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

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

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

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

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

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Ranitidine: 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: 0-597-84601-4 1. Ranitidine-Popular works. I. Title.

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

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

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

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

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

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. NUTRITION AND RANITIDINE ....................................................................................... 3 Overview........................................................................................................................................ 3 Finding Nutrition Studies on Ranitidine ...................................................................................... 3 Federal Resources on Nutrition ..................................................................................................... 5 Additional Web Resources ............................................................................................................. 6 CHAPTER 2. ALTERNATIVE MEDICINE AND RANITIDINE ................................................................ 9 Overview........................................................................................................................................ 9 National Center for Complementary and Alternative Medicine.................................................... 9 Additional Web Resources ........................................................................................................... 15 General References ....................................................................................................................... 16 CHAPTER 3. DISSERTATIONS ON RANITIDINE ................................................................................ 17 Overview...................................................................................................................................... 17 Dissertations on Ranitidine ......................................................................................................... 17 Keeping Current .......................................................................................................................... 17 CHAPTER 4. CLINICAL TRIALS AND RANITIDINE ........................................................................... 19 Overview...................................................................................................................................... 19 Recent Trials on Ranitidine ......................................................................................................... 19 Keeping Current on Clinical Trials ............................................................................................. 20 CHAPTER 5. PATENTS ON RANITIDINE ........................................................................................... 23 Overview...................................................................................................................................... 23 Patents on Ranitidine .................................................................................................................. 23 Patent Applications on Ranitidine............................................................................................... 44 Keeping Current .......................................................................................................................... 47 CHAPTER 6. PERIODICALS AND NEWS ON RANITIDINE ................................................................. 49 Overview...................................................................................................................................... 49 News Services and Press Releases................................................................................................ 49 Newsletter Articles ...................................................................................................................... 52 Academic Periodicals covering Ranitidine................................................................................... 53 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 55 Overview...................................................................................................................................... 55 U.S. Pharmacopeia....................................................................................................................... 55 Commercial Databases ................................................................................................................. 56 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 59 Overview...................................................................................................................................... 59 NIH Guidelines............................................................................................................................ 59 NIH Databases............................................................................................................................. 61 Other Commercial Databases....................................................................................................... 63 APPENDIX B. PATIENT RESOURCES ................................................................................................. 65 Overview...................................................................................................................................... 65 Patient Guideline Sources............................................................................................................ 65 Finding Associations.................................................................................................................... 70 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 73 Overview...................................................................................................................................... 73 Preparation................................................................................................................................... 73 Finding a Local Medical Library.................................................................................................. 73 Medical Libraries in the U.S. and Canada ................................................................................... 73 ONLINE GLOSSARIES.................................................................................................................. 79 Online Dictionary Directories ..................................................................................................... 79

Contents

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RANITIDINE DICTIONARY........................................................................................................ 81 INDEX .............................................................................................................................................. 119

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with ranitidine 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 ranitidine, 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 ranitidine, 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 ranitidine. 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 ranitidine, 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 ranitidine. The Editors

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

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CHAPTER 1. NUTRITION AND RANITIDINE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and ranitidine.

Finding Nutrition Studies on Ranitidine 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.2 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 “ranitidine” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

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

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

A comparative study of misoprostol and ranitidine in the healing of duodenal ulcers. A double-blind controlled trial. Source: Simjee, A E Spitaels, J M Pettengell, K E Manion, G L S-Afr-Med-J. 1987 July 4; 72(1): 15-7 0038-2469

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Distribution of bismuth in the rat after oral dosing with ranitidine bismuth citrate and bismuth subcitrate. Author(s): Clinica Universitaria de Medicina Interna e Gastrenterologia da Universidade, Nova de Lisboa--Hospital de Pulido Valente, Lisbon, Portugal. Source: Canena, J Reis, J Pinto, A S Santos, A M Leitao, J Pinheiro, T Quina, M G JPharm-Pharmacol. 1998 March; 50(3): 279-83 0022-3573

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Effect of aluminum phosphate on the bioavailability of ranitidine. Source: Albin, H Vincon, G Begaud, B Bistue, C Perez, P Eur-J-Clin-Pharmacol. 1987; 32(1): 97-9 0031-6970

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Effect of cimetidine and ranitidine on plasma theophylline in patients with chronic obstructive airways disease treated with theophylline and corticosteroids. Author(s): Internal Medicine Clinic, Bad Lippspringe, Federal Republic of Germany. Source: Boehning, W Eur-J-Clin-Pharmacol. 1990; 38(1): 43-5 0031-6970

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Effect of metoclopramide and ranitidine on acetylcholine release from isolated rat stomach. Author(s): Department of Pharmacology, Dainippon Pharmaceutical Co., Ltd., Suita/Osaka, Japan. Source: Yoshida, N Karasawa, T Kadokawa, T Arch-Int-Pharmacodyn-Ther. 1988 SepOctober; 295245-56 0003-9780

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Effects of equimolar doses of cimetidine and ranitidine on theophylline elimination. Author(s): Department of Pharmacology, College of Medicine, Lagos, Nigeria. Source: Adebayo, G I Biopharm-Drug-Dispos. 1989 Jan-February; 10(1): 77-85 0142-2782

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Enprostil and ranitidine: comparative efficacy and safety in patients with duodenal ulcer. Author(s): Gastroenterology Unit, Flinders Medical Centre, SA. Source: Mackinnon, M Alp, M Austad, W I Byrnes, D Cowen, A Duggan, J Pirola, R Thomas, M Ward, M Aust-N-Z-J-Med. 1987 June; 17(3): 316-20 0004-8291

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Gastric antral erosions and Helicobacter pylori infection in cirrhotic patients: a pilot controlled study of oral bismuth vs ranitidine therapy. Author(s): Divisione di Gastroenterologia, Ospedale A Cardarelli, USL 40, Napoli, Italy. Source: Balzano, A Mosca, S Amitrano, L Di Blasi, A Piccirillo, M M Gigliotti, T Ital-JGastroenterol. 1991 Mar-April; 23(3): 132-5 0392-0623

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Gastric fluid volume and pH in elective inpatients. Part II: Coffee or orange juice with ranitidine. Author(s): Department of Anaesthesia, Foothills Hospital, University of Calgary, Albeta. Source: Maltby, J R Reid, C R Hutchinson, A Can-J-Anaesth. 1988 January; 35(1): 16-9 0832-610X

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Gastric ulcer: a double blind comparison of 800 mcg misoprostol versus 300 mg ranitidine. Author(s): Division of Gastroenterology CHUV-PMU, University of Lausanne.

Nutrition

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Source: Gonvers, J J Aenishanslin, W Backwinkel, K Bretholz, A Egger, G Feyerabend, H Fumagalli, I Guller, R Hammer, B Mattle, W P et al. Hepatogastroenterology. 1987 October; 34(5): 233-5 0172-6390 •

Histamine type-2 receptor antagonist immune modulation. II. Cimetidine and ranitidine increase interleukin-2 production. Source: Gifford, R R Tilberg, A F Surgery. 1987 August; 102(2): 242-7 0039-6060

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Influence of acute copper deficiency, cold-restraint stress and the H2 blocker ranitidine on the severity of acute gastric mucosal lesions and lipid peroxidation in rats. Author(s): Laboratory for Clinical Microbiology, Alexander Hospital, Medical University, Sofia, Bulgaria. Source: VeliNovember, H Mileva, M Nachev, C Methods-Find-Exp-Clin-Pharmacol. 2001 September; 23(7): 401-7 0379-0355

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Ranitidine but not famotidine releases acetylcholine from the guinea pig myenteric plexus. Author(s): Institute of Pharmacology, University of Parma, Ospedale Maggiore, Italy. Source: Poli, E Coruzzi, G Bertaccini, G Agents-Actions. 1990 April; 30(1-2): 191-4 00654299

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Seizures during concomitant treatment with theophylline and ranitidine: a case report. Author(s): Istituto Scientifico di Medicina Interna, Universita degli Studi di Genova. Source: Murialdo, G Piovano, P L Costelli, P Fonzi, S Barberis, A Ghia, M Ann-Ital-MedInt. 1990 Oct-December; 5(4 Pt 1): 413 0393-9340

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The following is a specific Web list relating to ranitidine; 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: •

Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B12 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B12 (Cobalamin) Alternative names: Cobalamin Source: Integrative Medicine Communications; www.drkoop.com

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Minerals Iron Source: Healthnotes, Inc.; www.healthnotes.com Iron Alternative names: Ferrous Sulfate Source: Integrative Medicine Communications; www.drkoop.com

Nutrition

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Food and Diet Ferrous Sulfate Alternative names: Iron Source: Integrative Medicine Communications; www.drkoop.com

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CHAPTER 2. ALTERNATIVE MEDICINE AND RANITIDINE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to ranitidine. 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 ranitidine 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 “ranitidine” (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 ranitidine: •

A comparison of two prophylactic regimens for hypersensitivity reactions to paclitaxel. Author(s): Kwon JS, Elit L, Finn M, Hirte H, Mazurka J, Moens F, Trim K. Source: Gynecologic Oncology. 2002 March; 84(3): 420-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11855881

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A feasibility study of 1-h paclitaxel infusion in patients with solid tumors. Author(s): Tsavaris N, Polyzos A, Kosmas C, Giannikos L, Gogas J. Source: Cancer Chemotherapy and Pharmacology. 1997; 40(4): 353-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9225955

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A phase I trial of 3-hour infusions of paclitaxel (Taxol) with or without granulocyte colony-stimulating factor. Author(s): Schiller JH, Storer B, Tutsch K, Arzoomanian R, Alberti D, Feierabend C, Spriggs D.

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Source: Seminars in Oncology. 1994 October; 21(5 Suppl 8): 9-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7524159 •

A phase II study of paclitaxel and cisplatin combination chemotherapy in recurrent or metastatic head and neck cancer. Author(s): Basaran M, Bavbek SE, Gullu I, Demirelli F, Sakar B, Tenekeci N, Altun M, Yalcin S, Onat H. Source: J Chemother. 2002 April; 14(2): 207-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12017379

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Alternative and rescue treatment regimens for Helicobacter pylori eradication. Author(s): Xia HH, Yu Wong BC, Talley NJ, Lam SK. Source: Expert Opinion on Pharmacotherapy. 2002 September; 3(9): 1301-11. Review. Erratum In: Expert Opin Pharmacother. 2002 December; 3(12): 1803. Expert Opin Pharmacother. 2992 October; 3(10): 1539. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12186623

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Amoxicillin/tetracycline combinations are inadequate as alternative therapies for Helicobacter pylori infection. Author(s): Perri F, Festa V, Merla A, Quitadamo M, Clemente R, Andriulli A. Source: Helicobacter. 2002 April; 7(2): 99-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966868

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An early phase II study of a 3-hour infusion of paclitaxel for advanced gastric cancer. Author(s): Ohtsu A, Boku N, Tamura F, Muro K, Shimada Y, Saigenji K, Akazawa S, Kitajima M, Kanamaru R, Taguchi T. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 1998 August; 21(4): 416-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9708646

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Antiulcer drugs and gastric prostaglandin E2: an in vitro study. Author(s): Ota S, Takahashi M, Yoshiura K, Hata Y, Kawabe T, Terano A, Omata M. Source: Journal of Clinical Gastroenterology. 1993; 17 Suppl 1: S15-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7904284

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Antiulcerogenic activity of Lippia alba (Mill.) N. E. Brown (Verbenaceae). Author(s): Pascual ME, Slowing K, Carretero ME, Villar A. Source: Farmaco (Societa Chimica Italiana : 1989). 2001 May-July; 56(5-7): 501-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11482786

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Antiulcerogenic effects of two Maytenus species in laboratory animals. Author(s): Souza-Formigoni ML, Oliveira MG, Monteiro MG, da Silveira-Filho NG, Braz S, Carlini EA.

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Source: Journal of Ethnopharmacology. 1991 August; 34(1): 21-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1753784 •

Antiulcerogenicity of the flavonoid fraction from Bidens aurea: comparison with ranitidine and omeprazole. Author(s): Alarcon de la Lastra C, Martin MJ, La Casa C, Motilva V. Source: Journal of Ethnopharmacology. 1994 May; 42(3): 161-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7934085

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Binding of taxol to human plasma, albumin and alpha 1-acid glycoprotein. Author(s): Kumar GN, Walle UK, Bhalla KN, Walle T. Source: Res Commun Chem Pathol Pharmacol. 1993 June; 80(3): 337-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8102493

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Biotransformation of taxoids by human cytochromes P450: structure-activity relationship. Author(s): Monsarrat B, Royer I, Wright M, Cresteil T. Source: Bulletin Du Cancer. 1997 February; 84(2): 125-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9180834

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Chemical and pharmacological characterization of Erythrophleum lasianthum alkaloids. Author(s): Verotta L, Aburjai T, Rogers CB, Dorigo P, Maragno I, Fraccarollo D, Santostasi G, Gaion RM, Floreani M, Carpenedo F. Source: Planta Medica. 1995 June; 61(3): 271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7617772

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Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. Author(s): Giles LG, Muller R. Source: Journal of Manipulative and Physiological Therapeutics. 1999 July-August; 22(6): 376-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10478769

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Clinical pharmacokinetics and pharmacodynamics of paclitaxel: a 3-hour infusion versus a 24-hour infusion. Author(s): Ohtsu T, Sasaki Y, Tamura T, Miyata Y, Nakanomyo H, Nishiwaki Y, Saijo N. Source: Clinical Cancer Research : an Official Journal of the American Association for Cancer Research. 1995 June; 1(6): 599-606. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9816021

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Comparison between ranitidine and ranitidine plus Caved-S in the treatment of gastric ulceration. Author(s): Morgan AG, Pacsoo C, McAdam WA. Source: Gut. 1985 December; 26(12): 1377-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3910523

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Comparison of ranitidine and high-dose antacid in the treatment of prepyloric or duodenal ulcer. A double-blind controlled trial. Author(s): Lauritsen K, Bytzer P, Hansen J, Bekker C, Rask-Madsen J. Source: Scandinavian Journal of Gastroenterology. 1985 January; 20(1): 123-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3887547

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Controlled trial of hypnotherapy in relapse prevention of duodenal ulceration. Author(s): Colgan SM, Faragher EB, Whorwell PJ. Source: Lancet. 1988 June 11; 1(8598): 1299-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2897556

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Cost-effectiveness of Helicobacter pylori eradication therapy in duodenal ulcer disease. Author(s): Jonsson B. Source: Scandinavian Journal of Gastroenterology. Supplement. 1996; 215: 90-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8722390

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Determination of unbound etoposide concentration in ultrafiltered plasma by highperformance liquid chromatography with fluorimetric detection. Author(s): Robieux I, Aita P, Sorio R, Toffoli G, Boiocchi M. Source: Journal of Chromatography. B, Biomedical Applications. 1996 November 8; 686(1): 35-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8953190

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Dietary supplementation with pectin in the maintenance treatment of duodenal ulcer. A controlled study. Author(s): Kang JY, Tay HH, Guan R, Math MV, Yap I, Labrooy SJ. Source: Scandinavian Journal of Gastroenterology. 1988 January; 23(1): 95-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3278367

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Do the copper complexes of histamine, histidine and of two H2-antagonists react with O2-? Author(s): Konstantinova SG, Russanova IE, Russanov EM. Source: Free Radic Res Commun. 1991; 12-13 Pt 1: 215-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1676975


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Docetaxel as neoadjuvant chemotherapy in patients with advanced cervical carcinoma. Author(s): Vallejo CT, Machiavelli MR, Perez JE, Romero AO, Bologna F, Vicente H, Lacava JA, Ortiz EH, Cubero A, Focaccia G, Suttora G, Scenna M, Boughen JM, Leone BA. Source: American Journal of Clinical Oncology : the Official Publication of the American Radium Society. 2003 October; 26(5): 477-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14528074

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Does 360 ml of apple juice ingested before elective surgery worsen gastric volume and acidity in patients given acid aspiration prophylaxis? Author(s): Vincent RD Jr, McNeil TJ, Spaid CL, MacMahon FR, Maxwell SJ, Brenner JS, Schryer VL. Source: Journal of Clinical Anesthesia. 1991 July-August; 3(4): 285-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1910795

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Does Caved-S decrease the gastric ulcer relapse rate during maintenance treatment with ranitidine? Author(s): Morgan AG, Pacsoo C, Taylor P, McAdam WA. Source: Alimentary Pharmacology & Therapeutics. 1987 December; 1(6): 633-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2979691

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Dose reduction of steroid premedication for paclitaxel: no increase of hypersensitivity reactions. Author(s): Koppler H, Heymanns J, Weide R. Source: Onkologie. 2001 June; 24(3): 283-5. English, German. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11455223

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Effect of jianpiyiqi prescription on the expression of heat shock proteins in acetic acid-induced chronic gastric ulcer rats. Author(s): Tao X, Li G, Luo S. Source: J Tongji Med Univ. 2001; 21(2): 105-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11523209

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Effect of N alpha-methyl-histamine on acid secretion in isolated cultured rabbit parietal cells: implications for Helicobacter pylori associated gastritis and gastric physiology. Author(s): Beales IL, Calam J. Source: Gut. 1997 January; 40(1): 14-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9155569

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Effect of oral liquids and ranitidine on gastric fluid volume and pH in children undergoing outpatient surgery. Author(s): Sandhar BK, Goresky GV, Maltby JR, Shaffer EA.

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Source: Anesthesiology. 1989 September; 71(3): 327-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2774259 •

Efficacy, duration, and absorption of a paediatric oral liquid preparation of ranitidine hydrochloride. Author(s): Goresky GV, Finley GA, Bissonnette B, Shaffer EA. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1992 October; 39(8): 791-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1288904

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Gastric fluid volume and pH in elective inpatients. Part II: Coffee or orange juice with ranitidine. Author(s): Maltby JR, Reid CR, Hutchinson A. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1988 January; 35(1): 16-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3349550

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High dose of antacid (Mylanta II) reduces bioavailability of ranitidine. Author(s): Mihaly GW, Marino AT, Webster LK, Jones DB, Louis WJ, Smallwood RA. Source: British Medical Journal (Clinical Research Ed.). 1982 October 9; 285(6347): 998-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6289961

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Mechanism of intestinal absorption of ranitidine and ondansetron: transport across Caco-2 cell monolayers. Author(s): Gan LS, Hsyu PH, Pritchard JF, Thakker D. Source: Pharmaceutical Research. 1993 December; 10(12): 1722-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8302757

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Nocturnal gastric acid breakthrough during the administration of rabeprazole and ranitidine in Helicobacter pylori-negative subjects: effects of different regimens. Author(s): Adachi K, Komazawa Y, Fujishiro H, Mihara T, Ono M, Yuki M, Kawamura A, Karim Rumi MA, Amano Y, Kinoshita Y. Source: Journal of Gastroenterology. 2003; 38(9): 830-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14564627

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Ranitidine and high-dose antacid in reflux oesophagitis. A randomized, placebocontrolled trial. Author(s): Grove O, Bekker C, Jeppe-Hansen MG, Karstoft E, Sanchez G, Axelsson CK, Nielsen HO, Andersen B, Rask-Madsen J. Source: Scandinavian Journal of Gastroenterology. 1985 May; 20(4): 457-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3895381


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Ranitidine in children with peptic ulcer and patients with pancreatic cystic fibrosis. Author(s): Scorza A, Conti-Nibali S, Sferlazzas C, Saitta G, Tedeschi A. Source: Int J Clin Pharmacol Res. 1990; 10(3): 179-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2228343

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Stability of paclitaxel with ondansetron hydrochloride or ranitidine hydrochloride during simulated Y-site administration. Author(s): Burm JP, Jhee SS, Chin A, Moon YS, Jeong E, Nii L, Fox JL, Gill MA. Source: Am J Hosp Pharm. 1994 May 1; 51(9): 1201-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7913797

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Synergistic and potentiating effects of ranitidine and two new anti-ulcer compounds from Enantia chlorantha and Voacanga africana in experimental animal models. Author(s): Tan PV, Nyasse B, Dimo T, Wafo P, Akahkuh BT. Source: Pharmazie. 2002 June; 57(6): 409-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12116879

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The effect of renal function on the pharmacokinetics of ranitidine. Author(s): Dixon JS, Borg-Costanzi JM, Langley SJ, Lacey LF, Toon S. Source: European Journal of Clinical Pharmacology. 1994; 46(2): 167-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8039538

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

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

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Gastroesophageal Reflux Disease Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Healthnotes, Inc.; www.healthnotes.com Ulcers Source: Prima Communications, Inc.www.personalhealthzone.com

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Herbs and Supplements Antacids/Acid Blockers Source: Healthnotes, Inc.; www.healthnotes.com Cobalamin Alternative names: Vitamin B12 (Cobalamin) Source: Integrative Medicine Communications; www.drkoop.com Famotidine Source: Healthnotes, Inc.; www.healthnotes.com H2 Blockers Source: Prima Communications, Inc.www.personalhealthzone.com Histamine H2 Antagonists Source: Integrative Medicine Communications; www.drkoop.com Ranitidine 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.

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CHAPTER 3. DISSERTATIONS ON RANITIDINE Overview In this chapter, we will give you a bibliography on recent dissertations relating to ranitidine. 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 “ranitidine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on ranitidine, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Ranitidine 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 ranitidine. 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: •

Novel Cation-Sensitive Mechanisms for Intestinal Absorption and Secretion of Famotidine and Ranitidine: Potential Clinical Implications by Ng, Chee Meng; PhD from The University of North Carolina at Chapel Hill, 2003, 186 pages http://wwwlib.umi.com/dissertations/fullcit/3086591

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

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CHAPTER 4. CLINICAL TRIALS AND RANITIDINE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning ranitidine.

Recent Trials on Ranitidine The following is a list of recent trials dedicated to ranitidine.3 Further information on a trial is available at the Web site indicated. •

A Pilot Randomized, Double-Blind, Placebo-Controlled, Parallel Design, Multicenter Trial to Evaluate the Effect of Ranitidine on Immunologic Indicators in Asymptomatic HIV-1 Infected Subjects With a CD4 Cell Count Between 400-700 Cells/mm3 Condition(s): HIV Infections Study Status: This study is completed. Sponsor(s): Glaxo Wellcome Purpose - Excerpt: To evaluate the effect of ranitidine on immunologic indicators in asymptomatic HIV-1 infected patients with CD4 counts of 400-700 cells/mm3. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00002106

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These are listed at www.ClinicalTrials.gov.

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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. 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 “ranitidine” (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/

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For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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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

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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

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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

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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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/

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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

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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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

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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

Clinical Trials 21

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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

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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

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CHAPTER 5. PATENTS ON RANITIDINE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.4 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “ranitidine” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on ranitidine, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Ranitidine By performing a patent search focusing on ranitidine, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 4Adapted

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

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

Aqueous compositions comprising ranitidine and LCMT sucrose Inventor(s): Caricofe; Ralph Boyer (Raleigh, NC) Assignee(s): Glaxo Wellcome Inc. (research Triangle Park, Nc) Patent Number: 6,265,449 Date filed: December 10, 1999 Abstract: The invention relates to an aqueous pharmaceutical composition for oral administration comprising ranitidine, or a pharmaceutically acceptable salt thereof, characterized in that the composition contains low color, metal, turbidity (LCMT) sucrose. Excerpt(s): The present invention relates to aqueous compositions containing the histamine H.sub.2 -receptor antagonist ranitidine. Ranitidine, N-[2-[[[5(dimethylamino)methyl-2-furanyl]methyl]thio]ethyl]-N'-methyl-2-n itro-1,1ethenediamine, and its pharmaceutically acceptable salts are described and claimed in British Patent Specification No. 1565966 and a particular crystalline form of ranitidine hydrochloride is described and claimed in British Patent Specification No. 2084580. In both these specifications there is reference to formulations for oral administration, which may take the form of for example tablets, capsules, granules, powders, solutions, syrups, suspensions, or tablets, or lozenges for buccal administration. Oral administration constitutes a preferred route for administering ranitidine. Oral administration in the form of a conventional tablet, pill or capsule constitutes a preferred route for administration of pharmaceuticals since this route is generally convenient and acceptable to patients. Unfortunately such compositions may be associated with certain disadvantages, particularly in the treatment of pediatric or geriatric patients, who may dislike or have difficulty in swallowing such compositions, or where administration of a conventional tablet, pill or capsule is not feasible. In such situations, oral liquid compositions are often preferable. It is highly desirable, particularly in the treatment of acute conditions, that pharmaceutical compositions have a rapid and consistent onset of action combined with sustained activity and good bioavailability. Web site: http://www.delphion.com/details?pn=US06265449__

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Aqueous ranitidine compositions stabilized with ethanol Inventor(s): Long; David R. (Royston, GB2) Assignee(s): Glaxo Group Limited (london, Gb2) Patent Number: 5,068,249 Date filed: March 14, 1990 Abstract: The stability of aqueous formulations of ranitidine or a physiologically acceptable salt thereof is enhanced by the addition of ethanol. Excerpt(s): The present invention relates to a pharmaceutical composition containing as active ingredient the histamine H.sub.2 antagonist ranitidine. Ranitidine, [N-[2-[[[5(dimethylamino)methyl-2-furanyl]methyl]thio]ethyl]-N'-methyl-2nitro-1,1ethenediamine, and its physiologically acceptable salts are described in British Patent

Patents

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Specification No. 1565966. In that specification there is reference to liquid formulations for oral and parenteral administrations and there is a description of an aqueous based formulation for intravenous use and another of an oral syrup. Both of these formulations contained sufficient hydrochloric acid to achieve a pH of 5.0 and the syrups also contained Sorbitol solution BPC and a flavour as required. British Patent Application No. GB 2142820A describes aqueous based formulations containing ranitidine and/or one or more of its physiologically acceptable salts thereof having a pH within the range 6.5-7.5. In that specification there is reference to liquid formulations for oral and parenteral administration and there are examples of aqueous formulations for intravenous and oral use. These formulations contain ranitidine hyrochloride and are buffered to a pH of approximately 7 and for intravenous administration the formulations also contain phenol or sodium chloride. For oral administration the formulation also contains hydroxypropylmethyl cellulose as a viscosity enhancing agent, a preservative (parabens), a sweetening agent and a flavour. These compositions have a significantly greater shelf-life over those in British Patent No. 1565966. Web site: http://www.delphion.com/details?pn=US05068249__ •

Controlled release device Inventor(s): Chopra; Sham K. (Mississauga, CA), Lee; David (Mississauga, CA), Molloy; Thomas P. (Mississauga, CA), Nangia; Avinash K. (Mississauga, CA) Assignee(s): Glaxo Canada Inc. (mississauga, Ca) Patent Number: 5,342,627 Date filed: November 12, 1992 Abstract: The invention relates to a device for the release of at least one active substance (e.g. ranitidine) into a fluid medium by dissolution comprising a covering, which is impermeable to the active substance and the fluid, having at least one aperture therein and defining a shaped cavity, the cavity being filled by a shaped core comprising the active substance, and wherein: on exposure of the device to the fluid medium, a surface of the core is exposed and dissolution of the surface by the fluid medium causes a change in at least one dimension of the area of the surface, while the surface area of the exposed surface remains substantially constant over at least 50% of the total dissolution time of the core; or the active substance is disposed in a matrix of an inert insoluble excipient, the device being axially symmetrical, with its aperture being peripherally disposed so that the release surface of core which is exposed through the aperture is substantially cylindrical or part of a cylinder in shape; whereby to allow substantially constant release of the active substance over at least part of the dissolution time; and processes for its preparation. Excerpt(s): The present invention relates to a device for the controlled release of an active substance, for example an H.sub.2 -antagonist such as ranitidine. In particular it relates to a tablet whose geometrical configuration and formulation is such that it releases active substance at a constant rate over a significant portion of the total dissolution time. Ranitidine, N-[2-[[[5-(dimethylamino)methyl-2furanyl]methyl]thio]ethyl]-N'-methyl-2-n itro-1,1-ethenediamine, and its pharmaceutically acceptable salts are described in British Patent Specification No. 1565966, and a particular crystalline form of ranitidine hydrochloride is described and claimed in GB-B-2084580. In both of these specifications there is reference to a variety of formulations including preparations for oral, topical, parenteral or rectal administration. Oral preparations of ranitidine are further described in GB-B-2142820, GB-B-2198352,

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GB-B-2218336, GB-B-2219940, GB-B2222772 and GB-A-2229094. Ranitidine is a potent histamine H.sub.2 -antagonist which, in the form of its hydrochloride salt, is widely used in the treatment of conditions where there is an advantage in lowering gastric acidity. Such conditions include duodenal and gastric ulceration, reflux oesophagitis and Zollinger-Ellison syndrome. Ranitidine may also be used prophylactically in surgical procedures, and in the treatment of allergic and inflammatory conditions where histamine is a known mediator. Web site: http://www.delphion.com/details?pn=US05342627__ •

Controlled release formulations of Ranitidine Inventor(s): Doshi; Madhukant Mansukhlal (Maharashtra, IN), Joshi; Milind Dattatraya (Maharashtra, IN), Mody; Shri Shirish Bhagwanlal (Maharashtra, IN) Assignee(s): J. B. Chemicals & Pharmaceuticals Limited (bombay, In) Patent Number: 5,853,756 Date filed: September 1, 1995 Abstract: The present invention provides oral formulations of Ranitidine Hydrochloride in the form of coated tablets and capsules which produce controlled or regulated dissolution and release at a fairly uniform rate over long periods--as long as 12 to 24 hours--to maintain Ranitidine at desired levels above the MEC. Excerpt(s): The present invention relates to pharmaceutical formulations which provide controlled release at regulated rates and within desired periods of the pharmacologically useful and active drug Ranitidine Hydrochloride, among others, for anti-ulcer treatment. Ranitidine Hydrochloride is a water soluble drug. It readily dissolves and gets absorbed in the system soon after it is taken orally in the form of a tablet or capsule. Even when oral tablets are sugar coated or film coated in usual fashion, the dissolution and absorption takes places soon after the coating-film or sugar dissolves. As such, the concentration of the drug in the system reaches a peak, then falls rapidly. Even with such increased dosages, the rate of release, and consequently the MEC levels cannot be maintained uniformly or for long periods of time. For more effective treatment of gastric and intestinal ulcers, it is desirable and necessary to have a formulation which will maintain a level above minimum effective concentration (MEC) and in a regulated manner in the system for longer duration preferably for about 12 to 24 hours. The oral formulations of Ranitidine Hydrochloride presently produced and available are not designed to provide such controlled release. Presently, a drug regimen of two or three doses per day is generally prescribed, and if patient compliance is compromised, and the patient fails to take the second or third dose as prescribed, the efficacy of the treatment may be greatly impaired. Web site: http://www.delphion.com/details?pn=US05853756__

Patents

•

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Crystalline cyclodextrin complexes of ranitidine hydrochloride, process for their preparation and pharmaceutical compositions containing the same Inventor(s): Fischer; Wilfried (Holzkirchen, DE), Klokkers; Karin (Holzkirchen, DE) Assignee(s): Hexal Pharma Gmbh (holzkirchen, De) Patent Number: 5,665,767 Date filed: December 15, 1995 Abstract: The present invention relates to cyclodextrin inclusion complexes of ranitidine hydrochloride which exhibit a novel, to date unknown crystalline structure, being significantly different from those of known "Form 1 and 2" and to the preparation of such inclusion complexes. The inclusion complexes are prepared from aqueous common solution or suspensions of ranitidine hydrochloride and cyclodextrin by removal of water. As complexing agents.alpha.-,.beta.- and gamma-cyclodextrins, their alkylated, hydroxy alkylated derivates or their suitable mixtures are utilized. Finally, the invention concerns pharmaceutical compositions comprising the new complexes. Excerpt(s): This application is a 371 of PCT/EP94/00645 filed Mar. 4, 1994. The present invention relates to a novel type crystalline cyclodextrin inclusion complex of ranitidine hydrochloride, to the process for the preparation thereof, and to pharmaceutical compositions containing the same. Ranitidine.HCl, i.e. N-[2(5-dimethylamino)methyl-2furanylmethyl thio]ethyl-N-methyl-2-nitro-1-ethenediamine hydrochloride has been widely used as a histamine H.sub.2 receptor atagonist for the treatment of gastric and duodenal ulcers, as well as for treating hyperacidic conditions. The substance inhibits the normal and stimulated secretion of gastric acid, thus it reduces the amount of gastric juice and its acid and pepsine content. Web site: http://www.delphion.com/details?pn=US05665767__

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Debittered ranitidine preparation Inventor(s): Assmus; Manfred (Bickenbach, DE), Petereit; Hans-Ulrich (Darmstadt, DE) Assignee(s): Roehm Gmbh Chemische Fabrik (darmstadt, De) Patent Number: 5,708,021 Date filed: December 18, 1995 Abstract: Ranitidine salts with polycarboxylic acids, such as copolymers of acrylic and/or methacrylic acid with their lower alkyl esters, are water-soluble salts with a very reduced bitter taste. The salts are suitable as liquid gastritis preparations. Excerpt(s): A method is known for the preparation of compositions with neutral taste from basic active substances with a pronounced bitter taste, by precipitating insoluble salts from aqueous solutions of the active substances by means of polyanions, in particular neutralized copolymers of acrylic acid and/or methacrylic acid with lower alkyl esters of these acids, from CH 664,284, DE 27 52 705, and U.S. Pat. No. 4,539,199. The precipitated salts are then processed into tablets or suspensions. In this form, the insoluble salts are tasteless, but are, once again, converted into the original components after ingestion in the stomach, so that the active substance can be absorbed. In this way, preparations of chloroquines, ephedrine, doxepin, chlorpromazine, trimipramine, quinidine, benzyclan, papaverine, chloroanolol, and other active substances have been prepared. Hard-to-dissolve or insoluble salts of this type are prepared by reaction in a moistened powder mixture in accordance with EP 417,488. The processing of the

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insoluble salts to suspensions is not always satisfactory because of the danger of gradual demixing. A method is also known from U.S. Pat. No. 3,629,392, in which a basic active substance is reacted with an aqueous dispersion of a polymer containing acid groups. The active substance is thereby bound to the surface of dispersed latex particles. In many cases, the dispersion coagulates by itself. Otherwise, coagulation agents are added in order to obtain a solid reaction product. The administration of an uncoagulated active substance-containing latex as a liquid preparation is not described. One object of the invention is to provide a ranitidine preparation, in the form of an aqueous solution, which is completely free or substantially free of bitter taste. It was surprisingly discovered that, in contrast to numerous other basic active substances, the salts of ranitidine with polycarboxylic acids are water-soluble and after ingestion, are absorbable and thus fulfill the desired requirement. Web site: http://www.delphion.com/details?pn=US05708021__ •

Effect of a combination of a terbutaline, diphenhydramine and ranitidine composition on gastrointestinal injury produced by nonsteroidal anti-inflammatory compositions Inventor(s): Lukacsko; Alison B. (Robbinsville, NJ), Piala; Joseph J. (Metuchen, NJ) Assignee(s): Bristol Myers Squibb Company (new York, Ny) Patent Number: 5,260,333 Date filed: April 9, 1992 Abstract: Pharmaceutical composition and process for administering NSAIDs with a combination of beta-adrenergic agonist and certain H.sub.1 -and H.sub.2 -receptor blockers which protect against injury to the gastrointestinal tract. Said composition being terbutaline, diphenhydramine and ranitidine. Excerpt(s): This invention relates to nonsteroidal anti-inflammatory compositions containing, as protectants against gastrointestinal injury caused by said nonsteroidal anti-inflammatory drugs (hereinafter referred to as NSAID), combinations of a betaadrenergic agonist and histamine-receptor blockers selected from the group consisting of H.sub.1 -and H.sub.2 -blockers and mixtures thereof. The compositions of this invention are useful in treating conditions and symptoms that are classically treated by the administration of NSAIDS, e.g., headache pain, pain and inflammation associated with arthritis and other systemic diseases, elevated body temperatures. Aspirin and other NSAIDs have long been the most popular drugs for the management of pain, inflammation and fever in individuals. However, one of the drawbacks is the gastrointestinal injury and/or bleeding that sometimes accompanies their administration. This becomes a particular problem where large and sustained doses of NSAIDs must be given to control the symptoms, as for example, in the case of the management of arthritis. It has now been found that NSAID-induced gastrointestinal injury can be significantly reduced when a combination of a betaadrenergic agonist and a histamine-receptor blocker selected from the group consisting of histamine H.sub.1 -, H.sub.2 -receptor blockers and mixtures thereof is administered concurrently with said NSAID. Web site: http://www.delphion.com/details?pn=US05260333__

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Form of form 1 Ranitidine Inventor(s): Murthy; Keshava (Brantford, CA), Radatus; Bruno K. (Brantford, CA), Swidhu; Kanwarpal S. (Brantford, CA) Assignee(s): Acic (canada) Inc. (brantford, Ca) Patent Number: 5,523,423 Date filed: June 2, 1995 Abstract: Process for the production of an improved form of Form 1 Ranitidine Hydrochloride having improved filtration and drying characteristics, said process comprising in a substantially anhydrous hydroxylic solvent, comprising at least one alkanol solvent having 3-4 carbon atoms, adding anhydrous hydrogen chloride gas to Ranitidine free base wherein said substantially anhydrous hydroxylic solvent has the characteristics that it solubilizes the Ranitidine free base and hydrogen chloride gas, and subsequently recovering the improved form of Form 1 Ranitidine Hydrochloride. Excerpt(s): This invention relates to an improved form of Form 1 Ranitidine Hydrochloride and processes for the manufacture thereof. Canadian Letters Patent 1,099,268 (corresponding to U.S. Pat. No. 4,128,658 and U.K. Patent 1565966) teaches the medicine Ranitidine and salts thereof (including the hydrochloride salt) and processes for the manufacture thereof. Canadian Letters Patent 1,202,638 (corresponding to U.S. Pat. Nos. 4,521,431 and 4,672,133) purports to teach a specific new form of Ranitidine Hydrochloride which form the Inventor, Mr. Derek L. Crookes, termed "Form 2" to purportedly distinguish the purportedly new form from the purported forms taught in the original patents (Canadian Letters Patent 1,099,268, U.S. Pat. No. 4,128,658, U.K. Patent 1565966 and all corresponding patents and which form taught by these patents the Inventor identified as Form 1 forms of Ranitidine Hydrochloride). Web site: http://www.delphion.com/details?pn=US05523423__

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Granular product or tablet containing an effervescent system and an active pharmaceutical substance, as well as a method for its preparation Inventor(s): Gergely; Gehard (Vienna, AT), Gergely; Irmgard (Vienna, AT), Gergely; Stefan (Vienna, AT), Gergely; Thomas (Vienna, AT) Assignee(s): Gergely; Gerhard (vienna, At) Patent Number: 5,792,473 Date filed: March 22, 1996 Abstract: In accordance with this invention there is provided a granular product with an effervescent system which comprises acid-sensitive pharmaceutically active substances, such as, for example, betacarotene, cimetidine, ranitidine or cisapride, which is specially useful to prevent antacid action, having an acid-neutralizing capacity below about 5 meq, at a weight of about 1.6 to about 2.3 grams. The effervescent grains are made from carrier crystals of at least one solid, edible organic acid, preferably citric acid and/or tartaric acid, and are present as a granular product, separate from the pharmaceutically active substance, and are coated with at least one layer of a neutral substance which is soluble in water and/or alcohol and which is able to bring about a melting point depression of the acid grains at their surface, such as, for example, a water-soluble polymer, a polyalcohol, a carbohydrate and/or a hydrocolloid. A second coating

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contains at least a part of the alkali and/or alkaline earth carbonate or bicarbonate provided for the total dosage. Excerpt(s): This is a continuation-in-part application of PCT International application No. PCT/EP95/00650 filed on Feb. 23, 1995 which designated the United States, the entire contents of which are herein incorporated by reference. This invention relates to a granular pharmaceutical preparation or more particularly a tablet containing an effervescent system and a--preferably acid-sensitive-pharmaceutical substance, such as cisapride, beta-carotene, an H2 blocker such as cimetidine or ranitidine, and/or a substance which is to be administered in an effervescent pharmaceutical preparation with comparatively small amounts of effervescent components or a comparatively low acid-neutralizing capacity. Heretofore it has been possible only with difficulty to incorporate acid-sensitive drugs in stable form into effervescent tablets or effervescent instant granular products, since in contact with the acid of the effervescent system such compositions hydrolyze or decompose, i.e. they are not shelf-stable. Furthermore, whenever such a substance also affects the surface tension of water, frothing occurs which is highly undesirable for the consumption of the effervescent solution, or in any event, hydrophobic particles of the drug tend to creep upward on the glass. On the other hand, in certain cases, the antacid side-effect of an effervescent tablet is undesirable for many drugs. Web site: http://www.delphion.com/details?pn=US05792473__ •

Imidazole derivatives Inventor(s): Clitherow; John W. (Sawbridgeworth, GB2), Collington; Eric W. (Knebworth, GB2) Assignee(s): Glaxo Group Limited (london, Gb2) Patent Number: 5,221,688 Date filed: April 24, 1991 Abstract: The invention relates to salts formed between basic H.sub.2 -receptor antagonists and a complex of zinc with a carboxylic acid selected from tartaric acid, citric acid and alkyl citric acids, and to solvates of such salts, excluding salts in which the basic H.sub.2 -receptor antagonist is ranitidine. Examples of basic H.sub.2 -receptor antagonists are cimetidine, famotidine, nizatidine and roxatidine.The salts are useful in the treatment of gastrointestinal disorders, such as peptic ulcer disease and non-ulcer dyspepsia. Excerpt(s): This invention relates to salts of compounds having antagonist activity at histamine H.sub.2 -receptors, to a process for the preparation thereof, to pharmaceutical compositions containing them and to their use in therapeutics. More particularly the invention is concerned with salts of histamine H.sub.2 -receptor antagonists formed with zinc complexes of certain carboxylic acids. Compounds which have antagonist activity at histamine H.sub.2 -receptors are used in the treatment of conditions where there is an advantage in lowering gastric acidity. Such conditions include duodenal and gastric ulceration, reflux oesophagitis and Zollinger-Ellison syndrome. Ranitidine may also be used prophylactically in surgical procedures, and in the treatment of allergic and inflammatory conditions where histamine is a known mediator. where R is respectively cimetidine, etintidine, nizatidine, zaltidine or ranitidine, X is an anion of a pharmaceutically acceptable acid, a is an integer from 1 to 5, and b is an integer from 1 to 7. According to UK Specification No. 2218987A, c is an integer from 1 to 4, and d is 2a-

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c. According to European Specifications Nos. 350422 and 351348, and Spanish Specifications Nos. 8804023 and 8900857, c is zero or an integer from 1 to 4, and d is 2a-c for monovalent acid anions, a-c for divalent acid anions and zero or 2 when c is zero. Such compounds are described as having antiulcer properties. Web site: http://www.delphion.com/details?pn=US05221688__ •

Medicaments for treating inflammatory conditions or for analgesia Inventor(s): Stables; Roger (Ware, GB3) Assignee(s): Glaxo Group Limited (london, Gb2) Patent Number: 5,466,436 Date filed: December 17, 1993 Abstract: The use is described of both (i) ranitidine bismuth citrate and (ii) a nonsteroidal anti-inflammatory drug in treating or preventing inflammatory conditions and for analgesia. Pharmaceutical compositions containing both (i) and (ii) and methods for the preparation of pharmaceutical compositions containing (i) and (ii) are also described. Excerpt(s): The present invention relates to improvements in the treatment of inflammatory conditions and for analgesia. More particularly it relates to the coadministration of a non-steroidal anti-inflammatory drug with a salt formed between ranitidine and a complex of bismuth with a carboxylic acid. Systemic non-steroidal antiinflammatory drugs, such as aspirin, indomethacin, ibuprofen and piroxicam, are known to give rise to undesirable side effects. In particular, they are known to be ulcerogenic and can thus, for example, give rise to gastric and/or duodenal ulceration when administered orally. This side effect may be further enhanced in combination with other factors such as stress and smoking. Since in some treatments these compounds may have to be used for an extended period, such side effects can prove a serious disadvantage. In our UK Patent Specification No. 2220937B we describe and claim salts formed between ranitidine and a complex of bismuth with a carboxylic acid, particularly tartaric acid and, more especially, citric acid. One such salt is N-[2-[[[5[(dimethylamino)methyl]-2-furanyl]methyl]thio]ethyl]-N'-methyl-2 -nitro-1,1ethenediamine 2-hydroxy-1,2,3-propanetricarboxylate bismuth (3.sup.+) complex, also known as ranitidine bismuth citrate. Web site: http://www.delphion.com/details?pn=US05466436__

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Method and composition for the treatment of apathy-amotivation syndrome Inventor(s): Kaminski; Ram (New York, NY) Assignee(s): The Mount Sinai School of Medicine of the City of New York (new York, Ny) Patent Number: 5,453,428 Date filed: September 7, 1993 Abstract: In accordance with the present invention, neuropsychiatric symptoms of apathy-amotivation syndrome and particularly those symptoms in: Alzheimer's disease, multiple sclerosis, Huntington's chorea, frontal lobe lesions, and AIDS dementia can be ameliorated by treating a patient with a histamine H.sub.2 -antagonist that passes the

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blood-brain barrier. Suitable H.sub.2 -antagonists include famotidine and ranitidine. The H.sub.2 -antagonists may be co-administered with other compounds which are known to be useful in the treatment of the above neuropsychiatric conditions, and in one aspect of the invention can be formulated with such other compounds into a therapeutic composition. Excerpt(s): This application relates to a method and composition for use in the treatment of apathy-amotivation syndrome (also known as abulia or anergia syndrome) in neuropsychiatric disorders. The syndrome of apathy is defined as absence of or decrease in motivation (Marin, Differential Diagnosis and Classification of Apathy, American Journal of Psychiatry 147: 22-30, Jan. 1990). Slowness of thinking and diminished ability to shift from one set of thinking to the other. This can occur in a variety of apparently unrelated neuropsychiatric disorders. Some of the most common conditions that result in apathy-amotivation syndrome are: schizophrenia, Parkinson's disease, Alzheimer's disease, multiple sclerosis, Huntington's chorea and frontal lobe lesions. (Marin, Apathy: A Neuropsychiatric Syndrome, Journal of Neuropsychiatry and Clinical Neurosciences, 3: 243-254, 1991). In each case apathy-amotivation is just one of a plurality of symptoms associated with the disease. In the past, treatments of other aspects of these conditions such as motor and sensory deficits, dementia, and depression have little or no benefit with respect to apathy-amotivation syndrome. There is large body of evidence that describe apathy-amotivation syndrome and its manifestation in neuropsychiatric disorders. (Starkstein, et al., Reliability, Validity, and Clinical Correlates of Apathy in Parkinson's Disease, Journal of Neuropsychiatry, Volume 4, Number 2, Spring 1992; Bozzola, et al., Personality Changes in Alzheimer's Disease, Arch Neurol, Volume 49, March 1992; Burns, et al., Clinical Assessment of Irritability, Aggression, and Apathy in Huntington and Alzheimer Disease, The Journal of Nervous and Mental Disease Vol. 178, No. 1; Mendez, et al., Neurobehavioral changes associated with caudate lesions, Neurology 39, Mar. 1989; Robinson, et al., Mood Disorders in Stroke Patients, Brain (1984); House, et al., Mood Disorders in the Year after First Stroke, British Journal of Psychiatry (1991); Benson, et al., Psychiatric Aspects of Neurological Disease, Personality Changes With Frontal and Temporal Lobe Lesions, Grune & Stratton, Inc., 1975; Cummings, Clinical Neuropsychiatry, Grune & Stratton, Inc., 1985; McHugh, et al., Psychiatric Aspects of Neurological Disease, Psychiatric Syndromes of Huntington's Chorea: A Clinical and Phenomenologic Study, Grune & Stratton, 1975; Caine, et al., Psychiatric Syndromes in Huntington's Disease, Am J Psychiatry 140:6, June 1983; Ho, et al., The Acquired Immunodeficiency Syndrome (AIDS) Dementia Complex, Annals of Internal Medicine, Volume III, Number 5, Sep. 1, 1989; Cohen, et al., Amantadine Treatment of Fatigue Associated With Multiple Sclerosis, Arch Neurol Vol. 46, Jun. 1989). The common scientific view is to ascribe apathy-amotivation to deficits in the function of the frontal lobes. (Hecaen, et al., Psychiatric Aspects of Neurological Disease, Disorders of Mental Functioning Related to Frontal Lobe Pathology, Grune & Stratton, 1975; Trimble, Psychopathology of Frontal Lobe Syndromes, Seminars in Neurology, Volume 10, No. 3, Sep. 1990; Strub, Frontal Lobe Syndrome in a Patient With Bilateral Globus Pallidus Lesions, Arch Neurol, Vol. 46, Sep. 1989). In recent years, studies have implicated other brain structures that may be involved in the production of the apathy-amotivation syndrome (e.g., striatum and hippocampal formation) (Wang, Neurobehavioral Changes Following Caudate Infarct: A Case Report with Literature Review, Chin Med J (Taipei), 1991; Hedreen, et al., Neuronol loss in layers V and VI of cerebral cortex in Huntington's disease, Neuroscience Letters, 133 (1991); Alvarez, et al., The role of histamine in the anterior hypothalamus and its functional interaction with the hippocampus on exploratory behavior in adult male rats, Behavioural Brain Research, 48: 127-33, 1992) but their specific contribution is yet to be elucidated.

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Method for the treatment of bradyphrenia in Parkinson's disease patients Inventor(s): Kaminski; Ram (Riverdale, NY) Assignee(s): Mount Sinai School of Medicine of the City University of New York (ny) Patent Number: 5,547,969 Date filed: September 28, 1994 Abstract: The neuropsychiatric symptom of bradyphrenia in a Parkinson's Disease patient may be ameliorated by treating the patient with a histamine H.sub.2 -antagonist that passes the blood brain barrier. Suitable H.sub.2 -antagonists include famotidine and ranitidine. The H.sub.2 -antagonists may be co-administered with other compounds such as histamine H.sub.1 -antagonists which are known to be useful in the treatment of Parkinson's Disease, and can be formulated with such other compounds into a therapeutic composition. Excerpt(s): This application relates to a method and composition for use in the treatment of Parkinson's Disease. Parkinson's Disease was first described in 1817 by James Parkinson in a paper entitled "An Essay on the Shaking Palsy". Since then, it has become increasingly clear that Parkinson's Disease involves a complex cluster of symptoms which respond differently to therapeutic treatments. These symptoms can be classified into two groups: those manifesting themselves as motor dysfunction, and those which can be characterized as neuropsychiatric disorders or symptoms. In the latter group there are three recognized components, (1) apathy-amotivation; (2) depression and (3) dementia. Web site: http://www.delphion.com/details?pn=US05547969__

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Methods and pharmaceutical compositions for treating episodic heartburn Inventor(s): Wolfe; M. Michael (Newton, MA) Assignee(s): Brigham and Women's Hospital, Inc. (boston, Ma) Patent Number: 5,229,137 Date filed: May 6, 1992 Abstract: Pharmaceutical medications and methods are disclosed for providing instant and sustained relief from pain or symptoms associated with episodic heartburn in humans. The medications consist essentially of antacids and histamine H.sub.2 -receptor antagonists, and may be administered on an as-needed basis in liquid or solid dosage forms. Typical antacids which may be used in combination with the histamine H.sub.2 receptor antagonist are conventional antacids which are well known and widely used in the treatment of excess acid related gastrointestinal dysfunctions. Exemplary of typical antacids include, sodium bicarbonate, calcium carbonate, magnesium hydroxide and aluminum hydroxide, as well as commercially available high potency, flavored antacids. Histamine H.sub.2 -receptor antagonists which may be used in combination include those conventionally used in the treatment of peptic ulcers, such as, for example, cimetidine, ranitidine, famotidine and nizatidine. In carrying out the methods, an antacid and histamine H.sub.2 -receptor antagonist may be administered together as a single unitary dose in the form of a liquid or solid, or administered together, but

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separately as either liquids or solids or a combination thereof. The oral medications when formulated as a single unitary dose may include other additives, such as, for example, antiflatulents, flavorings, sweeteners and the like. Excerpt(s): The present invention relates to pharmaceutical compositions and methods for providing immediate and sustained relief from pain, discomfort and/or symptoms associated with episodic heartburn in humans. About 7-10 percent of all people suffer daily, and about 25-40 percent monthly, from pain, discomfort and/or symptoms associated with episodic heartburn. Episodic heartburn is defined as the sensation of burning under the sternum (breastbone) and is usually associated with the ingestion of different foods. Episodic heartburn has also been referred to as "sour stomach," "indigestion," and "waterbrash/regurgitation." Although different foods, such as coffee, mints, fatty foods, alcohol, and chocolate, are usually implicated in the etiology of episodic heartburn, these symptoms can be caused by any type of food in certain people. Moreover, in many people, there is no inciting agent that can be identified, rather the disorder occurs without any known provocation. At present, the primary treatment is based upon the neutralization of gastric acid and pepsin with antacids, such as, for example, aluminum hydroxides, calcium carbonates, magnesium hydroxides and sodium bicarbonates. Of less importance, treatment is based upon the inhibition of secretion by histamine H.sub.2 -receptor antagonists, such as cimetidine and ranitidine. Web site: http://www.delphion.com/details?pn=US05229137__ •

Pharmaceutical capsules containing panetidine Inventor(s): Chopra; Sham K. (Bramalea, CA), Makadia; Tribhovan T. (Mississauga, CA) Assignee(s): Glaxo Canada, Inc. (ca) Patent Number: 5,028,432 Date filed: February 22, 1990 Abstract: The invention relates to a pharmaceutical composition in the form of a gelatin capsules consisting of a filling containing as active ingredient ranitidine or a physiologically acceptable salt thereof surrounded by a gelatin shell. The filling is formulated based on a non-aqueous matrix consisting of at least one fatty acid glyceride and/or mineral oil or paraffin. Preferably the matrix contains at least one surfactant. The matrix is essentially hydrophobic in character but is also sufficiently hydrophilic to permit dispersion and dissolution of the capsule filling in the gastrointenstinal tract. Excerpt(s): The present invention relates to a pharmaceutical composition containing as active ingredient the histamine H.sub.2 -antagonist ranitidine, more particularly a composition for oral administration. Ranitidine, N-[2-[[[5-(dimethylamino)methyl-2furanyl]methyl]thio]ethyl]-N'-methyl-2-n itro-1,1-ethenediamine, and its physiologically acceptable salts are described and claimed in British Patent Specification No. 1565966, and a particular crystalline form of ranitidine hydrochloride is described and claimed in British Patent Specification No. 2084580B. In both of these specifications there is reference to a variety of formulations including preparations for oral, topical, parenteral or rectal administration. Particular types of aqueous formulation for oral use are further described in British Patent Specifications Nos. 2142820A and 2198352A. Oral administration constitutes a preferred route for administering ranitidine, and tablets and capsules represent particular types of formulation for oral use. Capsules conventionally possess an outer shell of which the prime ingredient is gelatin, and in general such capsules may be presented as either hard or soft gelatin capsules.

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Preparation of form 1 ranitidine hydrochloride Inventor(s): Antczak; Casimir (Aurora, CA), McGolrick; Jeffry D. (Aurora, CA), Ngooi; Teng-Ko (Scarborough, CA), Tindall; James L. A. (Goodwood, CA) Assignee(s): Torcan Chemical Ltd. (aurora, Ca) Patent Number: 5,338,871 Date filed: April 1, 1993 Abstract: Pure Form 1 ranitidine hydrochloride is prepared by a process of crystallization from a solution of ranitidine hydrochloride in a mixed solvent comprising 1 part by volume of at least one lower alkanol such as ethanol and 1-2.0 parts by volume of a C.sub.6 -C.sub.10 aromatic hydrocarbon such as toluene, and in the presence of seed crystals of pure Form 1 ranitidine hydrochloride. In the preferred process according to the invention, the ranitidine hydrochloride is prepared in situ in the solvent mixture by adding hydrochloric acid to a solution of the free base in the solvent mixture, in the presence of the seed crystals. Excerpt(s): This invention relates to the pharmaceutical chemical compound known as ranitidine hydrochloride, and to processes for its preparation and isolation in a specific crystalline form. In the form of its hydrochloride salt, ranitidine has achieved widespread acceptance as a medicament for treating ulcers. The patent and technical literature concerning ranitidine hydrochloride reports that it exists in two different crystalline forms, Form 1 and Forth 2. The preparation and characteristics of ranitidine hydrochloride Form 2, which is the commercially marketed form, are described in Canadian Patent no. 1,202,638 Crookes, assigned to Glaxo Group Limited, and issued Apr. 1, 1986. In this patent disclosure, ranitidine hydrochloride Form 1 is reported to be formed by precipitation and crystallization from a solution of ranitidine in industrial methylated spirit containing hydrogen chloride, by addition of ethyl acetate thereto. It is also reported therein that Form 1 ranitidine hydrochloride so produced has unsuitable filtration and drying characteristics, and that Form 2 ranitidine hydrochloride has more advantageous properties, and better characteristics from a manufacturing point of view. This Form 2 ranitidine hydrochloride is reportedly obtained by appropriately chosen crystallization processes. One of these is dissolving the free base in a hydroxylic solvent such as propan-2-ol and treating the solution with hydrochloric acid, followed by crystallization at an elevated temperature by adding further quantities of propan-2-ol. Another is dissolving Form 1 ranitidine hydrochloride in methanol or ethanol with warming, followed by cooling to cause crystallization of the Form 2 salt, optionally accompanied by the addition of an anti-solvent or accompanied by seeding with Form 2 ranitidine hydrochloride crystals. Web site: http://www.delphion.com/details?pn=US05338871__

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Preparation of substituted ethenes Inventor(s): Grayson; James I. (Durham City, GB2), Heyes; Graham (Durham City, GB2), Jackson; Arthur (Washington, GB2), Rowney; Paul E. (Acklam, GB2) Assignee(s): Glaxo Group Limited (london, Gb2) Patent Number: 5,112,995 Date filed: April 4, 1990 Abstract: A potassium salt useful in the production of N-substituted-1-alkylthio-2nitroethenamines is produced by the reaction of the dipotassium salt of nitrodithioacetic acid with certain straight chain alkylamines, thereby converting only one of the KSgroups to an alkylamine group. The resulting monopotassium salt may be alkylated to produce the required N-substituted-1-alkylthio compound which may be reacted with a suitable amine to produce the histamine H.sub.2 -antagonist ranitidine. Excerpt(s): The present invention relates to the preparation of certain substituted ethenes, more specifically certain N-substituted-1-alkylthio-2-nitroethenamines. Such derivatives are useful as intermediates in the manufacture of pharmaceutically active compounds, including particularly the histamine H.sub.2 -antagonist N-[2-[5(dimethylamino)methyl-2-furanylmethylthio]ethyl]-N'-methyl-2-nitro -1,1ethenediamine known as ranitidine. The starting material in the above sequence is the dipotassium salt of nitrodithioacetic acid (1-nitro-2,2-bismercapto-ethylene), and the three stage process involves firstly a methylation by reaction with dimethyl sulphate, secondly the conversion of the resulting CH.sub.3 S-group into a CH.sub.3 NH-- group by reaction with methylamine and thirdly a further methylation using a further quantity of dimethyl sulphate. The three stage process described in the Spanish Patent has been found to require careful control at all stages to avoid the production of unwanted reaction products such as the bis(methylthio) derivative and is disadvantageous in requiring a repetition of the dimethyl sulphate reaction due to the toxic nature of that compound. Web site: http://www.delphion.com/details?pn=US05112995__

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Process for preparing form 1 ranitidine hydrochloride Inventor(s): Nikolopoulos; Aggelos (Bayreuth, DE), Schickaneder; Helmut (Eckental, DE) Assignee(s): Hexal Pharmaceuticals, Inc. (mobile, Al) Patent Number: 5,663,381 Date filed: April 21, 1995 Abstract: A process for preparing pure N-[2-[[[5-[dimethylamino)-methyl-2furanyl]methyl]thio]ethyl]-N'-methyl-2nitro-1,1-ethyldiamine hydrochloride, designated Form 1 ranitidine hydrochloride, from ranitidine in methylene chloride with the addition of hydrochloric acid. The Form 1 ranitidine hydrochloride thus obtained is stable and therefore useful for producing commercial-scale quantities of Form 1 ranitidine hydrochloride. Excerpt(s): The present invention is concerned with hydrochloride salt of the H.sub.2 antagonist N-[2-[[[5-[dimethylamino)-methyl-2-furanyl]methyl]thio]ethyl]-N'-methyl-2nitro-1,1-ethyldiamine, also known as ranitine. More specifically, the present invention is concerned with a novel process for the production of Form 1 rantidine hydrochloride.

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U.S. Pat. No. 4,128,558 granted on Dec. 5, 1978 to Price et al. describes various aminoalkyl furan derivatives including ranitidine. Example 32 of U.S. Pat. No. 4,128,658 in particular describes the preparation of Form 1 ranitidine hydrochloride by dissolving rantidine in industrial methylated spirit (a solvent made up largely of ethanol) containing hydrogen chloride gas, and crystallizing with the addition of ethyl acetate. This procedure is unsatisfactory because of the instability of Form 1 rantidine hydrochloride in the described solvent crystallization system which contains ethyl acetate and ethanol. In particular, the process is inadequate for large scale production. U.S. Pat. Nos. 4,521,431 and 4,672,133 granted to Crookes on Jun. 4, 1985 and Jun. 9, 1987, respectively, describe a crystalline form of rantidine hydrochloride which is designated as Form 2 and which purportedly has more favorable filtration and drying characteristics than the Form 1 ranitidine hydrochloride obtained from the process using hydrogen chloride gas in industrial methylated spirit and ethyl acetate, as described in Example 32 of U.S. Pat. No. 4,128,558. The Form 2 ranitidine hydrochloride of Crookes may be prepared by treating a solution of ranitidine in a hydroxylic solvent, e.g., a lower alkanol, with hydrochloric acid followed by crystallization at elevated temperatures by adding further quantities of solvent. Alternatively, Form 2 ranitidine hydrochloride may be prepared from previously isolated Form 1 or Form 2 ranitidine hydrochloride by dissolving the salt, e.g., by warming in an organic solvent such as methanol or ethanol, followed by cooling to cause crystallization of the Form 2 salt, optionally accompanied by the addition of an anti-solvent or by the addition of Form 2 seeds to induce crystallization. Web site: http://www.delphion.com/details?pn=US05663381__ •

Process for the manufacture of form 1 ranitidine hydrochloride Inventor(s): Khanna; Jag M. (New Delhi, IN), Khanna; Mahavir S. (Delhi, IN), Khera; Brij (New Delhi, IN), Kumar; Naresh (New Delhi, IN) Assignee(s): Ranbaxy Laboratories Limited (new Delhi, In) Patent Number: 5,621,120 Date filed: June 24, 1994 Abstract: A process for the manufacture of Form 1 ranitidine hydrochloride (N-[2-[[[5(Dimethylamino)methyl]-2-furanyl]methyl]thio]ethyl-N'-methyl-2nitro-1,1ethenediamine) hydrochloride, is described. A process to convert ranitidine hydrochloride Form 2 to Form 1 is also described. Excerpt(s): This invention relates to a process for manufacturing Form 1 of the H.sub.2 antagonist `Ranitidine hydrochloride` (N-[2-[[[5-(Dimethylamino)methyl]-2furanyl]methyl]thio]ethyl-N'-methyl-2- nitro-1,1-ethenediamine) hydrochloride, at a commercial scale. Ranitidine hydrochloride, as described and claimed in British Patent Specification No. 1,565,966, (Apr. 1980) and U.S. Pat. No. 4,128,658 (Dec. 1978) shows potent histamine H.sub.2 -blocking activity. A process for preparing ranitidine hydrochloride is known and described in U.S. Pat. No. 4,128,658 (Dec. 1978) and British Patent Specification No. 1,565,966 (Apr. 1980). In U.S. Pat. No. 4,521,431 (June 1985), the ranitidine hydrochloride produced by the method described in U.S. Pat. No. 4,128,658 (Dec. 1978) and British Patent Specification No. 1,565,966 (Apr. 1980) was designated as crystalline Form 1 of ranitidine hydrochloride. A process for preparing crystalline Form 2 ranitidine hydrochloride was disclosed in U.S. Pat. No. 4,521,431 (June 1985), which is now commercially produced and marketed by Glaxo Holdings, the owner of the foregoing patents.

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Process for the manufacture of pharmaceutical grade ranitidine base Inventor(s): Khanna; Jag Mohan (New Delhi, IN), Khera; Brij (New Delhi, IN), Kumar; Naresh (New Delhi, IN), Ray; Purna Chandra (New Delhi, IN) Assignee(s): Ranbaxy Laboratories Limited (new Delhi, In) Patent Number: 5,696,275 Date filed: June 24, 1994 Abstract: A process for the manufacture of pharmaceutical grade ranitidine base(N-›2›››5-(Dimethylamino)methyl!-2-furanyl!methyl!thio!ethyl-N'-methy l-2-nitro-1, 1ethenediamine), is described. In-vitro and in-vivo pharmacological studies and acute toxicity studies indicate that it is as active and as safe as Form 2 ranitidine hydrochloride. Excerpt(s): This invention relates to a manufacturing process for the H.sub.2 -antagonist `ranitidine`, that is, N-›2-›››5-(Dimethylamino) methyl!-2-furanyl!methyl!thio!ethyl-N'methyl-2-nitro-1,1-ethenediamine in crystalline form having >99.5% purity. Ranitidine hydrochloride, as described and claimed in British Patent Specification No. 1,565,966 (April 1980) shows potent histamine H.sub.2 -blocking activity. A process for preparing ranitidine is known and described in U.S. Pat. No. 4,128,658 (December 1978) and in British Patent Specification No. 1,565,966 (April 1980). Though a method to prepare crude ranitidine base is described in U.S. Pat. No. 4,128,658 (December 1978), see Example 15 thereby, the ranitidine base produced by this method has not been evaluated for clinical application. In experiments following Example 15, the ranitidine base produced thereby is brownish yellow in color and has a purity of less than 97% (HPLC), with related substances being ca. 2%. The present invention provides a process for producing ranitidine base which is crystalline, is of pharmaceutical grade (>99.5% purity), and is convenient to produce on a commercial scale. Web site: http://www.delphion.com/details?pn=US05696275__

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Processes for preparing ranitidine Inventor(s): Strom; Robert M. (Midland, MI) Assignee(s): Hoechst Marion Roussel, Inc. (cincinnati, Oh) Patent Number: 5,672,724 Date filed: November 16, 1995 Abstract: The present invention relates to a novel method for preparing ranitidine and pharmaceutically acceptable salts thereof. Excerpt(s): The present invention relates to a novel process for preparing ranitidine, N›2-›››5-(dimethylamino)methyl-2-furanyl!methyl!thio!ethyl!-N'-methyl-2-n itro-1,1ethenediamine, and pharmaceutically acceptable salts thereof, an antagonist of the H.sub.2 -histamine receptor which is useful in the treatment of gastric and peptic ulcers (U.S. Pat. No. 4,128,658, Dec. 5, 1978). The process of the present invention provides a novel and efficient method for preparing ranitidine and pharmaceutically acceptable salts thereof. reacting 2-nitromethylene-thiazolidine with methylamine to give a reaction mixture and then reacting the reaction mixture with an appropriate 5-

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›(dimethylamino)methyl!-furan derivative. The expression "pharmaceutically acceptable acid addition salts" is intended to apply to any non-toxic organic or inorganic acid addition salt of ranitidine. Illustrative inorganic acids which form suitable salts include hydrochloric, hydrobromic, sulphuric, and phosphoric acid and acid metal salts such as sodium monohydrogen orthophosphate, and potassium hydrogen sulfate. Illustrative organic acids which form suitable salts include the mono-, di-, and tricarboxylic acids. Illustrative of such acids are for example, acetic, glycolic, lactic, pyruvic, malonic, succinic, glutaric, fumaric, malic, tartaric, citric, ascorbic, maleic, hydroxymaleic, benzoic, hydroxybenzoic, phenylacetic, cinnamic, salicylic, 2-phenoxybenzoic, and sulfonic acids such as p-toluenesulfonic acid, methanesulfonic acid and 2hydroxyethanesulfonic acid. Such salts can exist in either a hydrated or substantially anhydrous form. Web site: http://www.delphion.com/details?pn=US05672724__ •

Ranitidine pharmaceutical compositions Inventor(s): Cameron; James M. (Oxfordshire, GB2), Jackson; David A. (Maidenhead, GB2), Quirk; Christopher W. (Middx, GB2) Assignee(s): Glaxo Group Limited (london, Gb2) Patent Number: 5,456,918 Date filed: January 13, 1994 Abstract: The invention provides a pharmaceutical composition for use in human or veterinary medicine which comprises ranitidine or a physiologically acceptable salt thereof, alginic acid or a physiologically acceptable salt thereof, and a carbonate or bicarbonate. The composition preferably comprises 1.25% to 10% w/w ranitidine hydrochloride, 5% to 35% w/w alginic acid, and 2% to 15% w/w sodium bicarbonate and is preferably in the form of a capsule or tablet. The compositions are suitable for the treatment of gastrointestinal disorders and particularly reflux oesophagitis. Excerpt(s): This invention relates to improvements in the treatment of gastrointestinal disorders. More particularly it relates to pharmaceutical compositions containing ranitidine and alginic acid or an alginate. Ranitidine is the approved name for N-[2-[[5[(dimethylamino) methyl]-2-furanylmethyl]thio]ethyl]-N'-methyl-2-nitro-1,1ethenediamine which, together with its physiologically acceptable salts, is described and claimed in British Patent Specification No. 1565966. Ranitidine is a potent histamine H.sub.2 -antagonist which, in the Form of its hydrochloride salt, is widely used in the treatment of conditions where there is an advantage in lowering gastric acidity. Such conditions include duodenal and gastric ulceration, reflux oesophagitis and ZollingerEllison syndrome. Ranitidine may also be used prophylactically in surgical procedures, and in the treatment of allergic and inflammatory conditions where histamine is a known mediator. Alginic acid and alginate salts have long been used in the treatment of gastrointestinal disorders. Co-administration of alginic acid or an alginate with the H.sub.2 -receptor antagonist ranitidine provides a useful and advantageous combination For the treatment of disorders of this type, and is particularly useful For the treatment of conditions such as reflux oesophagitis. In reflux oesophagitis there is regurgitation of the stomach contents into the oesophagus, which produces heartburn and other symptoms and may lead to damage of the oesophageal mucosa. Ingestion of alginic acid or an alginate results in the Formation of a raft on the top of the contents of the stomach, which serves as a physical barrier to regurgitation and, in the event that reflux does occur, will preferentially bathe the oesophageal mucosa, thereby protecting

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it from exposure to gastric contents. The role of the H.sub.2 -antagonist ranitidine is to reduce the volume and acidity of the gastric juice. This, combined with the action of the alginic acid or alginate, constitutes an effective means for the relief of symptoms and promotion of healing. Web site: http://www.delphion.com/details?pn=US05456918__ •

Ranitidine solid dosage form Inventor(s): Coffin; Mark D. (Cary, NC), Parr; Alan F. (Cary, NC) Assignee(s): Glaxo Inc. (research Triangle Park, Nc) Patent Number: 5,407,687 Date filed: February 22, 1994 Abstract: The present invention comprises a bi-layer, pharmaceutical tablet having one layer formulated for the immediate release (IR) of ranitidine and a second layer formulated for sustained release (SR) of ranitidine with the ratio of ranitidine in the IR layer to that in the SR in the range of from about 30:70 to about 60:40. Excerpt(s): The present invention relates to pharmaceutical solid dosage forms having an immediate release layer and a slow release layer with each layer containing ranitidine as an active ingredient. The drug ranitidine, chemically identified as N-[2[[[5-(dimethyl-amino)methyl-2-furany]methyl]thio]ethyl]-N'-methyl-2-n itro-1,1ethenediamine and its physiologically acceptable salts are described and claimed in U.S. Pat. No. 4,128,658, and a particular crystalline form of ranitidine hydrochloride is described and claimed in U.S. Pat. No. 4,521,431 (both incorporated herein by reference). In both these patents there is reference to formulations for oral administration, which may, for example, be in the form of tablets, capsules, granules powders, solution, syrups, suspensions, or tablets or lozenges for buccal administration. Oral preparations of ranitidine are also disclosed in U.S. Pat. Nos. 4,585,790, 4,880,636, 5,028,432, 5,068,249 and 5,102,665. As used herein the term "ranitidine" refers to both the free base and the pharmaceutically acceptable acid addition salts thereof unless otherwise noted. Ranitidine is an antagonist to histamine H.sub.2 receptors. This drug is widely used in the treatment of duodenal ulcers in humans in the form of the hydrochloride salt. While the drug is generally given orally or by injection, the oral route is preferred. Ranitidine HCI is sold under the trademark Zantac.RTM. by Glaxo Inc. of Research Triangle Park, North Carolina. Web site: http://www.delphion.com/details?pn=US05407687__

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Ranitidine tablet having a hydroxypropylmethylcellulose containing coating and a method for producing said coating Inventor(s): Gebhard-Hansen; Knud Erik (Birker.o slashed.d, DK), Kann; Helle (Frederiksberg, DK), Pedersen; S.o slashed.ren Bols (Hvidovre, DK) Assignee(s): A/s Gea Farmaceutisk Fabrik (frederiksberg, Dk) Patent Number: 5,741,507 Date filed: January 15, 1997 Abstract: The present invention deals with a ranitidine tablet containing at least 30% ranitidine chloride and having a hydroxypropylmethylcellulose containing coating

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characterized in that the coating comprises hydroxypropylmethylcellulose and ethylcellulose in a mutual ratio between 10:1 and 1:2 as well as a method for producing the desired coating when manufacturing such ranitidine tablets. Excerpt(s): The present invention deals with a ranitidine tablet containing at least 30% ranitidine hydrochloride and having a hydroxypropylmethylcellulose containing coating as well as a method for producing the desired coating when manufacturing such ranitidine tablets. It is conventional to provide a coating on pharmaceutical tablets for oral administration, either by dragging or by means of a film-coating technique, i.e. a process similar to a spray-painting. The present invention is related to the use of this last mentioned technique on tablets containing ranitidine hydrochloride. Web site: http://www.delphion.com/details?pn=US05741507__ •

Simethicone containing pharmaceutical compositions Inventor(s): Hoy; Michael R. (North Wales, PA), Roche; Edward J. (Paoli, PA), Stevens; Charles A. (Lansdale, PA) Assignee(s): Mcneil-ppc, Inc. (skillman, Nj) Patent Number: 5,679,376 Date filed: May 31, 1995 Abstract: A solid oral dosage form for the treatment of gastrointestinal disorders comprising a therapeutically effective amount of a pharmaceutical suitable for the treatment of gastric disorders selected from the group consisting of cimetidine, ranitidine, famotidine, diphenoxylate, loperamide, loperamide-N-oxide, pharmaceutically acceptable salts thereof and combinations thereof; and a therapeutically effective amount of simethicone wherein the pharmaceutical and simethicone are separated by a barrier which is substantially impermeable to simethicone. Excerpt(s): This invention relates to a solid oral dosage form for a pharmaceutical composition for treating gastrointestinal distress comprising a therapeutically effective amount of simethicone and a therapeutically effective amount of an antidiarrheal, an antiperistaltic and/or an H.sub.2 blocker. This invention also relates to methods of making the aforesaid solid oral dosage form. Simethicone has been utilized in a variety of therapeutic liquid and solid dosage forms. The most common dosage formulations for simethicone are combinations of simethicone with various separate antacids. In this dosage formulation it is necessary to separate the simethicone from the antacid to avoid the inactivation of the simethicone. Other formulations of simethicone have been suggested in the literature such as simethicone and dextromethorphan, and simethicone, tranquilizer and an antacid. Simethicone may advantageously be combined with an antidiarrheal or antiperistaltic to provide enhanced relief for gastrointestinal distress due to diarrhea. However, in formulating simethicone with these antidiarrheals, antiperistaltics and H.sub.2 blockers, we discovered that without special precautions being taken, the dissolution rate of the antidiarrheals, antiperistaltics and H.sub.2 blockers was adversely effected. Web site: http://www.delphion.com/details?pn=US05679376__

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Tablet or capsule having a content of stable ranitidine hydrochloride form 1 Inventor(s): Fischer; Wilfried (Holzkirchen, DE), Klokkers; Karin (Holzkirchen, DE) Assignee(s): Hexal AG (holzkirchen, De) Patent Number: 5,910,320 Date filed: August 19, 1996 Abstract: The invention relates to a tablet or capsule that is characterised by a powder mixture having a content of stable ranitidine hydrochloride Form 1 together with a carrier and/or diluent, and to manufacturing processes for the tablet. Excerpt(s): From GB-B-1 565 966 ranitidine hydrochloride is known in a crystalline form that according to DE-C-3 139 134 is to be referred to an Form 1. It was not yet possible according to DE-C-3 139 134, however, to produce tablets with pure and highly crystalline ranitidine hydrochloride. That prior art provides for that purpose a new form of ranitidine hydrochloride that is said to be pure and highly crystalline and is referred to as Form 2. Form 2 can be obtained by recrystallisation of Form 1, it being possible to accelerate the recrystallisation process by adding seed crystals of Form 2. According to DE-C-3 139 134, the X-ray diffraction spectrum of Form a is characterised inter alia by a strong band.theta.=10.degree. (4.40.ANG.) which Form 1 lacks according to Hohnjec et al. in Flory, Analytical Profiles of Drug Substances, Vol. 15, 1986, pages 549 to 550. The two forms can therefore be distinguished well from each other by means of radiography. According to the prior art mentioned, therefore, at room temperature ranitidine hydrochloride exists as Form 2, whereas Form 1 is unstable, with the result that it changes into Form 2 in the presence of seed crystals of Form 2. It is therefore to be considered surprising that, according to the invention, tablets or capsules can be provided that are characterised by a powder mixture having a content of stable ranitidine hydrochloride Form 1 together with a carrier and/or diluent. Web site: http://www.delphion.com/details?pn=US05910320__

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Taste-making compositions of ranitidine Inventor(s): Douglas; Stephen J. (Ware, GB3), Evans; Jill (Ware, GB3) Assignee(s): Glaxo Group Limited (greenford, Gb3) Patent Number: 5,635,200 Date filed: April 12, 1995 Abstract: This invention relates to a composition which is substantially free of the bitter taste associated with ranitidine and comprises: a) a dispersion of lipid coated particles of ranitidine or a physiologically acceptable salt thereof in a non-aqueous vehicle; b) particles comprising ranitidine or a physiologically acceptable salt thereof incorporated into a core and coated with a lipid coating; c) lipid coated particles of a form of ranitidine which is poorly soluble in water; and processes for the preparation thereof and pharmaceutical compositions thereof. Excerpt(s): This application is a 371 of PCT/EP93/02832 filed on Oct. 14, 1993 published as WO94/08576 Apr. 28, 1994. The present invention relates to improvements in the formulation of the histamine H.sub.2 -receptor antagonist ranitidine, particularly for oral administration. Ranitidine, N-[2-[[5-[(dimethylamino)methyl]-2-furanylmethyl]thio]ethyl]-N'-methyl-2- nitro-1, 1-ethenediamine, and its physiologically acceptable salts are described and claimed in British Patent Specification No. 1565966, and a

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particular crystalline form of ranitidine hydrochloride is described and claimed in British Patent Specification No. 2084580B. In both these specifications there is reference to formulations for oral administration, which may take the form of for example tablets, capsules, granules, powders, solutions, syrups, suspensions, or tablets or lozenges for buccal administration. Oral preparations of ranitidine are also disclosed in British Patent Specification Nos. 2142820, 2198352, 2218336, 2219940, 2222772 and 2229094. Web site: http://www.delphion.com/details?pn=US05635200__ •

Unbuffered premixed ranitidine formulation Inventor(s): Johnson; Douglas G. (Grayslake, IL), Titus; Allan E. (Round Lake, IL) Assignee(s): Baxter International Inc. (deerfield, Il) Patent Number: 5,169,864 Date filed: November 15, 1991 Abstract: A pharmaceutical composition is provided comprising an unbuffered isoosmotic aqueous formulation containing an effective amount of ranitidine for the treatment of conditions mediated through histamine H.sub.2 receptors. The formulation has a pH of greater than or equal to 5.0 and less than 6.5 and preferably includes an osmotic adjusting agent chosen from the group consisting of dextrose and sodium chloride. Excerpt(s): The present invention relates generally to pharmaceutical compositions. More specifically, the present invention relates to premixed ranitidine formulations. Ranitidine [N-[2-[[[5-(dimethylamino) methyl-2-furanyl] methyl] thio] ethyl]-N'-methyl2-nitro-1,1-ethenediamine] is a histamine H.sub.2 antagonist that blocks the secretion of gastric acid and is widely used to treat peptic ulcer disease. Oral and parenteral formulations including ranitidine are known. Typically, pharmaceutical products must be discarded after they degrade to less than 90% potency. One of the problems encountered with ranitidine formulations is that they suffer the disadvantage of degradation during terminal sterilization. This can be compensated for by manufacturing overages, but doing so means that when the product is at 100% potency, it already contains several % degradation. Web site: http://www.delphion.com/details?pn=US05169864__

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Use of cimetidine for the control of retrovirus infections Inventor(s): Bourinbaiar; Aldar S. (New York, NY) Assignee(s): Metatron, Inc. (deer Park, Ny) Patent Number: 5,541,212 Date filed: April 21, 1994 Abstract: The invention relates to histamine H2-receptor antagonists such as cimetidine and related compounds such as ranitidine and famotidine that can be used for controlling human immunodeficiency virus (HIV) infection. The preferred agent is cimetidine. The invention comprises a method in vitro as well as in vivo for controlling, i.e., prevention and/or treatment, of HIV infection, associated with the development of acquired immune deficiency syndrome (AIDS), at pharmacological doses of these drugs commonly used for the treatment of gastrointestinal ulcers. The method is based on

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inhibiting HIV in vitro or on the administration to a host that has been exposed to HIV prior to diagnosis or has been diagnosed as having an HIV infection, of an amount of a H2 antagonist which is sufficient to exert an anti-HIV effect for a sufficient period of time. Excerpt(s): The present invention relates to the field of chemotherapeutic treatment of vital infections and is particularly directed to a method of treating retroviral infection and infection-associated diseases. This invention relates to histamine type 2 anti-ulcer drugs, and more particularly to cimetidine, ranitidine, and famotidine which are useful for treating diseases caused by retroviral infection and, therefore, the compounds as such and their chemical synthesis are not the part of the present invention. A group of viruses known as retroviruses are of particular concern because they cause diseases that are potentially lethal to an infected host. Retroviruses are a subgroup of RNA viruses that replicate by a reverse transcription mechanism using DNA polymerase that converts viral RNA into proviral DNA which becomes a part of the host cell DNA. At the present time, several retroviruses are recognized as causative agents of infections in humans and animals. For example, human T cell lymphotropic viruses of type 1 and 2 (HTLV-1 and (HTLV-2) are known as the causative agents of T cell leukemia and debilitating neurological diseases. Web site: http://www.delphion.com/details?pn=US05541212__

Patent Applications on Ranitidine As of December 2000, U.S. patent applications are open to public viewing.5 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to ranitidine: •

Composition and method for treating the effects of diseases and maladies Inventor(s): Gelber, Daniel; (Woodland Hills, CA), Kleinberger, Richard; (Sherman Oaks, CA) Correspondence: Terry W. Kramer; Kramer & Associates; Suite 1101; 2001 JEFF. Davis HWY.; Arlington; VA; 22202; US Patent Application Number: 20010043959 Date filed: January 5, 2001 Abstract: A medicinal composition for treating acid reflux disease comprises an effective amount of a pharmaceutical and an effective amount of a nutraceutical in a pharmaceutically acceptable base. The pharmaceutical is an acid-controlling pharmaceutical, such as cimetidine or ranitidine. The nutraceutical is a nutraceutical which is useful for treating stomach disorders, a nutraceutical which protects the mucosal linings of the digestive system, or a liver protectants. A method of using such a cmposition in the treatment of acid reflex disease is also disclosed. Excerpt(s): The present invention relates to the field of medicinal compositions and methods of using said compositions for treating diseases and maladies. In particular, the present invention relates to formulations comprising combinations of a pharmaceutical in combination with a nutraceutical, which when administered to a person in need

5

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

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thereof have the effect of increasing the beneficial effects of the pharmaceutical utilized. This application claims the benefit of U.S. Provisional Application Ser. No. 60/184,351 entitled "Composition and Method For Treating The Effects of A Cold or Flu," filed on Feb. 23, 2000. Beginning in prehistoric times, humans have attempted to treat every known type of illness and malady with naturally occurring products. Such products were initially in their natural state, such as leaves, berries, roots, tree cuttings and extracts. With the advance of science, and greater understanding of chemistry, humans have been able to synthetically produce and extract a great variety of pharmaceuticals which were previously unknown or unidentified. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Novel process for the preparation of form 1 ranitidine hydrochloride Inventor(s): Briggs, Roger L.; (Midland, MI), Cheng, Wen J.; (Midland, MI), McCoy, Lee V.; (Midland, MI) Correspondence: Aventis Pharmaceuticals, INC.; Patents Department; Route 202-206, P.O. Box 6800; Bridgewater; NJ; 08807-0800; US Patent Application Number: 20020151729 Date filed: May 31, 2002 Abstract: The present invention provides a novel process for preparing Form 1 ranitidine hydrochloride by crystallization from at least one C.sub.1-C.sub.6 alkanol. Excerpt(s): This application is a continuation of U.S. application Ser. No. 08/822,168, filed Mar. 21, 1997, which claims the benefit of U.S. Provisional Application No. 60/042,579, filed Mar. 25, 1996. The present invention relates to a novel process for preparing ranitidine hydrochloride; N-[2-[[[5-(dimethylamino)methyl-2-furanyl]methyl]thio]ethyl]-N'-methyl-2-nitro-1,1-ethenediamine hydrochloride, an antagonist of the H.sub.2-histamine receptor which is useful in the treatment of gastric and peptic ulcers (U.S. Pat. No. 4,128,658, Dec. 5, 1978). More particularly, the present invention provides a novel process for preparing Form 1 ranitidine hydrochloride by crystallization from at least one C.sub.1-C.sub.6 alkanol. Ranitidine hydrochloride is reported to exist in two polymorphic crystalline forms, designated Form 1 and Form 2. The preparation of Form 1 ranitidine hydrochloride is reported in U.S. Pat. No. 4,128,658. According to that preparation ranitidine hydrochloride is formed in a volume of industrial methylated spirits and the Form 1 polymorph is obtained upon precipitation or crystallization induced by the addition of an equal volume of ethyl acetate. However, Form 1 ranitidine hydrochloride prepared in this manner is reported to possess unsuitable filtration and drying characteristics, see U.S. Pat. No. 4,672,133. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Osmotic device containing ranitidine and a prokinetic agent Inventor(s): Faour, Joaquina; (Buenos Aires, AR) Correspondence: Innovar, Llc; P O Box 250647; Plano; TX; 75025; US Patent Application Number: 20010051185 Date filed: January 5, 2001

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Abstract: The present invention provides an osmotic device containing controlled release ranitidine in the core in combination with a prokinetic agent in a rapid release external coat. A wide range of prokinetic agents can be used in this device. Particular embodiments of the invention provide osmotic devices having predetermined release profiles. One embodiment of the osmotic device includes an external coat that has been spray coated rather compression coated onto the device. The device with spray-coated external core is smaller and easier to swallow than the similar device having a compression-coated external coat. The device is useful for the treatment of gastric acid related disorders. The device can be tailored for once or twice daily administration. The amounts of ranitidine and prokinetic agent can be varied. One embodiment provides two different charges of ranitidine (one rapid release and the other controlled release) and a rapid release charge of prokinetic agent. Excerpt(s): The present application claims the priority of U.S. provisional application for patent Ser. No. 60/175,844 filed Jan. 13, 2000. This invention pertains to an osmotic device containing ranitidine. More particularly, it pertains to an osmotic device tablet which provides a controlled release of ranitidine and a prokinetic agent, following a particularly advantageous release profile. Gastroesophageal reflux disease (GERD), reflux oesophagitis, peptic ulcer, gastric ulcer and other gastric acid related disorders are disorders having a pathogenesis related to reduced gastric motility, i.e., reduced clearing capacity of the stomach, and release of excessive gastric acid. Aside from behavioral changes, GERD and gastric ulcer have been successfully treated with a range of gastric acid inhibitors, such as ranitidine and omeprazol, which are known as H2 blocker or acid-suppressing drugs. Stimulation of gastric motility has been proposed to accelerate the healing of gastric ulcer. Prokinetic drugs, such as cisapride, are known to enhance gastrointestinal motility and prevent duodenogastric reflux, and are widely used to treat GERD. Ranitidine and prokinetic drugs have been used in combination to treat gastric ulcer and other related disorders. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

SUBSTANCE TO PREVENT OR REVERSE WEIGHT GAIN INDUCED BY PSYCHOACTIVE AGENTS Inventor(s): MILLER, JON M.; (LOUISVILLE, KY) Correspondence: Donald L. Cox; Lynch, Cox, Gilman & Mahan; Aegon Center- Suite 2200; 400 W. Market; Louisville; KY; 40202; US Patent Application Number: 20030096808 Date filed: March 29, 1999 Abstract: A substance to prevent or reverse weight gain induced by psychoactive agents (10) having an antipsychotic drug (12) or mood stabilizing drug (14) in a concentration from 0.01% to 99.99% in combination with a histamine H2-receptor antagonist (16) in a concentration from 99.99% to 0.01%. The antipsychotic drug (12) is selected from a group consisting of olanzapine (12A), clozapine (12B), risperidone (12C), and quetiapine (12D). The antipsychotic drug (12) is typically in a concentration of 10% to 90%, 30% to 60% and 50%. The mood stabilizing drug (14) is selected from a group consisting of divalproex sodium (14A), valproic acid (14B), and mirtazapine (14C). The mood stabilizing drug (14) is typically in a concentration of 10% to 90%, 30% to 60% and 50%. The histamine H2-receptor antagonist (16) is selected from a group consisting of nizatidine (16A), famotidine (16B), cimetidine (16C) and ranitidine (16D). The histamine

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H2-receptor antagonist (16) is in a concentration of 90% to 10%. The histamine H2receptor antagonist (16) is typically in a concentration of 60% to 30% and 50%. Excerpt(s): The present invention relates to medications used for weight control. More particularly, the present invention relates to the use of a histamine H.sub.2-receptor antagonist with antipsychotic and mood stabilizing drugs to control weight. Numerous innovations for substances to prevent or reverse weight gain have been provided in the past. Even though these innovations may be suitable for the specific individual purposes to which they address, they differ from the present invention because they fail to describe or claim at least one combination of the features depicted in the present invention. Even though these innovations may be suitable for the specific individual purposes to which they address, they would not be suitable for the purposes of the present invention as heretofore described. The present invention prevents and reverses weight gain associated with the use of olanzapine and other antipsychotic drugs. The combination of psychoactive drugs and histamine H.sub.2-receptor antagonists may represent a combined single dose delivery system or multiple drug regimen taken at preselected times. The psychoactive drugs are dosed as recommended by the manufacturer and the histamine H.sub.2-receptor antagonists are dosed as for use in maintenance treatment of duodenal ulcer. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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

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

News Services and Press Releases One of the simplest ways of tracking press releases on ranitidine 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 “ranitidine” (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 ranitidine. 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 “ranitidine” (or synonyms). The following was recently listed in this archive for ranitidine: •

Ranitidine may improve survival in some cases of colon cancer Source: Reuters Industry Breifing Date: November 07, 2002

•

Pantoprazole superior to ranitidine in preventing reflux esophagitis relapse Source: Reuters Medical News Date: August 17, 2001

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•

Omeprazole supports H. pylori eradication better than ranitidine Source: Reuters Industry Breifing Date: July 13, 2001

•

Glaxo India up 8% on ranitidine decontrol news Source: Reuters Industry Breifing Date: May 16, 2001

•

Rabeprazole superior to ranitidine in patients with erosive GERD Source: Reuters Industry Breifing Date: September 19, 2000

•

Lansoprazole better than ranitidine in healing NSAID-associated gastric ulcers Source: Reuters Medical News Date: May 23, 2000

•

FDA approves Watson Pharmaceutical's ranitidine Source: Reuters Medical News Date: January 21, 2000

•

Low-dose pantoprazole superior to ranitidine for mild reflux esophagitis Source: Reuters Medical News Date: January 18, 2000

•

Ranbaxy gets FDA approval for generic ranitidine Source: Reuters Medical News Date: January 13, 2000

•

Omeprazole superior to high-dose ranitidine for mild reflux Source: Reuters Medical News Date: April 09, 1999

•

Ranitidine bismuth citrate triple therapy eradicates metronidazole-resistant H. pylori Source: Reuters Medical News Date: March 29, 1999

•

Rare side effect of ranitidine reported Source: Reuters Medical News Date: June 15, 1998

•

Ranitidine Reduces GI Bleeding Associated With Mechanical Ventilation Source: Reuters Medical News Date: March 19, 1998

•

Omeprazole More Effective Than Misoprostol Or Ranitidine For NSAID-Associated Ulcers Source: Reuters Medical News Date: March 12, 1998

•

Geneva To Market Generic Ranitidine At End Of Month Source: Reuters Medical News Date: August 11, 1997

•

Novopharm Unit To Market Generic Ranitidine In US Source: Reuters Medical News Date: August 05, 1997

•

Ranitidine Ineffective For Treatment Of Psoriasis Source: Reuters Medical News Date: July 03, 1997

Periodicals and News 51

•

Merck AG Gets 2-Month Exclusivity On Ranitidine Source: Reuters Medical News Date: June 23, 1997

•

Lansoprazole Superior To Ranitidine In Treatment Of Erosive Reflux Esophagitis Source: Reuters Medical News Date: March 21, 1997

•

Ranitidine Effective Therapy For Idiopathic Gastric Acid Hypersecretion Source: Reuters Medical News Date: September 13, 1995

•

Ranitidine Bismuth Citrate Taken With Food Improves Suppression Of H. Pylori Source: Reuters Medical News Date: August 15, 1995

•

Omeprazole Effective In Children With Esophagitis Refractory To Treatment With Ranitidine Source: Reuters Medical News Date: March 30, 1995 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 “ranitidine” (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.

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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 “ranitidine” (or synonyms). If you know the name of a company that is relevant to ranitidine, 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 “ranitidine” (or synonyms).

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 “ranitidine” (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 ranitidine: •

Heartburn: Don't Ignore the Fire Source: Mayo Clinic Health Letter. 18(8): 1-3. August 2000. Contact: Available from Mayo Clinic Health Letter. Subscription Services, P.O. Box 53889, Boulder, CO 80322-3889. (800) 333-9037 or (303) 604-1465. Summary: This health newsletter article reviews heartburn, the burning sensation behind the breastbone, often accompanied by a sour taste in the back of the mouth. Heartburn is the result of stomach acid flowing up into the esophagus (gastroesophageal reflux). The article reviews the anatomy of the stomach and esophagus, and notes the factors that can result in heartburn, including simply overeating, or a weakened or abnormally relaxed esophageal sphincter. Frequent heartburn is called gastroesophageal reflux disease (GERD); people with GERD may also experience nausea, sore throat, hoarseness, wheezing, and a cough. Untreated, GERD can lead to inflammation of the esophagus (esophagitis) or to a precancerous condition called Barrett's esophagus. The article focuses on practical strategies to help prevent heartburn: control weight, avoid foods or beverages that can trigger heartburn, wear loose clothing, avoid lying down for 2 hours after eating, do not smoke, chew gum after meals, and drink adequate water when taking medications. Along with these lifestyle changes, nonprescription drugs that reduce painful stomach acid may relieve mild and occasional heartburn. These drugs include antacids and H2 blockers such as famotidine (Pepcid), nizatidine (Axid), ranitidine (Zantac), and cimetidine (Tagamet). When heartburn becomes frequent, readers are counseled to seek medical assistance.

Periodicals and News 53

Diagnosis may include endoscopy and a pH monitoring test. After diagnosis, prescription medications may include stronger H2 blockers and proton pump inhibitors such as lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex). Surgery may be indicated when drug therapy and lifestyle changes are not effective. One sidebar reports on new endoscopic treatments for heartburn; another sidebar cautions readers about the side effects of chronic heartburn. 1 figure.

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

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

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

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following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to ranitidine: Clarithromycin •

Systemic - U.S. Brands: Biaxin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202667.html

Histamine H 2 -Receptor Antagonists •

Systemic - U.S. Brands: Axid; Axid AR; Mylanta AR Acid Reducer; Pepcid; Pepcid AC Acid Controller; Pepcid I.V.; Pepcid RPD; Tagamet; Tagamet HB; Zantac; Zantac EFFERdose Granules; Zantac EFFERdose Tablets http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202283.html

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

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

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APPENDICES

59

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.

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources 61

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.

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•

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

•

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

The NLM 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 “ranitidine” (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 6546 10 860 10 28 7454

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 “ranitidine” (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 63

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.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on ranitidine 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 ranitidine. 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 ranitidine. 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 “ranitidine”:

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Drug and Medical Device Safety http://www.nlm.nih.gov/medlineplus/drugandmedicaldevicesafety.html Medicines http://www.nlm.nih.gov/medlineplus/medicines.html Pancreatic Cancer http://www.nlm.nih.gov/medlineplus/pancreaticcancer.html Pancreatic Diseases http://www.nlm.nih.gov/medlineplus/pancreaticdiseases.html Peptic Ulcer http://www.nlm.nih.gov/medlineplus/pepticulcer.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 ranitidine. 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: •

Helicobacter Pylori Source: Atlanta, GA: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services. 199x. 4 p. Contact: Available from Centers for Disease Control and Prevention (CDC), Department of Health and Human Services. 1600 Clifton Road, NE, MS C09, Atlanta, GA 30333. (888) 698-5237. Website: www.cdc.gov/ncidod/dbmd/hpylori.htm. PRICE: Single copy free. Order number 995503. Summary: This fact sheet brings physicians up to date on the diagnosis and treatment of Helicobacter pylori infections. H. pylori is a spiral shaped bacterium that is found in the gastric mucus layer of the stomach and is thought to cause more than 90 percent of duodenal ulcers and more than 80 percent of gastric ulcers. The fact sheet lists common questions and answers, covering topics such as the incidence of H. pylori infection, the illnesses caused by the bacterium, ulcer symptoms, patient selection for testing and treatment for H. pylori, diagnostic tests, treatment regimens to eradicate H. pylori, long term consequences of infection, and current activities of the Centers for Disease Control and Prevention (CDC) in this area. Persons with active gastric or duodenal ulcers or documented history of ulcers should be tested for H. pylori, and if found to be infected, they should be treated. Testing for and treatment for H. pylori infection are also recommended after resection of early gastric cancer and for low grade gastric MALT

Patient Resources 67

lymphoma. Diagnostic tests used to determine H. pylori infection include serological (blood) tests, breath tests, and upper esophagogastroduodenal endoscopy. Therapy for H. pylori infection consists of 1 to 2 weeks of one or two effective antibiotics, such as amoxicillin, tetracycline, metronidazole, or clarithromycin, plus either ranitidine bismuth citrate, bismuth subsalicylate, or a proton pump inhibitor. The CDC has established an H. pylori information line for physicians and patients (888-MY-ULCER). Two other information resources are listed, the American Gastroenterological Association and the National Digestive Diseases Information Clearinghouse. 1 table. 3 references. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “ranitidine” (or synonyms). The following was recently posted: •

ASHP therapeutic guidelines on stress ulcer prophylaxis Source: American Society of Health-System Pharmacists - Professional Association; 1999 February 15; 33 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1745&nbr=971&am p;string=ranitidine

•

Delirium: strategies for assessing and treating Source: The John A. Hartford Foundation Institute for Geriatric Nursing - Academic Institution; 2003; 25 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3509&nbr=2735&a mp;string=ranitidine

•

Dyspepsia Source: Institute for Clinical Systems Improvement - Private Nonprofit Organization; 1998 October (revised 2003 Jan); 48 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3664&nbr=2890&a mp;string=ranitidine

•

Evaluation of dyspepsia Source: American Gastroenterological Association - Medical Specialty Society; 1997 November 8 (reviewed 2001); 17 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1295&nbr=529&am p;string=ranitidine

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•

Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children Source: North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition - Professional Association; 2001; 31 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3593&nbr=2819&a mp;string=ranitidine

•

Guidelines for surgical treatment of gastroesophageal reflux disease (GERD) Source: Society of American Gastrointestinal Endoscopic Surgeons - Medical Specialty Society; 1998 February (revised 2001 Jun); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3147&nbr=2373&a mp;string=ranitidine

•

Helicobacter pylori infection in children: recommendations for diagnosis and treatment Source: North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition - Professional Association; 2000 November; 8 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3594&nbr=2820&a mp;string=ranitidine

•

HIV disease management Source: University of Texas Medical Branch Correctional Managed Care - Academic Institution; 1996 September (revised 2002 Jul); 7 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3477&nbr=2703&a mp;string=ranitidine

•

Management of gastroesophageal reflux disease (GERD) Source: University of Michigan Health System - Academic Institution; 2002 March; 9 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3372&nbr=2598&a mp;string=ranitidine

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Peptic ulcer disease Source: University of Michigan Health System - Academic Institution; 1996 October (revised 1999 May); 6 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2286&nbr=1512&a mp;string=ranitidine


•

Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration Source: American Society of Anesthesiologists - Medical Specialty Society; 1999; 10 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1854&nbr=1080&a mp;string=ranitidine

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Surgical treatment of reflux esophagitis Source: Society for Surgery of the Alimentary Tract, Inc - Medical Specialty Society; 1996 (revised 2000); 4 pages http://www.guideline.gov/summary/summary.aspx?doc_id=2170&nbr=1396&a mp;string=ranitidine

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The diagnosis and management of urticaria: a practice parameter part I: acute urticaria/angioedema part II: chronic urticaria/angioedema Source: American Academy of Allergy, Asthma and Immunology - Medical Specialty Society; 2000 December; 24 pages http://www.guideline.gov/summary/summary.aspx?doc_id=3622&nbr=2848&a mp;string=ranitidine

•

VHA/DOD clinical practice guideline for the management of major depressive disorder in adults Source: Department of Defense - Federal Government Agency [U.S.]; 1997 (updated 2000); Various pagings http://www.guideline.gov/summary/summary.aspx?doc_id=2585&nbr=1811&a mp;string=ranitidine 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 ranitidine. 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.

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Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •


•

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

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

•

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

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

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

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WebMDHealth: 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 ranitidine. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with ranitidine. 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 ranitidine. 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 “ranitidine” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received


your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “ranitidine”. 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 “ranitidine” (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 “ranitidine” (or a synonym) into the search box, and click “Submit Query.”

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

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

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •

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

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

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

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

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

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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

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California: Gateway Health Library (Sutter Gould Medical Foundation)

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

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

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

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

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

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

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

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

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

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

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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 75

•

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

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

•

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 77

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

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

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

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

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

•

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/

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

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

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

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

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

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

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

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

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

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

•

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

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

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

•

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

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

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

•

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

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RANITIDINE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abulia: Impairment or loss of will power. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acidity: The quality of being acid or sour; containing acid (hydrogen ions). [EU] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] 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] Adjuvant: A substance which aids another, such as an auxiliary remedy; in immunology, nonspecific stimulator (e.g., BCG vaccine) of the immune response. [EU] 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] Aerosol: A solution of a drug which can be atomized into a fine mist for inhalation therapy. [EU]

Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and

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stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Aluminum Hydroxide: Hydrated aluminum. A compound with many biomedical applications: as a gastric antacid, an antiperspirant, in dentifrices, as an emulsifier, as an adjuvant in bacterins and vaccines, in water purification, etc. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and

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many other compounds. [EU] 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] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Angioedema: A vascular reaction involving the deep dermis or subcutaneous or submucal tissues, representing localized edema caused by dilatation and increased permeability of the capillaries, and characterized by development of giant wheals. [EU] Anhydrous: Deprived or destitute of water. [EU] 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] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [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] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibiotic Prophylaxis: Use of antibiotics before, during, or after a diagnostic, therapeutic, or surgical procedure to prevent infectious complications. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on

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the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticoagulants: Agents that prevent blood clotting. Naturally occurring agents in the blood are included only when they are used as drugs. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidiarrheals: Miscellaneous agents found useful in the symptomatic treatment of diarrhea. They have no effect on the agent(s) that cause diarrhea, but merely alleviate the condition. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Aperture: A natural hole of perforation, especially one in a bone. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal

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phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Aromatic: Having a spicy odour. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspartate: A synthetic amino acid. [NIH] Aspiration: The act of inhaling. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autacoids: A chemically diverse group of substances produced by various tissues in the body that cause slow contraction of smooth muscle; they have other intense but varied pharmacologic activities. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form 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] Basophils: Granular leukocytes characterized by a relatively pale-staining, lobate nucleus and cytoplasm containing coarse dark-staining granules of variable size and stainable by basic dyes. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

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]

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Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] 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] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bismuth Subsalicylate: A nonprescription medicine such as Pepto-Bismol. Used to treat diarrhea, heartburn, indigestion, and nausea. It is also part of the treatment for ulcers caused by the bacterium Helicobacter pylori (HELL-uh-koh-BAK-tur py-LOH-ree). [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [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] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [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]

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Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breath Tests: Any tests done on exhaled air. [NIH] Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchodilator: A drug that relaxes the smooth muscles in the constricted airway. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] 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] Calcium Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Calcium Channels: Voltage-dependent cell membrane glycoproteins selectively permeable to calcium ions. They are categorized as L-, T-, N-, P-, Q-, and R-types based on the activation and inactivation kinetics, ion specificity, and sensitivity to drugs and toxins. The L- and T-types are present throughout the cardiovascular and central nervous systems and the N-, P-, Q-, & R-types are located in neuronal tissue. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carboxy: Cannabinoid. [NIH] Carboxylic Acids: Organic compounds containing the carboxy group (-COOH). This group of compounds includes amino acids and fatty acids. Carboxylic acids can be saturated, unsaturated, or aromatic. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH]

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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] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] 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 Division: The fission of a cell. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotherapy: Treatment with anticancer drugs. [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] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs

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in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Citric Acid: A key intermediate in metabolism. It is an acid compound found in citrus fruits. The salts of citric acid (citrates) can be used as anticoagulants due to their calcium chelating ability. [NIH] Citrus: Any tree or shrub of the Rue family or the fruit of these plants. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [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] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot

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or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Collagen: A polypeptide substance comprising about one third of the total protein in mammalian organisms. It is the main constituent of skin, connective tissue, and the organic substance of bones and teeth. Different forms of collagen are produced in the body but all consist of three alpha-polypeptide chains arranged in a triple helix. Collagen is differentiated from other fibrous proteins, such as elastin, by the content of proline, hydroxyproline, and hydroxylysine; by the absence of tryptophan; and particularly by the high content of polar groups which are responsible for its swelling properties. [NIH] Colloidal: Of the nature of a colloid. [EU] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination chemotherapy: Treatment using more than one anticancer drug. [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]

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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] Concomitant: Accompanying; accessory; joined with another. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective 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] Constriction: The act of constricting. [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] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [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] Corticosteroids: Hormones that have antitumor activity in lymphomas and lymphoid leukemias; in addition, corticosteroids (steroids) may be used for hormone replacement and for the management of some of the complications of cancer and its treatment. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Curative: Tending to overcome disease and promote recovery. [EU] 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] Cyclodextrins: A homologous group of cyclic glucans consisting of alpha-1,4 bound glucose units obtained by the action of cyclodextrin glucanotransferase on starch or similar substrates. The enzyme is produced by certain species of Bacillus. Cyclodextrins form inclusion complexes with a wide variety of substances. [NIH]

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Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dermis: A layer of vascular connective tissue underneath the epidermis. The surface of the dermis contains sensitive papillae. Embedded in or beneath the dermis are sweat glands, hair follicles, and sebaceous glands. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH]

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Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] 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] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Diphenhydramine: A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. It has some undesired antimuscarinic and sedative effects. [NIH] Diphenoxylate: A meperidine congener used as an antidiarrheal, usually in combination with atropine. At high doses, it acts like morphine. Its unesterified metabolite difenoxin has similar properties and is used similarly. It has little or no analgesic activity. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [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] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU]

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Doxepin: A dibenzoxepin tricyclic compound. It displays a range of pharmacological actions including maintaining adrenergic innervation. Its mechanism of action is not fully understood, but it appears to block reuptake of monoaminergic neurotransmitters into presynaptic terminals. It also possesses anticholinergic activity and modulates antagonism of histamine H(1)- and H(2)-receptors. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenogastric Reflux: Reflux of duodenal contents into the stomach. [NIH] Duodenum: The first part of the small intestine. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysmenorrhea: Painful menstruation. [NIH] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [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] Elastic: Susceptible of resisting and recovering from stretching, compression or distortion applied by a force. [EU] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electrocoagulation: Electrosurgical procedures used to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emollient: Softening or soothing; called also malactic. [EU] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [NIH] Endothelial cell: The main type of cell found in the inside lining of blood vessels, lymph vessels, and the heart. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH]

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Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophils: Granular leukocytes with a nucleus that usually has two lobes connected by a slender thread of chromatin, and cytoplasm containing coarse, round granules that are uniform in size and stainable by eosin. [NIH] 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 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 betaadrenergic 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] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Etoposide: A semisynthetic derivative of podophyllotoxin that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle. [NIH] Excipient: Any more or less inert substance added to a prescription in order to confer a suitable consistency or form to the drug; a vehicle. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward

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current causes an action potential. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exploratory Behavior: The tendency to explore or investigate a novel environment. It is considered a motivation not clearly distinguishable from curiosity. [NIH] Extracellular: Outside a cell or cells. [EU] 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] Famotidine: A competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [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] Food Technology: The application of knowledge to the food industry. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [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] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical

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preparations, and in the manufacturing of capsules and suppositories. [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]

Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucans: Polysaccharides composed of repeating glucose units. They can consist of branched or unbranched chains in any linkages. [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] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Gonadal: Pertaining to a gonad. [EU] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granulocyte: A type of white blood cell that fights bacterial infection. Neutrophils, eosinophils, and basophils are granulocytes. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH]

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Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] 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] Host: Any animal that receives a transplanted graft. [NIH] Hydrochloric Acid: A strong corrosive acid that is commonly used as a laboratory reagent. It is formed by dissolving hydrogen chloride in water. Gastric acid is the hydrochloric acid component of gastric juice. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH]

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Hypnotherapy: Sleeping-cure. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypotension: Abnormally low blood pressure. [NIH] 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] Hypoxic: Having too little oxygen. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]

Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In situ: In the natural or normal place; confined to the site of origin without invasion of neighbouring tissues. [EU] 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] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Indomethacin: A non-steroidal anti-inflammatory agent (NSAID) that inhibits the enzyme cyclooxygenase necessary for the formation of prostaglandins and other autacoids. It also inhibits the motility of polymorphonuclear leukocytes. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be

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clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inorganic: Pertaining to substances not of organic origin. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Interleukin-2: Chemical mediator produced by activated T lymphocytes and which regulates the proliferation of T cells, as well as playing a role in the regulation of NK cell activity. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [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] 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] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH]

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Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [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] Loperamide: 4-(p-Chlorophenyl)-4-hydroxy-N.N-dimethyl-alpha,alpha-diphenyl-1piperidine butyramide hydrochloride. Synthetic anti-diarrheal agent with a long duration of action; it is not significantly absorbed from the gut, has no effect on the adrenergic system or central nervous system, but may antagonize histamine and interfere with acetylcholine release locally. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Lymphocyte: A white blood cell. Lymphocytes have a number of roles in the immune system, including the production of antibodies and other substances that fight infection and diseases. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Magnesium Hydroxide: Magnesium hydroxide (Mg(OH)2). An inorganic compound that occurs in nature as the mineral brucite. It acts as an antacid with cathartic effects. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Manic: Affected with mania. [EU]

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Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Assistance: Financing of medical care provided to public assistance recipients. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [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] Meperidine: 1-Methyl-4-phenyl-4-piperidinecarboxylic acid ethyl ester. A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metastasis: The spread of cancer from one part of the body to another. Tumors formed from cells that have spread are called "secondary tumors" and contain cells that are like those in the original (primary) tumor. The plural is metastases. [NIH] Metastatic: Having to do with metastasis, which is the spread of cancer from one part of the body to another. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methylene Chloride: A chlorinated hydrocarbon that has been used as an inhalation anesthetic and acts as a narcotic in high concentrations. Its primary use is as a solvent in manufacturing and food technology. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as

Dictionary 103

treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal cells. They are composed of the protein tubulin. [NIH] Mineral Oil: A mixture of liquid hydrocarbons obtained from petroleum. It is used as laxative, lubricant, ointment base, and emollient. [NIH] Misoprostol: A synthetic analog of natural prostaglandin E1. It produces a dose-related inhibition of gastric acid and pepsin secretion, and enhances mucosal resistance to injury. It is an effective anti-ulcer agent and also has oxytocic properties. [NIH] Mitotic: Cell resulting from mitosis. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucosal Lining: The lining of GI tract organs that makes mucus. [NIH] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myenteric: On stimulation of an intestinal segment, the segment above contracts and that below relaxes. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle

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known as cardiac muscle. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] 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] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutralization: An act or process of neutralizing. [EU] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nizatidine: A histamine H2 receptor antagonist with low toxicity that inhibits gastric acid secretion. The drug is used for the treatment of duodenal ulcers. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used

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pharmacologically as a sympathomimetic. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Oesophagitis: Inflammation of the esophagus. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]

Orthostatic: Pertaining to or caused by standing erect. [EU] Osmosis: Tendency of fluids (e.g., water) to move from the less concentrated to the more concentrated side of a semipermeable membrane. [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] 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] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxytocic: 1. Pertaining to, characterized by, or promoting oxytocia (= rapid labor). 2. An agent that hastens evacuation of the uterus by stimulating contractions of the myometrium. [EU]

Paclitaxel: Antineoplastic agent isolated from the bark of the Pacific yew tree, Taxus brevifolia. Paclitaxel stabilizes microtubules in their polymerized form and thus mimics the action of the proto-oncogene proteins c-mos. [NIH]

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Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Papaverine: An alkaloid found in opium but not closely related to the other opium alkaloids in its structure or pharmacological actions. It is a direct-acting smooth muscle relaxant used in the treatment of impotence and as a vasodilator, especially for cerebral vasodilation. The mechanism of its pharmacological actions is not clear, but it apparently can inhibit phosphodiesterases and it may have direct actions on calcium channels. [NIH] Paraffin: A mixture of solid hydrocarbons obtained from petroleum. It has a wide range of uses including as a stiffening agent in ointments, as a lubricant, and as a topical antiinflammatory. It is also commonly used as an embedding material in histology. [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] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Parietal Cells: Cells in the stomach wall that make hydrochloric acid. [NIH] Parietal Lobe: Upper central part of the cerebral hemisphere. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU]

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Peptic Ulcer: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perforation: 1. The act of boring or piercing through a part. 2. A hole made through a part or substance. [EU] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] 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] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Photocoagulation: Using a special strong beam of light (laser) to seal off bleeding blood vessels such as in the eye. The laser can also burn away blood vessels that should not have grown in the eye. This is the main treatment for diabetic retinopathy. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]

Piroxicam: 4-Hydroxy-2-methyl-N-2-pyridyl-2H-1,2-benzothiazine-3-carboxamide 1,1dioxide. A non-steroidal anti-inflammatory agent that is well established in the treatment of rheumatoid arthritis and osteoarthritis. Its usefulness has also been demonstrated in the treatment of musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. The drug has also been shown to be effective if administered rectally. Gastrointestinal complaints are the most frequently reported side effects. [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]

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Plasma protein: One of the hundreds of different proteins present in blood plasma, including carrier proteins ( such albumin, transferrin, and haptoglobin), fibrinogen and other coagulation factors, complement components, immunoglobulins, enzyme inhibitors, precursors of substances such as angiotension and bradykinin, and many other types of proteins. [EU] Platinum: Platinum. A heavy, soft, whitish metal, resembling tin, atomic number 78, atomic weight 195.09, symbol Pt. (From Dorland, 28th ed) It is used in manufacturing equipment for laboratory and industrial use. It occurs as a black powder (platinum black) and as a spongy substance (spongy platinum) and may have been known in Pliny's time as "alutiae". [NIH]

Plexus: A network or tangle; a general term for a network of lymphatic vessels, nerves, or veins. [EU] Pneumonia: Inflammation of the lungs. [NIH] Podophyllotoxin: The main active constituent of the resin from the roots of may apple or mandrake (Podophyllum peltatum and P. emodi). It is a potent spindle poison, toxic if taken internally, and has been used as a cathartic. It is very irritating to skin and mucous membranes, has keratolytic actions, has been used to treat warts and keratoses, and may have antineoplastic properties, as do some of its congeners and derivatives. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymerase: An enzyme which catalyses the synthesis of DNA using a single DNA strand as a template. The polymerase copies the template in the 5'-3'direction provided that sufficient quantities of free nucleotides, dATP and dTTP are present. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH] Postoperative: After surgery. [NIH] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Precipitation: The act or process of precipitating. [EU] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic

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prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Preoperative: Preceding an operation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prokinetic Drugs: Medicines that cause muscles in the GI tract to move food. An example is cisapride (SIS-uh-pryd) (Propulsid). [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino

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acids determines the shape and function of the protein. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity. [NIH] Proto-Oncogene Proteins c-mos: Cellular proteins encoded by the c-mos genes. They function in the cell cycle to maintain maturation promoting factor in the active state and have protein-serine/threonine kinase activity. Oncogenic transformation can take place when c-mos proteins are expressed at the wrong time. [NIH] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] 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] Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [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] Quinidine: An optical isomer of quinine, extracted from the bark of the Cinchona tree and similar plant species. This alkaloid dampens the excitability of cardiac and skeletal muscles by blocking sodium and potassium currents across cellular membranes. It prolongs cellular action potential, and decreases automaticity. Quinidine also blocks muscarinic and alphaadrenergic neurotransmission. [NIH] Quinine: An alkaloid derived from the bark of the cinchona tree. It is used as an antimalarial drug, and is the active ingredient in extracts of the cinchona that have been used for that purpose since before 1633. Quinine is also a mild antipyretic and analgesic and has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita,

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because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [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] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Ranitidine Bismuth Citrate: Drug used to eradicate Helicobacter pylori. [NIH] Ranitidine Hydrochloride: Drug used to eradicate Helicobacter pylori. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] 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] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [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] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Relaxant: 1. Lessening or reducing tension. 2. An agent that lessens tension. [EU] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Retrovirus: A member of a group of RNA viruses, the RNA of which is copied during viral replication into DNA by reverse transcriptase. The viral DNA is then able to be integrated into the host chromosomal DNA. [NIH] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Rheumatoid: Resembling rheumatism. [EU] Rheumatoid arthritis: A form of arthritis, the cause of which is unknown, although infection, hypersensitivity, hormone imbalance and psychologic stress have been suggested as possible causes. [NIH]

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Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Rod: A reception for vision, located in the retina. [NIH] Salicylic: A tuberculosis drug. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Saponins: Sapogenin glycosides. A type of glycoside widely distributed in plants. Each consists of a sapogenin as the aglycon moiety, and a sugar. The sapogenin may be a steroid or a triterpene and the sugar may be glucose, galactose, a pentose, or a methylpentose. Sapogenins are poisonous towards the lower forms of life and are powerful hemolytics when injected into the blood stream able to dissolve red blood cells at even extreme dilutions. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [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] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH]

Dictionary 113

Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Sterilization: The destroying of all forms of life, especially microorganisms, by heat, chemical, or other means. [NIH] Sternum: Breast bone. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

114 Ranitidine

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Strand: DNA normally exists in the bacterial nucleus in a helix, in which two strands are coiled together. [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] Stress Ulcer: An upper GI ulcer from physical injury such as surgery, major burns, or critical head injury. [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] Structure-Activity Relationship: The relationship between the chemical structure of a compound and its biological or pharmacological activity. Compounds are often classed together because they have structural characteristics in common including shape, size, stereochemical arrangement, and distribution of functional groups. Other factors contributing to structure-activity relationship include chemical reactivity, electronic effects, resonance, and inductive effects. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU] Subarachnoid: Situated or occurring between the arachnoid and the pia mater. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfonic Acids: Inorganic or organic oxy acids of sulfur which contain the RSO2(OH) radical. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppositories: A small cone-shaped medicament having cocoa butter or gelatin at its basis and usually intended for the treatment of local conditions in the rectum. [NIH]

Dictionary 115

Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Suspensions: Colloids with liquid continuous phase and solid dispersed phase; the term is used loosely also for solid-in-gas (aerosol) and other colloidal systems; water-insoluble drugs may be given as suspensions. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Terbutaline: A selective beta-2 adrenergic agonist used as a bronchodilator and tocolytic. [NIH]

Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Theophylline: Alkaloid obtained from Thea sinensis (tea) and others. It stimulates the heart and central nervous system, dilates bronchi and blood vessels, and causes diuresis. The drug is used mainly in bronchial asthma and for myocardial stimulation. Among its more prominent cellular effects are inhibition of cyclic nucleotide phosphodiesterases and antagonism of adenosine receptors. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [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] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH]

116 Ranitidine

Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] 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] Transcriptase: An enzyme which catalyses the synthesis of a complementary mRNA molecule from a DNA template in the presence of a mixture of the four ribonucleotides (ATP, UTP, GTP and CTP). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Trimipramine: Tricyclic antidepressant similar to imipramine, but with more antihistaminic and sedative properties. [NIH] Tunica: A rather vague term to denote the lining coat of hollow organs, tubes, or cavities. [NIH]

Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium

Dictionary 117

channels. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilation: Physiological dilation of the blood vessels without anatomic change. For dilation with anatomic change, dilatation, pathologic or aneurysm (or specific aneurysm) is used. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] 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] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viral: Pertaining to, caused by, or of the nature of virus. [EU] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Wheezing: Breathing with a rasp or whistling sound; a sign of airway constriction or obstruction. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

Xenograft: The cells of one species transplanted to another species. [NIH]

119

INDEX A Abdomen, 81, 86, 101, 114 Abulia, 32, 81 Acceptor, 81, 101, 105 Acetylcholine, 4, 5, 81, 89, 101, 104 Acidity, 26, 30, 39, 81 Adaptation, 81, 89 Adenosine, 81, 107, 115 Adjuvant, 81, 82, 96 Adrenergic, 28, 81, 83, 84, 93, 94, 95, 101, 110, 115 Adverse Effect, 81, 89, 112 Aerosol, 81, 115 Affinity, 81, 89, 93, 113 Agonist, 28, 81, 93, 95, 115 Airway, 82, 87, 117 Akathisia, 82, 84 Albumin, 82, 108 Algorithms, 82, 86 Alimentary, 69, 82, 100, 106 Alkaline, 30, 82, 83, 87 Alkaloid, 82, 85, 103, 106, 110, 115 Allylamine, 82 Alpha-1, 82, 91 Alternative medicine, 51, 82 Aluminum, 4, 33, 34, 82 Aluminum Hydroxide, 33, 34, 82 Amebiasis, 82, 102 Ameliorated, 31, 33, 82 Amine, 36, 82, 98 Amino acid, 83, 85, 87, 93, 95, 98, 102, 107, 109, 112, 114, 115 Ammonia, 82, 83 Amoxicillin, 67, 83 Ampicillin, 83 Ampulla, 83, 94 Analgesic, 83, 90, 93, 99, 101, 102, 103, 105, 110 Analog, 83, 93, 103 Angioedema, 69, 83 Anhydrous, 29, 39, 83 Animal model, 83 Anions, 31, 82, 83, 100 Anode, 83 Antagonism, 83, 89, 94, 115 Anti-Anxiety Agents, 83, 109 Antibacterial, 83, 113 Antibiotic, 83, 87, 89, 95, 108, 113, 115

Antibiotic Prophylaxis, 83, 109 Antibody, 81, 83, 84, 90, 98, 99, 100, 102 Anticholinergic, 84, 94 Anticoagulants, 84, 89 Anticonvulsant, 84, 116 Antidepressant, 84, 99, 116 Antidiarrheals, 41, 84 Antiemetic, 84, 89, 93, 102 Antigen, 81, 83, 84, 90, 98, 99, 100, 102 Anti-inflammatory, 28, 31, 84, 85, 99, 106, 107 Anti-Inflammatory Agents, 84, 85 Antipsychotic, 46, 47, 84, 88, 89, 104, 112 Antitussive, 84, 93, 105 Anus, 84, 86, 90, 100, 111 Anxiolytic, 84, 105 Apathy, 31, 32, 33, 84, 104 Aperture, 25, 84 Aqueous, 24, 25, 27, 34, 42, 43, 84, 85, 98 Arachidonic Acid, 84, 109 Aromatic, 35, 85, 87 Arteries, 85, 86, 91, 103 Aspartate, 85, 93 Aspiration, 69, 85 Aspirin, 28, 31, 85 Asymptomatic, 19, 82, 85 Atropine, 85, 93 Atypical, 85, 89, 112 Autacoids, 85, 99 Autoimmune disease, 85, 103 Autonomic, 81, 84, 85, 104 B Bacteria, 83, 84, 85, 89, 95, 96, 103, 113, 116 Bactericidal, 85, 95 Bacterium, 66, 85, 86 Basal Ganglia, 84, 85, 89 Basal Ganglia Diseases, 85, 89 Base, 29, 35, 38, 40, 44, 85, 92, 100, 103, 112, 115 Basophils, 85, 97, 101 Benign, 85, 97 Bile, 85, 86, 96, 101, 113 Bile Acids, 85, 86, 96, 113 Bilirubin, 82, 86 Bioavailability, 4, 24, 86 Biochemical, 86, 105, 107, 112 Biotechnology, 51, 61, 86 Biotransformation, 86

Ranitidine

Bismuth, 4, 31, 50, 67, 86 Bismuth Subsalicylate, 67, 86 Bladder, 86, 99, 103 Bloating, 86, 99 Blood Coagulation, 86, 87 Blood pressure, 86, 88, 98, 99, 113 Blood vessel, 86, 88, 94, 101, 107, 113, 114, 115, 117 Blood-Brain Barrier, 32, 86 Body Fluids, 86, 113 Bone Marrow, 86, 101, 113 Bowel, 86, 93, 100, 114 Bowel Movement, 86, 93, 114 Branch, 68, 77, 87, 101, 106, 113, 115 Breakdown, 87, 93, 96 Breath Tests, 67, 87 Broad-spectrum, 83, 87 Bronchi, 87, 95, 115 Bronchial, 87, 98, 115 Bronchodilator, 87, 115 Buccal, 24, 40, 43, 87 Burns, 32, 87, 114 C Calcium, 33, 34, 87, 89, 90, 106 Calcium Carbonate, 33, 34, 87 Calcium Channels, 87, 106 Capsules, 24, 26, 34, 40, 42, 43, 87, 93, 97 Carbohydrate, 29, 87, 108 Carboxy, 87 Carboxylic Acids, 30, 87 Carcinogen, 87, 103 Carcinogenic, 87, 113 Carcinoma, 87 Cardiac, 82, 87, 95, 96, 104, 110, 113 Carotene, 30, 87 Case report, 5, 88 Caudal, 88, 93, 99 Cell Division, 85, 88, 95 Cellobiose, 88 Cellulose, 25, 88 Central Nervous System, 81, 87, 88, 89, 95, 96, 97, 101, 103, 112, 115 Central Nervous System Infections, 88, 97 Cerebral, 32, 85, 86, 88, 92, 95, 96, 106, 115 Cerebral Cortex, 32, 88 Cerebrum, 88, 115 Cervical, 88 Cervix, 88 Character, 34, 88 Chemoreceptor, 84, 88 Chemotherapy, 88 Chin, 32, 88, 102

120

Chlorpromazine, 27, 88 Cholesterol, 85, 89, 113 Cholinergic, 84, 89 Chorea, 31, 32, 84, 89 Chromosomal, 89, 111 Chronic, 4, 53, 69, 82, 89, 95, 100, 114 Cimetidine, 4, 5, 29, 30, 33, 34, 41, 43, 44, 46, 52, 89 Cisplatin, 89, 105 Citric Acid, 29, 30, 31, 89 Citrus, 89 Clarithromycin, 56, 67, 89 Clinical trial, 19, 20, 61, 89, 91, 93, 106, 111 Cloning, 86, 89 Clozapine, 46, 89 Coagulation, 28, 86, 89, 108 Codeine, 90, 93, 105 Collagen, 83, 90, 96 Colloidal, 82, 90, 115 Colon, 49, 90, 100 Combination chemotherapy, 90 Complement, 90, 108 Complementary and alternative medicine, 9, 16, 90 Complementary medicine, 90 Computational Biology, 61, 91 Concomitant, 5, 91 Congestion, 84, 91, 95 Connective Tissue, 86, 90, 91, 92, 96, 101, 111 Consciousness, 83, 91, 92, 110 Constipation, 84, 91 Constriction, 91, 117 Consumption, 30, 91 Contraindications, ii, 91 Controlled study, 4, 91 Coordination, 91, 103 Coronary, 91, 103 Coronary Thrombosis, 91, 103 Corticosteroids, 4, 91 Cortisol, 82, 91 Cranial, 91, 97 Craniocerebral Trauma, 85, 91, 97 Crystallization, 35, 37, 45, 91 Curative, 91, 115 Cyclic, 91, 109, 115 Cyclodextrins, 27, 91 Cytochrome, 89, 92 Cytotoxic, 92, 105 Cytotoxic chemotherapy, 92, 105 Cytotoxicity, 82, 89, 92

121

D Decarboxylation, 92, 98 Delirium, 67, 84, 92 Dementia, 31, 32, 33, 84, 92 Dentate Gyrus, 92, 98 Dentifrices, 82, 92 Depressive Disorder, 69, 92, 101 Dermis, 83, 92 Deuterium, 92, 98 Dextromethorphan, 41, 93 Diagnostic procedure, 23, 51, 93 Diarrhea, 41, 82, 84, 86, 93 Diencephalon, 93, 99, 115 Digestion, 82, 85, 86, 93, 94, 99, 101, 106, 114 Digestive system, 20, 44, 93 Dilatation, 83, 93, 117 Dimethyl, 36, 40, 93, 101, 112 Diphenhydramine, 28, 93 Diphenoxylate, 41, 93 Direct, iii, 55, 93, 97, 106, 111, 115 Disinfectant, 93, 95 Distal, 93, 96, 109 Diuresis, 93, 115 Dopamine, 84, 89, 93, 102, 104, 112 Dosage Forms, 33, 40, 41, 93 Double-blind, 4, 93 Doxepin, 27, 94 Drug Interactions, 56, 94 Duodenal Ulcer, 4, 27, 31, 40, 47, 66, 94, 104 Duodenogastric Reflux, 46, 94 Duodenum, 85, 94, 106, 107, 114 Dyskinesia, 84, 94 Dysmenorrhea, 94, 107 Dyspepsia, 30, 67, 94, 99 Dysphoric, 92, 94 Dystonia, 84, 94 E Edema, 83, 94 Effector, 81, 90, 94 Efficacy, 4, 26, 94 Elastic, 94, 115 Elective, 4, 94 Electrocoagulation, 90, 94 Electrolysis, 83, 94 Electrolyte, 92, 94, 108, 113 Emollient, 94, 103, 105 Endoscope, 94 Endoscopic, 53, 68, 94 Endoscopy, 53, 67, 94 Endothelial cell, 86, 94

Entorhinal Cortex, 94, 98 Environmental Health, 60, 62, 95 Enzymatic, 83, 87, 90, 95, 98 Enzyme, 91, 94, 95, 99, 106, 108, 116, 117 Eosinophils, 95, 97, 101 Ephedrine, 27, 95 Epinephrine, 81, 93, 95, 104 Epithelium, 95, 96 Erythema, 95, 116 Erythromycin, 89, 95 Esophageal, 52, 95 Esophagitis, 49, 50, 51, 52, 69, 95 Esophagus, 52, 93, 95, 96, 97, 101, 105, 107, 111, 114 Ethanol, 24, 35, 37, 95 Etoposide, 95 Excipient, 25, 95 Excitability, 95, 110 Exogenous, 86, 96 Exploratory Behavior, 32, 96 Extracellular, 91, 96, 113 Extrapyramidal, 82, 84, 93, 96 F Family Planning, 61, 96 Famotidine, 5, 16, 17, 30, 32, 33, 41, 43, 44, 46, 52, 96 Fat, 84, 86, 87, 96, 101, 103, 111, 115 Fatty acids, 82, 87, 96, 109 Fibrosis, 82, 96, 112 Filtration, 29, 35, 37, 45, 96 Flatus, 96 Food Technology, 96, 102 Frontal Lobe, 31, 32, 96 G Gallbladder, 93, 96 Ganglia, 81, 85, 96, 104 Gas, 29, 37, 83, 96, 98, 99, 104, 114, 115 Gastric Juices, 96, 106 Gastric Mucosa, 5, 96 Gastrin, 89, 96, 98 Gastritis, 27, 96 Gastroesophageal Reflux, 16, 52, 68, 96 Gastrointestinal, 28, 30, 33, 39, 41, 43, 46, 68, 95, 96, 107, 111, 112, 114 Gastrointestinal tract, 28, 95, 96, 112 Gelatin, 34, 96, 114 Gene, 86, 97 Giardiasis, 97, 102 Gland, 97, 101, 106, 112, 114, 115 Glucans, 91, 97 Glucose, 88, 91, 97, 112 Glutamate, 93, 97

Ranitidine

Glycoprotein, 97 Gonadal, 97, 113 Governing Board, 97, 108 Grade, 38, 66, 97 Graft, 97, 98 Granulocyte, 97 Growth, 83, 97, 104, 110 H Habitual, 88, 97 Half-Life, 97, 107 Headache, 28, 97 Headache Disorders, 97 Heart failure, 95, 97 Heartburn, 33, 34, 39, 52, 86, 97, 99 Hemodialysis, 87, 98 Hemorrhage, 91, 94, 97, 98, 114 Hepatic, 82, 92, 98 Hiccup, 89, 98 Hippocampus, 32, 92, 98, 114 Histidine, 98 Histology, 98, 106 Hoarseness, 52, 98 Homologous, 91, 98 Hormone, 91, 95, 96, 98, 102, 109, 111 Host, 44, 98, 111, 117 Hydrochloric Acid, 25, 35, 36, 37, 98, 106 Hydrogen, 29, 35, 37, 39, 81, 82, 85, 87, 92, 98, 101, 103, 105, 110 Hydrogen Peroxide, 98, 101 Hydrolysis, 86, 88, 89, 98, 110 Hydrophilic, 34, 98 Hydrophobic, 30, 34, 98 Hypersensitivity, 93, 98, 111 Hypertension, 97, 98 Hypnotherapy, 99 Hypnotic, 93, 99 Hypotension, 84, 99 Hypothalamus, 32, 93, 99, 115 Hypoxic, 99, 103 I Ibuprofen, 31, 99 Id, 6, 67, 68, 69, 70, 76, 78, 99 Imidazole, 30, 98, 99, 111 Imipramine, 99, 116 Immune response, 81, 84, 85, 99, 114, 117 Immunodeficiency, 32, 43, 99 Immunologic, 19, 99 Impairment, 81, 92, 94, 99, 102, 110 Impotence, 99, 106 In situ, 35, 99 In vitro, 43, 99 In vivo, 43, 99

122

Incompetence, 96, 99 Incontinence, 95, 99 Indigestion, 34, 86, 99 Indomethacin, 31, 99 Induction, 84, 99 Infarction, 91, 99, 103 Infection, 4, 43, 44, 66, 68, 82, 92, 97, 99, 101, 111, 114, 116, 117 Inflammation, 28, 52, 82, 84, 85, 95, 96, 100, 105, 108, 111, 112 Infusion, 100 Ingestion, 27, 34, 39, 100, 102, 108 Inhalation, 81, 98, 100, 102, 108 Innervation, 94, 100 Inorganic, 39, 89, 100, 101, 103, 114 Inpatients, 4, 100 Insulator, 100, 103 Interleukin-2, 5, 100 Intestinal, 17, 26, 87, 100, 103 Intestines, 96, 100 Intracellular, 100, 102, 108, 109 Intramuscular, 100, 106 Intravenous, 25, 100, 106 Involuntary, 85, 89, 100, 103, 111 Ions, 81, 85, 87, 94, 98, 100, 113 K Kb, 60, 100 Kinetic, 100 L Large Intestine, 93, 100, 111, 113 Laxative, 100, 103 Lethal, 44, 85, 100 Leukemia, 44, 100 Leukocytes, 85, 86, 95, 99, 101 Levorphanol, 93, 101 Library Services, 76, 101 Lipid, 5, 42, 101, 103 Lipid Peroxidation, 5, 101 Lithium, 84, 101 Liver, 44, 82, 84, 85, 86, 93, 96, 98, 101 Localized, 83, 100, 101, 116 Loperamide, 41, 101 Lower Esophageal Sphincter, 96, 101 Lymph, 88, 94, 101 Lymph node, 88, 101 Lymphatic, 100, 101, 108, 113 Lymphatic system, 101, 113 Lymphocyte, 84, 101, 102 Lymphoid, 91, 101 Lymphoma, 67, 101 M Magnesium Hydroxide, 33, 34, 101

123

Malnutrition, 82, 101 Manic, 84, 101, 110 Mediate, 93, 102, 111 Mediator, 26, 30, 39, 100, 102, 112 Medical Assistance, 52, 102 Medicament, 35, 102, 114 MEDLINE, 61, 102 Medullary, 93, 102 Membrane, 87, 90, 95, 102, 103, 105, 107, 110, 111, 112, 113 Membrane Proteins, 102, 110 Memory, 92, 102 Mental, iv, 21, 32, 60, 62, 88, 92, 99, 102, 110, 112 Mental Disorders, 21, 102, 110 Meperidine, 93, 102 Mesolimbic, 84, 102 Metabolite, 86, 93, 102 Metastasis, 102 Metastatic, 102 Methanol, 35, 37, 102 Methionine, 93, 102, 114 Methylene Chloride, 36, 102 Metoclopramide, 4, 102 Metronidazole, 50, 67, 102 MI, 34, 38, 45, 79, 103 Microbe, 103, 116 Microorganism, 103, 117 Microtubules, 103, 105 Mineral Oil, 34, 103 Misoprostol, 4, 50, 103 Mitotic, 95, 103 Molecular, 61, 63, 86, 91, 92, 103, 116 Molecule, 84, 85, 90, 94, 98, 103, 105, 111, 116 Morphine, 90, 93, 102, 103, 104, 105 Motility, 46, 99, 103, 112 Motion Sickness, 103, 104 Movement Disorders, 84, 103 Mucosa, 39, 96, 103 Mucosal Lining, 44, 103 Mucus, 66, 103 Multiple sclerosis, 31, 32, 103 Myelin, 103 Myenteric, 5, 103 Myocardium, 103 N Narcolepsy, 95, 104 Narcotic, 101, 102, 103, 104 Nausea, 52, 84, 86, 93, 99, 104, 105 NCI, 1, 20, 59, 104 Need, 44, 52, 71, 104

Neoplastic, 101, 104 Nerve, 81, 88, 100, 102, 103, 104, 112, 114, 116 Nervous System, 88, 102, 104, 109, 114 Neuroleptic, 82, 84, 89, 104, 105 Neuromuscular, 81, 104 Neuromuscular Junction, 81, 104 Neurotoxicity, 93, 104 Neurotransmitter, 81, 83, 93, 97, 98, 104, 114 Neutralization, 34, 104 Nitrogen, 82, 104 Nizatidine, 30, 33, 46, 52, 104 Norepinephrine, 81, 93, 95, 104 O Odour, 85, 105 Oesophagitis, 26, 30, 39, 46, 105 Ointments, 93, 105, 106 Omeprazole, 50, 51, 53, 105, 110 Ondansetron, 105 Opium, 103, 105, 106 Optic Chiasm, 99, 105 Orthostatic, 84, 105 Osmosis, 105 Osmotic, 43, 45, 46, 82, 105 Osteoarthritis, 105, 107 Outpatient, 105 Oxidation, 81, 86, 92, 101, 105 Oxytocic, 103, 105 P Paclitaxel, 105 Paediatric, 106 Palliative, 106, 115 Pancreas, 93, 106 Pancreatic, 66, 96, 106 Pancreatic Juice, 96, 106 Papaverine, 27, 105, 106 Paraffin, 34, 106 Parenteral, 25, 34, 43, 106 Parietal, 105, 106 Parietal Cells, 106 Parietal Lobe, 106 Parkinsonism, 84, 106 Pathogenesis, 46, 106 Pathologic, 91, 98, 106, 117 Patient Compliance, 26, 106 Patient Education, 66, 74, 76, 79, 106 Patient Selection, 66, 106 Pepsin, 34, 89, 103, 106 Pepsin A, 89, 106 Peptic, 16, 30, 33, 38, 43, 45, 46, 66, 68, 106, 107

Ranitidine

Peptic Ulcer, 16, 30, 33, 38, 43, 45, 46, 66, 107 Peptide, 83, 89, 106, 107, 109 Peptide Chain Elongation, 89, 107 Perforation, 84, 107 Petroleum, 103, 106, 107 Pharmaceutical Preparations, 88, 95, 97, 107 Pharmaceutical Solutions, 93, 107 Pharmacodynamics, 107 Pharmacokinetic, 107 Pharmacologic, 69, 85, 97, 107, 116 Pharynx, 96, 107 Phosphorus, 87, 107 Photocoagulation, 90, 107 Physiologic, 82, 97, 107, 109, 111 Physiology, 81, 107 Pigments, 87, 107 Piroxicam, 31, 107 Plasma, 4, 82, 96, 107, 108 Plasma protein, 82, 108 Platinum, 89, 108 Plexus, 5, 108 Pneumonia, 91, 108 Podophyllotoxin, 95, 108 Poisoning, 92, 104, 108 Polymerase, 44, 108 Polymorphic, 45, 92, 108 Polysaccharide, 84, 88, 108 Postoperative, 102, 107, 108 Potassium, 36, 39, 108, 110 Potentiating, 108 Practice Guidelines, 62, 67, 108 Precancerous, 52, 108 Precipitation, 35, 45, 108 Premalignant, 108 Premedication, 108 Preoperative, 69, 109 Presynaptic, 94, 104, 109 Presynaptic Terminals, 94, 109 Progesterone, 109, 113 Progression, 83, 109 Progressive, 92, 97, 105, 109 Prokinetic Drugs, 46, 109 Prophylaxis, 67, 109 Prostaglandin, 103, 109 Prostaglandins A, 99, 109 Protein C, 82, 109 Protein S, 86, 89, 95, 109, 115 Proteins, 83, 84, 90, 95, 102, 103, 104, 106, 107, 108, 109, 110, 112, 116 Proton Pump, 53, 67, 105, 110

124

Proton Pump Inhibitors, 53, 110 Protons, 98, 110, 111 Proto-Oncogene Proteins, 105, 110 Proto-Oncogene Proteins c-mos, 105, 110 Pruritus, 93, 110 Psychic, 102, 110 Psychoactive, 46, 47, 110 Psychosis, 84, 110 Public Assistance, 102, 110 Public Policy, 61, 110 Pulmonary, 69, 86, 91, 110, 115, 117 Q Quinidine, 27, 110 Quinine, 110 R Radiation, 103, 111 Radioactive, 97, 98, 111 Radiography, 42, 111 Randomized, 19, 94, 111 Ranitidine Bismuth Citrate, 4, 31, 51, 67, 111 Ranitidine Hydrochloride, 24, 25, 26, 27, 29, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 45, 111 Reagent, 98, 111 Rectal, 25, 34, 111 Rectum, 84, 86, 90, 93, 96, 99, 100, 111, 114 Refer, 1, 87, 90, 104, 110, 111 Reflex, 44, 111 Reflux, 26, 30, 39, 44, 46, 49, 50, 51, 52, 69, 94, 96, 111 Refraction, 111, 113 Regimen, 26, 47, 94, 106, 111 Regurgitation, 34, 39, 96, 97, 111 Relapse, 49, 111 Relaxant, 106, 111 Resection, 66, 111 Retrovirus, 43, 111 Rheumatism, 99, 111 Rheumatoid, 107, 111 Rheumatoid arthritis, 107, 111 Rhinitis, 95, 112 Risperidone, 46, 112 Rod, 85, 112 S Salicylic, 39, 112 Salivary, 93, 112 Salivary glands, 93, 112 Saponins, 112, 113 Schizophrenia, 32, 112 Sclerosis, 32, 103, 112 Screening, 89, 112

125

Secretion, 17, 27, 34, 43, 89, 96, 98, 103, 104, 105, 111, 112 Secretory, 105, 112 Sedative, 90, 93, 99, 112, 116 Semisynthetic, 83, 89, 95, 112 Serotonin, 84, 89, 104, 105, 112 Serum, 82, 83, 90, 112 Shock, 112, 116 Side effect, 31, 50, 53, 55, 81, 82, 84, 107, 112, 115 Signs and Symptoms, 111, 112 Simethicone, 41, 112 Skeletal, 110, 113 Skeleton, 109, 113 Small intestine, 94, 97, 98, 100, 113 Smooth muscle, 82, 85, 87, 98, 103, 106, 113, 114 Sodium, 25, 33, 34, 39, 43, 46, 110, 111, 113, 116 Sodium Bicarbonate, 33, 34, 39, 113 Sodium Channels, 111, 113, 117 Solid tumor, 113 Solvent, 29, 35, 37, 95, 102, 105, 107, 113 Specialist, 70, 113 Species, 91, 95, 110, 113, 114, 117 Spectrum, 42, 113 Sphincter, 52, 113 Spinal cord, 88, 89, 104, 111, 113 Sterilization, 43, 113 Sternum, 34, 113 Steroid, 91, 112, 113 Stimulant, 98, 113 Stimulus, 100, 111, 114 Stool, 90, 99, 100, 114 Strand, 108, 114 Stress, 5, 31, 67, 91, 104, 111, 114, 116 Stress Ulcer, 67, 114 Striatum, 32, 114 Stroke, 21, 32, 60, 114 Structure-Activity Relationship, 114 Subacute, 100, 114 Subarachnoid, 97, 114 Subclinical, 100, 114 Subcutaneous, 83, 94, 106, 114 Subiculum, 98, 114 Subspecies, 113, 114 Substance P, 95, 102, 112, 114 Suction, 96, 114 Sulfonic Acids, 39, 114 Sulfur, 102, 114 Supplementation, 114 Suppositories, 97, 114

Surfactant, 34, 115 Suspensions, 24, 27, 40, 43, 115, 116 Symptomatic, 83, 84, 115 Symptomatic treatment, 83, 84, 115 Synapse, 81, 104, 109, 115, 116 Systemic, 28, 31, 56, 86, 92, 95, 100, 113, 115 Systemic disease, 28, 115 T Tardive, 84, 115 Telencephalon, 85, 88, 115 Temporal, 32, 97, 98, 115 Terbutaline, 28, 115 Tetracycline, 67, 115 Theophylline, 4, 5, 115 Therapeutics, 30, 56, 115 Third Ventricle, 99, 115 Thrombosis, 109, 114, 115 Thyroxine, 82, 115 Tissue, 84, 85, 86, 87, 90, 91, 94, 96, 97, 100, 101, 102, 103, 104, 111, 112, 113, 115 Topical, 25, 34, 95, 98, 106, 113, 115 Toxic, iv, 36, 39, 85, 92, 102, 108, 115, 116 Toxicity, 38, 94, 104, 116 Toxicokinetics, 116 Toxicology, 62, 116 Toxins, 84, 87, 100, 116 Transcriptase, 111, 116 Transfection, 86, 116 Translocation, 89, 95, 116 Transmitter, 81, 93, 102, 104, 116 Trauma, 92, 95, 116 Trichomoniasis, 102, 116 Tricyclic, 94, 99, 116 Trigger zone, 84, 116 Trimipramine, 27, 116 Tunica, 103, 116 U Ulcer, 4, 26, 30, 44, 46, 66, 68, 94, 103, 114, 116 Ulceration, 26, 30, 39, 107, 116 Unconscious, 99, 116 Urinary, 95, 99, 116 Urticaria, 69, 116 Uterus, 88, 105, 109, 116 V Vaccines, 82, 116, 117 Valproic Acid, 46, 116 Vascular, 82, 83, 92, 97, 99, 100, 116, 117 Vasodilation, 106, 117 Vasodilator, 93, 98, 106, 117 Vein, 100, 117

Ranitidine

Ventricle, 98, 115, 117 Veterinary Medicine, 39, 61, 117 Viral, 44, 111, 117 Virulence, 116, 117 Virus, 43, 88, 117 Viscosity, 25, 117 Vitro, 38, 44, 117

126

Vivo, 38, 117 W Weight Gain, 46, 47, 117 Wheezing, 52, 117 White blood cell, 83, 97, 101, 103, 117 X Xenograft, 83, 117

127

Ranitidine

128

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