PHENTERMINE 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
ii
ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2003 by ICON Group International, Inc. Copyright 2003 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., 1960Phentermine: 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: 0-597-83633-7 1. Phentermine-Popular works. I. Title.
iii
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.
v
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 phentermine. 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.
vi
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.
vii
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
ix
Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON PHENTERMINE .......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Phentermine .................................................................................. 4 The National Library of Medicine: PubMed .................................................................................. 9 CHAPTER 2. NUTRITION AND PHENTERMINE ................................................................................ 25 Overview...................................................................................................................................... 25 Finding Nutrition Studies on Phentermine................................................................................. 25 Federal Resources on Nutrition ................................................................................................... 28 Additional Web Resources ........................................................................................................... 29 CHAPTER 3. ALTERNATIVE MEDICINE AND PHENTERMINE .......................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 32 General References ....................................................................................................................... 33 CHAPTER 4. DISSERTATIONS ON PHENTERMINE ............................................................................ 35 Overview...................................................................................................................................... 35 Dissertations on Phentermine...................................................................................................... 35 Keeping Current .......................................................................................................................... 35 CHAPTER 5. CLINICAL TRIALS AND PHENTERMINE ....................................................................... 37 Overview...................................................................................................................................... 37 Recent Trials on Phentermine...................................................................................................... 37 Keeping Current on Clinical Trials ............................................................................................. 37 CHAPTER 6. BOOKS ON PHENTERMINE .......................................................................................... 39 Overview...................................................................................................................................... 39 Book Summaries: Online Booksellers........................................................................................... 39 Chapters on Phentermine............................................................................................................. 39 CHAPTER 7. PERIODICALS AND NEWS ON PHENTERMINE ............................................................. 41 Overview...................................................................................................................................... 41 News Services and Press Releases................................................................................................ 41 Newsletter Articles ...................................................................................................................... 43 Academic Periodicals covering Phentermine ............................................................................... 43 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 47 Overview...................................................................................................................................... 47 NIH Guidelines............................................................................................................................ 47 NIH Databases............................................................................................................................. 49 Other Commercial Databases....................................................................................................... 51 APPENDIX B. PATIENT RESOURCES ................................................................................................. 53 Overview...................................................................................................................................... 53 Patient Guideline Sources............................................................................................................ 53 Finding Associations.................................................................................................................... 55 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 57 Overview...................................................................................................................................... 57 Preparation................................................................................................................................... 57 Finding a Local Medical Library.................................................................................................. 57 Medical Libraries in the U.S. and Canada ................................................................................... 57 ONLINE GLOSSARIES.................................................................................................................. 63 Online Dictionary Directories ..................................................................................................... 63
x
Contents
PHENTERMINE DICTIONARY................................................................................................... 65 INDEX ................................................................................................................................................ 85
1
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 phentermine 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 phentermine, 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 phentermine, 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 phentermine. 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 phentermine, 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 phentermine. The Editors
1
From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
3
CHAPTER 1. STUDIES ON PHENTERMINE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on phentermine.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and phentermine, 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 “phentermine” (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: •
Valvular Abnormalities and Cardiovascular Status Following Exposure to Dexfenfluramine or Phentermine/Fenfluramine Source: JAMA. 283(13):1703-1709. April 5, 2000. Summary: The authors studied 934 patients who had taken dexfenfluramine or a combination of phentermine and fenfluramine for at least 30 days sometime in the 14 months before the study began. They compared this data with that obtained from a control group of 539 untreated subjects. Their data indicate that the drugs are associated with an increased prevalence of aortic valve disease, but not with mitral valve disease.
•
The Combined Use of Phentermine and Dexfenfluramine in Weight Management Source: The Bariatrician. p.15-17. Spring 1997.
4
Phentermine
Contact: American Society of Bariatric Physicians, 5600 South Quebec, Suite 160-D, Englewood, CO 80111. (303) 770-2526. Summary: This article reports on a case study of four patients given a combination of phenteramine and dexfenfluramine for 4 weeks, then continued on dexfenfluramine only. The authors report rapid weight loss in the first week, followed by slowing but significant weight loss in the following 3 weeks. The authors conclude that the combination is safe and effective. •
Phentermine and Fenfluramine: The 'New' Obesity Drugs? Source: The Bariatrician. p.14-16. Summer 1997. Contact: American Society of Bariatric Physicians, 5600 South Quebec, Suite 160-D, Englewood, CO 80111. (303) 770-2526. Summary: This article discusses using phentermine and fenfluramine in combination, also known as phen-fen, to treat obesity. The authors state that obesity is a chronic condition and therefore requires long-term treatment, which is not an approved use of the drugs. For this reason, they say physicians may want to have patients complete a consent form for off-label use of the medications. The pharmacology and mechanism of action is described, and precautions for specific contra-indicating conditions, such as schizophrenia, pregnancy, lactation, and age are given. Suggested dosages and medication schedules are also included. The article concludes with the suggestion that the medications be used as part of a carefully supervised program which includes diet and exercise.
Federally Funded Research on Phentermine The U.S. Government supports a variety of research studies relating to phentermine. 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 phentermine. 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 phentermine. The following is typical of the type of information found when searching the CRISP database for phentermine: •
Project Title: ANALYSIS OF HEART RATE VARIABILITY Principal Investigator & Institution: Hirsch, Jules; Rockefeller University New York, NY 100216399 Timing: Fiscal Year 2001
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).
Studies
5
Summary: The control of energy metabolism in man involves a complex network of neural and humoral signals which include the autonomic nervous system. It is clear that the sympathetic division of the autonomic nervous system has an important role to play in these controls. Measures of epinephrine and norepinephrine are the usual techniques for evaluating sympathetic activity. The role of the parasympathetic nervous system has been much more difficult to evaluate. We have devised a technique of spectral analysis of heart rate variability and drug manipulation of heart rate that permits measures of autonomic input into the heart which we believe reflect autonomic activity elsewhere in the body. We have studied sympathetic and parasympathetic alteration as patients vary in body weight. We now wish to examine the effects on autonomic activity of phentermine hydrochloride, a drug commonly used to promote weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CENTRAL SEROTONERGIC PATHWAYS REGULATING ENERGY BALANCE Principal Investigator & Institution: Heisler, Lora K.; Beth Israel Deaconess Medical Center St 1005 Boston, MA 02215 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-MAY-2007 Summary: (provided by applicant): Elucidating the basic neurobiology of energy homeostasis is paramount in the prevention and treatment of obesity and type II diabetes. Drugs that increase the activity of central serotonin (5-hydroxytryptamine, 5HT) have been widely used as appetite suppressants. However, these drugs often elicit unwanted side effects because they target multiple 5-HT pathways and receptors. A notable example is d-fenfluramine (d-Fen), a drug that blocks the reuptake of 5-HT and stimulates its release. In the mid-1990's, d-Fen was prescribed to millions of people in the United States for weight loss, frequently in combination with the sympathomimetic phentermine, but was withdrawn from clinical use in 1997 by the Food and Drug Administration due to reports of adverse cardiopulmonary events. The purpose of this proposal is to delineate the central nervous system (CNS) pathways through which drugs such as d-Fen selectively mediate their effects on food intake. We have strong preliminary data indicating that these drugs exert their effect on energy homeostasis by engaging melanocortin pathways. These central melanocortin pathways, through the melanocortin-4 receptors (MC4-Rs), have potent effects on metabolic-hormonal, neuroendocrine, and behavioral parameters associated with energy balance. In this proposal, we will assess whether 5-HT drugs selectively affect energy homeostasis through a necessary downstream activation of MC4-Rs. We propose a model of the mechanism of serotonergic drug action in which activation of specific serotonergic receptors increases the release of the endogenous MC4-R agonist alpha-melanocyte stimulating hormone (alpha-MSH) and inhibits the release of the endogenous antagonist agouti related peptide (AgRP). We will determine whether serotonergic diet drugs require functional downstream MC4-Rs to exert their effect. We offer a series of behavioral, physiological, genetic, and electrophysiological experiments to test components of our model. Data generated from this proposal have the potential to not only delineate the interaction between two key pathways regulating energy homeostasis, but to also identify a promising and very selective target for the prevention and treatment of obesity and type II diabetes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
6
Phentermine
•
Project Title: FUNCTIONAL AMPHETAMINES
MONOAMINE
DEFICITS
INDUCED
BY
Principal Investigator & Institution: John, Carrie E.; Physiology and Pharmacology; Wake Forest University Health Sciences Winston-Salem, NC 27157 Timing: Fiscal Year 2003; Project Start 18-SEP-2003; Project End 10-APR-2006 Summary: (provided by applicant): This application proposes to assess the acute and chronic effects of methamphetamine (METH) and 3,4methylenedioxymethamphetamine (MDMA) on dopamine (DA) and serotonin (5-HT) terminal function and evaluate the relationship between DA and 5-HT neurotoxicity. We will first compare the effects of METH and MDMA on monoamine terminal function acutely in mouse brain slices. Then we will evaluate terminal function recovery following a repeated administration paradigm. Voltammetry at carbon fiber electrodes will be used to measure release and uptake of DA and 5-HT in brain slices. With the use of the DA and the 5-HT transporter knockout mouse lines, and the selective neurotoxins phentermine and fenfluramine, we will evaluate whether DA influences 5-HT neurotoxicity, and vice versa. The research proposed will provide valuable insights into the differential long-term impact of amphetamine derivatives on monoamine systems and the potential interactions between DA and 5-HT in inducing neurotoxicity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LONG TERM CARDIAC EFFECTS WITH FENFLURAMINEPHENTERMINE Principal Investigator & Institution: Eichelberger, James; University of Rochester Orpa Rc Box 270140 Rochester, NY 14627 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: PHARMACOLOGIC INDUCTION OF WEIGHT LOSS TO TREAT TYPE II DIABETES MELLITUS Principal Investigator & Institution: Bantle, John P.; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, MN 554552070 Timing: Fiscal Year 2001 Summary: Weight loss is an important therapeutic objective for most patients with type II diabetes mellitus. This protocol was a double blind, placebo controlled study of the usefulness of the appetite suppressants fenfluramine and phentermine in the treatment of overweight type II diabetic subjects. However, fenfluramine was withdrawn from the study in September, 1997, when it was withdrawn from the U.S. market. Treatment with appetite suppressants resulted in significant reductions in body weight, body mass index and Hgb AlC at all time points through 10 months. Follow-up of subjects continues. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: PHARMACOLOGICAL MODULATION OF COCAINE EFFECTS Principal Investigator & Institution: Bigelow, George E.; Professor and Director; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218
Studies
7
Timing: Fiscal Year 2001; Project Start 30-SEP-1987; Project End 31-DEC-2002 Summary: (Applicant's Abstract) This is a proposal to renew an ongoing, productive human laboratory research project directed toward identification and development of medications for treatment of cocaine dependence. The project has developed and will use an efficient and sensitive human laboratory screening procedure to assess the effects of potential pharmacotherapeutic approaches. The goal is to identify medications that modulate the abuse liability of cocaine or craving for cocaine. Within a residential laboratory volunteer experienced cocaine abusers will be challenged with intravenous cocaine. Challenge sessions consist of a series of ascending doses of i.v. cocaine at one-hr intervals, yielding a dose-effect characterization of the profile and time course of cocaine's subjective and physiological effects. Potential pharmacotherapies are evaluated by superimposing the cocaine challenge test procedure on a schedule of chronic ascending-dose administration (and then discontinuation) of the potential pharmacotherapy -- yielding a dose-effect characterization of the effects of the pharmacotherapy alone, and of its modulation of or interaction with the cocaine response. Medications that alter cocaine response may have potential as anti-cocaine pharmacotherapies, or may help identify mechanisms relevant to developing such pharmacotherapies. Assessment will be multidimensional, including subjective, behavioral, and physiological. Intensive electrocardiologic recordings will assess for potential cardiologic effects relevant to safety of the test medications, including disturbances of autonomic balance as indicated by heart rate variability indices. Potential pharmacotherapeutic approaches to be tested include: oral cocaine (testing the feasibility of an agonist-substitution approach to cocaine dependence pharmacotherapy); the neuroleptic and dopamine partial agonist (+)UH232; the serotonergic agent tryptophan; a dopamine D-1 antagonist; a blocker of cocaine binding at the dopamine transporter; the combination of phentermine and fenfluramine, which combines dopaminergic and serotonergic activities; and/or other promising agents that become available for human testing during the term of this project. These studies will provide valuable data concerning both the safety and the potential efficacy of the tested pharmacotherapies alone and in combination with cocaine. This may be an efficient procedure for identifying pharmacotherapies sufficiently promising to warrant outpatient therapeutic trials. By testing in the laboratory some pharmacotherapies that also receive outpatient clinical trial evaluation, this project will help to address the relative merits of human laboratory studies versus outpatient clinical trials as strategies for drug abuse medications development research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: POTENTIAL TREATMENT MEDICATIONS FOR DRUG ABUSE Principal Investigator & Institution: Blough, Bruce E.; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, NC 27709 Timing: Fiscal Year 2001; Project Start 30-SEP-1999; Project End 30-APR-2003 Summary: The major goal of this application is to discover and develop medications for the treatment of substance abuse. The compounds developed will also serve as biochemical probes useful in gaining a better understanding of the biochemical and molecular mechanisms of cocaine and amphetamine addiction and withdrawal. Clinical evidence indicates that the anorectic therapy PHEN/FEN, a combination of releasers phentermine (DA releaser) and fenfluramine (5-HT releaser) decreases cocaine dependence; the primary objective of this application is to discover and develop novel classes of dual releasers which mimic the combination therapy. The scope of this study will include: (1) the synthesis of several small molecule libraries based on known
8
Phentermine
releasers concurrent with the synthesis other potential small phenylamine scaffolds; (2) in vitro evaluation of the compounds using a high throughput releaser assay; (3) the development of a theoretical model for selective releaser activity; and (4) in vivo evaluation in animal models. The "dopamine hypothesis" of cocaine reward which drives much of current addiction research has failed to find DAergic medications. Some recent evidence suggests that the reward mechanism may involve 5-HT in a much larger way than previously thought. A "dual deficit" model for cocaine reward is thus the basis for the project. Compounds that demonstrate DA and 5-HT releasing activity, but not NE, will be tested for NE uptake. Candidates will also be evaluated for 5-HT2A, MAOA, and MAO-B in vitro activity. Compounds which fit our in vitro criteria will be tested in vivo for neurotoxicity and their releasing properties confirmed via in vivo microdialysis. We will also submit interesting candidates to the NIDA Cocaine Treatment Discovery Program for further in vitro and in vivo evaluation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PSYCHOTHERAPY AND MEDICATION FOR BINGE EATING DISORDER Principal Investigator & Institution: Devlin, Michael J.; Associate Professor; New York State Psychiatric Institute 1051 Riverside Dr New York, NY 10032 Timing: Fiscal Year 2001; Project Start 01-APR-1997; Project End 31-MAR-2003 Summary: Binge Eating Disorder (BED) is a recently described eating disorder characterized by binge eating not accompanied by compensatory behavior such as purging, but associated with significant stress. A large proportion of patients with BED are overweight. When presenting for weight control treatment, they exhibit, in addition to their eating disorder, higher rates of associated psychopathology compared to other overweight patients, particularly depressive symptoms. This study will examine the relative and additive efficacy of two contrasting treatments for BED: individual cognitive behavioral therapy (CBT) and medication. The study sample will consist of 120 overweight patients with BED. All patients will receive standard group behavioral treatment, and the study will determine whether individual CBT, medication, or both CBT and medication confer significant additional benefit compared to this standard treatment. The medications used will be phentermine and fluoxetine, a regimen based on literature suggesting the efficacy of a combination of stimulant and serotonergic agents in weight loss treatment, and on the demonstrated antidepressant efficacy of fluoxetine. Outcome variables will include frequency of binge eating, weight, and measures of overall psychological distress, including depressive symptoms. Treatment will take place over a period of five months, and patients will be followed for two years after treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
•
Project Title: SAFETY ASSESSMENT OF FENFLURAMINE/PHENTERMINE Principal Investigator & Institution: Ricaurte, George A.; Associate Professor; Neurology; Johns Hopkins University 3400 N Charles St Baltimore, MD 21218 Timing: Fiscal Year 2001; Project Start 01-SEP-1997; Project End 31-JUL-2003 Summary: (Applicant's Abstract) Results from two recent studies have led to the proposal that fenfluramine, when given in combination with phentermine, is effective in the treatment of drug abuse. While double-blind, placebo-controlled studies validating this proposal are not yet available, efforts to carry out such studies are underway. Since successful development of any pharmacologic drug abuse treatment
Studies
9
strategy will require information on both treatment safety and efficacy, the present studies are designed to assess the safety of fenfluramine/phentermine treatment. Safety concerns arise because there is a large body of preclinical data (including data in nonhuman primates) which strongly suggests that fenfluramine produces toxic effects on serotonin neurons in the central nervous system. While the serotonin neurotoxic potential of fenfluramine (alone or in combination with phentermine) is well documented in animals, its long-term effects in humans have not been investigated, largely because of the difficulty inherent in assessing serotonin neuronal integrity in the living human brain. Positron emission tomography (PET), when used in conjunction with neuron specific ligands, is an imaging technique that can now be used to study central serotonin neurons in humans during life. The present studies will therefore use PET imaging with the serotonin transporter ligand [11C]McN-5652, in conjunction with studies of CSF 5-HIAA, and serotonin-linked functions and behaviors, to assess the neurobiological effects of pharmacotherapy with fenfluramine and phentermine upon the structure and/or function of serotonin neurons in the living human brain. In this prospective, double-blind, placebo-controlled study, the following treatment groups will be used: 1) Fenfluramine/phentermine; 2) Fenfluramine alone; 3) Phentermine alone; 4) Placebo control; (n=15/group). Since the study cohort will consist of subjects undergoing treatment of obesity (where fenfluramine/phentermine is indicated and has efficacy), an additional control group will be incorporated (non-obese control group) to guard for possible effects of obesity per SE on serotonin measures. Subjects in all groups will undergo PET, CSF, neuroendocrine and functional studies of 5-HT-linked behaviors before and after treatment. Studies after treatment will be performed 4-8 weeks after completion of treatment, so as to measure long-rather short-term effects of treatment of serotonin neural indexes. The project's long-term goals are: 1) To better define the risks of fenfluramine/phentermine treatment in humans; and 2) To use obesity as a model for analyzing the risk/benefit ratio for fenfluramine and phentermine in the treatment of drug abuse. 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 phentermine, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “phentermine” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for “phentermine” (hyperlinks lead to article summaries):
3
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.
10 Phentermine
•
A comparative study of phentermine and diethylpropion in the treatment of obese patients in general practice. Author(s): Valle-Jones JC, Brodie NH, O'Hara H, O'Hara J, McGhie RL. Source: Pharmatherapeutica. 1983; 3(5): 300-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6844367&dopt=Abstract
•
A comparative trial of different regimens of fenfluramine and phentermine in obesity. Author(s): Steel JM, Munro JF, Duncan LJ. Source: Practitioner. 1973 August; 211(262): 232-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4580610&dopt=Abstract
•
A comparison of tyrosine against placebo, phentermine, caffeine, and Damphetamine during sleep deprivation. Author(s): Waters WF, Magill RA, Bray GA, Volaufova J, Smith SR, Lieberman HR, Rood J, Hurry M, Anderson T, Ryan DH. Source: Nutritional Neuroscience. 2003 August; 6(4): 221-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887139&dopt=Abstract
•
A controlled trial of phentermine in obese diabetic patients. Author(s): Campbell CJ, Bhalla IP, Steel JM, Duncan LJ. Source: Practitioner. 1977 June; 218(1308): 851-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=329259&dopt=Abstract
•
A double-blind clinical evaluation of the safety and efficacy of phentermine hydrochloride (Fastin) in the treatment of exogenous obesity. Author(s): Langlois KJ, Forbes JA, Bell GW, Grant GF Jr. Source: Curr Ther Res Clin Exp. 1974 April; 16(4): 289-96. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4208343&dopt=Abstract
•
A double-blind clinical trial in weight control. Use of fenfluramine and phentermine alone and in combination. Author(s): Weintraub M, Hasday JD, Mushlin AI, Lockwood DH. Source: Archives of Internal Medicine. 1984 June; 144(6): 1143-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6375610&dopt=Abstract
•
A fatality involving phentermine. Author(s): Levine B, Caplan YH, Dixon AM. Source: J Forensic Sci. 1984 October; 29(4): 1242-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6502120&dopt=Abstract
Studies 11
•
A toxic reaction from combining fluoxetine and phentermine. Author(s): Bostwick JM, Brown TM. Source: Journal of Clinical Psychopharmacology. 1996 April; 16(2): 189-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8690835&dopt=Abstract
•
Acute interstitial nephritis following treatment with anorectic agents phentermine and phendimetrazine. Author(s): Markowitz GS, Tartini A, D'Agati VD. Source: Clinical Nephrology. 1998 October; 50(4): 252-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9799071&dopt=Abstract
•
Aortic and mitral fenfluramine-phentermine valvulopathy in 64 patients treated with anorectic agents. Author(s): Volmar KE, Hutchins GM. Source: Archives of Pathology & Laboratory Medicine. 2001 December; 125(12): 1555-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11735689&dopt=Abstract
•
Appetite suppressant drugs as inhibitors of human cytochromes P450: in vitro inhibition of P450-2D6 by D- and L-fenfluramine, but not phentermine. Author(s): von Moltke LL, Greenblatt DJ, Ciraulo DA, Grassi JM, Granda BW, Duan SX, Harmatz JS, Shader RI. Source: Journal of Clinical Psychopharmacology. 1998 August; 18(4): 338-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9690701&dopt=Abstract
•
Autopsy findings of heart and lungs in a patient with primary pulmonary hypertension associated with use of fenfluramine and phentermine. Author(s): Tomita T, Zhao Q. Source: Chest. 2002 February; 121(2): 649-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11834685&dopt=Abstract
•
Bipolar depression associated with fenfluramine and phentermine. Author(s): Zimmer JE, Gregory RJ. Source: The Journal of Clinical Psychiatry. 1998 July; 59(7): 383-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9714271&dopt=Abstract
•
Cerebral hemorrhage in a patient taking fenfluramine and phentermine for obesity. Author(s): Wen PY, Feske SK, Teoh SK, Stieg PE. Source: Neurology. 1997 August; 49(2): 632-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9270617&dopt=Abstract
12 Phentermine
•
Chronic treatment with phentermine combined with fenfluramine lowers plasma serotonin. Author(s): Rothman RB, Redmon JB, Raatz SK, Kwong CA, Swanson JE, Bantle JP. Source: The American Journal of Cardiology. 2000 April 1; 85(7): 913-5, A10. Erratum In: Am J Cardiol 2000 June 15; 85(12): 1511. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10758942&dopt=Abstract
•
Clinical and echocardiographic follow-up of patients previously treated with dexfenfluramine or phentermine/fenfluramine. Author(s): Gardin JM, Weissman NJ, Leung C, Panza JA, Fernicola D, Davis KD, Constantine GD, Reid CL. Source: Jama : the Journal of the American Medical Association. 2001 October 24-31; 286(16): 2011-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11667938&dopt=Abstract
•
Combination of the dopaminergic agent, phentermine, and the serotonergic agent, fenfluramine, in the treatment of cocaine dependence. Author(s): Kampman KM, Volpicelli J. Source: Journal of Substance Abuse Treatment. 1997 July-August; 14(4): 401-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9368218&dopt=Abstract
•
Comparison of phentermine-amphetamine resin complex with sustained-release dextroamphetamine and placebo in the treatment of exogenous obesity. Author(s): De Felice EA, Cohen A, Schmitz PL, Rothwell KG, Truant AP. Source: J Clin Pharmacol J New Drugs. 1968 November-December; 8(6): 360-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4883784&dopt=Abstract
•
Comparison of the acute physical and mental effects of ephedrine, fenfluramine, phentermine and prolintane. Author(s): Kuitunen T, Karkkainen S, Ylitalo P. Source: Methods Find Exp Clin Pharmacol. 1984 May; 6(5): 265-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6471970&dopt=Abstract
•
Complex vascular lesions at autopsy in a patient with phentermine-fenfluramin. Author(s): Widgren S. Source: Archives of Pathology & Laboratory Medicine. 2000 June; 124(6): 801-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10835505&dopt=Abstract
Studies 13
•
Complex vascular lesions at autopsy in a patient with phentermine-fenfluramine use and rapidly progressing pulmonary hypertension. Author(s): Strother J, Fedullo P, Yi ES, Masliah E. Source: Archives of Pathology & Laboratory Medicine. 1999 June; 123(6): 539-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10383810&dopt=Abstract
•
Death from irreversible pulmonary hypertension associated with short-term use of fenfluramine and phentermine. Author(s): Dillon KA, Putnam KG, Avorn JL. Source: Jama : the Journal of the American Medical Association. 1997 October 22-29; 278(16): 1320. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9343461&dopt=Abstract
•
Detailed examination of fenfluramine-phentermine users with valve abnormalities identified in Fargo, North Dakota. Author(s): Kimmel SE, Keane MG, Crary JL, Jones J, Kinman JL, Beare J, Sammel M, Sutton MS, Strom BL. Source: The American Journal of Cardiology. 1999 August 1; 84(3): 304-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10496440&dopt=Abstract
•
Determination of amphetamine and phentermine in biological fluids. Author(s): O'Brien JE, Zazulak W, Abbey V, Hinsvark O. Source: Journal of Chromatographic Science. 1972 May; 10(5): 336-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5054850&dopt=Abstract
•
Dexfenfluramine, fenfluramine, and phentermine for the treatment of morbid obesity. Author(s): Torretta LK. Source: Journal of the American Academy of Nurse Practitioners. 1997 August; 9(8): 38994, Quiz 395-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9325813&dopt=Abstract
•
Does phentermine inhibit monoamine oxidase? Author(s): Rothman RB. Source: Lancet. 1999 April 17; 353(9161): 1362-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10218558&dopt=Abstract
14 Phentermine
•
Dose and duration of fenfluramine-phentermine therapy impacts the risk of significant valvular heart disease. Author(s): Lepor NE, Gross SB, Daley WL, Samuels BA, Rizzo MJ, Luko SP, Hickey A, Buchbinder NA, Naqvi TZ. Source: The American Journal of Cardiology. 2000 July 1; 86(1): 107-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10867106&dopt=Abstract
•
Dose effect of fenfluramine-phentermine in the production of valvular heart disease. Author(s): Tovar EA, Landa DW, Borsari BE. Source: The Annals of Thoracic Surgery. 1999 April; 67(4): 1213-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10320298&dopt=Abstract
•
Double-blind comparison of efficacy, safety, and side effects of Bionamin, phentermine compound, and placebo in the treatment of exogenous obesity. Author(s): Cohen A, De Felice EA, Leb SM, Fuentes JG, Rothwell KG, Truant AP. Source: Curr Ther Res Clin Exp. 1968 July; 10(7): 323-34. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4969672&dopt=Abstract
•
Echocardiographic improvement over time after cessation of use of fenfluramine and phentermine. Author(s): Hensrud DD, Connolly HM, Grogan M, Miller FA, Bailey KR, Jensen MD. Source: Mayo Clinic Proceedings. 1999 December; 74(12): 1191-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10593346&dopt=Abstract
•
Echocardiographic prevalence of mitral and/or aortic regurgitation in patients exposed to either fenfluramine-phentermine combination or to dexfenfluramine. Author(s): Kancherla MK, Salti HI, Mulderink TA, Parker M, Bonow RO, Mehlman DJ. Source: The American Journal of Cardiology. 1999 December 1; 84(11): 1335-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10614800&dopt=Abstract
•
Effects of tyrosine, phentermine, caffeine D-amphetamine, and placebo on cognitive and motor performance deficits during sleep deprivation. Author(s): Magill RA, Waters WF, Bray GA, Volaufova J, Smith SR, Lieberman HR, McNevin N, Ryan DH. Source: Nutritional Neuroscience. 2003 August; 6(4): 237-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12887140&dopt=Abstract
•
Endocardial fibrosis associated with fenfluramine-phentermine. Author(s): Fowles RE, Cloward TV, Yowell RL. Source: The New England Journal of Medicine. 1998 April 30; 338(18): 1316. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9565497&dopt=Abstract
Studies 15
•
Evaluation of phentermine and fenfluramine, alone and in combination, in normal, healthy volunteers. Author(s): Brauer LH, Johanson CE, Schuster CR, Rothman RB, de Wit H. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 1996 April; 14(4): 233-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8924191&dopt=Abstract
•
Fatal pulmonary hypertension associated with short-term use of fenfluramine and phentermine. Author(s): Mark EJ, Patalas ED, Chang HT, Evans RJ, Kessler SC. Source: The New England Journal of Medicine. 1997 August 28; 337(9): 602-6. Erratum In: N Engl J Med 1997 November 13; 337(20): 1483. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9271482&dopt=Abstract
•
Fenfluramine and phentermine and cardiovascular findings: effect of treatment duration on prevalence of valve abnormalities. Author(s): Jollis JG, Landolfo CK, Kisslo J, Constantine GD, Davis KD, Ryan T. Source: Circulation. 2000 May 2; 101(17): 2071-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10790349&dopt=Abstract
•
Fenfluramine and phentermine. Author(s): Shuster J. Source: Nursing. 1997 February; 27(2): 69. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9171612&dopt=Abstract
•
Fluorometric determination of DL-fenfluramine, DL-norfenfluramine and phentermine in plasma by achiral and chiral high-performance liquid chromatography. Author(s): Kaddoumi A, Nakashima MN, Nakashima K. Source: J Chromatogr B Biomed Sci Appl. 2001 November 5; 763(1-2): 79-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11710586&dopt=Abstract
•
Further cases of valvular heart disease associated with fenfluramine-phentermine. Author(s): Graham DJ, Green L. Source: The New England Journal of Medicine. 1997 August 28; 337(9): 635. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9280830&dopt=Abstract
•
Gas-liquid chromatographic determination of phentermine in human plasma following oral administration to healthy subjects. Author(s): Dadgar D, Climax J, Lambe R, Darragh A. Source: Journal of Chromatography. 1985 January 11; 337(1): 136-41. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3980643&dopt=Abstract
16 Phentermine
•
Internet pharmacy prescription and phentermine overdose. Author(s): Takeshita J. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 215. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633132&dopt=Abstract
•
Is phentermine an inhibitor of monoamine oxidase? A critical appraisal. Author(s): Rothman RB. Source: Synapse (New York, N.Y.). 1999 May; 32(2): 141-5. Retraction In: http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10231134&dopt=Abstract
•
Isolation of drugs with macroreticular resins. Determination of phentermine in blood. Author(s): Vycudilik W. Source: Journal of Chromatography. 1975 September 3; 111(2): 439-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1159023&dopt=Abstract
•
Letter: Phentermine addiction and thyroxine abuse associated with hypothyroidism. Author(s): Valenta LJ. Source: The American Journal of Psychiatry. 1975 May; 132(5): 569. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1119631&dopt=Abstract
•
Long-term weight control study. I (weeks 0 to 34). The enhancement of behavior modification, caloric restriction, and exercise by fenfluramine plus phentermine versus placebo. Author(s): Weintraub M, Sundaresan PR, Madan M, Schuster B, Balder A, Lasagna L, Cox C. Source: Clinical Pharmacology and Therapeutics. 1992 May; 51(5): 586-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1587072&dopt=Abstract
•
Long-term weight control study. II (weeks 34 to 104). An open-label study of continuous fenfluramine plus phentermine versus targeted intermittent medication as adjuncts to behavior modification, caloric restriction, and exercise. Author(s): Weintraub M, Sundaresan PR, Schuster B, Ginsberg G, Madan M, Balder A, Stein EC, Byrne L. Source: Clinical Pharmacology and Therapeutics. 1992 May; 51(5): 595-601. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1587073&dopt=Abstract
•
Long-term weight control study. III (weeks 104 to 156). An open-label study of dose adjustment of fenfluramine and phentermine. Author(s): Weintraub M, Sundaresan PR, Schuster B, Moscucci M, Stein EC. Source: Clinical Pharmacology and Therapeutics. 1992 May; 51(5): 602-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1587074&dopt=Abstract
Studies 17
•
Low prevalence of valvular heart disease in 226 phentermine-fenfluramine protocol subjects prospectively followed for up to 30 months. Author(s): Burger AJ, Sherman HB, Charlamb MJ, Kim J, Asinas LA, Flickner SR, Blackburn GL. Source: Journal of the American College of Cardiology. 1999 October; 34(4): 1153-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10520805&dopt=Abstract
•
Lower dosages of phentermine-fenfluramine given in the afternoon: five cases with significant weight loss. Author(s): Katz DA, Maloney MJ, Sutkamp JC, McConville BJ. Source: The International Journal of Eating Disorders. 1999 May; 25(4): 469-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10202659&dopt=Abstract
•
Metabolism of chlorphentermine and phentermine in man to yield hydroxylamino, C-nitroso- and nitro-compounds. Author(s): Beckett AH, Belanger PM. Source: The Journal of Pharmacy and Pharmacology. 1974 March; 26(3): 205-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4151081&dopt=Abstract
•
Open treatment of overweight binge eaters with phentermine and fluoxetine as an adjunct to cognitive-behavioral therapy. Author(s): Devlin MJ, Goldfein JA, Carino JS, Wolk SL. Source: The International Journal of Eating Disorders. 2000 November; 28(3): 325-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10942919&dopt=Abstract
•
Peripheral vasculopathy and nephropathy in association with phentermine. Author(s): Jefferson HJ, Jayne DR. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 1999 July; 14(7): 1761-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10435891&dopt=Abstract
•
Phentermine (Duromine) for obese diabetics. Author(s): Jackson WP, Vinik AI. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1976 August 14; 50(35): 1351. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=968682&dopt=Abstract
18 Phentermine
•
Phentermine and other monoamine-oxidase inhibitors may increase plasma serotonin when given with fenfluramines. Author(s): Maher TJ, Ulus IH, Wurtman RJ. Source: Lancet. 1999 January 2; 353(9146): 38. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10023954&dopt=Abstract
•
Phentermine and psychosis. Author(s): Devan GS. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1990 March; 156: 442-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2346853&dopt=Abstract
•
Phentermine inhibition of recombinant human liver monoamine oxidases A and B. Author(s): Nandigama RK, Newton-Vinson P, Edmondson DE. Source: Biochemical Pharmacology. 2002 March 1; 63(5): 865-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11911838&dopt=Abstract
•
Phentermine resin as an adjunct in medical weight reduction: a controlled, randomized, double-blind prospective study. Author(s): Truant AP, Olon LP, Cobb S. Source: Curr Ther Res Clin Exp. 1972 November; 14(11): 726-38. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4629111&dopt=Abstract
•
Phentermine self-administration in naive free-feeding and food-deprived rats: a dose response study. Author(s): Papasava M, Singer G, Papasava CL. Source: Psychopharmacology. 1985; 85(4): 410-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3927335&dopt=Abstract
•
Phentermine, psychosis, and family history. Author(s): Cleare AJ. Source: Journal of Clinical Psychopharmacology. 1996 December; 16(6): 470-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8959483&dopt=Abstract
•
Phentermine--resin or salt--there are differences. Author(s): Coyne TC. Source: Archives of Internal Medicine. 1997 November 10; 157(20): 2381-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9361582&dopt=Abstract
Studies 19
•
Plasma phentermine levels, weight loss and side-effects. Author(s): Douglas A, Douglas JG, Robertson CE, Munro JF. Source: International Journal of Obesity. 1983; 7(6): 591-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6654575&dopt=Abstract
•
Possible association of ischemic stroke with phentermine. Author(s): Kokkinos J, Levine SR. Source: Stroke; a Journal of Cerebral Circulation. 1993 February; 24(2): 310-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8421834&dopt=Abstract
•
Pregnancy outcomes after first trimester exposure to phentermine/fenfluramine. Author(s): Jones KL, Johnson KA, Dick LM, Felix RJ, Kao KK, Chambers CD. Source: Teratology. 2002 March; 65(3): 125-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11877776&dopt=Abstract
•
Psychological treatment of obesity with phentermine resin as an adjunct. Author(s): Roberts CR. Source: The American Journal of Psychiatry. 1978 August; 135(8): 936-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=665837&dopt=Abstract
•
Psychotic mania associated with fenfluramine and phentermine use. Author(s): Raison CL, Klein HM. Source: The American Journal of Psychiatry. 1997 May; 154(5): 711. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9137134&dopt=Abstract
•
Regression and progression of valvulopathy associated with fenfluramine and phentermine. Author(s): Dahl CF, Allen MR. Source: Annals of Internal Medicine. 2002 March 19; 136(6): 489. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11900508&dopt=Abstract
•
Regression of multivalvular regurgitation after the cessation of fenfluramine and phentermine treatment. Author(s): Cannistra LB, Cannistra AJ. Source: The New England Journal of Medicine. 1998 September 10; 339(11): 771. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9742026&dopt=Abstract
•
Ruptured retroperitoneal aneurysm in a patient taking phentermine hydrochloride. Author(s): Sobel RM. Source: The American Journal of Emergency Medicine. 1999 January; 17(1): 102-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9928715&dopt=Abstract
20 Phentermine
•
Schizophreniform-like psychotic disorder induced by phentermine: a case report. Author(s): Lee SH, Liu CY, Yang YY. Source: Zhonghua Yi Xue Za Zhi (Taipei). 1998 January; 61(1): 44-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9509692&dopt=Abstract
•
Serial echocardiographic and clinical evaluation of valvular regurgitation before, during, and after treatment with fenfluramine or dexfenfluramine and mazindol or phentermine. Author(s): Ryan DH, Bray GA, Helmcke F, Sander G, Volaufova J, Greenway F, Subramaniam P, Glancy DL. Source: Obesity Research. 1999 July; 7(4): 313-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10440587&dopt=Abstract
•
Simultaneous determination of fenfluramine and phentermine in urine using gas chromatography mass spectrometry with pentafluoropropionic anhydride derivatization. Author(s): Palmer RB, Kim NH, Dasgupta A. Source: Therapeutic Drug Monitoring. 2000 August; 22(4): 418-22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10942181&dopt=Abstract
•
Smoking cessation in a patient being treated with fenfluramine plus phentermine for simple obesity. Author(s): Rothman RB. Source: The Journal of Clinical Psychiatry. 1996 February; 57(2): 92-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8591979&dopt=Abstract
•
Steady-state pharmacokinetics of phentermine extended-release capsules. Author(s): Groenewoud G, Schall R, Hundt HK, Muller FO, van Dyk M. Source: Int J Clin Pharmacol Ther Toxicol. 1993 August; 31(8): 368-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8225680&dopt=Abstract
•
Successful appetite suppression therapy with fenfluramine and phentermine in the obese diabetic transplant patient. Author(s): Khan M, Lum CT, Rao V. Source: Transplantation Proceedings. 1995 February; 27(1): 975-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7879251&dopt=Abstract
•
Sympathetic overactivity from fenfluramine-phentermine overdose. Author(s): Koury R, Stone CK, Stapczynski JS, Blake J. Source: European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine. 1999 June; 6(2): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10461560&dopt=Abstract
Studies 21
•
Synergistic interactions between fenfluramine and phentermine. Author(s): Wellman PJ, Maher TJ. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1999 July; 23(7): 723-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10454106&dopt=Abstract
•
The anorectic effect of a long-acting preparation of phentermine (duromine). Author(s): Silverstone T. Source: Psychopharmacologia. 1972; 25(4): 315-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4559293&dopt=Abstract
•
The combination of phentermine and fenfluramine reduced cocaine withdrawal symptoms in an open trial. Author(s): Kampman KM, Rukstalis M, Pettinati H, Muller E, Acosta T, Gariti P, Ehrman R, O'Brien CP. Source: Journal of Substance Abuse Treatment. 2000 July; 19(1): 77-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10867304&dopt=Abstract
•
The fenfluramine/phentermine combination for weight loss. Author(s): Garrett SD, Cupp MJ. Source: The Nurse Practitioner. 1997 August; 22(8): 166, 168, 170. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9279853&dopt=Abstract
•
The identification of P-hydroxyphentermine as a urinary metabolite of phentermine. Author(s): Cho AK. Source: Res Commun Chem Pathol Pharmacol. 1974 January; 7(1): 67-78. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4811460&dopt=Abstract
•
The influence of diuretics on the excretion and metabolism of doping agents. II. Phentermine. Author(s): Delbeke FT, Debackere M. Source: Arzneimittel-Forschung. 1986; 36(1): 134-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3954816&dopt=Abstract
•
The metabolism and urinary excretion in man of phentermine, and the influence of N-methyl and p-chloro-substitution. Author(s): Beckett AH, Brookes LG. Source: The Journal of Pharmacy and Pharmacology. 1971 April; 23(4): 288-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4396907&dopt=Abstract
22 Phentermine
•
Treatment of a 4-year-old boy with ADHD with the dopamine releaser phentermine. Author(s): Rothman RB. Source: The Journal of Clinical Psychiatry. 1996 July; 57(7): 308-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8666575&dopt=Abstract
•
Unusual hypotension and bradycardia in a patient receiving fenfluramine, phentermine, and fluoxetine. Author(s): Rich JM, Njo L, Roberts KW, Smith KP. Source: Anesthesiology. 1998 February; 88(2): 529-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9477076&dopt=Abstract
•
Use of dexfenfluramine, fenfluramine and phentermine and the risk of stroke. Author(s): Derby LE, Myers MW, Jick H. Source: British Journal of Clinical Pharmacology. 1999 May; 47(5): 565-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10336582&dopt=Abstract
•
Valvular abnormalities and cardiovascular status following exposure to dexfenfluramine or phentermine/fenfluramine. Author(s): Gardin JM, Schumacher D, Constantine G, Davis KD, Leung C, Reid CL. Source: Jama : the Journal of the American Medical Association. 2000 April 5; 283(13): 1703-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10755496&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Marshall EM. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1775; Author Reply 1775-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411252&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Spitzer WO. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1774-5; Author Reply 1775-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411251&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Wolff FW. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1774; Author Reply 1775-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411250&dopt=Abstract
Studies 23
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Redmon B, Raatz S, Bantle JP. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1773-4; Author Reply 1775. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411249&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Rasmussen S, Corya BC, Glassman RD. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1773; Author Reply 1775. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411248&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Kurz X, Van Ermen A. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1772-3; Author Reply 1775. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411247&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Thompson PD. Source: The New England Journal of Medicine. 1997 December 11; 337(24): 1772; Author Reply 1775. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411246&dopt=Abstract
•
Valvular heart disease associated with fenfluramine-phentermine. Author(s): Connolly HM, Crary JL, McGoon MD, Hensrud DD, Edwards BS, Edwards WD, Schaff HV. Source: The New England Journal of Medicine. 1997 August 28; 337(9): 581-8. Erratum In: N Engl J Med 1997 December 11; 337(24): 1783. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9271479&dopt=Abstract
•
Valvular heart disease in fenfluramine- phentermine-treated patients: a comparison with control patients. Author(s): Wadden TA, Silvestry FE, Aber JL, Berkowitz RI, Foster GD, Sutton MG. Source: Obesity Research. 1999 May; 7(3): 309-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10348504&dopt=Abstract
•
Virus-like particles in the mitral and tricuspid valves explanted from a patient treated with Fenfluramine-Phentermine. Author(s): Rothman RB. Synapse. 1999 Jul;33(1):81; discussion 82 Source: J Heart Valve Dis. 1999 March; 8(2): 232. No Abstract Available. /entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10400539
24 Phentermine
•
Weight reduction in osteoarthritis using phentermine. Author(s): Willims RA, Foulsham BM. Source: Practitioner. 1981 February; 225(1352): 231-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7022428&dopt=Abstract
25
CHAPTER 2. NUTRITION AND PHENTERMINE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and phentermine.
Finding Nutrition Studies on Phentermine 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 “phentermine” (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.
26 Phentermine
The following information is typical of that found when using the “Full IBIDS Database” to search for “phentermine” (or a synonym): •
A comparison of cocaine, GBR 12909, and phentermine self-administration by rhesus monkeys on a progressive-ratio schedule. Author(s): Department of Pharmacology and Therapeutics, Louisiana State University Medical Center, 1501 Kings Highway, Shreveport, LA 71130-3932, USA. Source: Stafford, D LeSage, M G Rice, K C Glowa, J R Drug-Alcohol-Depend. 2001 March 1; 62(1): 41-7 0376-8716
•
Behavioural and neurochemical characteristics of phentermine and fenfluramine administered separately and as a mixture in rats. Author(s): Preclinical Pharmacology Laboratory, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA. Source: Shoaib, M Baumann, M H Rothman, R B Goldberg, S R Schindler, C W Psychopharmacology-(Berl). 1997 June; 131(3): 296-306 0033-3158
•
Complex vascular lesions at autopsy in a patient with phentermine-fenfluramine use and rapidly progressing pulmonary hypertension. Author(s): Department of Pathology, University of California, San Diego, La Jolla, CA 92093-0624, USA. Source: Strother, J Fedullo, P Yi, E S Masliah, E Arch-Pathol-Lab-Med. 1999 June; 123(6): 539-40 0003-9985
•
Cytochemical demonstration of increased phospholipid content in cell membranes in chlorphentermine-induced phospholipidosis. Author(s): Department of Anatomy, Faculty of Medicine, Universite de Montreal, Quebec, Canada. Source: Coulombe, P A Bendayan, M J-Histochem-Cytochem. 1989 February; 37(2): 13947 0022-1554
•
Detailed examination of fenfluramine-phentermine users with valve abnormalities identified in Fargo, North Dakota. Author(s): Department of Medicine, Hospital of the University of Pennsylvania, and Center for Clinical Epidemiology, and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia 19104, USA.
[email protected] Source: Kimmel, S E Keane, M G Crary, J L Jones, J Kinman, J L Beare, J Sammel, M Sutton, M S Strom, B L Am-J-Cardiol. 1999 August 1; 84(3): 304-8 0002-9149
•
Effects of phentermine and fenfluramine on alcohol consumption and alcohol withdrawal seizures in rats. Author(s): Department of Psychology, Rutgers University, New Brunswick, NJ 08904, USA. Source: Halladay, A K Fisher, H Wagner, G C Alcohol. 2000 January; 20(1): 19-29 07418329
•
Effects of phentermine and fenfluramine on extracellular dopamine and serotonin in rat nucleus accumbens: therapeutic implications. Author(s): Clinical Psychopharmacology Section, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, Maryland 21224, USA. Source: Baumann, M H Ayestas, M A Dersch, C M Brockington, A Rice, K C Rothman, R B Synapse. 2000 May; 36(2): 102-13 0887-4476
Nutrition 27
•
Effects of phentermine on responding maintained by progressive-ratio schedules of cocaine and food delivery in rhesus monkeys. Author(s): Department of Pharmacology and Therapeutics, Louisiana State University Medical Center, Shreveport 71130-3932, USA. Source: Stafford, D LeSage, M G Glowa, J R Behav-Pharmacol. 1999 December; 10(8): 775-84 0955-8810
•
Effects of phentermine on responding maintained under multiple fixed-ratio schedules of food and cocaine presentation in the rhesus monkey. Author(s): Laboratory of Medicinal Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA. Source: Wojnicki, F H Rothman, R B Rice, K C Glowa, J R J-Pharmacol-Exp-Ther. 1999 February; 288(2): 550-60 0022-3565
•
Effects of phentermine on striatal dopamine and serotonin release in conscious rats: in vivo microdialysis study. Author(s): Massachusetts Institute of Technology, Cambridge, MA. Source: Balcioglu, A. Wurtman, R.J. International-journal-of-obesity-and-relatedmetabolic-disorders-:-journal-of-the-International-Association-for-the-Study-of-Obesity (USA). (April 1998). volume 22(4) page 325-328. rats serotonin dopamine appetite drugs dialysis filtration liquids toxins animal models
•
Inhibition of cocaine self-administration by fluoxetine or D-fenfluramine combined with phentermine. Author(s): Department of Psychology, Princeton University, Princeton, NJ 08544, USA. Source: Glatz, Andrew C Ehrlich, Michelle Bae, Richard S Clarke, Michelle J Quinlan, Patricia A Brown, Emily C Rada, Pedro Hoebel, Bartley G Pharmacol-BiochemBehavolume 2002 Jan-February; 71(1-2): 197-204 0091-3057
•
Long-term weight control study. I (weeks 0 to 34). The enhancement of behavior modification, caloric restriction, and exercise by fenfluramine plus phentermine versus placebo. Author(s): Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, NY. Source: Weintraub, M Sundaresan, P R Madan, M Schuster, B Balder, A Lasagna, L Cox, C Clin-Pharmacol-Ther. 1992 May; 51(5): 586-94 0009-9236
•
Long-term weight control study. II (weeks 34 to 104). An open-label study of continuous fenfluramine plus phentermine versus targeted intermittent medication as adjuncts to behavior modification, caloric restriction, and exercise. Author(s): Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, NY. Source: Weintraub, M Sundaresan, P R Schuster, B Ginsberg, G Madan, M Balder, A Stein, E C Byrne, L Clin-Pharmacol-Ther. 1992 May; 51(5): 595-601 0009-9236
•
Phentermine and fenfluramine. Preclinical studies in animal models of cocaine addiction. Author(s): Clinical Psychopharmacology Section, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, Maryland 21224, USA.
[email protected] Source: Rothman, R B Elmer, G I Shippenberg, T S Rea, W Baumann, M H Ann-N-YAcad-Sci. 1998 May 30; 84459-74 0077-8923
28 Phentermine
•
Phentermine pretreatment antagonizes the cocaine-induced rise in mesolimbic dopamine. Author(s): Clinical Psychopharmacology Section, DIR, NIDA, NIH, Baltimore, MD 21224, USA. Source: Rothman, R B Ayestas, M Baumann, M H Neuroreport. 1996 December 20; 8(1): 7-9 0959-4965
•
Phentermine/fenfluramine decreases cocaine self-administration in rhesus monkeys. Author(s): Department of Psychiatry, Uniformed Services University of the Health Science, Bethesda, MD 20814, USA. Source: Glowa, J R Rice, K C Matecka, D Rothman, R B Neuroreport. 1997 April 14; 8(6): 1347-51 0959-4965
•
Phentermine+fenfluramine produce cocaine-like discriminative cues. Author(s): Department of Pharmacology, Northeastern Ohio Universities, College of Medicine, Rootstown 44272, USA. Source: Schechter, M D McBurney, D Life-Sci. 1996; 59(20): PL303-8 0024-3205
•
Role of phospholipase C in chlorphentermine-induced pulmonary phospholipidosis in rat. Author(s): Department of Pharmacology, Faculty of Health Sciences, School of Medicine, University of Ottawa, Ontario, Canada. Source: Kacew, S Proc-Soc-Exp-Biol-Med. 1988 May; 188(1): 35-9 0037-9727
•
Successful appetite suppression therapy with fenfluramine and phentermine in the obese diabetic transplant patient. Author(s): University of Minnesota Medical School, Departments of Medicine and Surgery, Minneapolis. Source: Khan, M Lum, C T Rao, V Transplant-Proc. 1995 February; 27(1): 975-6 0041-1345
•
Use of dexfenfluramine, fenfluramine and phentermine and the risk of stroke. Author(s): The Boston Collaborative Drug Surveillance Program, Boston University Medical Center, 11 Muzzey Street, Lexington, MA 02173, USA. Source: Derby, L E Myers, M W Jick, H Br-J-Clin-Pharmacol. 1999 May; 47(5): 565-9 0306-5251
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
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
Nutrition 29
•
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/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
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
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMDHealth: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html
31
CHAPTER 3. ALTERNATIVE MEDICINE AND PHENTERMINE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to phentermine. 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 phentermine 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 “phentermine” (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 phentermine: •
Action of fenfluramine, phenylpropanolamine, phentermine and diethylpropion on acoustic startle in rats. Author(s): Kutscher CL. Source: Pharmacology, Biochemistry, and Behavior. 1987 August; 27(4): 749-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3659098&dopt=Abstract
•
Analysis and confirmation of synthetic anorexics in adulterated traditional Chinese medicines by high-performance capillary electrophoresis. Author(s): Ku YR, Chang YS, Wen KC, Ho LK. Source: J Chromatogr A. 1999 July 2; 848(1-2): 537-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10427768&dopt=Abstract
•
Herbal therapy for management of obesity: observations from a clinical endocrinology practice. Author(s): Sindler BH.
32 Phentermine
Source: Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2001 November-December; 7(6): 443-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11747280&dopt=Abstract •
Lysergic acid diethylamide (LSD) and exstrophy of the bladder. Author(s): Gelehrter TD. Source: The Journal of Pediatrics. 1970 December; 77(6): 1065-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5486624&dopt=Abstract
•
Misconceptions and misleading information prevail--less regulation does not mean less danger to consumers: dangerous herbal weight loss products. Author(s): Sardina J. Source: J Law Health. 1999-00; 14(1): 107-32. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187364&dopt=Abstract
•
Peripheral vascular tone on cardiac resuscitation. Author(s): Pearson JW, Redding JS. Source: Anesthesia and Analgesia. 1965 November-December; 44(6): 746-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5891904&dopt=Abstract
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/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMDHealth: http://my.webmd.com/drugs_and_herbs
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
Alternative Medicine 33
The following is a specific Web list relating to phentermine; 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 (some Web sites are subscription based): •
General Overview Obesity Source: Integrative Medicine Communications; www.drkoop.com
•
Herbs and Supplements Ephedra (Ma huang) Source: WholeHealthMD.com, LLC. www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,777,00.html Phentermine Source: Healthnotes, Inc. www.healthnotes.com
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.
35
CHAPTER 4. DISSERTATIONS ON PHENTERMINE Overview In this chapter, we will give you a bibliography on recent dissertations relating to phentermine. 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 “phentermine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on phentermine, we have not necessarily excluded nonmedical dissertations in this bibliography.
Dissertations on Phentermine 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 phentermine. 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: •
Biopharmaceutical Studies of Some Phentermine Tablet Formulations by Pandey, Ganga Shankar; Phd from University of Alberta (canada), 1973 http://wwwlib.umi.com/dissertations/fullcit/NK15301
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.
37
CHAPTER 5. CLINICAL TRIALS AND PHENTERMINE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning phentermine.
Recent Trials on Phentermine The following is a list of recent trials dedicated to phentermine.5 Further information on a trial is available at the Web site indicated. •
Cardiovascular System in Obesity: Effect of Treatment Condition(s): Heart Diseases; Obesity; Vascular Diseases Study Status: This study is completed. Sponsor(s): National Heart, Lung, and Blood Institute (NHLBI) Purpose - Excerpt: To determine the long-term efficacy of the combination therapy of phentermine and fenfluramine in conjunction with diet, exercise, and behavior modification in the treatment of simple, moderate obesity. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000506
Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions.
5
These are listed at www.ClinicalTrials.gov.
38 Phentermine
The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “phentermine” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: •
For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/
•
For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html
•
For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/
•
For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm
•
For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm
•
For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm
•
For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp
•
For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm
•
For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/
•
For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm
•
For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm
•
For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm
•
For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm
•
For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm
•
For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials
39
CHAPTER 6. BOOKS ON PHENTERMINE Overview This chapter provides bibliographic book references relating to phentermine. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on phentermine include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “phentermine” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “phentermine” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “phentermine” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Lose Weight!: Fen-Phen: Fenfluramine & Phentermine by Larry S. Hobbs, Edwin H. Ford; ISBN: 0963962590; http://www.amazon.com/exec/obidos/ASIN/0963962590/icongroupinterna
•
The Phentermine Fenfluramine Phenomenon by Raymond Glen, Yansen Oei (1996); ISBN: 0965234800; http://www.amazon.com/exec/obidos/ASIN/0965234800/icongroupinterna
Chapters on Phentermine In order to find chapters that specifically relate to phentermine, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and phentermine using the “Detailed Search” option. Go to the following
40 Phentermine
hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use 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 “Book Chapter.” Type “phentermine” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on phentermine: •
Weight-Loss Treatments for Overweight Individuals with Type 2 Diabetes Source: in Franz, M.J. and Bantle, J.P., eds. American Diabetes Association Guide to Medical Nutrition Therapy for Diabetes. Alexandria, VA: American Diabetes Association. 1999. p. 69-82. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $39.95 for members; $49.95 for nonmembers; plus shipping and handling. ISBN: 158040006X. Order number 561601. Summary: This chapter focuses on weight loss treatments for overweight people who have diabetes. Most people with type 2 diabetes are overweight, and this aggravates insulin resistance and impairs glucose disposal. Long term weight loss is difficult because energy intake, energy balance, and therefore body weight are controlled by the central nervous system. Available evidence suggests that obesity is caused by a defect in the hypothalamic control center or its biochemical signals, caloric intake in excess of that for which the control center can compensate, or some combination of these factors. Although standard weight reduction diets that restrict caloric intake are usually not effective, some people may achieve long term weight loss with them. Very low calorie diets (VLCDs) which provide 800 or fewer calories daily can produce substantial weight loss and rapid improvements in glycemia and lipemia in patients with type 2 diabetes; however, most people who follow VLCDs are not able to maintain long term weight loss. Although gastric reduction surgery is the most effective weight loss treatment for obese people with type 2 diabetes, data defining the benefits and risks are lacking. Studies have shown that fenfluramine and phentermine produce significant weight loss, but fenfluramine and dexfenfluramine have been withdrawn from the U.S. market. phentermine continues to be available, but as a single agent it appears to have limited efficacy. Other available pharmacologic weight loss agents include sibutramine and orlistat. Although available data suggest that weight loss drugs are an important approach to the treatment of overweight patients with type 2 diabetes, they also suggest that the drugs work only as long as they are taken. In addition, limited data on the efficacy and safety of phentermine, sibutramine, and orlistat are available. 1 figure. 4 tables. 47 references.
41
CHAPTER 7. PERIODICALS AND NEWS ON PHENTERMINE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover phentermine.
News Services and Press Releases One of the simplest ways of tracking press releases on phentermine 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 “phentermine” (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 phentermine. 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 “phentermine” (or synonyms). The following was recently listed in this archive for phentermine: •
Able Laboratories to market generic phentermine Source: Reuters Industry Breifing Date: September 04, 2001 http://www.reutershealth.com/archive/2001/09/04/business/links/20010904rglt007. html
42 Phentermine
•
UK pulls phentermine from the market Source: Reuters Industry Breifing Date: April 17, 2000 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 “phentermine” (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 “phentermine” (or synonyms). If you know the name of a company that is relevant to phentermine, 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 “phentermine” (or synonyms).
Periodicals and News 43
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “phentermine” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on phentermine: •
Diet Pills: Past and Future Source: AABA Newsletter. p.1-3. Winter/Spring 1998. Contact: American Anorexia Bulimia Association, 165 West 46 St., Suite 1108, New York, NY 10036. (212) 575-6200. Summary: Mickley reviews the state of diet medications in America as it relates to the treatment of eating disorders. She discusses the most popular medications, such as phentermine, diethylproprion, and others, as well as the new medication sibutramine. Finally, Mickley examines the future of obesity treatment and the directions of current research.
Academic Periodicals covering Phentermine Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to phentermine. In addition to these sources, you can search for articles covering phentermine 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.”
45
APPENDICES
47
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 Institute6: •
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/
6
These publications are typically written by one or more of the various NIH Institutes.
48 Phentermine
•
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
Physician Resources 49
NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 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:8 •
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
7
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). 8 See http://www.nlm.nih.gov/databases/databases.html.
50 Phentermine
•
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 Gateway9 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.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “phentermine” (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 891 15 6 See Details 0 912
HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 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.13 Simply search by “phentermine” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
9
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
10
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). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13
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.
Physician Resources 51
Coffee Break: Tutorials for Biologists14 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.15 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.16 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/.
14 Adapted 15
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. 16 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.
53
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 phentermine 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 phentermine. 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 phentermine. 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 “phentermine”:
54 Phentermine
•
Other Guides Eating Disorders http://www.nlm.nih.gov/medlineplus/eatingdisorders.html Stroke http://www.nlm.nih.gov/medlineplus/stroke.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 Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on phentermine. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
The Fen/Phen Phenomenon Source: San Diego, CA: American Council on Exercise, 1997. Contact: American Council on Exercise, 5820 Oberlin Dr., Suite 102, San Diego, CA 92121. (800) 529-8227. Summary: This article discusses the weight-loss drug combination fen/phen (fenfluramine and phentermine) in lay terms. The authors describe how the medications work and explain why the combination is more effective that either one alone. The authors stress that the combination is not for everyone and should be reserved for those individuals whose weight puts them at increased risk for disease.
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 phentermine. 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.
Patient Resources 55
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: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
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/
•
WebMDHealth: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to phentermine. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with phentermine. 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 phentermine. 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 “phentermine” (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
56 Phentermine
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 “phentermine”. 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 “phentermine” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. 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 “phentermine” (or a synonym) into the search box, and click “Submit Query.”
57
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.17
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
17
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
58 Phentermine
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)18: •
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/
18
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
Finding Medical Libraries 59
•
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/
60 Phentermine
•
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/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
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
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
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/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
Finding Medical Libraries 61
•
Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
•
New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
•
Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
•
Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
•
Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
•
Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
•
Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
•
Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
•
Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
•
Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
62 Phentermine
•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
•
Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
•
Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
•
Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
63
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
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
•
Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
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
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
•
Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
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).
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
•
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
65
PHENTERMINE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 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] Acoustic: Having to do with sound or hearing. [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] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] 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] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] 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] 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] 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] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics
66 Phentermine
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] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Aneurysm: A sac formed by the dilatation of the wall of an artery, a vein, or the heart. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [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] Antidepressant: A drug used to treat depression. [NIH] Aorta: The main trunk of the systemic arteries. [NIH] Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. 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] 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] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autopsy: Postmortem examination of the body. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form
Dictionary 67
salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [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] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [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 Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Bradycardia: Excessive slowness in the action of the heart, usually with a heart rate below 60 beats per minute. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]
Breakdown: A physical, metal, or nervous collapse. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH]
68 Phentermine
Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [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] Carbohydrates: The largest class of organic compounds, including starches, glycogens, cellulose, gums, and simple sugars. Carbohydrates are composed of carbon, hydrogen, and oxygen in a ratio of Cn(H2O)n. [NIH] Cardiac: Having to do with the heart. [NIH] 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] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [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] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [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] Chronic: A disease or condition that persists or progresses over a long period of time. [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]
Dictionary 69
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] Colloidal: Of the nature of a colloid. [EU] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [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] 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] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective
70 Phentermine
tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [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] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [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] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [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] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dexfenfluramine: The S-isomer of fenfluramine. It is a serotonin agonist and is used as an anorectic. Unlike fenfluramine, it does not possess any catecholamine agonist activity. [NIH] 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] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diethylproprion: An appetite suppressant prescribed in the treatment of obesity. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH]
Dictionary 71
Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Diuresis: Increased excretion of urine. [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] Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] 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] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [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] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endocrinology: A subspecialty of internal medicine concerned with the metabolism, physiology, and disorders of the endocrine system. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [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] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system
72 Phentermine
stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [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] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] 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] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Filtration: The passage of a liquid through a filter, accomplished by gravity, pressure, or vacuum (suction). [EU] 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] 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] Gastric: Having to do with the stomach. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [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]
Glomerulus: A tiny set of looping blood vessels in the nephron where blood is filtered in the kidney. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less
Dictionary 73
than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [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] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [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]
Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [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] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality
74 Phentermine
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] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [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] 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] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Joint: The point of contact between elements of an animal skeleton with the parts that surround and support it. [NIH] 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] Kinetic: Pertaining to or producing motion. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH]
Dictionary 75
Lethargy: Abnormal drowsiness or stupor; a condition of indifference. [EU] Library Services: circulation. [NIH]
Services offered to the library user. They include reference and
Lipase: An enzyme of the hydrolase class that catalyzes the reaction of triacylglycerol and water to yield diacylglycerol and a fatty acid anion. It is produced by glands on the tongue and by the pancreas and initiates the digestion of dietary fats. (From Dorland, 27th ed) EC 3.1.1.3. [NIH] Lipid: Fat. [NIH] Lipid A: Lipid A is the biologically active component of lipopolysaccharides. It shows strong endotoxic activity and exhibits immunogenic properties. [NIH] 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] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mazindol: Tricyclic anorexigenic agent unrelated to and less toxic than amphetamine, but with some similar side effects. It inhibits uptake of catecholamines and blocks the binding of cocaine to the dopamine uptake transporter. [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] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanin: The substance that gives the skin its color. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methamphetamine: A central nervous system stimulant and sympathomimetic with actions and uses similar to dextroamphetamine. The smokable form is a drug of abuse and is referred to as crank, crystal, crystal meth, ice, and speed. [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]
76 Phentermine
Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [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] Mitral Valve: The valve between the left atrium and left ventricle of the heart. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Motility: The ability to move spontaneously. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nephritis: Inflammation of the kidney; a focal or diffuse proliferative or destructive process which may involve the glomerulus, tubule, or interstitial renal tissue. [EU] Nephropathy: Disease of the kidneys. [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
Dictionary 77
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] 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] 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] 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] Norfenfluramine: A fenfluramine analog that inhibits serotonin uptake and may provoke release of serotonin. It is used as an appetite depressant and an experimental tool in animal studies. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Orlistat: A lipase inhibitor used for weight loss. Lipase is an enzyme found in the bowel that assists in lipid absorption by the body. Orlistat blocks this enzyme, reducing the amount of fat the body absorbs by about 30 percent. It is known colloquially as a "fat blocker." Because more oily fat is left in the bowel to be excreted, Orlistat can cause an oily anal leakage and fecal incontinence. Orlistat may not be suitable for people with bowel conditions such as irritable bowel syndrome or Crohn's disease. [NIH] Osteoarthritis: A progressive, degenerative joint disease, the most common form of arthritis, especially in older persons. The disease is thought to result not from the aging process but from biochemical changes and biomechanical stresses affecting articular cartilage. In the foreign literature it is often called osteoarthrosis deformans. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [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] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU]
78 Phentermine
Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [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] Phentermine: A central nervous system stimulant and sympathomimetic with actions and uses similar to those of dextroamphetamine. It has been used most frequently in the treatment of obesity. [NIH] Phenylalanine: An aromatic amino acid that is essential in the animal diet. It is a precursor of melanin, dopamine, noradrenalin, and thyroxine. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [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] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Pneumonia: Inflammation of the lungs. [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] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [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
Dictionary 79
severity. [EU] 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] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] 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] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] 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] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [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 hypertension: Abnormally high blood pressure in the arteries of the lungs. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [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] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [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]
80 Phentermine
Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] 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] Restoration: Broad term applied to any inlay, crown, bridge or complete denture which restores or replaces loss of teeth or oral tissues. [NIH] Resuscitation: The restoration to life or consciousness of one apparently dead; it includes such measures as artificial respiration and cardiac massage. [EU] Retroperitoneal: Having to do with the area outside or behind the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [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] 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] 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,
Dictionary 81
and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sibutramine: A drug used for the management of obesity that helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet. It works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. Side effects include dry mouth, headache, constipation, insomnia, and a slight increase in average blood pressure. In some patients it causes a higher blood pressure increase. [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] Sleep Deprivation: The state of being deprived of sleep under experimental conditions, due to life events, or from a wide variety of pathophysiologic causes such as medication effect, chronic illness, psychiatric illness, or sleep disorder. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]
Solitary Nucleus: Gray matter located in the dorsomedial part of the medulla oblongata associated with the solitary tract. The solitary nucleus receives inputs from most organ systems including the terminations of the facial, glossopharyngeal, and vagus nerves. It is a major coordinator of autonomic nervous system regulation of cardiovascular, respiratory, gustatory, gastrointestinal, and chemoreceptive aspects of homeostasis. The solitary nucleus is also notable for the large number of neurotransmitters which are found therein. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] 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] 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] 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] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH]
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] 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]
Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by
82 Phentermine
means of a tube and a device that acts on negative pressure. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Thrombus: An aggregation of blood factors, primarily platelets and fibrin with entrapment of cellular elements, frequently causing vascular obstruction at the point of its formation. Some authorities thus differentiate thrombus formation from simple coagulation or clot formation. [EU] Thyroid: A gland located near the windpipe (trachea) that produces thyroid hormone, which helps regulate growth and metabolism. [NIH] Thyroid Gland: A highly vascular endocrine gland consisting of two lobes, one on either side of the trachea, joined by a narrow isthmus; it produces the thyroid hormones which are concerned in regulating the metabolic rate of the body. [NIH] Thyrotropin: A peptide hormone secreted by the anterior pituitary. It promotes the growth of the thyroid gland and stimulates the synthesis of thyroid hormones and the release of thyroxine by the thyroid gland. [NIH] Thyroxine: An amino acid of the thyroid gland which exerts a stimulating effect on thyroid metabolism. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] 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] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH]
Dictionary 83
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] Tricuspid Valve: The valve consisting of three cusps situated between the right atrium and right ventricle of the heart. [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] Tubercle: A rounded elevation on a bone or other structure. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [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] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [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] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitro:
Descriptive of an event or enzyme reaction under experimental investigation
84 Phentermine
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] 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 cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH]
85
INDEX A Abdominal, 65, 77, 78, 80 Acoustic, 31, 65 Adenosine, 65, 67 Adjustment, 16, 65 Adrenergic, 65, 71, 72, 78, 82, 83 Adverse Effect, 65, 81 Age of Onset, 65, 83 Agonist, 65, 70, 71, 78 Alertness, 65, 67 Algorithms, 65, 67 Alkaloid, 65, 69 Alternative medicine, 42, 65 Amino acid, 65, 78, 79, 80, 81, 82, 83 Amphetamine, 10, 12, 13, 14, 65, 70, 75 Anal, 66, 77 Analog, 66, 77 Aneurysm, 19, 66 Animal model, 27, 66 Antagonism, 66, 67 Antidepressant, 66, 72 Aorta, 66, 83 Aortic Valve, 3, 66 Arteries, 66, 67, 70, 74, 75, 79 Arterioles, 66, 67, 68 Artery, 66, 67, 70, 74, 83 Articular, 66, 77 Astrocytes, 66, 76 Atrium, 66, 76, 83 Autonomic, 66, 77, 81, 82 Autonomic Nervous System, 66, 81, 82 Autopsy, 11, 12, 13, 26, 66 B Basal Ganglia, 66, 77 Base, 66, 74 Bile, 67, 72, 73, 75 Biochemical, 18, 40, 67, 77, 80 Biotechnology, 9, 42, 49, 67 Biotransformation, 67 Bladder, 32, 67, 74, 83 Blood Platelets, 67, 80 Blood pressure, 67, 73, 79, 81 Blood vessel, 67, 68, 72, 81, 82, 83 Body Mass Index, 67, 77 Bowel, 66, 67, 71, 77, 78 Bowel Movement, 67, 71 Bradycardia, 22, 67 Branch, 61, 67, 81 Breakdown, 67, 70, 72 C Caffeine, 10, 14, 67 Calcium, 67, 68, 69
Caloric intake, 40, 68 Capillary, 31, 68, 83 Capsules, 20, 68 Carbohydrates, 68 Cardiac, 32, 67, 68, 72, 76, 80 Cardiovascular, 3, 15, 22, 37, 66, 68, 81 Case report, 20, 68 Catecholamine, 68, 70, 71 Caudal, 68, 73, 77 Caudate Nucleus, 68, 77 Cell, 26, 65, 67, 68, 69, 70, 71, 72, 74, 76, 77, 78, 79, 80, 83 Cell membrane, 26, 68 Central Nervous System, 40, 65, 66, 67, 68, 69, 70, 71, 72, 73, 75, 76, 78, 80 Chin, 68, 75 Chronic, 4, 12, 68, 81 Clinical trial, 10, 37, 38, 49, 68, 70, 71, 79 Cloning, 67, 68 Coca, 69 Cocaine, 12, 21, 26, 27, 28, 69, 75 Colloidal, 69, 71 Combination Therapy, 37, 69 Complement, 69 Complementary and alternative medicine, 31, 33, 69 Complementary medicine, 31, 69 Computational Biology, 49, 69 Connective Tissue, 69, 70, 72 Consciousness, 70, 79, 80 Constipation, 70, 81 Consumption, 26, 70, 80 Contraindications, ii, 70 Control group, 3, 70 Controlled study, 70 Coronary, 70, 75 Coronary Thrombosis, 70, 75 Cortical, 70, 80 Cues, 28, 70 Cyclic, 67, 70 Cytoplasm, 68, 70 D Deamination, 70, 76 Degenerative, 70, 77 Delusions, 70, 79 Dexfenfluramine, 3, 4, 12, 13, 14, 20, 22, 28, 40, 70 Dextroamphetamine, 12, 66, 70, 75, 78 Diabetes Mellitus, 70, 73 Diagnostic procedure, 42, 70 Diethylproprion, 43, 70 Digestion, 67, 70, 75, 81
86 Phentermine
Digestive system, 38, 71 Dilatation, 66, 71, 78 Direct, iii, 71, 78, 80 Diuresis, 67, 71 Dopamine, 22, 26, 27, 28, 66, 69, 70, 71, 75, 76, 77, 78 Doping, 21, 71 Double-blind, 10, 14, 18, 71 E Eating Disorders, 17, 43, 54, 71 Efficacy, 10, 14, 37, 40, 71 Electrophoresis, 31, 71 Endocrine System, 71 Endocrinology, 31, 32, 71 Endogenous, 71 Energy balance, 40, 71 Energy Intake, 40, 71 Environmental Health, 48, 50, 71 Enzyme, 71, 75, 76, 77, 79, 83 Ephedrine, 12, 71 Epinephrine, 65, 71, 72, 77, 83 Esophagus, 71, 72, 81 Exogenous, 10, 12, 14, 67, 71, 72, 83 Extracellular, 26, 66, 70, 72, 76 Extracellular Space, 72, 76 Extrapyramidal, 71, 72 F Family Planning, 49, 72 Fat, 72, 75, 77 Fibrosis, 14, 72 Filtration, 27, 72 Flatus, 72 Fluoxetine, 11, 17, 22, 27, 72 G Gallbladder, 65, 71, 72 Ganglia, 72, 77, 82 Gas, 15, 20, 72, 81 Gastric, 40, 72 Gastrointestinal, 72, 80, 81 Gastrointestinal tract, 72, 80 Gene, 67, 72 Glomerulus, 72, 76 Glucose, 40, 70, 72, 74 Glucose Intolerance, 70, 72 Governing Board, 73, 78 H Headache, 67, 73, 81 Heart failure, 71, 73 Hemorrhage, 11, 73, 81 Hemostasis, 73, 80 Homeostasis, 73, 81 Hormone, 72, 73, 74, 82 Humoral, 73 Humour, 73 Hypertension, 73 Hypotension, 22, 73
Hypothalamic, 40, 73 Hypothalamus, 66, 73 Hypothyroidism, 16, 73 I Id, 29, 32, 55, 60, 62, 73 Immune system, 73, 76, 83 Impairment, 73, 75, 79 In vitro, 11, 74 In vivo, 27, 74, 76 Incontinence, 71, 74, 77 Indicative, 39, 74, 83 Infarction, 70, 74, 75 Inflammation, 72, 74, 76, 78, 80 Inotropic, 71, 74 Insomnia, 74, 81 Insulin, 40, 74, 83 Insulin-dependent diabetes mellitus, 74 Intermittent, 16, 27, 74 Internal Medicine, 10, 18, 19, 71, 74 Interstitial, 11, 72, 74, 76 Intoxication, 74, 84 Intracellular, 67, 74, 79 Ischemic stroke, 19, 74 J Joint, 66, 74, 77 K Kb, 48, 74 Kinetic, 74 L Lactation, 4, 74 Large Intestine, 71, 74, 80 Lethargy, 73, 75 Library Services, 60, 75 Lipase, 75, 77 Lipid, 74, 75, 77 Lipid A, 75, 77 Liver, 18, 65, 67, 71, 72, 75, 76 Localized, 75, 76, 78 M Mania, 19, 75 Manic, 75, 79 Manic-depressive psychosis, 75, 79 Mazindol, 20, 75 Mediate, 71, 75 Mediator, 75, 81 MEDLINE, 49, 75 Melanin, 75, 78, 83 Membrane, 66, 68, 69, 75, 76, 80 Meninges, 68, 75 Mental, v, 12, 18, 38, 48, 50, 68, 73, 75, 79, 80 Mental Disorders, 38, 75, 79 Mesolimbic, 28, 75 Metabolite, 21, 67, 75 Methamphetamine, 75 MI, 63, 75
Index 87
Microdialysis, 27, 76 Microglia, 66, 76 Mitral Valve, 3, 76 Modification, 16, 27, 37, 65, 76 Molecular, 49, 51, 67, 69, 76, 79 Monoamine, 13, 16, 18, 66, 70, 76, 83 Monoamine Oxidase, 13, 16, 18, 66, 70, 76, 83 Motility, 76, 80 Myocardium, 75, 76 N Naive, 18, 76 Narcolepsy, 70, 72, 76 NCI, 1, 38, 47, 76 Need, 3, 39, 43, 56, 76 Nephritis, 11, 76 Nephropathy, 17, 76 Nerve, 65, 68, 75, 76, 77, 83 Nervous System, 66, 68, 75, 76, 77, 81, 82, 83 Neural, 73, 76, 77 Neurons, 69, 72, 77, 82 Neurotransmitter, 65, 71, 77, 81, 83 Norepinephrine, 65, 71, 77, 78, 81 Norfenfluramine, 15, 77 Nucleus, 26, 70, 77, 81 Nucleus Accumbens, 26, 77 O Orlistat, 40, 77 Osteoarthritis, 24, 77 Overdose, 16, 20, 77 Overweight, 17, 28, 40, 77 P Pancreas, 65, 71, 74, 75, 77 Parenteral, 71, 77 Patient Education, 54, 58, 60, 63, 78 Peritoneum, 78, 80 Pharmacokinetic, 78 Pharmacologic, 40, 78, 82 Phenylalanine, 78, 83 Phenylpropanolamine, 31, 78 Physiology, 71, 78 Plants, 65, 69, 72, 77, 78, 82 Plasma, 12, 15, 18, 19, 68, 72, 73, 78 Pleomorphic, 77, 78 Pneumonia, 70, 78 Practice Guidelines, 50, 78 Precursor, 71, 77, 78, 83 Prevalence, 3, 14, 15, 17, 78 Probe, 76, 78 Progression, 19, 66, 78 Progressive, 26, 27, 77, 78 Prospective study, 18, 79 Protease, 69, 79 Protein S, 67, 79 Proteins, 65, 68, 69, 78, 79, 82 Protocol, 17, 79
Psychiatric, 75, 79, 81 Psychic, 75, 79, 80 Psychoactive, 79, 84 Psychosis, 18, 79 Psychotomimetic, 66, 70, 79 Public Policy, 49, 79 Pulmonary, 11, 13, 15, 26, 28, 67, 70, 79, 83 Pulmonary hypertension, 11, 13, 15, 26, 79 R Race, 71, 79 Randomized, 18, 71, 79 Reality Testing, 79 Receptor, 71, 79, 81 Receptors, Serotonin, 79, 81 Recombinant, 18, 80 Rectum, 67, 71, 72, 74, 80 Refer, 1, 69, 76, 79, 80 Regimen, 71, 80 Regurgitation, 14, 19, 20, 80 Respiration, 80 Restoration, 80 Resuscitation, 32, 80 Retroperitoneal, 19, 80 Rhinitis, 71, 80 Risk factor, 79, 80 S Salivary, 71, 80 Salivary glands, 71, 80 Schizoid, 80, 84 Schizophrenia, 4, 80, 84 Schizotypal Personality Disorder, 80, 84 Screening, 68, 80 Secretion, 73, 74, 76, 80 Seizures, 26, 80 Serotonin, 12, 18, 26, 27, 70, 72, 76, 77, 79, 80, 81, 83 Sibutramine, 40, 43, 81 Side effect, 14, 65, 75, 81, 82 Sleep Deprivation, 10, 14, 81 Smooth muscle, 67, 81 Solitary Nucleus, 66, 81 Somatic, 73, 81 Specialist, 55, 81 Spinal cord, 66, 68, 75, 76, 81, 82 Stimulant, 65, 67, 70, 75, 78, 81 Stomach, 65, 71, 72, 73, 81 Stress, 54, 66, 68, 81 Striatum, 77, 81 Stroke, 19, 22, 28, 38, 48, 54, 74, 81 Subclinical, 80, 81 Substance P, 75, 80, 81 Suction, 72, 81 Suppression, 20, 28, 82 Sympathetic Nervous System, 66, 82 Sympathomimetic, 65, 70, 71, 72, 75, 77, 78, 82, 83
88 Phentermine
T Thrombosis, 79, 81, 82 Thrombus, 70, 74, 82 Thyroid, 73, 82, 83 Thyroid Gland, 82 Thyrotropin, 73, 82 Thyroxine, 16, 78, 82 Tissue, 68, 69, 70, 74, 75, 76, 77, 80, 81, 82 Tone, 32, 82 Tonus, 82 Toxic, v, 11, 75, 82 Toxicokinetics, 82 Toxicology, 50, 82 Toxins, 27, 82 Transfection, 67, 83 Transmitter, 66, 71, 75, 77, 83 Tricuspid Valve, 23, 83 Tryptophan, 80, 83 Tubercle, 77, 83 Type 2 diabetes, 40, 83 Tyramine, 76, 83 Tyrosine, 10, 14, 71, 83
U Unconscious, 73, 83 Urethra, 83 Urinary, 21, 71, 74, 83 Urine, 20, 67, 71, 74, 83 V Vaccine, 79, 83 Vascular, 12, 13, 26, 32, 37, 74, 82, 83 Vasodilator, 71, 83 Vein, 66, 83 Ventral, 73, 77, 83 Ventricle, 66, 68, 73, 76, 77, 83 Venules, 67, 68, 83 Veterinary Medicine, 49, 83 Visceral, 66, 78, 83 Visceral Afferents, 66, 83 Vitro, 83 Vivo, 84 W Withdrawal, 21, 26, 84 X Xenograft, 66, 84
Index 89
90 Phentermine