DEXTROMETHORPHAN 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., 1960Dextromethorphan: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00352-X 1. Dextromethorphan-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.
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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 dextromethorphan. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DEXTROMETHORPHAN ............................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Dextromethorphan ........................................................................ 4 The National Library of Medicine: PubMed ................................................................................ 15 CHAPTER 2. NUTRITION AND DEXTROMETHORPHAN ................................................................... 61 Overview...................................................................................................................................... 61 Finding Nutrition Studies on Dextromethorphan....................................................................... 61 Federal Resources on Nutrition ................................................................................................... 63 Additional Web Resources ........................................................................................................... 64 CHAPTER 3. ALTERNATIVE MEDICINE AND DEXTROMETHORPHAN ............................................. 65 Overview...................................................................................................................................... 65 National Center for Complementary and Alternative Medicine.................................................. 65 Additional Web Resources ........................................................................................................... 70 General References ....................................................................................................................... 71 CHAPTER 4. PATENTS ON DEXTROMETHORPHAN .......................................................................... 73 Overview...................................................................................................................................... 73 Patents on Dextromethorphan ..................................................................................................... 73 Patent Applications on Dextromethorphan ................................................................................. 95 Keeping Current .......................................................................................................................... 98 CHAPTER 5. BOOKS ON DEXTROMETHORPHAN ............................................................................. 99 Overview...................................................................................................................................... 99 Book Summaries: Online Booksellers........................................................................................... 99 CHAPTER 6. PERIODICALS AND NEWS ON DEXTROMETHORPHAN.............................................. 101 Overview.................................................................................................................................... 101 News Services and Press Releases.............................................................................................. 101 Academic Periodicals covering Dextromethorphan ................................................................... 103 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................. 105 Overview.................................................................................................................................... 105 U.S. Pharmacopeia..................................................................................................................... 105 Commercial Databases ............................................................................................................... 107 APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 111 Overview.................................................................................................................................... 111 NIH Guidelines.......................................................................................................................... 111 NIH Databases........................................................................................................................... 113 Other Commercial Databases..................................................................................................... 115 APPENDIX B. PATIENT RESOURCES ............................................................................................... 117 Overview.................................................................................................................................... 117 Patient Guideline Sources.......................................................................................................... 117 Finding Associations.................................................................................................................. 119 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 121 Overview.................................................................................................................................... 121 Preparation................................................................................................................................. 121 Finding a Local Medical Library................................................................................................ 121 Medical Libraries in the U.S. and Canada ................................................................................. 121 ONLINE GLOSSARIES................................................................................................................ 127 Online Dictionary Directories ................................................................................................... 128 DEXTROMETHORPHAN DICTIONARY ............................................................................... 131
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INDEX .............................................................................................................................................. 189
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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 dextromethorphan 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 dextromethorphan, 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 dextromethorphan, 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 dextromethorphan. 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 dextromethorphan, 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 dextromethorphan. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON DEXTROMETHORPHAN Overview In this chapter, we will show you how to locate peer-reviewed references and studies on dextromethorphan.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and dextromethorphan, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “dextromethorphan” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Best Products for Treating Colds Or Flu When You Have Diabetes Source: Diabetes Forecast. 54(2): 74-76. February 2001. Contact: Available from American Diabetes Association. 1701 North Beauregard Street, Alexandria, VA 22311. (800) 232-3472. Website: www.diabetes.org. Summary: This article discusses the best products for treating colds or flu when a person has diabetes. Nonsteroidal antiinflammatory drugs and acetaminophen are two kinds of nonprescription drugs that subdue pain caused by colds and flu. An expectorant, which loosens phlegm, may be the best choice for a productive cough. A nonproductive cough may be treated with a cough suppressant such as dextromethorphan. Two types of decongestants may be helpful in treating a stuffy nose. A good oral decongestant is
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Dextromethorphan
pseudoephedrine. Topical decongestants are available as nose sprays or drops. They work faster and better than oral decongestants and tend to cause fewer side effects. Sneezing and a runny nose may be treated with antihistamines. Throat lozenges and sprays containing dyclonine, benzocaine, hexylresorcinol, menthol, and phenol work by numbing the throat. Ingredients in cold and flu remedies that are either dangerous or a waste of money include phenylpropanolamine, vitamin C, and zinc. Tips for choosing cold or flu remedies include buying products that treat single symptoms, reading safety information, and using sugar free remedies so their carbohydrate content does not need to be taken into account in a meal plan. The article also includes a list of other aids for treating a cold or flu and outlines symptoms that indicate the need for consultation with a doctor.
Federally Funded Research on Dextromethorphan The U.S. Government supports a variety of research studies relating to dextromethorphan. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to dextromethorphan. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore dextromethorphan. The following is typical of the type of information found when searching the CRISP database for dextromethorphan: •
Project Title: ABUSED NMDA ANTAGONISTS: EFFECTS ON CORTICAL DEVELOPMENT Principal Investigator & Institution: Wilson, Mary A.; Assistant Professor; Kennedy Krieger Research Institute, Inc. Baltimore, Md 21205 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2005 Summary: This R21 application evaluates the hypothesis that the abused NMDA antagonists ketamine and dextromethorphan, by altering the function and expression of glutamate receptors, may have detrimental effects on the development of neocortex. Abuse of drugs that inhibit the NMDA receptor, such as PCP, ketamine and dextromethorphan, is increasing among adolescents. Because NMDA receptors play a critical role in the development of neo-cortical circuitry, abuse of NMDA antagonists has the potential to permanently alter the circuitry needed for normal sensory processing and cognition. NMDA antagonists may impair brain development in several ways: altering the developmentally programmed expression of neurotransmitter receptors, impairing the development of axonal and dendritic arbors, changing the precision of cortical maps, and increasing neuronal apoptosis. The proposed experiments use a well-
2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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characterized model of neocortical development that exhibits robust activity-dependent plasticity, the rodent whisker to barrel pathway. Three glutamate antagonists will be evaluated: 1) ketamine, a short-acting dissociative anesthetic that blocks the NMDAR channel, commonly used as an anesthetic in children and abused in the Club or rave scene; 2) dextromethorphan, a cough suppressant that blocks the NMDAR channel and is abused by adolescents; 3) MK-801, a longer- acting NMDAR channel blocker with documented effects on brain development. The specific aims use the rodent barrel field model to examine the effects of these NMDA antagonists on: 1) the development of somatosensory maps and the expression of glutamate receptors, 2) programmed cell death and BDNF expression in the postnatal rat brain, 3) experience-dependent cortical plasticity. The experiments will evaluate barrel field morphologic development and plasticity, expression of glutamate receptors, downstream effects on BDNF and c- fos mRNA expression and apoptosis. Based on our previous experience, the rodent barrel field model should provide a powerful, highly sensitive assessment of the potential impact of these abused drugs on neocortical development and plasticity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: BRAINSTEM NEURAL NETWORKS AND AIRWAY DEFENSIVE REFLEXES Principal Investigator & Institution: Shannon, Roger; Physiology and Biophysics; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2002; Project Start 01-DEC-1993; Project End 30-NOV-2003 Summary: The goal of this research is to define the functional organization and internal operations of the brainstem network through which airway defensive reflex motor patterns are generated and modulated. Many-neuron recording technology and spike train analysis methods (i.e., cross-correlation, gravity) will be used to determine parallel and sequential neuronal responses during fictive cough and the laryngeal expiration reflex, and the define concurrent functional interactions among physiologically characterized neurons in several brainstem regions. The plausibility of network models derived from this approach will be tested with computer simulations. Fictive cough and the expiration reflex will be evoked by mechanical stimulation of the intrathoracic trachea and larynx, respectively, in decerebrated, paralyzed, ventilated cats. Hypothesis I. Botzinger/ventral respiratory group (BOT/VRG) network interactions produce the cough patterns that are relayed to spinal respiratory motoneurons. Hypothesis II. Laryngeal motoneuron activity during cough is controlled by BOT/VRG propriobulbar neurons. Hypothesis III. Cough receptors activate neurons in the caudal nucleus tractus solitarius (NTS) which distribute information concurrently to neurons in the dorsal respiratory group (DRG), and pontine respiratory group (PRG). Hypothesis IV. Functional connectivity among PRG neurons contribute to their respiratory modulation, and are similar to interactions among rhythm/pattern generating BOT/VRG neurons. Hypothesis V. The PRG modulates the BOT/VRG generated cough motor pattern through divergent actions of specific neurons uon the and raphe nuclei. Hypothesis VI. The raphe neuronal network is modulated during cough by inputs from NTS, PRG, and BOT/VRG. Hypothesis VII. The raphe neuronal network modulates the cough motor pattern through actions on the BOT/VRG. Other Parallel Studies: In the course of the planned experiments, we will also examine brainstem mechanisms that generate laryngeal expiration reflex motor patterns. Airway defensive reflexes are essential for the day-to-day survival of individuals with and without lung disease; they can also exacerbate other pathological conditions. These studies will contribute basic information
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Dextromethorphan
that could be useful for future development of more effective therapeutic interventions for disorders involving these reflexes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: CYTOCHROME P450 IA2, IID6, IIIA4, NAT 2 & XANTHINE OXIDASE IN HIV 1 Principal Investigator & Institution: Kashuba, Angela D.; Associate Professor; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEXTROMETHORPHAN & GABAPENTIN TREATMENT OF PAIN IN SPINAL CORD INJURY Principal Investigator & Institution: Sang, Christine N.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DEXTROMETHORPHAN CYP3A PROBE & GRAPEFRUIT JUICE ON CYCLO Principal Investigator & Institution: Min, David I.; University of Iowa Iowa City, Ia 52242 Timing: Fiscal Year 2002 Summary: This study is evaluating the relationship of the metabolic ratio of dextromethorphan/3-methoxymorphinan in 24 hour urine with cyclosporine pharmacokinetics and differentiating the metabolism of cyclosporine in the liver from that in the intestinal wall by using grapefruit juice in healthy African American subjects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DRUG INTERACTIONS AND BIOAVAILABILITY OF CRANBERRY Principal Investigator & Institution: Donovan, Jennifer L.; Psychiatry and Behavioral Scis; Medical University of South Carolina P O Box 250854 Charleston, Sc 29425 Timing: Fiscal Year 2004; Project Start 06-JAN-2004; Project End 31-DEC-2005 Summary: (provided by applicant): Cranberry (CB) juice and powders are currently being used as complementary and alternative medications. CB products may be used alone or in combination with conventional medications to treat urinary tract infection, or other medications to treat acute or chronic conditions. CB is a rich source of flavonoids, a class of phytochemicals with diverse biological activities. The specific aims of this research are 1) to evaluate the potential for CB-drug interactions and 2) to determine the pharmacokinetics and renal clearance of four major CB flavonoids. A normal volunteer study is proposed to determine the potential of CB to participate in interactions with conventional drugs. The induction/inhibition of the major cytochrome P-450 (CYP) enzymes will be the primary method of evaluation. The CYP isoforms to be studied, CYP3A4, CYP2D6 and CYP1A2, are involved in the metabolism of >80% of marketed prescription and over the counter medications. Single doses of the three safe, probe
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drugs alprazolam (ALPZ; 3A4 probe), dextromethorphan (DM; CYP2D6 probe), and caffeine (CAF; CYP1A2 probe) will be administered at baseline (before treatment with CB) and after a 14-day treatment period with CB powder. Changes in the pharmacokinetics of these probe drugs will indicate the degree of specific enzyme inhibition or induction. In the same normal volunteers, the key pharmacokinetic parameters for four major CB flavonoids will be estimated by following the plasma concentration versus time course of absorbed flavonoids and their excretion in urine. The area under the plasma concentration versus time curve (AUC), oral clearance (Clo), terminal elimination half-life (T1/2) and renal clearance (Clren) will be determined for: epicatechin, quercetin (total glycosides), procyanidin A2, and cyanidin-3-galactoside. These components represent the major classes of flavonoids in CB and are selected for study due to their abundance in CB and their documented biological activities. The pharmacokinetics and renal clearance of CB flavonoids will be determined first after a single dose of a characterized CB juice prior to administration of any probe drugs. Steady-state plasma levels of flavonoids will be determined at the end of the 14-day treatment period of multiple dosing with the characterized CB powder. This research will provide new, important data on the pharmacokinetics of flavonoids from CB juice and from a CB powder, an area where no data currently exist. This information is essential to elucidate the mechanisms of action of CB flavonoids in the context of specific conditions/diseases and to evaluate CB as a source of dietary flavonoids. These data will also complement NCCAM studies assessing the clinical safety and efficacy of CB and will allow more informed recommendations about the use of CB when combined with conventional medications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EEG STUDIES OF VIBROTACTILE ADAPTATION Principal Investigator & Institution: Kelly, E F.; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-DEC-2001; Project End 30-NOV-2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECT OF DIET ON DRUG METABOLISM IN INFANTS Principal Investigator & Institution: Blake, Michael J.; Children's Mercy Hosp (Kansas City, Mo) 2401 Gillham Rd Kansas City, Mo 64108 Timing: Fiscal Year 2003; Project Start 01-MAY-2004; Project End 30-APR-2006 Summary: (provided by applicant): This proposal investigates the effect of diet on drug metabolism in the neonate by comparing the development of CYP450 enzyme activities between breast-fed and formula-fed infants The hypothesis tested by this proposal asserts that The development of cytochrome P450 1A and 2D functional activities is significantly different between breast-fed and formula-fed infants Specific experiments are designed to 1) Determine the relative activity of CYPIA2 between breast-fed and formula-fed infants being administered caffeine for the treatment of apnea, 2) Determine the relative activity of CYP1A2 and CYP2D6 between healthy breast-fed and formulafed infants receiving subtherapeutic doses of caffeine and dextromethorphan, and 3) Determine the CYP2D6 genotype in infants participating in these studies to identify potential genotype-phenotype discordance for this polymorphically expressed enzyme Results will be obtained by measurement of caffeine serum half-life, assessment of CYP450 enzyme activity by measuring urinary drug metabolites and by the use of PCR-
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Dextromethorphan
based techniques for genotyping assays The overall goals of this proposal are to determine the impact of infant diet on the activity of key drug metabolizing enzymes and to provide insight into the impact of ontogeny on their functional activity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTS OF DEXTROMETHORPHAN, NALOXONE & FENTANYL ON EXPERIMENTAL PAIN Principal Investigator & Institution: Staud, Roland M.; Associate Professor; University of Florida Gainesville, Fl 32611 Timing: Fiscal Year 2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTS OF GINSENG AND GINKGO ON DRUG DISPOSITION IN MAN Principal Investigator & Institution: Hurwitz, Aryeh A.; Professor; Internal Medicine; University of Kansas Medical Center Msn 1039 Kansas City, Ks 66160 Timing: Fiscal Year 2002; Project Start 27-SEP-2001; Project End 30-JUN-2004 Summary: Over 60 million Americans use herbal medicines, of whom one fourth also take prescription drugs. Physicians often are unaware of herbal use and of possible drug/herb interactions. Ginseng and ginkgo, enhancers of physical and mental performance, are two of the most widely taken herbals. We propose a double- blind, randomized, prospective study of effects of ginseng and ginkgo on 1) disposition of probe drugs, 2) cognitive function, and 3) glutathione-S-transferase (GST) and quinone reductase (NQO1), enzymes implicated in chemoprevention of cancer. Probe drugs will be administered to study effects of herbs on their disposition, not for therapeutic effect. Ideal probes must be safe, well tolerated, have minimal pharmacological effect, and share known metabolic pathways with other clinically used drugs. Medically stable drug-free non-smokers will be enrolled. During a 4-week single-blind run-in subjects will be given a 4-drug probe cocktail: caffeine to study cytochrome P4501A2 (CYP1A2), dextromethorphan for CYP2D6, buspirone (and endogenous cortisol) for CYP3A and fexofenadine for P-glycoprotein. Losartan will be given separately for CYP2C9. These enzymes metabolize over 95 percent of clinically used drugs. Enzyme activities will be determined by assaying appropriate blood and urine specimens for probe drugs and metabolites. Cognitive function will be tested and blood lymphocytes collected for measuring GST and NQO1 activities. Sixty subjects will then be randomly assigned to one of 4 double-blind treatment groups of 15 each: 1) ginseng extract (Ginsana), 2) ginkgo extract (EGb761), 3) both herbs, or 4) matching placebos. Tolerability of herbs will be determined. After 6 to 8 weeks of twice daily treatment with study agents, all effect parameters will be reevaluated: probe drug pharmacokinetics, cognitive function, and GST and NQO1 in blood lymphocytes. Interactions of chronic ginseng and ginkgo with drug-metabolizing pathways and with cognitive function will thus be determined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: GLUTAMATERGIC SYSTEMS IN PAIN AND OPIOID ACTION Principal Investigator & Institution: Inturrisi, Charles E.; Professor; Pharmacology; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-MAY-1976; Project End 29-FEB-2004
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Summary: (adapted from the applicant's abstract) This is a request for continued support of projects designed to test the hypothesis that Excitatory Amino Acid (EAA) receptors mediate the neuronal plasticity that is manifest as opioid tolerance and dependence or as certain types of nociceptive behavior. These studies will use NMDA and non-NMDA receptor antagonists as well as antisense targeted to NMDA receptors in selected animal behavioral paradigms to demonstrate the role of EAA receptors in opioid tolerance and nociception. These antagonists include the open channel blockers, dextromethorphan, and the d and 1 isomers of methadone and newer antagonists acting at the glycine site, the NR2B subunit of NMDAR1 or the GluR5 subunit of non-NMDA receptors. Antisense oligos will be targeted to the NR1, NR2B and GluR5 subunits. To complement and extend these approaches, opioid tolerance, dependence and nociceptive behaviors will be measured in knockout mice engineered with an absent or mutated EAA receptor. A strategy is presented for the production of the first conditional knockout of the NR1 subunit that is confined to the dorsal horn of the spinal cord. Molecular and biochemical techniques including receptor binding, autoradiography, subunit specific ribonuclease protection assays and immunocytochemistry will be used to identify and localize to neuroanatomical areas, the changes in gene expression that are associated with these altered behaviors. Nociception, opioid tolerance and dependence are complex phenomena involving the alterations in integrated neuronal circuits (between systems events) as well as plasticity changes expressed in individual neurons. They appear to share a common locus, the EEA receptor system. An understanding of this system is important for the development of new and more selective drugs for the management of pain and opioid abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: HYPERALGESIA IN METHADONE PATIENTS: CAN IT BE TREATED? Principal Investigator & Institution: Compton, Margaret Ann.; None; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-MAY-2007 Summary: (provided by applicant): Addressing the under-treatment of clinical pain has become a national priority, with a central goal being to identify effective interventions for those subgroups of patients most at risk for suffering unrelieved pain (NIH Program Announcement PA-01 -115). In fact, the under-treatment of pain was recently ruled a form of patient abuse with a California court awarding one million dollars in damages to the family of such a patient. Novel data accumulated by our investigative group has shown that patients maintained on the mu-opioid agonist, methadone, for the treatment of addiction, are significantly hyperalgesic to cold-pressor experimental pain as compared to normal controls. This diminished pain tolerance, in addition to the contextual prohibitions associated with providing known opioid addicts with opioid analgesics, makes them a population uniquely vulnerable to the under treatment of pain. Unfortunately, little is known about how to best manage the pain suffered by the over 120,000 methadone-maintained (MM) patients in this country, in part because the hyperalgesia they suffer appears to be akin to neuropathic pain and opioid-induced. In the proposed series of studies, the Principal Investigator (a first-time RO1 applicant) will build upon her previous studies validating and characterizing hyperalgesia in MM samples to explore it's underlying mechanism from a pharmacological perspective. Utilizing slightly different double-blind, placebo-controlled designs, the proposed work will evaluate the ability of three classes of medication (N-methyl-D-aspartate (NMDA)antagonists, adjuvant anticonvulsant analgesics, and novel opioid analgesics) to
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diminish or reverse the opioid-induced hyperalgesia complicating the pain states suffered by MM patients. Specifically, in a sample of MM patients, (1) dextromethorphan, which interferes with the development of opioid-induced hyperalgesia, (2) gabapentin, which has proven efficacy in treating neuropathic pain, and (3) oxycodone, which has novel opioid activity, will each be evaluated for its ability to ameliorate or diminish the opioid-induced hyperalgesia in these patients as reflected by changes on pain threshold and tolerance to both cold-pressor and electrical pain, at peak and through methadone blood levels. The results of this work will not only provide pharmacologic insight into the mechanisms underlying poor pain tolerance in this at-risk population, but also direction for the medical management of pain complicated by opioid-induced hyperalgesia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: LABORATORY MODEL FOR HEROIN ABUSE MEDICATIONS Principal Investigator & Institution: Fischman, Marian W.; Professor of Behavioral Biology; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 100321098 Timing: Fiscal Year 2002 Summary: Heroin use and treatment admissions for heroin dependence have been increasing steadily over the past several years. Clearly, there is a need for new effective treatments for opioid dependence. Although methadone, levo alpha-acetylmethadol (LAAM), and naltrexone are currently approved for the treatment of opioid dependence, many problems are associated with their use such as patient noncompliance, continued opioid use during treatment, and high relapse rates during withdrawal from treatment. Several possible causes for these problems have been suggested but insufficient research has been conducted to evaluate the effects of these medications on ongoing human behavior in a research laboratory setting. In the proposed research, participants residing in a controlled setting will be given the opportunity to work for heroin and money. These studies will examine the multiplicity of ways in which several current and proposed medications affect heroin consumption, performance, mood, physiological measures, and participants' verbal reports of drug effects. The model thus developed will be used to evaluate potential new medications for opioid abuse as they are developed and before they are put into large multi-center trials. The specific aims of the proposal are to evaluate: l) the effects of the combination tablet containing buprenorphine and naloxone; 2) the time course and efficacy of a depot formulation of naltrexone; 3) the ability of oral naltrexone maintenance to induce supersensitivity to the effects of heroin; and 4) the effects of memantine and dextromethorphan, which are low-affinity N-methyl-D-aspartate receptor antagonists. Several of these medications will also be evaluated in another project as adjunct medications for the treatment of withdrawal during detoxification from heroin. Together, data from these projects should shed light on the effects of these medications on a broad range of heroin's effects, from actual heroin taking to detoxification from heroin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: MODEL MEDICATIONS
FOR
SCREENING
HEROIN
DETOXIFICATION
Principal Investigator & Institution: Collins, Eric; New York State Psychiatric Institute 1051 Riverside Dr New York, Ny 100321098
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Timing: Fiscal Year 2002 Summary: Heroin dependence has reemerged as a significant public health problem in the 1990's. Detoxification is and will continue to be a common first step in the treatment of individuals with heroin dependence, but the two detoxification approaches in widespread use today, the methadone taper and clonidine-assisted detoxification, are flawed. There is a need for new pharmacological approaches to heroin detoxification. The research proposed here aims to develop and implement a model screening procedure to evaluate potentially promising new medications for use in heroin detoxification. Our approach is to carry out a series of three 7-day, three- arm randomized, double-blind clinical trials, each one comparing two matched promising medications for opioid detoxification with a clonidine- assisted detoxification. We incorporate a comprehensive assessment of withdrawal Severity, cognitive and motor performance, and follow-up data four weeks following entry into the study. Our first study compares two medications, a potentially less hypotensive alpha-2 agonist, lofexidine, and a calcium channel antagonist, isradipine, directly with clonidine-assisted detoxification. Our second trial examines the potential utility of NMDA antagonists by comparing two noncompetitive NMDA antagonists, memantine and dextromethorphan, with clonidine. The third trial investigates the role of partial mu opioid agonists with differential kappa activities by comparing buprenorphine and butorphanol with clonidine. The strength of our approach lies in the controlled evaluation of potentially promising detoxification medications under consistent conditions. We expect to provide information about new mechanisms for medications development for opioid detoxification. We focus on the role heroin detoxification procedures may have in maximizing the likelihood of opioid abstinence and treatment retention following detoxification. While we recognize that detoxification is only the first step in treatment, we also believe that improving this procedure could increase the number of heroin- dependent individuals entering it, completing it, and continuing after it with more definitive treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NATURAL HISTORY, SEARCH FOR A MARKER AND THERAPY Principal Investigator & Institution: Sakkubai, Naidu; Kennedy Krieger Research Institute, Inc. Baltimore, Md 21205 Timing: Fiscal Year 2002 Summary: The goal of this project is to define the natural history, identify a diagnostic marker, understand the mechanism of neuronal dysfunction, and apply specific therapies early in the evolution of the disease to improve neurological status in Rett syndrome (RS). Based on the postulate that RS is a disorder of early brain growth, AIM 1 focuses on the identification of younger patients and delineation of early clinical features. Familial cases and their pedigrees will be documented in search of a genetic abnormality. Cases identified in Aim 1 will be a vital resource for all projects. In Aim 2 gene(s) defective in RS will be sought by classical cytogenetic approaches, and by representational difference analysis (RDA). Aim 2 will also search for proteins, and expressed genes that have up- or down regulated in RS, which may serve as a molecular fingerprint for the disease. Aim 3 is designed to study olfactory receptor neurons (ORNs) obtained from biopsies of olfactory neuroepithelium in RS girls, and compared to ORNs from normal and disease controls. A cell culture approach will provide direct access to RS neurons early in the course of the disease, and permit study of the evolution of neuronal defects in this disorder. In Aim 4 therapeutic interventions will attempt to prevent the devastating consequences of increased glutamate NMDA, and AMPA
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receptor induced neuronal injury by specific treatments with receptor antagonists, dextromethorphan and topiramate. To compensate for the significant reductions in choline acetyltransferase levels, treatment with an acetylcholine esterase inhibitordonepezil hydrochloride- to improve cognition will be tested. Efficacy of treatment will be monitored by clinical and neuroimaging techniques. Careful study of the nutritional status, and the role of dysphagia in growth failure will be examined in the light of therapeutic interventions. Use of growth factors or gene therapy will be considered when efficacy is established in the animal model. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NOVEL COCAINE PHARMACOTHERAPIES: LAB STUDIES Principal Investigator & Institution: Haney, Margaret; Assistant Professor; Psychiatry; Columbia University Health Sciences Po Box 49 New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 30-SEP-1996; Project End 30-JUN-2004 Summary: (Applicant's Abstract) There is no effective pharmacotherapy for cocaine abuse and dependence despite extensive testing of potential medications. The clinical data suggest that the search for direct-acting dopaminergic agents effective in treating cocaine abuse is unlikely to be productive, and investigations of other agents which perturb the noradrenergic and serotonergic systems have been equally disappointing. Recent data suggest that both NMDA and GABA may provide new avenues for pharmacological intervention in the treatment of cocaine abuse. We propose to continue our laboratory investigation into novel potential medications for the treatment of cocaine abusers by evaluating the NMDA antagonist, dextromethorphan, and the GABAergic agents, vigabatrin and gabapentin. We will include measures of cocaine selfadministration under a modified progressive ratio procedure, a cocaine discrimination procedure and measures of subjective effects, including cocaine craving. This expanded profile of the ways in which these potential treatment medications interact with cocaine use and the consequences of that use, will allow us to make more informed decisions in designing specific pharmacological interventions to treat cocaine abusers. All participants will be tested under double blind conditions with placebo and active medication maintenance and with multiple doses of smoked cocaine. This use of a medication-maintenance model mimics the treatment situation and increases our ability to detect the effects of active medications, even those with slow onset of therapeutic effects. Laboratory research with human participants provides the necessary bridge from laboratory to clinic, and allows a relatively short, well controlled and safe alternative to the initial testing of a medication in an open label or even small controlled clinical trial. Combining the data from sensitive drug self-administration, drug discrimination and subjective effects measures will allow us to understand more fully the interaction between NMDA antagonism or GABAergic effects and cocaine's effects, and consequently to inform cocaine medication development endeavors. Such data will provide important information about the underlying neural mechanisms of single and repeated dose cocaine use in humans. The overall strength of this protocol lies in our utilization of a controlled laboratory setting to examine the interactive effects of an NMDA antagonist (dextromethorphan), a GABA transaminase inhibitor (vigabatrin), and a GABA analog which potentiates GABA (gabapentin), with cocaine use, cocaine "craving," and the subjective, physiological and discriminative stimulus effects of cocaine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OPIOID ANALGESICS: PHARMACOLOGICAL FACTORS Principal Investigator & Institution: Dykstra, Linda A.; Professor; Psychology; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002; Project Start 01-SEP-1977; Project End 30-JUN-2004 Summary: Recent studies indicate that the effects of opioid analgesics can be modulated by interactions between opioid as well as nonopioid receptor systems. For example, the N-methyl-D-aspartate (NMDA) receptor system has been shown to be involved in both the acute effects of morphine as well as in the development of morphine tolerance. Although a wealth of studies have examined interactions between opioid and NMDA receptor systems, very little is known about the behavioral mechanisms that underlie these interactions. Therefore, the studies proposed here examine NMDA/opioid interactions in a complex behavioral paradigm, the squirrel money shock titration procedure. This procedure is particularly appropriate for these studies because it provides a way to differentiate the contribution of discriminative and response variables in NMDA/opioid interactions. In addition, studies are proposed to examine pharmacological mechanisms that are important in NMDA/opioid interactions. In particular, investigations will examine NMDA-induced alterations in the effects of opioids that differ from morphine in terms of their relative efficacy. These investigations employ the squirrel monkey titration procedure as well as a rodent tail withdrawal procedure which can be altered so it reveals activity for opioids with low efficacy relative to morphine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PK-PD MODELS: THE ROLE OF METABOLITES IN DRUG ACTION Principal Investigator & Institution: Hendrickson, Howard P.; Pharmacology and Toxicology; University of Arkansas Med Scis Ltl Rock Little Rock, Ar 72205 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2005 Summary: The long-term goal of this Mentored Quantitative Research Career Award (K25) is to compliment the career preparation of the PI, an analytical chemist, with the training and research experience he needs to become a successful, independent researcher in drug abuse. This will be accomplished through a program of training and research in the pharmacology of drug abuse, focusing on the advanced areas of pharmacokinetics and behavioral pharmacology. In the final phase of this career development plan these diverse research areas will be integrated and used to conduct studies employing pharmacokinetic- pharmacodynamic (PK-PD) modeling. The mentor and co-mentor are both drug-abuse researchers with extensive research experience in these areas. The aims of the research-training proposal are to investigate the pharmacology of dextromethorphan with regard to its actions as a drug of abuse. Dextromethorphan, a common component of cold and cough remedies, is an increasingly abused club drug ("robo") among youth, often masquerading as more popular drugs such as MDMA ("ecstasy") or gamma-hydroxybutyrate ("GHB"). The applicant will investigate the role of dextrorphan, the primary active metabolite of dextromethorphan, as the agent responsible for the phencyclidine-like actions of dextromethorphan. Because dextromethorphan is extensively metabolized to dextrorphan in the liver, first-pass effects play a significant role in its metabolism. To test the hypothesis that oral and intravenous administration of dextromethorphan will produce unique behavioral-time profiles, dose-response and time-course studies of spontaneous locomotor activity will be studied in rats. Concurrently, serum
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concentration-time profiles of dextromethorphan and metabolites will be determined. PK-PD modeling of response-time and concentration-time profiles will be used to determine in vivo pharmacodynamic parameters such as, intrinsic efficacy, estimated drug-receptor binding, and drug concentration at the effect site. This approach should provide evidence about whether dextromethorphan or dextrorphan, or both, are primarily responsible for the actions sought by abusers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: RETT SYNDROME: NATURAL HISTORY AND TREATMENT Principal Investigator & Institution: Naidu, Sakkubai R.; Professor of Neurology and Pediatrics; Kennedy Krieger Research Institute, Inc. Baltimore, Md 21205 Timing: Fiscal Year 2003; Project Start 29-SEP-2003; Project End 30-JUN-2008 Summary: Patients with (70-80%) and those without mutations in MeCP2 gene are recognized to have the clinical features of Rett Syndrome. Although location of mutations can in part be correlated with the phenotype, they do not provide essential prognostic guidelines. We will attempt to delineate the molecular profiles of the various mutations that contribute to phenotypic variability. We will therefore correlate the clinical, gastrointestinal status, and neuroimaging changes (MRI, MRS) to levels of MeCP2, other methyl-binding domain proteins, and histone acetylation in Project 10, and with changes in olfactory receptor neurons in Project 9. We will also compare these changes to those with the phenotype but without mutations in MeCP2 to determine commonality in factors that may contribute to phenotypic similarities. In collaboration with Dr. Shemer (Israel), we will attempt to identify mutations in the promoter region of the MeCP2 gene in this latter group. The increased expression of the glutamatergic system in younger RS subjects leads us to treat patients below 15 years of age with dextromethorphan to block NMDA/glutamate receptors so as to prevent excitotoxicity and provide neuroprotection. To gain additional insight into the neurobiology of RS, we will conduct SPECT and PET studies in conjunction with Project 8 to delineate abnormalities in the cholinergic and glutamatergic systems that would provide future therapeutic strategies in conjunction with studies in murine models in Project 5. Data from interaction between this and other projects will support our hypothesis that the phenotype of RS is the result of the unique effects of different MeCP2 mutations on specific neuronal populations and their interconnections during the dynamic phase of activity-dependant synaptic plasticity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: SCREENING HERBS FOR DRUG INTERACTIONS Principal Investigator & Institution: Markowitz, John S.; Associate Professor; Pharmaceutical Sciences; Medical University of South Carolina P O Box 250854 Charleston, Sc 29425 Timing: Fiscal Year 2002; Project Start 05-JUN-2001; Project End 31-MAY-2004 Summary: The use of herbal agents by the lay public and medical professionals has accelerated in the last decade. Additionally, there has been increasing interest by the NIH National Center for Complementary & Alternative Medicine (NCCAM) and others in the safety and efficacy of herbal medicines in the treatment of a variety of medical and psychiatric conditions. It has also become evident that herbal medications are being used concomitantly with conventional prescription and over-the-counter medications. However, the systematic evaluation of the potential of these agents to interact with conventional medications has been generally neglected. Compounding this problem is
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the fact that even single entity herbal products can contain a multitude of naturally occurring chemicals which serve as candidates for potential herb-drug interactions by inhibiting or inducing specific hepatic isozymes. Numerous reports document the importance of pharmacokinetic interactions involving inhibition or induction of the cytochrome P450 (CYP) enzyme system. Importantly, recent publications have documented that clinically significant herb-drug interactions can occur. Prominent examples include herb-induced reductions in plasma concentrations of the anti-HIV medication indinavir and the immunosuppressant cyclosporine by St. John's wort (Hypericum perforatum). In vitro screening studies are of limited value due to difficulties in approximating physiologic concentrations, assessing the influence of nonhepatic metabolism, and accounting for the contribution of active metabolites. However, based upon findings of the effects of concurrently administered herbs on the metabolism of enzyme specific probe drug substrates alprazolam (CYP 3A4) and dextromethorphan (CYP 2D6), the potential specificity and magnitude of CYP enzyme inhibition and/or induction can be determined in normal volunteers. In a preliminary study in human subjects using this validated probe drug technique assessing inhibitory effects only, the investigators found no effects of St. John's wort on CYP 3A4 or CYP 2D6. In the present proposal, the 10 most commonly used herbal products in the US will be systematically evaluated for inhibition of CYP 3A4 and 2136, and induction of CYP 3A4. Collectively, these enzyme systems are involved in the metabolism of approximately 80% of all marketed medications. A combination of probe drugs will be given to normal volunteers both in the absence and presence of herbal medications. The plasma and urine concentration of these agents and their respective metabolites will be determined in order to evaluate individual herbal products degree and specificity of enzyme inhibitory or inductive effects. This data will fill a void regarding the relative safety of combining specific herbal agents with conventional medications and will serve as the basis for further investigations of other isozymes and herb interactions. Further, the proposed studies will complement existing and future NCCAM studies of agents such as St. John's wort and Gingko biloba. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TOLBUTAMIDE, CAFFEINE, DEXTROMETHORPHAN FOR P450 ACTIVIT Principal Investigator & Institution: Hall, Stephen D.; Professor; Indiana Univ-Purdue Univ at Indianapolis 620 Union Drive, Room 618 Indianapolis, in 462025167 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater 3
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with dextromethorphan, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “dextromethorphan” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for dextromethorphan (hyperlinks lead to article summaries): •
A clinical trial of dextromethorphan in amyotrophic lateral sclerosis. Author(s): Gredal O, Werdelin L, Bak S, Christensen PB, Boysen G, Kristensen MO, Jespersen JH, Regeur L, Hinge HH, Jensen TS. Source: Acta Neurologica Scandinavica. 1997 July; 96(1): 8-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9262126
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A controlled one-year trial of dextromethorphan in amyotrophic lateral sclerosis. Author(s): Blin O, Azulay JP, Desnuelle C, Bille-Turc F, Braguer D, Besse D, Branger E, Crevat A, Serratrice G, Pouget JY. Source: Clinical Neuropharmacology. 1996 April; 19(2): 189-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8777774
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A double-blind, crossover controlled evaluation of a syrup for the night-time relief of the symptoms of the common cold, containing paracetamol, dextromethorphan hydrobromide, doxylamine succinate and ephedrine sulphate. Author(s): Thackray P. Source: J Int Med Res. 1978; 6(2): 161-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=344089
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A phase I clinical trial of dextromethorphan in intractable partial epilepsy. Author(s): Kimiskidis VK, Mirtsou-Fidani V, Papaioannidou PG, Niopas I, Georgiadis G, Constadinidis TC, Kazis AD. Source: Methods Find Exp Clin Pharmacol. 1999 December; 21(10): 673-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10702964
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A pilot study of dextromethorphan in naloxone-precipitated opiate withdrawal. Author(s): Rosen MI, McMahon TJ, Woods SW, Pearsall HR, Kosten TR. Source: European Journal of Pharmacology. 1996 July 4; 307(3): 251-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8836612
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A pilot trial of dextromethorphan in amyotrophic lateral sclerosis. Author(s): Askmark H, Aquilonius SM, Gillberg PG, Liedholm LJ, Stalberg E, Wuopio R. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1993 February; 56(2): 197200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8437010
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A randomized, controlled trial of high-dose dextromethorphan in facial neuralgias. Author(s): Gilron I, Booher SL, Rowan MS, Smoller MS, Max MB. Source: Neurology. 2000 October 10; 55(7): 964-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11061252
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A randomized, double-blind, placebo-controlled safety study of high-dose dextromethorphan in methadone-maintained male inpatients. Author(s): Cornish JW, Herman BH, Ehrman RN, Robbins SJ, Childress AR, Bead V, Esmonde CA, Martz K, Poole S, Caruso FS, O'Brien CP. Source: Drug and Alcohol Dependence. 2002 July 1; 67(2): 177-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12095667
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A rapid thin layer chromatographic procedure to identify poor and extensive oxidative drug metabolizers in man using dextromethorphan. Author(s): De Zeeuw RA, Eikema D, Franke JP, Jonkman JH. Source: Pharmazie. 1992 May; 47(5): 346-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1409826
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A sensitive assay of metoprolol and its major metabolite alpha-hydroxy metoprolol in human plasma and determination of dextromethorphan and its metabolite dextrorphan in urine with high performance liquid chromatography and fluorometric detection. Author(s): Mistry B, Leslie J, Eddington NE. Source: Journal of Pharmaceutical and Biomedical Analysis. 1998 February; 16(6): 10419. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9547708
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A trial of dextromethorphan in parkinsonian patients with motor response complications. Author(s): Verhagen Metman L, Blanchet PJ, van den Munckhof P, Del Dotto P, Natte R, Chase TN. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1998 May; 13(3): 414-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9613730
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A urine metabolic ratio of dextromethorphan and 3-methoxymorphinan as a probe for CYP3A activity and prediction of cyclosporine clearance in healthy volunteers. Author(s): Min DI, Ku YM, Vichiendilokkul A, Fleckenstein LL. Source: Pharmacotherapy. 1999 June; 19(6): 753-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10391422
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Absence of the preemptive analgesic effect of dextromethorphan in total knee replacement under epidural anesthesia. Author(s): Yeh CC, Ho ST, Kong SS, Wu CT, Wong CS. Source: Acta Anaesthesiol Sin. 2000 December; 38(4): 187-93. Erratum In: Acta Anaesthesiol Sin 2001 March; 39(1): Inside Back Cover. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11392066
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Abuse of dextromethorphan. Author(s): Cranston JW, Yoast R. Source: Archives of Family Medicine. 1999 March-April; 8(2): 99-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10101977
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Abuse of dextromethorphan-based cough syrup as a substitute for licit and illicit drugs: a theoretical framework. Author(s): Darboe MN. Source: Adolescence. 1996 Spring; 31(121): 239-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9173789
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Abuse potential of morphine/dextromethorphan combinations. Author(s): Jasinski DR. Source: Journal of Pain and Symptom Management. 2000 January; 19(1 Suppl): S26-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10687336
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Acute dystonia in a child associated with therapeutic ingestion of a dextromethorphan containing cough and cold syrup. Author(s): Graudins A, Fern RP. Source: Journal of Toxicology. Clinical Toxicology. 1996; 34(3): 351-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8667476
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An attempt to attenuate experimental pain in humans by dextromethorphan, an NMDA receptor antagonist. Author(s): Kauppila T, Gronroos M, Pertovaara A. Source: Pharmacology, Biochemistry, and Behavior. 1995 November; 52(3): 641-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8545487
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An open label trial of dextromethorphan in Huntington's disease. Author(s): Walker FO, Hunt VP. Source: Clinical Neuropharmacology. 1989 August; 12(4): 322-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2529964
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Analgesic effect of dextromethorphan in neuropathic pain. Author(s): Carlsson KC, Hoem NO, Moberg ER, Mathisen LC. Source: Acta Anaesthesiologica Scandinavica. 2004 March; 48(3): 328-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14982566
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Analgesic effects of dextromethorphan and morphine in patients with chronic pain. Author(s): Heiskanen T, Hartel B, Dahl ML, Seppala T, Kalso E. Source: Pain. 2002 April; 96(3): 261-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11972998
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Analysis of dextrorphan, a metabolite of dextromethorphan, using gas chromatography with electron-capture detection. Author(s): Salsali M, Coutts RT, Baker GB. Source: Journal of Pharmacological and Toxicological Methods. 1999 August; 41(4): 1436. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10691018
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Analysis of pharmacokinetic parameters for assessment of dextromethorphan metabolic phenotypes. Author(s): Yeh GC, Tao PL, Ho HO, Lee YJ, Chen JY, Sheu MT. Source: Journal of Biomedical Science. 2003 September-October; 10(5): 552-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12928596
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Analysis of the CYP2D6 gene in relation to dextromethorphan O-demethylation capacity in a Japanese population. Author(s): Tateishi T, Chida M, Ariyoshi N, Mizorogi Y, Kamataki T, Kobayashi S. Source: Clinical Pharmacology and Therapeutics. 1999 May; 65(5): 570-5. Erratum In: Clin Pharmacol Ther 1999 December; 66(6): 581. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10340923
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Antihyperalgesic effect of the N-methyl-D-aspartate receptor antagonist dextromethorphan in the oral surgery model. Author(s): Gordon SM, Dubner R, Dionne RA. Source: Journal of Clinical Pharmacology. 1999 February; 39(2): 139-46. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11563405
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Antitussive effect of dextromethorphan and dextromethorphan-salbutamol combination in healthy volunteers with artificially induced cough. Author(s): Karttunen P, Tukiainen H, Silvasti M, Kolonen S. Source: Respiration; International Review of Thoracic Diseases. 1987; 52(1): 49-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3659583
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Antitussive efficacy of dextromethorphan in cough associated with acute upper respiratory tract infection. Author(s): Lee PCL, Jawad MS, Eccles R. Source: The Journal of Pharmacy and Pharmacology. 2000 September; 52(9): 1137-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11045895
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Applicability of continuous-flow fast atom bombardment liquid chromatographymass spectrometry in bioanalysis. Dextromethorphan in plasma. Author(s): Kokkonen P, Niessen WM, Tjaden UR, van der Greef J. Source: Journal of Chromatography. 1989 July 14; 474(1): 59-68. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2768399
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Assessment of CYP2D6 and CYP2C19 activity in vivo in humans: a cocktail study with dextromethorphan and chloroguanide alone and in combination. Author(s): Tenneze L, Verstuyft C, Becquemont L, Poirier JM, Wilkinson GR, FunckBrentano C. Source: Clinical Pharmacology and Therapeutics. 1999 December; 66(6): 582-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10613613
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Assessment of individual CYP2D6 activity in extensive metabolizers with renal failure: comparison of sparteine and dextromethorphan. Author(s): Kevorkian JP, Michel C, Hofmann U, Jacqz-Aigrain E, Kroemer HK, Peraldi MN, Eichelbaum M, Jaillon P, Funck-Brentano C. Source: Clinical Pharmacology and Therapeutics. 1996 May; 59(5): 583-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8646830
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Assessment of the debrisoquin and dextromethorphan phenotyping tests by gaussian mixture distributions analysis. Author(s): Henthorn TK, Benitez J, Avram MJ, Martinez C, Llerena A, Cobaleda J, Krejcie TC, Gibbons RD. Source: Clinical Pharmacology and Therapeutics. 1989 March; 45(3): 328-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2920506
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Assessment of the effect of dextromethorphan and ketamine on the acute nociceptive threshold and wind-up of the second pain response in healthy male volunteers. Author(s): Hughes AM, Rhodes J, Fisher G, Sellers M, Growcott JW. Source: British Journal of Clinical Pharmacology. 2002 June; 53(6): 604-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12047485
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Automated determination of dextromethorphan and its main metabolites in human plasma by high-performance liquid chromatography and column switching. Author(s): Hartter S, Baier D, Dingemanse J, Ziegler G, Hiemke C. Source: Therapeutic Drug Monitoring. 1996 June; 18(3): 297-303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8738772
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Benylin (dextromethorphan) abuse and mania. Author(s): Walker J, Yatham LN. Source: Bmj (Clinical Research Ed.). 1993 April 3; 306(6882): 896. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8490415
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Bioavailability evaluation of a controlled-release dextromethorphan liquid. Author(s): Woodworth JR, Dennis SR, Hinsvark ON, Amsel LP, Rotenberg KS. Source: Journal of Clinical Pharmacology. 1987 February; 27(2): 133-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3680564
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Bioavailability of dextromethorphan (as dextrorphan) from sustained release formulations in the presence of guaifenesin in human volunteers. Author(s): Demirbas S, Reyderman L, Stavchansky S. Source: Biopharmaceutics & Drug Disposition. 1998 November; 19(8): 541-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9840216
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Bromide intoxication by the combination of bromide-containing over-the-counter drug and dextromethorphan hydrobromide. Author(s): Hung YM. Source: Human & Experimental Toxicology. 2003 August; 22(8): 459-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12948087
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Bufuralol, dextromethorphan, and debrisoquine as prototype substrates for human P450IID6. Author(s): Kronbach T. Source: Methods Enzymol. 1991; 206: 509-17. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1686064
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Bulimia and dextromethorphan abuse. A case study. Author(s): Marsh LD, Key JD, Spratt E. Source: Journal of Substance Abuse Treatment. 1997 July-August; 14(4): 373-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9368214
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Characterization of dextromethorphan N-demethylation by human liver microsomes. Contribution of the cytochrome P450 3A (CYP3A) subfamily. Author(s): Gorski JC, Jones DR, Wrighton SA, Hall SD. Source: Biochemical Pharmacology. 1994 July 5; 48(1): 173-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8043020
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Characterization of dextromethorphan O- and N-demethylation catalyzed by highly purified recombinant human CYP2D6. Author(s): Yu A, Dong H, Lang D, Haining RL. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2001 November; 29(11): 1362-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11602510
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Cognitive deterioration from long-term abuse of dextromethorphan: a case report. Author(s): Hinsberger A, Sharma V, Mazmanian D. Source: Journal of Psychiatry & Neuroscience : Jpn. 1994 November; 19(5): 375-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7803371
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Combined pre-incisional oral dextromethorphan and epidural lidocaine for postoperative pain reduction and morphine sparing: a randomised double-blind study on day-surgery patients. Author(s): Weinbroum AA, Lalayev G, Yashar T, Ben-Abraham R, Niv D, Flaishon R. Source: Anaesthesia. 2001 July; 56(7): 616-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11437760
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Comparative contribution to dextromethorphan metabolism by cytochrome P450 isoforms in vitro: can dextromethorphan be used as a dual probe for both CTP2D6 and CYP3A activities? Author(s): Yu A, Haining RL. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2001 November; 29(11): 1514-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11602530
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Comparison of quantitative methods to assess hepatic function: Pugh's classification, indocyanine green, antipyrine, and dextromethorphan. Author(s): Figg WD, Dukes GE, Lesesne HR, Carson SW, Songer SS, Pritchard JF, Hermann DJ, Powell JR, Hak LJ. Source: Pharmacotherapy. 1995 November-December; 15(6): 693-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8602375
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Comparison of the antitussive effects of codeine phosphate 20 mg, dextromethorphan 30 mg and noscapine 30 mg using citric acid-induced cough in normal subjects. Author(s): Empey DW, Laitinen LA, Young GA, Bye CE, Hughes DT. Source: European Journal of Clinical Pharmacology. 1979; 16(6): 393-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=527635
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Concordance between tramadol and dextromethorphan parent/metabolite ratios: the influence of CYP2D6 and non-CYP2D6 pathways on biotransformation. Author(s): Abdel-Rahman SM, Leeder JS, Wilson JT, Gaedigk A, Gotschall RR, Medve R, Liao S, Spielberg SP, Kearns GL. Source: Journal of Clinical Pharmacology. 2002 January; 42(1): 24-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11808821
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Concordance of P450 2D6 (debrisoquine hydroxylase) phenotype and genotype: inability of dextromethorphan metabolic ratio to discriminate reliably heterozygous and homozygous extensive metabolizers. Author(s): Evans WE, Relling MV. Source: Pharmacogenetics. 1991 December; 1(3): 143-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1688245
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Contribution of cytochrome P-4502D6 phenotype to the neuromodulatory effects of dextromethorphan. Author(s): Desmeules JA, Oestreicher MK, Piguet V, Allaz AF, Dayer P. Source: The Journal of Pharmacology and Experimental Therapeutics. 1999 February; 288(2): 607-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9918565
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CYP2D6- and CYP3A-dependent metabolism of dextromethorphan in humans. Author(s): Jacqz-Aigrain E, Funck-Brentano C, Cresteil T. Source: Pharmacogenetics. 1993 August; 3(4): 197-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8220439
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CYP2D6 genotype and phenotyping by determination of dextromethorphan and metabolites in serum of healthy controls and of patients under psychotropic medication. Author(s): Kohler D, Hartter S, Fuchs K, Sieghart W, Hiemke C. Source: Pharmacogenetics. 1997 December; 7(6): 453-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9429230
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Cytochrome P450-dependent metabolism of dextromethorphan: fetal and adult studies. Author(s): Jacqz-Aigrain E, Cresteil T. Source: Dev Pharmacol Ther. 1992; 18(3-4): 161-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1306804
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Cytochrome P-450IID6 phenotyping in cancer patients: debrisoquin and dextromethorphan as probes. Author(s): Anthony LB, Boeve TJ, Hande KR. Source: Cancer Chemotherapy and Pharmacology. 1995; 36(2): 125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7767948
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Debrisoquine and dextromethorphan phenotyping and antidepressant treatment. Author(s): Perault MC, Bouquet S, Bertschy G, Vandel S, Chakroun R, Guibert S, Vandel B. Source: Therapie. 1991 January-February; 46(1): 1-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2020918
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Dependence on dextromethorphan hydrobromide. Author(s): Fleming PM. Source: British Medical Journal (Clinical Research Ed.). 1986 September 6; 293(6547): 597. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3092943
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Determination of cytochrome P450 3A4/5 activity in vivo with dextromethorphan Ndemethylation. Author(s): Jones DR, Gorski JC, Haehner BD, O'Mara EM Jr, Hall SD. Source: Clinical Pharmacology and Therapeutics. 1996 October; 60(4): 374-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8873685
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Determination of dextromethorphan and dextrorphan in human plasma by liquid chromatography/tandem mass spectrometry. Author(s): Eichhold TH, Greenfield LJ, Hoke SH 2nd, Wehmeyer KR. Source: Journal of Mass Spectrometry : Jms. 1997 November; 32(11): 1205-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9373961
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Determination of dextromethorphan and dextrorphan in urine by high-performance liquid chromatography after solid-phase extraction. Author(s): Wenk M, Todesco L, Keller B, Follath F. Source: Journal of Pharmaceutical and Biomedical Analysis. 1991; 9(4): 341-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1911987
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Determination of dextromethorphan and its metabolite dextrorphan in human urine by capillary gas chromatography without derivatization. Author(s): Wu YJ, Cheng YY, Zeng S, Ma MM. Source: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences. 2003 February 5; 784(2): 219-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12505769
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Determination of dextromethorphan and its O-demethylated metabolite from urine. Author(s): Marshall PS, Straka RJ, Johnson K. Source: Therapeutic Drug Monitoring. 1992 October; 14(5): 402-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1448849
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Determination of dextromethorphan in serum by gas chromatography. Author(s): Barnhart JW, Massad EN. Source: Journal of Chromatography. 1979 August 21; 163(4): 390-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=544605
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Determination of dextromethorphan metabolic phenotype by salivary analysis with a reference to genotype in Chinese patients receiving renal hemodialysis. Author(s): Hou ZY, Chen CP, Yang WC, Lai MD, Buchert ET, Chung HM, Pickle LW, Woosley RL. Source: Clinical Pharmacology and Therapeutics. 1996 April; 59(4): 411-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8612385
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Determination of dextromethorphan metabolizer phenotype in healthy volunteers. Author(s): Hildebrand M, Seifert W, Reichenberger A. Source: European Journal of Clinical Pharmacology. 1989; 36(3): 315-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2744072
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Determination of dextrorphan in plasma and evaluation of bioavailability of dextromethorphan hydrobromide in humans. Author(s): Ramachander G, Williams FD, Emele JF. Source: Journal of Pharmaceutical Sciences. 1977 July; 66(7): 1047-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=886444
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Development of an ELISA to study the polymorphism of dextromethorphan oxidation in a French population. Author(s): Freche JP, Dragacci S, Petit AM, Siest JP, Galteau MM, Siest G. Source: European Journal of Clinical Pharmacology. 1990; 39(5): 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2076741
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Dextromethorphan abuse among youth. Author(s): Noonan WC, Miller WR, Feeney DM. Source: Archives of Family Medicine. 2000 September-October; 9(9): 791-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11031382
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Dextromethorphan abuse in a dually diagnosed patient. Author(s): Iaboni RP, Aronowitz JS. Source: The Journal of Nervous and Mental Disease. 1995 May; 183(5): 341-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7745393
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Dextromethorphan ameliorates effects of neonatal hypoxia on brain morphology and seizure threshold in rats. Author(s): Laroia N, McBride L, Baggs R, Guillet R. Source: Brain Research. Developmental Brain Research. 1997 May 20; 100(1): 29-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174243
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Dextromethorphan anaphylaxis. Author(s): Knowles SR, Weber E. Source: The Journal of Allergy and Clinical Immunology. 1998 August; 102(2): 316-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9723677
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Dextromethorphan and caffeine as probes for simultaneous determination of debrisoquin-oxidation and N-acetylation phenotypes in children. Author(s): Evans WE, Relling MV, Petros WP, Meyer WH, Mirro J Jr, Crom WR. Source: Clinical Pharmacology and Therapeutics. 1989 May; 45(5): 568-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2721111
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Dextromethorphan and dexmedetomidine: new agents for the control of perioperative pain. Author(s): Weinbroum AA, Ben-Abraham R. Source: The European Journal of Surgery = Acta Chirurgica. 2001 August; 167(8): 563-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11716440
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Dextromethorphan and diabetic neuropathy. Author(s): Criner TM, Perdun CS. Source: The Annals of Pharmacotherapy. 1999 November; 33(11): 1221-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573324
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Dextromethorphan and ecstasy pills. Author(s): Boyer EW, Quang L, Woolf A, Shannon M, Magnani B. Source: Jama : the Journal of the American Medical Association. 2001 January 24-31; 285(4): 409-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11242417
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Dextromethorphan and high-dose benzoate therapy for nonketotic hyperglycinemia in an infant. Author(s): Hamosh A, McDonald JW, Valle D, Francomano CA, Niedermeyer E, Johnston MV. Source: The Journal of Pediatrics. 1992 July; 121(1): 131-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1385627
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Dextromethorphan and intrathecal morphine for analgesia after Caesarean section under spinal anaesthesia. Author(s): Choi DM, Kliffer AP, Douglas MJ. Source: British Journal of Anaesthesia. 2003 May; 90(5): 653-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12697594
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Dextromethorphan and its metabolite dextrorphan block alpha3beta4 neuronal nicotinic receptors. Author(s): Hernandez SC, Bertolino M, Xiao Y, Pringle KE, Caruso FS, Kellar KJ. Source: The Journal of Pharmacology and Experimental Therapeutics. 2000 June; 293(3): 962-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10869398
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Dextromethorphan and memantine in painful diabetic neuropathy and postherpetic neuralgia: efficacy and dose-response trials. Author(s): Sang CN, Booher S, Gilron I, Parada S, Max MB. Source: Anesthesiology. 2002 May; 96(5): 1053-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11981142
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Dextromethorphan and mephenytoin phenotyping of patients treated with thioridazine or amitriptyline. Author(s): Baumann P, Meyer JW, Amey M, Baettig D, Bryois C, Jonzier-Perey M, Koeb L, Monney C, Woggon B. Source: Therapeutic Drug Monitoring. 1992 February; 14(1): 1-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1546384
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Dextromethorphan and neuromodulation: old drug coughs up new activities. Author(s): Tortella FC, Pellicano M, Bowery NG. Source: Trends in Pharmacological Sciences. 1989 December; 10(12): 501-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2694543
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Dextromethorphan and pain after total abdominal hysterectomy. Author(s): McConaghy PM, McSorley P, McCaughey W, Campbell WI. Source: British Journal of Anaesthesia. 1998 November; 81(5): 731-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10193285
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Dextromethorphan and parkinsonism. Author(s): Bonuccelli U, Del Dotto P, Piccini P, Behge F, Corsini GU, Muratorio A. Source: Lancet. 1992 July 4; 340(8810): 53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1351627
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Dextromethorphan- and pseudoephedrine-induced agitated psychosis and ataxia: case report. Author(s): Roberge RJ, Hirani KH, Rowland PL 3rd, Berkeley R, Krenzelok EP. Source: The Journal of Emergency Medicine. 1999 March-April; 17(2): 285-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195488
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Dextromethorphan and sigma ligands: common sites but diverse effects. Author(s): Musacchio JM, Klein M, Canoll PD. Source: Life Sciences. 1989; 45(19): 1721-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2556614
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Dextromethorphan attenuation of postoperative pain and primary and secondary thermal hyperalgesia. Author(s): Weinbroum AA, Gorodezky A, Niv D, Ben-Abraham R, Rudick V, Szold A. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2001 February; 48(2): 167-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11220426
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Dextromethorphan can produce false positive phencyclidine testing with HPLC. Author(s): Budai B, Iskandar H. Source: The American Journal of Emergency Medicine. 2002 January; 20(1): 61-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11781921
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Dextromethorphan challenge in alcohol-dependent patients and controls. Author(s): Schutz CG, Soyka M. Source: Archives of General Psychiatry. 2000 March; 57(3): 291-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10711916
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Dextromethorphan danger. Author(s): Katona B, Wason S. Source: The New England Journal of Medicine. 1986 April 10; 314(15): 993. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3960067
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Dextromethorphan decreases the excitability of the human motor cortex. Author(s): Ziemann U, Chen R, Cohen LG, Hallett M. Source: Neurology. 1998 November; 51(5): 1320-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9818853
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Dextromethorphan for intubation. Author(s): Poznak AV. Source: Anesthesiology. 1972 December; 37(6): 662. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4652788
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Dextromethorphan for phantom pain attenuation in cancer amputees: a double-blind crossover trial involving three patients. Author(s): Ben Abraham R, Marouani N, Kollender Y, Meller I, Weinbroum AA. Source: The Clinical Journal of Pain. 2002 September-October; 18(5): 282-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12218498
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Dextromethorphan for the reduction of immediate and late postoperative pain and morphine consumption in orthopedic oncology patients: a randomized, placebocontrolled, double-blind study. Author(s): Weinbroum AA, Gorodetzky A, Nirkin A, Kollender Y, Bickels J, Marouani N, Rudick V, Meller I. Source: Cancer. 2002 September 1; 95(5): 1164-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12209704
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Dextromethorphan for the treatment of neuropathic pain: a double-blind randomised controlled crossover trial with integral n-of-1 design. Author(s): McQuay HJ, Carroll D, Jadad AR, Glynn CJ, Jack T, Moore RA, Wiffeh PJ. Source: Pain. 1994 October; 59(1): 127-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7854793
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Dextromethorphan for treatment of complex partial seizures. Author(s): Fisher RS, Cysyk BJ, Lesser RP, Pontecorvo MJ, Ferkany JT, Schwerdt PR, Hart J, Gordon B. Source: Neurology. 1990 March; 40(3 Pt 1): 547-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2314601
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Dextromethorphan improves levodopa-induced dyskinesias in Parkinson's disease. Author(s): Verhagen Metman L, Del Dotto P, Natte R, van den Munckhof P, Chase TN. Source: Neurology. 1998 July; 51(1): 203-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9674803
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Dextromethorphan in a child with nonketotic hyperglycinaemia--a 6-year follow up. Author(s): Schmitt B, Steinmann B. Source: European Journal of Pediatrics. 1998 April; 157(4): 349-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9578977
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Dextromethorphan in chronic pain: a disappointing update. Author(s): Ben-Abraham R, Weinbroum AA. Source: Isr Med Assoc J. 2000 September; 2(9): 708-10. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11062774
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Dextromethorphan in infantile nonketotic hyperglycinemia. Author(s): Schmitt B, Steinmann B. Source: The Journal of Pediatrics. 1993 February; 122(2): 324-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8429455
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Dextromethorphan in molybdenum cofactor deficiency. Author(s): Kurlemann G, Debus O, Schuierer G. Source: European Journal of Pediatrics. 1996 May; 155(5): 422-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8741046
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Dextromethorphan in nonketotic hyperglycinaemia: metabolic variation confounds the dose-response relationship. Author(s): Arnold GL, Griebel ML, Valentine JL, Koroma DM, Kearns GL. Source: Journal of Inherited Metabolic Disease. 1997 March; 20(1): 28-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9061564
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Dextromethorphan in nonketotic hyperglycinemia. Author(s): Allen RJ. Source: Neurology. 1993 November; 43(11): 2422-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8110239
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Dextromethorphan in pregnancy. Author(s): Debus O, Kurlemann G, Gehrmann J, Krasemann T. Source: Chest. 2001 September; 120(3): 1038-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11555552
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Dextromethorphan induces multifocal fixed drug eruption. Author(s): Kawakami A, Nakayama H, Yamada Y, Hirosaki K, Yamashita T, Kondo S, Jimbow K. Source: International Journal of Dermatology. 2003 June; 42(6): 501-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12786886
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Dextromethorphan inhibits 5-hydroxytryptamine uptake by human blood platelets and decreases 5-hydroxyindoleacetic acid content in rat brain. Author(s): Ahtee L. Source: The Journal of Pharmacy and Pharmacology. 1975 March; 27(3): 177-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=238000
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Dextromethorphan is an effective cough suppressant. Author(s): Lexchin J. Source: The Journal of Emergency Medicine. 2001 May; 20(4): 415-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11394377
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Dextromethorphan is effective in the treatment of subacute methotrexate neurotoxicity. Author(s): Drachtman RA, Cole PD, Golden CB, James SJ, Melnyk S, Aisner J, Kamen BA. Source: Pediatric Hematology and Oncology. 2002 July-August; 19(5): 319-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12078863
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Dextromethorphan metabolic phenotyping in a Chinese population. Author(s): Cai WM, Chen B, Liu YX, Chu X. Source: Zhongguo Yao Li Xue Bao. 1997 September; 18(5): 441-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10322937
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Dextromethorphan metabolism in Jordanians: dissociation of dextromethorphan Odemethylation from debrisoquine 4-hydroxylation. Author(s): Irshaid YM, al-Hadidi HF, Latif A, Awwadi F, al-Zoubi M, Rawashdeh NM. Source: Eur J Drug Metab Pharmacokinet. 1996 October-December; 21(4): 301-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9074894
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Dextromethorphan mitigates phantom pain in cancer amputees. Author(s): Ben Abraham R, Marouani N, Weinbroum AA. Source: Annals of Surgical Oncology : the Official Journal of the Society of Surgical Oncology. 2003 April; 10(3): 268-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12679312
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Dextromethorphan O-demethylation and dextrorphan glucuronidation in a French population. Author(s): Duche JC, Querol-Ferrer V, Barre J, Mesangeau M, Tillement JP. Source: Int J Clin Pharmacol Ther Toxicol. 1993 August; 31(8): 392-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8225685
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Dextromethorphan O-demethylation in a large number of French Caucasian families. Author(s): Vincent-Viry M, Fournier B, Siest G, Galteau MM. Source: Pharmacogenetics. 1992 June; 2(3): 135-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1306113
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Dextromethorphan O-demethylation in liver microsomes as a prototype reaction to monitor cytochrome P-450 db1 activity. Author(s): Dayer P, Leemann T, Striberni R. Source: Clinical Pharmacology and Therapeutics. 1989 January; 45(1): 34-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2910636
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Dextromethorphan O-demethylation polymorphism in an African-American population. Author(s): He N, Daniel HI, Hajiloo L, Shockley D. Source: European Journal of Clinical Pharmacology. 1999 August; 55(6): 457-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10492059
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Dextromethorphan O-demethylation polymorphism in Jordanians. Author(s): Irshaid YM, al-Hadidi HF, Rawashdeh NM. Source: European Journal of Clinical Pharmacology. 1993; 45(3): 271-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8276053
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Dextromethorphan O-demethylation polymorphism in the Uruguayan population. Author(s): Estevez F, Giusti M, Parrillo S, Oxandabarat J. Source: European Journal of Clinical Pharmacology. 1997; 52(5): 417-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9272415
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Dextromethorphan oxidation phenotypes as markers for susceptibility to lung cancer. Author(s): Faccini GB, Puchetti V, Zatti N. Source: Clinical Chemistry. 1990 February; 36(2): 387. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2302789
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Dextromethorphan phenotypes determined by high-performance liquid chromatography and fluorescence detection. Author(s): Jacqz-Aigrain E, Menard Y, Popon M, Mathieu H. Source: Journal of Chromatography. 1989 October 27; 495: 361-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2613825
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Dextromethorphan phenotypes in paediatric patients with autoimmune hepatitis. Author(s): Jacqz-Aigrain E, Laurent J, Alvarez F. Source: British Journal of Clinical Pharmacology. 1990 July; 30(1): 153-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2390427
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Dextromethorphan phenotyping and haloperidol disposition in schizophrenic patients. Author(s): Lane HY, Hu OY, Jann MW, Deng HC, Lin HN, Chang WH. Source: Psychiatry Research. 1997 March 24; 69(2-3): 105-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9109178
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Dextromethorphan poisoning in an adolescent with genetic cytochrome P450 CYP2D6 deficiency. Author(s): Baumann P, Vlatkovic D, Macciardi F. Source: Therapie. 1997 November-December; 52(6): 607-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9734115
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Dextromethorphan poisoning reversed by naloxone. Author(s): Schneider SM, Michelson EA, Boucek CD, Ilkhanipour K. Source: The American Journal of Emergency Medicine. 1991 May; 9(3): 237-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2018593
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Dextromethorphan polymorphic hepatic oxidation (CYP2D6) in healthy black American adult subjects. Author(s): Marinac JS, Foxworth JW, Willsie SK. Source: Therapeutic Drug Monitoring. 1995 April; 17(2): 120-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7624898
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Dextromethorphan reduces immediate and late postoperative analgesic requirements and improves patients' subjective scorings after epidural lidocaine and general anesthesia. Author(s): Weinbroum AA. Source: Anesthesia and Analgesia. 2002 June; 94(6): 1547-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12032024
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Dextromethorphan shows efficacy in experimental pain (nociception) and opioid tolerance. Author(s): Elliott KJ, Brodsky M, Hyanansky A, Foley KM, Inturrisi CE. Source: Neurology. 1995 December; 45(12 Suppl 8): S66-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8545027
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Dextromethorphan sites, sigma receptors, and the psychotomimetic effects of sigma opiates. Author(s): Musacchio JM, Klein M, Canoll PD. Source: Prog Clin Biol Res. 1990; 328: 13-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2154766
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Dextromethorphan test for evaluation of congenital predisposition to lung cancer. Author(s): Puchetti V, Faccini GB, Micciolo R, Ghimenton F, Bertrand C, Zatti N. Source: Chest. 1994 February; 105(2): 449-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8306745
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Dextromethorphan toxicity: reversal by naloxone. Author(s): Shaul WL, Wandell M, Robertson WO. Source: Pediatrics. 1977 January; 59(1): 117-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=840529
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Dextromethorphan, dysphoria and NMDA receptors. Neuromodulatory effects of dextromethorphan: role of NMDA receptors in responses. Author(s): Church J. Source: Trends in Pharmacological Sciences. 1990 April; 11(4): 146-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2159197
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Dextromethorphan. Author(s): Loscher W, Netzer R, Schmitt B. Source: Neurology. 1994 March; 44(3 Pt 1): 582-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8179707
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Dextromethorphan. An overview of safety issues. Author(s): Bem JL, Peck R. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1992 May-June; 7(3): 190-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1503667
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Dextromethorphan. Extrapolation of findings from reproductive studies in animals to humans. Author(s): Einarson A, Koren G. Source: Can Fam Physician. 1999 October; 45: 2309-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10540688
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Dextromethorphan: another "ecstasy"? Author(s): McFee RB, Mofenson HC, Caraccio TR. Source: Archives of Family Medicine. 2000 February; 9(2): 123. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10693726
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Dextromethorphan: cellular effects reducing neuronal hyperactivity. Author(s): Trube G, Netzer R. Source: Epilepsia. 1994; 35 Suppl 5: S62-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7518769
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Dextromethorphan: enhancing its systemic availability by way of low-dose quinidine-mediated inhibition of cytochrome P4502D6. Author(s): Zhang Y, Britto MR, Valderhaug KL, Wedlund PJ, Smith RA. Source: Clinical Pharmacology and Therapeutics. 1992 June; 51(6): 647-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1611804
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Dextromethorphan: polymorphic serum pattern of the O-demethylated and didemethylated metabolites in man. Author(s): Mortimer O, Lindstrom B, Laurell H, Bergman U, Rane A. Source: British Journal of Clinical Pharmacology. 1989 February; 27(2): 223-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2713216
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Dextromethorphan: radioimmunoassay and pharmacokinetics in the dog. Author(s): Dixon R, Carbone JJ, Mohacsi E, Perry C. Source: Res Commun Chem Pathol Pharmacol. 1978 November; 22(2): 243-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=734214
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Dextromethorphan-associated epidural patient-controlled analgesia provides better pain- and analgesics-sparing effects than dextromethorphan-associated intravenous patient-controlled analgesia after bone-malignancy resection: a randomized, placebocontrolled, double-blinded study. Author(s): Weinbroum AA, Bender B, Nirkin A, Chazan S, Meller I, Kollender Y. Source: Anesthesia and Analgesia. 2004 March; 98(3): 714-22, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14980926
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Dextromethorphan-induced mania. Author(s): Polles A, Griffith JL. Source: Psychosomatics. 1996 January-February; 37(1): 71-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8600498
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Dextromethorphan-induced manic symptoms in a bipolar patient on lithium. Author(s): Bostwick JM. Source: Psychosomatics. 1996 November-December; 37(6): 571-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8942208
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Dextromethorphan-induced psychosis. Author(s): Price LH, Lebel J. Source: The American Journal of Psychiatry. 2000 February; 157(2): 304. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10671422
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Differential foetal development of the O- and N-demethylation of codeine and dextromethorphan in man. Author(s): Ladona MG, Lindstrom B, Thyr C, Dun-Ren P, Rane A. Source: British Journal of Clinical Pharmacology. 1991 September; 32(3): 295-302. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1838002
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Direct determination of dextromethorphan and its three metabolites in urine by highperformance liquid chromatography using a precolumn switching system for sample clean-up. Author(s): Motassim N, Decolin D, Le Dinh T, Nicolas A, Siest G. Source: Journal of Chromatography. 1987 November 27; 422: 340-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3437023
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Discrepancy between CYP2D6 phenotype and genotype derived from post-mortem dextromethorphan blood level. Author(s): Bailey B, Daneman R, Daneman N, Mayer JM, Koren G. Source: Forensic Science International. 2000 May 8; 110(1): 61-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10802201
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Dose dependency of dextromethorphan for cytochrome P450 2D6 (CYP2D6) phenotyping. Author(s): Streetman DS, Ellis RE, Nafziger AN, Leeder JS, Gaedigk A, Gotschall R, Kearns GL, Bertino JS Jr. Source: Clinical Pharmacology and Therapeutics. 1999 November; 66(5): 535-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10579482
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Dose escalation safety and tolerance study of the N-methyl-D-aspartate antagonist dextromethorphan in neurosurgery patients. Author(s): Steinberg GK, Bell TE, Yenari MA. Source: Journal of Neurosurgery. 1996 May; 84(5): 860-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8622162
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Drug abuse update: dextromethorphan. Author(s): Nevin J. Source: Emerg Med Serv. 2004 February; 33(2): 34, 36. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14994669
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Drug extrapyramidal side-effects or not: is there a dextromethorphan phenotype difference? Author(s): Vandel P, Haffen E, Vandel S, Bonin B, Sechter D, Bizouard P, Dalery J. Source: Therapie. 2000 May-June; 55(3): 349-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10967711
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Drug refractory epilepsy in brain damage: effect of dextromethorphan on EEG in four patients. Author(s): Schmitt B, Netzer R, Fanconi S, Baumann P, Boltshauser E. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1994 March; 57(3): 333-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8158182
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Dystonic reaction associated with dextromethorphan ingestion in a toddler. Author(s): Warden CR, Diekema DS, Robertson WO. Source: Pediatric Emergency Care. 1997 June; 13(3): 214-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9220509
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Effect of liver disease on dextromethorphan oxidation capacity and phenotype: a study in 107 patients. Author(s): Larrey D, Babany G, Tinel M, Freneaux E, Amouyal G, Habersetzer F, Letteron P, Pessayre D. Source: British Journal of Clinical Pharmacology. 1989 September; 28(3): 297-304. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2789923
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Effect of preoperative oral dextromethorphan on immediate and late postoperative pain and hyperalgesia after total abdominal hysterectomy. Author(s): Ilkjaer S, Bach LF, Nielsen PA, Wernberg M, Dahl JB. Source: Pain. 2000 May; 86(1-2): 19-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10779656
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Effect of quinidine on the dextromethorphan O-demethylase activity of microsomal fractions from human liver. Author(s): Broly F, Libersa C, Lhermitte M, Bechtel P, Dupuis B. Source: British Journal of Clinical Pharmacology. 1989 July; 28(1): 29-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2775613
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Effect of systemic N-methyl-D-aspartate receptor antagonist (dextromethorphan) on primary and secondary hyperalgesia in humans. Author(s): Ilkjaer S, Dirks J, Brennum J, Wernberg M, Dahl JB. Source: British Journal of Anaesthesia. 1997 November; 79(5): 600-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9422898
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Effect of the low-affinity, noncompetitive N-methyl-d-aspartate receptor antagonist dextromethorphan on visceral perception in healthy volunteers. Author(s): Kuiken SD, Lei A, Tytgat GN, Holman R, Boeckxstaens GE. Source: Alimentary Pharmacology & Therapeutics. 2002 November; 16(11): 1955-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12390105
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Effect of venlafaxine versus fluoxetine on metabolism of dextromethorphan, a CYP2D6 probe. Author(s): Amchin J, Ereshefsky L, Zarycranski W, Taylor K, Albano D, Klockowski PM. Source: Journal of Clinical Pharmacology. 2001 April; 41(4): 443-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11304901
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Effects of dextromethorphan in clinical doses on capsaicin-induced ongoing pain and mechanical hypersensitivity. Author(s): Kinnman E, Nygards EB, Hansson P. Source: Journal of Pain and Symptom Management. 1997 October; 14(4): 195-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9379066
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Effects of the antitussive fominoben (PB89) on hypoxia in chronic obstructive lung disease: comparison with dextromethorphan using a double-blind method. Author(s): Sasaki T, Sugiyama M, Sasaki H, Suzuki S, Takishima T. Source: J Int Med Res. 1985; 13(2): 96-101. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3158563
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Efficacy and tolerability of levodropropizine in adult patients with non-productive cough. Comparison with dextromethorphan. Author(s): Catena E, Daffonchio L. Source: Pulmonary Pharmacology & Therapeutics. 1997; 10(2): 89-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9425640
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Efficacy of low-dose dextromethorphan in the treatment of nonketotic hyperglycinemia. Author(s): Alemzadeh R, Gammeltoft K, Matteson K. Source: Pediatrics. 1996 June; 97(6 Pt 1): 924-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8657542
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Enzyme polymorphism on the metabolic O-demethylation of dextromethorphan in a South American population. Author(s): Estevez F, Giusti M, Parrillo S, Oxandabarat J. Source: Medicina (B Aires). 1996; 56(4): 378-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9138342
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Enzymes in addition to CYP3A4 and 3A5 mediate N-demethylation of dextromethorphan in human liver microsomes. Author(s): Wang Y, Unadkat JD. Source: Biopharmaceutics & Drug Disposition. 1999 October; 20(7): 341-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10760842
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Epidemiologic analysis of prenatal exposure to cough medicines containing dextromethorphan: no evidence of human teratogenicity. Author(s): Martinez-Frias ML, Rodriguez-Pinilla E. Source: Teratology. 2001 January; 63(1): 38-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11169553
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Evaluation of CYP2D6 oxidation of dextromethorphan and propafenone in a Chinese population with atrial fibrillation. Author(s): Chow MS, White CM, Lau CP, Fan C, Tang MO. Source: Journal of Clinical Pharmacology. 2001 January; 41(1): 92-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11144999
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Evaluation of dextromethorphan N-demethylation activity as a biomarker for cytochrome P450 3A activity in man. Author(s): Kawashima Y, Hagiwara M, Inoue Y, Someya T. Source: Pharmacology & Toxicology. 2002 February; 90(2): 82-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12071430
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Extensive oxidative metabolism of dextromethorphan in patients with almitrine neuropathy. Author(s): Belec L, Larrey D, De Cremoux H, Tinel M, Louarn F, Pessayre D, Gherardi R. Source: British Journal of Clinical Pharmacology. 1989 March; 27(3): 387-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2719897
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Failure of early dextromethorphan and sodium benzoate therapy in an infant with nonketotic hyperglycinemia. Author(s): Zammarchi E, Donati MA, Ciani F, Pasquini E, Pela I, Fiorini P. Source: Neuropediatrics. 1994 October; 25(5): 274-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7885541
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Four years' treatment with ketamine and a trial of dextromethorphan in a patient with severe post-herpetic neuralgia. Author(s): Klepstad P, Borchgrevink PC. Source: Acta Anaesthesiologica Scandinavica. 1997 March; 41(3): 422-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9113190
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Frequencies of CYP2D6 mutant alleles in a normal Japanese population and metabolic activity of dextromethorphan O-demethylation in different CYP2D6 genotypes. Author(s): Kubota T, Yamaura Y, Ohkawa N, Hara H, Chiba K. Source: British Journal of Clinical Pharmacology. 2000 July; 50(1): 31-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10886115
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GC and GC-MS procedures for simultaneous phenotyping with dextromethorphan and mephenytoin. Author(s): Baumann P, Jonzier-Perey M. Source: Clinica Chimica Acta; International Journal of Clinical Chemistry. 1988 February 15; 171(2-3): 211-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3370821
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High performance liquid chromatography determination of dextromethorphan and its metabolites in urine using solid-phase extraction. Author(s): Bartoletti RA, Belpaire FM, Rosseel MT. Source: Journal of Pharmaceutical and Biomedical Analysis. 1996 June; 14(8-10): 1281-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8818046
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High-dose dextromethorphan in amyotrophic lateral sclerosis: phase I safety and pharmacokinetic studies. Author(s): Hollander D, Pradas J, Kaplan R, McLeod HL, Evans WE, Munsat TL. Source: Annals of Neurology. 1994 December; 36(6): 920-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7998781
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High-dose oral dextromethorphan versus placebo in painful diabetic neuropathy and postherpetic neuralgia. Author(s): Nelson KA, Park KM, Robinovitz E, Tsigos C, Max MB. Source: Neurology. 1997 May; 48(5): 1212-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9153445
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Highly sensitive high-performance liquid chromatographic-tandem mass spectrometric method for the analysis of dextromethorphan in human plasma. Author(s): Eichhold TH, Quijano M, Seibel WL, Cruze CA, Dobson RL, Wehmeyer KR. Source: J Chromatogr B Biomed Sci Appl. 1997 September 26; 698(1-2): 147-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9367202
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High-performance liquid chromatographic assays for bufuralol 1'-hydroxylase, debrisoquine 4-hydroxylase, and dextromethorphan O-demethylase in microsomes and purified cytochrome P-450 isozymes of human liver. Author(s): Kronbach T, Mathys D, Gut J, Catin T, Meyer UA. Source: Analytical Biochemistry. 1987 April; 162(1): 24-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3605590
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High-performance liquid chromatography assay for simultaneous determination of dextromethorphan and its main metabolites in urine and in microsomal preparations. Author(s): Bendriss EK, Markoglou N, Wainer IW. Source: J Chromatogr B Biomed Sci Appl. 2001 April 15; 754(1): 209-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11318417
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High-performance liquid chromatography determination of dextromethorphan and dextrorphan for oxidation phenotyping by fluorescence and ultraviolet detection. Author(s): Lam YW, Rodriguez SY. Source: Therapeutic Drug Monitoring. 1993 August; 15(4): 300-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8236365
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Improved postoperative pain control in pediatric adenotonsillectomy with dextromethorphan. Author(s): Dawson GS, Seidman P, Ramadan HH. Source: The Laryngoscope. 2001 July; 111(7): 1223-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568544
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In vivo comparison of putative probes of CYP3A4/5 activity: erythromycin, dextromethorphan, and verapamil. Author(s): Krecic-Shepard ME, Barnas CR, Slimko J, Gorski JC, Wainer IW, Schwartz JB. Source: Clinical Pharmacology and Therapeutics. 1999 July; 66(1): 40-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10430108
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Ineffectiveness of dextromethorphan in cancer pain. Author(s): Mercadante S, Casuccio A, Genovese G. Source: Journal of Pain and Symptom Management. 1998 November; 16(5): 317-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9846026
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Influence of amesergide treatment on the dextromethorphan test. Author(s): Baumann P, Hatzinger M, Hemmeter U, Seifritz E, Eap CB, Holsboer E. Source: British Journal of Clinical Pharmacology. 1994 August; 38(2): 151-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7981017
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Inhibition of cytochrome P450 by nefazodone in vitro: studies of dextromethorphan O- and N-demethylation. Author(s): Schmider J, Greenblatt DJ, von Moltke LL, Harmatz JS, Shader RI. Source: British Journal of Clinical Pharmacology. 1996 April; 41(4): 339-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8730981
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Inhibition of debrisoquin clearance in perfused rat livers and inhibition of dextromethorphan metabolism in human liver microsomes by 4-hydroxydebrisoquin or other metabolites of debrisoquin. Author(s): Jaruratanasirikul S, Cooper AD, Blaschke TF. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1992 MayJune; 20(3): 379-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1355711
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Inhibition of dermographia, histamine, and dextromethorphan skin tests by ketotifen. A possible effect on cutaneous vascular response to mediators. Author(s): Mansfield LE, Taistra P, Santamauro J, Ting S, Andriano K. Source: Ann Allergy. 1989 September; 63(3): 201-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2774302
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Inhibition of dextromethorphan metabolism by moclobemide. Author(s): Hartter S, Dingemanse J, Baier D, Ziegler G, Hiemke C. Source: Psychopharmacology. 1998 January; 135(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9489930
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Inhibitory effects of anticancer drugs on dextromethorphan-O-demethylase activity in human liver microsomes. Author(s): Le Guellec C, Lacarelle B, Catalin J, Durand A. Source: Cancer Chemotherapy and Pharmacology. 1993; 32(6): 491-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8258200
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Inhibitory studies of mexiletine and dextromethorphan oxidation in human liver microsomes. Author(s): Broly F, Libersa C, Lhermitte M, Dupuis B. Source: Biochemical Pharmacology. 1990 March 15; 39(6): 1045-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2322292
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Insulin-dependent diabetes mellitus induced by the antitussive agent dextromethorphan. Author(s): Konrad D, Sobetzko D, Schmitt B, Schoenle EJ. Source: Diabetologia. 2000 February; 43(2): 261-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10753054
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Interaction between dextromethorphan and monoamine oxidase inhibitor therapy with isocarboxazid. Author(s): Sovner R, Wolfe J. Source: The New England Journal of Medicine. 1988 December 22; 319(25): 1671. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3200285
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Intra-individual variability and influence of urine collection period on dextromethorphan metabolic ratios in healthy subjects. Author(s): Chladek J, Zimova G, Martinkova J, Tuma I. Source: Fundamental & Clinical Pharmacology. 1999; 13(4): 508-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10456294
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In-vivo indices of CYP2D6 activity: comparison of dextromethorphan metabolic ratios in 4-h urine and 3-h plasma. Author(s): Chladek J, Zimova G, Beranek M, Martinkova J. Source: European Journal of Clinical Pharmacology. 2000 December; 56(9-10): 651-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11214771
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Lack of association between glucose-6-phosphate dehydrogenase deficiency and dextromethorphan O-demethylation polymorphism. Author(s): Irshaid YM, al-Hadidi HF, Rawashdeh NM. Source: European Journal of Clinical Pharmacology. 1993; 44(3): 303-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8491251
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Lack of effect of dextromethorphan on breathlessness and exercise performance in patients with chronic obstructive pulmonary disease (COPD). Author(s): Giron AE, Stansbury DW, Fischer CE, Light RW. Source: The European Respiratory Journal : Official Journal of the European Society for Clinical Respiratory Physiology. 1991 May; 4(5): 532-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1936224
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Lack of gender differences and large intrasubject variability in cytochrome P450 activity measured by phenotyping with dextromethorphan. Author(s): McCune JS, Lindley C, Decker JL, Williamson KM, Meadowcroft AM, Graff D, Sawyer WT, Blough DK, Pieper JA. Source: Journal of Clinical Pharmacology. 2001 July; 41(7): 723-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452704
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Lack of pharmacokinetic interaction between dextromethorphan, coumarin and mephenytoin in man after simultaneous administration. Author(s): Endres HG, Henschel L, Merkel U, Hippius M, Hoffmann A. Source: Pharmazie. 1996 January; 51(1): 46-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8999435
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Large-dose oral dextromethorphan as an adjunct to patient-controlled analgesia with morphine after knee surgery. Author(s): Wadhwa A, Clarke D, Goodchild CS, Young D. Source: Anesthesia and Analgesia. 2001 February; 92(2): 448-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11159249
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Limitations of dextromethorphan N-demethylation as a measure of CYP3A activity. Author(s): Kashuba AD, Nafziger AN, Kearns GL, Leeder JS, Gotschall R, Gaedigk A, Bertino JS Jr. Source: Pharmacogenetics. 1999 August; 9(4): 453-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10780265
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Long-term use of high-dose benzoate and dextromethorphan for the treatment of nonketotic hyperglycinemia. Author(s): Hamosh A, Maher JF, Bellus GA, Rasmussen SA, Johnston MV. Source: The Journal of Pediatrics. 1998 April; 132(4): 709-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9580775
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Low frequency of dextromethorphan O-demethylation deficiency in a Chinese population. Author(s): Lane HY, Deng HC, Huang SM, Hu WH, Chang WH, Hu OY. Source: Clinical Pharmacology and Therapeutics. 1996 December; 60(6): 696-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8988073
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Massive dextromethorphan ingestion and abuse. Author(s): Wolfe TR, Caravati EM. Source: The American Journal of Emergency Medicine. 1995 March; 13(2): 174-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7893303
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Metabolism of dextromethorphan in human liver microsomes: a rapid HPCL assay to monitor cytochrome P450 2D6 activity. Author(s): Vielnascher E, Spatzenegger M, Mayrhofer A, Klinger P, Jager W. Source: Pharmazie. 1996 August; 51(8): 586-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8794469
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Metabolism of dextromethorphan in vitro: involvement of cytochromes P450 2D6 and 3A3/4, with a possible role of 2E1. Author(s): Schmider J, Greenblatt DJ, Fogelman SM, von Moltke LL, Shader RI. Source: Biopharmaceutics & Drug Disposition. 1997 April; 18(3): 227-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9113345
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Methoxyphenamine and dextromethorphan as safe probes for debrisoquine hydroxylation polymorphism. Author(s): Roy SD, Hawes EM, Hubbard JW, McKay G, Midha KK. Source: Lancet. 1984 December 15; 2(8416): 1393. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6150386
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Modified high-performance liquid chromatographic method to measure both dextromethorphan and proguanil for oxidative phenotyping. Author(s): Hoskins JM, Shenfield GM, Gross AS. Source: J Chromatogr B Biomed Sci Appl. 1997 August 15; 696(1): 81-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9300912
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Morphine with dextromethorphan: conversion from other opioid analgesics. Author(s): Chevlen E. Source: Journal of Pain and Symptom Management. 2000 January; 19(1 Suppl): S42-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10687339
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Multiple human cytochromes contribute to biotransformation of dextromethorphan in-vitro: role of CYP2C9, CYP2C19, CYP2D6, and CYP3A. Author(s): von Moltke LL, Greenblatt DJ, Grassi JM, Granda BW, Venkatakrishnan K, Schmider J, Harmatz JS, Shader RI. Source: The Journal of Pharmacy and Pharmacology. 1998 September; 50(9): 997-1004. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9811160
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National Association of Medical Examiners Pediatric Toxicology (PedTox) Registry Report 3. Case submission summary and data for acetaminophen, benzene, carboxyhemoglobin, dextromethorphan, ethanol, phenobarbital, and pseudoephedrine. Author(s): Hanzlick R. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1995 December; 16(4): 270-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8599337
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NMDA receptor challenge with dextromethorphan - subjective response, neuroendocrinological findings and possible clinical implications. Author(s): Soyka M, Bondy B, Eisenburg B, Schutz CG. Source: Journal of Neural Transmission (Vienna, Austria : 1996). 2000; 107(6): 701-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10943910
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N-methyl-D-aspartate (NMDA) antagonist and Parkinson's disease: a pilot study with dextromethorphan. Author(s): Montastruc JL, Fabre N, Rascol O, Senard JM, Blin O. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1994 March; 9(2): 242-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8196695
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Nonketotic hyperglycinemia: clinical and electrophysiologic effects of dextromethorphan, an antagonist of the NMDA receptor. Author(s): Schmitt B, Steinmann B, Gitzelmann R, Thun-Hohenstein L, Mascher H, Dumermuth G. Source: Neurology. 1993 February; 43(2): 421-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8437713
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Novel single-point plasma or saliva dextromethorphan method for determining CYP2D6 activity. Author(s): Hu OY, Tang HS, Lane HY, Chang WH, Hu TM. Source: The Journal of Pharmacology and Experimental Therapeutics. 1998 June; 285(3): 955-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9618394
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Objective evaluation of dextromethorphan and glaucine as antitussive agents. Author(s): Ruhle KH, Criscuolo D, Dieterich HA, Kohler D, Riedel G. Source: British Journal of Clinical Pharmacology. 1984 May; 17(5): 521-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6375709
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Observations of the interaction between tricyclic antidepressants and fluvoxamine in poor metabolizers of dextromethorphan and mephenytoin. Author(s): Vandel P, Bonin B, Bertschy G, Baumann P, Bouquet S, Vandel S, Sechter D, Bizouard P. Source: Therapie. 1997 January-February; 52(1): 74-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9183927
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Omission of the deconjugation step in urine analysis and the unaltered outcome of CYP2D6 phenotyping with dextromethorphan. Author(s): Basci NE, Bozkurt A, Kayaalp SO, Sayal A, Isimer A. Source: Eur J Drug Metab Pharmacokinet. 1998 January-March; 23(1): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9625265
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Opiate withdrawal with dextromethorphan. Author(s): Bisaga A, Gianelli P, Popik P. Source: The American Journal of Psychiatry. 1997 April; 154(4): 584. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9090360
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Oxidative polymorphism of dextromethorphan in a Burundi population. Author(s): Nsabiyumva F, Furet Y, Autret E, Jonville AP, Breteau M. Source: European Journal of Clinical Pharmacology. 1991; 41(1): 75-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1782983
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Patient-controlled analgesia (PCA) with codeine for postoperative pain relief in ten extensive metabolisers and one poor metaboliser of dextromethorphan. Author(s): Persson K, Sjostrom S, Sigurdardottir I, Molnar V, Hammarlund-Udenaes M, Rane A. Source: British Journal of Clinical Pharmacology. 1995 February; 39(2): 182-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7742159
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Perioperative dextromethorphan reduces postoperative pain after hysterectomy. Author(s): Henderson DJ, Withington BS, Wilson JA, Morrison LM. Source: Anesthesia and Analgesia. 1999 August; 89(2): 399-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10439755
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Pharmacogenetics of dextromethorphan O-demethylation in man. Author(s): Kupfer A, Schmid B, Pfaff G. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 1986 May; 16(5): 421-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3739367
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Pharmacokinetic comparison of a dextromethorphan-salbutamol combination tablet and a plain dextromethorphan tablet. Author(s): Silvasti M, Karttunen P, Happonen P, Mykkanen M, Romppanen T, Tukiainen H. Source: Int J Clin Pharmacol Ther Toxicol. 1990 June; 28(6): 268-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2376428
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Pharmacokinetic drug interaction potential of risperidone with cytochrome p450 isozymes as assessed by the dextromethorphan, the caffeine, and the mephenytoin test. Author(s): Eap CB, Bondolfi G, Zullino D, Bryois C, Fuciec M, Savary L, Jonzier-Perey M, Baumann P. Source: Therapeutic Drug Monitoring. 2001 June; 23(3): 228-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11360030
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Pharmacokinetics and polymorphic oxidation of dextromethorphan in a Japanese population. Author(s): Nagai N, Kawakubo T, Kaneko F, Ishii M, Shinohara R, Saito Y, Shimamura H, Ohnishi A, Ogata H. Source: Biopharmaceutics & Drug Disposition. 1996 July; 17(5): 421-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8830977
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Pharmacokinetics of dextromethorphan and dextrorphan in epileptic patients. Author(s): Kazis A, Kimiskidis V, Niopas I. Source: Acta Neurologica Scandinavica. 1996 February-March; 93(2-3): 94-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8741125
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Pharmacokinetics of dextromethorphan and dextrorphan: a single dose comparison of three preparations in human volunteers. Author(s): Silvasti M, Karttunen P, Tukiainen H, Kokkonen P, Hanninen U, Nykanen S. Source: Int J Clin Pharmacol Ther Toxicol. 1987 September; 25(9): 493-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3679620
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Pharmacokinetics of dextromethorphan and metabolites in humans: influence of the CYP2D6 phenotype and quinidine inhibition. Author(s): Schadel M, Wu D, Otton SV, Kalow W, Sellers EM. Source: Journal of Clinical Psychopharmacology. 1995 August; 15(4): 263-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7593709
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Pharmacokinetics of sabeluzole and dextromethorphan oxidation capacity in patients with severe hepatic dysfunction and healthy volunteers. Author(s): Pageaux GP, Micallef J, Nataf MB, Levron JC, Lacarelle B, Le Moing JP, Bouhours P, Blin O. Source: British Journal of Clinical Pharmacology. 2001 February; 51(2): 164-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11259989
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Phenotypic differences in dextromethorphan metabolism. Author(s): Vetticaden SJ, Cabana BE, Prasad VK, Purich ED, Jonkman JH, de Zeeuw R, Ball L, Leeson LJ, Braun RL. Source: Pharmaceutical Research. 1989 January; 6(1): 13-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2717511
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Physiologically based modelling of inhibition of metabolism and assessment of the relative potency of drug and metabolite: dextromethorphan vs. dextrorphan using quinidine inhibition. Author(s): Moghadamnia AA, Rostami-Hodjegan A, Abdul-Manap R, Wright CE, Morice AH, Tucker GT. Source: British Journal of Clinical Pharmacology. 2003 July; 56(1): 57-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12848776
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Plasma levels of the enantiomers of thioridazine, thioridazine 2-sulfoxide, thioridazine 2-sulfone, and thioridazine 5-sulfoxide in poor and extensive metabolizers of dextromethorphan and mephenytoin. Author(s): Eap CB, Guentert TW, Schaublin-Loidl M, Stabl M, Koeb L, Powell K, Baumann P. Source: Clinical Pharmacology and Therapeutics. 1996 March; 59(3): 322-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8653995
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Polymorphic dextromethorphan metabolism: co-segregation of oxidative Odemethylation with debrisoquin hydroxylation. Author(s): Schmid B, Bircher J, Preisig R, Kupfer A. Source: Clinical Pharmacology and Therapeutics. 1985 December; 38(6): 618-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4064464
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Polymorphic formation of morphine from codeine in poor and extensive metabolizers of dextromethorphan: relationship to the presence of immunoidentified cytochrome P-450IID1. Author(s): Mortimer O, Persson K, Ladona MG, Spalding D, Zanger UM, Meyer UA, Rane A. Source: Clinical Pharmacology and Therapeutics. 1990 January; 47(1): 27-35. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2295216
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Polymorphism of dextromethorphan metabolism: relationships between phenotype, genotype and response to the administration of encainide in humans. Author(s): Funck-Brentano C, Thomas G, Jacqz-Aigrain E, Poirier JM, Simon T, Bereziat G, Jaillon P. Source: The Journal of Pharmacology and Experimental Therapeutics. 1992 November; 263(2): 780-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1432700
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Polymorphism of dextromethorphan oxidation in a French population. Author(s): Larrey D, Amouyal G, Tinel M, Letteron P, Berson A, Labbe G, Pessayre D. Source: British Journal of Clinical Pharmacology. 1987 November; 24(5): 676-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3435696
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Polymorphism of dextromethorphan oxidation in South Indian subjects. Author(s): Mamidi RN, Satyavageeswaran S, Vakkalanka SV, Chaluvadi MR, Katneni K, Brahmadevara N, Damodarram G, Subramaniam S. Source: Clinical Pharmacology and Therapeutics. 1999 August; 66(2): 193-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10460073
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Postoperative intramuscular dextromethorphan injection provides pain relief and decreases opioid requirement after modified radical mastectomy. Author(s): Wu CT, Yu JC, Yeh CC, Lee MM, Lin TC, Wong CS. Source: International Journal of Surgical Investigation. 2000; 2(2): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12678512
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Postoperative intramuscular dextromethorphan injection provides postoperative pain relief and decreases opioid requirement after hemorrhoidectomy. Author(s): Chang FL, Wu CT, Yeh CC, Lin TC, Ho ST, Wong CS. Source: Acta Anaesthesiol Sin. 1999 December; 37(4): 179-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10670115
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Potent inhibition of cytochrome P-450 2D6-mediated dextromethorphan Odemethylation by terbinafine. Author(s): Abdel-Rahman SM, Marcucci K, Boge T, Gotschall RR, Kearns GL, Leeder JS. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 1999 July; 27(7): 770-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10383919
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Prediction of phenotype for dextromethorphan O-demethylation by using polymerase chain reaction in healthy volunteers. Author(s): Zimmermann T, Schlenk R, Pfaff G, Lach P, Wildfeuer A. Source: Arzneimittel-Forschung. 1995 January; 45(1): 41-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7893267
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Preincisional dextromethorphan decreases postoperative pain and opioid requirement after modified radical mastectomy. Author(s): Wong CS, Wu CT, Yu JC, Yeh CC, Lee MM, Tao PL. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 1999 December; 46(12): 1122-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10608204
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Preincisional dextromethorphan treatment decreases postoperative pain and opioid requirement after laparoscopic cholecystectomy. Author(s): Wu CT, Yu JC, Yeh CC, Liu ST, Li CY, Ho ST, Wong CS. Source: Anesthesia and Analgesia. 1999 June; 88(6): 1331-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10357340
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Preincisional dextromethorphan treatment for postoperative pain management after upper abdominal surgery. Author(s): Wu CT, Yu JC, Liu ST, Yeh CC, Li CY, Wong CS. Source: World Journal of Surgery. 2000 May; 24(5): 512-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10787068
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Premedication with dextromethorphan provides posthemorrhoidectomy pain relief. Author(s): Liu ST, Wu CT, Yeh CC, Ho ST, Wong CS, Jao SW, Wu CC, Kang JC. Source: Diseases of the Colon and Rectum. 2000 April; 43(4): 507-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10789747
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Premedication with oral dextromethorphan reduces postoperative pain after tonsillectomy. Author(s): Kawamata T, Omote K, Kawamata M, Namiki A. Source: Anesthesia and Analgesia. 1998 March; 86(3): 594-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9495423
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Preoperative and postoperative dextromethorphan provides sustained reduction in postoperative pain and patient-controlled epidural analgesia requirement: a randomized, placebo-controlled, double-blind study in lower-body bone malignancyoperated patients. Author(s): Weinbroum AA, Bender B, Bickels J, Nirkin A, Marouani N, Chazam S, Meller I, Kollender Y. Source: Cancer. 2003 May 1; 97(9): 2334-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12712491
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Preoperative dextromethorphan reduces intraoperative but not postoperative morphine requirements after laparotomy. Author(s): Grace RF, Power I, Umedaly H, Zammit A, Mersiades M, Cousins MJ, Mather LE. Source: Anesthesia and Analgesia. 1998 November; 87(5): 1135-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9806696
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Preoperative oral dextromethorphan attenuated tourniquet-induced arterial blood pressure and heart rate increases in knee cruciate ligament reconstruction patients under general anesthesia. Author(s): Yamashita S, Yamaguchi H, Hisajima Y, Ijima K, Saito K, Chiba A, Yasunaga T. Source: Anesthesia and Analgesia. 2004 April; 98(4): 994-8, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15041587
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Preoperative oral dextromethorphan does not reduce pain or analgesic consumption in children after adenotonsillectomy. Author(s): Rose JB, Cuy R, Cohen DE, Schreiner MS. Source: Anesthesia and Analgesia. 1999 April; 88(4): 749-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10195517
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Psychosis associated with pseudoephedrine and dextromethorphan. Author(s): Soutullo CA, Cottingham EM, Keck PE Jr. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1999 December; 38(12): 1471-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10596243
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Psychotropic effects of dextromethorphan are altered by the CYP2D6 polymorphism: a pilot study. Author(s): Zawertailo LA, Kaplan HL, Busto UE, Tyndale RF, Sellers EM. Source: Journal of Clinical Psychopharmacology. 1998 August; 18(4): 332-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9690700
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Quantification of dextromethorphan and metabolites: a dual phenotypic marker for cytochrome P450 3A4/5 and 2D6 activity. Author(s): Jones DR, Gorski JC, Hamman MA, Hall SD. Source: Journal of Chromatography. B, Biomedical Applications. 1996 March 29; 678(1): 105-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8861660
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Quantification of intraindividual variability and the influence of menstrual cycle phase on CYP2D6 activity as measured by dextromethorphan phenotyping. Author(s): Kashuba AD, Nafziger AN, Kearns GL, Leeder JS, Shirey CS, Gotschall R, Gaedigk A, Bertino JS Jr. Source: Pharmacogenetics. 1998 October; 8(5): 403-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9825832
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Quantitative determination of dextromethorphan and three metabolites in urine by reverse-phase high-performance liquid chromatography. Author(s): Park YH, Kullberg MP, Hinsvark ON. Source: Journal of Pharmaceutical Sciences. 1984 January; 73(1): 24-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6694076
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Rapid screening for polymorphisms in dextromethorphan and mephenytoin metabolism. Author(s): Guttendorf RJ, Britto M, Blouin RA, Foster TS, John W, Pittman KA, Wedlund PJ. Source: British Journal of Clinical Pharmacology. 1990 April; 29(4): 373-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2328190
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Safety and tolerance of oral dextromethorphan in patients at risk for brain ischemia. Author(s): Albers GW, Saenz RE, Moses JA Jr, Choi DW. Source: Stroke; a Journal of Cerebral Circulation. 1991 August; 22(8): 1075-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1866755
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Salivary analysis for determination of dextromethorphan metabolic phenotype. Author(s): Hou ZY, Pickle LW, Meyer PS, Woosley RL. Source: Clinical Pharmacology and Therapeutics. 1991 April; 49(4): 410-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2015730
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Screening for hydroxylation and acetylation polymorphisms in man via simultaneous analysis of urinary metabolites of mephenytoin, dextromethorphan and caffeine by capillary electrophoretic procedures. Author(s): Caslavska J, Hufschmid E, Theurillat R, Desiderio C, Wolfisberg H, Thormann W. Source: Journal of Chromatography. B, Biomedical Applications. 1994 June 3; 656(1): 219-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7952033
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Semi-automated liquid--liquid back-extraction in a 96-well format to decrease sample preparation time for the determination of dextromethorphan and dextrorphan in human plasma. Author(s): Bolden RD, Hoke SH 2nd, Eichhold TH, McCauley-Myers DL, Wehmeyer KR. Source: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences. 2002 May 25; 772(1): 1-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12016010
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Simplified phenotyping with dextromethorphan by thin-layer chromatography: application to clinical laboratory screening for deficiencies in oxidative drug metabolism. Author(s): Guttendorf RJ, Wedlund PJ, Blake J, Chang SL. Source: Therapeutic Drug Monitoring. 1988; 10(4): 490-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3201536
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Simultaneous determination of dextromethorphan and its metabolites in human plasma by capillary electrophoresis. Author(s): Kristensen HT. Source: Journal of Pharmaceutical and Biomedical Analysis. 1998 December; 18(4-5): 827-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9919985
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Simultaneous determination of dextromethorphan and three metabolites in plasma and urine using high-performance liquid chromatography with application to their disposition in man. Author(s): Chen ZR, Somogyi AA, Bochner F. Source: Therapeutic Drug Monitoring. 1990 January; 12(1): 97-104. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2305428
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Single and multiple dose pharmacokinetics of nefazodone in subjects classified as extensive and poor metabolizers of dextromethorphan. Author(s): Barbhaiya RH, Buch AB, Greene DS. Source: British Journal of Clinical Pharmacology. 1996 November; 42(5): 573-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8951188
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Single-point plasma or urine dextromethorphan method for determining CYP3A activity. Author(s): Kuo BP, Hu OY, Hsiong CH, Pao LH, Chen TS, Hung CF. Source: Biopharmaceutics & Drug Disposition. 2003 December; 24(9): 367-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14689465
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Spurious hyperchloremia and decreased anion gap in a patient with dextromethorphan bromide. Author(s): Ng YY, Lin WL, Chen TW, Lin BC, Tsai SH, Chang CC, Huang TP. Source: American Journal of Nephrology. 1992; 12(4): 268-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1481876
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Studies of the fetal effects of dextromethorphan in ovo. Author(s): Brent RL. Source: Teratology. 1999 August; 60(2): 57-8; Author Reply 58-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10440774
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Studies of the fetal effects of dextromethorphan in ovo. Author(s): Polifka JE, Shepard TH. Source: Teratology. 1999 August; 60(2): 56-7; Author Reply 58-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10440773
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Terbinafine-associated inhibition of dextromethorphan metabolism in Chinese subjects. Author(s): Cai WM, Chen B, Ling SS, Zhang YD. Source: British Journal of Clinical Pharmacology. 2001 January; 51(1): 107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11167673
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The abuse of dextromethorphan-based cough syrup: a pilot study of the community of Waynesboro, Pennsylvania. Author(s): Darboe MN, Keenan GR Jr, Richards TK. Source: Adolescence. 1996 Fall; 31(123): 633-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8874609
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The antitussive effect of dextromethorphan in relation to CYP2D6 activity. Author(s): Abdul Manap R, Wright CE, Gregory A, Rostami-Hodjegan A, Meller ST, Kelm GR, Lennard MS, Tucker GT, Morice AH. Source: British Journal of Clinical Pharmacology. 1999 September; 48(3): 382-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10510150
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The combination of tizanidine markedly improves the treatment with dextromethorphan of heroin addicted outpatients. Author(s): Koyuncuoglu H. Source: Int J Clin Pharmacol Ther. 1995 January; 33(1): 13-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7711985
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The dextromethorphan defense: dextromethorphan and the opioid screen. Author(s): Storrow AB, Magoon MR, Norton J. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1995 September; 2(9): 791-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7584765
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The effect of dextromethorphan, alone or in combination with ibuprofen, on postoperative pain after minor gynaecological surgery. Author(s): Ilkjaer S, Nielsen PA, Bach LF, Wernberg M, Dahl JB. Source: Acta Anaesthesiologica Scandinavica. 2000 August; 44(7): 873-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10939702
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The effect of grapefruit juice and seville orange juice on the pharmacokinetics of dextromethorphan: the role of gut CYP3A and P-glycoprotein. Author(s): Di Marco MP, Edwards DJ, Wainer IW, Ducharme MP. Source: Life Sciences. 2002 July 26; 71(10): 1149-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12095536
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The effect of inhaled and oral dextromethorphan on citric acid induced cough in man. Author(s): Grattan TJ, Marshall AE, Higgins KS, Morice AH. Source: British Journal of Clinical Pharmacology. 1995 March; 39(3): 261-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7619666
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The effect of the N-methyl-D-aspartate receptor antagonist dextromethorphan on perioperative brain injury in children undergoing cardiac surgery with cardiopulmonary bypass: results of a pilot study. Author(s): Schmitt B, Bauersfeld U, Fanconi S, Wohlrab G, Huisman TA, Bandtlow C, Baumann P, Superti-Furga A, Martin E, Arbenz U, Molinari L, Turina M, Boltshauser E, Schmid ER. Source: Neuropediatrics. 1997 August; 28(4): 191-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9309708
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The effect of the preemptive use of the NMDA receptor antagonist dextromethorphan on postoperative analgesic requirements. Author(s): Helmy SA, Bali A. Source: Anesthesia and Analgesia. 2001 March; 92(3): 739-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11226111
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The influence of CYP2D6 polymorphism and quinidine on the disposition and antitussive effect of dextromethorphan in humans. Author(s): Capon DA, Bochner F, Kerry N, Mikus G, Danz C, Somogyi AA. Source: Clinical Pharmacology and Therapeutics. 1996 September; 60(3): 295-307. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8841152
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The inhibitory effect of amiodarone and desethylamiodarone on dextromethorphan O-demethylation in human and rat liver microsomes. Author(s): Jaruratanasirikul S, Hortiwakul R. Source: The Journal of Pharmacy and Pharmacology. 1994 November; 46(11): 933-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7897605
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The mephenytoin (cytochrome P450 2C 19) and dextromethorphan (cytochrome P450 2D6) polymorphisms in Saudi Arabians and Filipinos. Author(s): Evans DA, Krahn P, Narayanan N. Source: Pharmacogenetics. 1995 April; 5(2): 64-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7663530
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The N-methyl-D-aspartate receptor antagonist dextromethorphan selectively reduces temporal summation of second pain in man. Author(s): Price DD, Mao J, Frenk H, Mayer DJ. Source: Pain. 1994 November; 59(2): 165-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7892014
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The N-methyl-D-aspartate-receptor antagonist dextromethorphan lacks analgesic effect in a human experimental ischemic pain model. Author(s): Plesan A, Sollevi A, Segerdahl M. Source: Acta Anaesthesiologica Scandinavica. 2000 September; 44(8): 924-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10981567
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The polymorphic metabolism of dextromethorphan. Author(s): Woodworth JR, Dennis SR, Moore L, Rotenberg KS. Source: Journal of Clinical Pharmacology. 1987 February; 27(2): 139-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3680565
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The preoperative administration of intravenous dextromethorphan reduces postoperative morphine consumption. Author(s): Chia YY, Liu K, Chow LH, Lee TY. Source: Anesthesia and Analgesia. 1999 September; 89(3): 748-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10475318
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The role of CYP2D6 in primary and secondary oxidative metabolism of dextromethorphan: in vitro studies using human liver microsomes. Author(s): Kerry NL, Somogyi AA, Bochner F, Mikus G. Source: British Journal of Clinical Pharmacology. 1994 September; 38(3): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7826826
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The role of dextromethorphan in pain control. Author(s): Weinbroum AA, Rudick V, Paret G, Ben-Abraham R. Source: Canadian Journal of Anaesthesia = Journal Canadien D'anesthesie. 2000 June; 47(6): 585-96. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10875724
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The safety of dextromethorphan in pregnancy : results of a controlled study. Author(s): Einarson A, Lyszkiewicz D, Koren G. Source: Chest. 2001 February; 119(2): 466-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11171724
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The treatment of a chronic organic mental disorder with dextromethorphan in a man with severe mental retardation. Author(s): Welch L, Sovner R. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 July; 161: 118-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1638308
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The treatment of acute transient cough: a placebo-controlled comparison of dextromethorphan and dextromethorphan-beta 2-sympathomimetic combination. Author(s): Tukiainen H, Karttunen P, Silvasti M, Flygare U, Korhonen R, Korhonen T, Majander R, Seuri M. Source: Eur J Respir Dis. 1986 August; 69(2): 95-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3758244
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The treatment of heroin addicts with dextromethorphan: a double-blind comparison of dextromethorphan with chlorpromazine. Author(s): Koyuncuoglu H, Saydam B. Source: Int J Clin Pharmacol Ther Toxicol. 1990 April; 28(4): 147-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2187002
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The urinary excretion of dextromethorphan and three metabolites in dogs and humans. Author(s): Barnhart JW. Source: Toxicology and Applied Pharmacology. 1980 August; 55(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7423506
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Tolerability of oral dextromethorphan in patients with a history of brain ischemia. Author(s): Albers GW, Saenz RE, Moses JA Jr. Source: Clinical Neuropharmacology. 1992 December; 15(6): 509-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1477851
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Toxicity with dextromethorphan-containing preparations: a literature review and report of two additional cases. Author(s): Pender ES, Parks BR. Source: Pediatric Emergency Care. 1991 June; 7(3): 163-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1876508
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Toxicological findings in a death involving dextromethorphan and terfenadine. Author(s): Kintz P, Mangin P. Source: The American Journal of Forensic Medicine and Pathology : Official Publication of the National Association of Medical Examiners. 1992 December; 13(4): 351-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1288270
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Treatment with the N-methyl-D-aspartate receptor antagonist dextromethorphan in severe bacterial meningitis: preliminary results. Author(s): Schmitt B, Wohlrab G, Steinlin M, Fanconi S, Nadal D, Boltshauser E. Source: European Journal of Pediatrics. 1998 October; 157(10): 863-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9809832
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Urinary metabolism of dextromethorphan in man. Author(s): Koppel C, Tenczer J, Ibe K. Source: Arzneimittel-Forschung. 1987 November; 37(11): 1304-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3440042
•
Variables in human liver microsome preparation: impact on the kinetics of l-alphaacetylmethadol (LAAM) n-demethylation and dextromethorphan O-demethylation. Author(s): Nelson AC, Huang W, Moody DE. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2001 March; 29(3): 319-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11181502
•
Visual hallucinations after combining fluoxetine and dextromethorphan. Author(s): Achamallah NS. Source: The American Journal of Psychiatry. 1992 October; 149(10): 1406. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1530079
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CHAPTER 2. NUTRITION AND DEXTROMETHORPHAN Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and dextromethorphan.
Finding Nutrition Studies on Dextromethorphan The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “dextromethorphan” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “dextromethorphan” (or a synonym): •
Effect of dextromethorphan and levomethorphan on gastric emptying and intestinal transit in the rat. Source: Gaginella, T S Bertko, R J Kachur, J F J-Pharmacol-Exp-Ther. 1987 February; 240(2): 388-91 0022-3565
•
Effects of methylprednisolone and dextromethorphan on lipid peroxidation in an experimental model of spinal cord injury. Author(s): Firat Universitesi, Tip Merkezi, Norosirurji Klinigi, Elazig, Turkey.
[email protected] Source: Topsakal, C Erol, F S Ozveren, M F Yilmaz, N Ilhan, N Neurosurg-Revolume 2002 August; 25(4): 258-66 0344-5607
•
High affinity dextromethorphan binding sites in guinea pig brain. Effect of sigma ligands and other agents. Author(s): Department of Pharmacology, New York University Medical Center, NY 10016. Source: Klein, M Musacchio, J M J-Pharmacol-Exp-Ther. 1989 October; 251(1): 207-15 0022-3565
•
High-affinity dextromethorphan and (+)-3-(-3-hydroxyphenyl)-N-(1propyl)piperidine binding sites in rat brain. Allosteric effects of ropizine. Author(s): Department of Pharmacology, New York University Medical Center, New York. Source: Klein, M Musacchio, J M J-Pharmacol-Exp-Ther. 1992 March; 260(3): 990-9 00223565
•
High-pressure liquid chromatographic assay of dextromethorphan hydrobromide, guaifenesin, and sodium benzoate in an expectorant syrup. Author(s): Parke-Davis Pharmaceutical Research Division, Warner-Lambert Company, Morris Plains, New Jersey 07981. Source: Chen, T M Pacifico, J R Daly, R E J-Chromatogr-Sci. 1988 December; 26(12): 636-9 0021-9665
•
Monotherapy with dextromethorphan or tirilazad--but not a combination of both-improves outcome after transient focal cerebral ischemia in rats. Author(s): Department of Neurosurgery, Ludwig-Maximilians-Universitat, Klinikum Grosshadern, Munich, Germany. Source: Schmid Elsaesser, R Zausinger, S Hungerhuber, E Baethmann, A Reulen, H J Exp-Brain-Res. 1998 September; 122(1): 121-7 0014-4819
•
Neocortical epileptogenesis in vitro: studies with N-methyl-D-aspartate, phencyclidine, sigma and dextromethorphan receptor ligands. Author(s): Department of Veterinary Basic Sciences, Royal Veterinary College, London, United Kingdom. Source: Aram, J A Martin, D Tomczyk, M Zeman, S Millar, J Pohler, G Lodge, D JPharmacol-Exp-Ther. 1989 January; 248(1): 320-8 0022-3565
•
Neuroprotection (focal ischemia) and neurotoxicity (electroencephalographic) studies in rats with AHN649, a 3-amino analog of dextromethorphan and low-affinity Nmethyl-D-aspartate antagonist. Author(s): Department of Neuropharmacology and Molecular Biology, Walter Reed Army Institute of Research, Washington, D.C., USA.
[email protected] Source: Tortella, F C Britton, P Williams, A Lu, X C Newman, A H J-Pharmacol-ExpTher. 1999 October; 291(1): 399-408 0022-3565
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Neuroprotection by dextromethorphan in acute experimental subdural hematoma in the rat. Author(s): Division of Neurosurgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine 19104, USA. Source: Duhaime, A C Gennarelli, L M Boardman, C J-Neurotrauma. 1996 February; 13(2): 79-84 0897-7151
•
N-methyl-D-aspartate (NMDA)-mediated muscle relaxant dextromethorphan in rats. Author(s): Dept. of Neurology, University of Essen, Germany. Source: Block, F Schwarz, M Neuroreport. 1993 July; 4(7): 941-3 0959-4965
•
Plasma-polymerized membrane electrode for the determination of dextromethorphan and dimemorfan. Source: Hazemoto, N Ishizaka, S Haga, M Kato, Y Kurosawa, S Kamo, N Kobatake, Y Chem-Pharm-Bull-(Tokyo). 1989 August; 37(8): 2153-4 0009-2363
•
Synthesis and anticonvulsant activity of dextromethorphan analogs. Author(s): Department of Medical Neurosciences, Walter Reed Army Institute of Research, Washington, D.C. Source: Tortella, F C Newman, A H NIDA-Res-Monogr. 1991; 105337-8 1046-9516
•
The effects of dextromethorphan on kainic acid-induced seizures in the rat. Author(s): Section of Neuropharmacology, National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, North Carolina 27709, USA. Source: Kim, H C Pennypacker, K R Bing, G Bronstein, D McMillian, M K Hong, J S Neurotoxicology. 1996 Summer; 17(2): 375-85 0161-813X
•
The stimulus properties of two common over-the-counter drug mixtures: dextromethorphan + ephedrine and dextromethorphan + diphenhydramine. Author(s): Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City 73190-3000, USA.
[email protected] Source: Gauvin, D V Vanecek, S A Baird, T J Vallett, M Briscoe, R J Carl, K L Holloway, F A Sannerud, C A J-Psychopharmacol. 1998; 12(1): 84-92 0269-8811
action
of
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
•
The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
•
The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
•
The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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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/
•
Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
•
Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
•
Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
•
Google: http://directory.google.com/Top/Health/Nutrition/
•
Healthnotes: http://www.healthnotes.com/
•
Open Directory Project: http://dmoz.org/Health/Nutrition/
•
Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
•
WebMD®Health: http://my.webmd.com/nutrition
•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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CHAPTER
3.
ALTERNATIVE MEDICINE DEXTROMETHORPHAN
AND
Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to dextromethorphan. 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 dextromethorphan 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 “dextromethorphan” (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 dextromethorphan: •
A comparison of basal and induced hepatic microsomal cytochrome P450 monooxygenase activities in the cynomolgus monkey (Macaca fascicularis) and man. Author(s): Weaver RJ, Dickins M, Burke MD. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 1999 May; 29(5): 467-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10379985
•
Abuse of over-the-counter dextromethorphan by teenagers. Author(s): Murray S, Brewerton T. Source: Southern Medical Journal. 1993 October; 86(10): 1151-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8211334
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•
Activation of ERK5 is mediated by N-methyl-D-aspartate receptor and L-type voltagegated calcium channel via Src involving oxidative stress after cerebral ischemia in rat hippocampus. Author(s): Wang RM, Zhang QG, Zhang GY. Source: Neuroscience Letters. 2004 February 26; 357(1): 13-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15036602
•
Affinity and specificity of N-methyl- D-aspartate channel blockers affect their ability to disrupt prepulse inhibition of acoustic startle in rats. Author(s): Wiley JL, Harvey SA, Balster RL, Nicholson KL. Source: Psychopharmacology. 2003 February; 165(4): 378-85. Epub 2002 November 30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12459931
•
Anticonvulsant properties of non-competitive antagonists of the N-methyl-Daspartate receptor in genetically epilepsy-prone rats: comparison with CPPene. Author(s): De Sarro GB, De Sarro A. Source: Neuropharmacology. 1993 January; 32(1): 51-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8094234
•
Anticough and antimicrobial activities of Psidium guajava Linn. leaf extract. Author(s): Jaiarj P, Khoohaswan P, Wongkrajang Y, Peungvicha P, Suriyawong P, Saraya ML, Ruangsomboon O. Source: Journal of Ethnopharmacology. 1999 November 1; 67(2): 203-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10619385
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Antitussive activity of some naturally occurring cannabinoids in anesthetized cats. Author(s): Gordon R, Gordon RJ, Sofia D. Source: European Journal of Pharmacology. 1976 February; 35(2): 309-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1248507
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Dextromethorphan as an in vivo probe for the simultaneous determination of CYP2D6 and CYP3A activity. Author(s): Ducharme J, Abdullah S, Wainer IW. Source: Journal of Chromatography. B, Biomedical Applications. 1996 March 29; 678(1): 113-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8861661
•
Dextromethorphan attenuates ethanol withdrawal syndrome in rats. Author(s): Erden BF, Ozdemirci S, Yildiran G, Utkan T, Gacar N, Ulak G. Source: Pharmacology, Biochemistry, and Behavior. 1999 March; 62(3): 537-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10080248
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•
Diabetic neuropathy: an intensive review. Author(s): Duby JJ, Campbell RK, Setter SM, White JR, Rasmussen KA. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2004 January 15; 61(2): 160-73; Quiz 175-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14750401
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Dystonia as acute adverse reaction to cough suppressant in a 3-year-old girl. Author(s): Polizzi A, Incorpora G, Ruggieri M. Source: European Journal of Paediatric Neurology : Ejpn : Official Journal of the European Paediatric Neurology Society. 2001; 5(4): 167-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11587381
•
Effect of St John's wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. Author(s): Markowitz JS, Donovan JL, DeVane CL, Taylor RM, Ruan Y, Wang JS, Chavin KD. Source: Jama : the Journal of the American Medical Association. 2003 September 17; 290(11): 1500-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=13129991
•
Effect of St John's wort on the activities of CYP1A2, CYP3A4, CYP2D6, Nacetyltransferase 2, and xanthine oxidase in healthy males and females. Author(s): Wenk M, Todesco L, Krahenbuhl S. Source: British Journal of Clinical Pharmacology. 2004 April; 57(4): 495-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15025748
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Effect of St. John's wort (Hypericum perforatum) on cytochrome P-450 2D6 and 3A4 activity in healthy volunteers. Author(s): Markowitz JS, DeVane CL, Boulton DW, Carson SW, Nahas Z, Risch SC. Source: Life Sciences. 2000 January 21; 66(9): Pl133-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10698361
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Effective analgesic modalities for ambulatory patients. Author(s): Redmond M, Florence B, Glass PS. Source: Anesthesiology Clinics of North America. 2003 June; 21(2): 329-46. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812399
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Effects of flavonoids isolated from Scutellariae radix on cytochrome P-450 activities in human liver microsomes. Author(s): Kim JY, Lee S, Kim DH, Kim BR, Park R, Lee BM.
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Source: Journal of Toxicology and Environmental Health. Part A. 2002 March; 65(5-6): 373-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11936218 •
Effects of garlic (Allium sativum L.) supplementation on cytochrome P450 2D6 and 3A4 activity in healthy volunteers. Author(s): Markowitz JS, Devane CL, Chavin KD, Taylor RM, Ruan Y, Donovan JL. Source: Clinical Pharmacology and Therapeutics. 2003 August; 74(2): 170-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12891227
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Green tea (Camellia sinensis) extract does not alter cytochrome P-450 3A4 or 2D6 activity in healthy volunteers. Author(s): Donovan JL, Devane CL, Chavin KD, Taylor RM, Wang JS, Ruan Y, Markowitz JS. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2004 June 9 [epub Ahead of Print] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15189977
•
Hazards of nonprescription medications. Author(s): Cetaruk EW, Aaron CK. Source: Emergency Medicine Clinics of North America. 1994 May; 12(2): 483-510. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8187693
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Identification of cytochrome P450 isozymes involved in metabolism of the alpha1adrenoceptor blocker tamsulosin in human liver microsomes. Author(s): Kamimura H, Oishi S, Matsushima H, Watanabe T, Higuchi S, Hall M, Wood SG, Chasseaud LF. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 1998 October; 28(10): 909-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9849639
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Inhibitory effects of silibinin on cytochrome P-450 enzymes in human liver microsomes. Author(s): Beckmann-Knopp S, Rietbrock S, Weyhenmeyer R, Bocker RH, Beckurts KT, Lang W, Hunz M, Fuhr U. Source: Pharmacology & Toxicology. 2000 June; 86(6): 250-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10895987
•
Mechanisms of deafferentation-induced plasticity in human motor cortex. Author(s): Ziemann U, Hallett M, Cohen LG.
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Source: The Journal of Neuroscience : the Official Journal of the Society for Neuroscience. 1998 September 1; 18(17): 7000-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9712668 •
Mechanisms of enhancement of human motor cortex excitability induced by interventional paired associative stimulation. Author(s): Stefan K, Kunesch E, Benecke R, Cohen LG, Classen J. Source: The Journal of Physiology. 2002 September 1; 543(Pt 2): 699-708. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12205201
•
Multiple doses of saw palmetto (Serenoa repens) did not alter cytochrome P450 2D6 and 3A4 activity in normal volunteers. Author(s): Markowitz JS, Donovan JL, Devane CL, Taylor RM, Ruan Y, Wang JS, Chavin KD. Source: Clinical Pharmacology and Therapeutics. 2003 December; 74(6): 536-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14663456
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Multiple-dose administration of Ginkgo biloba did not affect cytochrome P-450 2D6 or 3A4 activity in normal volunteers. Author(s): Markowitz JS, Donovan JL, Lindsay DeVane C, Sipkes L, Chavin KD. Source: Journal of Clinical Psychopharmacology. 2003 December; 23(6): 576-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14624188
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Non-competitive N-methyl-D-aspartate antagonists protect against sound-induced seizures in DBA/2 mice. Author(s): Chapman AG, Meldrum BS. Source: European Journal of Pharmacology. 1989 July 18; 166(2): 201-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2676564
•
Opiate and N-methyl-D-aspartate receptors in form-deprivation myopia. Author(s): Fischer AJ, Seltner RL, Stell WK. Source: Visual Neuroscience. 1998 November-December; 15(6): 1089-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9839973
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Siberian ginseng (Eleutheroccus senticosus) effects on CYP2D6 and CYP3A4 activity in normal volunteers. Author(s): Donovan JL, DeVane CL, Chavin KD, Taylor RM, Markowitz JS. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2003 May; 31(5): 519-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12695337
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St. John's wort: effect on CYP2D6 activity using dextromethorphan-dextrorphan ratios. Author(s): Roby CA, Dryer DA, Burstein AH. Source: Journal of Clinical Psychopharmacology. 2001 October; 21(5): 530-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11593081
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The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo. Author(s): Gorski JC, Huang SM, Pinto A, Hamman MA, Hilligoss JK, Zaheer NA, Desai M, Miller M, Hall SD. Source: Clinical Pharmacology and Therapeutics. 2004 January; 75(1): 89-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14749695
•
The effects of St John's wort (Hypericum perforatum) on human cytochrome P450 activity. Author(s): Wang Z, Gorski JC, Hamman MA, Huang SM, Lesko LJ, Hall SD. Source: Clinical Pharmacology and Therapeutics. 2001 October; 70(4): 317-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11673747
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Tigabine hydrochloride, an inhibitor of gamma-aminobutyric acid (GABA) uptake, induces cortical depolarizations in vitro. Author(s): Hu RQ, Davies JA. Source: Brain Research. 1997 April 11; 753(2): 260-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9125411
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
•
AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
•
Chinese Medicine: http://www.newcenturynutrition.com/
•
drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html
•
Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
•
Google: http://directory.google.com/Top/Health/Alternative/
•
Healthnotes: http://www.healthnotes.com/
•
MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
•
Open Directory Project: http://dmoz.org/Health/Alternative/
•
HealthGate: http://www.tnp.com/
•
WebMD®Health: http://my.webmd.com/drugs_and_herbs
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•
WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
•
Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to dextromethorphan; 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 Bronchitis Source: Healthnotes, Inc.; www.healthnotes.com Common Cold/Sore Throat Source: Healthnotes, Inc.; www.healthnotes.com Cough Source: Healthnotes, Inc.; www.healthnotes.com
•
Herbs and Supplements Cardec DM Source: Healthnotes, Inc.; www.healthnotes.com Dextromethorphan Source: Healthnotes, Inc.; www.healthnotes.com Nyquil Source: Healthnotes, Inc.; www.healthnotes.com Nyquil Hot Therapy Powder Source: Healthnotes, Inc.; www.healthnotes.com Robitussin CF Source: Healthnotes, Inc.; www.healthnotes.com Robitussin DM Source: Healthnotes, Inc.; www.healthnotes.com Tylenol Cold Source: Healthnotes, Inc.; www.healthnotes.com Tylenol Multi-Symptom Hot Medication 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
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dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. PATENTS ON DEXTROMETHORPHAN Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “dextromethorphan” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dextromethorphan, we have not necessarily excluded non-medical patents in this bibliography.
Patents on Dextromethorphan By performing a patent search focusing on dextromethorphan, 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. 5Adapted
from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.
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The following is an example of the type of information that you can expect to obtain from a patent search on dextromethorphan: •
Anticonvulsant composition and method Inventor(s): Musacchio; Jose M. (New York, NY), Tortella; Frank C. (Columbia, MD) Assignee(s): New York University (New York, NY) Patent Number: 4,898,860 Date filed: March 28, 1988 Abstract: An anticonvulsant composition comprising as an active ingredient an amount effective for controlling seizures in mammals of a compound selected from the group consisting of dextromethorphan and other non-narcotic, non-addictive, low-toxicity compounds that bind to the same central nervous system sites as dextromethorphan. The composition may also contain an antiepileptic hydantoin, which is potentiated by said compound. Excerpt(s): This invention relates to a group of novel compositions containing diphenylhydantoin and/or dextromethorphan or another compound that binds to the same sites in the brain as dextromethorphan, with substantially the same or higher affinity. Another aspect of this invention relates to the use of these compositions as anticonvulsants, and to methods for controlling seizures using these compositions. Most types of epileptic seizures, including induced generalized or focal seizures, except absence seizures, can be treated and prevented with diphenylhydantion (DPH), which is also commonly called phenytoin, and other antiepileptic hydantoins. Antiepileptic preparations containing DPH (and other antiepileptic hydantions) are available in solid (oral) and liquid (oral and injectable) forms; they contain from 30 to 250 mg of DPH per unit dose. Web site: http://www.delphion.com/details?pn=US04898860__
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Antitussive composition containing dextromethorphan and benzydamine Inventor(s): Galli Angeli; Depalmo (Falconara Marittima, IT) Assignee(s): Aziende Chimiche Riunite Angelini Francesco A.C.R.A.F. S.p.A. (Rome, IT) Patent Number: 5,932,589 Date filed: December 24, 1996 Abstract: Oral antitussive pharmaceutical composition which allows a significant contact of its components with mucous membranes of the buccal cavity and comprises a centrally acting antitussive or a pharmaceutically acceptable salt thereof and benzydamine or a pharmaceutically acceptable acid addition salt thereof. Excerpt(s): This invention relates to an antitussive composition. More particularly, this invention relates to an oral antitussive composition, characterized in that it comprises a centrally acting antitussive or a pharmaceutically acceptable salt thereof and benzydamine or a pharmaceutically acceptable acid addition salt thereof. Coughing is a physiological action heplful to free the respiratory tract from foreign substances and from excess secretions. In some cases however, coughing performs no useful purpose, and instead anger the patient or prevent his or her rest or sleep. This leads to the need
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for administering a drug capable of reducing the recurrence and/or severity of coughing. Web site: http://www.delphion.com/details?pn=US05932589__ •
Antitussive drugs delivered by ion exchange resins Inventor(s): Dokuzovic; Val (Mississauga, CA), Lam; Vincent (Markham, CA), Ramsay; Michael P. (Ajax, CA), Scheurer; Heinrich (Scarborough, CA), Wen; Betty (Scarborough, CA) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 6,001,392 Date filed: December 19, 1997 Abstract: The present invention relates generally to a mixture of coated and non-coated sulfonic acid cation exchange resins (Amberlite IR69) cross-linked with about 8% divinyl benzene onto which dextromethorphan has been loaded. About 30% of the drug/resin complexes are coated with a mixture of ethyl cellulose or ethyl cellulose latexes with plasticizers and water dispersible polymers such as SURELEASE. The coating level is about 50% w/w drug. Coated and uncoated drug/resin complexes are loaded with drug to about 45% by weight drug/resin complex. The ratio of coated and uncoated drug/resin complexes is about 55/45. The particle sizes of the coated and uncoated drug/resin complexes is about 20 to about 300 and about 20 to about 250 microns, respectively. Excerpt(s): The present invention relates generally to a controlled-release syrup suspension for oral administration, preferably containing a dextromethorphan polystyrene sulfonate resin. The composition provides up to 12 hours of symptomatic relief from dry coughing. Dextromethorphan is an antitussive used in many over-thecounter cold medications. It has an opioid-like structure but, being a d-isomer, it does not possess the analgesic or addicveti retes of opioids. It acts centrally to relieve cough, similarly as opioids. It is active against dry cough and does not exhibit significant expectorant properties for productive cough. As is well known, the maximum time of effectiveness in dextromethorphan compositions is only a few hours because of biological modification and/or elimination of the medication in the body (i.e., the usual doses for immediate-release formulations range from 15-30 mg every 4-6 hours). Consequently, repeated dosages must be taken at frequent intervals to obtain long term therapeutic levels of drug. Furthermore, this drug usually dissolves readily in the digestive juices and the total dosage is immediately fed into the blood stream. After high initial peak concentrations, the level of drug in the blood stream constantly decreases because of the biological elimination, so there is little or no therapeutic effect at the end of the period between dosages. As a result, the therapeutic effect fluctuates between dosages corresponding to the peaks and valleys in the level of drug in the blood as commonly measured by trough to peak ratios. Web site: http://www.delphion.com/details?pn=US06001392__
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Composition for reducing the risk or progression of cardiovascular diseases Inventor(s): Lang; Philip C. (Toms River, NJ), Sosnowski; Robert E. (Manasquan, NJ) Assignee(s): DexGen Pharmaceuticals, Inc. (Manasquan, NJ) Patent Number: 6,583,152 Date filed: April 30, 2001 Abstract: Elevated levels of homocysteine have been implicated as an important risk factor for cardiovascular and other diseases. A composition for decreasing levels of plasma homocysteine and a method for administering the composition are provided the composition containing dextromethorphan (DM), folic acid and vitamins B.sub.6 and B.sub.12. The composition provides a synergistic therapeutic effect so that lower amounts of the above ingredients may be employed to minimize any undesirable side effects caused by the use of high levels of a component such as DM. Preferred compositions for cardiovascular diseases further include lecithin, vitamin E, betacarotene, procyanidins/flavonoids, trimethylglycine, garlic oil and minerals. Other compositions for treating glaucoma include bilberry, bioflavonoids and beta-carotene and for treating tardive dyskinesia include an antioxidant such as grape seed extract and pine bark extract, lecithin and oligomeric proanthocyanidins. The compositions may be administered using any suitable means such as orally or intravenous. Excerpt(s): The present invention relates to a composition and method for reducing the risk or progression of cardiovascular, glaucoma and tardive dyskinesia diseases and, more particularly, to a composition containing a number of ingredients which are present in amounts lower than amounts considered harmful to the body but which act synergistically to provide enhanced disease inhibition. Cardiovascular disease is the most frequent cause of death in industrialized countries. Atherosclerosis (AS) is the principal cause of cardiovascular disease. AS is a disease of the intima of the arteries that leads to fatty lesions called artheromatous plaques on the inside surface of the arteries. This deposit of fat and cholesterol narrows the arteries, and often becomes calcified, providing sites for abnormal blood clots to form, leading to high blood pressure, heart attacks and strokes. Elevated plasma homocysteine (Hcy) concentrations have repeatedly been associated with increased vascular risk. Hcy causes cells to decrease their production of clot preventing and clot dissolving substances and increases production of clot promoting substances. Hcy is an intermediate sulfhydryl alpha-amino acid formed during conversion of methionine to cysteine. Web site: http://www.delphion.com/details?pn=US06583152__
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Dextromethorphan and an oxidase inhibitor for treating intractable conditions Inventor(s): Licht; Jonathan M. (San Diego, CA), Smith; Richard Alan (La Jolla, CA) Assignee(s): Center for Neurologic Study (La Jolla, CA) Patent Number: 5,863,927 Date filed: September 19, 1996 Abstract: Methods are disclosed for increasing the effectiveness of dextromethorphan in treating chronic or intractable pain, for treating tinnitus and for treating sexual dysfunction comprising administering dextromethorphan in combination with a therapeutically effective dosage of a debrisoquin hydroxylase inhibitor. A preferred combination is dextromethorphan and the oxidative inhibitor quinidine.
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Excerpt(s): This application is a 371 of PCT/US94/10771, filed Sep. 22, 1994. This invention relates to pharmacology. More specifically, the invention relates to compositions of matter useful for preparing medicaments for the treatment of various disorders. A number of chronic disorders have symptoms which are known to be very difficult to treat, and often fail to respond to safe, non-addictive, and non-steroid medications. Such disorders, such as intractable coughing, fail to respond to conventional medicines and must be treated by such drugs as codeine, morphine, or the anti-inflammatory steroid prednisone. These drugs are unacceptable for long-term treatment due to dangerous side-effects, long-term risks to the patient's health, or the danger of addiction. Other disorders, such as dermatitis, have no satisfactory treatment for the severe itching and rash at this time. Drugs such as prednisone and even tricyclic antidepressants, as well as topical applications, have been tried, but do not appear to offer substantial and consistent relief. Web site: http://www.delphion.com/details?pn=US05863927__ •
Dextromethorphan and oxidase inhibitor for weaning patients from narcotics and anti-depressants Inventor(s): Smith; Richard A. (7569 Cabrillo Ave., La Jolla, CA 92037) Assignee(s): none reported Patent Number: 6,207,674 Date filed: December 22, 1999 Abstract: Patients can be helped to break free of addictive or habit-forming narcotics and anti-depressants, by treatment using two drugs. One drug is dextromethorphan (DM), which has been used for decades as an anti-tussive (cough-suppressing) drug in cough syrups. The other drug is an oxidase inhibitor which suppresses activity of a liver enzyme called cytochrome P450-2D6 (also called debrisoquin hydroxylase, sparteine monooxygenase, cytochrome P450-DB, and CYP2D6). In most patients, this oxidase enzyme rapidly degrades DM and converts it into a metabolite called dextrorphan. An oxidase inhibitor (such as quinidine) which suppresses cytochrome P450-2D6 activity increases the half-life and concentration of DM in the circulating blood. When this combined treatment was administered orally to patients who had become dependent on morphine and anti-depressant drugs because of chronic intractable pain, it initially helped the patients reduce their dosages of morphine and other drugs, including antidepressants. When additional testing was done, the combined treatment allowed patients to entirely terminate all use of morphine and anti-depressants, with minimal withdrawal or other adverse effects. Importantly, these same patients received no substantial benefit from taking dm by itself, without an oxidase inhibitor. Accordingly, the combination of dextromethorphan plus an anti-oxidase drug can allow at least some patients to break entirely free of narcotics and/or anti-depressants, even after years of use for chronic pain and other medical problems, even when they are not substantially helped by dextromethorphan alone. Excerpt(s): This invention is in the field of pharmacology, and relates to drug treatments for reducing the dependence of patients on habit-forming and potentially addictive drugs, including narcotics and anti-depressants. The term "narcotic" as used herein has the same meaning used in standard medical reference works, such as the "more recent" definitions used in Stedman's Medical Dictionary, 26th edition (Williams & Wilkins Publ., Baltimore, 1995) and in the "Analgesics" chapter in the "Drug Evaluations" subscription service published by the American Medical Association (Chicago). Briefly,
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"narcotics" as used in any definition (either classical or recent) includes: (1) opiate drugs, defined as any preparation or derivative of opium, a natural mixture derived from poppy plants that includes a number of medically important and/or habit-forming or addictive drugs, including morphine, codeine, noscapine, papaverine, thebaine, and heroin; and, (2) opioid drugs, which includes opiates as well as various synthetic narcotic drugs having similar or related chemical structures and effects. Such synthetic narcotics include meperidine (sold under trademarks such as DEMEROL.TM.), hydrocodone (sold under trademarks such as VICODIN.TM.), hydromorphone (sold under trademarks such as DILAUDID.TM.), propoxyphene (sold under trademarks such as DARVON.TM.), oxycodone (sold under trademarks such as PERCODAN.TM. when mixed with aspirin, or PERCOCET.TM. when mixed with acetaminophen), levorphanol, fentanyl, and methadone. Under a more recent definition that has come to be accepted within the medical profession, the term "narcotics" has been broadened somewhat, to include other synthetic drugs which have "effects that are similar to opium and its derivatives". In order for a drug to be to classified as a "narcotic", its effects must include: (1) the ability to induce "significant alteration of mood and behavior"; (2) the ability to induce a condition of "stuporous analgesia"; and (3) a substantial risk of dependence, tolerance, and/or addiction. Web site: http://www.delphion.com/details?pn=US06207674__ •
Dextromethorphan antitussive compositions Inventor(s): Smith; Ronald L. (West Chester, OH) Assignee(s): The Procter & Gamble Company (Cincinnati, OH) Patent Number: 5,196,436 Date filed: February 24, 1992 Abstract: The subject invention involves antitussive pharmaceutical compositions for the peroral administration of dextromethorphan, the composition being at a pH of from about 8 to about 11. Excerpt(s): This invention is concerned with novel antitussive compositions containing dextromethorphan. More particularly, it is concerned with compositions and methods for rapidly achieving therapeutic systemic levels of dextromethorphan. Dextromethorphan (racemethorphan), 3-methoxy-17-methylmorphinan, is disclosed in the Merck Index. 10th edition (1983), M. Windholz, ed., No. 8009, p. 1170; it is disclosed to be an antitussive agent. Dextromethorphan hydrobromide is used extensively as an antitussive agent in commercial products as disclosed in the Physician's Desk Reference for Nonprescription Drugs, 11th Edition (1990), E. R. Barnhardt, pub., p. 306, and in Physician's Desk Reference, 44th Edition (1990), E. R. Barnhardt, pub., p. 309: Bayer Children's Cough Syrup by Glenbrook, Benylin DM by Parke-Davis, Benylin Expectorant by Parke-Davis, Cerose-DM by Wyeth-Ayerst, Cheracol D Cough Formula by Upjohn, Cheracol Plus Head Cough/Cold Formula by Upjohn, Cough Formula Comtrex by Bristol-Myers Products, Comtrex Multi-Symptom Cold Reliever Tablets/Caplets/Liquid/Liquigels by Bristol-Myers Products, Contac Cough Formula by SmithKline Consumer, Contac Cough & Sore Throat Formula by SmithKiline Consumer, Contac Jr. Children's Cold Medicine by SmithKline Consumer, Contac Nighttime Cold Medicine by SmithKline Consumer, Contac Severe Cold Formula Caplets by SmithKline Consumer, Dimacol Caplets by Robins, Dorcol Children's Cough Syrup by Sandoz Consumer, Hold by SmithKline Beecham, Naldecon DX Adult Liquid by Bristol Laboratories, Naldecon DX Children's Syrup by Bristol Laboratories,
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Naldecon DX Pediatric Drops by Bristol Laboratories, Naldecon Senior DX Cough/Cold Liquid by Bristol Laboratories, Novahistine DMX by Lakeside Pharmaceuticals, Pediacare Cough-Cold Formula Liquid and Chewable Tablets by McNeil Consumer Products, Pediacare Night Rest Cough-Cold Formula Liquid by McNeil Consumer Products, Robitussin Night Relief by Robins, Robitussin-CF by Robins, Robitussin-DM by Robins, Scot-Tussin Sugar-Free DM Cough & Cold Medicine by Scot-Tussin, Snaplets-DM by Baker Cummins Pharmaceuticals, Snaplets-Multi by Baker Cummins Pharmaceuticals, St. Joseph Cough Suppressant for Children by Plough, St. Joseph Nighttime Cold Medicine by Plough, Sucrets Cough Control Formula by SmithKline Beecham, Sudafed Cough Syrup by Burroughs Wellcome, Triaminic Night Light by Sandoz Consumer, Triaminic-DM Syrup by Sandoz Consumer, Triaminicol MultiSymptom Cold Tablets by Sandoz Consumer, Triaminicol Multi-Symptom Relief by Sandoz Consumer, Tylenol Cold Medication Caplets and Tablets by McNeil Consumer Products, Tylenol Cold Medication Liquid by McNeil Consumer Products, Tylenol Cold Medication No Drowsiness Formula Caplets by McNeil Consumer Products, Vicks Children's Cough Syrup by Richardson-Vicks, Inc., Vicks Children's NyQuil by Richardson-Vicks, Inc., Vicks Cough Silencers Cough Drops by Richardson-Vicks, Inc., Vicks Daycare Daytime Colds Medicine Caplets by Richardson-Vicks, Inc., Vicks Daycare Multi-Symptom Colds Medicine Liquid by Richardson-Vicks, Inc., Vicks Formula 44 Cough Control Discs by Richardson-Vicks, Inc., Vicks Formula 44 Cough Medicine by Richardson-Vicks, Inc., Vicks Formula 44D Decongestant Cough Medicine by Richardson-Vicks, Inc., Vicks Formula 44M Multi-Symptom Cough Medicine by Richardson-Vicks, Inc., Vicks NyQuil Nighttime Colds Medicine-Original & Cherry Flavor by Richardson-Vicks, Inc., Vicks Pediatric Formula 44 Cough Medicine by Richardson-Vicks, Inc., Vicks Pediatric Formula 44 Cough & Colds Medicine by Richardson-Vicks, Inc., Vicks Pediatric Formula 44 Cough & Congestion Medicine by Richardson-Vicks, Inc., Ambenyl-D Decongestant Cough Formula by Forest Pharmaceuticals, Bromarest DX Cough Syrup by Warner Chilcott, BromFed-DM Cough Syrup by Muro, Codimal DM by Central Pharmaceuticals, Dimetane-DX Cough Syrup by Robins, Guaifenesin w/D-Methorphan Hydrobromide Syrup by Lederle, Humibid DM Tablets by Adams, IoTuss-DM Liquid by Muro, Medi-Tuss DM by Warner Chilcott, Phenergan with Dextromethorphan by Wyeth-Ayerst, Poly-Histine DM Syrup by Bock, Quelidrine Syrup by Abbott, Rondec-DM Oral Drops by Ross, Rondec DM Syrup by Ross, Tusibron-DM by RAM Laboratories, Tussar DM by Rorer Pharmaceuticals, and Tussi-Organidin DM Liquid by Wallace. Delsym Cough Suppressant Syrup by McNeil Consumer contains dextromethorphan polistirex as an antitussive agent. It is believed that all of the above commercial products containing dextromethorphan are included in compositions at about neutral pH or lower. Web site: http://www.delphion.com/details?pn=US05196436__ •
Dextromethorphan continuous lozenge manufacturing process Inventor(s): Beahm; James S. (Exton, PA) Assignee(s): McNeil-PPC, Inc. (Milltown, NJ) Patent Number: 5,302,394 Date filed: July 14, 1992 Abstract: A process for producing a palatable dextromethorphan medicated hard candy lozenges on a continuous system comprising suspending dextromethorphan HBr
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adsorbate in a liquid suspension and adding this suspension to other candy materials in a novel continuous process. Excerpt(s): This invention relates to a process for producing dextromethorphan medicated hard candy lozenges. More particularly, the process of the invention is capable of producing dextromethorphan lozenges on an efficient continuous system. Dextromethorphan particularly in its hydrobromide salt is a demonstrated safe and effective non-narcotic cough suppressant for the temporary relief of coughing. Dextromethorphan hydrobromide is available in a wide variety of cough and cough/cold medications. Dextromethorphan hydrobromide is available as a sole ingredient in cough medication by itself or with other active ingredients. Dextromethorphan hydrobromide is also available in a cough control lozenge form from various manufacturers which have a dosage of 5.0 milligram of dextromethorphan hydrobromide per lozenge. Such lozenqes are in candy form and comprise corn syrup solids and sugar as major ingredients. However, incorporating dextromethorphan hydrobromide into lozenges is highly troublesome because dextromethorphan has a bitter taste an anesthetic mouth-feel and an unpleasant after-taste. In fact it is very difficult to effectively mask the taste of dextromethorphan at concentrations of greater than 2.0 milligrams per lozenge with sweeteners or flavors. To incorporate more than 2.0 milligrams of dextromethorphan hydrobromide in lozenges the dextromethorphan hydrobromide is generally provided as a 10% adsorbate onto magnesium trisilicate. The adsorbate form provides efficient taste masking to produce an acceptably palatable lozenge form. This adsorbate, which releases the dextromethorphan hydrobromide at the lower pH of the stomach fluids renders the active ingredient almost tasteless in the mouth. Unfortunately, ten times the weight of dextromethorphan hydrobromide adsorbate must be added to achieve an equivalent dosage of dextromethorphan hydrobromide. Web site: http://www.delphion.com/details?pn=US05302394__ •
Dextromethorphan potentiator for anticonvulsant composition and method Inventor(s): Ferkany; John W. (Baltimore, MD), Pontecorvo; Michael J. (Belcamp, MD) Assignee(s): Nova Pharmaceutical Corporation (Baltimore, MD) Patent Number: 4,906,638 Date filed: December 22, 1987 Abstract: A pharmaceutical composition comprises an anti-epileptic drug that does not inhibit, enhance or otherwise modify dextromethorphan binding to the central nervous system dextromethorphan receptor and an effective amount of dextromethorphan to potentiate the anticonvulsant activity of the drug. Other related compounds similar to dextromethorphan which inhibit or enhance dextromethorphan binding to the dextromethorphan site in the brain are also suitable as potentiating agents for the anticonvulsants. A method of treating epilepsy and other convulsions include the steps of introducing to the patient an effective amount of the compound comprising an antiepileptic drug and potentiating amount of dextromethorphan or one of the related compounds. Excerpt(s): The present application is related to a co-pending application entitled DEXTRORPHAN POTENTIATOR FOR ANTICONVULSANT COMPOSITIONS AND METHOD, Ser. No. 136,564 filed concurrently herewith. The present invention relates to a novel combination comprising dextromethorphan in combination with a suitable anti-
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epileptic drug. More specifically the invention is directed to a pharmaceutical combination and method of treating epilepsy and other convulsions by introducing to the patient an effective amount of a composition comprised of dextromethorphan or one of the similarly related compounds as a potentiating agent in combination with at least one known anti-epileptic drug which does not either inhibit or enhance binding at the [.sup.3 H]dextromethorphan receptor site in the central nervous system, but does act either to inhibit excitatory amino acid neutrotransmission or to otherwise reduce neutronal excitability. In recent years the field of medicine has had varying success in treating epileptic seizures. Most types of seizures, including induced generalized or focal seizures, can be treated with one of several anti-epileptic hydantoins and in particular diphenylhydantoin (DPH) commonly referred to as phenytoin or dilantin. Dilantin is the registered trademark of the Parke-Davis Company. Web site: http://www.delphion.com/details?pn=US04906638__ •
Dextromethorphan tannate Inventor(s): Chopdekar; Vilas M. (Edison, NJ), Desai; Hemant S. (Flemington, NJ), Schleck; James R. (Somerset, NJ) Assignee(s): Jame Fine Chemicals, Inc. (Bound Brook, NJ) Patent Number: 6,670,370 Date filed: October 28, 2002 Abstract: The invention pertains to a composition comprising dextromethorphan tannate and to a method for preparing dextromethorphan tannate by reacting dextromethorphan at a temperature of about 80 to about 180.degree. C. with tannic acid either neat or as an aqueous slurry containing about 5 to about 30 wt. % water. The dextromethorphan tannate has extended release properties and is useful in pharmaceutical compositions as an antitussive for human beings. Excerpt(s): The invention pertains to dextromethorphan tannate, its method of preparation and to pharmaceutical compositions containing dextromethorphan tannate. Dextromethorphan (hereinafter also referred to as dextromethorphan free base) is a well-known commercially available compound. It is the methyl ether of the dextrorotary isomer of levorphanol, anarcotic analgesic. Its chemical name is 3-methoxy-17-methyl9.alpha., 13.alpha., 14.alpha.-morphinan and its CAS number is 125-71-3. It is a solid having a melting point of 109.5 to 112.5.degree. C. and its molecular formula is C.sub.18 H.sub.25 NO. It is insoluble in water, and therefore is utilized typically in the form of its hydrobromide monohydrate salt that is soluble in water. Dextromethorphan finds its principal use as an antitussive, i.e., a cough suppressant that acts centrally to elevate the threshold for coughing, but it does not have addictive, analgesic or sedative actions and does not produce respiratory depression with usual doses. It is typically administered to human beings in need of such medication in the form of tablets and/or suspensions. It frequently is administered as an antitussive/expectorant composition consisting of dextromethorphan hydrobromide monohydrate and guaifenesin. Web site: http://www.delphion.com/details?pn=US06670370__
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Inhibiting the development of tolerance to and/or dependence on a narcotic addictive substance Inventor(s): Lyle; John W. (Belmar, NJ), Mao; Jianren (Richmond, VA), Mayer; David J. (Richmond, VA), Price; Donald D. (Richmond, VA) Assignee(s): Virginia Commonwealth University Medical College (Richmond, VA) Patent Number: 5,321,012 Date filed: April 6, 1993 Abstract: Nontoxic substances that block the N-methyl-D-aspartate (NMDA) receptor, e.g., a morphinan such as dextromethorphan or dextrorphan, or that block a major intracellular consequence of NMDA receptor activation, e.g., a ganglioside such as GM.sub.1 or GT.sub.1b, a phenothiazine such as trifluoperazine or a naphthalenesulfonamide such as N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide, inhibit the development of tolerance to and/or dependence on addictive drugs, e.g., narcotic analgesics such as morphine, codeine, etc. Excerpt(s): This invention relates to a composition containing an addictive substance and a component which inhibits the development of tolerance to and/or dependence on the addictive substance. More particularly, the invention relates to a composition containing an addictive substance such as morphine or codeine and at least one nontoxic substance that blocks the N-methyl-D-aspartate (NMDA) receptor, e.g., a morphinan such as dextromethorphan or dextrorphan, or that blocks at least one major intracellular consequence of NMDA receptor activation, e.g., a ganglioside such as ganglioside GM.sub.1 or GT.sub.1b, a phenothiazine such as trifluoperazine or a naphthalenesulfonamide such as N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide. Morphine is a rapid and effective drug for the treatment of severe pain but its long term administration has been limited due to its negative side effects, principally tolerance and dependence, which develop rapidly after administration. In an effort to make morphine of greater use in the treatment of pain, it has been combined with a variety of substances intended to inhibit one or more of its undesirable side effects. U.S. Pat. No. 2,770,569 describes the combination of morphine with the compound levo-d-hydroxy-N-allylmorphinan which is said to suppress or eliminate such undesirable side reactions of morphine as depression, nausea and vomiting. U.S. Pat. No. 4,126,684 discloses reducing either the addiction liability of an addictive substance such as a narcotic analgesic or a barbiturate or the withdrawal symptoms caused by deprivation of such a substance in an addicted subject by administering the addictive substance, e.g., morphine, with a 4amino-3-p-halophenylbutyric acid. U.S. Pat. No. 4,415,871 describes the prevention of treatment tolerance and physical dependence in chronic morphine treatment by combining the morphine with any of the specific dipeptides indicated therein. U.S. Pat. No. 5,041,446 discloses inhibiting the development of tolerance to morphine by combining the morphine with dapiprazole. U.S. Pat. No. 5,057,519 achieves a reduction in morphine tolerance by combining the morphine with a benzamide antagonist for a subtype of the serotonin receptor, 5-HT.sub.3. Trujillo et al., "Inhibition of morphine tolerance and dependence by the NMDA receptor antagonist MK-801", Science, 251 (4989), pp. 85-87, Jan. 4, 1991; Tanganelli et al., "Glutamate antagonists prevent morphine withdrawal in mice and guinea pigs", Neuroscience Letters, 122(2), pp. 270272, Jan. 28, 1991; Marek et al., "Excitatory amino acid antagonists (kynurenic acid and MK-801) attenuate the development of morphine tolerance in the rat", Brain Research, 547(1), pp. 77-81, Apr. 26, 1991; and, Marek et al., "Delayed application of MK-801 attenuates development of morphine tolerance in rats, Brain Research, 558(1), pp. 163165, Aug. 30, 1991 discuss the role of MK-801 (the compound 5-methyl-10,11-dihydro-
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SH-dibenzo[a,d]cyclohepten-5,10-imine), an NMDA receptor antagonist or blocker, in reducing morphine dependence in laboratory animals. However, MK-801 has been found to be toxic and is therefore unsuitable for pharmaceutical use. In accordance with the present invention, a composition is provided which comprises an addictive substance and at least one nontoxic substance that blocks the N-methyl-D-aspartate receptor or at least one major intracellular consequence of N-methyl-D-aspartate receptor activation. Web site: http://www.delphion.com/details?pn=US05321012__ •
Method and composition for treating migraine Inventor(s): Caruso; Frank S. (Colts Neck, NJ) Assignee(s): Algos Pharmaceutical Corporation (Neptune, NJ) Patent Number: 6,043,244 Date filed: January 7, 1999 Abstract: This invention relates to methods and compositions for the treatment of migraine headache by administering a combination of a) a migraine-treating amount of an ergot alkaloid and b) an antimigraine-potentiating amount of at least one of dextromethorphan or dextrorphan. Excerpt(s): This invention relates to a method and composition for treating migraine. More particularly, this invention is concerned with alleviating a migraine by administration of an antimigraine drug together with a nontoxic antagonist, or blocker, for the N-methyl-D-aspartate (NMDA) receptor or nontoxic substance that blocks a major intracellular consequence of NMDA receptor activation. The term migraine is defined herein as a severe recurring headache resulting from cerebral vasoconstriction and is classified as either a classical migraine or a common migraine. See, e.g., "Remington's Pharmaceutical Sciences", 17th ed., Mack Publishing Company (1985), p. 946 and Goodman and Gilman's "The Pharmaceutical Basis Of Therapeutics", 8th ed., McGraw-Hill, Inc. (1990), pp. 944-947. A common migraine is much more likely to occur than a classical migraine. The classical migraine is associated with objective prodromal neurological signs and symptoms involving a headache that is preceded by a slowly expanding area of blindness surrounded by a sparkling edge that increases to involve up to one half of the field of vision of each eye. When the blindness clears up after approximately 20 minutes, it is often followed by a severe one-sided headache with nausea, vomiting and sensitivity to light. The common migraine is an attack without prodromal symptoms and begins as a slowly developing pain in the form of a headache that transforms into a mounting throbbing pain made worse by the slightest movement or noise. The pain is often on one side of the head only and usually occurs with nausea and sometimes vomiting. The length of migraine is from about two hours to two days. Examples of causes of migraine are: stress related, e.g., anxiety, anger, worry, excitement, shock, depression, overexertion, changes of routine and changes of climate, food-related, e.g., chocolate, cheese and other dairy products, red wine, fried food and citrus fruits, sensory-related, e.g., bright lights or glare, loud noises and intense or penetrating smells, menstruation and contraceptive drugs. Web site: http://www.delphion.com/details?pn=US06043244__
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Method for enhancing the systemic delivery of dextromethorphan for the treatment of neurological disorders Inventor(s): Smith; Richard A. (La Jolla, CA) Assignee(s): NeuroTherapeutics, Inc. (San Diego, CA) Patent Number: 5,166,207 Date filed: June 17, 1991 Abstract: A method for enhancing the systemic delivery of dextromethorphan for the treatment of a neurological disorder resulting in injury to nervous tissue, which comprises administering to a patient suffering from the disorder an amount of a cytochrome P450IID6 enzyme inhibitor, sufficient to block dextromethorphan metabolism, and an amount of dextromethorphan sufficient to treat the neurological disorder. Quinidine is particularly suitable for use in the method of the invention. Excerpt(s): The invention relates to compounds that enhance the delivery of a drug, dextromethorphan, used in the treatment of neurological disorders. It is now known that two common amino acids, glutamate and aspartate, are the major excitatory neurotransmitters in the mammalian brain. It is estimated that between 30 and 40% of all brain neurons use these two agents to communicate. Glutamate and aspartate are referred to as excitatory amino acids (EAA's). After physical trauma or stroke (ischemia), nerve cells which use the EAA's as their neurotransmitters become hyperactive and begin to release very large quantities of the EAA transmitters. This process results in the exhaustion and death of the neurons from EAA overstimulation. The two natural neurotransmitters, glutamate and aspartate, actually become toxins in the injured brain, due to their increased release from neurons. This phenomenon has been termed excitotoxicity. U.S. Pat. No. 4,806,543 discloses the use of dextrorotatory opiate agonists such as dextrorphan and dextromethorphan to protect against this phenomenon in a number of acute and chronic neurologic disorders, including ischemia, hypoxia, hypoglycemia, epilepsy, Huntington's disease, Alzheimer's disease, and amyotrophic lateral sclerosis (ALS). Web site: http://www.delphion.com/details?pn=US05166207__
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Method for reducing emotional lability Inventor(s): Smith; Richard A. (7569 Cabrillo Ave., La Jolla, CA 92037) Assignee(s): none reported Patent Number: 5,206,248 Date filed: March 27, 1992 Abstract: This invention discloses that certain types of non-addictive opioid drugs such as dextromethorphan (which is widely used in cough syrups) provide a highly effective means of treating the feelings and symptoms of emotional lability in at least some patients suffering from neurologic impairment, without sedating, tranquilizing, or otherwise significantly interfering with consciousness or alertness in the patient. In several patients tested to date who were suffering from amyotrophic lateral sclerosis (ALS), dextromethorphan, administered orally, was remarkably effective and became quite obvious to the patients even though it was being tested for an entirely different purpose. Its effectiveness is enhanced by co-administration of a second drug such as
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quinidine which reduces the degradation of dextromethorphan by oxidative enzymes and which therefore increases dextromethorphan concentrations in the blood. Excerpt(s): This invention is in the field of neuropharmacology, and relates to methods of treating patients suffering from emotional problems that occur in relation to neurodegenerative diseases or to brain damage such as caused by stroke or head injury. The phrase "emotional lability" is used by psychiatrists and neurologists to refer to a set of symptoms that are often observed in patients who have suffered a brain insult such as a head injury, stroke, brain tumor, or encephalitis, or who are suffering from a progressive neurodegenerative disease such as amyotrophic lateral sclerosis (ALS, also called motor neuron disease or Lou Gehrig's disease), Parkinson's disease, Alzheimer's disease, or multiple sclerosis. In the great majority of such cases, emotional lability occurs in patients who have bilateral damage (i.e., damage which affects both hemispheres of the brain) involving subcortical forebrain structures. Emotional lability, which is distinct from clinical forms of reactive or endogenous depression, is characterized by intermittent spasmodic outbursts of emotion (usually manifested as intense or even explosive crying or laughing) at inappropriate times or in the absence of any particular provocation. The feelings that accompany emotional lability are often described in words such as "disconnectedness," since patients are fully aware that an outburst is not appropriate in a particular situation, but they do not have control over their emotional displays. Emotional lability is also described by some as "emotional incontinence," which draws an analogy between someone who is unable to control emotional outbursts, and someone who is unable to control their bladder or bowels. Web site: http://www.delphion.com/details?pn=US05206248__ •
Method for treatment of amyotrophic lateral sclerosis comprising administration of DMP Inventor(s): Salazar-Grueso; Edgar F. (Chicago, IL) Assignee(s): Arch Development Corporation (Chicago, IL) Patent Number: 5,229,394 Date filed: July 30, 1990 Abstract: A method for treating ALS (Amyotrophic Lateral Sclerosis) is disclosed. The inventive method comprises the administration of controlled dosages of dextromethorphan in therapeutically effective amounts in a pharmaceutically acceptable vehicle Dextromethorphan (DMP) is a dimethylaminomethyl-substituted phenol, a sigma receptor antagonist known also as d-3-methoxy-N methylmorphinan, a d-isomer of the codeine analog, levorphanol. The inventive method has proven useful in controlling the progression of ALS in afflicted patients. Excerpt(s): This invention relates to a method for treatment of Amyotrophic Lateral Sclerosis and other neurodegenerative disorders. This invention further relates to a method for treatment of Amyotrophic Lateral Sclerosis and other neurodegenerative disorders by administering a medicament in controlled doses of therapeutically effective amounts. Amyotrophic Lateral Sclerosis (ALS) is a progressive degenerative disease of the motor system which is usually relentlessly progressive, leading to death in half the cases within three years of onset. It is related to a group of diverse motor-system diseases which include Huntington's Chorea, Parkinson's disease and Alzheimer's disease. Numerous agents have been tried therapeutically in ALS, but none have been unequivocally demonstrated to benefit the disorder. This suggested to us that the L-
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BMAA might be affecting a neuroreceptor type responsible for the ALS symptoms. It is known that other excitatory amino acids can bind in vitro to neuronal receptors. It has further been demonstrated in recent years that the dextrorotary opioid derivative dextromethorphan (DMP) binds to excitatory amino acid receptors in the brain. DMP has long been known as a highly effective cough suppressant. We, therefore, theorized that since a neuro-excitatory receptor in the brain appears to be adversely affected by LBMAA and may produce the motor degeneration characteristic of ALS, the action of LBMAA with the involved receptors might be antagonized by an agent such as DMP that suppresses central synaptic transmission. Web site: http://www.delphion.com/details?pn=US05229394__ •
Method of treating commercial grade products to remove undesirable odors and flavors Inventor(s): Kuhn; Dale F. (Shawnee Mission, KS) Assignee(s): Tillin, Inc. (Shawnee Mission, KS) Patent Number: 6,303,172 Date filed: September 26, 2000 Abstract: A method of treating antimicrobial products, dairy products, pharmaceutical products and other products having offensive tastes or odors to remove the off-odors and off-tastes from the products. The method involves exposing a selected commercial grade product that contains a small amount of free acid impurities to an ammonia gas. The ammonia gas reacts with the free acid impurities to convert the free acids into ammonium salts, thereby reducing or eliminating the off-flavor and off-odor of the product. The products to be treated include antimicrobial products selected from the group consisting of sodium benzoate, calcium benzoate, potassium benzoate, sodium diacetate, paraben, niacin, calcium acetate, calcium diacetate, sodium sorbate, calcium sorbate, potassium sorbate, sodium propionate, calcium propionate, potassium propionate and mixtures thereof; dairy products selected from the group consisting of casein, whey, skim milk powder, and calostrum; pharmaceutical products selected from the group consisting of acetaminiphen, aspirin, ibuprophen, dextromethorphan hydrobromide, guaejenesin, paracetamol, and sodium erythorbate; and various other products selected from the group consisting of butylate hydroxy tolulene, polydextrose powder, sodium acid sulfate, and sodium diacetate. The common characteristic of the commercial grades of each of these products is that they contain a small amount of free acid impurities that react favorably with ammonia gas. Excerpt(s): The present invention relates generally to methods of treating antimicrobial products, dairy products, pharmaceutical products, and other products having offensive odors or tastes to remove the off-odors and off-tastes from the products. The method involves exposing a selected commercial grade product containing a small amount of free acid impurities to an ammonia gas to convert the free acid impurities into ammonium salts, thereby eliminating the offensive odors and/or tastes caused by the free acids. The growth of mold, rope, yeasts and bacteria is a significant problem in packaged or processed foods such as dairy products, margarine, butter, baked goods, fruit and vegetable containing products such as fruit fillings for pies or pastries, and processed meats. The growth of mold, rope, yeasts and bacteria not only significantly reduces the useful shelf life of the product, thus increasing the sellers' direct costs due to stale or moldy products that cannot be sold, but also requires that certain items be refrigerated during shipping and/or at the marketplace, which causes additional
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indirect expenses for the end seller of the product. Various food preservatives are on the market. However, when used at concentrations that effectively increase shelf life, the prior art food preservatives impart an off-flavor, odor, color and/or texture to the final product that is undesirable. Consequently, a need exists for a food preservative that increases the shelf life of the product while not requiring refrigeration or causing offflavor, color, odor and/or texture. Web site: http://www.delphion.com/details?pn=US06303172__ •
Multiple action cold/sinus preparations Inventor(s): Denick, Jr.; John (Newton, NJ), Lech; Stanley (Rockaway, NJ), Schobel; Alexander M. (Flemington, NJ) Assignee(s): Warner-Lambert Company (Morris Plains, NJ) Patent Number: 5,681,577 Date filed: September 19, 1995 Abstract: A chewable cold/sinus preparation comprising a bitter tasting mixture of a decongestant such as pseudoephedrine and an antihistamine such as diphenhydramine and/or chlorpheniramine maleate is made with no bitter, metallic taste or unpleasant mouthfeel by adsorbing the active drug mixture using a wet granulation process onto a silicon dioxide carrier which comprises from about 50 to about 85% of total weight of the adsorbate composition. A truly multi-symptom relief formula is prepared through the optional addition of an antitussive such as dextromethorphan hydrobromide and/or an analgesic such as meclofenamic acid, aspirin or ibuprofen. Additional excipients such as flavors, sweeteners, lubricants and bulk fillers are added for better taste, improved mouthfeel and as an aid to the tabletting process. Excerpt(s): There have been numerous efforts over the years to make bad tasting things that are otherwise good for you taste good. This is particularly true in the area of pharmaceuticals where many drugs possess bitter, acidic or metallic tastes. This problem of course, is confined to those drugs which are administered orally and whereas bitter tastes are readily perceived in swallowable tablets or capsules, they are very apparent and unpleasant in chewable delivery systems such as chewable tablets. The effective taste masking of unpleasant or bitter tasting drugs is important in many respects, not the least of which, particularly in childrens medications, is insuring the likelihood of better patient compliance. Many drugs, both prescription and over-thecounter that are bitter tasting or that possess an undesirable mouth feel can be made less objectionable if they can be encapsulated and swallowed whole with subsequent breakdown and absorption of the active ingredient either in the stomach or enterically in the small intestine. Many drugs however, especially childrens' medications, are better administered in chewable dosage forms since children generally don't like or have difficulty swallowing whole tablets or capsules. Obviously, if the drugs taste bad, chewing the tablet directly exposes the taste buds and sensitive oral tissues to the unpleasant drugs to a greater extent and for a longer period of time thereby exacerbating the problem than if swallowed whole. There are many known taste masking agents and preparations tailored for specific applications. Sweeteners, flavors, bulking agents and the like have long been used as taste masking agents. See U.S. Pat. No. 5,013,716 to Cherukuri et. al. The general approach is using a composition whose taste is stronger than and thereby overpowers the unpleasant tasting compound. Artificial, high intensity sweeteners have proven particularly useful in this regard.
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Web site: http://www.delphion.com/details?pn=US05681577__ •
Nasal administration of dextromethorphan Inventor(s): Goldberg; Arthur H. (Montclair, NJ), Matluck; Meyer (Flushing, NY), Ranucci; Joseph A. (North Caldwell, NJ) Assignee(s): Hoffmann-La Roche Inc. (Nutley, NJ) Patent Number: 4,454,140 Date filed: September 7, 1982 Abstract: The invention relates to a novel method of administering dextromethorphan, a known anti-tussive agent used for the suppresion of coughs due to colds and allergies. The novel method utilizes dosage forms of dextromethorphan which are adapted for nasal administration. Excerpt(s): Dextromethorphan is a known anti-tussive agent and is widely used for the suppression of cough due to colds and allergies. The common mode for administering dextromethorphan is by oral administration. When the drug is administered orally, there is variation in the absorption and bioavailability. There exists the need for an improved delivery of dextromethorphan and a dosage form which will provide enhanced bioavailability and absorption of dextromethorphan. Nasal administration of dextromethorphan provides for a more rapid and more complete absorption of the drug than the standard oral route. The term "pharmaceutically acceptable acid addition salt" denotes salts derived from inorganic acids, such as hyrochloric acid, hydrobromic acid sulfuric acid and the like, and organic acids such as acetic acid, citric acid, lactic acid, maleic acid, salicylic acid, succinic acid, and the like. The preferred salt is the hydrobromide salt. Web site: http://www.delphion.com/details?pn=US04454140__
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NMDA receptor blockers in the therapy of urogenital disease Inventor(s): Gonzalez-Cadavid; Nestor F. (Pasadena, CA), Rajfer; Jacob A. (Rolling Hills Estates, CA) Assignee(s): Harbor-UCLA Research and Education Institute (Torrance, CA) Patent Number: 6,133,281 Date filed: October 23, 1997 Abstract: Methods are presented for the treatment of benign prostatic hyperplasia. The methods provide for administration to a person at least one compound identified generically as antagonists of N-methyl-D-aspartate receptors. These compounds are selected from the group consisting of memantidine, amantidine, dextromethorphan and ketamine. Excerpt(s): This invention relates generally to methods for therapy of urogenital disease, and more particularly concerns methods for blocking N-methyl-D-aspartate receptors in urogenital organs, utilizing the response of these tissues to blockers of these receptors, and novel therapeutic uses for these drugs. Prostate cancer is one of the most prevalent pathologies in men over 50 years of age and the most common internal cancer of males in the USA. Approximately 140,000 cases are newly diagnosed and about 30,000 die from the disease annually. Radical prostatectomy is the only treatment available to
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remove the malignant organ, while surgical or chemical androgen ablation is used to avoid or delay the onset of extraprostatic disease. The failure of surgical or medical treatment of prostate cancer is mostly due to the establishment of extraprostatic progression or metastasis, and the parallel progression of the tumor from androgen dependency to androgen unresponsiveness. As a result, androgen ablation fails to stop tumor growth and its spread. Treatment with chemotherapy or other types of drugs is not effective. Benign prostatic hyperplasia (BPH), an abnormal non-malignant growth of the prostate leading to voiding obstruction and potential bladder instability, also afflicts 50% of men over the age of 50, and is one of the primary causes of hospitalization and surgical procedures in men. Transurethral resection ablation of the prostate (TURP) is one of the most common surgical procedures performed in the USA. The main clinical symptoms are obstructive in nature (decrease force of strain, hesitancy, incomplete voiding) as well as irritative (frequency, urgency, dysuria, nocturia). This is due to partial occlusion of the prostatic urethra by the enlarged prostate, combined with an increase in the tone (contraction) of the prostatic smooth muscle, and in certain cases hypertrophy of the bladder muscle (detrusor). Medical treatment of BPH is based on mainly drugs affecting either prostate growth or tone, with efficacy limited to a fraction of patients and undesirable side effects. Web site: http://www.delphion.com/details?pn=US06133281__ •
Qualitative metabolism chromatography
assessment
using
high
performance
thin
layer
Inventor(s): Chang; Shih-Ling (Lexington, KY) Assignee(s): The University of Kentucky Research Foundation (Lexington, KY) Patent Number: 4,877,744 Date filed: July 27, 1987 Abstract: A method for the qualitative assessment of oxidative drug metabolism deficiencies, preferably for the qualitative assessment of dextromethorphan metabolism, in a subject comprises analyzing a sample fluid from the subject, for example urine, which contains metabolites of a probe drug using high performance thin layer chromatography. Excerpt(s): The present invention relates to a method for the qualitative assessment of oxidative drug metabolism deficiencies in a subject. The subject may be human or a nonhuman animal. The present invention further relates to a method for the qualitative assessment of dextromethorphan metabolism in a subject. Interest in the pharmacogenetics of oxidative drug metabolism has grown rapidly in the past several years. It has been discovered that a genetic deficiency in oxidative drug metabolism exists in certain subjects which causes the subjects to act as a slow or poor metabolizer rather than a fast, efficient or extensive metabolizer of certain drugs. Several drugs have been used as probes for the assessment of oxidative drug metabolism deficiencies in subjects, including dextromethorphan, debrisoquine and sparteine. See, for example, Kupfer et al, "Dextromethorphan as a Safe Probe for Debrisoquine Hydroxylation Polymorphism", The Lancet (Sept. 1, 1984), pages 517-518; Roy et al, "Methoxyphenamine and Dextromethorphan as Safe Probes for Debrisoquine Hydroxylation Polyamorphism", The Lancet (Dec. 15, 1984), page 1393; Schmid et al, "Polymorphic Dextromethorphan Metabolism: Co-Segregation of Oxidative ODemethylation with Debrisoquine Hydroxylation", Clinical Pharmacology and Therapeutics, Vol. 38, No. 6 (1985), pages 618-624; De Zeeuw et al, "Interindividual
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Differences in Dextromethorphan Kinetics in Man", Acta Pharmacologica et Toxicologica, Vol. 59, Supplement V (1986), page 44; and Kupfer et al, "Pharmacogenetics of Dextromethorphan O-Demethylation in Man", Xenobiotica, Vol. 16, No. 5 (1986), pages 421-433, for further details of previous studies in this regard. Generally, pharmacogenetic screening using the aforementioned or other drugs as probes has been conducted by administering the probe drug to a subject and then quantitatively monitoring a body fluid containing metabolites of the probe drug. Known methods for analyzing body fluids such as urine containing the drug and its metabolites include gas chromatography and high performance liquid chromatography. Both gas chromatography and high performance liquid chromatography provide a quantitative indication of the relative amounts of the probe drug and the metabolites of the probe drug in the sampled body fluid. The gas chromatography and high performance liquid chromatography method are particularly suitable for determining the relative amounts of the substances. Reports of pharmacogenetic screenings using either gas chromatography or high performance liquid chromatography techniques are disclosed by, for example, Price Evans et al, Journal of Medical Genetics, 17 (1980), pages 102-105 (gas chromatography); Kupfer et al, European Journal of Clinical Pharmacology, 26 (1984,) pages 753-759 (gas liquid chromatograph); Wedlund et al, Clinical Pharmacology and Therapeutics, Vol. 36, No. 6 (1984), pages 773-780 (high performance liquid chromatography); Jurima et al, British Journal of Clinical Pharmacology, 19 (1985), pages 483-487 (gas chromatography); and Eichelbaum et al, Xenobiotica, Vol. 16, No. 5 (1986), pages 465-481 (gas chromatography). Web site: http://www.delphion.com/details?pn=US04877744__ •
Rapid narcotic detoxification Inventor(s): Simon; David Lew (Mansfield Center, CT) Assignee(s): Intensive Narcotic Detoxification Centers of America, LLC (Tolland, CT) Patent Number: 5,922,705 Date filed: April 13, 1998 Abstract: Methods for rapid detoxification of patients addicted to opioid narcotics are provided. The methods include administering nalmefene to induce acute withdrawal, and administering dextromethorphan with nalmefene or other opioid antagonists to reduce the patient's subjective feelings of residual withdrawal symptoms following detoxification. In one method of rapid detoxification, unconsciousness is induced by anesthetizing the patient with desflurane. Excerpt(s): The present invention relates to novel methods for rapid detoxification of patients addicted to opioid narcotics. In particular, the invention relates to such methods using opioid antagonists, such as nalmefene, and dextromethorphan and/or desflurane. An opiate is a remedy containing or derived from opium, Dordand's Illustrated Medical Dictionary, 26th edition. An opioid is any synthetic narcotic that has opiate-like activities but is not derived from opium, Dorland's illustrated Medical Dictionary, 26th edition. Either of said drugs may be classified as a narcotic. Many human beings are addicted to exogenous narcotics and want to become free of this addiction, but traditional withdrawal techniques result in high rates of dropout and early relapse. In order to improve the success of becoming free from addiction to exogenous narcotics, newer techniques have been promulgated which offer to lower the dropout rate from treatment and the relapse rate relating to failed treatment and further use of exogenous narcotics. In general, the process by which an addicted human being is ridded of the
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effects of an exogenous narcotic and undergoes the resultant process of withdrawal, is termed detoxification. Techniques for detoxification have been used whereby a narcotic antagonist is administered to a human being who is addicted to narcotics and currently using exogenous narcotics such that said narcotic antagonist displaces the exogenous narcotic from physiologic receptors in the body of the addicted human being, thus freeing up said exogenous narcotic from said receptors and allowing said exogenous narcotic to be excreted from the body by normal bodily mechanisms, as seen with LOIMER, LENZ et al., American Journal of Psychiatry, (1991), 148(7), 933-35. One of these techniques for detoxification involves the administration of the chemical compound (-)-17-Allyl-4,5alpha-epoxy-3,14dihydroxy=morphinan-6-one hydrochloride, known as naloxone, in conjunction with anesthesia, shown by LOIMER, HOFMANN, et al. American Journal of Psychiatry, (1993), 150(5), 839. Naloxone is used for this purpose because its salt preparation can be administered intravenously, but it is a bad drug for this purpose for two reasons: Firstly, it has a short chemical half-life in the human body so that its effects are too short-lasting, as shown in NARCAN package insert, @ 1995, Dupont Pharma; Secondly, it is associated with life-threatening adverse reactions, as shown by TAFT, Anesthesiology, (1983), 59, 576-77, and PARTRIDGE, et al., Anesthesiology, (1986), 65, 709-10, notably when used for the purpose of detoxification as indicated by SAN et al., American Journal of Psychiatry. (1995), 152, 956. A chemical compound related to naloxone in which the methyl group on the nitrogen atom is replaced by a cyclopropylmethyl group, known as naltrexone, has been used for this purpose by LEGARDA et al., Drug Alcohol Depend (1994), 35(2), 91-93, but it too has a major drawback: Naltrexone is known to cause hepatocellular injury, stated in REVIA.TM. package insert,.RTM.1995, DuPont Pharma. Many human beings addicted to narcotics are at risk for abnormalities of liver function. Therefore, naltrexone is potentially very harmful to this group of human beings. The chemical compound 17(cyclopropylmethyl)-4,5alpha-epoxy-6-methylenemorphinian-3,14-diol,hydr ochloride salt, known as nalmefene, may be used for detoxifying human beings addicted to narcotics in association with anesthesia because it is able to be administered intravenously, and because it does not cause hepatocellular injury as does naltrexone, shown by REVIA.TM. package insert, and REVEX.TM. package insert, April, 1995, Ohmeda Pharmaceutical Products Division, Inc. Also, because it is longer acting than naloxone, nalmefene is very favorable to naloxone for the purpose of rapid detoxification of narcotic addicts. Of all available narcotic antagonists, nalmefene is uniquely suited for the purpose of rapid narcotic detoxification. Despite this, nalmefene has not been used in published reports for the purpose of rapid narcotic detoxification, but naltrexone and naloxone have been used for this purpose in published reports. Nalmefene is not marketed by its manufacturer for narcotic detoxification, as evidenced by REVEX.TM. package insert Nalmefene's use as a drug for rapid detoxification is not obvious to its manufacturer or investigators in the field of narcotic detoxification. Nalmefene is not a new chemical compound. Web site: http://www.delphion.com/details?pn=US05922705__ •
Resinate sustained release dextromethorphan composition Inventor(s): Fischer; Franz X. (Riehen, CH), Khanna; Satish C. (Bottmingen, CH) Assignee(s): Ciba-Geigy Corporation (Ardsley, NY) Patent Number: 4,788,055 Date filed: December 9, 1985
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Abstract: A pharmaceutical preparation for controlled, sustained release of dextromethorphan comprising a polystyrene sulfonate resin which has been crosslinked with about 3% to about 10% divinyl benzene, having an average particle size of at least 48.mu.m and less than 100.mu.m onto which dextromethorphan has been loaded in a ratio of dextromethorphan hydrobromid to resin of about 1:3 to about 1:10 and at least one pharmaceutically acceptable adjuvant. Excerpt(s): The invention relates to the field of resinate sustained release compositions. A number of resinous materials have been known to form complexes with drug substances which are subsequently released in gastrointestinal media at a rate different from that demonstrated by conventional drug delivery systems. Such phenomena have been reported, particularly between weakly basic drugs and cationic sulfonic acid resins, in U.S. Pat. Nos. 2,990,332 and 4,221,778. While such systems have yielded reasonable results in some cases, other drug-resin complexes yield products having drug release rates which cannot be suitably controlled. As stated in U.S. Pat. No. 4,221,778, the uncoated complexes of U.S. Pat. No. 2,990,332 provide only a relatively short delay in drug release. Therefore, it was generally believed that for drugs such as the narcotic analgesics and their related anti-tussives, uncoated resin complexes thereof were unsuitable as truly useful sustained release products. At the time the instant invention was made, it was believed that suitable resin-drug complexes for sustained release of dextromothorphan required a "different barrier coated" outer surface, e.g. according to U.S. Pat. No. 4,221,778, to retard the release of active agent. Additionally, there are formulation and stability problems which are apparent in the art. While drug complexes according to U.S. Pat. No. 2,990,332 might give reasonably useful products in dry formulations, their utility in aqueous media is seriously curtailed. Since U.S. Pat. No. 2,990,332 indicates drug release in both gastric and intestinal fluids, it is apparent that drug release occurs over a very broad range of pH, and, given time, even at a pH close to neutral. Hence, products containing appreciable amounts of water with slightly basic or acidic compounds dissolved therein are viewed as unsuitable as vehicles for the drug-resin complex if a commercially reasonable shelf-life (more than 3 months, preferably greater than 6 months, more preferably more than 1 year) for a preformulated liquid medication is to be achieved. Upon storage in aqueous media, such as in an aqueous syrup or suspension, drug would be expected to readily dissociate itself from the resin resulting in a formulation containing free drug and free resin or resin having other formulation components bound thereto in place of some or all of the drug which should remain bound. Such a formulation obviously would not be expected to adequately perform the desired function of sustained release. Hence, it was even more strongly believed that the "diffusion barrier coatings" such as those disclosed in U.S. Pat. No. 4,221,778 were necessary. Web site: http://www.delphion.com/details?pn=US04788055__ •
Stabilized solid pharmaceutical preparation and method of producing the same Inventor(s): Isobe; Mitsutaka (Suita, JP), Itoh; Shunichi (Suita, JP), Kiyoshima; Kenichiro (Suita, JP), Kurihara; Masahiko (Ikeda, JP), Moriyama; Kou (Tokyo, JP) Assignee(s): Takeda Chemical Industries, Ltd. (Osaka, JP) Patent Number: 5,629,316 Date filed: June 28, 1994 Abstract: To stabilize the active ingredients, a caffeine is incorporated into a solid pharmaceutical preparation comprising a dextromethorphan and a
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phenylpropanolamine. The pharmaceutical preparation may further comprise ibuprofen. The active ingredients may be further stabilized, in combination with the incorporation of the caffeine, by grouping and incorporating separately each or suitably combined plural of the active ingredients into different groups or by minimizing the amount of any reducing sugar such as lactose. The solid pharmaceutical preparation is practically valuable since decomposition of each active ingredient with the lapse of time is remarkably suppressed and the active ingredients are stabilized for a longer period of time. Excerpt(s): The present invention relates to a stabilized solid pharmaceutical preparation which is useful for therapy and prophylaxis of various symptoms of cold, and a method of producing the same. In more detail, the present invention relates to a stabilized solid pharmaceutical preparation which comprises a dextromethorphan as an antitussive and/or an expectorant, a phenylpropanolamine as a decongestant effective for nasal mucus and nasal congestion, and a caffeine, and which may further comprise ibuprofen as an antipuretic, analgesic and/or antiinflammatory agent, and method of producing such preparations. Particularly, the present invention provides a stabilized pharmaceutical preparation comprising a dextromethorphan, ibuprofen and a phenylpropanolamine which are stabilized by further adding a caffeine to suppress or inhibit decomposition of each of the active ingredients even when these active ingredients are incorporated or granulated in one group. Ibuprofen was first synthesized by Nicholson and Adamo in 1964, developed as a drug by Boots Pure Drug Co., Ltd., England, and has been utilized mainly as an antipyretic, analgesic and/or antiinflammatory agent. A phenylpropanolamine is a sympathomimetic drug having ephedrine-like pharmacological activities and therapeutic activities for nasal mucus and nasal congestion, and utilized as a drug for rhinitis in nonproprietary drugs. In JP-A-61501913 corresponding to WO85/04589, and in W091/17746, there are disclosed, for instance, pharmaceutical compositions of cold remedies comprising a nonsteroidal antiinflammatory agent such as ibuprofen and the like as an analgesic ingredient, phenylpropanolamine hydrochloride as a decongestive ingredient, dextromethorphan hydrobromide as an antitussive and chlorpheniramine maleate as an antihistamine. These pharmaceutical preparations are prepared by mixing dextromethorphan, ibuprofen and phenylpropanolamine hydrochloride directly with lactose and/or other base without being subjected to stabilization. Web site: http://www.delphion.com/details?pn=US05629316__ •
Transdermally administered dextromethorphan as antitussive agent Inventor(s): Hoeck; Ulla (Hillerod, DK), Kreilgaard; Bo (Hillerod, DK), Kristensen; Helle (Slangerup, DK) Assignee(s): Pharmacia & Upjohn AB (Stockholm, SE) Patent Number: 6,335,030 Date filed: October 23, 1998 Abstract: The present invention is drawn to a device for the transdermal administration of dextromethorphan, (+)-3-methoxy-17-methyl-9a,13a,14a-morphanin, and salts, prodrugs and metabolites thereof, together with a pharmaceutically acceptable carrier, to a human being or animal in need thereof, to achieve an antitussive effect. The present invention is further drawn to a method of achieving an antitussive effect in a human being or animal which comprises transdermally administering dextromethorphan, (+)-
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3-methoxy-17-methyl-9a,13a,14a-morphanin, and salts, prodrugs and metabolites thereof, together with a pharmaceutically acceptable carrier. Excerpt(s): This invention relates to the use of dextromethorphan, optionally encompassing salts, prodrugs and metabolites thereof, for the manufacturing of a medicament to be administered transdermally for achieving an antitussive effect and to methods of treating diseases being treatable with antitussive agents by transdermal administration of dextromethorphan, optionally encompassing salts, prodrugs and metabolites thereof. Dextromethorphan, (+)-3-methoxy-17-methyl-9a,13a,14amorphinan, is a synthetic opioid. Normally the hydrobromide of dextromethorphan is used pharmacologically, although other salts are not excluded. The preparation of (+)-3methoxy-17-methyl-9a,13a,14a-morphinan was disclosed in U.S. Pat. No. 2,676,177 (SCHNIDER ET AL) and in Hafliger et al., Helv. Chil. Acta 39, 1956: 2053. Clinically, in connection with tussometri dextromethorphan has shown a significant effect on reducing coughing frequency as well as intensity compared to placebo at a dosage of 40 mg perorally, an effect of the same order of magnitude as 60 mg codeine, see Mathys, Schweiz Med Wschr 1985;115: 307-11. However dextromethorphan has not shown any antitussive effect upon inhalation of 1-30 mg. Also demethylated metabolites, including dextrorphan, have shown cough suppressing effects, see Martindale, The Pharmaceutical Press, London, 1993: 746. Web site: http://www.delphion.com/details?pn=US06335030__ •
Use of a cytochrome oxidase inhibitor to increase the cough-suppressing activity of dextromorphan Inventor(s): Smith; Richard A. (7569 Cabrillo Ave., La Jolla, CA 92037) Assignee(s): none reported Patent Number: 5,350,756 Date filed: May 28, 1992 Abstract: This invention discloses a method for increasing the effectiveness of dextromethorphan (DM) as an antitussive agent (i.e., as a cough suppressant). This method involves the concurrent administration of DM and a second agent which inhibits the oxidative activity of debrisoquin hydroxylase, a cytochrome P450 oxidase enzyme. Effective anti-oxidant compounds include quinidine, yohimbine, and fluoxetine. Excerpt(s): This invention relates to pharmacology, and to the use of dextromethorphan as a cough suppressant. Dextromethorphan (frequently abbreviated as DM) is the common name for (+)-3-methoxy-N-methylmorphinan. It widely used as a cough syrup, and is described in references such as Rodd 1960 (full citations to articles are provided below) and Goodman and Gilman's Pharmacological Basis of Therapeutics. Briefly, DM is a non-addictive opioid comprising a dextrorotatory enantiomer (mirror image) of the morphinan ring structure which forms the molecular core of most opiates. The coughsuppressing activity of DM is believed to be due primarily to its activity at a class of neuronal receptors known as sigma receptors. These are often referred to as sigma opiate receptors, but there is some question as to whether they are opiate receptors, so many researchers refer to them simply as sigma receptors, or as high-affinity dextromethorphan receptors. They are inhibitory receptors, which means that their activation by DM or other sigma agonists causes the suppression of certain types of nerve signals, apparently including the signals that mediate coughing.
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Web site: http://www.delphion.com/details?pn=US05350756__
Patent Applications on Dextromethorphan As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to dextromethorphan: •
Composition and method for reducing the risk or progression of cardiovascular, glaucoma and tardive dyskinesia diseases Inventor(s): Lang, Philip C.; (Toms River, NJ), Sosnowski, Robert E.; (Manasquan, NJ) Correspondence: Delio & Peterson; 121 Whitney Avenue; New Haven; CT; 06510 Patent Application Number: 20020164388 Date filed: April 30, 2001 Abstract: Elevated levels of homocysteine have been implicated as an important risk factor for cardiovascular and other diseases. A composition for decreasing levels of plasma homocysteine and a method for administering the composition are provided the composition containing dextromethorphan (DM), folic acid and vitamins B.sub.6 and B.sub.12. The composition provides a synergistic therapeutic effect so that lower amounts of the above ingredients may be employed to minimize any undesirable side effects caused by the use of high levels of a component such as DM. Preferred compositions for cardiovascular diseases further include lecithin, vitamin E, betacarotene, procyanidins/flavonoids, trimethylglycine, garlic oil and minerals. Other compositions for treating glaucoma include bilberry, bioflavonoids and beta-carotene and for treating tardive dyskinesia include an antioxidant such as grape seed extract and pine bark extract, lecithin and oligomeric proanthocyanidins. The compositions may be administered using any suitable means such as orally or intravenous. Excerpt(s): The present invention relates to a composition and method for reducing the risk or progression of cardiovascular, glaucoma and tardive dyskinesia diseases and, more particularly, to a composition containing a number of ingredients which are present in amounts lower than amounts considered harmful to the body but which act synergistically to provide enhanced disease inhibition. Cardiovascular disease is the most frequent cause of death in industrialized countries. Atherosclerosis (AS) is the principal cause of cardiovascular disease. AS is a disease of the intima of the arteries that leads to fatty lesions called artheromatous plaques on the inside surface of the arteries. This deposit of fat and cholesterol narrows the arteries, and often becomes calcified, providing sites for abnormal blood clots to form, leading to high blood pressure, heart attacks and strokes. Elevated plasma homocysteine (Hcy) concentrations have repeatedly been associated with increased vascular risk. Hcy causes cells to decrease their production of clot preventing and clot dissolving substances and increases production of clot promoting substances. Hcy is an intermediate sulfhydryl alpha-amino acid formed during conversion of methionine to cysteine. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
6
This has been a common practice outside the United States prior to December 2000.
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Phenylephrine tannate, pyrilamine tannate and dextromethorphan tannate salts in pharmaceutical compositions Inventor(s): Kiel, Jeffrey S.; (Gainesville, GA), Mani, Narasimhan; (Gainesville, GA), Thomas, H. Greg; (Villa Rica, GA) Correspondence: Wood, Herron & Evans, Llp; 2700 Carew Tower; 441 Vine Street; Cincinnati; OH; 45202; US Patent Application Number: 20040132827 Date filed: August 22, 2003 Abstract: Compositions of tannate salts of phenylephrine, pyrilamine, and dextromethorphan produced by a method that allows for the in-situ conversion and incorporation of the tannate salts in a single dosage form. The conversion process includes dissolving salts of phenylephrine, pyrilamine, and dextromethorphan in a solvent and mixing with a dispersing agent and tannic acid to generate tannate salts. The tannate salts may be further processed without further purification or isolation to single dosage forms, such as tablets and suspension. Excerpt(s): This application is a continuation-in-part of U.S. patent application Ser. No. 10/047,578, filed Oct. 26, 2001, by Jeffrey S. Kiel et al., which is hereby incorporated by reference herein in its entirety. The present invention relates generally to the field of tannate chemistry and more specifically to methods for processing phenylephrine tannate, pyrilamine tannate, and dextromethorphan tannate compositions for use in the treatment of coryza and the compositions produced. Pyrilamine, phenylephrine, and dextromethorphan are well known, both in their free base form as well as salts, such as hydrochloride, citrate, maleate, tannate, etc. These compounds, when in the form of tannate salts, are particularly desirable due to their stability. As a result, they may be combined without any untoward side effects. The tannate salts have also been found to have better organoleptic properties such as taste, in comparison to other salts or free base forms of such compounds. In addition, tannate salts are relatively large molecules, which results in absorption over prolonged intervals of time. This reduces the frequency of administration of the compounds and thereby improves patient compliance factors. Due to the above properties, such compounds are amenable to use as active pharmaceutical ingredients in a composition. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Sustained release formulations for nifedipine, dextromethorphan, and danazol Inventor(s): Keller, Brian C.; (Antioch, CA) Correspondence: Bruce D. Grant; Morrison & Foerster Llp; Suite 500; 3811 Valley Centre Drive; San Diego; CA; 92130-2332; US Patent Application Number: 20030003144 Date filed: May 1, 2002 Abstract: Disclosed herein are sustained release formulations of nifedipine and dextromethorphan that are compatible with a soft elastic gelatin capsule and a twopiece hard shell gelatin capsule. It has been discovered that specific lipids in the formulations can spontaneously form multilamellar liposomes upon introduction of the formulation to an aqueous environment. These spontaneously formed liposomes are stable under conditions that simulate the environment of the stomach and upper small
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intestine. The formulations can be administered orally, intra-ocularly, intranasally, rectally, or vaginally. Excerpt(s): This application claims the benefit of the May 1, 2001 filing date for U.S. Application No. 60/287,992, entitled "Sustained Release Formulations for Nifedipine and Dextromethorphan," naming Brian C. Keller as an inventor. This application is incorporated herein by reference. The invention relates to the field of liposome drug delivery systems. The therapeutic effect of an administered substance is usually directly related to the quantity and rate at which the substance reaches the bloodstream. There are many factors that affect the ability of the substance to reach the systemic circulation, including the site of entry into the body, the physical form of the substance, the design of the formulation of the product, various physicochemical properties of the compound and the excipients, and control and maintenance of the location of the substance at the proper absorption site. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •
Therapeutic tannate compositions Inventor(s): Gremminger, Larry J.; (Richmond, TX), Tutag, Robert S.; (Edwards, CO) Correspondence: Blackwell Sanders Peper Martin Llp; 720 Olive Street; Suite 2400; ST. Louis; MO; 63101; US Patent Application Number: 20040033961 Date filed: August 19, 2002 Abstract: The present invention relates to novel therapeutic compositions having pharmaceutically effective amounts of pseudoephedrine tannate and dexchlorpheniramine tannate, as well as, in one embodiment, a pharmaceutically effective amount of dextromethorphan tannate. The present invention also encompasses a method of using the novel therapeutic compositions, above, for symptomatically treating and relieving, among other things, the distress of coryza associated with sinusitis, allergic rhinitis, the common cold, and similar discrasias of the upper respiratory tract in affected patients. Excerpt(s): The present invention relates generally to the field of antihistaminic/decongestant/antitussive tannate compositions. More specifically, the present invention relates to such tannate compositions having as essential active ingredients pseudoephedrine tannate and dexchlorpheniramine tannate. In some embodiments, the present invention relates to such tannate antihistamine compositions having the additional active ingredient dextromethorphan tannate. Many tannic acids, a heterogeneous class of polymers with varying hydroxybenzenecarboxylic acids, occur in nature. In general usage, as in the present case, the terms tannic acid or tannin refer to gallotannic acid, the internal ester of gallic acid. The esters usually contain glucose, or less frequently, other sugars. The color of tannic acid varies from yellowish-white to light brown. Physical forms of the acid vary from amorphous powder to glistening scales or spongy masses. It is very soluble in water, warm glycerol or alcohol. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html
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Keeping Current In order to stay informed about patents and patent applications dealing with dextromethorphan, 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 “dextromethorphan” (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 dextromethorphan. You can also use this procedure to view pending patent applications concerning dextromethorphan. 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 5. BOOKS ON DEXTROMETHORPHAN Overview This chapter provides bibliographic book references relating to dextromethorphan. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on dextromethorphan include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “dextromethorphan” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “dextromethorphan” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “dextromethorphan” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •
Hallucinogens and dissociative drugs : including LSD, PCP, ketamine, dextromethorphan (SuDoc HE 20.3965/2:H 15) by U.S. Dept of Health and Human Services; ISBN: B000114QLM; http://www.amazon.com/exec/obidos/ASIN/B000114QLM/icongroupinterna
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The Official Patient's Sourcebook on Dextromethorphan Dependence: A Revised and Updated Directory for the Internet Age by Icon Health Publications; ISBN: 0597832366; http://www.amazon.com/exec/obidos/ASIN/0597832366/icongroupinterna
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CHAPTER
6.
PERIODICALS AND DEXTROMETHORPHAN
NEWS
ON
Overview In this chapter, we suggest a number of news sources and present various periodicals that cover dextromethorphan.
News Services and Press Releases One of the simplest ways of tracking press releases on dextromethorphan 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 “dextromethorphan” (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 dextromethorphan. 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 “dextromethorphan” (or synonyms). The following was recently listed in this archive for dextromethorphan: •
Claim that dextromethorphan causes birth defects not supported in humans Source: Reuters Industry Breifing Date: February 15, 2001
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•
Avanir licenses dextromethorphan formulation from Irisys Source: Reuters Industry Breifing Date: August 10, 2000
•
Antitussive Dextromethorphan Teratogenic In Chicken Embryos Source: Reuters Medical News Date: January 16, 1998 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 “dextromethorphan” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “dextromethorphan” (or synonyms). If you know the name of a company that is relevant to dextromethorphan, 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/.
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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 “dextromethorphan” (or synonyms).
Academic Periodicals covering Dextromethorphan Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to dextromethorphan. In addition to these sources, you can search for articles covering dextromethorphan 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 dextromethorphan. 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 non-profit 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 dextromethorphan. 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.).
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The following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to dextromethorphan: Cough/Cold Combinations •
Systemic - U.S. Brands: Alka-Seltzer Plus Cold and Cough; Alka-Seltzer Plus Cold and Cough Medicine Liqui-Gels; Alka-Seltzer Plus Night-Time Cold LiquiGels; Ami-Tex LA; Anatuss LA; Benylin Expectorant; Bromfed-DM; Broncholate; Carbinoxamine Compound-Drops; Cardec DM; Children's Tylenol Cold Plus Cough Multi Symptom; Co-Apap; Comtrex Daytime Maximum Strength Cold and Flu Relief; Comtrex Daytime Maximum Strength Cold, Cough, and Flu Relief; Comtrex Multi-Symptom Maximum Strength Non-Drowsy Caplets; Comtrex Nighttime Maximum Strength Cold and Flu Relief; Congestac Caplets; Contac Cold/Flu Day Caplets; Contac Severe Cold and Flu Caplets; Co-Tuss V; Deconsal II; Despec; Despec-SR Caplets; Donatussin; Donatussin DC; Duratuss; Duratuss HD; ED Tuss HC; ED-TLC; Endagen-HD; Endal Expectorant; Entex LA; Father John's Medicine Plus; Genatuss DM; GP-500; Guaifed; Guaifenex PSE 120; Guaifenex PSE 60; GuaiMAX-D; Guai-Vent/PSE; Guiatuss A.C.; Guiatuss CF; Guiatuss DAC; Guiatuss PE; Histinex HC; Histinex PV; Hycodan; Hycomine Compound; Hydropane; Iobid DM; Iodal HD; Iosal II; Iotussin HC; Kolephrin GG/DM; Kolephrin/DM Cough and Cold Medication; Kwelcof Liquid; Mapap Cold Formula; Marcof Expectorant; Nalex DH; Novahistine DH Liquid; Nucofed Expectorant; Nucofed Pediatric Expectorant; Nucotuss Expectorant; Nucotuss Pediatric Expectorant; Nytcold Medicine; Nytime Cold Medicine Liquid; Ornex Severe Cold No Drowsiness Caplets; PanMist-JR; PediaCare Cough-Cold; PediaCare Night Rest Cough-Cold Liquid; Pediacof Cough; Phanatuss; Phenameth VC; Phenergan VC with Codeine; Phenergan with Codeine; Phenergan with Dextromethorphan; Pneumotussin HC; Poly-Histine; Primatuss Cough Mixture 4; Primatuss Cough Mixture 4D; Profen II; Prometh VC with Codeine; Promethazine DM; Promethazine VC w/Codeine; Protuss-D; PseudoCar DM; P-V-Tussin; Quelidrine Cough; Rentamine Pediatric; Rescon-DM; Rescon-GG; Respa-1st; Respa-DM; Respaire-120 SR; Respaire-60 SR; RhinosynDM; Rhinosyn-DMX Expectorant; Rhinosyn-X; Robafen AC Cough; Robafen DAC; Robafen DM; Robitussin A-C; Robitussin Cold and Cough Liqui-Gels; Robitussin Cold, Cough and Flu Liqui-Gels; Robitussin Night Relief; Robitussin Night-Time Cold Formula; Robitussin Pediatric Cough and Cold; Robitussin Severe Congestion Liqui-Gels; Robitussin-DAC; Robitussin-DM; Robitussin-PE; Rondamine-DM Drops; Rondec-DM; Rondec-DM Drops; Ru-Tuss DE; Ru-Tuss Expectorant; Ryna-C Liquid; Ryna-CX Liquid; Rynatuss; Rynatuss Pediatric; Safe Tussin 30; Scot-Tussin DM; Scot-Tussin Senior Clear; Sildec-DM; Silexin Cough; Siltussin DM; Sinufed Timecelles; Sinutab Non-Drying No Drowsiness Liquid Caps; S-T Forte 2; Stamoist E; Statuss Green; Sudafed Children's Cold and Cough; Sudafed Children's Non-Drowsy Cold and Cough; Sudafed Cold and Cough Liquid Caps; Sudal 60/500; Syracol CF; TheraFlu Flu, Cold and Cough Medicine; TheraFlu Maximum Strength Non-Drowsy Formula Flu, Cold and Cough Medicine; TheraFlu Maximum Strength Non-Drowsy Formula Flu, Cold and Cough Medicine Caplets; TheraFlu Nighttime Maximum Strength Flu, Cold and Cough; Tolu-Sed DM; Touro DM; Touro LA Caplets; Triacin C Cough; Triafed w/Codeine; Triaminic AM Non-Drowsy Cough and Decongestant; Triaminic Night Time; Triaminic Sore Throat Formula; Tri-Tannate Plus Pediatric; Tussafed; Tussafed Drops; Tussar DM; Tussigon; Tussionex Pennkinetic; Tussi-Organidin DM NR Liquid; Tussi-Organidin DM-S NR Liquid;
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Tussi-Organidin NR Liquid; Tussi-Organidin-S NR Liquid; Tussirex; Tuss-LA; Tusso-DM; Tylenol Cold and Flu No Drowsiness Powder; Tylenol Cold Medication; Tylenol Cold Medication Caplets; Tylenol Cold Medication, NonDrowsy Caplets; Tylenol Cold Medication, Non-Drowsy Gelcaps; Tylenol Cold Multi-Symptom; Tylenol Maximum Strength Flu Gelcaps; Tylenol MultiSymptom Cough; Uni-tussin DM; Vanex-HD; V-Dec-M; Versacaps; Vicks 44 Cough and Cold Relief Non-Drowsy LiquiCaps; Vicks 44D Cough and Head Congestion; Vicks 44E Cough and Chest Congestion; Vicks 44M Cough, Cold and Flu Relief; Vicks Children's Cough Syrup; Vicks Children's NyQuil Cold/Cough Relief; Vicks DayQuil Multi-Symptom Cold/Flu LiquiCaps; Vicks DayQuil Multi-Symptom Cold/Flu Relief; Vicks NyQuil Hot Therapy; Vicks NyQuil Multi-Symptom Cold/Flu LiquiCaps; Vicks NyQuil Multi-Symptom Cold/Flu Relief; Vicks Pediatric 44D Cough and Head Decongestion; Vicks Pediatric 44M Multi-Symptom Cough and Cold; Vicodin Tuss; Zephrex; Zephrex-LA http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202165.html Dextromethorphan •
Systemic - U.S. Brands: Benylin Adult Formula Cough Syrup; Benylin Pediatric Cough Suppressant; Cough-X; Creo-Terpin; Delsym Cough Formula; DiabeTUSS DM Syrup; Hold DM; Pertussin DM Extra Strength; Pertussin CS Children's Strength; Robitussin Maximum Strength Cough Suppressant; Robitussin Pediatric Cough Suppressant; Sucrets 4 Hour Cough Suppressant; Trocal; Vicks 44 Cough Relief http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202187.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.
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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
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
•
National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
•
National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
•
National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
•
National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
•
National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
•
National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
•
National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
7
These publications are typically written by one or more of the various NIH Institutes.
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•
National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
•
National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
•
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
•
National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
•
National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
•
National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
•
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
•
National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
•
National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
•
National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
•
National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
•
National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
•
National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
•
Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
•
National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
•
National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
•
Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
•
Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
•
HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
•
NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
•
Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
•
Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
•
Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
•
Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
•
Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
•
Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
•
Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
•
MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
8
Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
•
Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “dextromethorphan” (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 1637 0 193 6 14 1850
HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “dextromethorphan” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
10
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
11
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
•
Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
15 Adapted 16
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on dextromethorphan can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internetbased 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 dextromethorphan. 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 dextromethorphan. 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 “dextromethorphan”:
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Herbal Medicine http://www.nlm.nih.gov/medlineplus/herbalmedicine.html Teen Health http://www.nlm.nih.gov/medlineplus/teenhealth.html Voice Disorders http://www.nlm.nih.gov/medlineplus/voicedisorders.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to dextromethorphan. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
•
Family Village: http://www.familyvillage.wisc.edu/specific.htm
•
Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
•
Med Help International: http://www.medhelp.org/HealthTopics/A.html
•
Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
•
Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
•
WebMD®Health: http://my.webmd.com/health_topics
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Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to dextromethorphan. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with dextromethorphan. 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 dextromethorphan. 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 “dextromethorphan” (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 “dextromethorphan”. 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 “dextromethorphan” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months.
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The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “dextromethorphan” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
18
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
•
Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
•
California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
•
California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
•
California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
•
California: Gateway Health Library (Sutter Gould Medical Foundation)
•
California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
•
California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
•
California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
•
California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
•
California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
•
California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
•
California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
•
California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
•
Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
•
Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
19
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
•
Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
•
Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
•
Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
•
Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
•
Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
•
Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
•
Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
•
Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
•
Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
•
Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
•
Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
•
Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
•
Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
•
Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
•
Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
•
Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
•
Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
•
Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
•
Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
•
Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
•
Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
•
Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
•
Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
•
Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
•
Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
•
Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
•
Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
•
Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
•
Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
•
Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
•
Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
•
Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
•
National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
•
National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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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/
•
New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
•
New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
•
New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
•
New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
•
New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
•
New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
•
Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
•
Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
•
Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on dextromethorphan: •
Basic Guidelines for Dextromethorphan Dextromethorphan overdose Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002628.htm
•
Signs & Symptoms for Dextromethorphan Bluish colored fingernails and lips Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003215.htm Drowsiness Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003208.htm Emesis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Hallucinations Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm
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Low blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003083.htm Muscle spasticity Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm No breathing Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003069.htm Spasms Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003193.htm Weak pulse Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003078.htm •
Diagnostics and Tests for Dextromethorphan Gastric lavage Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003882.htm
•
Background Topics for Dextromethorphan Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Breathing shallow Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm Breathing slow and labored Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000007.htm Intravenous Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002383.htm Respiratory Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002290.htm
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
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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
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•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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DEXTROMETHORPHAN DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. 5-hydroxyindoleacetic acid: 5HIAA. A break-down product of serotonin that is excreted in the urine. Serotonin is a hormone found in high levels in many body tissues. Serotonin and 5HIAA are produced in excess amounts by carcinoid tumors, and levels of these substances may be measured in the urine to test for carcinoid tumors. [NIH] Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Ablation: The removal of an organ by surgery. [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] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acetaminophen: Analgesic antipyretic derivative of acetanilide. It has weak antiinflammatory properties and is used as a common analgesic, but may cause liver, blood cell, and kidney damage. [NIH] 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] Acoustic: Having to do with sound or hearing. [NIH] Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] 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] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a
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synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, oxidative metabolism, or cell respiration. [NIH] Aerobic Respiration: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as oxidative metabolism, cell respiration, or aerobic metabolism. [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 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] 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] Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] 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] Alleles: Mutually exclusive forms of the same gene, occupying the same locus on homologous chromosomes, and governing the same biochemical and developmental process. [NIH]
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Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Almitrine: A respiratory stimulant that enhances respiration by acting as an agonist of peripheral chemoreceptors located on the carotid bodies. The drug increases arterial oxygen tension while decreasing arterial carbon dioxide tension in patients with chronic obstructive pulmonary disease. It may also prove useful in the treatment of nocturnal oxygen desaturation without impairing the quality of sleep. [NIH] Alpha-1: A protein with the property of inactivating proteolytic enzymes such as leucocyte collagenase and elastase. [NIH] Alprenolol: 1-((1-Methylethyl)amino)-3-(2-(2-propenyl)phenoxy)-2-propanol. Adrenergic beta-blocker used as an antihypertensive, anti-anginal, and anti-arrhythmic agent. [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] Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility. [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 many other compounds. [EU] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amiodarone: An antianginal and antiarrhythmic drug. It increases the duration of ventricular and atrial muscle action by inhibiting Na,K-activated myocardial adenosine triphosphatase. There is a resulting decrease in heart rate and in vascular resistance. [NIH] Amitriptyline: Tricyclic antidepressant with anticholinergic and sedative properties. It appears to prevent the re-uptake of norepinephrine and serotonin at nerve terminals, thus potentiating the action of these neurotransmitters. Amitriptyline also appears to antaganize cholinergic and alpha-1 adrenergic responses to bioactive amines. [NIH] 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] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile
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sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anaphylaxis: An acute hypersensitivity reaction due to exposure to a previously encountered antigen. The reaction may include rapidly progressing urticaria, respiratory distress, vascular collapse, systemic shock, and death. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Androgenic: Producing masculine characteristics. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Anesthetics: Agents that are capable of inducing a total or partial loss of sensation, especially tactile sensation and pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site. [NIH] Angina: Chest pain that originates in the heart. [NIH] Angina Pectoris: The symptom of paroxysmal pain consequent to myocardial ischemia usually of distinctive character, location and radiation, and provoked by a transient stressful situation during which the oxygen requirements of the myocardium exceed the capacity of the coronary circulation to supply it. [NIH] Anginal: Pertaining to or characteristic of angina. [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] Annealing: The spontaneous alignment of two single DNA strands to form a double helix. [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] Antianginal: Counteracting angina or anginal conditions. [EU] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibody: A type of protein made by certain white blood cells in response to a foreign
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substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticholinergic: An agent that blocks the parasympathetic nerves. Called also parasympatholytic. [EU] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]
Antiepileptic: An agent that combats epilepsy. [EU] Antifungal: Destructive to fungi, or suppressing their reproduction or growth; effective against fungal infections. [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] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Antihistamine: A drug that counteracts the action of histamine. The antihistamines are of two types. The conventional ones, as those used in allergies, block the H1 histamine receptors, whereas the others block the H2 receptors. Called also antihistaminic. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [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
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and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antitussive: An agent that relieves or prevents cough. [EU] Antitussive Agents: Agents that suppress cough. They act centrally on the medullary cough center. Expectorants, also used in the treatment of cough, act locally. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Aorta: The main trunk of the systemic arteries. [NIH] Apnea: A transient absence of spontaneous respiration. [NIH] Apoptosis: One of the two mechanisms by which cell death occurs (the other being the pathological process of necrosis). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA (DNA fragmentation) at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Aspartate: A synthetic amino acid. [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] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH]
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Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autoimmune Hepatitis: A liver disease caused when the body's immune system destroys liver cells for no known reason. [NIH] Autoradiography: A process in which radioactive material within an object produces an image when it is in close proximity to a radiation sensitive emulsion. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Barbiturate: A drug with sedative and hypnotic effects. Barbiturates have been used as sedatives and anesthetics, and they have been used to treat the convulsions associated with epilepsy. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [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]
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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] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]
Benign prostatic hyperplasia: A benign (noncancerous) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hypertrophy or BPH. [NIH] Benzocaine: A surface anesthetic that acts by preventing transmission of impulses along nerve fibers and at nerve endings. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Benzoic Acid: A fungistatic compound that is widely used as a food preservative. It is conjugated to glycine in the liver and excreted as hippuric acid. [NIH] Benzydamine: An analgesic, antipyretic, and anti-inflammatory agent used to reduce postsurgical and post-traumatic pain and edema and to promote healing. It is also used topically in treatment of rheumatic disease and inflammation of the mouth and throat. [NIH] Bilateral: Affecting both the right and left side of 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] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [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] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] 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]
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Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [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] Brain Hypoxia: Lack of oxygen leading to unconsciousness. [NIH] Brain Infarction: The formation of an area of necrosis in the brain, including the cerebral hemispheres (cerebral infarction), thalami, basal ganglia, brain stem (brain stem infarctions), or cerebellum secondary to an insufficiency of arterial or venous blood flow. [NIH] Brain Ischemia: Localized reduction of blood flow to brain tissue due to arterial obtruction or systemic hypoperfusion. This frequently occurs in conjuction with brain hypoxia. Prolonged ischemia is associated with brain infarction. [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] Bronchitis: Inflammation (swelling and reddening) of the bronchi. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bulking Agents: Laxatives that make bowel movements soft and easy to pass. [NIH] Bupivacaine: A widely used local anesthetic agent. [NIH] Buprenorphine: A derivative of the opioid alkaloid thebaine that is a more potent and longer lasting analgesic than morphine. It appears to act as a partial agonist at mu and kappa opioid receptors and as an antagonist at delta receptors. The lack of delta-agonist
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activity has been suggested to account for the observation that buprenorphine tolerance may not develop with chronic use. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Butorphanol: A synthetic morphinan analgesic with narcotic antagonist action. It is used in the management of severe pain. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] 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 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] Cannabidiol: Compound isolated from Cannabis sativa extract. [NIH] Cannabinoids: Compounds extracted from Cannabis sativa L. and metabolites having the cannabinoid structure. The most active constituents are tetrahydrocannabinol, cannabinol, and cannabidiol. [NIH] Cannabinol: A physiologically inactive constituent of Cannabis sativa L. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [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] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoid: A type of tumor usually found in the gastrointestinal system (most often in the
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appendix), and sometimes in the lungs or other sites. Carcinoid tumors are usually benign. [NIH]
Cardiac: Having to do with the heart. [NIH] Cardiac Output: The volume of blood passing through the heart per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with stroke volume (volume per beat). [NIH] Cardiopulmonary: Having to do with the heart and lungs. [NIH] Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs. [NIH] Cardiotonic: 1. Having a tonic effect on the heart. 2. An agent that has a tonic effect on the heart. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [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] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catalyse: To speed up a chemical reaction. [EU] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from intubation in that the tube here is used to restore or maintain patency in obstructions. [NIH] Cation Exchange Resins: High molecular weight insoluble polymers which contain functional cationic groups that are capable of undergoing exchange reactions; used in various types of chromatography; also to treat hyperkalemia. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH]
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Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [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] Centrifugation: A method of separating organelles or large molecules that relies upon differential sedimentation through a preformed density gradient under the influence of a gravitational field generated in a centrifuge. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] 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] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] 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] 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] Chemoprevention: The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer. [NIH] Chemoreceptors: Cells specialized to detect chemical substances and relay that information centrally in the nervous system. Chemoreceptors may monitor external stimuli, as in taste and olfaction, or internal stimuli, such as the concentrations of oxygen and carbon dioxide in the blood. [NIH] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest wall: The ribs and muscles, bones, and joints that make up the area of the body between the neck and the abdomen. [NIH]
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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] Chlorpheniramine: A histamine H1 antagonist used in allergic reactions, hay fever, rhinitis, urticaria, and asthma. It has also been used in veterinary applications. One of the most widely used of the classical antihistaminics, it generally causes less drowsiness and sedation than promethazine. [NIH] Chlorpromazine: The prototypical phenothiazine antipsychotic drug. Like the other drugs in this class chlorpromazine's antipsychotic actions are thought to be due to long-term adaptation by the brain to blocking dopamine receptors. Chlorpromazine has several other actions and therapeutic uses, including as an antiemetic and in the treatment of intractable hiccup. [NIH] Cholecystectomy: Surgical removal of the gallbladder. [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] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Cholinesterase Inhibitors: Drugs that inhibit cholinesterases. The neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. When cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. Cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system. [NIH] Chorda Tympani Nerve: A branch of the facial (7th cranial) nerve which passes through the middle ear and continues through the petrotympanic fissure. The chorda tympani nerve carries taste sensation from the anterior two-thirds of the tongue and conveys parasympathetic efferents to the salivary glands. [NIH] Chromatin: The material of chromosomes. It is a complex of DNA, histones, and nonhistone proteins (chromosomal proteins, non-histone) found within the nucleus of a cell. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Obstructive Pulmonary Disease: Collective term for chronic bronchitis and emphysema. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU]
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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] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Coenzymes: Substances that are necessary for the action or enhancement of action of an enzyme. Many vitamins are coenzymes. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] 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
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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] Compress: A plug used to occludate an orifice in the control of bleeding, or to mop up secretions; an absorbent pad. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computer Simulation: Computer-based representation of physical systems and phenomena such as chemical processes. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the formation of a viable zygote. [EU] Conduction: The transfer of sound waves, heat, nervous impulses, or electricity. [EU] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions. [NIH] Consultation: A deliberation between two or more physicians concerning the diagnosis and the proper method of treatment in a case. [NIH] Contraceptive: An agent that diminishes the likelihood of or prevents conception. [EU] 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]
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Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [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 heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cortisone: A natural steroid hormone produced in the adrenal gland. It can also be made in the laboratory. Cortisone reduces swelling and can suppress immune responses. [NIH] Coryza: Profuse discharge from the mucous membrane of the nose. [NIH] Coumarin: A fluorescent dye. [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] Curare: Plant extracts from several species, including Strychnos toxifera, S. castelnaei, S. crevauxii, and Chondodendron tomentosum, that produce paralysis of skeletal muscle and are used adjunctively with general anesthesia. These extracts are toxic and must be used with the administration of artificial respiration. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cyclosporine: A drug used to help reduce the risk of rejection of organ and bone marrow transplants by the body. It is also used in clinical trials to make cancer cells more sensitive to anticancer drugs. [NIH]
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Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]
Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Dairy Products: Raw and processed or manufactured milk and milk-derived products. These are usually from cows (bovine) but are also from goats, sheep, reindeer, and water buffalo. [NIH] Danazol: A synthetic steroid with antigonadotropic and anti-estrogenic activities that acts as an anterior pituitary suppressant by inhibiting the pituitary output of gonadotropins. It possesses some androgenic properties. Danazol has been used in the treatment of endometriosis and some benign breast disorders. [NIH] Debrisoquin: An adrenergic neuron-blocking drug similar in effects to guanethidine. It is also noteworthy in being a substrate for a polymorphic cytochrome P-450 enzyme. Persons with certain isoforms of this enzyme are unable to properly metabolize this and many other clinically important drugs. They are commonly referred to as having a debrisoquin 4hydroxylase polymorphism. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decongestant: An agent that reduces congestion or swelling. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deletion: A genetic rearrangement through loss of segments of DNA (chromosomes), bringing sequences, which are normally separated, into close proximity. [NIH] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Demethylation: Process that releases substantial amounts of carbon dioxide in the liver. [NIH]
Denaturation: Rupture of the hydrogen bonds by heating a DNA solution and then cooling it rapidly causes the two complementary strands to separate. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three
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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] 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] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Dermatitis: Any inflammation of the skin. [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] Dermographia: A condition in which pressure or friction on the skin gives rise to a transient raised usually reddish mark so that a word traced on the skin becomes visible. [EU] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Dexmedetomidine: A selective inhibitor of receptors, adrenergic alpha-2 that has analgesic and sedative properties. Medetomidine is the other racemic form. [NIH] Dextrorotatory: Turning towards the right hand. [NIH] Dextrorphan: Dextro form of levorphanol. It acts as a noncompetitive NMDA receptor antagonist, among other effects, and has been proposed as a neuroprotective agent. It is also a metabolite of dextromethorphan. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dihydrotestosterone: Anabolic agent. [NIH] Dilantin: A drug that is often used to control seizures. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Dipeptides: Peptides composed of two amino acid units. [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] Diploid: Having two sets of chromosomes. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU]
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Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Dissociative Disorders: Sudden temporary alterations in the normally integrative functions of consciousness. [NIH] 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] Donepezil: A drug used in the treatment of Alzheimer's disease. It belongs to the family of drugs called cholinesterase inhibitors. It is being studied as a treatment for side effects caused by radiation therapy to the brain. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific
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treatment. [NIH] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Doxylamine: Histamine H1 antagonist with pronounced sedative properties. It is used in allergies and as an antitussive, antiemetic, and hypnotic. Doxylamine has also been administered in veterinary applications and was formerly used in parkinsonism. [NIH] Drug Delivery Systems: Systems of administering drugs through controlled delivery so that an optimum amount reaches the target site. Drug delivery systems encompass the carrier, route, and target. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dura mater: The outermost, toughest, and most fibrous of the three membranes (meninges) covering the brain and spinal cord; called also pachymeninx. [EU] Dyes: Chemical substances that are used to stain and color other materials. The coloring may or may not be permanent. Dyes can also be used as therapeutic agents and test reagents in medicine and scientific research. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysphagia: Difficulty in swallowing. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dystonia: Disordered tonicity of muscle. [EU] Dysuria: Painful or difficult urination. [EU] Echinacea: A genus of perennial herbs used topically and internally. It contains echinacoside, glycosides, inulin, isobutyl amides, resin, and sesquiterpenes. [NIH] 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] Electrode: Component of the pacing system which is at the distal end of the lead. It is the interface with living cardiac tissue across which the stimulus is transmitted. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in
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all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]
Electroplating: Coating with a metal or alloy by electrolysis. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Emulsion: A preparation of one liquid distributed in small globules throughout the body of a second liquid. The dispersed liquid is the discontinuous phase, and the dispersion medium is the continuous phase. When oil is the dispersed liquid and an aqueous solution is the continuous phase, it is known as an oil-in-water emulsion, whereas when water or aqueous solution is the dispersed phase and oil or oleaginous substance is the continuous phase, it is known as a water-in-oil emulsion. Pharmaceutical emulsions for which official standards have been promulgated include cod liver oil emulsion, cod liver oil emulsion with malt, liquid petrolatum emulsion, and phenolphthalein in liquid petrolatum emulsion. [EU] Encainide: An effective and generally well-tolerated anti-arrhythmia agent for suppressing all forms of ventricular arrhythmia. Paradoxically, however, in myocardial infarct patients with either symptomatic or asymptomatic arrhythmia, encainide exacerbates the arrhythmia and is not recommended for use in these patients. The drug is a potent blocker of sodium channels and produces marked slowing of conduction within the His-Purkinje system and myocardium. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH]
Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometriosis: A condition in which tissue more or less perfectly resembling the uterine mucous membrane (the endometrium) and containing typical endometrial granular and stromal elements occurs aberrantly in various locations in the pelvic cavity. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH]
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Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] Enhancers: Transcriptional element in the virus genome. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Ephedrine: An alpha- and beta-adrenergic agonist that may also enhance release of norepinephrine. It has been used in the treatment of several disorders including asthma, heart failure, rhinitis, and urinary incontinence, and for its central nervous system stimulatory effects in the treatment of narcolepsy and depression. It has become less extensively used with the advent of more selective agonists. [NIH] Epidural: The space between the wall of the spinal canal and the covering of the spinal cord. An epidural injection is given into this space. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [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] Escalation: Progressive use of more harmful drugs. [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] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evoke: The electric response recorded from the cerebral cortex after stimulation of a
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peripheral sense organ. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Excitatory Amino Acid Agonists: Drugs that bind to and activate excitatory amino acid receptors. [NIH] Excitatory Amino Acids: Endogenous amino acids released by neurons as excitatory neurotransmitters. Glutamic acid is the most common excitatory neurotransmitter in the brain. Aspartic acid has been regarded as an excitatory transmitter for many years, but the extent of its role as a transmitter is unclear. [NIH] Excitotoxicity: Excessive exposure to glutamate or related compounds can kill brain neurons, presumably by overstimulating them. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU]
Expiration: The act of breathing out, or expelling air from the lungs. [EU] Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Facial Neuralgia: Neuralgic syndromes and other conditions which feature chronic or recurrent facial pain as the primary manifestation of disease. Disorders of the trigeminal and facial nerves are frequently associated with these conditions. [NIH] Facial Pain: Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic
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syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as facial pain syndromes. [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Femoral: Pertaining to the femur, or to the thigh. [EU] Femoral Artery: The main artery of the thigh, a continuation of the external iliac artery. [NIH] Fentanyl: A narcotic opioid drug that is used in the treatment of pain. [NIH] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fertilizers: Substances or mixtures that are added to the soil to supply nutrients or to make available nutrients already present in the soil, in order to increase plant growth and productivity. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Flatus: Gas passed through the rectum. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Foetal: Of or pertaining to a fetus; pertaining to in utero development after the embryonic period. [EU] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH]
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Friction: Surface resistance to the relative motion of one body against the rubbing, sliding, rolling, or flowing of another with which it is in contact. [NIH] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Fungus: A general term used to denote a group of eukaryotic protists, including mushrooms, yeasts, rusts, moulds, smuts, etc., which are characterized by the absence of chlorophyll and by the presence of a rigid cell wall composed of chitin, mannans, and sometimes cellulose. They are usually of simple morphological form or show some reversible cellular specialization, such as the formation of pseudoparenchymatous tissue in the fruiting body of a mushroom. The dimorphic fungi grow, according to environmental conditions, as moulds or yeasts. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallic Acid: A colorless or slightly yellow crystalline compound obtained from nutgalls. It is used in photography, pharmaceuticals, and as an analytical reagent. [NIH] Gamma-hydroxybutyrate: Anxiolytic. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]
Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [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 Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH]
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Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genital: Pertaining to the genitalia. [EU] Genitourinary: Pertaining to the genital and urinary organs; urogenital; urinosexual. [EU] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Ginseng: An araliaceous genus of plants that contains a number of pharmacologically active agents used as stimulants, sedatives, and tonics, especially in traditional medicine. [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] Glare: Scatter from bright light that decreases vision. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU]
Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucocorticoid: A compound that belongs to the family of compounds called corticosteroids (steroids). Glucocorticoids affect metabolism and have anti-inflammatory and immunosuppressive effects. They may be naturally produced (hormones) or synthetic (drugs). [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]
Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH]
Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoprotein: A protein that has sugar molecules attached to it. [NIH] Goats: Any of numerous agile, hollow-horned ruminants of the genus Capra, closely related to the sheep. [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
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microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Guanethidine: An antihypertensive agent that acts by inhibiting selectively transmission in post-ganglionic adrenergic nerves. It is believed to act mainly by preventing the release of norepinephrine at nerve endings and causes depletion of norepinephrine in peripheral sympathetic nerve terminals as well as in tissues. [NIH] Gynaecological: Pertaining to gynaecology. [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] Hallucinogen: A hallucination-producing drug, a category of drugs producing this effect. The user of a hallucinogenic drug is almost invariably aware that what he is seeing are hallucinations. [NIH] Haloperidol: Butyrophenone derivative. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Hay Fever: A seasonal variety of allergic rhinitis, marked by acute conjunctivitis with lacrimation and itching, regarded as an allergic condition triggered by specific allergens. [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 attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heart failure: Loss of pumping ability by the heart, often accompanied by fatigue, breathlessness, and excess fluid accumulation in body tissues. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] 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] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemorrhoidectomy: An operation to remove hemorrhoids. [NIH]
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Hemorrhoids: Varicosities of the hemorrhoidal venous plexuses. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Hepatic: Refers to the liver. [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heroin Dependence: Strong dependence, both physiological and emotional, upon heroin. [NIH]
Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]
Hexylresorcinol: A substituted dihydroxybenzene that is used topically as an antiseptic for the treatment of minor skin infections. [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] 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] Hydrobromic Acid: Hydrobromic acid (HBr). A solution of hydrogen bromide gas in water. [NIH]
Hydrocodone: Narcotic analgesic related to codeine, but more potent and more addicting by weight. It is used also as cough suppressant. [NIH] Hydrofluoric Acid: A solution of hydrogen fluoride in water. It is a colorless fuming liquid which can cause painful burns. [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]
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Hydromorphone: An opioid analgesic made from morphine and used mainly as an analgesic. It has a shorter duration of action than morphine. [NIH] Hydroxylation: Hydroxylate, to introduce hydroxyl into (a compound or radical) usually by replacement of hydrogen. [EU] Hyperalgesia: Excessive sensitiveness or sensibility to pain. [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] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypoxanthine: A purine and a reaction intermediate in the metabolism of adenosine and in the formation of nucleic acids by the salvage pathway. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Hysterectomy: Excision of the uterus. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Immunology: The study of the body's immune system. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] 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 vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisional: The removal of a sample of tissue for examination under a microscope. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence)
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or the escape of stool from the rectum (fecal incontinence). [NIH] Indinavir: A potent and specific HIV protease inhibitor that appears to have good oral bioavailability. [NIH] Indocyanine Green: A tricarbocyanine dye that is used diagnostically in liver function tests and to determine blood volume and cardiac output. [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] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infantile: Pertaining to an infant or to infancy. [EU] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be 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] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [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] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Interstitial: Pertaining to or situated between parts or in the interspaces of a tissue. [EU] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intraindividual: Being or occurring within the individual. [EU] Intramuscular: IM. Within or into muscle. [NIH]
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Intrathecal: Describes the fluid-filled space between the thin layers of tissue that cover the brain and spinal cord. Drugs can be injected into the fluid or a sample of the fluid can be removed for testing. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Intubation: Introduction of a tube into a hollow organ to restore or maintain patency if obstructed. It is differentiated from catheterization in that the insertion of a catheter is usually performed for the introducing or withdrawing of fluids from the body. [NIH] Inulin: A starch found in the tubers and roots of many plants. Since it is hydrolyzable to fructose, it is classified as a fructosan. It has been used in physiologic investigation for determination of the rate of glomerular function. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ion Exchange: Reversible chemical reaction between a solid, often an ION exchange resin, and a fluid whereby ions may be exchanged from one substance to another. This technique is used in water purification, in research, and in industry. [NIH] Ion Exchange Resins: High molecular weight, insoluble polymers which contain functional groups that are capable of undergoing exchange reactions (ion exchange) with either cations or anions. [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] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isozymes: The multiple forms of a single enzyme. [NIH] Isradipine: 4-(4-Benzofurazanyl)-1,4-dihydro-2,6-dimethyl-3,5-pyridinedicarboxylic acid methyl 1-methyl ethyl ester. A potent calcium channel antagonist that is highly selective for vascular smooth muscle. It is effective in the treatment of chronic stable angina pectoris, hypertension, and congestive cardiac failure. [NIH] Kainic Acid: (2S-(2 alpha,3 beta,4 beta))-2-Carboxy-4-(1-methylethenyl)-3-pyrrolidineacetic acid. Ascaricide obtained from the red alga Digenea simplex. It is a potent excitatory amino acid agonist at some types of excitatory amino acid receptors and has been used to discriminate among receptor types. Like many excitatory amino acid agonists it can cause neurotoxicity and has been used experimentally for that purpose. [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] Ketamine: A cyclohexanone derivative used for induction of anesthesia. Its mechanism of action is not well understood, but ketamine can block NMDA receptors (receptors, NMethyl-D-Aspartate) and may interact with sigma receptors. [NIH] Keto: It consists of 8 carbon atoms and within the endotoxins, it connects poysaccharide and lipid A. [NIH] Ketotifen: A cycloheptathiophene that interferes with the release of inflammatory mediators and blocks histamine H1 receptors. It has been proposed as an anti-asthmatic and for the
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treatment of rhinitis, skin allergies, and anaphylaxis. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Kynurenic Acid: A broad-spectrum excitatory amino acid antagonist used as a research tool. [NIH]
Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Laparotomy: A surgical incision made in the wall of the abdomen. [NIH] 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] Laryngeal: Having to do with the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leukemia: Cancer of blood-forming tissue. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Lidocaine: A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [NIH] Ligament: A band of fibrous tissue that connects bones or cartilages, serving to support and strengthen joints. [EU] Ligands: A RNA simulation method developed by the MIT. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Liposome: A spherical particle in an aqueous medium, formed by a lipid bilayer enclosing an aqueous compartment. [EU] 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
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and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Lubricants: Oily or slippery substances. [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] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignancy: A cancerous tumor that can invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] 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 Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [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]
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Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Memantine: Amantadine derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Meningitis: Inflammation of the meninges. When it affects the dura mater, the disease is termed pachymeningitis; when the arachnoid and pia mater are involved, it is called leptomeningitis, or meningitis proper. [EU] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [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] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]
Menthol: An alcohol produced from mint oils or prepared synthetically. [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] Mephenytoin: An anticonvulsant effective in tonic-clonic epilepsy. It may cause blood dyscrasias. [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] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Methylprednisolone: (6 alpha,11 beta)-11,17,21-Trihydroxy-6-methylpregna-1,4-diene-3,2dione. A prednisolone derivative which has pharmacological actions similar to prednisolone. [NIH]
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Metoprolol: Adrenergic beta-1-blocking agent with no stimulatory action. It is less bound to plasma albumin than alprenolol and may be useful in angina pectoris, hypertension, or cardiac arrhythmias. [NIH] Mexiletine: Antiarrhythmic agent pharmacologically similar to lidocaine. It may have some anticonvulsant properties. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] 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] Microsomal: Of or pertaining to microsomes : vesicular fragments of endoplasmic reticulum formed after disruption and centrifugation of cells. [EU] Microsome: One of the specific metabolic pathways of the liver. [NIH] Milligram: A measure of weight. A milligram is approximately 450,000-times smaller than a pound and 28,000-times smaller than an ounce. [NIH] Mitosis: A method of indirect cell division by means of which the two daughter nuclei normally receive identical complements of the number of chromosomes of the somatic cells of the species. [NIH] Moclobemide: A reversible inhibitor of monoamine oxidase type A (RIMA) that has antidepressive properties. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Modified radical mastectomy: Surgery for breast cancer in which the breast, some of the lymph nodes under the arm, the lining over the chest muscles, and sometimes part of the chest wall muscles are removed. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] 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] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH]
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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] Morphine Dependence: Strong dependence, both physiological and emotional, upon morphine. [NIH] Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [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] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Motor Cortex: Area of the frontal lobe concerned with primary motor control. It lies anterior to the central sulcus. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]
Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] 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] Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [NIH] Muscle tension: A force in a material tending to produce extension; the state of being stretched. [NIH] Mydriatic: 1. Dilating the pupil. 2. Any drug that dilates the pupil. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH]
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Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Narcotic Antagonists: Agents inhibiting the effect of narcotics on the central nervous system. [NIH] 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] Nearsightedness: The common term for myopia. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neocortex: The largest portion of the cerebral cortex. It is composed of neurons arranged in six layers. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Nerve Endings: Specialized terminations of peripheral neurons. Nerve endings include neuroeffector junction(s) by which neurons activate target organs and sensory receptors which transduce information from the various sensory modalities and send it centrally in the nervous system. Presynaptic nerve endings are presynaptic terminals. [NIH] Nerve Fibers: Slender processes of neurons, especially the prolonged axons that conduct nerve impulses. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neuronal Plasticity: The capacity of the nervous system to change its reactivity as the result of successive activations. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon,
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and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neurosurgery: A surgical specialty concerned with the treatment of diseases and disorders of the brain, spinal cord, and peripheral and sympathetic nervous system. [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] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Noscapine: A naturally occurring opium alkaloid that is a centrally acting antitussive agent. [NIH]
Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nutritional Status: State of the body in relation to the consumption and utilization of nutrients. [NIH] Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH]
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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] Olfactory Bulb: Ovoid body resting on the cribriform plate of the ethmoid bone where the olfactory nerve terminates. The olfactory bulb contains several types of nerve cells including the mitral cells, on whose dendrites the olfactory nerve synapses, forming the olfactory glomeruli. The accessory olfactory bulb, which receives the projection from the vomeronasal organ via the vomeronasal nerve, is also included here. [NIH] Olfactory Receptor Neurons: Neurons in the olfactory epithelium with proteins (receptors, odorant) that bind, and thus detect, odorants. Olfactory receptor neurons are bipolar. They send to the surface of the epithelium apical dendrites with non-motile cilia from which project odorant receptor molecules. Their unmyelinated axons synapse in the olfactory bulb of the brain. Unlike other neurons, they can be generated from precursor cells in adults. [NIH]
Oncology: The study of cancer. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Organoleptic: Of, relating to, or involving the employment of the sense organs; used especially of subjective testing (as of flavor, odor, appearance) of food and drug products. [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] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]
Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Oxidative metabolism: A chemical process in which oxygen is used to make energy from carbohydrates (sugars). Also known as aerobic respiration, cell respiration, or aerobic metabolism. [NIH] Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxycodone: Semisynthetic derivative of codeine that acts as a narcotic analgesic more potent and addicting than codeine. [NIH] Oxygenator: An apparatus by which oxygen is introduced into the blood during circulation
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outside the body, as during open heart surgery. [NIH] 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]
Pachymeningitis: Inflammation of the dura mater of the brain, the spinal cord or the optic nerve. [NIH] Paediatric: Of or relating to the care and medical treatment of children; belonging to or concerned with paediatrics. [EU] Pain Threshold: Amount of stimulation required before the sensation of pain is experienced. [NIH]
Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] 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] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [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] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]
Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Particle: A tiny mass of material. [EU] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [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] Pathologic Processes: The abnormal mechanisms and forms involved in the dysfunctions of tissues and organs. [NIH]
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Pathologies: The study of abnormality, especially the study of diseases. [NIH] Patient Compliance: Voluntary cooperation of the patient in following a prescribed regimen. [NIH] Pelvic: Pertaining to the pelvis. [EU] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Perennial: Lasting through the year of for several years. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Perioperative: Around the time of surgery; usually lasts from the time of going into the hospital or doctor's office for surgery until the time the patient goes home. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peroral: Performed through or administered through the mouth. [EU] Phantom: Used to absorb and/or scatter radiation equivalently to a patient, and hence to estimate radiation doses and test imaging systems without actually exposing a patient. It may be an anthropomorphic or a physical test object. [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] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacogenetics: A branch of genetics which deals with the genetic components of variability in individual responses to and metabolism (biotransformation) of drugs. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] 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]
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Phencyclidine: A hallucinogen formerly used as a veterinary anesthetic, and briefly as a general anesthetic for humans. Phencyclidine is similar to ketamine in structure and in many of its effects. Like ketamine, it can produce a dissociative state. It exerts its pharmacological action through inhibition of NMDA receptors (receptors, N-methyl-Daspartate). As a drug of abuse, it is known as PCP and Angel Dust. [NIH] Phenobarbital: A barbituric acid derivative that acts as a nonselective central nervous system depressant. It promotes binding to inhibitory GABA subtype receptors, and modulates chloride currents through receptor channels. It also inhibits glutamate induced depolarizations. [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phenyl: Ingredient used in cold and flu remedies. [NIH] Phenylephrine: An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [NIH] Phenylpropanolamine: A sympathomimetic that acts mainly by causing release of norepinephrine but also has direct agonist activity at some adrenergic receptors. It is most commonly used as a nasal vasoconstrictor and an appetite depressant. [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [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] Physicochemical: Pertaining to physics and chemistry. [EU] 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]
Pigments: Any normal or abnormal coloring matter in plants, animals, or micro-organisms. [NIH]
Pilot study: The initial study examining a new method or treatment. [NIH] Placebos: Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of
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organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasticity: In an individual or a population, the capacity for adaptation: a) through gene changes (genetic plasticity) or b) through internal physiological modifications in response to changes of environment (physiological plasticity). [NIH] Plasticizers: Materials incorporated mechanically in plastics (usually PVC) to increase flexibility, workability or distensibility; due to the non-chemical inclusion, plasticizers leach out from the plastic and are found in body fluids and the general environment. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Pollen: The male fertilizing element of flowering plants analogous to sperm in animals. It is released from the anthers as yellow dust, to be carried by insect or other vectors, including wind, to the ovary (stigma) of other flowers to produce the embryo enclosed by the seed. The pollens of many plants are allergenic. [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] Polymerase Chain Reaction: In vitro method for producing large amounts of specific DNA or RNA fragments of defined length and sequence from small amounts of short oligonucleotide flanking sequences (primers). The essential steps include thermal denaturation of the double-stranded target molecules, annealing of the primers to their complementary sequences, and extension of the annealed primers by enzymatic synthesis with DNA polymerase. The reaction is efficient, specific, and extremely sensitive. Uses for the reaction include disease diagnosis, detection of difficult-to-isolate pathogens, mutation analysis, genetic testing, DNA sequencing, and analyzing evolutionary relationships. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postherpetic Neuralgia: Variety of neuralgia associated with migraine in which pain is felt in or behind the eye. [NIH] Postnatal: Occurring after birth, with reference to the newborn. [EU] Postoperative: After surgery. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] 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
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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] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Potentiating: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Predisposition: A latent susceptibility to disease which may be activated under certain conditions, as by stress. [EU] Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states. [NIH] Prednisone: A synthetic anti-inflammatory glucocorticoid derived from cortisone. It is biologically inert and converted to prednisolone in the liver. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Preoperative: Preceding an operation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Procaine: A local anesthetic of the ester type that has a slow onset and a short duration of action. It is mainly used for infiltration anesthesia, peripheral nerve block, and spinal block. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1016). [NIH] Prodrug: A substance that gives rise to a pharmacologically active metabolite, although not itself active (i. e. an inactive precursor). [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] Promethazine: A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals. [NIH] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prone: Having the front portion of the body downwards. [NIH]
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Propafenone: An antiarrhythmia agent that is particularly effective in ventricular arrhythmias. It also has weak beta-blocking activity. The drug is generally well tolerated. [NIH]
Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Propoxyphene: A narcotic analgesic structurally related to methadone. Only the dextroisomer has an analgesic effect; the levo-isomer appears to exert an antitussive effect. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Prostate: A gland in males that surrounds the neck of the bladder and the urethra. It secretes a substance that liquifies coagulated semen. It is situated in the pelvic cavity behind the lower part of the pubic symphysis, above the deep layer of the triangular ligament, and rests upon the rectum. [NIH] Prostate gland: A gland in the male reproductive system just below the bladder. It surrounds part of the urethra, the canal that empties the bladder, and produces a fluid that forms part of semen. [NIH] Prostatectomy: Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (transurethral resection of prostate). [NIH] Prostatic Hyperplasia: Enlargement or overgrowth of the prostate gland as a result of an increase in the number of its constituent cells. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proteolytic: 1. Pertaining to, characterized by, or promoting proteolysis. 2. An enzyme that promotes proteolysis (= the splitting of proteins by hydrolysis of the peptide bonds with formation of smaller polypeptides). [EU] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other
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psychological or behavioral functions. [NIH] Psychology: The science dealing with the study of mental processes and behavior in man and animals. [NIH] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]
Purines: A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include adenine and guanine, constituents of nucleic acids, as well as many alkaloids such as caffeine and theophylline. Uric acid is the metabolic end product of purine metabolism. [NIH] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Pyridoxal: 3-Hydroxy-5-(hydroxymethyl)-2-methyl-4- pyridinecarboxaldehyde. [NIH] Pyrilamine: A histamine H1 antagonist. It has mild hypnotic properties and some local anesthetic action and is used for allergies (including skin eruptions) both parenterally and locally. It is a common ingredient of cold remedies. [NIH] Quercetin: Aglucon of quercetrin, rutin, and other glycosides. It is widely distributed in the plant kingdom, especially in rinds and barks, clover blossoms, and ragweed pollen. [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
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has been used in common cold preparations for that purpose. It was used commonly and as a bitter and flavoring agent, and is still useful for the treatment of babesiosis. Quinine is also useful in some muscular disorders, especially nocturnal leg cramps and myotonia congenita, because of its direct effects on muscle membrane and sodium channels. The mechanisms of its antimalarial effects are not well understood. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Radical mastectomy: Surgery for breast cancer in which the breast, chest muscles, and all of the lymph nodes under the arm are removed. For many years, this was the operation most used, but it is used now only when the tumor has spread to the chest muscles. Also called the Halsted radical mastectomy. [NIH] Radioactive: Giving off radiation. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [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] Raphe Nuclei: Collections of small neurons centrally scattered among many fibers from the level of the trochlear nucleus in the midbrain to the hypoglossal area in the medulla oblongata. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Adrenergic: Cell-surface proteins that bind epinephrine and/or norepinephrine with high affinity and trigger intracellular changes. The two major classes of adrenergic receptors, alpha and beta, were originally discriminated based on their cellular actions but now are distinguished by their relative affinity for characteristic synthetic ligands. Adrenergic receptors may also be classified according to the subtypes of G-proteins with
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which they bind; this scheme does not respect the alpha-beta distinction. [NIH] Receptors, Odorant: Proteins, usually projecting from the cilia of olfactory receptor neurons, that specifically bind odorant molecules and trigger responses in the neurons. The large number of different odorant receptors appears to arise from several gene families or subfamilies rather than from DNA rearrangement. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recombinant: A cell or an individual with a new combination of genes not found together in either parent; usually applied to linked genes. [EU] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [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] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] 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] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic
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nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retropubic: A potential space between the urinary bladder and the symphisis and body of the pubis. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rhinitis: Inflammation of the mucous membrane of the nose. [NIH] Ribonuclease: RNA-digesting enzyme. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [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] Rutin: 3-((6-O-(6-Deoxy-alpha-L-mannopyranosyl)-beta-D-glucopyranosyl)oxy)-2-(3,4dihydroxyphenyl)-5,7-dihydroxy-4H-1-benzopyran-4-one. Found in many plants, including buckwheat, tobacco, forsythia, hydrangea, pansies, etc. It has been used therapeutically to decrease capillary fragility. [NIH] Rye: A hardy grain crop, Secale cereale, grown in northern climates. It is the most frequent host to ergot (claviceps), the toxic fungus. Its hybrid with wheat is triticale, another grain. [NIH]
Salicylic: A tuberculosis drug. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [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] Scatter: The extent to which relative success and failure are divergently manifested in qualitatively different tests. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH]
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Screening: Checking for disease when there are no symptoms. [NIH] Secondary tumor: Cancer that has spread from the organ in which it first appeared to another organ. For example, breast cancer cells may spread (metastasize) to the lungs and cause the growth of a new tumor. When this happens, the disease is called metastatic breast cancer, and the tumor in the lungs is called a secondary tumor. Also called secondary cancer. [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] Segregation: The separation in meiotic cell division of homologous chromosome pairs and their contained allelomorphic gene pairs. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semen: The thick, yellowish-white, viscid fluid secretion of male reproductive organs discharged upon ejaculation. In addition to reproductive organ secretions, it contains spermatozoa and their nutrient plasma. [NIH] Sensibility: The ability to receive, feel and appreciate sensations and impressions; the quality of being sensitive; the extend to which a method gives results that are free from false negatives. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, 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] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal osmotic pressure and transporting large organic anions. [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] Silicon: A trace element that constitutes about 27.6% of the earth's crust in the form of silicon dioxide. It does not occur free in nature. Silicon has the atomic symbol Si, atomic number 14, and atomic weight 28.09. [NIH]
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Silicon Dioxide: Silica. Transparent, tasteless crystals found in nature as agate, amethyst, chalcedony, cristobalite, flint, sand, quartz, and tridymite. The compound is insoluble in water or acids except hydrofluoric acid. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skin test: A test for an immune response to a compound by placing it on or under the skin. [NIH]
Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [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 Benzoate: The sodium salt of benzoic acid. It is used as an antifungal preservative in pharmaceutical preparations and foods. It may also be used as a test for liver function. [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] Sparteine: An alkaloid isolated from lupin beans, Lupinus luteus and Lupinus niger. It has been used as an oxytocic and an anti-arrhythmia agent. It has also been of interest because of genetic variation in its metabolism. [NIH] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [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] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU]
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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] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Stabilization: The creation of a stable state. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]
Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] 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] 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] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] 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] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
Substrate: A substance upon which an enzyme acts. [EU] Sulfuric acid: A strong acid that, when concentrated is extemely corrosive to the skin and mucous membranes. It is used in making fertilizers, dyes, electroplating, and industrial explosives. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH]
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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] Sympathetic Nervous System: The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symphysis: A secondary cartilaginous joint. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or 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] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synergistic: Acting together; enhancing the effect of another force or agent. [EU] Systemic: Affecting the entire body. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [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] Tendon: A discrete band of connective tissue mainly composed of parallel bundles of collagenous fibers by which muscles are attached, or two muscles bellies joined. [NIH] Teratogenicity: The power to cause abnormal development. [NIH] Terfenadine: A selective histamine H1-receptor antagonist devoid of central nervous system depressant activity. The drug is used in the treatment of seasonal allergic rhinitis, asthma,
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allergic conjunctivitis, and chronic idiopathic urticaria. [NIH] Testosterone: A hormone that promotes the development and maintenance of male sex characteristics. [NIH] Tetrahydrocannabinol: A psychoactive compound extracted from the resin of Cannabis sativa (marihuana, hashish). The isomer delta-9-tetrahydrocannabinol (THC) is considered the most active form, producing characteristic mood and perceptual changes associated with this compound. Dronabinol is a synthetic form of delta-9-THC. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Topical: On the surface of the body. [NIH] Tourniquet: A device, band or elastic tube applied temporarily to press upon an artery to stop bleeding; a device to compress a blood vessel in order to stop bleeding. [NIH]
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Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tractus: A part of some structure, usually that part along which something passes. [NIH] Tramadol: A narcotic analgesic proposed for severe pain. It may be habituating. [NIH] Transaminase: Aminotransferase (= a subclass of enzymes of the transferase class that catalyse the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally 2-keto acid). Most of these enzymes are pyridoxal-phosphate-proteins. [EU]
Transdermal: Entering through the dermis, or skin, as in administration of a drug applied to the skin in ointment or patch form. [EU] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [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] Transurethral: Performed through the urethra. [EU] Transurethral resection: Surgery performed with a special instrument inserted through the urethra. Also called TUR. [NIH] Transurethral Resection of Prostate: Resection of the prostate using a cystoscope passed through the urethra. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trifluoperazine: A phenothiazine with actions similar to chlorpromazine. It is used as an
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antipsychotic and an antiemetic. [NIH] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Ureters: Tubes that carry urine from the kidneys to the bladder. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]
Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]
Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urogenital: Pertaining to the urinary and genital apparatus; genitourinary. [EU] 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] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagina: The muscular canal extending from the uterus to the exterior of the body. Also called the birth canal. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vascular Resistance: An expression of the resistance offered by the systemic arterioles, and to a lesser extent by the capillaries, to the flow of blood. [NIH] Vasoconstriction: Narrowing of the blood vessels without anatomic change, for which constriction, pathologic is used. [NIH] 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] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH]
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Venter: Belly. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] 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] Visceral: , from viscus a viscus) pertaining to a viscus. [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] Void: To urinate, empty the bladder. [NIH] Voltage-gated: It is opened by the altered charge distribution across the cell membrane. [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]
Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality
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disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xanthine: An urinary calculus. [NIH] Xanthine Oxidase: An iron-molybdenum flavoprotein containing FAD that oxidizes hypoxanthine, some other purines and pterins, and aldehydes. Deficiency of the enzyme, an autosomal recessive trait, causes xanthinuria. EC 1.1.3.22. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Yohimbine: A plant alkaloid with alpha-2-adrenergic blocking activity. Yohimbine has been used as a mydriatic and in the treatment of impotence. It is also alleged to be an aphrodisiac. [NIH]
189
INDEX 5 5-hydroxyindoleacetic acid, 31, 131 A Abdomen, 131, 139, 142, 160, 162, 182 Abdominal, 28, 37, 51, 131, 170 Ablation, 89, 131 Acceptor, 131, 162, 169, 185 Accommodation, 131, 166 Acetaminophen, 3, 46, 78, 131 Acetylcholine, 12, 131, 143, 168 Acoustic, 66, 131, 187 Adaptability, 131, 142 Adaptation, 131, 143, 173 Adenosine, 131, 133, 140, 159, 172 Adjuvant, 9, 92, 131 Adrenal Cortex, 131, 146, 174 Adrenergic, 131, 133, 135, 147, 149, 152, 157, 165, 172, 176, 177, 183, 188 Adverse Effect, 77, 132, 172, 180 Aerobic, 132, 169 Aerobic Metabolism, 132, 169 Aerobic Respiration, 132, 169 Aerosol, 132, 183 Affinity, 10, 38, 62, 66, 74, 94, 132, 136, 177, 181 Agonist, 9, 11, 132, 133, 139, 140, 149, 152, 161, 166, 172 Airway, 5, 132 Albumin, 132, 165 Aldehydes, 132, 188 Alertness, 84, 132, 140 Algorithms, 132, 138 Alkaline, 132, 133, 140 Alkaloid, 83, 132, 139, 140, 144, 166, 168, 170, 176, 181, 188 Alleles, 40, 132 Allergic Rhinitis, 97, 133, 157, 183 Almitrine, 39, 133 Alpha-1, 133 Alprenolol, 133, 165 Alternative medicine, 102, 133 Ambulatory Care, 133 Amine, 133, 158 Amino Acids, 84, 133, 152, 153, 171, 175, 185 Amiodarone, 57, 133 Amitriptyline, 27, 133 Ammonia, 86, 133
Amnestic, 133, 154 Amphetamines, 133, 144 Anaesthesia, 22, 27, 28, 38, 51, 58, 133, 160 Analgesic, 18, 19, 33, 52, 56, 57, 67, 75, 81, 82, 87, 93, 131, 134, 138, 139, 140, 144, 148, 158, 159, 162, 164, 166, 169, 175, 176, 185 Analog, 12, 62, 85, 134 Anaphylatoxins, 134, 144 Anaphylaxis, 26, 134, 162 Anatomical, 134, 137, 143, 145, 159, 165, 179 Androgenic, 134, 147 Anemia, 134, 154 Anesthesia, 18, 33, 35, 44, 48, 51, 52, 56, 57, 91, 132, 134, 146, 161, 174 Anesthetics, 134, 137, 152 Angina, 134, 161, 165 Angina Pectoris, 134, 161, 165 Anginal, 133, 134, 168 Animal model, 12, 134 Anions, 132, 134, 161, 180 Annealing, 134, 173 Antagonism, 12, 134, 140 Antianginal, 133, 134 Antiarrhythmic, 133, 134, 165 Antibiotic, 134, 139, 152, 171 Antibody, 132, 134, 135, 144, 157, 158, 160, 163, 177, 181 Anticholinergic, 133, 135 Anticonvulsant, 9, 63, 66, 74, 80, 135, 164, 165, 172 Antidepressant, 24, 133, 135, 154, 186 Antiemetic, 135, 136, 143, 148, 150, 186 Antiepileptic, 74, 135 Antifungal, 135, 181 Antigen, 132, 134, 135, 144, 158, 159, 160, 163, 165, 177 Antigen-Antibody Complex, 135, 144 Antihistamine, 87, 93, 97, 135 Anti-inflammatory, 77, 131, 135, 136, 138, 156, 159, 174 Anti-Inflammatory Agents, 135, 136 Antimetabolite, 135, 164 Antimicrobial, 66, 86, 135 Antineoplastic, 135, 164 Antioxidant, 76, 95, 135, 169 Antipsychotic, 135, 143, 179, 186
190
Dextromethorphan
Antipyretic, 93, 131, 136, 138, 176 Antiseptic, 136, 158 Antispasmodic, 136, 169 Antitussive Agents, 47, 94, 136 Anxiety, 83, 136, 154, 168, 170 Anxiolytic, 136, 140, 155 Aorta, 136, 141, 187 Apnea, 7, 136 Apoptosis, 4, 136 Aqueous, 81, 92, 96, 136, 138, 147, 151, 158, 162 Arterial, 52, 133, 136, 139, 159, 175 Arteries, 76, 95, 136, 139, 146 Arterioles, 136, 139, 140, 186 Artery, 136, 154, 176, 184 Aspirin, 78, 86, 87, 136 Assay, 17, 41, 45, 62, 136, 177 Astrocytes, 136, 165 Asymptomatic, 137, 151 Ataxia, 28, 137, 184 Atrial, 39, 133, 137 Atrial Fibrillation, 39, 137 Atrium, 137, 141, 187 Atrophy, 137, 167 Attenuated, 52, 137 Attenuation, 28, 29, 137 Atypical, 137, 179 Autoimmune disease, 137, 166 Autoimmune Hepatitis, 33, 137 Autoradiography, 9, 137 Axons, 137, 148, 167, 169 B Bacteria, 86, 134, 135, 137, 145, 165, 185, 186 Bactericidal, 137, 152 Bacteriostatic, 137, 152 Barbiturate, 82, 137 Basal cells, 137, 183 Basal Ganglia, 136, 137, 139, 159 Basal Ganglia Diseases, 137, 159 Base, 81, 93, 96, 137, 138, 153, 161, 183 Benign, 88, 89, 138, 141, 147, 157 Benign prostatic hyperplasia, 88, 89, 138 Benzocaine, 4, 138 Benzodiazepines, 138, 140 Benzoic Acid, 138, 181 Benzydamine, 74, 138 Bilateral, 85, 138 Bile, 138, 155, 163, 182 Binding Sites, 62, 138 Bioavailability, 21, 25, 88, 138, 160 Biochemical, 9, 22, 43, 132, 135, 138, 180
Biological therapy, 138, 157 Biological Transport, 138, 148 Biotechnology, 15, 102, 113, 138 Biotransformation, 23, 46, 138, 171 Bladder, 85, 89, 138, 139, 143, 159, 166, 175, 179, 186, 187 Blood Coagulation, 139, 140 Blood Platelets, 31, 139, 180 Blood pressure, 52, 76, 95, 128, 139, 141, 159, 165, 168, 181 Blood vessel, 139, 141, 142, 143, 153, 161, 171, 181, 182, 184, 186 Blood Volume, 139, 160 Blood-Brain Barrier, 139, 162 Body Fluids, 90, 139, 150, 173, 181 Bone Marrow, 139, 146, 155, 163 Bowel, 139, 160, 182 Bowel Movement, 139, 182 Brain Hypoxia, 139, 184 Brain Infarction, 139 Brain Ischemia, 53, 59, 139 Broad-spectrum, 139, 162 Bronchi, 139, 152, 153, 185 Bronchial, 139, 158 Bronchitis, 71, 139, 143 Buccal, 74, 139 Bulking Agents, 87, 139 Bupivacaine, 139, 162 Buprenorphine, 10, 11, 139 Buspirone, 8, 140 Butorphanol, 11, 140 C Caffeine, 7, 8, 26, 48, 54, 92, 93, 140, 176 Calcium, 11, 66, 86, 140, 144, 161, 168, 170, 187 Calcium Channels, 140, 170 Cannabidiol, 140 Cannabinoids, 66, 140 Cannabinol, 140 Capillary, 25, 54, 140, 179, 187 Capsaicin, 38, 140 Capsules, 87, 140, 149 Carbohydrate, 4, 140, 156 Carbon Dioxide, 133, 140, 142, 147, 178 Carcinogenic, 140, 174, 182 Carcinoid, 131, 140 Cardiac, 56, 134, 137, 140, 141, 150, 152, 153, 160, 161, 162, 165, 166, 176, 182 Cardiac Output, 141, 160 Cardiopulmonary, 56, 141 Cardiopulmonary Bypass, 56, 141 Cardiotonic, 141, 172
191
Cardiovascular, 76, 95, 140, 141, 180 Cardiovascular disease, 76, 95, 141 Carotene, 76, 95, 141 Carrier Proteins, 141, 177 Case report, 22, 28, 141, 143 Catalyse, 141, 185 Catecholamine, 141, 149, 171 Catheter, 141, 161 Catheterization, 141, 161 Cation Exchange Resins, 75, 141 Cations, 141, 161 Caudal, 5, 141, 173 Cause of Death, 76, 95, 141 Cell Death, 5, 136, 142, 167 Cell Division, 137, 142, 157, 164, 165, 172, 175, 180 Cell membrane, 138, 140, 141, 142, 155, 172, 187 Cell Respiration, 132, 142, 169, 178 Cell Survival, 142, 157 Central Nervous System Infections, 142, 157 Centrifugation, 142, 165 Cerebellar, 137, 142, 178, 185 Cerebral, 53, 62, 66, 83, 137, 139, 142, 146, 152, 155, 167, 170, 176 Cerebral Cortex, 137, 142, 152, 167, 176 Cerebrovascular, 137, 141, 142, 184 Cerebrum, 142 Character, 134, 142, 147 Chemoprevention, 8, 142 Chemoreceptors, 133, 142, 156 Chemotactic Factors, 142, 144 Chemotherapy, 24, 43, 89, 142 Chest wall, 142, 165 Chin, 143, 164 Chlorpheniramine, 87, 93, 143 Chlorpromazine, 58, 143, 185 Cholecystectomy, 51, 143 Cholesterol, 76, 95, 138, 143, 146, 182 Choline, 12, 143 Cholinergic, 14, 133, 135, 143 Cholinesterase Inhibitors, 143, 149 Chorda Tympani Nerve, 143, 183 Chromatin, 136, 143, 163 Chromosome, 143, 145, 157, 180 Chronic, 6, 8, 19, 30, 38, 44, 58, 76, 77, 82, 84, 133, 140, 143, 153, 160, 161, 181, 182, 184 Chronic Obstructive Pulmonary Disease, 44, 133, 143 Clinical study, 143, 146
Clinical trial, 4, 11, 16, 113, 143, 146, 149, 150, 172, 175, 177 Clonic, 143, 164 Cloning, 138, 144 Coca, 144 Cocaine, 12, 144 Cochlear, 144, 184, 187 Cochlear Diseases, 144, 184 Codeine, 23, 36, 47, 50, 77, 78, 82, 85, 94, 106, 144, 158, 169 Coenzymes, 144, 168 Cofactor, 30, 144, 175 Cognition, 4, 12, 144 Collapse, 134, 144 Colloidal, 132, 144, 151, 180, 183 Complement, 7, 9, 15, 134, 144, 145 Complementary and alternative medicine, 65, 72, 144 Complementary medicine, 65, 145 Compress, 145, 184 Computational Biology, 113, 145 Computer Simulation, 5, 145 Conception, 145, 154 Conduction, 145, 151 Congestion, 79, 93, 106, 136, 145, 147 Conjugated, 138, 145, 147 Conjugation, 138, 145 Conjunctivitis, 145, 157, 184 Consciousness, 84, 134, 145, 149, 175 Constriction, 145, 161, 186 Constriction, Pathologic, 145, 186 Consultation, 4, 145 Contraceptive, 83, 145 Contraindications, ii, 145 Control group, 146, 172 Controlled clinical trial, 12, 146 Controlled study, 58, 146 Convulsions, 80, 81, 135, 137, 146 Coordination, 146, 166 Coronary, 134, 141, 146 Coronary heart disease, 141, 146 Cortex, 146, 152 Cortical, 4, 70, 146, 153, 180, 184 Cortisol, 8, 132, 146 Cortisone, 146, 174 Coryza, 96, 97, 146 Coumarin, 44, 146 Cranial, 143, 146, 153, 156, 157, 160, 167, 170, 171, 186, 187 Craniocerebral Trauma, 137, 146, 157, 184 Curare, 146, 166 Curative, 146, 168, 184
192
Dextromethorphan
Cutaneous, 43, 146 Cyclic, 140, 146 Cyclosporine, 6, 15, 17, 146 Cysteine, 76, 95, 147 Cystine, 147 Cytoplasm, 136, 142, 147, 152, 163 D Dairy Products, 83, 86, 147 Danazol, 96, 147 Debrisoquin, 20, 24, 26, 42, 49, 76, 77, 94, 147 Decarboxylation, 147, 158 Decongestant, 3, 79, 87, 93, 97, 106, 147, 172 Degenerative, 85, 147 Deletion, 136, 147 Delusions, 147, 176 Demethylation, 19, 22, 24, 31, 32, 36, 39, 40, 42, 44, 45, 48, 49, 51, 57, 59, 89, 147 Denaturation, 147, 173 Dendrites, 147, 148, 168, 169 Dendritic, 4, 147 Dentate Gyrus, 147, 158 Depressive Disorder, 148, 162 Deprivation, 69, 82, 148 Dermatitis, 77, 148 Dermis, 148, 185 Dermographia, 43, 148 Detoxification, 10, 11, 90, 148 Dexmedetomidine, 26, 148 Dextrorotatory, 84, 94, 148 Dextrorphan, 13, 17, 19, 21, 24, 25, 27, 32, 42, 48, 49, 54, 70, 77, 82, 83, 84, 94, 148 Diabetes Mellitus, 43, 148, 156 Diagnostic procedure, 73, 102, 148 Dialyzer, 148, 157 Diffusion, 92, 138, 148 Digestion, 138, 139, 148, 160, 163, 182 Digestive tract, 148, 181 Dihydrotestosterone, 148, 178 Dilantin, 81, 148 Dimethyl, 148, 161 Dipeptides, 82, 148 Diphenhydramine, 63, 87, 148 Diploid, 148, 173 Direct, iii, 11, 12, 36, 86, 105, 148, 149, 170, 172, 177, 178, 183 Discrimination, 12, 149 Disinfectant, 149, 152 Disposition, 8, 21, 22, 33, 39, 42, 45, 48, 51, 54, 55, 57, 59, 68, 69, 149 Dissociation, 31, 132, 149
Dissociative Disorders, 149 Distal, 149, 150 Diuresis, 140, 149 Donepezil, 12, 149 Dopa, 149, 162 Dopamine, 135, 143, 144, 149, 162, 165, 168, 179 Dorsal, 5, 9, 149, 173 Dorsum, 149 Dosage Forms, 87, 88, 96, 149 Double-blind, 8, 9, 11, 16, 17, 22, 29, 35, 38, 52, 58, 149, 150 Double-Blind Method, 38, 149 Double-blinded, 35, 150 Doxylamine, 16, 150 Drug Delivery Systems, 92, 97, 150 Drug Interactions, 6, 15, 107, 150 Drug Tolerance, 150, 184 Duct, 141, 150, 179 Duodenum, 138, 150, 155, 182 Dura mater, 150, 164, 170 Dyes, 150, 182 Dyskinesia, 76, 95, 136, 150 Dysphagia, 12, 150 Dysphoria, 34, 150 Dystonia, 18, 67, 136, 150 Dysuria, 89, 150 E Echinacea, 70, 150 Edema, 138, 150, 160 Effector, 131, 144, 150 Efficacy, 7, 10, 12, 13, 14, 20, 27, 34, 38, 39, 89, 140, 150 Elastic, 96, 150, 184 Electrode, 63, 150 Electrolyte, 150, 174, 181 Electrons, 135, 138, 150, 161, 169, 177 Electrophoresis, 54, 151 Electroplating, 151, 182 Embryo, 151, 160, 173 Emollient, 151, 156, 169 Emphysema, 143, 151 Emulsion, 137, 151 Encainide, 50, 151 Encapsulated, 87, 151 Encephalitis, 85, 151 Encephalitis, Viral, 151 Endogenous, 8, 85, 149, 151, 152, 153 Endometriosis, 147, 151 Endometrium, 151, 164 Endorphins, 151, 168 Endotoxins, 144, 152, 161
193
Enhancers, 8, 152 Enkephalins, 152, 168 Entorhinal Cortex, 152, 158 Environmental Health, 63, 68, 112, 114, 152 Enzymatic, 140, 141, 144, 152, 158, 173 Ephedrine, 16, 63, 93, 152 Epidural, 18, 22, 33, 35, 52, 152 Epinephrine, 131, 149, 152, 168, 177 Epithelium, 152, 169 Ergot, 83, 152, 179 Erythromycin, 42, 152 Escalation, 37, 152 Esophagus, 148, 152, 171, 182 Ethanol, 46, 66, 152, 154 Ether, 81, 152 Evacuation, 152, 155, 170 Evoke, 152, 182 Excipients, 87, 97, 153 Excitability, 29, 69, 81, 153, 167, 176 Excitation, 133, 153, 168 Excitatory, 9, 81, 82, 84, 86, 153, 156, 161, 162 Excitatory Amino Acid Agonists, 153, 161 Excitatory Amino Acids, 84, 86, 153 Excitotoxicity, 14, 84, 153 Exhaustion, 84, 134, 153 Exogenous, 90, 138, 151, 153 Expectorant, 3, 62, 75, 78, 81, 93, 106, 153 Expiration, 5, 153, 178 Extracellular, 136, 153, 181 Extraction, 24, 41, 54, 153 Extrapyramidal, 37, 136, 149, 153 Extravasation, 153, 157 Exudate, 153, 169 F Facial, 17, 143, 153, 183 Facial Nerve, 153, 183 Facial Neuralgia, 17, 153 Facial Pain, 153 Family Planning, 113, 154 Fat, 76, 95, 139, 141, 146, 154, 162, 166 Femoral, 141, 154 Femoral Artery, 141, 154 Fentanyl, 78, 154 Fermentation, 154 Fertilizers, 154, 182 Fetus, 154, 174, 186 Fibrosis, 154, 179 Flatus, 154, 155 Fluorescence, 33, 42, 154 Fluoxetine, 38, 59, 94, 154
Fluvoxamine, 47, 154 Foetal, 36, 154 Folate, 154 Folic Acid, 76, 95, 154 Food Preservatives, 87, 154 Forearm, 139, 154 Free Radicals, 135, 149, 154 Friction, 148, 155 Frontal Lobe, 155, 166 Fungus, 152, 155, 179 G Gallbladder, 131, 143, 155 Gallic Acid, 97, 155 Gamma-hydroxybutyrate, 13, 155 Ganglia, 131, 137, 155, 167, 171, 183 Ganglioside, 82, 155 Gap Junctions, 155, 183 Gas, 19, 25, 86, 90, 133, 140, 148, 154, 155, 158, 168, 183 Gastric, 62, 92, 128, 149, 155, 158 Gastric Emptying, 62, 155 Gastrointestinal, 14, 92, 140, 143, 152, 155, 180, 182 Gastrointestinal tract, 143, 152, 155, 180 Gene, 9, 11, 14, 19, 132, 138, 155, 173, 178, 180 Gene Expression, 9, 155 Gene Therapy, 12, 155 Genetic testing, 155, 173 Genetics, 90, 145, 156, 171 Genital, 156, 186 Genitourinary, 156, 186 Genotype, 7, 23, 25, 36, 50, 156, 172 Ginseng, 8, 69, 156 Gland, 131, 146, 156, 163, 170, 175, 180, 182 Glare, 83, 156 Glomerular, 156, 161, 178 Glossopharyngeal Nerve, 154, 156, 183 Glucocorticoid, 156, 174 Glucose, 44, 97, 148, 156, 179 Glucose Intolerance, 148, 156 Glutamate, 4, 11, 14, 82, 84, 153, 156, 172 Glutamic Acid, 154, 156, 168 Glycerol, 97, 156, 172 Glycine, 9, 138, 156, 168 Glycoprotein, 8, 56, 156 Goats, 147, 156 Gonadal, 156, 182 Governing Board, 156, 174 Grade, 86, 156 Grasses, 154, 157
194
Dextromethorphan
Growth factors, 12, 157, 165 Guanethidine, 147, 157 Gynaecological, 56, 157 H Half-Life, 7, 77, 91, 157 Hallucinogen, 157, 172 Haloperidol, 33, 157 Haploid, 157, 173 Haptens, 132, 157, 177 Hay Fever, 133, 143, 157 Headache, 83, 140, 157 Headache Disorders, 157 Heart attack, 76, 95, 141, 157 Heart failure, 152, 157 Hematoma, 63, 157 Hemodialysis, 25, 148, 157 Hemoglobinopathies, 155, 157 Hemorrhage, 146, 157, 182 Hemorrhoidectomy, 50, 157 Hemorrhoids, 157, 158 Hemostasis, 158, 180 Hepatic, 15, 22, 33, 49, 65, 132, 158 Hepatocellular, 91, 158 Heredity, 155, 156, 158 Heroin Dependence, 10, 11, 158 Heterogeneity, 132, 158 Hexylresorcinol, 4, 158 Hippocampus, 66, 148, 158, 182 Histamine, 43, 134, 135, 143, 148, 150, 158, 161, 174, 176, 183 Histidine, 158 Homologous, 132, 155, 158, 180, 183 Hormone, 131, 146, 152, 158, 174, 184 Hydrobromic Acid, 88, 158 Hydrocodone, 78, 158 Hydrofluoric Acid, 158, 181 Hydrogen, 131, 133, 138, 140, 147, 158, 159, 162, 165, 169 Hydrogen Peroxide, 158, 162 Hydrolysis, 138, 158, 175 Hydromorphone, 78, 159 Hydroxylation, 31, 45, 49, 54, 89, 159 Hyperalgesia, 9, 28, 37, 38, 159 Hypersensitivity, 38, 134, 148, 159 Hypertension, 141, 159, 160, 161, 165 Hypertrophy, 89, 138, 159 Hypnotic, 137, 148, 150, 159, 176 Hypoglycemia, 84, 159 Hypokinesia, 159, 170 Hypotension, 136, 146, 159 Hypotensive, 11, 159 Hypoxanthine, 159, 188
Hypoxia, 26, 38, 84, 159 Hysterectomy, 28, 37, 48, 159 I Ibuprofen, 56, 87, 93, 159 Idiopathic, 159, 184 Immune response, 131, 135, 137, 146, 157, 159, 181, 182, 187 Immune system, 137, 138, 159, 166, 186, 187 Immunogenic, 159, 177 Immunology, 26, 131, 132, 159 Immunosuppressant, 15, 159, 164 Impairment, 84, 137, 150, 159, 164, 176 Impotence, 159, 170, 188 In vitro, 15, 22, 42, 45, 58, 62, 70, 86, 155, 159, 173 In vivo, 14, 20, 24, 42, 66, 70, 155, 159 Incision, 159, 162, 175 Incisional, 22, 159 Incontinence, 85, 152, 159 Indinavir, 15, 160 Indocyanine Green, 22, 160 Induction, 6, 15, 67, 135, 160, 161 Infancy, 160 Infantile, 30, 160 Infection, 20, 138, 142, 151, 160, 163, 168, 171, 182, 186, 187 Inflammation, 132, 133, 135, 136, 138, 139, 145, 148, 151, 153, 154, 160, 164, 170, 173, 179 Ingestion, 18, 37, 45, 160, 173 Inhalation, 94, 132, 160, 173 Inorganic, 88, 160, 166 Inpatients, 17, 160 Insight, 8, 10, 14, 160 Insulator, 160, 166 Intermittent, 85, 160 Interstitial, 160, 178 Intestinal, 6, 62, 92, 141, 160 Intestine, 139, 160, 162 Intoxication, 21, 40, 160, 188 Intracellular, 82, 83, 140, 160, 173, 177, 178 Intracranial Hypertension, 157, 160, 184 Intraindividual, 53, 160 Intramuscular, 50, 160 Intrathecal, 27, 161 Intravenous, 13, 35, 57, 76, 95, 128, 161 Intrinsic, 14, 132, 161 Intubation, 29, 141, 161 Inulin, 150, 161 Involuntary, 137, 161, 166, 178, 181 Ion Channels, 136, 161, 172, 183
195
Ion Exchange, 75, 161 Ion Exchange Resins, 75, 161 Ions, 138, 140, 149, 150, 158, 161, 165 Ischemia, 62, 66, 84, 134, 137, 139, 155, 161 Isozymes, 15, 41, 48, 68, 161 Isradipine, 11, 161 K Kainic Acid, 63, 161 Kb, 112, 161 Ketamine, 4, 20, 40, 88, 99, 161, 172 Keto, 161, 185 Ketotifen, 43, 161 Kinetics, 59, 90, 140, 162 Kynurenic Acid, 82, 162 L Labile, 144, 162 Laparotomy, 52, 162 Large Intestine, 148, 160, 162, 178, 181 Laryngeal, 5, 162 Larynx, 5, 162, 185 Latent, 162, 174 Lesion, 162, 183 Leukemia, 155, 162 Levo, 10, 82, 149, 162, 175 Levodopa, 30, 149, 162 Levorphanol, 78, 81, 85, 148, 162 Lidocaine, 22, 33, 162, 165 Ligament, 52, 162, 175 Ligands, 28, 62, 162, 177 Lipid, 62, 143, 156, 161, 162, 166, 169 Lipid Peroxidation, 62, 162, 169 Liposome, 97, 162 Lithium, 36, 135, 162 Localized, 139, 151, 157, 160, 163, 172, 186 Locomotion, 163, 173 Locomotor, 13, 163 Lubricants, 87, 163 Lymph, 163, 165, 177 Lymph node, 163, 165, 177 Lymphatic, 160, 163 Lymphocytes, 8, 135, 163, 187 Lymphoid, 163 M Malaise, 150, 163 Malignancy, 35, 52, 163 Malignant, 89, 135, 163 Mania, 21, 36, 163 Manic, 36, 135, 162, 163, 176 Manic-depressive psychosis, 163, 176 Manifest, 9, 163 Mediate, 9, 39, 94, 149, 163 Mediator, 149, 163, 180
Medical Staff, 150, 163 Medicament, 85, 94, 163 MEDLINE, 113, 163 Medullary, 136, 164, 176 Megaloblastic, 154, 164 Meiosis, 164, 183 Memantine, 10, 11, 27, 164 Membrane, 63, 133, 136, 142, 144, 146, 148, 151, 153, 161, 162, 164, 166, 172, 177, 178, 179 Meninges, 142, 146, 150, 164 Meningitis, 59, 164 Menstrual Cycle, 53, 164, 174 Menstruation, 83, 164 Mental, iv, 4, 8, 26, 58, 112, 114, 142, 143, 144, 149, 159, 163, 164, 175, 176, 179, 186 Mental Disorders, 159, 164, 175, 176 Mental Health, iv, 4, 112, 114, 164, 176 Mental Processes, 149, 164, 176 Mental Retardation, 58, 164 Menthol, 4, 164 Meperidine, 78, 164 Mephenytoin, 27, 40, 44, 47, 48, 49, 53, 54, 57, 164 Metabolite, 13, 17, 19, 23, 25, 27, 41, 49, 77, 138, 148, 164, 174 Metastasis, 89, 164 Methotrexate, 31, 164 Methylprednisolone, 62, 164 Metoprolol, 17, 165 Mexiletine, 43, 165 Microbe, 165, 185 Microglia, 136, 165 Microorganism, 144, 165, 187 Microsomal, 38, 41, 65, 165 Microsome, 59, 165 Milligram, 80, 165 Mitosis, 136, 165 Moclobemide, 43, 165 Modeling, 13, 165 Modification, 75, 165 Modified radical mastectomy, 50, 51, 165 Molecular, 9, 11, 14, 62, 81, 94, 113, 115, 138, 141, 145, 148, 161, 165, 178, 185 Molecular Structure, 165, 185 Molecule, 135, 138, 144, 149, 150, 153, 157, 158, 165, 169, 177 Monitor, 32, 45, 142, 165 Monoamine, 43, 165 Morphine, 13, 18, 19, 22, 27, 29, 44, 46, 50, 52, 57, 77, 78, 82, 139, 144, 159, 164, 166, 167, 169
196
Dextromethorphan
Morphine Dependence, 83, 166 Morphology, 26, 166 Motility, 166, 180 Motion Sickness, 166, 167, 174 Motor Activity, 146, 166 Motor Cortex, 29, 68, 69, 166, 178 Motor nerve, 166 Mucins, 166, 179 Mucociliary, 166, 181 Mucus, 93, 153, 166 Multiple sclerosis, 85, 166 Muscle relaxant, 63, 166, 172 Muscle Spindles, 166, 172 Muscle tension, 166 Mydriatic, 166, 172, 188 Myelin, 166 Myocardium, 134, 151, 166 Myopia, 69, 166, 167, 178 N Naloxone, 10, 16, 33, 34, 91, 166, 167 Naltrexone, 10, 91, 167 Narcolepsy, 152, 167 Narcosis, 167 Narcotic, 74, 77, 80, 82, 90, 92, 140, 154, 158, 162, 164, 166, 167, 169, 175, 185 Narcotic Antagonists, 91, 167 Nausea, 82, 83, 135, 149, 167, 170, 186 Nearsightedness, 166, 167 Necrosis, 136, 139, 167 Neocortex, 4, 167 Neonatal, 26, 167 Nerve Endings, 138, 157, 167 Nerve Fibers, 138, 167 Nervous System, 74, 80, 81, 131, 133, 140, 142, 143, 144, 152, 155, 156, 162, 163, 165, 166, 167, 168, 171, 172, 180, 183 Neural, 12, 46, 165, 167 Neuralgia, 40, 167, 173 Neurodegenerative Diseases, 85, 137, 167 Neurologic, 76, 84, 167 Neuromuscular, 131, 167 Neuromuscular Junction, 131, 167 Neuronal, 4, 5, 9, 11, 14, 27, 35, 86, 94, 140, 167 Neuronal Plasticity, 9, 167 Neurons, 5, 9, 11, 84, 144, 147, 148, 153, 155, 162, 166, 167, 169, 177, 178, 183, 187 Neuropathy, 26, 27, 39, 41, 67, 168 Neuropharmacology, 16, 18, 59, 62, 63, 66, 85, 168 Neurosurgery, 16, 37, 62, 63, 168 Neurotoxicity, 31, 62, 161, 168
Neurotransmitter, 4, 131, 143, 149, 153, 156, 158, 161, 168, 182, 183 Niacin, 86, 168, 186 Nifedipine, 96, 97, 168 Nitrogen, 91, 132, 133, 168, 186 Norepinephrine, 131, 133, 149, 152, 157, 168, 172, 177 Noscapine, 23, 78, 168 Nuclei, 145, 151, 155, 165, 168, 187 Nucleic acid, 159, 168, 176 Nucleus, 5, 136, 137, 143, 146, 147, 163, 164, 168, 175, 177, 182, 184, 187 Nutritional Status, 12, 168 O Obsessive-Compulsive Disorder, 154, 168 Ointments, 149, 169 Olfactory Bulb, 169 Olfactory Receptor Neurons, 11, 14, 169, 178 Oncology, 29, 31, 169 Opiate, 16, 47, 69, 78, 84, 90, 94, 166, 169 Opium, 78, 90, 166, 168, 169, 170 Organoleptic, 96, 169 Outpatient, 169 Overdose, 127, 169 Oxidation, 25, 26, 32, 33, 37, 39, 42, 43, 48, 49, 50, 131, 135, 138, 147, 162, 169 Oxidation-Reduction, 138, 169 Oxidative metabolism, 39, 58, 132, 169 Oxidative Stress, 66, 169 Oxycodone, 10, 78, 169 Oxygenator, 141, 169 Oxytocic, 170, 181 P Pachymeningitis, 164, 170 Paediatric, 33, 67, 170 Pain Threshold, 10, 170 Palate, 156, 170, 183 Palliative, 170, 184 Pancreas, 131, 170 Panic, 154, 170 Panic Disorder, 154, 170 Papaverine, 78, 169, 170 Paranasal Sinuses, 170, 181 Parkinsonism, 28, 136, 150, 162, 170 Particle, 75, 92, 162, 170 Patch, 170, 185 Pathologic, 136, 146, 159, 170, 186 Pathologic Processes, 136, 170 Pathologies, 88, 171 Patient Compliance, 87, 96, 171 Pelvic, 151, 171, 175
197
Penicillin, 134, 171 Peptide, 171, 175 Perception, 38, 171, 179 Perennial, 150, 171 Perfusion, 159, 171 Perioperative, 26, 48, 56, 171 Peripheral Nervous System, 152, 167, 168, 171, 182 Peroral, 78, 171 Phantom, 29, 31, 171 Pharmaceutical Preparations, 93, 152, 171, 181 Pharmaceutical Solutions, 149, 171 Pharmacodynamic, 13, 171 Pharmacogenetics, 23, 32, 44, 48, 53, 57, 89, 171 Pharmacokinetic, 7, 13, 15, 19, 41, 44, 48, 171 Pharmacologic, 10, 134, 157, 171, 185 Pharmacotherapy, 12, 17, 22, 26, 171 Pharynx, 171, 183 Phencyclidine, 13, 28, 62, 172 Phenobarbital, 46, 172 Phenotype, 7, 14, 23, 25, 36, 37, 49, 50, 51, 53, 172 Phenyl, 164, 172 Phenylephrine, 96, 172 Phenylpropanolamine, 4, 93, 172 Phenytoin, 74, 81, 172 Phospholipids, 154, 172 Phosphorus, 140, 172 Physicochemical, 97, 172 Physiologic, 15, 91, 132, 149, 157, 159, 161, 164, 172, 177, 185 Pigments, 141, 172 Pilot study, 16, 46, 52, 55, 56, 172 Placebos, 8, 172 Plants, 78, 132, 140, 143, 144, 156, 161, 166, 168, 172, 173, 179, 185 Plasma, 7, 15, 17, 20, 21, 24, 25, 41, 44, 47, 49, 54, 55, 63, 76, 95, 132, 139, 142, 156, 158, 165, 173, 180 Plasticity, 5, 9, 14, 68, 173 Plasticizers, 75, 173 Pneumonia, 145, 173 Poisoning, 33, 152, 160, 167, 173 Pollen, 173, 176 Polymerase, 51, 173 Polymerase Chain Reaction, 51, 173 Polymers, 75, 97, 141, 161, 173, 175 Polymorphic, 33, 35, 48, 49, 50, 57, 89, 147, 148, 173
Polymorphism, 25, 32, 39, 44, 45, 47, 50, 52, 57, 89, 147, 173 Pontine, 5, 173 Posterior, 137, 149, 156, 170, 173 Postherpetic Neuralgia, 27, 41, 173 Postnatal, 5, 173 Postoperative, 22, 28, 29, 33, 37, 42, 47, 48, 50, 51, 52, 56, 57, 164, 173 Postsynaptic, 173, 183 Post-traumatic, 138, 157, 173 Potassium, 86, 173, 176 Potentiates, 12, 174 Potentiating, 80, 81, 83, 133, 174 Practice Guidelines, 114, 174 Precursor, 143, 149, 150, 151, 152, 162, 168, 169, 174, 186 Predisposition, 34, 174 Prednisolone, 164, 174 Prednisone, 77, 174 Prenatal, 39, 151, 174 Preoperative, 37, 52, 57, 174 Presynaptic, 167, 168, 174, 183 Probe, 6, 8, 15, 17, 22, 38, 66, 89, 174 Procaine, 162, 174 Prodrug, 174 Progesterone, 174, 182 Progression, 76, 85, 89, 95, 134, 174 Progressive, 12, 85, 150, 152, 167, 174, 178 Promethazine, 106, 143, 174 Promoter, 14, 174 Prone, 66, 174 Propafenone, 39, 175 Prophase, 175, 183 Prophylaxis, 93, 175 Propoxyphene, 78, 175 Prospective study, 8, 175 Prostate, 88, 138, 175, 185 Prostate gland, 175 Prostatectomy, 88, 175 Prostatic Hyperplasia, 175 Protease, 160, 175 Protein S, 138, 152, 175 Proteolytic, 133, 144, 175 Protocol, 12, 172, 175 Pruritus, 148, 174, 175 Psychiatric, 10, 14, 164, 175 Psychiatry, 6, 12, 16, 22, 28, 33, 36, 37, 47, 52, 58, 59, 63, 91, 175, 182 Psychic, 164, 175, 180 Psychoactive, 175, 184, 188 Psychology, 13, 149, 176 Psychosis, 28, 36, 52, 135, 176
198
Dextromethorphan
Psychotomimetic, 34, 176 Psychotropic, 23, 52, 176 Public Health, 11, 114, 176 Public Policy, 113, 176 Pulmonary, 38, 139, 176, 187 Pulmonary Artery, 139, 176, 187 Pulse, 128, 165, 176 Purines, 176, 188 Pyramidal Tracts, 153, 176 Pyridoxal, 176, 185 Pyrilamine, 96, 176 Q Quercetin, 7, 176 Quinidine, 35, 38, 49, 57, 76, 77, 84, 85, 94, 176 Quinine, 176 R Race, 148, 149, 177 Racemic, 148, 149, 177 Radiation, 134, 137, 149, 154, 171, 177 Radiation therapy, 149, 177 Radical mastectomy, 177 Radioactive, 137, 157, 158, 177 Radioimmunoassay, 35, 177 Randomized, 8, 11, 17, 29, 35, 52, 150, 177 Raphe Nuclei, 5, 177 Reagent, 155, 177 Reality Testing, 176, 177 Receptors, Adrenergic, 148, 177 Receptors, Odorant, 169, 178 Receptors, Serotonin, 178, 180 Recombinant, 22, 178 Recombination, 145, 155, 178 Rectum, 51, 139, 148, 154, 155, 160, 162, 175, 178 Recurrence, 75, 142, 163, 178 Red Nucleus, 137, 178 Reductase, 8, 164, 178 Refer, 1, 85, 94, 97, 139, 144, 151, 163, 176, 178, 185 Reflex, 5, 166, 178 Refraction, 166, 178 Refractive Power, 166, 178 Refractory, 37, 178 Regimen, 150, 171, 178 Relapse, 10, 90, 178 Relaxant, 170, 172, 178 Remission, 163, 178 Renal failure, 20, 178 Resection, 35, 178, 185 Respiration, 19, 133, 136, 140, 146, 165, 178 Retina, 166, 178
Retropubic, 175, 179 Retroviral vector, 155, 179 Rhinitis, 93, 143, 152, 162, 179 Ribonuclease, 9, 179 Rigidity, 170, 172, 179 Risk factor, 76, 95, 175, 179 Risperidone, 48, 179 Rutin, 176, 179 Rye, 152, 179 S Salicylic, 88, 179 Saliva, 47, 179 Salivary, 25, 53, 143, 153, 179 Salivary glands, 143, 153, 179 Saponins, 179, 182 Scatter, 156, 171, 179 Schizoid, 179, 187 Schizophrenia, 179, 187 Schizotypal Personality Disorder, 179, 188 Sclerosis, 16, 41, 84, 85, 166, 179 Screening, 11, 15, 53, 54, 90, 143, 180 Secondary tumor, 164, 180 Secretion, 158, 165, 166, 180 Secretory, 180, 183 Sedative, 81, 133, 137, 144, 148, 150, 174, 180 Segregation, 49, 89, 178, 180 Seizures, 29, 63, 69, 74, 81, 148, 172, 180 Semen, 175, 180 Sensibility, 134, 159, 180 Sequencing, 173, 180 Serotonin, 82, 131, 133, 135, 140, 154, 168, 171, 178, 179, 180, 186 Serum, 7, 13, 23, 25, 35, 132, 134, 144, 177, 180 Serum Albumin, 177, 180 Shock, 13, 83, 134, 180, 185 Side effect, 4, 76, 82, 89, 95, 96, 105, 132, 136, 138, 149, 180, 185 Signs and Symptoms, 83, 178, 180 Silicon, 87, 180, 181 Silicon Dioxide, 87, 180, 181 Sinusitis, 97, 181 Skeletal, 143, 146, 166, 176, 181 Skin test, 43, 181 Skull, 146, 181, 183 Small intestine, 87, 97, 150, 158, 160, 181 Smooth muscle, 89, 133, 134, 140, 158, 161, 166, 170, 181, 182 Sodium, 40, 62, 86, 151, 176, 177, 181 Sodium Benzoate, 40, 62, 86, 181 Solvent, 96, 152, 156, 171, 181
199
Sparteine, 20, 77, 89, 181 Spasm, 136, 181 Spasmodic, 85, 181 Spasticity, 128, 181 Specialist, 119, 181 Species, 140, 146, 152, 164, 165, 176, 177, 181, 186, 187, 188 Specificity, 15, 66, 132, 140, 181 Sphincter, 162, 181 Spinal cord, 9, 62, 136, 142, 143, 150, 152, 161, 164, 167, 168, 170, 171, 176, 178, 182, 183 Sporadic, 167, 182 Stabilization, 93, 172, 182 Steroid, 77, 146, 147, 179, 182 Stimulant, 133, 140, 158, 182 Stimulus, 12, 63, 150, 153, 161, 178, 182, 184 Stomach, 80, 87, 96, 131, 148, 152, 155, 158, 167, 171, 181, 182 Stool, 160, 162, 182 Strand, 173, 182 Stress, 83, 141, 146, 167, 169, 174, 182, 186 Stroke, 53, 84, 85, 112, 141, 182 Stupor, 167, 182 Subacute, 31, 160, 181, 182 Subarachnoid, 157, 182 Subclinical, 160, 180, 182 Subiculum, 158, 182 Substance P, 152, 164, 180, 182 Substrate, 147, 182 Sulfuric acid, 88, 182 Supplementation, 68, 182 Suppression, 88, 94, 182 Suspensions, 81, 183 Sympathetic Nervous System, 168, 183 Sympathomimetic, 58, 93, 149, 152, 168, 172, 183 Symphysis, 143, 175, 183 Symptomatic, 75, 151, 183 Synapse, 132, 167, 169, 174, 183, 185 Synapsis, 183 Synaptic, 14, 86, 168, 183 Synaptic Transmission, 86, 183 Synergistic, 76, 95, 183 Systemic, 35, 38, 78, 84, 97, 106, 107, 134, 136, 139, 152, 160, 174, 177, 183, 186 T Tardive, 76, 95, 136, 183 Taste Buds, 87, 183 Temporal, 57, 157, 158, 183 Tendon, 181, 183
Teratogenicity, 39, 183 Terfenadine, 59, 183 Testosterone, 178, 184 Tetrahydrocannabinol, 140, 184 Thalamic, 137, 184 Thalamic Diseases, 137, 184 Thermal, 28, 149, 173, 184 Threshold, 20, 26, 81, 153, 159, 184 Thrombosis, 175, 182, 184 Tinnitus, 76, 184, 187 Tolerance, 9, 13, 34, 37, 53, 78, 82, 131, 140, 156, 184 Tone, 89, 181, 184 Tonic, 141, 164, 184 Tonicity, 150, 184 Tonus, 184 Topical, 4, 77, 152, 158, 184 Tourniquet, 52, 184 Toxic, iv, 83, 145, 146, 157, 168, 179, 185 Toxicity, 34, 59, 74, 150, 185 Toxicology, 13, 18, 21, 34, 39, 40, 46, 58, 68, 114, 185 Toxin, 184, 185 Trace element, 180, 185 Trachea, 5, 139, 153, 162, 171, 185 Tractus, 5, 185 Tramadol, 23, 185 Transaminase, 12, 185 Transdermal, 93, 94, 185 Transfection, 138, 155, 185 Translation, 152, 185 Translocation, 152, 185 Transmitter, 131, 136, 149, 153, 161, 163, 168, 185 Transurethral, 89, 175, 185 Transurethral resection, 89, 175, 185 Transurethral Resection of Prostate, 175, 185 Trauma, 84, 167, 185 Tremor, 170, 185 Tricyclic, 47, 77, 133, 185 Trifluoperazine, 82, 185 Trigeminal, 153, 154, 186 Tryptophan, 180, 186 Tuberculosis, 179, 186 U Uremia, 178, 186 Ureters, 186 Urethra, 89, 138, 175, 185, 186 Urinary, 6, 7, 54, 58, 59, 143, 152, 156, 159, 175, 179, 186, 188 Urinary tract, 6, 186
200
Dextromethorphan
Urinary tract infection, 6, 186 Urinate, 186, 187 Urine, 6, 7, 8, 15, 17, 24, 25, 36, 41, 43, 44, 47, 53, 54, 55, 89, 90, 131, 138, 139, 149, 159, 186 Urogenital, 88, 156, 186 Urticaria, 134, 143, 184, 186 Uterus, 151, 159, 164, 170, 174, 186 V Vaccine, 131, 175, 186 Vagina, 164, 186 Vascular, 43, 76, 95, 133, 134, 148, 157, 160, 161, 186 Vascular Resistance, 133, 186 Vasoconstriction, 83, 152, 186 Vasodilation, 170, 186 Vasodilator, 149, 158, 168, 170, 186 Vein, 161, 186 Venlafaxine, 38, 186 Venter, 187 Ventral, 5, 187 Ventricle, 158, 176, 187 Ventricular, 133, 151, 175, 187 Venules, 139, 140, 187 Verapamil, 42, 187
Vertebrae, 182, 187 Vesicular, 165, 187 Vestibulocochlear Nerve, 184, 187 Vestibulocochlear Nerve Diseases, 184, 187 Veterinary Medicine, 113, 187 Virulence, 137, 185, 187 Virus, 142, 152, 179, 187 Visceral, 38, 156, 187 Vitro, 46, 187 Vivo, 44, 187 Void, 15, 187 Voltage-gated, 66, 187 W White blood cell, 134, 163, 166, 187 Withdrawal, 10, 11, 13, 16, 47, 66, 77, 82, 90, 164, 187 X Xanthine, 67, 188 Xanthine Oxidase, 67, 188 Xenograft, 134, 188 Y Yeasts, 86, 155, 172, 188 Yohimbine, 94, 188
