Prilosec: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

PRILOSEC 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., 1960Prilosec: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84052-0 1. Prilosec-Popular works. I. Title.

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

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

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Prilosec. 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 PRILOSEC ................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Prilosec.......................................................................................... 5 The National Library of Medicine: PubMed .................................................................................. 6 CHAPTER 2. BOOKS ON PRILOSEC ..................................................................................................... 9 Overview........................................................................................................................................ 9 Chapters on Prilosec....................................................................................................................... 9 CHAPTER 3. PERIODICALS AND NEWS ON PRILOSEC ..................................................................... 11 Overview...................................................................................................................................... 11 News Services and Press Releases................................................................................................ 11 Newsletter Articles ...................................................................................................................... 14 Academic Periodicals covering Prilosec ....................................................................................... 16 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 19 Overview...................................................................................................................................... 19 NIH Guidelines............................................................................................................................ 19 NIH Databases............................................................................................................................. 21 Other Commercial Databases....................................................................................................... 23 APPENDIX B. PATIENT RESOURCES ................................................................................................. 25 Overview...................................................................................................................................... 25 Patient Guideline Sources............................................................................................................ 25 Finding Associations.................................................................................................................... 29 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 31 Overview...................................................................................................................................... 31 Preparation................................................................................................................................... 31 Finding a Local Medical Library.................................................................................................. 31 Medical Libraries in the U.S. and Canada ................................................................................... 31 ONLINE GLOSSARIES.................................................................................................................. 37 Online Dictionary Directories ..................................................................................................... 37 PRILOSEC DICTIONARY ............................................................................................................. 39 INDEX ................................................................................................................................................ 55

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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 Prilosec 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 Prilosec, 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 Prilosec, 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 Prilosec. 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 Prilosec, 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 Prilosec. 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 PRILOSEC Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Prilosec.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and Prilosec, 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 “Prilosec” (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: •

Top 10 Most Commonly Prescribed Medications for 2001 Source: Access. 16(6): 48-50,58. July 2002. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Chicago, IL 60611. (312) 440-8900. E-mail: [email protected]. Website: www.adha.org. Summary: Each year, a list of the most commonly prescribed medications is released, based on data gathered from pharmacies throughout the United States. This article reviews the various drug classes represented in the top 10 list for 2001 and highlights the oral side effects and critical drug interactions of significance to dental hygiene practice. Drug classes covered include cholesterol-lowering drugs, hormones, pain relievers, cardiovascular medications, gastrointestinal drugs, antidepressants, and

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antihistamines. One chart lists the oral side effects (xerostomia, candida, altered taste, vomiting, gingival hyperplasia, stomatitis, and bruxism) associated with 10 commonly prescribed medications: Lipitor, Synthroid, Premarin, HYCD/APAP, Norvasec, Prilosec, Zoloft, Claritin, Prevacid, and Celebrex. 2 tables. 5 references. •

Antisecretory Therapy and Genotoxicity (editorial) Source: Digestive Diseases and Sciences. 36(5): 545-547. May 1991. Summary: Recent reports of toxicological findings with omeprazole (Losec or Prilosec) have caused much debate and frank contention. This editorial summarizes the toxicological information on omeprazole and addresses concerns that omeprazole may damage the DNA of gastric mucosal cells, a process called genotoxicity. The authors conclude that there is no current evidence to support the contention that omeprazole is genotoxic. 19 references.

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Update on Peptic Ulcer Disease Source: Drug Therapy. 20(5): 48-50, 53. May 1990. Summary: This article presents an update of activities and research in the area of peptic ulcer disease (PUD) during the late 1980s. Topics covered include pathophysiology; the role of nonsteroidal anti-inflammatory drugs; mucosal defenses; the role of Helicobacter pylori; diagnosis; and treatment, including new drugs such as omeprazole (Prilosec), and misoprostol (Cytotec). The author concludes by summarizing important research issues and questions for the 90s. 2 tables. 5 references.

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Relationship Between H. Pylori and Gastric Cancers Needs Further Evaluation: NIH Consensus Panel Source: Blue Sheet. 37(7): 11-12. February 16, 1994. Contact: Available from Health Policy and Biomedical Research News of the Week. 5550 Friendship Boulevard, Suite One, Chevy Chase, MD 20815. (301) 657-9830; FAX (301) 656-3094. Summary: This article reports on the conclusions of an NIH Consensus Conference Panel that investigated the relationship between Helicobacter pylori and gastric cancers. The panel suggested that the 'interesting relationship between H. pylori and gastric cancers requires further exploration,' noting that 'the effect of prevention or treatment of H. pylori infection on gastric cancer risk has not been studied adequately. The article reports on research evidence related to this topic; recommendations for antimicrobial therapy in people infected with H. pylori, including triple therapy with various antibiotics such as tetracycline, metronidazole, amoxicillin, bismuth subsalicylate, and omeprazole; the value of treating non-ulcer dyspepsia patients; side effects of antimicrobial therapy; and the use of the proton pump inhibitor Prilosec.

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Gastrointestinal Effects of NSAIDs: Difficulties in Detection and Management Source: Postgraduate Medicine. 100(5): 131-132, 135-136, 141-143. November 1996. Summary: This article, the fourth of a four-part series on peptic acid disease, focuses on the common effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal (GI) tract. NSAIDs are well tolerated by the majority of patients. In a significant minority, however, GI side effects may result in serious complications. Because these complications may be asymptomatic, physicians prescribing NSAIDs

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must weigh the analgesic and anti-inflammatory benefits of the drugs against their potential for causing adverse outcomes. Treatment of NSAID-induced GI disease includes use of H2-receptor antagonists or proton pump inhibitors. Although NSAIDinduced ulcers can heal while the drugs are continued, only omeprazole (Prilosec) has been shown to speed healing during NSAID use. For persons at higher risk, consideration must be given to prophylaxis against peptic ulcer disease. 1 table. 20 references. (AA-M).

Federally Funded Research on Prilosec The U.S. Government supports a variety of research studies relating to Prilosec. 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 Prilosec. 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 Prilosec. The following is typical of the type of information found when searching the CRISP database for Prilosec: •

Project Title: NEW APPROACHES TO MEMBRANE PROTEIN STRUCTURE Principal Investigator & Institution: Kaback, H R.; Howard Hughes Medical Inst Investigator; Physiology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 01-JUN-1996; Project End 30-APR-2005 Summary: A highly significant percentage of the genomes sequenced thus far are thought to encode polytopic transmembrane proteins which catalyze a multitude of essential cellular functions, energy and signal transduction in particular. Many are important with regard to human disease (e.g. cystic fibrosis, drug resistance), and many widely prescribed drugs (eg. Prozac and Prilosec) are targeted to membrane transport proteins. Although progress over the last 20 years has led to the characterization, purification and modification of this class of proteins, only a few have been studied at a level useful for understanding mechanism. Furthermore, many membrane proteins require conformational flexibility in order to function, making it imperative to obtain dynamic structural information. The objectives of this application are to continue to utilize the lactose permease of Escherichia coli as a paradigm for structure/function studies on transmembrane proteins. Only 6 amino acid residues are irreplaceable with respect to mechanism, and application of novel site-directed biochemical and biophysical approaches has yielded a helix packing model to a resolution approximating 4 Angstrom units. Further efforts will be made to refine and extend the structure using

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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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these methods. In addition, newly developed approaches using site-directed fluorescence resonance energy transfer and solid-state 19F-NMR will be introduced. Ligand-induced conformational changes in certain helices can also be demonstrated, and these studies will be extended to the remainder of the molecule in order to delineate overall structural changes that result from ligand binding. The substrate binding site is located at the interface between helices IV and V, and specificity is directed towards the galactosyl moiety of the substrate. A spin-labeled galactoside that binds to the permease with high affinity has been synthesized and will be used to further define the substrate binding site. Ligands that bind but are not translocated are also being synthesized in order to study binding from the inner and outer surface of the membrane in the absence of translocation. Site-specific alkylation combined with mass spectrometry will be used to determine changes in the protonation of His322 (helix X) upon ligand binding. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PREVENTION/TREATMENT OF H. PYLORI WITH LACTOFERRIN Principal Investigator & Institution: Schroder, Bruce G.; Dairilean, Inc. Box 88647 Sioux Falls, Sd 57105 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 28-FEB-2003 Summary: (Scanned from the applicant's description) An estimated 25 million persons in the United States have had peptic ulcer disease during their lifetimes. A high proportion, over 90 percent, of these cases are caused by infection with helicobacter pylori (H. pylori). Preliminary research has found that bovine lactoferrin, a native antibiotic in bovine milk, is inhibitory to the growth of H. pylori and lactoferrin is a potential therapeutic agent for the prevention and treatment of H. pylori infection. The proposed Phase I research will investigate the feasibility of using native bovine lactoferrin to treat and prevent H. pyloric infections and ulcers in humans. The study will determine if consuming milk or milk-based nutraceutical beverage containing high levels of bovine lactoferrin is bacteriostatic or bactericidal to H. pylori bacteria in volunteers with H. pylori infection but no preexisting ulcers. Volunteers will be screened to determine the presence of H. pylori and placed on a 21-day regime of consuming the proposed high lactoferrin nutraceutical beverage. The effect of the lactoferrin treatment on the H. pylori will be monitored. If successful, Phase II research will involve a larger and longer-term prevention study as well as a study on the use of the high lactoferrin nutraceutical beverage in conjunction with current treatment regimes for ulcers. PROPOSED COMMERCIAL APPLICATION: Sales of one proton pump inhibitor, Losec/Prilosec, used to treat ulcers were $4.4 billion during 9 months in 1999. The market for a nutraceutical that prevents or is effective in treating ulcers would be huge. Trans Ova Genetics and Dairilean have current business relationships with several large pharmaceutical and nutraceutical companies that would facilitate commercialization of the product. 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 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

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

By the way, doctor. I take 10 mg of Prilosec about four times each week to control my heartburn. Does taking this drug on a continuing basis affect my body's ability to utilize nutrients in food? Author(s): Robb-Nicholson C. Source: Harvard Women's Health Watch. 1999 November; 7(3): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10521942&dopt=Abstract

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By the way, doctor.No need to take Prilosec forever. Author(s): Lee TH. Source: Harvard Health Letter / from Harvard Medical School. 2000 September; 25(11): 8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10966656&dopt=Abstract

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Is lansoprazole (Prevacid) or omeprazole (Prilosec) more effective in treating erosive esophagitis? Author(s): Kim JD. Source: The Journal of Family Practice. 2002 April; 51(4): 384. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11978268&dopt=Abstract

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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CHAPTER 2. BOOKS ON PRILOSEC Overview This chapter provides bibliographic book references relating to Prilosec. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Prilosec include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Chapters on Prilosec In order to find chapters that specifically relate to Prilosec, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Prilosec using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Prilosec” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on Prilosec: •

Ulcer Prophylaxis and Treatment Source: in Pirsch, J.; Simmons, W.; Sollinger, H. Transplantation Drug Manual. 3rd ed. Georgetown, TX: Landes Bioscience. 1999. p. 103-113. Contact: Available from Landes Bioscience. 810 South Church Street, Georgetown, TX 78626. (512) 863-7762. Fax (512) 863-0081. Website: www.landesbioscience.com. PRICE: $45.00. ISBN: 1570595933. Summary: This chapter on ulcer prophylaxis and treatment is from a transplantation drug manual, designed to help physicians safely and accurately prescribe drugs for transplant patients. Written in chart format, the chapter offers information on the brand name, company, mechanism of action, indications, contraindications, warnings, special precautions, adverse reactions, drug interactions, and dosage and administration considerations for each of the drugs covered. The first chart summarizes ulcer prophylaxis and treatment overview (the types of drugs used and their dosage and administration). The chapter then covers magnesium and aluminum hydroxide

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suspension; aluminum hydroxide suspension; calcium carbonate; histamine H2 receptor antagonists, including famotidine (Pepcid), ranitidine (Zantac), and cimetidine (Tagamet); proton pump inhibitors, omeprazole (Prilosec), and lansoprazole; sucralfate (Carafate); and misoprostol (Cytotec). For ease of access, all information is presented in chart or outline form.

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CHAPTER 3. PERIODICALS AND NEWS ON PRILOSEC Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Prilosec.

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

Eon Labs - no plans for generic Prilosec yet Source: Reuters Industry Breifing Date: December 03, 2003

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CORRECTION: Apotex launches generic Prilosec Source: Reuters Industry Breifing Date: November 27, 2003

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Canada's Apotex plans launch of generic Prilosec Source: Reuters Industry Breifing Date: November 26, 2003

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Mylan earnings rise on Prilosec copycat Source: Reuters Industry Breifing Date: October 30, 2003

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PG profit up 20 percent on Prilosec, cost cuts Source: Reuters Industry Breifing Date: October 27, 2003

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Aetna joins rivals in giving Prilosec free Source: Reuters Health eLine Date: October 07, 2003

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Court stops PG from making Prilosec claim Source: Reuters Industry Breifing Date: September 22, 2003

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Prilosec OTC launch set next week despite lawsuit Source: Reuters Industry Breifing Date: September 12, 2003

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PG raises 1st-quarter outlook, helped by Prilosec Source: Reuters Industry Breifing Date: September 04, 2003

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PG to spend more than $100 million on ads for OTC Prilosec Source: Reuters Industry Breifing Date: August 20, 2003

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Ads for OTC Prilosec to top $100 million Source: Reuters Health eLine Date: August 20, 2003

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Novartis launches third generic Prilosec in U.S. Source: Reuters Industry Breifing Date: August 19, 2003

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AstraZeneca seeking damages from Mylan on Prilosec Source: Reuters Industry Breifing Date: August 08, 2003

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FDA approves OTC version of Prilosec Source: Reuters Health eLine Date: June 23, 2003

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Prilosec to change colors if it goes over counter Source: Reuters Health eLine Date: June 17, 2003

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OTC Prilosec -- The "purple pill" goes pink Source: Reuters Industry Breifing Date: June 17, 2003

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Mylan gets approval for Prilosec generic Source: Reuters Industry Breifing Date: June 02, 2003

Periodicals and News

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AstraZeneca's Prilosec loses half US market to generic Source: Reuters Industry Breifing Date: January 14, 2003

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Eon Labs gets final FDA approval for generic Prilosec but delays launch Source: Reuters Industry Breifing Date: January 03, 2003

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Schwarz Pharma's generic Prilosec off to strong start in US Source: Reuters Industry Breifing Date: December 19, 2002

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Biovail buys private drug delivery firm for $190 million, gets interest in generic Prilosec Source: Reuters Industry Breifing Date: December 11, 2002

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IMPAX wins FDA nod to market generic Prilosec Source: Reuters Industry Breifing Date: November 11, 2002

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AstraZeneca to appeal US Prilosec ruling Source: Reuters Industry Breifing Date: November 05, 2002

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Three drugmakers to share profits on generic Prilosec Source: Reuters Industry Breifing Date: November 01, 2002

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Andrx posts Q3 loss on generic Prilosec charge; stock climbs on analyst upgrade Source: Reuters Industry Breifing Date: October 31, 2002

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AstraZeneca shrugs off extra generic Prilosec capacity Source: Reuters Industry Breifing Date: February 19, 2003

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Schwarz to raise generic Prilosec forecast Source: Reuters Industry Breifing Date: February 11, 2003

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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name.

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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 “Prilosec” (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 “Prilosec” (or synonyms). If you know the name of a company that is relevant to Prilosec, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “Prilosec” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “Prilosec” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on Prilosec: •

Peptic Ulcer: A Twentieth Century Disease Source: Digestive Health Matters. 2(4): 1-2. Winter 2000. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217. (888) 964-2001 or (414) 9641799. Fax (414) 964-7176. Website: www.iffgd.org. Summary: This article reviews the history of peptic ulcer disease (PUD), its diagnosis, incidence, and treatments. The greatest accomplishment of gastric acid research was the development of drugs that control stomach acid secretion. After the 1970s, the need for elective surgery declined in response to the use of H2 antagonists (cimetidine, Tagamet,

Periodicals and News

15

and then others). In the 1990s came the development of proton pump inhibitors (omeprazole, Prilosec, and then others), which could heal almost any ulcer by powerful acid suppression. However, it was not until the discovery of a bacteria called Helicobacter pylori when a peptic ulcer cure became possible. The author concludes by noting that although effective treatments are available, Helicobacter and the resulting ulcers and other diseases are still very common as lingering sources of disease, particularly in the developing world. In addition, the use of nonsteroidal antiinflammatory drugs (given for pain and arthritis) contributes markedly to the incidence of ulcers. The author emphasizes the need for continuing support of research with adequate funding, in order to maintain quality and advancement in medical care. 1 figure. •

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

•

Cause and Treatment of Pain in Chronic Intestinal Pseudo-Obstruction Source: ASAP Forum Journal. 2(1): 7-10. May 1995. Contact: Available from American Society of Adults with Pseudo-Obstruction (ASAP). 19 Carroll Road, Woburn, MA 01801. (617) 935-9776. Fax (617) 933-4151. Summary: This newsletter article addresses the cause and treatment of pain associated with chronic intestinal pseudo-obstruction (CIP). The author defines the current knowledge on the cause of pain, discusses the results obtained with the use of various medications and procedures, including surgical procedures, and provides thoughts on

16

Prilosec

future developments for pain control. The author notes that although CIP produces numerous symptoms and problems, the subjective complaint that most patients have is that of abdominal pain. Specific drug agents covered include antacids; histamine blockers, such as Tagamet, Zantac, and Pepcid; Prilosec, an acid pump inhibitor; Carafate; nonsteroidal anti-inflammatory agents (NSAIDs), including ibuprofen, Motrin, or Orudis; antibiotics including Flagyl and Bactrim; antidepressants, including Librax, Ativan, and Paxil; pain inhibitors, including Darvon, Vicodin, and Lortab; Codeine; Percocet; Demerol; Morphine; Buprenex; Stadol; and Dilaudid.

Academic Periodicals covering Prilosec Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Prilosec. In addition to these sources, you can search for articles covering Prilosec 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.”

17

APPENDICES

19

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 Institute4: •

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/

4

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Physician Resources

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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.5 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:6 •

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

5

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). 6 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 Gateway7 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.8 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Prilosec” (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 5052 See Details 912 15 0 5979

HSTAT9 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.10 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.11 Simply search by “Prilosec” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

7

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

8

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). 9 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 10 11

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

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

Physician Resources

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Coffee Break: Tutorials for Biologists12 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.13 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.14 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/.

12 Adapted 13

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. 14 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.

25

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 Prilosec can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Prilosec. 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 Prilosec. 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 “Prilosec”:

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Prilosec

•

Other guides Digestive Diseases http://www.nlm.nih.gov/medlineplus/digestivediseases.html Esophagus Disorders http://www.nlm.nih.gov/medlineplus/esophagusdisorders.html Lupus http://www.nlm.nih.gov/medlineplus/lupus.html Peptic Ulcer http://www.nlm.nih.gov/medlineplus/pepticulcer.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on Prilosec. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

'I'm Taking Medicine for Frequent Heartburn. Why Am I Still Suffering?': A Patient Information Resource About Symptomatic Acid Reflux Disease Source: [Wayne, PA]: Astra Merck Inc. 1997. 15 p. Contact: Available from Astra Merck Inc. (800) 336-9992. PRICE: Single copy free. Summary: This booklet provides readers with basic information about heartburn and gastroesophageal reflux disease (GERD). The brochure encourages readers to ask their physicians about omeprazole (Prilosec), a drug therapy for heartburn and other symptoms associated with GERD. The brochure notes that if heartburn is present two or more times a week, GERD may be present. The author outlines the incidence of heartburn, the symptoms of GERD (heartburn, sour or bitter taste, difficult or painful swallowing), the causes of GERD symptoms, why GERD symptoms occur so frequently, how the stomach makes acid, and the action of acid pump inhibitors, such as omeprazole. GERD symptoms happen when juices containing harsh acid back up from the stomach into the esophagus. Included with the brochure is the package insert information from Prilosec. The brochure is illustrated with humorous, colorful line drawings of a variety of patients with heartburn and GERD. Blank space is available for notes or questions to ask the health care provider. (AA-M).

Patient Resources

•

27

Medications and GERD Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2001. [2 p.]. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: [email protected]. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members. Summary: This brochure answers common questions about proton pump inhibitors (PPIs) and gastroesophageal reflux disease (GERD, characterized by return or reflux of stomach acid back to the esophagus). PPIs are powerful drug inhibitors of gastric (stomach) acid secretion. A single daily dose of omeprazole (Prilosec), lansoprazole (Prevacid); rabeprazole (Aciphex), or pantoprazole (Protonix), results in decreased acid production to allow healing of erosive esophagitis (tissue damage in the esophagus) and relief of heartburn in close to 90 percent of patients. The author reviews the use of these drugs, including standard administration and dosing, long term use, drug interactions, and potential side effects. GERD is a chronic disease so most individuals with the disease will require some kind of medication for long periods of time. One sidebar summarizes basic facts about GERD. The brochure concludes with a brief description of the International Foundation for Functional Gastrointestinal Disorders (IFFGD), a nonprofit education and research organization (www.iffgd.org).

•

Medical Treatment of GERD: The Proton Pump Inhibitors Source: Milwaukee, WI: International Foundation for Functional Gastrointestinal Disorders (IFFGD). 2000. [2 p.]. Contact: Available from International Foundation for Functional Gastrointestinal Disorders (IFFGD). P.O. Box 170864, Milwaukee, WI 53217-8076. (888) 964-2001 or (414) 964-1799. E-mail: [email protected]. Website: www.iffgd.org. PRICE: $1.00 for nonmembers; single copy free to members. Summary: This brochure reviews the medical (drug) treatment of gastroesophageal reflux disease (GERD) with proton pump inhibitors (PPIs). PPIs are powerful drug inhibitors of gastric (stomach) acid secretion. A single daily dose of omeprazole (Prilosec), lansoprazole (Prevacid); rabeprazole (Aciphex), or pantoprazole (Protonix), results in decreased acid production to allow healing of erosive esophagitis (tissue damage in the esophagus) and relief of heartburn in close to 90 percent of patients. The author reviews the use of these drugs, including standard administration and dosing, long term use, and potential side effects. The author notes that most patients will achieve symptom control in 4 to 8 weeks of therapy. However, some patients will need higher doses for an extended period of time (two to three months) to achieve optimal relief. GERD is a chronic disease so most individuals with the disease will require some kind of medication for long periods of time. Long term maintenance of symptom relief is usually possible with one dose of proton pump inhibitor per day. One sidebar summarizes basic facts about GERD. The brochure concludes with a brief description of the International Foundation for Functional Gastrointestinal Disorders (IFFGD), a nonprofit education and research organization (www.iffgd.org).

•

Helicobacter Pylori Infection (Gastritis) Source: in Sodeman, W.A., Jr. Instructions for Geriatric Patients. Philadelphia, PA: W.B. Saunders Company. 1995. p. 110-111.

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Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887. (800) 545-2522. Fax (800) 874-6418 or (407) 352-3445. PRICE: $38.95. ISBN: 0721643353. Summary: This chapter, from a book of instructions for geriatric patients, provides a basic information sheet on Helicobacter pylori infection (gastritis). H. pylori infections tend to become chronic or long lasting, although they usually cause no complaints or symptoms. But in some people, this chronic infection can lead to the development of stomach and duodenal ulcers. H. pylori infections are not difficult to eradicate, but they do require the use of two or three drugs. The fact sheet outlines the drugs commonly used, including omeprazole (Prilosec), amoxicillin, metronidazole (Flagyl), and bismuth (Pepto-Bismol). The author notes that the timing of treatment for H. pylori infections will take into consideration other health care problems that may need more urgent or immediate treatment. The information sheet concludes by reminding readers to contact their health care provider if they miss more than a single dose of a drug regimen to eradicate H. pylori. The instructions are designed to supplement and reinforce physician instructions to their patients. (AA-M). •

Heartburn: Hints on Dealing with the Discomfort Source: Kansas City, MO: American Academy of Family Physicians. 1994. 4 p. Contact: Available from American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. (800) 274-2237. Website: www.aafp.org. PRICE: $22.00 for 100 copies for members, $33.00 for 100 copies for nonmembers. Summary: This patient education brochure helps readers understand heartburn and how they can deal with the discomfort it may cause. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste of food in the throat and mouth. It usually occurs after eating a big meal or while lying down. Heartburn is caused by stomach contents (acid) going back up into the esophagus; this is called reflux. The stomach acid can irritate the esophagus and cause the feeling of burning pain. The brochure describes hiatus hernia, factors that can add to heartburn, complications that can arise because of heartburn, tips on preventing heartburn, the use of antacids, how to know when to consult a health care provider regarding heartburn problems, medications that can be used, and the indications for surgery. Most people get fast, short-term relief with antacids. Three kinds of medications might be used to treat heartburn. H2 blockers (Axid, Pepcid, Tagamet, Zantac) lower how much acid the stomach makes. Omeprazole (Prilosec) completely stops the stomach from making acid. Metoclopramide (Reglan) reduces reflux. Surgery is only needed when symptoms are very bad and don't go away after medicine and other measures have been tried. Simple line drawings illustrate the stomach and esophagus. 2 figures. 3 tables. (AA-M). 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 Prilosec. 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

Patient Resources

29

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Prilosec. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Prilosec. 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 Prilosec. 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 “Prilosec” (or a synonym), and you will receive information on all relevant organizations listed in the database.

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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 “Prilosec”. 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 “Prilosec” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Prilosec” (or a synonym) into the search box, and click “Submit Query.”

31

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.15

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

15

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)16: •

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/

16

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

Finding Medical Libraries

33

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

Finding Medical Libraries

35

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

•

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

•

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

37

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

39

PRILOSEC DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [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] Adverse Effect: An unwanted side effect of treatment. [NIH] 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] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkylation: The covalent bonding of an alkyl group to an organic compound. It can occur by a simple addition reaction or by substitution of another functional group. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Aluminum: A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. [NIH] Aluminum Hydroxide: Hydrated aluminum. A compound with many biomedical applications: as a gastric antacid, an antiperspirant, in dentifrices, as an emulsifier, as an adjuvant in bacterins and vaccines, in water purification, etc. [NIH] Amebiasis: Infection with any of various amebae. It is an asymptomatic carrier state in most individuals, but diseases ranging from chronic, mild diarrhea to fulminant dysentery may occur. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical

40

Prilosec

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] Amoxicillin: A broad-spectrum semisynthetic antibiotic similar to ampicillin except that its resistance to gastric acid permits higher serum levels with oral administration. [NIH] Ampicillin: Semi-synthetic derivative of penicillin that functions as an orally active broadspectrum antibiotic. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] 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 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] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Asymptomatic: Having no signs or symptoms of disease. [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] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance

Dictionary 41

whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Bismuth Subsalicylate: A nonprescription medicine such as Pepto-Bismol. Used to treat diarrhea, heartburn, indigestion, and nausea. It is also part of the treatment for ulcers caused by the bacterium Helicobacter pylori (HELL-uh-koh-BAK-tur py-LOH-ree). [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [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] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Broad-spectrum: Effective against a wide range of microorganisms; said of an antibiotic. [EU] Bronchial: Pertaining to one or more bronchi. [EU] Bruxism: A disorder characterized by grinding and clenching of the teeth. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Carcinogen: Any substance that causes cancer. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Differentiation: Progressive restriction of the developmental potential and increasing

42

Prilosec

specialization of function which takes place during the development of the embryo and leads to the formation of specialized cells, tissues, and organs. [NIH] Cell Division: The fission of a cell. [NIH] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [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] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cutaneous: Having to do with the skin. [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

Dictionary 43

and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytotoxic: Cell-killing. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Depolarization: The process or act of neutralizing polarity. In neurophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell. [EU] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] 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] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Resistance: Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from drug tolerance which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration. [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] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH]

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Dyspepsia: Impaired digestion, especially after eating. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Endoscope: A thin, lighted tube used to look at tissues inside the body. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endoscopy: Endoscopic examination, therapy or surgery performed on interior parts of the body. [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] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Famotidine: A competitive histamine H2-receptor antagonist. Its main pharmacodynamic effect is the inhibition of gastric secretion. [NIH] Fats: One of the three main classes of food and a source of energy in the body. Bile dissolves fats, and enzymes break them down. This process moves fats into cells. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [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] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH]

Dictionary 45

Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroesophageal Reflux: Reflux of gastric juice and/or duodenal contents (bile acids, pancreatic juice) into the distal esophagus, commonly due to incompetence of the lower esophageal sphincter. Gastric regurgitation is an extension of this process with entry of fluid into the pharynx or mouth. [NIH] Gastroesophageal Reflux Disease: Flow of the stomach's contents back up into the esophagus. Happens when the muscle between the esophagus and the stomach (the lower esophageal sphincter) is weak or relaxes when it shouldn't. May cause esophagitis. Also called esophageal reflux or reflux esophagitis. [NIH] Gastrointestinal: Refers to 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]

Geriatric: Pertaining to the treatment of the aged. [EU] Giardiasis: An infection of the small intestine caused by the flagellated protozoan Giardia lamblia. It is spread via contaminated food and water and by direct person-to-person contact. [NIH] Gingival Hyperplasia: A pathological increase in the depth of the gingival crevice surrounding a tooth at the gum margin. [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] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Granulocytes: Leukocytes with abundant granules in the cytoplasm. They are divided into three groups: neutrophils, eosinophils, and basophils. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [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] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH] Helicobacter: A genus of gram-negative, spiral-shaped bacteria that is pathogenic and has been isolated from the intestinal tract of mammals, including humans. [NIH] Helicobacter pylori: A spiral bacterium active as a human gastric pathogen. It is a gramnegative, urease-positive, curved or slightly spiral organism initially isolated in 1982 from patients with lesions of gastritis or peptic ulcers in Western Australia. Helicobacter pylori was originally classified in the genus Campylobacter, but RNA sequencing, cellular fatty acid profiles, growth patterns, and other taxonomic characteristics indicate that the microorganism should be included in the genus Helicobacter. It has been officially transferred to Helicobacter gen. nov. (see Int J Syst Bacteriol 1989 Oct;39(4):297-405). [NIH]

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Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hernia: Protrusion of a loop or knuckle of an organ or tissue through an abnormal opening. [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]

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] Hoarseness: An unnaturally deep or rough quality of voice. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] 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] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Ibuprofen: A nonsteroidal anti-inflammatory agent with analgesic properties used in the therapy of rheumatism and arthritis. [NIH] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immunology: The study of the body's immune system. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Indigestion: Poor digestion. Symptoms include heartburn, nausea, bloating, and gas. Also called dyspepsia. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be 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]

Dictionary 47

Intestinal: Having to do with the intestines. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intracellular: Inside a cell. [NIH] Intracellular Membranes: Membranes of subcellular structures. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lupus: A form of cutaneous tuberculosis. It is seen predominantly in women and typically involves the nasal, buccal, and conjunctival mucosa. [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] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medical Assistance: Financing of medical care provided to public assistance recipients. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Metronidazole: Antiprotozoal used in amebiasis, trichomoniasis, giardiasis, and as treponemacide in livestock. It has also been proposed as a radiation sensitizer for hypoxic cells. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985, p133), this substance may reasonably be anticipated to be a carcinogen (Merck, 11th ed). [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary

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arteries, upon which coronary thrombosis is usually superimposed. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] 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] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [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] 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] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nizatidine: A histamine H2 receptor antagonist with low toxicity that inhibits gastric acid secretion. The drug is used for the treatment of duodenal ulcers. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Pathogen: Any disease-producing microorganism. [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into

Dictionary 49

contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [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] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phospholipases: A class of enzymes that catalyze the hydrolysis of phosphoglycerides or glycerophosphatidates. EC 3.1.-. [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] 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]

Platelet Activation: A series of progressive, overlapping events triggered by exposure of the platelets to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Potentiation: An overall effect of two drugs taken together which is greater than the sum of the effects of each drug taken alone. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precancerous: A term used to describe a condition that may (or is likely to) become cancer. Also called premalignant. [NIH] Premalignant: A term used to describe a condition that may (or is likely to) become cancer. Also called precancerous. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prophylaxis: An attempt to prevent disease. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)-

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transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Public Assistance: Financial assistance to impoverished persons for the essentials of living through federal, state or local government programs. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] 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] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [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] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Rheumatism: A group of disorders marked by inflammation or pain in the connective tissue structures of the body. These structures include bone, cartilage, and fat. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [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] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the

Dictionary 51

GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [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]

Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [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] 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] Sucralfate: A basic aluminum complex of sulfated sucrose. It is advocated in the therapy of peptic, duodenal, and prepyloric ulcers, gastritis, reflux esophagitis, and other gastrointestinal irritations. It acts primarily at the ulcer site, where it has cytoprotective,

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pepsinostatic, antacid, and bile acid-binding properties. The drug is only slightly absorbed by the digestive mucosa, which explains the absence of systemic effects and toxicity. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [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] Systemic: Affecting the entire body. [NIH] Tetracycline: An antibiotic originally produced by Streptomyces viridifaciens, but used mostly in synthetic form. It is an inhibitor of aminoacyl-tRNA binding during protein synthesis. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Transduction: The transfer of genes from one cell to another by means of a viral (in the case of bacteria, a bacteriophage) vector or a vector which is similar to a virus particle (pseudovirion). [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Trichomoniasis: An infection with the protozoan parasite Trichomonas vaginalis. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Dictionary 53

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Wheezing: Breathing with a rasp or whistling sound; a sign of airway constriction or obstruction. [NIH] Xerostomia: Decreased salivary flow. [NIH]

55

INDEX A Abdominal, 16, 39, 48 Abdominal Pain, 16, 39 Adjuvant, 39 Adverse Effect, 39, 50 Affinity, 6, 39 Airway, 39, 53 Algorithms, 39, 41 Alimentary, 39, 47, 48 Alkaline, 39, 41 Alkylation, 6, 39 Alternative medicine, 14, 39 Aluminum, 9, 39, 51 Aluminum Hydroxide, 9, 39 Amebiasis, 39, 47 Amine, 39, 46 Amino Acids, 40, 49 Amoxicillin, 4, 28, 40 Ampicillin, 40 Ampulla, 40, 44 Analgesic, 5, 40, 46 Antibiotic, 6, 40, 41, 52 Antibody, 39, 40, 45, 46, 51 Antigen, 39, 40, 46 Anti-inflammatory, 4, 16, 40, 46 Anti-Inflammatory Agents, 16, 40 Antimicrobial, 4, 40 Arteries, 40, 41, 42, 48 Asymptomatic, 4, 39, 40 B Bacteria, 6, 15, 40, 44, 45, 48, 52 Bactericidal, 6, 40 Bacteriostatic, 6, 40 Bacterium, 40, 41, 45 Base, 40, 47 Bile, 41, 44, 45, 47, 52 Bile Acids, 41, 45 Biochemical, 5, 41, 47 Biotechnology, 6, 14, 21, 41 Bismuth, 4, 28, 41 Bismuth Subsalicylate, 4, 41 Blood Coagulation, 41 Blood vessel, 41, 51, 53 Branch, 35, 41, 51 Broad-spectrum, 40, 41 Bronchial, 41, 46 Bruxism, 4, 41 Buccal, 41, 47, 51

C Calcium, 10, 41, 51 Calcium Carbonate, 10, 41 Carcinogen, 41, 47 Cardiac, 41, 44, 48 Cardiovascular, 3, 41 Cell, 40, 41, 42, 43, 45, 47, 48, 50, 52 Cell Differentiation, 41, 50 Cell Division, 40, 42 Cell proliferation, 42, 50 Cholesterol, 3, 41, 42 Chronic, 15, 27, 28, 39, 42, 44, 46, 51 Chronic Disease, 27, 42 Cimetidine, 10, 14, 15, 42 Clinical trial, 5, 21, 42 Cloning, 41, 42 Computational Biology, 21, 42 Connective Tissue, 42, 44, 50 Consciousness, 40, 42, 43 Constriction, 42, 53 Contraindications, ii, 9, 42 Coronary, 42, 47 Coronary Thrombosis, 42, 48 Cutaneous, 42, 47 Cytochrome, 42 Cytotoxic, 43, 51 D Databases, Bibliographic, 21, 43 Decarboxylation, 43, 46 Dentifrices, 39, 43 Depolarization, 43, 51 Diagnostic procedure, 14, 43 Diarrhea, 39, 41, 43 Digestion, 39, 41, 43, 44, 46, 47, 48, 51 Direct, iii, 43, 45, 50 Dissociation, 39, 43 Distal, 43, 45 Drug Interactions, 3, 9, 27, 43 Drug Resistance, 5, 43 Drug Tolerance, 43 Duodenal Ulcer, 28, 43, 48 Duodenum, 41, 43, 44, 48, 51 Dyspepsia, 4, 44, 46 E Elective, 14, 44 Endocrine Glands, 44 Endoscope, 44 Endoscopic, 15, 44

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Endoscopy, 15, 44 Environmental Health, 20, 22, 44 Enzymatic, 41, 44, 46 Enzyme, 44, 48, 50, 51 Epithelium, 44 Esophageal, 15, 44, 45 Esophagitis, 7, 15, 27, 44, 45, 51 Esophagus, 15, 26, 27, 28, 44, 45, 47, 49, 50, 51 F Family Planning, 21, 44 Famotidine, 10, 15, 44 Fats, 41, 42, 44 Fibrosis, 5, 44 Fluorescence, 6, 44 G Gallbladder, 39, 44 Gastric, 4, 14, 27, 39, 40, 42, 44, 45, 46, 48, 49, 50 Gastric Acid, 14, 40, 42, 44, 48 Gastric Juices, 44, 48 Gastric Mucosa, 4, 44, 49 Gastrin, 42, 45, 46 Gastritis, 27, 28, 45, 51 Gastroesophageal Reflux, 15, 26, 27, 45 Gastroesophageal Reflux Disease, 15, 26, 27, 45 Gastrointestinal, 3, 4, 14, 27, 45, 50, 51 Gene, 41, 45 Geriatric, 27, 28, 45 Giardiasis, 45, 47 Gingival Hyperplasia, 4, 45 Gland, 45, 48, 50 Governing Board, 45, 49 Gram-negative, 45 Granulocytes, 45, 51 Growth, 6, 40, 42, 45 H Haptens, 39, 45 Heartburn, 7, 15, 26, 27, 28, 41, 45, 46 Helicobacter, 4, 6, 15, 27, 28, 41, 45 Helicobacter pylori, 4, 6, 15, 28, 41, 45 Hemodialysis, 41, 46 Hernia, 28, 46 Heterogeneity, 39, 46 Histamine, 10, 16, 42, 44, 46, 48, 50 Histidine, 46 Hoarseness, 15, 46 Hormone, 45, 46, 47, 50 Hydrogen, 40, 41, 46, 48, 50 Hydrolysis, 46, 49

I Ibuprofen, 16, 46 Id, 29, 34, 36, 46 Imidazole, 46, 50 Immunology, 39, 46 Incompetence, 45, 46 Indigestion, 41, 46 Infarction, 42, 46, 47 Infection, 4, 6, 27, 28, 39, 45, 46, 47, 51, 52 Inflammation, 15, 40, 44, 45, 46, 50, 51 Intestinal, 15, 45, 47 Intestinal Pseudo-Obstruction, 15, 47 Intestines, 39, 45, 47 Intracellular, 46, 47, 50 Intracellular Membranes, 47 Intrinsic, 39, 47 K Kb, 20, 47 L Lectin, 47 Lesion, 47, 52 Lethal, 40, 47 Library Services, 34, 47 Liver, 39, 41, 44, 47 Localized, 46, 47, 52 Loop, 46, 47 Lower Esophageal Sphincter, 45, 47 Lupus, 26, 47 Lymphatic, 46, 47 M Mediate, 47, 50 Medical Assistance, 15, 47 MEDLINE, 21, 47 Membrane, 5, 43, 45, 47, 48, 49, 51 Membrane Proteins, 5, 47, 49 Metronidazole, 4, 28, 47 MI, 37, 47 Micro-organism, 45, 48 Modification, 5, 48 Molecular, 21, 23, 41, 42, 48 Molecule, 6, 40, 41, 43, 46, 47, 48, 50 Motion Sickness, 48 Mucosa, 44, 47, 48, 51, 52 Myocardium, 47, 48 N Nausea, 15, 41, 46, 48 Necrosis, 46, 47, 48 Need, 3, 7, 9, 14, 27, 28, 30, 48 Nizatidine, 15, 48 P Palate, 48, 51 Pancreas, 39, 48

Index 57

Pancreatic, 45, 48 Pancreatic Juice, 45, 48 Pathogen, 45, 48 Pathophysiology, 4, 48 Patient Education, 26, 28, 32, 34, 37, 48 Pepsin, 42, 48, 49 Pepsin A, 42, 48, 49 Peptic, 4, 6, 14, 26, 45, 48, 51 Peptic Ulcer, 4, 5, 6, 14, 26, 45, 48 Peptide, 48, 49 Pharmacodynamic, 44, 49 Pharmacologic, 49, 52 Pharynx, 45, 49 Phospholipases, 49, 51 Phosphorus, 41, 49 Physiologic, 49, 50 Platelet Activation, 49, 51 Poisoning, 48, 49 Postsynaptic, 49, 51 Potentiation, 49, 51 Practice Guidelines, 22, 49 Precancerous, 15, 49 Premalignant, 49 Progressive, 41, 43, 45, 48, 49 Prophylaxis, 5, 9, 49 Protein S, 41, 49, 52 Proteins, 5, 40, 47, 48, 49, 50, 52 Proton Pump, 4, 5, 6, 10, 15, 27, 49, 50 Proton Pump Inhibitors, 5, 10, 15, 27, 50 Protons, 46, 49, 50 Public Assistance, 47, 50 Public Policy, 21, 50 R Radiation, 44, 47, 50 Ranitidine, 10, 15, 50 Receptor, 5, 10, 40, 44, 48, 50 Refer, 1, 41, 50 Reflux, 26, 27, 28, 45, 50, 51 Regimen, 28, 50 Regurgitation, 45, 50 Rheumatism, 46, 50 S Salivary, 50, 53 Screening, 42, 50 Secretion, 14, 27, 42, 44, 46, 48, 50 Semisynthetic, 40, 50 Sequencing, 45, 50 Serum, 40, 50 Side effect, 3, 4, 15, 27, 39, 50, 52

Signal Transduction, 5, 50 Small intestine, 43, 45, 46, 47, 51 Smooth muscle, 46, 51 Specialist, 29, 51 Species, 51, 52 Specificity, 6, 39, 51 Sphincter, 15, 51 Spinal cord, 42, 51 Stimulant, 46, 51 Stomach, 14, 15, 26, 27, 28, 39, 44, 45, 46, 47, 48, 49, 50, 51 Stomatitis, 4, 51 Stress, 48, 51 Subacute, 46, 51 Subclinical, 46, 51 Substance P, 50, 51 Substrate, 6, 51 Sucralfate, 10, 51 Suppression, 15, 52 Synaptic, 51, 52 Systemic, 46, 51, 52 T Tetracycline, 4, 52 Tissue, 27, 40, 42, 43, 46, 47, 48, 49, 50, 51, 52 Toxic, iv, 52 Toxicity, 43, 48, 52 Toxicology, 22, 52 Toxins, 40, 46, 52 Transduction, 50, 52 Transfection, 41, 52 Translocation, 6, 52 Transplantation, 9, 52 Trauma, 44, 48, 52 Trichomoniasis, 47, 52 Tuberculosis, 47, 52 U Ulcer, 4, 9, 15, 43, 48, 51, 52 Unconscious, 46, 52 V Vaccines, 39, 52 Vascular, 46, 53 Vasodilator, 46, 53 Veterinary Medicine, 21, 53 W Wheezing, 15, 53 X Xerostomia, 4, 53

58

Prilosec

Index 59

60

Prilosec