA. [email protected] Source: Hughes, C E Dykstra, L A Drug-Alcohol-Depend. 1997 May 2; 45(3): 197-206 0376-8716

•

Comparison of butorphanol tartrate and meperidine in moderate to severe renal colic. Source: Henry, H 2nd Nordan, J Tomlin, E M Urology. 1987 March; 29(3): 339-45 00904295

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GABAmimetics diminish antinociception of meperidine under conditions which enhance other opioid mu-agonists. Author(s): Department of Pharmacology, Dental School, University of Maryland, Baltimore 21201. Source: Wynn, R L Bergman, S A Rudo, F G Leventer, M Arch-Int-Pharmacodyn-Ther. 1990 Mar-April; 304136-46 0003-9780

•

The effect of fentanyl, meperidine and diamorphine on nerve conduction in vitro. Author(s): University Department of Anaesthetics, Royal Infirmary, Edinburgh, Scotland. Source: Power, I Brown, D T Wildsmith, J A Reg-Anesth. 1991 Jul-August; 16(4): 204-8 0146-521X

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

Nutrition

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to meperidine; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Food and Diet Nutritional Yeast Alternative names: Brewer's Yeast Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 3. ALTERNATIVE MEDICINE AND MEPERIDINE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to meperidine. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to meperidine and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “meperidine” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to meperidine: •

A clinical study on physiological response in electroacupuncture analgesia and meperidine analgesia for colonoscopy. Author(s): Wang HH, Chang YH, Liu DM, Ho YJ. Source: The American Journal of Chinese Medicine. 1997; 25(1): 13-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9166993

•

A combination of analgesic and antagonist in postoperative pain. Author(s): HOSSLI G, BERGMANN G. Source: British Journal of Anaesthesia. 1960 October; 32: 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13716092

•

A comparative study of transcutaneous electrical nerve stimulation (TENS), entonox, pethidine + promazine and lumbar epidural for pain relief in labor. Author(s): Harrison RF, Shore M, Woods T, Mathews G, Gardiner J, Unwin A.

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Source: Acta Obstetricia Et Gynecologica Scandinavica. 1987; 66(1): 9-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3300138 •

A quantitative evaluation of psycho-prophylaxis in childbirth. Author(s): Huttel FA, Mitchell I, Fischer WM, Meyer AE. Source: Journal of Psychosomatic Research. 1972 April; 16(2): 81-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5038892

•

A systemic reaction following exposure to a pyrethroid insecticide. Author(s): Box SA, Lee MR. Source: Human & Experimental Toxicology. 1996 May; 15(5): 389-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8735461

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A test for antinociceptive activity of narcotic and narcotic antagonist analgesics in the guinea pig. Author(s): Teiger DG. Source: The Journal of Pharmacology and Experimental Therapeutics. 1976 May; 197(2): 311-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5596

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A timely reminder: anaphylaxis associated with use of sclerosing agents. Author(s): WEINSTEIN BM. Source: J Tenn Med Assoc. 1963 October; 56: 395-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14076542

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ABC of labour care. Relief of pain. Author(s): Findley I, Chamberlain G. Source: Bmj (Clinical Research Ed.). 1999 April 3; 318(7188): 927-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10102864

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Accelerated painless labor. Author(s): Louros NC, Papadimitriou GC, Papapostolou MG. Source: American Journal of Obstetrics and Gynecology. 1967 June 15; 98(4): 555-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4381625

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Acupuncture anaesthesia. Observations on its use for removal of thyroid adenomata and influence on recovery and morbidity in a Chinese hospital. Author(s): Kho HG, van Egmond J, Zhuang CF, Lin GF, Zhang GL. Source: Anaesthesia. 1990 June; 45(6): 480-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2382806

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•

Acupuncture analgesia and acuthesia--its economic aspect. Author(s): Subramaniam MS. Source: Trop Doct. 1981 January; 11(1): 19-21. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7222228

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Acupuncture during labor can reduce the use of meperidine: a controlled clinical study. Author(s): Nesheim BI, Kinge R, Berg B, Alfredsson B, Allgot E, Hove G, Johnsen W, Jorsett I, Skei S, Solberg S. Source: The Clinical Journal of Pain. 2003 May-June; 19(3): 187-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12792557

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Comparative study of the analgesic effect of transcutaneous nerve stimulation (TNS); electroacupuncture (EA) and meperidine in the treatment of postoperative pain. Author(s): Martelete M, Fiori AM. Source: Acupuncture & Electro-Therapeutics Research. 1985; 10(3): 183-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2866672

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Ectopic inhibition of the complexes of the electron transport system by rotenone, piericidin A, demerol and antimycin A. Author(s): Teeter ME, Baginsky ML, Hatefi Y. Source: Biochimica Et Biophysica Acta. 1969 February 25; 172(2): 331-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4304726

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Intrapartum vibratory acoustic stimulation after maternal meperidine administration. Author(s): Panayotopoulos N, Salamalekis E, Kassanos D, Vitoratos N, Loghis C, Batalias L. Source: Clin Exp Obstet Gynecol. 1998; 25(4): 139-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9987572

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Stimulation of the periaqueductal gray subdues sensitized pain in morphine- and meperidine-dependent rats. Author(s): Emmers R. Source: Experimental Neurology. 1985 May; 88(2): 405-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3872807

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The effect of pretreatment with pentobarbital, meperidine, or hyperbaric oxygen on the response to anoxia and resuscitation in newborn rabbits. Author(s): Campbell AG, Milligan JE, Talner NS. Source: The Journal of Pediatrics. 1968 April; 72(4): 518-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5689607

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Meperidine

The use of hypnotic technique in anesthesia to decrease postoperative meperidine requirements. Author(s): Kiefer RC, Hospodarsky J. Source: J Am Osteopath Assoc. 1980 July; 79(11): 693-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7419443

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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•

Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to meperidine; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Pancreatitis Source: Integrative Medicine Communications; www.drkoop.com

•

Herbs and Supplements Brewer's Yeast Alternative names: Nutritional Yeast Source: Integrative Medicine Communications; www.drkoop.com

Alternative Medicine 61

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON MEPERIDINE Overview In this chapter, we will give you a bibliography on recent dissertations relating to meperidine. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “meperidine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on meperidine, we have not necessarily excluded nonmedical dissertations in this bibliography.

Dissertations on Meperidine ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to meperidine. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

Synthesis and biological evaluation of meperidine analogues as ligands for the dopamine transporter by Rhoden, Jill Elizabeth Butler, PhD from University of New Orleans, 2003, 139 pages http://wwwlib.umi.com/dissertations/fullcit/3102781

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON MEPERIDINE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “meperidine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on meperidine, we have not necessarily excluded nonmedical patents in this bibliography.

Patents on Meperidine By performing a patent search focusing on meperidine, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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example of the type of information that you can expect to obtain from a patent search on meperidine: •

Method of administering a narcotic analgesic and dosage forms therefor Inventor(s): Cohen; Edwin A. (Mahwah, NJ) Assignee(s): Barr Laboratories, Inc. (Pomona, NY) Patent Number: 4,973,596 Date filed: May 20, 1988 Abstract: The invention provides a novel method of administering meperidine or its pharmaceutically acceptable salts and novel dosage forms containing these compounds which are adapted for nasal administration. The nasal dosage forms disclosed include solutions, suspensions, gels and ointments. Excerpt(s): The present invention relates to a method for the nasal administration of narcotic analgesics, namely, merperidine and its pharmaceutically acceptable salts. The invention also relates to nasal dosage forms of meperidine and its pharmaceutically acceptable salts. Meperidine hydrochloride is a potent narcotic analgesic with multiple actions qualitatively similar to those of morphine. The principal actions of therapeutic value are analgesia and sedation. A 60 mg. to 80 mg. parenteral dose of meperidine hydrochloride is approximately equivalent in analgesic effect to 10 mg. of morphine. The onset of action is slightly more rapid than with morphine, and the duration of action is slightly shorter. Web site: http://www.delphion.com/details?pn=US04973596__

Patent Applications on Meperidine As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to meperidine: •

Novel use of ion channel active compound, meperidine, to mediate process of accelerated wound healing Inventor(s): Nickel, Alfred A.; (Pollock Pines, CA) Correspondence: Alfred A. Nickel; 4663 Jenkinson Circle; Pollock Pines; CA; 95726; US Patent Application Number: 20040116470 Date filed: December 16, 2002 Abstract: The present invention discloses a method of employing ion channel active compounds to deliver metabolism-enhancing molecules within the cell to promote rapid wound healing. It also develops a delivery kit for meperidine as a local anesthetic and wound healing accelerant for dental surgical use. And meperidine thus serves as a pattern for future design of novel wound healing compounds.

6

This has been a common practice outside the United States prior to December 2000.

Patents 67

Excerpt(s): 1. Meperidine pkg insert. Manufactured by Baxter Healthcare Corporation (12,2001). 2. Jaffe RA, Rowe MA. "A comparison of local anesthetic effects of meperidine, fentanyl, and sufentanil on dorsal root axons". Anesth Analg 83:776-81 (1996). 3. Hassan H G, Youssef H., Renck H. "Duration of Experimental nerve block by combinations of local anesthetic agents". Acta Anesthesiol Scand 37:70-74 (1993). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with meperidine, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “meperidine” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on meperidine. You can also use this procedure to view pending patent applications concerning meperidine. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. PERIODICALS AND NEWS ON MEPERIDINE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover meperidine.

News Services and Press Releases One of the simplest ways of tracking press releases on meperidine is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “meperidine” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to meperidine. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “meperidine” (or synonyms). The following was recently listed in this archive for meperidine: •

Mallinckrodt's generic Demerol gets nod from FDA Source: Reuters Industry Breifing Date: June 16, 2000

•

Watson Pharmaceuticals Gets FDA Approval For Meperidine Tablets Source: Reuters Medical News Date: July 08, 1997

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “meperidine” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “meperidine” (or synonyms). If you know the name of a company that is relevant to meperidine, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “meperidine” (or synonyms).

Periodicals and News

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Academic Periodicals covering Meperidine Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to meperidine. In addition to these sources, you can search for articles covering meperidine that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for meperidine. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with meperidine. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to meperidine: Narcotic Analgesics For Pain Relief •

Systemic - U.S. Brands: Astramorph PF; Buprenex; Cotanal-65; Darvon; DarvonN; Demerol; Dilaudid; Dilaudid-5; Dilaudid-HP; Dolophine; Duramorph; Hydrostat IR; Kadian; Levo-Dromoran; M S Contin; Methadose; MS/L; MS/L Concentrate; MS/S; MSIR; Nubain; Numorphan; OMS Concentrate; Oramorph SR; OxyContin; PP-Cap; Rescudose; RMS Uniserts; Roxanol; Roxanol 100; Roxanol UD; Roxicodone; Roxicodone Intensol; Stadol; Talwin; Talwin-Nx http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202390.html

Narcotic Analgesics For Surgery and Obstetrics •

Systemic - U.S. Brands: Alfenta; Astramorph; Astramorph PF; Buprenex; Demerol; Duramorph; Nubain; Stadol; Sublimaze; Sufenta; Ultiva http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202391.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA

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75

through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

79

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

7

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

8

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “meperidine” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 6140 41 46 4 54 6285

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “meperidine” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

11

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

15 Adapted 16

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on meperidine can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to meperidine. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to meperidine. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “meperidine”:

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Parkinson's Disease http://www.nlm.nih.gov/medlineplus/parkinsonsdisease.html Prescription Drug Abuse http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html Teens' Page http://www.nlm.nih.gov/medlineplus/teenspage.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to meperidine. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •


•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to meperidine. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with meperidine. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about meperidine. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “meperidine” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “meperidine”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “meperidine” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.

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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “meperidine” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

18

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

19

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

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National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

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New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on meperidine: •

Basic Guidelines for Meperidine Demerol overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002624.htm Meperidine hydrochloride overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002676.htm

•

Signs & Symptoms for Meperidine Bluish colored fingernails and lips Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm Coma Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003202.htm Convulsions Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm

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Difficulty breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003075.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Muscle spasticity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm No breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003069.htm Spasms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Weak pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003078.htm •

Diagnostics and Tests for Meperidine Gastric lavage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003882.htm

•

Background Topics for Meperidine Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Breathing shallow Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm Breathing slow and labored Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm Unconscious Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000022.htm

Online Glossaries 97

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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MEPERIDINE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine: A dopaminergic neurotoxic compound which produces irreversible clinical, chemical, and pathological alterations that mimic those found in Parkinson disease. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Acoustic: Having to do with sound or hearing. [NIH] Acute renal: A condition in which the kidneys suddenly stop working. In most cases, kidneys can recover from almost complete loss of function. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] Adenine: A purine base and a fundamental unit of adenine nucleotides. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adrenergic Agonists: Drugs that bind to and activate adrenergic receptors. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction

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between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Alfentanil: A short-acting opioid anesthetic and analgesic derivative of fentanyl. It produces an early peak analgesic effect and fast recovery of consciousness. Alfentanil is effective as an anesthetic during surgery, for supplementation of analgesia during surgical procedures, and as an analgesic for critically ill patients. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amino acid: Any organic compound containing an amino (-NH2 and a carboxyl (- COOH) group. The 20 a-amino acids listed in the accompanying table are the amino acids from which proteins are synthesized by formation of peptide bonds during ribosomal translation of messenger RNA; all except glycine, which is not optically active, have the L configuration. Other amino acids occurring in proteins, such as hydroxyproline in collagen, are formed by posttranslational enzymatic modification of amino acids residues in polypeptide chains. There are also several important amino acids, such as the neurotransmitter y-aminobutyric acid, that have no relation to proteins. Abbreviated AA. [EU] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH]

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Ampulla: A sac-like enlargement of a canal or duct. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Anoxia: Clinical manifestation of respiratory distress consisting of a relatively complete absence of oxygen. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Antiallergic: Counteracting allergy or allergic conditions. [EU] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a

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specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Arthroscopy: Endoscopic examination, therapy and surgery of the joint. [NIH] Articular: Of or pertaining to a joint. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord.

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Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its

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composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bleeding Time: Duration of blood flow after skin puncture. This test is used as a measure of capillary and platelet function. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bolus: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus infusion. [NIH] Bolus infusion: A single dose of drug usually injected into a blood vessel over a short period of time. Also called bolus. [NIH] Bolus injection: The injection of a drug (or drugs) in a high quantity (called a bolus) at once, the opposite of gradual administration (as in intravenous infusion). [EU] Brachial: All the nerves from the arm are ripped from the spinal cord. [NIH] Brachial Plexus: The large network of nerve fibers which distributes the innervation of the upper extremity. The brachial plexus extends from the neck into the axilla. In humans, the nerves of the plexus usually originate from the lower cervical and the first thoracic spinal cord segments (C5-C8 and T1), but variations are not uncommon. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist

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activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain. [NIH] Caesarean section: A surgical incision through the abdominal and uterine walls in order to deliver a baby. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiac catheterization: A procedure in which a thin, hollow tube is inserted into a blood vessel. The tube is then advanced through the vessel into the heart, enabling a physician to study the heart and its pumping activity. [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Caspase: Enzyme released by the cell at a crucial stage in apoptosis in order to shred all cellular proteins. [NIH] Catabolism: Any destructive metabolic process by which organisms convert substances into excreted compounds. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH]

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Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Ceramide: A type of fat produced in the body. It may cause some types of cells to die, and is being studied in cancer treatment. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Aqueduct: Narrow channel in the mesencephalon that connects the third and fourth ventricles. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cesarean Section: Extraction of the fetus by means of abdominal hysterotomy. [NIH] Cetirizine: A potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoembolization: A procedure in which the blood supply to the tumor is blocked surgically or mechanically, and anticancer drugs are administered directly into the tumor. This permits a higher concentration of drug to be in contact with the tumor for a longer period of time. [NIH] Chemopreventive: Natural or synthetic compound used to intervene in the early precancerous stages of carcinogenesis. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chloral Hydrate: A hypnotic and sedative used in the treatment of insomnia. The safety margin is too narrow for chloral hydrate to be used as a general anesthetic in humans, but it is commonly used for that purpose in animal experiments. It is no longer considered useful as an anti-anxiety medication. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other

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actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholecystitis: Inflammation of the gallbladder. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Circulatory system: The system that contains the heart and the blood vessels and moves blood throughout the body. This system helps tissues get enough oxygen and nutrients, and it helps them get rid of waste products. The lymph system, which connects with the blood system, is often considered part of the circulatory system. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clot Retraction: Retraction of a clot resulting from contraction of platelet pseudopods attached to fibrin strands that is dependent on the contractile protein thrombosthenin. Used as a measure of platelet function. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2.

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Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Compacta: Part of substantia nigra. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU]

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Conjugated: Acting or operating as if joined; simultaneous. [EU] Conscious Sedation: An alternative to general anesthesia in patients for whom general anesthesia is refused or considered inadvisable. It involves the administering of an antianxiety drug (minor tranquilizer) and an analgesic or local anesthetic. This renders the patient free of anxiety and pain while allowing the patient to remain in verbal contact with the physician or dentist. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH]

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Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dermatitis: Any inflammation of the skin. [NIH] Desensitization: The prevention or reduction of immediate hypersensitivity reactions by administration of graded doses of allergen; called also hyposensitization and immunotherapy. [EU] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Dihydroergotamine: A derivative of ergotamine prepared by the catalytic hydrogenation of ergotamine. It is used as a vasoconstrictor, specifically for the therapy of migraine. [NIH] Dilation: A process by which the pupil is temporarily enlarged with special eye drops (mydriatic); allows the eye care specialist to better view the inside of the eye. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the

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back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duodenum: The first part of the small intestine. [NIH] Dysmenorrhea: Painful menstruation. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Embryology: The study of the development of an organism during the embryonic and fetal stages of life. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum

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for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Ergotamine: A vasoconstrictor found in ergot of Central Europe. It is an alpha-1 selective adrenergic agonist and is commonly used in the treatment of migraine headaches. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Fallopian tube: The oviduct, a muscular tube about 10 cm long, lying in the upper border of the broad ligament. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical,

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characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fenretinide: A synthetic retinoid that is used orally as a chemopreventive against prostate cancer and in women at risk of developing contralateral breast cancer. It is also effective as an antineoplastic agent. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fetal Heart: The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (heart/embryology) only on the basis of time. [NIH] Fetal Movement: Motion of the fetus perceived by the mother and felt by palpation of the abdomen. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Flame Ionization: Pyrolysis of organic compounds at the temperature of a hydrogen-air flame to produce ionic intermediates which can be collected and the resulting ion current measured by gas chromatography. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Formulary: A book containing a list of pharmaceutical products with their formulas and means of preparation. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or

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participate in blood production. [NIH] Gout: Hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Groin: The external junctural region between the lower part of the abdomen and the thigh. [NIH]

Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemodynamics: The movements of the blood and the forces involved in systemic or regional blood circulation. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [NIH]

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Herniorrhaphy: An operation to repair a hernia. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histamine Release: The secretion of histamine from mast cell and basophil granules by exocytosis. This can be initiated by a number of factors, all of which involve binding of IgE, cross-linked by antigen, to the mast cell or basophil's Fc receptors. Once released, histamine binds to a number of different target cell receptors and exerts a wide variety of effects. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydrocodone: Narcotic analgesic related to codeine, but more potent and more addicting by weight. It is used also as cough suppressant. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogenation: Specific method of reduction in which hydrogen is added to a substance by the direct use of gaseous hydrogen. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydromorphone: An opioid analgesic made from morphine and used mainly as an analgesic. It has a shorter duration of action than morphine. [NIH] Hydroxyzine: A histamine H1 receptor antagonist that is effective in the treatment of chronic urticaria, dermatitis, and histamine-mediated pruritus. Unlike its major metabolite cetirizine, it does cause drowsiness. It is also effective as an antiemetic, for relief of anxiety and tension, and as a sedative. [NIH] Hyperbaric: Characterized by greater than normal pressure or weight; applied to gases under greater than atmospheric pressure, as hyperbaric oxygen, or to a solution of greater specific gravity than another taken as a standard of reference. [EU] Hyperbaric oxygen: Oxygen that is at an atmospheric pressure higher than the pressure at sea level. Breathing hyperbaric oxygen to enhance the effectiveness of radiation therapy is being studied. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU]

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Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterotomy: An incision in the uterus, performed through either the abdomen or the vagina. [NIH] Immunology: The study of the body's immune system. [NIH] Immunotherapy: Manipulation of the host's immune system in treatment of disease. It includes both active and passive immunization as well as immunosuppressive therapy to prevent graft rejection. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Inguinal: Pertaining to the inguen, or groin. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus

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has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intraperitoneal: IP. Within the peritoneal cavity (the area that contains the abdominal organs). [NIH] Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Ketorolac: A drug that belongs to a family of drugs called nonsteroidal anti-inflammatory agents. It is being studied in cancer prevention. [NIH] Ketorolac Tromethamine: A pyrrolizine carboxylic acid derivative structurally related to indomethacin. It is a non-steroidal anti-inflammatory agent used for analgesia for postoperative pain and inhibits cyclooxygenase activity. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Laceration: 1. The act of tearing. 2. A torn, ragged, mangled wound. [EU] Lavage: A cleaning of the stomach and colon. Uses a special drink and enemas. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Ligation: Application of a ligature to tie a vessel or strangulate a part. [NIH] Lipid: Fat. [NIH] Lipophilic: Having an affinity for fat; pertaining to or characterized by lipophilia. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH]

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Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Lordosis: The anterior concavity in the curvature of the lumbar and cervical spine as viewed from the side. The term usually refers to abnormally increased curvature (hollow back, saddle back, swayback). It does not include lordosis as normal mating posture in certain animals ( = posture + sex behavior, animal). [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mechanical ventilation: Use of a machine called a ventilator or respirator to improve the exchange of air between the lungs and the atmosphere. [NIH] Median Nerve: A major nerve of the upper extremity. In humans, the fibers of the median nerve originate in the lower cervical and upper thoracic spinal cord (usually C6 to T1), travel via the brachial plexus, and supply sensory and motor innervation to parts of the forearm and hand. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Metabolic acidosis: (met-ah-BOL-ik as-id-O-sis): A condition in which the blood is too acidic. It may be caused by severe illness or sepsis (bacteria in the bloodstream). [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU]

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Methohexital: An intravenous anesthetic with a short duration of action that may be used for induction of anesthesia. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH]

Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monocytes: Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness,

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and air sickness. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] Nalbuphine: A narcotic used as a pain medication. It appears to be an agonist at kappa opioid receptors and an antagonist or partial agonist at mu opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Naproxen: An anti-inflammatory agent with analgesic and antipyretic properties. Both the acid and its sodium salt are used in the treatment of rheumatoid arthritis and other rheumatic or musculoskeletal disorders, dysmenorrhea, and acute gout. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroleptanalgesia: A form of analgesia accompanied by general quiescence and psychic indifference to environmental stimuli, without loss of consciousness, and produced by the combined administration of a major tranquilizer (neuroleptic) and a narcotic. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH]

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Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonmalignant: Not cancerous. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nulliparous: Having never given birth to a viable infant. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oncology: The study of cancer. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Orthopaedic: Pertaining to the correction of deformities of the musculoskeletal system; pertaining to orthopaedics. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovaries: The pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus. [NIH]

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Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxycodone: Semisynthetic derivative of codeine that acts as a narcotic analgesic more potent and addicting than codeine. [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Oxygenation: The process of supplying, treating, or mixing with oxygen. No:1245 oxygenation the process of supplying, treating, or mixing with oxygen. [EU] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation outside the body, as during open heart surgery. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palpation: Application of fingers with light pressure to the surface of the body to determine consistence of parts beneath in physical diagnosis; includes palpation for determining the outlines of organs. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Pancuronium: A bis-quaternary steroid that is a competitive nicotinic antagonist. As a neuromuscular blocking agent it is more potent than curare but has less effect on the circulatory system and on histamine release. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Particle: A tiny mass of material. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pelvis: The lower part of the abdomen, located between the hip bones. [NIH] Pemoline: A central nervous system stimulant used in fatigue and depressive states and to treat hyperkinetic disorders in children. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH]

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Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Periaqueductal Gray: Central gray matter surrounding the cerebral aqueduct in the mesencephalon. Physiologically it is probably involved in rage reactions, the lordosis reflex, feeding responses, bladder tonus, and pain. [NIH] Perinatal: Pertaining to or occurring in the period shortly before and after birth; variously defined as beginning with completion of the twentieth to twenty-eighth week of gestation and ending 7 to 28 days after birth. [EU] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenoperidine: A narcotic analgesic partly metabolized to meperidine in the liver. It is similar to morphine in action and used for neuroleptanalgesia, usually with droperidol. [NIH]

Phenyl: Ingredient used in cold and flu remedies. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Placebo Effect: An effect usually, but not necessarily, beneficial that is attributable to an expectation that the regimen will have an effect, i.e., the effect is due to the power of suggestion. [NIH] Plant Oils: Oils derived from plants or plant products. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasmin: A product of the lysis of plasminogen (profibrinolysin) by plasminogen activators. It is composed of two polypeptide chains, light (B) and heavy (A), with a molecular weight of 75,000. It is the major proteolytic enzyme involved in blood clot retraction or the lysis of

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fibrin and quickly inactivated by antiplasmins. EC 3.4.21.7. [NIH] Plasminogen: Precursor of fibrinolysin (plasmin). It is a single-chain beta-globulin of molecular weight 80-90,000 found mostly in association with fibrinogen in plasma; plasminogen activators change it to fibrinolysin. It is used in wound debriding and has been investigated as a thrombolytic agent. [NIH] Plasminogen Activators: A heterogeneous group of proteolytic enzymes that convert plasminogen to plasmin. They are concentrated in the lysosomes of most cells and in the vascular endothelium, particularly in the vessels of the microcirculation. EC 3.4.21.-. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Preoperative: Preceding an operation. [EU] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promazine: A phenothiazine with actions similar to chlorpromazine but with less antipsychotic activity. It is primarily used in short-term treatment of disturbed behavior and as an antiemetic. [NIH] Promethazine: A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and

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sedation, and also in animals. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propofol: A widely used anesthetic. [NIH] Propoxyphene: A narcotic analgesic structurally related to methadone. Only the dextroisomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Protein Subunits: Single chains of amino acids that are the units of a multimeric protein. They can be identical or non-identical subunits. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychotomimetic: Psychosis miming. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

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Pupil: The aperture in the iris through which light passes. [NIH] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radioactive: Giving off radiation. [NIH] Rage: Fury; violent, intense anger. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Respirator: A mechanical device that helps a patient breathe; a mechanical ventilator. [NIH]

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Respiratory Physiology: Functions and activities of the respiratory tract as a whole or of any of its parts. [NIH] Response rate: The percentage of patients whose cancer shrinks or disappears after treatment. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retrospective study: A study that looks backward in time, usually using medical records and interviews with patients who already have or had a disease. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH] Ribose: A pentose active in biological systems usually in its D-form. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Risk patient: Patient who is at risk, because of his/her behaviour or because of the type of person he/she is. [EU] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rotenone: A botanical insecticide that is an inhibitor of mitochondrial electron transport. [NIH]

Saline: A solution of salt and water. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sepsis: The presence of bacteria in the bloodstream. [NIH]

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Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Syndrome: An adverse drug interaction characterized by altered mental status, autonomic dysfunction, and neuromuscular abnormalities. It is most frequently caused by use of both serotonin reuptake inhibitors and monoamine oxidase inhibitors, leading to excess serotonin availability in the CNS at the serotonin 1A receptor. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shivering: Involuntary contraction or twitching of the muscles. It is a physiologic method of heat production in man and other mammals. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sound wave: An alteration of properties of an elastic medium, such as pressure, particle displacement, or density, that propagates through the medium, or a superposition of such alterations. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sprains and Strains: A collective term for muscle and ligament injuries without dislocation

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or fracture. A sprain is a joint injury in which some of the fibers of a supporting ligament are ruptured but the continuity of the ligament remains intact. A strain is an overstretching or overexertion of some part of the musculature. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Sufentanil: An opioid analgesic that is used as an adjunct in anesthesia, in balanced anesthesia, and as a primary anesthetic agent. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Suppressive: Tending to suppress : effecting suppression; specifically : serving to suppress activity, function, symptoms. [EU] Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects

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similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synthetic retinoid: A substance related to vitamin A that is produced in a laboratory. [NIH] Systemic: Affecting the entire body. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thoracic: Having to do with the chest. [NIH] Thoracic Surgery: A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs, and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular. [NIH] Thoracotomy: Surgical incision into the chest wall. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH]

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Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH] Transcutaneous: Transdermal. [EU] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubal ligation: An operation to tie the fallopian tubes closed. This procedure prevents pregnancy by blocking the passage of eggs from the ovaries to the uterus. [NIH] Tyramine: An indirect sympathomimetic. Tyramine does not directly activate adrenergic receptors, but it can serve as a substrate for adrenergic uptake systems and monoamine oxidase so it prolongs the actions of adrenergic transmitters. It also provokes transmitter release from adrenergic terminals. Tyramine may be a neurotransmitter in some invertebrate nervous systems. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urodynamic: Measures of the bladder's ability to hold and release urine. [NIH]

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Urokinase: A drug that dissolves blood clots or prevents them from forming. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vector: Plasmid or other self-replicating DNA molecule that transfers DNA between cells in nature or in recombinant DNA technology. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH] Venous: Of or pertaining to the veins. [EU] Ventilation: 1. In respiratory physiology, the process of exchange of air between the lungs and the ambient air. Pulmonary ventilation (usually measured in litres per minute) refers to the total exchange, whereas alveolar ventilation refers to the effective ventilation of the alveoli, in which gas exchange with the blood takes place. 2. In psychiatry, verbalization of one's emotional problems. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the

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cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

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INDEX 1 1-Methyl-4-phenyl-1,2,3,6tetrahydropyridine, 7, 99 A Abdominal, 12, 41, 99, 105, 106, 117, 122, 123 Acetaminophen, 13, 99 Acidosis, 99 Acoustic, 59, 99 Acute renal, 23, 99 Adaptation, 99, 106 Adenine, 99 Adenosine, 5, 99 Adrenal Medulla, 99, 105, 112, 121 Adrenergic, 5, 47, 99, 100, 101, 102, 110, 112, 126, 129, 131 Adrenergic Agonists, 5, 47, 99 Adverse Effect, 99, 128 Aerosol, 99, 129 Affinity, 7, 99, 100, 103, 117, 128 Agonist, 5, 100, 104, 110, 112, 120 Alfentanil, 33, 45, 100 Algorithms, 100, 104 Alimentary, 100, 117, 122 Alkaloid, 100, 103, 104, 107, 119, 126 Allergen, 100, 110 Alpha-1, 100, 112 Alternative medicine, 70, 100 Alveoli, 100, 132 Amino acid, 100, 123, 124, 125, 128, 129, 131 Amitriptyline, 10, 45, 100 Amnestic, 100, 119 Amphetamine, 5, 100, 110 Ampulla, 101, 112 Anaphylaxis, 58, 101 Anatomical, 101, 103, 106, 109, 116, 119 Anemia, 36, 101 Anesthetics, 101, 112 Anoxia, 59, 101 Antagonism, 21, 54, 101 Antiallergic, 101, 124 Anti-Anxiety Agents, 101, 124 Antibiotic, 101, 122, 124 Antibiotic Prophylaxis, 101, 124 Antibody, 100, 101, 102, 108, 114, 118, 126, 128 Anticholinergic, 100, 101, 106

Anticoagulant, 101, 125 Anticonvulsant, 101, 118 Antiemetic, 101, 102, 107, 115, 119, 124 Antigen, 100, 101, 108, 115, 118, 119 Anti-inflammatory, 99, 102, 116, 117, 120 Anti-Inflammatory Agents, 102, 117 Antineoplastic, 102, 113 Antipsychotic, 102, 106, 120, 124 Antipyretic, 99, 102, 120, 126 Antitussive, 102, 121, 125 Anxiety, 42, 101, 102, 106, 109, 115, 118 Anxiolytic, 102, 119, 121 Aorta, 102, 105, 132 Apoptosis, 102, 105 Arterial, 18, 22, 102, 115, 125 Arteries, 102, 104, 109, 119 Artery, 102, 109, 113, 125 Arthroscopy, 46, 102 Articular, 14, 102 Astrocytes, 102, 119 Asymptomatic, 103, 122 Atmospheric Pressure, 103, 115 Atrium, 103, 105, 132 Atropine, 20, 38, 103 Attenuated, 4, 103 Autodigestion, 103, 122 Autonomic, 102, 103, 121, 128 Autoradiography, 5, 103 Axons, 67, 103 B Bacteria, 101, 102, 103, 118, 119, 127, 131 Bacteriophage, 103, 131 Basophils, 103, 117 Belladonna, 103 Benign, 103, 105, 114 Benzene, 103 Benzodiazepines, 37, 103 Bile, 103, 104, 113, 117, 129 Bile duct, 104 Biliary, 10, 15, 22, 26, 104, 122 Biliary Tract, 104, 122 Biochemical, 104, 128 Biotechnology, 8, 70, 81, 104 Bladder, 104, 108, 123, 125, 131 Bleeding Time, 22, 104 Blood Platelets, 104, 128 Blood pressure, 96, 104, 115, 116, 128

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Blood vessel, 104, 105, 106, 107, 128, 130, 132 Body Fluids, 104, 128 Bolus, 24, 46, 104 Bolus infusion, 104 Bolus injection, 24, 104 Brachial, 104, 118 Brachial Plexus, 104, 118 Bradycardia, 46, 104 Bronchi, 104, 112, 131 Bronchitis, 104, 107 Bupivacaine, 9, 10, 11, 12, 28, 39, 47, 104, 117 Buprenorphine, 5, 104 Butorphanol, 5, 13, 20, 21, 54, 105 C Caesarean section, 11, 21, 24, 29, 39, 105 Capillary, 104, 105 Capsules, 105, 111 Carbon Dioxide, 32, 105, 113, 126 Carcinoid, 27, 105 Cardiac, 15, 38, 105, 112, 117, 119, 120, 126, 127, 129 Cardiac catheterization, 38, 105 Cardiopulmonary, 17, 27, 105 Cardiopulmonary Bypass, 17, 105 Cardiorespiratory, 105, 119 Cardiovascular, 100, 105, 128, 130 Case report, 49, 105, 107 Case series, 105, 107 Caspase, 6, 105 Catabolism, 6, 105 Catecholamine, 22, 105, 110 Catheterization, 105 Cell Respiration, 106, 126 Central Nervous System, 100, 103, 106, 107, 110, 113, 114, 119, 122, 128 Central Nervous System Infections, 106, 114 Ceramide, 6, 106 Cerebral, 18, 106, 112, 123, 125 Cerebral Aqueduct, 106, 123 Cervical, 19, 104, 106, 118 Cervix, 106 Cesarean Section, 23, 24, 28, 39, 106 Cetirizine, 106, 115 Character, 7, 106 Chemoembolization, 27, 106 Chemopreventive, 106, 113 Chemotherapy, 6, 106 Chest wall, 106, 130 Chin, 106, 118

Chloral Hydrate, 11, 14, 16, 17, 40, 106 Chlorpromazine, 9, 15, 16, 21, 27, 28, 38, 42, 44, 106, 124 Cholecystitis, 34, 107 Cholinergic, 100, 102, 107 Chromatin, 102, 107, 112, 118, 121 Chronic, 5, 15, 17, 18, 33, 50, 105, 106, 107, 112, 115, 118, 122, 131 Chronic Obstructive Pulmonary Disease, 18, 107 Chronic renal, 33, 107, 131 Circulatory system, 107, 122 Cisplatin, 107, 121 Clinical study, 57, 59, 107 Clinical trial, 4, 81, 107, 111, 126 Cloning, 104, 107 Clot Retraction, 107, 123 Coca, 107 Cocaine, 7, 107 Codeine, 5, 107, 115, 121, 122 Cofactor, 107, 125, 130 Collapse, 101, 107 Colloidal, 108, 129 Colon, 108, 117 Colonoscopy, 36, 42, 43, 46, 57, 108 Compacta, 7, 108 Complement, 108 Complementary and alternative medicine, 57, 61, 108 Complementary medicine, 57, 108 Compliance, 34, 108 Computational Biology, 81, 108 Conduction, 54, 108 Conjugated, 109 Conscious Sedation, 9, 16, 19, 20, 38, 41, 42, 109 Consciousness, 100, 101, 109, 110, 120, 125, 127 Constriction, 109, 132 Constriction, Pathologic, 109, 132 Contraindications, ii, 109 Contralateral, 109, 113 Coronary, 109, 119 Coronary Thrombosis, 109, 119 Cortical, 109, 127 Cranial, 109, 114 Craniocerebral Trauma, 109, 114 Curare, 109, 122 Curative, 109, 130 Cytochrome, 6, 109 Cytoplasm, 102, 103, 109, 112, 118, 119, 121

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Cytotoxic, 109, 121 Cytotoxic chemotherapy, 109, 121 Cytotoxicity, 6, 107, 110 D De novo, 6, 110 Deamination, 110, 119 Dendrites, 110, 120 Dental Care, 11, 110 Dermatitis, 110, 115 Desensitization, 5, 110 Dextroamphetamine, 100, 110, 119 Diagnostic procedure, 65, 70, 110 Diffusion, 110, 116 Digestion, 100, 104, 110, 117, 129 Dihydroergotamine, 14, 21, 110 Dilation, 19, 110 Direct, iii, 19, 73, 110, 115, 126, 130 Dissociation, 99, 110 Dopamine, 7, 63, 100, 102, 106, 107, 110, 119, 121 Dorsal, 67, 110, 124 Dorsum, 110, 111 Dosage Forms, 66, 111 Double-blind, 13, 20, 21, 22, 30, 36, 46, 54, 111 Drug Interactions, 74, 111 Drug Tolerance, 111, 130 Duodenum, 103, 111, 129 Dysmenorrhea, 111, 120 E Efficacy, 16, 21, 22, 23, 49, 111 Elective, 39, 111 Electroacupuncture, 57, 59, 111 Electrolyte, 111, 124, 128, 131 Embryology, 111, 113 Emollient, 111, 121 Emphysema, 107, 111 Emulsion, 103, 111 Endogenous, 110, 111 Endoscope, 111 Endoscopic, 15, 17, 102, 108, 111, 112, 119 Endoscopy, 9, 14, 19, 22, 26, 29, 36, 37, 41, 42, 45, 46, 47, 112 End-stage renal, 107, 112 Environmental Health, 80, 82, 112 Enzyme, 7, 105, 112, 116, 119, 123, 125, 129, 130, 132, 133 Eosinophils, 112, 117 Epidural, 9, 11, 12, 13, 21, 22, 23, 24, 27, 28, 29, 39, 41, 45, 57, 112 Epinephrine, 47, 99, 110, 112, 121, 131 Epithelial, 112, 114

Epithelial Cells, 112, 114 Ergotamine, 110, 112 Erythrocytes, 101, 112 Esophagus, 112, 129, 130 Evoke, 112, 129 Excitability, 112, 120, 126 Exhaustion, 101, 112 Expiration, 112, 126 Extracellular, 103, 112, 128 Extrapyramidal, 102, 110, 112 Extremity, 104, 112, 118 F Fallopian tube, 112, 131 Family Planning, 81, 112 Fat, 106, 112, 117 Fatigue, 112, 122 Femoral, 105, 113 Femoral Artery, 105, 113 Fenretinide, 6, 113 Fentanyl, 5, 14, 16, 20, 22, 25, 28, 42, 43, 47, 54, 67, 100, 113 Fetal Heart, 9, 16, 48, 113 Fetal Movement, 28, 113 Fetus, 19, 106, 113, 132 Flame Ionization, 30, 113 Flatus, 113 Fluoxetine, 41, 113 Forearm, 34, 104, 113, 118 Formulary, 43, 113 G Gallbladder, 99, 104, 107, 113 Ganglia, 102, 113, 116, 120 Gas, 25, 30, 46, 105, 110, 113, 115, 121, 129, 132 Gas exchange, 113, 132 Gastric, 26, 96, 103, 111, 113, 115 Gastrointestinal, 14, 22, 29, 36, 42, 45, 46, 47, 105, 112, 113, 128, 129 Gastrointestinal tract, 113, 128 Gels, 66, 113 Gene, 104, 113 Gestation, 113, 123 Gland, 99, 113, 118, 122, 125, 127, 129, 130 Gout, 114, 120 Governing Board, 114, 124 Graft, 41, 114, 116 Groin, 114, 116 H Habitual, 106, 114 Haptens, 100, 114 Headache, 14, 21, 27, 30, 31, 49, 50, 114 Headache Disorders, 114

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Heme, 109, 114 Hemodynamics, 22, 114 Hemoglobin, 101, 112, 114 Hemorrhage, 109, 114 Hemostasis, 114, 128 Hepatic, 13, 41, 114, 119 Hepatocytes, 26, 114 Hernia, 114, 115 Herniorrhaphy, 9, 115 Heterogeneity, 100, 115 Hiccup, 107, 115 Histamine, 102, 106, 115, 122, 124 Histamine Release, 115, 122 Hormone, 112, 115, 127, 130 Hybrid, 7, 115 Hydrocodone, 4, 115 Hydrogen, 99, 113, 115, 119, 122 Hydrogenation, 103, 110, 115 Hydrolysis, 12, 46, 107, 115, 124, 125 Hydromorphone, 15, 16, 115 Hydroxyzine, 11, 14, 17, 21, 30, 115 Hyperbaric, 9, 59, 115 Hyperbaric oxygen, 59, 115 Hypersensitivity, 5, 27, 100, 101, 110, 115, 127 Hypertension, 27, 114, 115, 131 Hypnotic, 60, 106, 115, 118, 119 Hypokinesia, 116, 122 Hypotension, 45, 102, 116 Hypoxemia, 36, 116 Hypoxia, 116 Hysterotomy, 106, 116 I Immunology, 99, 116 Immunotherapy, 110, 116 Impairment, 5, 116 In vitro, 6, 7, 41, 54, 116 In vivo, 6, 7, 116 Incision, 105, 116, 130 Indomethacin, 116, 117 Induction, 102, 116, 117, 119 Infarction, 109, 116, 119 Infiltration, 24, 116, 124 Inflammation, 102, 104, 107, 110, 116, 122, 124, 132 Infusion, 17, 30, 39, 104, 116 Inguinal, 9, 116 Innervation, 104, 116, 118 Inotropic, 110, 116 Insomnia, 106, 116 Intermittent, 30, 116 Intervertebral, 116, 118

Intervertebral Disk Displacement, 116, 118 Intestines, 99, 113, 117 Intoxication, 32, 117, 133 Intracellular, 6, 117, 124, 126 Intramuscular, 9, 16, 21, 23, 28, 38, 42, 43, 46, 117, 122 Intraperitoneal, 12, 117 Intrathecal, 5, 9, 10, 14, 15, 17, 28, 29, 33, 46, 117 Intrinsic, 100, 117 K Kb, 80, 117 Ketamine, 16, 17, 28, 30, 38, 117 Ketorolac, 10, 15, 22, 23, 29, 30, 31, 49, 117 Ketorolac Tromethamine, 23, 29, 117 Kinetics, 6, 117 L Laceration, 16, 117 Lavage, 96, 117 Leukemia, 6, 117 Leukocytes, 33, 103, 112, 116, 117, 119, 121 Levo, 74, 117, 125 Lidocaine, 8, 9, 11, 14, 15, 22, 24, 47, 117 Ligands, 7, 63, 117 Ligation, 117 Lipid, 6, 117, 119 Lipophilic, 7, 117 Liver, 12, 99, 103, 104, 111, 113, 114, 117, 119, 123 Localized, 19, 117, 119, 123, 132 Lorazepam, 48, 118 Lordosis, 118, 123 Low Back Pain, 31, 118 Lumbar, 57, 117, 118 Lymph, 106, 107, 118 Lymph node, 106, 118 Lymphocytes, 49, 102, 117, 118 Lymphoid, 118 M Malignant, 5, 102, 118 Mechanical ventilation, 25, 118 Median Nerve, 24, 118 Mediate, 66, 110, 118 Mediator, 118, 128 Medical Records, 118, 127 MEDLINE, 81, 118 Membrane, 6, 103, 108, 112, 118, 126 Mental, iv, 3, 4, 33, 80, 82, 106, 110, 112, 116, 118, 125, 127, 128, 131 Metabolic acidosis, 28, 118 Metabolite, 6, 46, 115, 118

139

Methohexital, 14, 119 Methylphenidate, 5, 119 Metoclopramide, 14, 119 MI, 18, 97, 119 Microbe, 119, 130 Microglia, 103, 119 Midazolam, 8, 9, 11, 16, 17, 23, 26, 30, 36, 37, 38, 41, 42, 45, 46, 47, 119 Molecular, 6, 81, 83, 104, 108, 119, 123, 124, 126, 131 Molecule, 7, 102, 108, 110, 115, 119, 122, 126, 132 Monoamine, 49, 100, 110, 119, 128, 131 Monoamine Oxidase, 49, 100, 110, 119, 128, 131 Monocytes, 117, 119 Mononuclear, 33, 119 Motility, 116, 119, 128 Motion Sickness, 119, 120, 124 Mydriatic, 110, 120 Myocardium, 119, 120 Myopathy, 18, 120 N Nalbuphine, 5, 8, 16, 20, 36, 54, 120 Naltrexone, 54, 120 Naproxen, 13, 120 Narcolepsy, 110, 119, 120 Narcosis, 120 Narcotic, 58, 66, 74, 105, 113, 115, 119, 120, 122, 123, 125, 131 Nausea, 40, 47, 101, 102, 111, 120, 121, 131 Necrosis, 102, 116, 119, 120 Neonatal, 20, 36, 38, 48, 120 Nerve, 5, 54, 57, 59, 67, 99, 100, 101, 103, 104, 106, 110, 116, 118, 119, 120, 121, 124, 129, 131 Nervous System, 13, 100, 103, 106, 118, 120, 121, 129, 131 Neural, 119, 120 Neuroleptanalgesia, 120, 123 Neuroleptic, 102, 120, 121 Neuromuscular, 120, 122, 128, 131 Neurons, 7, 107, 110, 113, 120, 130 Neurotoxic, 99, 121 Neurotoxicity, 11, 37, 121 Neurotransmitter, 99, 100, 110, 115, 121, 129, 131 Neutrophils, 117, 121 Nitrogen, 46, 100, 121, 131 Nonmalignant, 17, 121 Norepinephrine, 99, 100, 110, 121 Nucleic acid, 121

Nucleus, 102, 103, 107, 109, 112, 116, 118, 119, 121 Nulliparous, 13, 121 O Ointments, 66, 111, 121 Oncology, 11, 30, 121 Ondansetron, 17, 121 Opiate, 119, 121 Opium, 119, 121 Orthopaedic, 31, 33, 121 Outpatient, 4, 17, 42, 121 Ovaries, 121, 131 Overdose, 95, 122 Oxidation, 109, 122 Oxycodone, 4, 122 Oxygen Consumption, 122, 126 Oxygenation, 22, 27, 116, 122 Oxygenator, 105, 122 P Palliative, 43, 122, 130 Palpation, 113, 122 Pancreas, 99, 122 Pancreatic, 22, 34, 122 Pancreatitis, 34, 60, 122 Pancuronium, 15, 122 Parenteral, 18, 41, 66, 122 Parkinsonism, 7, 44, 102, 122 Particle, 122, 128, 131 Pathologic, 99, 102, 109, 115, 122 Pelvis, 118, 121, 122, 132 Pemoline, 5, 122 Penicillin, 101, 122 Peptide, 100, 123, 124, 125 Periaqueductal Gray, 59, 123 Perinatal, 27, 28, 36, 37, 123 Perioperative, 47, 123 Peritoneal, 117, 123 Peritoneal Cavity, 117, 123 Pharmaceutical Solutions, 111, 123 Pharmacodynamic, 5, 6, 123 Pharmacokinetic, 6, 14, 123 Pharmacologic, 101, 123, 130 Phenoperidine, 46, 123 Phenyl, 123 Physiologic, 40, 100, 116, 123, 126, 128, 131 Pilot study, 29, 123 Placebo Effect, 49, 123 Plant Oils, 121, 123 Plants, 100, 103, 105, 107, 121, 123, 131 Plasma, 18, 22, 26, 42, 114, 123, 124 Plasmin, 19, 123, 124 Plasminogen, 123, 124

140

Meperidine

Plasminogen Activators, 123, 124 Pneumonia, 109, 124 Poisoning, 117, 120, 124 Polypeptide, 100, 123, 124, 133 Posterior, 111, 122, 124 Postoperative, 4, 9, 11, 12, 16, 22, 23, 30, 35, 40, 45, 46, 48, 54, 57, 59, 60, 117, 124 Potassium, 124, 126 Potentiating, 100, 124 Practice Guidelines, 82, 124 Precursor, 110, 121, 124, 131 Premedication, 9, 44, 124 Preoperative, 18, 124 Procaine, 117, 124 Progression, 7, 124 Progressive, 7, 107, 111, 120, 124 Promazine, 57, 124 Promethazine, 3, 8, 9, 14, 15, 16, 18, 25, 27, 28, 31, 36, 38, 40, 42, 44, 48, 124 Prophylaxis, 58, 125 Propofol, 26, 37, 41, 42, 49, 125 Propoxyphene, 4, 125 Prospective study, 10, 125 Prostate, 113, 125 Protease, 125, 127 Protein C, 5, 103, 125 Protein S, 5, 104, 125 Protein Subunits, 5, 125 Proteins, 5, 100, 102, 105, 107, 108, 119, 121, 123, 125, 126, 128 Proteolytic, 100, 108, 123, 124, 125 Pruritus, 115, 124, 125, 131 Psychiatry, 33, 42, 125, 129, 132 Psychic, 118, 120, 125, 127 Psychoactive, 125, 133 Psychomotor, 5, 120, 125 Psychotomimetic, 100, 110, 125 Public Policy, 81, 125 Pulmonary, 41, 104, 125, 130, 132 Pulmonary Artery, 104, 125, 132 Pulse, 96, 125 Pupil, 110, 120, 126 Q Quaternary, 122, 126 Quinidine, 41, 126 Quinine, 126 R Radiation, 103, 115, 126 Radiation therapy, 115, 126 Radioactive, 103, 115, 126 Rage, 123, 126

Randomized, 11, 13, 23, 26, 29, 30, 42, 46, 111, 126 Receptor, 5, 99, 102, 110, 115, 121, 126, 128 Receptors, Serotonin, 126, 128 Rectum, 108, 113, 125, 126 Refer, 1, 108, 120, 126, 131 Reflex, 123, 126 Regimen, 3, 111, 123, 126 Respiration, 22, 105, 109, 126, 127 Respirator, 118, 126 Respiratory Physiology, 127, 132 Response rate, 54, 127 Resuscitation, 59, 127 Retrospective, 3, 11, 16, 38, 127 Retrospective study, 3, 11, 16, 38, 127 Rheumatoid, 120, 127 Rheumatoid arthritis, 120, 127 Ribose, 99, 127 Risk factor, 125, 127 Risk patient, 45, 127 Ritonavir, 48, 127 Rotenone, 59, 127 S Saline, 24, 49, 127 Schizoid, 127, 132 Schizophrenia, 127, 132 Schizotypal Personality Disorder, 127, 132 Screening, 107, 127 Secretion, 33, 115, 119, 127 Sedative, 8, 100, 106, 107, 115, 118, 119, 124, 127 Seizures, 32, 35, 127 Sensibility, 101, 127 Sepsis, 118, 127 Serotonin, 33, 41, 45, 100, 102, 113, 119, 121, 126, 128, 131 Serotonin Syndrome, 33, 41, 128 Serum, 18, 45, 108, 128 Shivering, 8, 9, 10, 12, 15, 17, 18, 29, 33, 36, 40, 44, 48, 50, 128 Shock, 101, 128, 131 Side effect, 5, 45, 73, 99, 102, 106, 118, 128, 130 Skeletal, 109, 126, 128 Smooth muscle, 115, 119, 128, 129 Sodium, 13, 114, 120, 126, 128 Sound wave, 108, 128 Specialist, 87, 110, 128 Species, 37, 46, 103, 109, 112, 115, 126, 128, 129, 131, 132, 133 Specificity, 100, 128 Sphincter, 22, 34, 128

141

Spinal cord, 5, 102, 104, 106, 112, 117, 118, 120, 126, 128 Sprains and Strains, 118, 128 Steroid, 122, 129 Stimulant, 100, 110, 115, 119, 122, 129 Stimulus, 4, 116, 126, 129, 130 Stomach, 99, 103, 112, 113, 115, 117, 120, 123, 129 Stress, 105, 120, 127, 129, 132 Stupor, 120, 129 Subarachnoid, 22, 23, 47, 50, 114, 129 Subclinical, 127, 129 Subcutaneous, 16, 122, 129 Subspecies, 128, 129 Substance P, 118, 127, 129 Substrate, 7, 129, 131 Sufentanil, 9, 14, 48, 67, 129 Supplementation, 100, 129 Suppression, 129 Suppressive, 49, 129 Suspensions, 66, 129 Sympathomimetic, 100, 110, 112, 121, 129, 131 Symptomatic, 101, 122, 130 Symptomatology, 7, 130 Synapse, 99, 130, 131 Synthetic retinoid, 113, 130 Systemic, 6, 58, 74, 101, 102, 104, 112, 114, 126, 130 T Therapeutics, 12, 19, 26, 32, 34, 37, 40, 43, 58, 59, 74, 119, 130 Thoracic, 22, 104, 118, 130, 132 Thoracic Surgery, 22, 130 Thoracotomy, 39, 45, 130 Thorax, 118, 130 Threshold, 12, 13, 18, 33, 48, 112, 115, 130 Thrombin, 125, 130 Thrombomodulin, 125, 130 Thrombosis, 125, 130 Thyroid, 58, 130, 131 Tolerance, 5, 105, 130 Tonus, 123, 130 Topical, 9, 47, 130 Toxic, iv, 21, 50, 103, 109, 110, 130, 131 Toxicity, 6, 7, 13, 35, 49, 111, 130 Toxicology, 4, 37, 41, 46, 58, 82, 130 Toxin, 7, 130, 131

Trachea, 104, 130, 131 Tramadol, 4, 10, 22, 23, 29, 43, 50, 131 Transcutaneous, 57, 59, 131 Transduction, 5, 131 Transfection, 104, 131 Transmitter, 103, 110, 118, 121, 131 Transplantation, 44, 107, 131 Trauma, 49, 120, 122, 131 Tremor, 122, 131 Tryptophan, 128, 131 Tubal ligation, 9, 12, 24, 131 Tyramine, 119, 131 Tyrosine, 110, 131 U Uraemia, 122, 131 Urethra, 125, 131 Urine, 30, 104, 131 Urodynamic, 12, 131 Urokinase, 19, 132 Urticaria, 50, 101, 106, 115, 132 Uterus, 106, 116, 121, 131, 132 V Vascular, 17, 22, 41, 101, 114, 116, 124, 132 Vasculitis, 122, 132 Vasoconstriction, 33, 112, 132 Vasodilator, 110, 115, 132 Vector, 131, 132 Vein, 117, 132 Venlafaxine, 45, 132 Venous, 125, 132 Ventilation, 22, 48, 132 Ventricle, 125, 132 Vertebrae, 116, 128, 132 Veterinary Medicine, 81, 132 Viral, 131, 132 Virulence, 103, 130, 132 Virus, 103, 106, 131, 132 Vitro, 132 Vivo, 132 W Windpipe, 130, 132 Withdrawal, 49, 132 Wound Healing, 66, 133 X Xenograft, 6, 133 Z Zymogen, 125, 133

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