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

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

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CISAPRIDE 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., 1960Cisapride: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00261-2 1. Cisapride-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 cisapride. 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 CISAPRIDE ................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Cisapride ....................................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND CISAPRIDE ....................................................................................... 55 Overview...................................................................................................................................... 55 Finding Nutrition Studies on Cisapride ...................................................................................... 55 Federal Resources on Nutrition ................................................................................................... 57 Additional Web Resources ........................................................................................................... 57 CHAPTER 3. ALTERNATIVE MEDICINE AND CISAPRIDE ................................................................. 59 Overview...................................................................................................................................... 59 National Center for Complementary and Alternative Medicine.................................................. 59 Additional Web Resources ........................................................................................................... 63 General References ....................................................................................................................... 64 CHAPTER 4. PATENTS ON CISAPRIDE.............................................................................................. 65 Overview...................................................................................................................................... 65 Patents on Cisapride .................................................................................................................... 65 Patent Applications on Cisapride ................................................................................................ 72 Keeping Current .......................................................................................................................... 72 CHAPTER 5. BOOKS ON CISAPRIDE ................................................................................................. 75 Overview...................................................................................................................................... 75 Book Summaries: Online Booksellers........................................................................................... 75 Chapters on Cisapride .................................................................................................................. 75 CHAPTER 6. PERIODICALS AND NEWS ON CISAPRIDE.................................................................... 81 Overview...................................................................................................................................... 81 News Services and Press Releases................................................................................................ 81 Newsletter Articles ...................................................................................................................... 83 Academic Periodicals covering Cisapride..................................................................................... 84 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 85 Overview...................................................................................................................................... 85 U.S. Pharmacopeia....................................................................................................................... 85 Commercial Databases ................................................................................................................. 86 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 89 Overview...................................................................................................................................... 89 NIH Guidelines............................................................................................................................ 89 NIH Databases............................................................................................................................. 91 Other Commercial Databases....................................................................................................... 93 APPENDIX B. PATIENT RESOURCES ................................................................................................. 95 Overview...................................................................................................................................... 95 Patient Guideline Sources............................................................................................................ 95 Finding Associations.................................................................................................................... 97 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 99 Overview...................................................................................................................................... 99 Preparation................................................................................................................................... 99 Finding a Local Medical Library.................................................................................................. 99 Medical Libraries in the U.S. and Canada ................................................................................... 99 ONLINE GLOSSARIES................................................................................................................ 105

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Online Dictionary Directories ................................................................................................... 105 CISAPRIDE DICTIONARY......................................................................................................... 107 INDEX .............................................................................................................................................. 147

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

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

New Drugs: Cisapride Source: Australian Prescriber. 14(1): 9. 1991. Summary: Cisapride is a drug that increases the motility of the gastrointestinal tract. It has been approved for the treatment of severe reflux esophagitis and gastroparesis associated with diabetic neuropathy. This brief article summarizes the pharmacology of cisapride, its actions, possible adverse clinical effects, and animal studies and human clinical data from early use of the drug. The recommended dosing of the drug is also described.

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Long-Term Cisapride Treatment Improves Diabetic Gastroparesis But Not Glycaemic Control Source: Alimentary Pharmacology and Therapeutics. 16(7):1341-1346. July 2002. Contact: Available from Alimentary Pharmacology and Therapeutics. Blackwell Science Ltd., Osney Mead, Oxford OX2 OEL, UK. +44(0)1865 206206. Fax +44(0)1865 721205. Email: [email protected]. Website: www.blackwell-science.com. Summary: In patients with diabetic gastroparesis (delayed emptying of the stomach's contents), delayed food delivery to the intestine may become a major obstacle to postprandial (after a meal) glycemic control. This article reports on a study undertaken to investigate whether cisapride accelerates gastric (stomach) emptying in the long term or improves diabetes control in patients with diabetic gastroparesis. The study included 85 patients with longstanding insulin dependent diabetes mellitus, dyspepsia, and diabetic neuropathy who were tested for impaired gastric emptying of solids. Nineteen of these patients with severe diabetic gastroparesis were randomly treated with 10 milligrams cisapride three times a day (n = 9) or placebo (n = 10) for 12 months. Thereafter, the breath test, dyspeptic symptoms and glycosylated hemoglobin (a measure of blood glucose control over time) values were reassessed. Half emptying times in nine patients with diabetic gastroparesis were significantly shortened by cisapride. Half emptying times in the 10 patients taking placebo did not change. Cisapride significantly reduced dyspepsia. HbA1c (glycosylated hemoglobin) values after 12 months of treatment were not different. The authors conclude that prokinetic treatment with cisapride accelerates gastric emptying of solids and improves dyspeptic symptoms in diabetic gastroparesis. Glycemic control, however, is not affected by cisapride. 2 figures. 2 tables. 22 references.

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Cisapride for the Treatment of Constipation in Children: A Double-Blind Study Source: Journal of Pediatrics. 136(1): 35-40. January 2000. Contact: Available from Mosby, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146-3318. (800) 453-4351 or (314) 453-4351. Fax (314) 432-1158. Website: www.mosby.com. Summary: This article reports on a study undertaken to determine whether cisapride is effective in treating children with constipation. The double blind, placebo controlled study included children with chronic constipation who were randomly assigned to treatment with cisapride or placebo for 12 weeks. Forty children were enrolled, and 36 completed the therapy. Treatment successes occurred in 13 of 17 subjects in the cisapride group (76 percent) and 8 of 19 subjects in the placebo group (37 percent). The odds ratio for response after cisapride administration was 8.2 times higher. During cisapride therapy, there was a significant improvement in the number of spontaneous bowel movements per week and a significant decrease in the number of fecal soiling episodes per day, percentage with encopresis, number of laxative doses per week, percentage using laxatives, and total gastrointestinal transit time. With placebo, there were no significant changes in the number of spontaneous bowel movements, percentage with encopresis, or total gastrointestinal time; but there was a significant decrease in the number of fecal soiling episodes per day and the number of laxative doses per week. The authors conclude that cisapride was effective in treating children with constipation. The authors note, however, that cisapride is not recommended as the first line drug for children with constipation. Dietary fiber and other behavior changes are recommended first. 1 figure. 2 tables. 27 references.

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Cisapride: A Prokinetic Drug for GERD Source: Internal Medicine Alert. 15(23): 180-182. December 15, 1993. Contact: Available from American Health Consultants. 3525 Piedmont Road, Building 6, Room 400, Atlanta, GA 30305. (800) 688-2421 or (404) 262-7436. PRICE: Single issue $7, prepaid. Subscription $116/year. Summary: This article reviews the use of cisapride, a gastrointestinal prokinetic drug, for gastroesophageal reflux disease (GERD). The article addresses indications; clinical pharmacology; pharmacokinetics; drug interactions; adverse effects; cost factors; and recommended dose and monitoring parameters. The author notes that cisapride has been demonstrated to be safe and effective in relieving symptoms of GERD and improving healing of mild esophagitis. Cisapride also has the potential for use in 'offlabel' indications such as non-ulcer dyspepsia, diabetic gastroparesis, and maintenance therapy in patients with GERD. 1 table. 6 references.

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New Safety Recommendations for Use of Cisapride (Propulsid) Source: Harvard Heart Letter. 10(8): 7. April 2000. Contact: Available from Harvard Medical School Health Publications Group. Harvard Heart Letter, P.O. Box 420300, Palm Coast, FL 32142-0300. (800) 829-9045. E-mail: [email protected]. Website: www.health.harvard.edu. Summary: This brief newsletter article, from the Harvard Heart Letter, reminds readers of the new safety recommendations for the use of cisapride (Propulsid). Cisapride is used to treat severe nighttime heartburn, usually caused by gastroesophageal reflux disease (GERD), a condition where the band of muscle that prevents stomach acid from leaking back into the esophagus relaxes spontaneously, creating a painful heartburn like sensation. Cisapride works by moving gastric acids through the digestive tract, thereby preventing their painful reflux into the esophagus. Because this drug has some risks, it is generally reserved for patients who have not responded well to lifestyle changes or other medications used to manage GERD. Serious adverse reactions occurring in patients on cisapride have included heart rhythm disorders and death (most often occurring in people with certain health problems or who were taking other medications). Although it could not find a direct link between the reported problems and cisapride, the U.S. Food and Drug Administration (FDA) did strengthen the precautions on using this drug. In January 2000, the FDA bolstered its efforts to reduce the likelihood of complications from cisapride by recommending that physicians consider performing an electrocardiogram and certain blood tests before prescribing it. The article lists the drugs that should not be combined with cisapride, as well as the complicating medical conditions that contraindicate its use.

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Propulsid (Cisapride) Source: Gastroenterology Nursing. 16(5): 235-236. April 1994. Contact: Available from Williams and Wilkins. 428 East Preston Street, Baltimore, MD 21202-3993. (800) 638-6423. Summary: This drug forum describes Propulsid, an oral gastrointestinal prokinetic agent containing cisapride as the monohydrate. Propulsid increases lower esophageal sphincter pressure, increases esophageal peristalsis, and increases gastric emptying. Propulsid was released for clinical use in July 1993 and is indicated in the treatment of patients with nocturnal heartburn due to gastroesophageal reflux disease. The article

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discusses the indications, mechanism of action, pharmacokinetics, contraindications, precautions, drug interactions, adverse effects, and dosage and administration considerations of propulsid. The article concludes with nursing interventions that may be appropriate for patients being treated with this medication. 1 reference.

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

Project Title: EX VIVO ASSESSMENT FOR CARDIOVASCULAR TOXICITY OF DRUGS Principal Investigator & Institution: Tanhehco, Elaine J.; Cordynamics, Inc. 2201 W Campbell Park Dr Chicago, Il 606123568 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-NOV-2004 Summary: (provided by applicant): Unanticipated reports of lethal arrhythmias associated with clinically approved drugs, such as terfenadine (Seldane(R)) and cisapride (Propulsid(R)), have led the Food and Drug Administration to recommend that all new drug candidates be screened for cardiac toxicity, particularly for proarrhythmic potential. Currently, there are no commercially available, cost-effective in vitro screens that can be used to determine a compound's functional effects on the myocardium. A model whereby rabbit myocardium is isolated and sustained ex vivo via perfusion with a buffer would be ideal to quickly and simultaneously assess the electrophysiologic, hemodynamic and potential proarrhythmic effects of new drug candidates. The goal of this project is to validate the use of the rabbit isolated heart to rapidly evaluate the potential toxicity of pharmaceutical compounds for commercial application. Commercializing this model to screen new drug candidates would provide a much needed service to improve the attrition rate of compounds selected for further testing, and thus reduce overall drug development costs and timelines. In this Phase I proposal, validation will be achieved by exposing rabbit isolated hearts to drugs with known effects on human myocardium, in order to confirm that the results from the rabbit isolated heart correspond with those of the human heart. The responses of isolated hearts to these drugs will also be examined under bradycardic and hypokalemic

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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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(low potassium) conditions, which can precipitate ventricular arrhythmias. The specific aims are: 1) determine the electrophysiologic and hemodynamic effects of recognized drugs on bradycardic rabbit isolated hearts compared to normal rabbit hearts; 2) determine the electrophysiologic and hemodynamic effects of recognized drugs on rabbit isolated hearts perfused with hypokalemic buffer; and 3) determine the electrophysiologic and hemodynamic effects of recognized drugs on bradycardic rabbit isolated hearts perfused with hypokalemic buffer. For Phase II, we plan to use the data obtained in the Phase I project as groundwork to modify and refine the ability of the rabbit isolated heart to more accurately differentiate between compounds which are truly proarrhythmic versus those that merely alter the cardiac electrophysiologic profile. Our ultimate goal is to utilize this model to screen compounds for pharmaceutical sponsors that lack the facilities and/or expertise to to perform this type of toxicologic testing. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: GASTROESOPHAGEAL REFLUX IN PRETERM INFANTS & EFFECT OF PROKINETIC AGE Principal Investigator & Institution: Sinkin, Robert; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEURAL CONTROL OF THE GALLBLADDER Principal Investigator & Institution: Mawe, Gary M.; Professor; Anatomy and Neurobiology; University of Vermont & St Agric College 340 Waterman Building Burlington, Vt 05405 Timing: Fiscal Year 2003; Project Start 01-JUL-1988; Project End 31-DEC-2007 Summary: (provided by applicant): A hallmark of biliary tract disease is a decrease in the tone of gallbladder smooth muscle (GBSM), and a decrease in the responsiveness of GBSM to excitatory agonists. Despite the importance of GBSM excitation, contraction (EC) coupling, little is known about this process. The objectives of this proposal are to establish the mechanisms for GBSM excitation and how this translates to muscle contraction. The first Specific Aim is to determine the cellular mechanisms that are responsible for electrical rhythmicity in GBSM. Our preliminary data indicate that the gallbladder rhythmicity departs radically from the mechanisms that dominate control in other parts: of the GI tract. The novel possibility that the action potential of GBSM is terminated by ERG K+ channel activation will be explored. The ERG channel is a target of a number of clinically relevant drugs including the prokinetic agent, cisapride. We will be particularly interested in determining whether the GBSM ERG channel differs pharmacologically from the cardiac muscle channel, with the hopes of ultimately guiding studies on the development of GBSM specific ERG blockers. The second Specific Aim will determine the mechanisms by which excitatory agonists such as acetylcholine and CCK stimulate GBSM, with a focus on non-selective cation channels, specifically: TRP channels. The role of K+ channel inhibition in the excitatory: effects of agonists will also be determined. The third Specific Aim will determine how excitatory agonists alter the pattern of calcium signaling in GBSM. We will test the novel concept that excitatory agonists shift calcium signaling from sparks - a smooth muscle relaxation mechanism through activation of K+ channels - to calcium waves, a signal that contributes to

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contraction. We propose an integrated approach using state-of-the-art techniques to determine GBSM function from single molecules to the intact tissue. Together with our previous studies on gallbladder nerves, we expect to provide a comprehensive view of gallbladder function, which should illuminate new pathways to handle biliary tract disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DISORDERS

PSYCHOBIOLOGY

OF

EATING

BEHAVIOR

IN

EATING

Principal Investigator & Institution: Walsh, B T.; Professor; Psychiatry; Columbia University Health Sciences Po Box 49 New York, Ny 10032 Timing: Fiscal Year 2002; Project Start 01-JAN-1997; Project End 31-DEC-2003 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: REGULATION OF HERG PROTEINS BY CHEMICAL CHAPERONES Principal Investigator & Institution: Delisle, Brian P.; Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-AUG-2002 Summary: (provided by applicant): The long-term goal of this project is to investigate the pharmacological rescue of ion channels that fail to traffic normally to the plasma membrane. Failure of protein trafficking underlies ion channelopathies associated with congenital Long QT2 syndrome (LQT2). Drugs that bind to channels with a high affinity can restore the trafficking defects of mutant ion channels. However, the mechanisms that underlie the drug rescue of these channels remain poorly understood. This proposal examines the differences in pharmacological rescue of Long QT2 trafficking defects at the molecular and functional level. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: ROLE OF HERG-LIKE K+ CHANNELS IN G.I. SMOOTH MUSCLE Principal Investigator & Institution: Akbarali, Hamid I.; Associate Professor; Physiology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73126 Timing: Fiscal Year 2002; Project Start 15-SEP-2000; Project End 31-AUG-2004 Summary: The objective of this proposal is to pursue studies on the genesis of the resting membrane potential in visceral smooth muscle. The resting potential is one of the major determinants of smooth muscle excitability and is largely governed by the permeability to K+ ions. Preliminary studies demonstrate that the resting potential of several gastrointestinal smooth muscle is, in part, controlled by a unique human ether-ago-go (HERG)-like K+ channel. This K+ current demonstrates inward rectification and appears to be a potential target of the commonly used prokinetic agent, cisapride. The first specific aim is to characterize the detailed biophysical properties of the HERG-like K+ current in gastrointestinal smooth muscle cells. The voltage- dependent kinetics of this current in single cells will be determined using the patch clamp technique and its physiological role in resting potential and repolarization of the action potential will be characterized. The second specific aim is to identify the pharmacological regulation of the smooth muscle HERG-like K+ currents. in these studies, the effects of class III antiarrhythmic compounds which are known HERG channel blockers will be

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determined, and the mechanism of action of the prokinetic agent, cisapride on the HERG currents will be investigated. Preliminary data show that cisapride attenuates the HERG currents in single gastrointestinal smooth muscle cells and depolarizes muscle strips. The effects of the excitatory neurotransmitter, acetylcholine on these K currents will be determined and the involvement of the second messenger regulation by protein kinase C will be evaluated. In the third specific aim, the protein expression of HERG-like channels will be localized by immunofluorescence techniques and by Western blotting. The fourth specific aim is to define the relationship of the HERG-like conductance with those of the other inwardly rectifying currents in smooth muscle. In these studies the role of IKi, ATP- sensitive K+ channel and the hyperpolarization-activated cation currents will be examined. Inhibitory modulators of the HERG-ike K+ channels in smooth muscle may provide new approaches to treatment of disorders that involve smooth muscle hyperexcitability. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: STOMACH CAPACITY AND EMPTYING IN OBESITY Principal Investigator & Institution: Geliebter, Allan; St. Luke's-Roosevelt Inst for Hlth Scis Health Sciences New York, Ny 100191102 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004 Summary: (Adapted From The Applicant's Abstract): Obesity, which can lead to a variety of chronic diseases and reduced life span, continues to increase in prevalence in the US. A subset of obese subjects (30 percent of those entering medical weight-loss programs) has the recently characterized binge-eating disorder (BED), ingestion of very large meals without purging as occurs in bulimia nervosa. We have shown that stomach capacity is greater in obese than lean subjects, but this may be due mainly to the BED subset. We hypothesize that stomach capacity is larger in obese BED subjects than in obese non-BED subjects and lean subjects. Stomach capacity will be estimated by filling a gastric balloon in 24 obese BED and 24 non-obese subjects and 24 lean controls, each group divided equally by sex. Gastric capacity will be estimated from a) maximum volume tolerated and b) volume required to induce a given rise in intragastric pressure. Gastric capacity will be correlated with laboratory test-meal intake. Gastric emptying of a liquid meal will also be determined and related to gastric capacity. From out previous work, we would predict slower emptying, especially in the early phase, from a stomach with a large capacity. During the gastric emptying test, blood will be sampled for plasma cholecystokinin (CCK), a satiety peptide, shown to be lower in bulimics postprandially. The reduced CCK in bulimics may be the result of slower gastric emptying and larger gastric capacity and is predicted to be reduced in BED. The extent to which gastric capacity and emptying, test meal intake, and CCK change after restrictive dieting in obese subjects will then be determined. The obese BED and nonBED subjects will be randomized for 3 mo. of a) cognitive-behavior modification with a recommended intake of 5016 kJ/day (1200 kcal/day) or b) ad-lib intake. Gastric capacity may not decline in BED subjects if it is a primary factor in the disorder. Body composition, including underwater weighing wil be assessed before and after this period. Afterwards, a double-blind, dose-response study of a gastric emptying accelerant (cisapride) will be conducted in 12 non-dieting subjects of each group. Especially for the BED group, cisapride may speed emptying, enhance CCK release, and increase satiety. The lowest effective dose will then be used in a double-blind, 2 month crossover clinical trial of 12 obese non-BED subjects. Body weight and composition will be assessed at the start and monthly. The studies may enhance knowledge of the etiology, pathophysiology, and treatment of BED.

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Cisapride

Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “cisapride” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for cisapride in the PubMed Central database: •

Coroner considers second cisapride inquest. by [No authors listed]; 2002 Apr 16; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=100894

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Pharmacokinetics of sparfloxacin and interaction with cisapride and sucralfate. by Zix JA, Geerdes-Fenge HF, Rau M, Vockler J, Borner K, Koeppe P, Lode H.; 1997 Aug; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=163982

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Position of aromatic residues in the S6 domain, not inactivation, dictates cisapride sensitivity of HERG and eag potassium channels. by Chen J, Seebohm G, Sanguinetti MC.; 2002 Sep 17; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=129467

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.6 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 cisapride, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “cisapride” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for cisapride (hyperlinks lead to article summaries): 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparative study of cisapride and ranitidine at controlling oesophageal acid exposure in erosive oesophagitis. Author(s): Pouderoux P, Kahrilas PJ. Source: Alimentary Pharmacology & Therapeutics. 1995 December; 9(6): 661-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8824654

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A comparison between cisapride and Gaviscon with Carobel in the treatment of gastro-oesophageal reflux in infancy. Author(s): Greally P, Hampton FJ, MacFadyen UM, Simpson H. Source: Ir Med J. 1992; 85(4 Suppl): 14. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1490841

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A comparison of the pharmacokinetics of two dosing regimens of cisapride and their effects on corrected QT interval in premature infants. Author(s): Cools F, Benatar A, Bruneel E, Theyskens C, Bougatef A, Casteels A, Vandenplas Y. Source: European Journal of Clinical Pharmacology. 2003 May; 59(1): 17-22. Epub 2003 April 01. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12682804

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A comparison of two cohort studies evaluating the safety of cisapride: PrescriptionEvent Monitoring and a large phase IV study. Author(s): Wager E, Tooley PJ, Pearce GL, Wilton LV, Mann RD. Source: European Journal of Clinical Pharmacology. 1997; 52(2): 87-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9174676

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A controlled trial of cisapride in anorexia nervosa. Author(s): Szmukler GI, Young GP, Miller G, Lichtenstein M, Binns DS. Source: The International Journal of Eating Disorders. 1995 May; 17(4): 347-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7620474

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A double-blind fluoroscopic study of cisapride on gastrointestinal motility in patients with functional dyspepsia. Author(s): Degryse H, De Schepper A, Verlinden M. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 195: 1-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8516652

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A double-blind placebo-controlled study on prophylactic use of cisapride on feed intolerance and gastric emptying in preterm neonates. Author(s): Reddy PS, Deorari AK, Bal CS, Paul VK, Singh M. Source: Indian Pediatrics. 2000 August; 37(8): 837-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10951632

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A double-blind randomized study of cisapride in the treatment of nonulcer dyspepsia. The Canadian Cisapride Nud Study Group. Author(s): Champion MC, MacCannell KL, Thomson AB, Tanton R, Eberhard S, Sullivan SN, Archambault A. Source: Canadian Journal of Gastroenterology = Journal Canadien De Gastroenterologie. 1997 March; 11(2): 127-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9113812

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A double-blind, randomized, placebo-controlled trial of cisapride in Saudi Arabs with functional dyspepsia. Author(s): al-Quorain A, Larbi EB, al-Shedoki F. Source: Scandinavian Journal of Gastroenterology. 1995 June; 30(6): 531-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7569759

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A German drug-monitoring study in general practice patients receiving cisapride for functional dyspepsia. Author(s): Liehr H, Schmidt R. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 195: 54-8; Discussion 58-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8516660

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A mechanism for the proarrhythmic effects of cisapride (Propulsid): high affinity blockade of the human cardiac potassium channel HERG. Author(s): Rampe D, Roy ML, Dennis A, Brown AM. Source: Febs Letters. 1997 November 3; 417(1): 28-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9395068

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A prospective, randomized, double-blinded, placebo-controlled trial of cisapride after colorectal surgery. Author(s): Brown TA, McDonald J, Williard W. Source: American Journal of Surgery. 1999 May; 177(5): 399-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10365879

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A randomised study evaluating the effects of cisapride on glucose variability and quality of life parameters in insulin-dependent diabetes mellitus patients. Author(s): Johansson UB, Wredling RA, Adamson UC, Lins PE. Source: Diabetes & Metabolism. 1999 September; 25(4): 314-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10566120

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A randomized placebo-controlled trial of simethicone and cisapride for the treatment of patients with functional dyspepsia. Author(s): Holtmann G, Gschossmann J, Mayr P, Talley NJ. Source: Alimentary Pharmacology & Therapeutics. 2002 September; 16(9): 1641-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12197843

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A randomized, double-blind placebo-controlled trial of the effects of the 5hydroxytriptamine(4) agonist cisapride on the female urinary bladder. Author(s): Steele AC, Walsh P, Bentley M, Neff J, Karram M. Source: American Journal of Obstetrics and Gynecology. 2001 July; 185(1): 62-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11483905

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A review of the adverse effects of Cisapride. Author(s): Gibson D. Source: J Ark Med Soc. 1999 February; 95(9): 384-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10036856

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A risk-benefit assessment of cisapride in the treatment of gastrointestinal disorders. Author(s): Tack J, Coremans G, Janssens J. Source: Drug Safety : an International Journal of Medical Toxicology and Drug Experience. 1995 June; 12(6): 384-92. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8527013

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A simple high-performance liquid chromatography assay for the major cisapride metabolite, norcisapride, in human urine. Author(s): Addison RS, Duffy SL, Mathers SR. Source: Journal of Chromatographic Science. 1999 March; 37(3): 61-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10089595

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Absent postprandial duodenal motility in a child with cystic fibrosis. Correction of the symptoms and manometric abnormality with cisapride. Author(s): Hyman PE. Source: Gastroenterology. 1986 May; 90(5 Pt 1): 1274-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2870003

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Absorption kinetics of oral sotalol combined with cisapride and sublingual sotalol in healthy subjects. Author(s): Deneer VH, Lie-A-Huen L, Kingma JH, Proost JH, Kelder JC, Brouwers JR. Source: British Journal of Clinical Pharmacology. 1998 May; 45(5): 485-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9643622

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Acid reflux test for gastroesophageal reflux after distal gastrectomy: diagnosis and clinical effect of cisapride. Author(s): Shibata Y, Nimura Y, Toyoda S, Yasui A, Kawamura T. Source: Journal of the American College of Surgeons. 1998 May; 186(5): 596-600. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9583703

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Acid, motility, and ulcers: a comparison of cisapride with placebo in the prevention of duodenal ulcer relapse. Author(s): Kerrigan DD, Taylor ME, Read NW, Johnson AG. Source: Gut. 1993 August; 34(8): 1042-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8174950

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Action of cisapride on gallbladder contraction in patients with diabetes mellitus. Author(s): Kapicioglu S, Senturk O, Bambul N, Ilgun K. Source: Hepatogastroenterology. 1998 September-October; 45(23): 1410-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9840075

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Acute effect of the gastrokinetics cisapride and metoclopramide on the gastric emptying function in patients with the early satiety syndrome. Author(s): Ghigliani M, Iantorno G, Vazquez S, Varela A. Source: Acta Gastroenterol Latinoam. 1987; 17(1): 43-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3442182

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Addition of cisapride shortens colonoscopy preparation with lavage in elderly patients. Author(s): Ueda S, Iishi H, Tatsuta M, Oda K, Osaka S. Source: Alimentary Pharmacology & Therapeutics. 1994 April; 8(2): 209-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8038353

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Aggravation of parkinsonian tremor by cisapride. Author(s): Sempere AP, Duarte J, Cabezas C, Claveria LE, Coria F. Source: Clinical Neuropharmacology. 1995 February; 18(1): 76-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8665538

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Analysis of cisapride in neonatal plasma using high-performance liquid chromatography with a base-stable column and fluorescence detection. Author(s): Preechagoon Y, Charles BG. Source: Journal of Chromatography. B, Biomedical Applications. 1995 August 4; 670(1): 139-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7493071

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Assessment by prolonged ambulatory manometry of the effect of oral cisapride on proximal small bowel inter-digestive motility. Author(s): Benson MJ, Castillo FD, Deeks JJ, Wingate DL. Source: Digestive Diseases and Sciences. 1992 October; 37(10): 1569-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1396005

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Bioavailability of three oral dosage forms of cisapride, a gastrointestinal stimulant agent. Author(s): Barone JA, Huang YC, Bierman RH, Colaizzi JL, Long JF, Kerr DA, Van Peer A, Woestenborghs R, Heykants J. Source: Clin Pharm. 1987 August; 6(8): 640-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3691010

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Blockage of the HERG human cardiac K+ channel by the gastrointestinal prokinetic agent cisapride. Author(s): Mohammad S, Zhou Z, Gong Q, January CT. Source: The American Journal of Physiology. 1997 November; 273(5 Pt 2): H2534-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9374794

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Bronchospasm associated with cisapride. Author(s): Pillans P. Source: Bmj (Clinical Research Ed.). 1995 December 2; 311(7018): 1472. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8520336

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Cardiotoxicity of new antihistamines and cisapride. Author(s): Paakkari I. Source: Toxicology Letters. 2002 February 28; 127(1-3): 279-84. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12052668

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Changes in related drug class utilization after market withdrawal of cisapride. Author(s): Glessner MR, Heller DA. Source: Am J Manag Care. 2002 March; 8(3): 243-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11915974

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Chronic idiopathic singultus: is there life after cisapride? Author(s): Petroianu GA. Source: N Z Med J. 2004 January 30; 117(1188): U756. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14999312

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Cisapride and the Vanessa Young inquest. Author(s): Arnott W. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2001 August 21; 165(4): 395. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11531044

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Cisapride controversy. Author(s): Sharma MP. Source: Trop Gastroenterol. 2002 October-December; 23(4): 188-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12833708

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Cisapride disposition in neonates and infants: in vivo reflection of cytochrome P450 3A4 ontogeny. Author(s): Kearns GL, Robinson PK, Wilson JT, Wilson-Costello D, Knight GR, Ward RM, van den Anker JN; Pediatric Pharmacology Research Unit Network. Source: Clinical Pharmacology and Therapeutics. 2003 October; 74(4): 312-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14534518

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Cisapride does not prevent postoperative vomiting in children. Author(s): Cook-Sather SD, Harris KA, Schreiner MS. Source: Anesthesia and Analgesia. 2002 January; 94(1): 50-4, Table of Contents. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11772799

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Cisapride fallout? Canada to gain access to largest adverse-event database. Author(s): Sibbald B. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 October 1; 167(7): 790. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12389847

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Cisapride improves gallbladder emptying in patients with type 2 diabetes mellitus. Author(s): Dhiman RK, Arke L, Bhansali A, Gupta S, Chawla YK. Source: Journal of Gastroenterology and Hepatology. 2001 September; 16(9): 1044-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11595071

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Cisapride inhibits meal-stimulated gastric acid secretion and post-prandial gastric acidity in subjects with gastro-oesophageal reflux disease. Author(s): Gardner JD, Rodriguez-Stanley S, Robinson M, Miner PB Jr. Source: Alimentary Pharmacology & Therapeutics. 2002 October; 16(10): 1819-29. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12269977

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Cisapride or metoclopramide to accelerate small bowel transit during barium followthrough examination? Author(s): Hare C, Halligan S, Bartram CI, Platt K, Raleigh G. Source: Abdominal Imaging. 2000 May-June; 25(3): 243-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10823442

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Cisapride raises the bioavailability of paracetamol by inhibiting its glucuronidation in man. Author(s): Itoh H, Nagano T, Takeyama M. Source: The Journal of Pharmacy and Pharmacology. 2001 July; 53(7): 1041-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11480539

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Cisapride treatment for gastro-oesophageal reflux in children. Author(s): Augood C, MacLennan S, Gilbert R, Logan S. Source: Cochrane Database Syst Rev. 2003; (4): Cd002300. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583950

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Cisapride treatment for gastro-oesophageal reflux in children. Author(s): Augood C, Gilbert R, Logan S, MacLennan S. Source: Cochrane Database Syst Rev. 2002; (3): Cd002300. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12137654

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Cisapride treatment for gastro-oesophageal reflux in children. Author(s): Augood C, MacLennan S, Gilbert R, Logan S. Source: Cochrane Database Syst Rev. 2000; (3): Cd002300. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10908549

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Cisapride: a potential model substrate to assess cytochrome P4503A4 activity in vivo. Author(s): Lowry JA, Kearns GL, Abdel-Rahman SM, Nafziger AN, Khan IS, Kashuba AD, Schuetz EG, Bertino JS Jr, van den Anker JN, Leeder JS. Source: Clinical Pharmacology and Therapeutics. 2003 March; 73(3): 209-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12621386

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Cisapride: limited access and alternatives. Author(s): Cochrane Database Syst Rev. 2002;(3):CD002300 Source: Cleve Clin J Med. 2000 July; 67(7): 471-2. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12137654

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Cisapride: questions and answers. Author(s): El Sayed A, Shammaa M. Source: J Med Liban. 2000 September-October; 48(5): 338. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12489590

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Cisapride: the black sheep. Author(s): Vandenplas Y. Source: Journal of Pediatric Gastroenterology and Nutrition. 2002 July; 35(1): 5-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12142801

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Cisapride: the problem of the heart. Author(s): Premji SS, Paes B. Source: Neonatal Netw. 1999 October; 18(7): 21-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808885

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Cisapride--a word of caution. Author(s): Rana S, Sharma B. Source: J Assoc Physicians India. 2001 April; 49: 495. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11762637

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CNS adverse effects of cisapride in children. Author(s): Torringa ML, van Roon EN, de Vries TW. Source: The Annals of Pharmacotherapy. 2003 September; 37(9): 1344. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12921525

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Cochrane's epitaph for cisapride in childhood gastro-oesophageal reflux. Author(s): Bourke B, Drumm B. Source: Archives of Disease in Childhood. 2002 February; 86(2): 71-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11827895

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Comparison between pediatricians and family practitioners in the use of the prokinetic cisapride for gastroesophageal reflux disease in children. Author(s): Shaoul R, Shahory R, Tamir A, Jaffe M. Source: Pediatrics. 2002 June; 109(6): 1118-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12042552

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Comparison of cisapride and metoclopramide for facilitating gastric emptying and improving tolerance to intragastric enteral nutrition in critically III, mechanically ventilated adults. Author(s): MacLaren R, Patrick WD, Hall RI, Rocker GM, Whelan GJ, Lima JJ. Source: Clinical Therapeutics. 2001 November; 23(11): 1855-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11768837

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Continued cisapride prescription. Author(s): Booth IW. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 July; 31(1): 95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10896085

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Contraindicated medications dispensed with cisapride: temporal trends in relation to the sending of 'Dear Doctor' letters. Author(s): Weatherby LB, Walker AM, Fife D, Vervaet P, Klausner MA. Source: Pharmacoepidemiology and Drug Safety. 2001 May; 10(3): 211-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11501334

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Coprescribing and codispensing of cisapride and contraindicated drugs. Author(s): Jones JK, Fife D, Curkendall S, Goehring E Jr, Guo JJ, Shannon M. Source: Jama : the Journal of the American Medical Association. 2001 October 3; 286(13): 1607-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11585484

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Cushing's syndrome in a patient with bilateral macronodular adrenal hyperplasia responding to cisapride: an in vivo and in vitro study. Author(s): Mannelli M, Ferruzzi P, Luciani P, Crescioli C, Buci L, Corona G, Serio M, Peri A. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 October; 88(10): 4616-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14557431

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Cytochrome P450 Involvement in the biotransformation of cisapride and racemic norcisapride in vitro: differential activity of individual human CYP3A isoforms. Author(s): Pearce RE, Gotschall RR, Kearns GL, Leeder JS. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2001 December; 29(12): 1548-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11717173

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Delayed gastric emptying after Billroth I pylorus-preserving pancreatoduodenectomy: effect of postoperative time and cisapride. Author(s): Takeda T, Yoshida J, Tanaka M, Matsunaga H, Yamaguchi K, Chijiiwa K. Source: Annals of Surgery. 1999 February; 229(2): 223-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10024104

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Delayed gastric emptying during interferon-alpha therapy in patients with chronic hepatitis C: relief by cisapride. Author(s): Nishibayashi H, Kanayama S, Shinomura Y, Kawata S, Matsuzawa Y. Source: Scandinavian Journal of Gastroenterology. 1997 June; 32(6): 547-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9200285

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Cisapride

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Determination of cisapride and norcisapride in human plasma using highperformance liquid chromatography with ultraviolet detection. Author(s): Cisternino S, Schlatter J, Saulnier JL. Source: J Chromatogr B Biomed Sci Appl. 1998 September 4; 714(2): 395-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9766883

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Determination of cisapride in plasma and animal tissues by high-performance liquid chromatography. Author(s): Woestenborghs R, Lorreyne W, Van Rompaey F, Heykants J. Source: Journal of Chromatography. 1988 January 22; 424(1): 195-200. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3079529

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Does cisapride influence cardiac rhythm? Results of a United States multicenter, double-blind, placebo-controlled pediatric study. Author(s): Levy J, Hayes C, Kern J, Harris J, Flores A, Hyams J, Murray R, Tolia V. Source: Journal of Pediatric Gastroenterology and Nutrition. 2001 April; 32(4): 458-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11396814

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Domperidone is more effective than cisapride in children with diabetic gastroparesis. Author(s): Franzese A, Borrelli O, Corrado G, Rea P, Di Nardo G, Grandinetti AL, Dito L, Cucchiara S. Source: Alimentary Pharmacology & Therapeutics. 2002 May; 16(5): 951-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11966504

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Domperidone should not be considered a no-risk alternative to cisapride in the treatment of gastrointestinal motility disorders. Author(s): Drolet B, Rousseau G, Daleau P, Cardinal R, Turgeon J. Source: Circulation. 2000 October 17; 102(16): 1883-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11034933

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Dose-finding of cisapride in non-ulcer dyspepsia. Author(s): Verlinden M. Source: Zeitschrift Fur Gastroenterologie. 1990 April; 28 Suppl 1: 31-5; Discussion 72-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2192504

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Double blind controlled trial of effect of cisapride on gastric emptying in diabetics. Author(s): Dutta U, Padhy AK, Ahuja V, Sharma MP. Source: Trop Gastroenterol. 1999 July-September; 20(3): 116-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695417

Studies

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Double-blind comparison of cisapride and cimetidine in treatment of reflux esophagitis. Author(s): Galmiche JP, Fraitag B, Filoche B, Evreux M, Vitaux J, Zeitoun P, Fournet J, Soule JC. Source: Digestive Diseases and Sciences. 1990 May; 35(5): 649-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2331957

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Double-blind placebo-controlled study of cisapride in patients with nonspecific esophageal motility disorder accompanied by delayed esophageal transit. Author(s): Song CW, UM SH, Kim CD, Ryu HS, Hyun JH, Choe JG. Source: Scandinavian Journal of Gastroenterology. 1997 June; 32(6): 541-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9200284

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Double-blind study of the effect of cisapride on constipation and abdominal discomfort as components of the irritable bowel syndrome. Author(s): Schutze K, Brandstatter G, Dragosics B, Judmaier G, Hentschel E. Source: Alimentary Pharmacology & Therapeutics. 1997 April; 11(2): 387-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9146780

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Double-blind, randomized study of the effect of cisapride on gastric emptying in critically ill patients. Author(s): Goldhill DR, Toner CC, Tarling MM, Baxter K, Withington PS, Whelpton R. Source: Critical Care Medicine. 1997 March; 25(3): 447-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9118661

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Drug interactions with cisapride: clinical implications. Author(s): Michalets EL, Williams CR. Source: Clinical Pharmacokinetics. 2000 July; 39(1): 49-75. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10926350

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Drugs recently released in Belgium. Ciprofloxacin-cisapride. Author(s): Harvengt C. Source: Acta Clin Belg. 1990; 45(2): 139-43. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2164311

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Dual effects of cisapride on gastric emptying and antropyloroduodenal motility. Author(s): Fraser R, Horowitz M, Maddox A, Dent J. Source: The American Journal of Physiology. 1993 February; 264(2 Pt 1): G195-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8447401

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Cisapride

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Dyspepsia and dyspepsia subgroups in Japan: symptom profiles and experience with cisapride. Author(s): Inoue M, Sekiguchi T, Harasawa S, Miwa T, Miyoshi A. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 195: 36-8; Discussion 38-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8516656

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Dystonic-like reaction following cisapride therapy. Author(s): Bucci KK, Haverstick DE, Abercrombie SA. Source: The Journal of Family Practice. 1995 January; 40(1): 86-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7807043

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Effect of cisapride on acid gastro-oesophageal reflux during treatment with caffeine. Author(s): Kentrup H, Baisch HJ, Kusenbach G, Heimann G, Skopnik H. Source: Biology of the Neonate. 2000 February; 77(2): 92-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10657685

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Effect of cisapride on corrected QT interval in neonates. Author(s): Khorana M, Chankajorn W, Kanjanapattanakul W, Kirawittaya T, Horpaopan S, Chotigeat U, Sangtawesin W. Source: J Med Assoc Thai. 2003 August; 86 Suppl 3: S590-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700153

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Effect of cisapride on gastric dysrhythmia and emptying of indigestible solids in type-II diabetic patients. Author(s): Chang CS, Lien HC, Yeh HZ, Poon SK, Tung CF, Chen GH. Source: Scandinavian Journal of Gastroenterology. 1998 June; 33(6): 600-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669631

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Effect of cisapride on gastric emptying in patients with gastro-oesophageal reflux disease. Author(s): Koruk M, Yildirim M, Onuk MD, Varoglu E. Source: J Int Med Res. 2001 September-October; 29(5): 389-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11725825

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Effect of cisapride on gastric emptying in premature infants with feed intolerance. Author(s): Barnett CP, Omari T, Davidson GP, Goodchild L, Lontis R, Dent J, Haslam RR. Source: Journal of Paediatrics and Child Health. 2001 December; 37(6): 559-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11903835

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Effect of cisapride on gastric sensitivity to distension, gastric compliance and duodeno-gastric reflexes in healthy humans. Author(s): Manes G, Dominguez-Munoz JE, Leodolter A, Malfertheiner P. Source: Dig Liver Dis. 2001 June-July; 33(5): 407-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11529652

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Effect of cisapride on gastroduodenal reflux and gall bladder motility in patients with gallstones. Author(s): Baxter PS, Maddern GJ. Source: Digestive Surgery. 1998; 15(1): 35-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9845561

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Effect of cisapride on gastroesophageal reflux disease of children. Author(s): Dinler G, Ozen H, Kocak N, Yuce A, Gurakan F. Source: The American Journal of Gastroenterology. 2000 February; 95(2): 552-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10685771

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Effect of cisapride on intestinal bacterial overgrowth and bacterial translocation in cirrhosis. Author(s): Pardo A, Bartoli R, Lorenzo-Zuniga V, Planas R, Vinado B, Riba J, Cabre E, Santos J, Luque T, Ausina V, Gassull MA. Source: Hepatology (Baltimore, Md.). 2000 April; 31(4): 858-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10733540

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Effect of cisapride on nocturnal transient lower oesophageal sphincter relaxations and nocturnal gastro-oesophageal reflux in patients with oesophagitis: a double-blind, placebo-controlled study. Author(s): Pehlivanov N, Sarosiek I, Whitman R, Olyaee M, McCallum R. Source: Alimentary Pharmacology & Therapeutics. 2002 April; 16(4): 743-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11929392

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Effect of cisapride on oesophageal motility and duodenogastro-oesophageal reflux in patients with Barrett's oesophagus. Author(s): Smythe A, Bird NC, Troy GP, Globe J, Johnson AG. Source: European Journal of Gastroenterology & Hepatology. 1997 December; 9(12): 1149-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9471019

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Effect of cisapride on rate-corrected QT intervals in children on peritoneal dialysis. Author(s): Marx M, Kitzmueller E, Pichler A, Arbeiter K, Aufricht C. Source: Pediatric Nephrology (Berlin, Germany). 2002 August; 17(8): 652-5. Epub 2002 May 25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12185476

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Cisapride

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Effect of cisapride on secondary peristalsis in patients with gastroesophageal reflux disease. Author(s): Holloway RH, Penagini R, Schoeman MN, Dent J. Source: The American Journal of Gastroenterology. 1999 March; 94(3): 799-803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10086669

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Effect of cisapride on the QT interval in infants with gastroesophageal reflux. Author(s): Khoshoo V, Edell D, Clarke R. Source: Pediatrics. 2000 February; 105(2): E24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10654984

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Effect of cisapride, a serotonin-4 receptor agonist, on aldosterone secretion: absence of age-related change. Author(s): Huang YY, Hsu BR, Tsai JS. Source: Journal of Clinical Pharmacology. 1997 December; 37(12): 1146-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9506010

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Effect of erythromycin and cisapride on emptying of the vagally denervated intrathoracic stomach. Author(s): Narasimhan R, Mittal BR, Gupta NM. Source: Trop Gastroenterol. 2002 July-September; 23(3): 122-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12693153

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Effect of mental stress and cisapride on autonomic nerve functions in functional dyspepsia. Author(s): Hveem K, Svebak S, Hausken T, Berstad A. Source: Scandinavian Journal of Gastroenterology. 1998 February; 33(2): 123-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9517520

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Effect of oral cisapride on gallbladder emptying during fasting and postprandial states. Author(s): Xynos E, Tsiaoussis J, Epanomeritakis E, Glynos M, Haroulakis N, Vassilakis JS, Gourtsoyiannis N. Source: Academic Radiology. 1998 February; 5(2): 115-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9484545

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Effect of prokinetic agents, cisapride and metoclopramide, on the bioavailability in humans and intestinal permeability in rats of ranitidine, and intestinal charcoal transit in rats. Author(s): Lee HT, Lee YJ, Chung SJ, Shim CK. Source: Res Commun Mol Pathol Pharmacol. 2000 November-December; 108(5-6): 31123. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11958284

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Effect of prolonged administration of the serotonin4 (5-HT4) receptor agonist cisapride on aldosterone secretion in healthy volunteers. Author(s): Lefebvre H, Gonzalez KN, Contesse V, Delarue C, Vaudry H, Kuhnl JM. Source: Endocrine Research. 1998 August-November; 24(3-4): 749-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9888571

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Effect of the serotonin4 receptor agonist cisapride on plasma aldosterone levels in cirrhotic patients with secondary hyperaldosteronism. Author(s): Lefebvre H, Heron F, Contesse V, Delarue C, Vaudry H, Kuhn JM. Source: European Journal of Clinical Pharmacology. 1998 February; 53(6): 479-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9551708

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Effects of cisapride on colonic transit in patients with progressive systemic sclerosis. Author(s): Wang SJ, Lan JL, Lan JL, Chen DY, Chen YH, Hsieh TY, Lin WY. Source: Clinical Rheumatology. 2002 August; 21(4): 271-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12189451

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Effects of cisapride on corrected QT interval, heart rate, and rhythm in infants undergoing polysomnography. Author(s): Benatar A, Feenstra A, Decraene T, Vandenplas Y. Source: Pediatrics. 2000 December; 106(6): E85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11099628

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Effects of cisapride on gall bladder emptying, intestinal transit, and serum deoxycholate: a prospective, randomised, double blind, placebo controlled trial. Author(s): Veysey MJ, Malcolm P, Mallet AI, Jenkins PJ, Besser GM, Murphy GM, Dowling RH. Source: Gut. 2001 December; 49(6): 828-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11709518

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Effects of cisapride on oesophageal transit of solids in patients with progressive systemic sclerosis. Author(s): Wang SJ, La JL, Chen DY, Chen YH, Hsieh TY, Lin WY. Source: Clinical Rheumatology. 2002 February; 21(1): 43-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11954884

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Cisapride

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Effects of cisapride on QT interval in children. Author(s): Khongphatthanayothin A, Lane J, Thomas D, Yen L, Chang D, Bubolz B. Source: The Journal of Pediatrics. 1998 July; 133(1): 51-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9672510

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Effects of cisapride on symptoms and postcibal small-bowel motor function in patients with irritable bowel syndrome. Author(s): Noor N, Small PK, Loudon MA, Hau C, Campbell FC. Source: Scandinavian Journal of Gastroenterology. 1998 June; 33(6): 605-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9669632

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Effects of prostaglandin F2alpha and cisapride on small intestinal activity during the early postoperative period in humans. Author(s): Shibata Y, Toyoda S. Source: Surgery Today. 1998; 28(8): 787-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9718997

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Efficacy and tolerability of cisapride in children. Author(s): Vandenplas Y, Benatar A, Cools F, Arana A, Hegar B, Hauser B. Source: Paediatric Drugs. 2001; 3(8): 559-73. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11577921

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Evidence of impaired cisapride metabolism in neonates. Author(s): Treluyer JM, Rey E, Sonnier M, Pons G, Cresteil T. Source: British Journal of Clinical Pharmacology. 2001 October; 52(4): 419-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11678785

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Factors affecting dose selection and outcome of cisapride treatment for dyspepsia in primary care. The Austro-Cis Study Group. Author(s): Brunner H. Source: Alimentary Pharmacology & Therapeutics. 1996 August; 10(4): 587-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8853763

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Factors affecting short- and long-term outcome of a short therapeutic trial with cisapride in dyspeptic patients. Author(s): Heyse PM, Rambaldo R, Hazelhoff B. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 195: 15-23; Discussion 23-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8516654

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Fat preload delays gastric emptying: reversal by cisapride. Author(s): Stacher G, Bergmann H, Gaupmann G, Schneider C, Kugi A, Hobart J, Binder A, Mittelbach-Steiner G. Source: British Journal of Clinical Pharmacology. 1990 December; 30(6): 839-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2288830

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FDA, Janssen bolster cardiac risk warnings for cisapride. Author(s): Miller JL. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2000 March 1; 57(5): 414. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10711516

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Flunitrazepam and cisapride in premedication for peroral small intestinal biopsy in children and adolescents. Author(s): Bonamico M, Montuori M, Danesi HM, Vecchia AL, Cipolletta E, Roggini M. Source: Journal of Pediatric Gastroenterology and Nutrition. 1999 September; 29(3): 3701. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10468011

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Frequency and clinical outcome of potentially harmful drug metabolic interactions in patients hospitalized on internal and pulmonary medicine wards: focus on warfarin and cisapride. Author(s): Laine K, Forsstrom J, Gronroos P, Irjala K, Kailajarvi M, Scheinin M. Source: Therapeutic Drug Monitoring. 2000 October; 22(5): 503-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11034253

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Gallbladder and cisapride. Author(s): Patankar R, Johnson CD. Source: Digestive Diseases and Sciences. 1993 August; 38(8): 1562-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8344118

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Gallbladder hypokinesia and normal gastric emptying of liquids in patients with dyspeptic symptoms. A double-blind placebo-controlled clinical trial with cisapride. Author(s): Marzio L, DiFelice F, Laico MG, Imbimbo B, Lapenna D, Cuccurullo F. Source: Digestive Diseases and Sciences. 1992 February; 37(2): 262-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1735345

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Gastric antral motility in functional dyspepsia. Effect of mental stress and cisapride. Author(s): Hveem K, Hausken T, Svebak S, Berstad A. Source: Scandinavian Journal of Gastroenterology. 1996 May; 31(5): 452-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8734341

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Cisapride

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Gastric emptying and myoelectrical activity in children with nonulcer dyspepsia. Effect of cisapride. Author(s): Riezzo G, Cucchiara S, Chiloiro M, Minella R, Guerra V, Giorgio I. Source: Digestive Diseases and Sciences. 1995 July; 40(7): 1428-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7628264

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Gastric emptying in critically ill patients is accelerated by adding cisapride to a standard enteral feeding protocol: results of a prospective, randomized, controlled trial. Author(s): Spapen HD, Duinslaeger L, Diltoer M, Gillet R, Bossuyt A, Huyghens LP. Source: Critical Care Medicine. 1995 March; 23(3): 481-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7874898

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Gastric emptying in infants with gastroesophageal reflux. Ultrasound evaluation before and after cisapride administration. Author(s): Carroccio A, Iacono G, Li Voti G, Montalto G, Cavataio F, Tulone V, Lorello D, Kazmierska I, Acierno C, Notarbartolo A. Source: Scandinavian Journal of Gastroenterology. 1992 September; 27(9): 799-804. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1411289

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Gastric emptying time and the effect of cisapride in cirrhotic patients with autonomic neuropathy. Author(s): Gumurdulu Y, Yapar Z, Canataroglu A, Serin E, Gumurdulu D, Kibar M, Colakoglu S. Source: Journal of Clinical Gastroenterology. 2003 February; 36(2): 175-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12544204

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Gastric emptying, body weight and symptoms in primary anorexia nervosa. Longterm effects of cisapride. Author(s): Stacher G, Abatzi-Wenzel TA, Wiesnagrotzki S, Bergmann H, Schneider C, Gaupmann G. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1993 March; 162: 398-402. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8453437

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Gastric myoelectric activity in older adults treated with cisapride for gastrooesophageal reflux disease. Author(s): Orr WC, Zhang M, McClanahan J, Sloan S, Chen JD. Source: Alimentary Pharmacology & Therapeutics. 2000 March; 14(3): 337-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10735928

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Gastroesophageal reflux and bronchial asthma: prevalence and effect of cisapride therapy. Author(s): Tucci F, Resti M, Fontana R, Novembre E, Lami CA, Vierucci A. Source: Journal of Pediatric Gastroenterology and Nutrition. 1993 October; 17(3): 265-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8271125

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Gastroesophageal reflux incidence and respiratory dysfunction during sleep in infants: treatment with cisapride. Author(s): Vandenplas Y, Deneyer M, Verlinden M, Aerts T, Sacre L. Source: Journal of Pediatric Gastroenterology and Nutrition. 1989 January; 8(1): 31-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2732861

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Gastrointestinal transit after spinal cord injury: effect of cisapride. Author(s): Rajendran SK, Reiser JR, Bauman W, Zhang RL, Gordon SK, Korsten MA. Source: The American Journal of Gastroenterology. 1992 November; 87(11): 1614-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1442685

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Gastro-oesophageal reflux and chronic respiratory disease in infants and children: treatment with cisapride. Author(s): Olafsdottir E. Source: Scandinavian Journal of Gastroenterology. Supplement. 1995; 211: 32-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8545628

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Gaviscon and Carobel compared with cisapride in gastro-oesophageal reflux. Author(s): Greally P, Hampton FJ, MacFadyen UM, Simpson H. Source: Archives of Disease in Childhood. 1992 May; 67(5): 618-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1599300

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Glucose control is not improved by accelerating gastric emptying in patients with type 1 diabetes mellitus and gastroparesis. a pilot study with cisapride as a model drug. Author(s): Lehmann R, Honegger RA, Feinle C, Fried M, Spinas GA, Schwizer W. Source: Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association. 2003 August; 111(5): 25561. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12951630

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Healing and prevention of relapse of reflux oesophagitis by cisapride. Author(s): Toussaint J, Gossuin A, Deruyttere M, Huble F, Devis G. Source: Gut. 1991 November; 32(11): 1280-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1752455

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Healing of grade-II and III oesophagitis through motility stimulation with cisapride. Author(s): Lepoutre L, Van der Spek P, Vanderlinden I, Bollen J, Laukens P. Source: Digestion. 1990; 45(2): 109-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2190850

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Hiccough relief with cisapride. Author(s): Duffy MC, Edmond H, Campbell K, Fulton JD. Source: Lancet. 1992 November 14; 340(8829): 1223. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1359287

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High performance liquid chromatographic determination, pharmacokinetic and comparative bioavailability studies of cisapride. Author(s): Emami J, Varshosaz J, Falamarzian M, Tahvilian R. Source: Journal of Pharmaceutical and Biomedical Analysis. 2003 October 15; 33(3): 51320. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14550869

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How safe and acceptable is cisapride? Author(s): Bennett JR. Source: Scandinavian Journal of Gastroenterology. Supplement. 1989; 165: 59-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2690326

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Hyperventilation alternating with apnea in neuroleptic malignant syndrome associated with metoclopramide and cisapride. Author(s): Shintani S, Shiigai T, Tsuchiya K, Kikuchi M. Source: Journal of the Neurological Sciences. 1995 February; 128(2): 232-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7738600

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Hypoprothrombinemia induced by warfarin sodium and cisapride. Author(s): Raburn M. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 1997 February 1; 54(3): 320-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9028427

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Identification of the cytochrome P450 enzymes involved in the metabolism of cisapride: in vitro studies of potential co-medication interactions. Author(s): Bohets H, Lavrijsen K, Hendrickx J, van Houdt J, van Genechten V, Verboven P, Meuldermans W, Heykants J. Source: British Journal of Pharmacology. 2000 April; 129(8): 1655-67. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10780971

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Idiopathic chronic hiccup: combination therapy with cisapride, omeprazole, and baclofen. Author(s): Petroianu G, Hein G, Petroianu A, Bergler W, Rufer R. Source: Clinical Therapeutics. 1997 September-October; 19(5): 1031-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9385490

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Impact of a Web-based clinical information system on cisapride drug interactions and patient safety. Author(s): McMullin ST, Reichley RM, Watson LA, Steib SA, Frisse ME, Bailey TC. Source: Archives of Internal Medicine. 1999 September 27; 159(17): 2077-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10510994

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Impact of cisapride label changes on codispensing of contraindicated medications. Author(s): Guo JJ, Curkendall S, Jones JK, Fife D, Goehring E, She D. Source: Pharmacoepidemiology and Drug Safety. 2003 June; 12(4): 295-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12812009

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Impact of gastric emptying on the pharmacokinetics of ethanol as influenced by cisapride. Author(s): Kechagias S, Jonsson KA, Jones AW. Source: British Journal of Clinical Pharmacology. 1999 November; 48(5): 728-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10594475

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Impact of safety alerts upon prescribing of cisapride to children in New Zealand. Author(s): de la Porte M, Reith D, Tilyard M. Source: N Z Med J. 2002 July 2; 115(1157): U24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12362188

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Impaired transit of chyme in chronic intestinal pseudoobstruction. Correction by cisapride. Author(s): Camilleri M, Brown ML, Malagelada JR. Source: Gastroenterology. 1986 September; 91(3): 619-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3525315

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Increased volume of gastric contents in diabetic patients undergoing renal transplantation: lack of effect with cisapride. Author(s): Reissell E, Taskinen MR, Orko R, Lindgren L. Source: Acta Anaesthesiologica Scandinavica. 1992 October; 36(7): 736-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1441879

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Influence of cisapride on antroduodenal motor function in healthy subjects and diabetics with autonomic neuropathy. Author(s): Wehrmann T, Lembcke B, Caspary WF. Source: Alimentary Pharmacology & Therapeutics. 1991 December; 5(6): 599-608. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1782304

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Influence of cisapride on food-stimulated gastro-oesophageal reflux: a radiological study. Author(s): Gelineck J, Aksglade K, Funch-Jensen P, Thommesen P. Source: Rontgenblatter. 1990 August; 43(8): 352-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2204995

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Influence of cisapride on gastric emptying of solids and liquids monitored by 13C breath tests. Author(s): Duan LP, Braden B, Caspary WF, Lembcke B. Source: Digestive Diseases and Sciences. 1995 October; 40(10): 2200-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7587790

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Influence of cisapride on the pharmacokinetics and antihypertensive effect of sustained-release nifedipine. Author(s): Satoh C, Sakai T, Kashiwagi H, Hongo K, Aizawa O, Watanabe H, Mochizuki S, Okamura T. Source: Intern Med. 1996 December; 35(12): 941-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9030991

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Influence of cisapride, metoclopramide and loperamide on gastric emptying of normal volunteers as measured by means of the area under the curve of the cumulative fraction absorbed-time profiles of paracetamol. Author(s): van Wyk M, Sommers DK, Moncrieff J. Source: Methods Find Exp Clin Pharmacol. 1992 June; 14(5): 379-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1513194

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Influence of coadministration of fluoxetine on cisapride pharmacokinetics and QTc intervals in healthy volunteers. Author(s): Zhao Q, Wojcik MA, Parier JL, Pesco-Koplowitz L. Source: Pharmacotherapy. 2001 February; 21(2): 149-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11213850

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Influence of grapefruit juice on cisapride pharmacokinetics. Author(s): Gross AS, Goh YD, Addison RS, Shenfield GM. Source: Clinical Pharmacology and Therapeutics. 1999 April; 65(4): 395-401. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10223776

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Inhibition of the human ether-a-go-go-related gene (HERG) potassium channel by cisapride: affinity for open and inactivated states. Author(s): Walker BD, Singleton CB, Bursill JA, Wyse KR, Valenzuela SM, Qiu MR, Breit SN, Campbell TJ. Source: British Journal of Pharmacology. 1999 September; 128(2): 444-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10510456

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Interaction of cisapride with the human cytochrome P450 system: metabolism and inhibition studies. Author(s): Desta Z, Soukhova N, Mahal SK, Flockhart DA. Source: Drug Metabolism and Disposition: the Biological Fate of Chemicals. 2000 July; 28(7): 789-800. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10859153

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Intestinal pseudo-obstruction due to neurofibromatosis responding to cisapride. Author(s): Sinha SK, Kochhar R, Rana S, Bapuraj R, Singh K. Source: Indian J Gastroenterol. 2000 April-June; 19(2): 83-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10812823

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Intestinal pseudoobstruction secondary to amyloidosis responsive to cisapride. Author(s): Fraser AG, Arthur JF, Hamilton I. Source: Digestive Diseases and Sciences. 1991 April; 36(4): 532-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2007373

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Intraperitoneal cisapride for the treatment of diabetics with gastroparesis and endstage renal disease. Author(s): Lazarovits AI, Page D. Source: Nephron. 1990; 56(1): 107-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2234243

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Intravenous cisapride accelerates delayed gastric emptying and increases antral contraction amplitude in patients with primary anorexia nervosa. Author(s): Stacher G, Bergmann H, Wiesnagrotzki S, Kiss A, Schneider C, Mittelbach G, Gaupmann G, Hobart J. Source: Gastroenterology. 1987 April; 92(4): 1000-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3556983

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Is rectally administered cisapride an effective prokinetic agent? Author(s): Gales MA, Harms DW. Source: The Annals of Pharmacotherapy. 1999 November; 33(11): 1217-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10573323

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Lack of effect of cisapride on phenytoin free fraction. Author(s): Roberts GW, Kowalski SR, Calabretto JP. Source: The Annals of Pharmacotherapy. 1992 July-August; 26(7-8): 1016-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1504387

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Lack of efficacy of cisapride and nizatidine in dyspepsia. Author(s): Adelman A, Alper BS. Source: The Journal of Family Practice. 1998 June; 46(6): 457-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9638107

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Lack of pharmacokinetic interaction between oral pantoprazole and cisapride in healthy adults. Author(s): Ferron GM, Paul JC, Fruncillo RJ, Martin PT, Yacoub L, Mayer PR. Source: Journal of Clinical Pharmacology. 1999 September; 39(9): 945-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10471987

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Liquid chromatographic method with electrochemical detection for determination of cisapride in serum. Author(s): de Condado MC, Malave A, Dorantes-Hernandez MA, Rathinavelu A. Source: J Aoac Int. 2001 January-February; 84(1): 9-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11234857

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Long QT syndrome during high-dose cisapride. Author(s): Bran S, Murray WA, Hirsch IB, Palmer JP. Source: Archives of Internal Medicine. 1995 April 10; 155(7): 765-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7695465

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Long-term cisapride treatment improves diabetic gastroparesis but not glycaemic control. Author(s): Braden B, Enghofer M, Schaub M, Usadel KH, Caspary WF, Lembcke B. Source: Alimentary Pharmacology & Therapeutics. 2002 July; 16(7): 1341-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12144585

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Long-term efficacy of cisapride in diabetic gastroparesis. Author(s): Horowitz M, Roberts AP. Source: The American Journal of Medicine. 1990 February; 88(2): 195-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2301447

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Long-term efficacy of oral cisapride in symptomatic upper gut dysmotility. Author(s): Abell TL, Camilleri M, DiMagno EP, Hench VS, Zinsmeister AR, Malagelada JR. Source: Digestive Diseases and Sciences. 1991 May; 36(5): 616-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2022163

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Longterm oral cisapride improves interdigestive antroduodenal motility in dyspeptic patients. Author(s): Testoni PA, Bagnolo F, Fanti L, Passaretti S, Tittobello A. Source: Gut. 1990 March; 31(3): 288-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2323591

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Long-term results with cisapride in Parkinson's disease. Author(s): Jost WH, Schimrigk K. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 1997 May; 12(3): 423-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9159740

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Long-Term treatment with cisapride and antibiotics in liver cirrhosis: effect on small intestinal motility, bacterial overgrowth, and liver function. Author(s): Madrid AM, Hurtado C, Venegas M, Cumsille F, Defilippi C. Source: The American Journal of Gastroenterology. 2001 April; 96(4): 1251-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11316178

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Long-term use of cisapride (prepulsid) in premature neonates of less than 34 weeks gestational age. Author(s): Janssens G, Melis K, Vaerenberg M. Source: Journal of Pediatric Gastroenterology and Nutrition. 1990 October; 11(3): 420-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2246729

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Long-term use of cisapride (Prepulsid) in premature neonates. Author(s): Melis K, Janssens G. Source: Acta Gastroenterol Belg. 1990 July-August; 53(4): 372-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2096583

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Maintenance therapy with cisapride after healing of erosive oesophagitis: a doubleblind placebo-controlled trial. Author(s): McDougall NI, Watson RG, Collins JS, McFarland RJ, Love AH. Source: Alimentary Pharmacology & Therapeutics. 1997 June; 11(3): 487-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9218071

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Management of idiopathic, diabetic and miscellaneous gastroparesis with cisapride. Author(s): Champion MC. Source: Scandinavian Journal of Gastroenterology. Supplement. 1989; 165: 44-52; Discussion 52-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2690324

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Measurement of gastric emptying in dyspeptic patients: effect of a new gastrokinetic agent (cisapride). Author(s): Jian R, Ducrot F, Piedeloup C, Mary JY, Najean Y, Bernier JJ. Source: Gut. 1985 April; 26(4): 352-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3884468

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Mechanisms of cisapride affecting gallbladder motility. Author(s): von Kiedrowski R, Huijghebaert S, Raedsch R. Source: Digestive Diseases and Sciences. 2001 May; 46(5): 939-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11341662

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Meta-analysis of randomized controlled trials on the benefits and risks of using cisapride for the treatment of gastroesophageal reflux in children. Author(s): Dalby-Payne JR, Morris AM, Craig JC. Source: Journal of Gastroenterology and Hepatology. 2003 February; 18(2): 196-202. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12542606

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NASPGN and ESPGHAN on the use of cisapride. Author(s): Spielberg SP. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 August; 31(2): 212-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10941984

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Nizatidine and cisapride enhance salivary secretion in humans. Author(s): Adachi K, Ono M, Kawamura A, Yuki M, Fujishiro H, Kinoshita Y. Source: Alimentary Pharmacology & Therapeutics. 2002 February; 16(2): 297-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11860413

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No clinical benefit of adding cisapride to pantoprazole for treatment of gastrooesophageal reflux disease. Author(s): van Rensburg CJ, Bardhan KD. Source: European Journal of Gastroenterology & Hepatology. 2001 August; 13(8): 909-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11507354

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No effect of cisapride on paracetamol absorption after oral simultaneous administration. Author(s): Rowbotham DJ, Parnacott S, Nimmo WS. Source: European Journal of Clinical Pharmacology. 1992; 42(2): 235-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1618258

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No pharmacokinetic but pharmacodynamic interactions between cisapride and bromperidol or haloperidol. Author(s): Mihara K, Otani K, Yasui N, Ishida M, Kondo T, Suzuki A, Furukori H, Nagashima U, Kaneko S, Inoue Y. Source: Therapeutic Drug Monitoring. 1999 June; 21(3): 297-300. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10365640

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Objective and subjective results of a randomized, double-blind, placebo-controlled trial using cisapride to treat gastroparesis. Author(s): Richards RD, Valenzuela GA, Davenport KG, Fisher KL, McCallum RW. Source: Digestive Diseases and Sciences. 1993 May; 38(5): 811-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8482178

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Open label study of long-term effectiveness of cisapride in patients with idiopathic gastroparesis. Author(s): Dworkin BM, Rosenthal WS, Casellas AR, Girolomo R, Lebovics E, Freeman S, Clark SB. Source: Digestive Diseases and Sciences. 1994 July; 39(7): 1395-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8026248

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Oral cisapride for the control of delayed vomiting following high-dose cisplatin. Author(s): Pizzo BA, Pisters KM, Miller VA, Grant SC, Baltzer L, Hinckley L, Kris MG. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 1999 January; 7(1): 44-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9926974

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Overexpression of serotonin4 receptors in cisapride-responsive adrenocorticotropinindependent bilateral macronodular adrenal hyperplasia causing Cushing's syndrome. Author(s): Cartier D, Lihrmann I, Parmentier F, Bastard C, Bertherat J, Caron P, Kuhn JM, Lacroix A, Tabarin A, Young J, Vaudry H, Lefebvre H. Source: The Journal of Clinical Endocrinology and Metabolism. 2003 January; 88(1): 24854. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519861

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Pharmacokinetic characteristics of cisapride in elderly patients. Author(s): Yamamoto T, Takano K, Sanaka M, Kuyama Y, Yamanaka M, Koike Y, Mineshita S. Source: Int J Clin Pharmacol Ther. 1998 August; 36(8): 432-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9726696

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Pharmacokinetic profile of cisapride 20 mg after once- and twice-daily dosing. Author(s): Zhou H, Herron J, Clyde C, Lee P, Mechlinski W, Pesco-Koplowitz L. Source: Clinical Therapeutics. 1998 March-April; 20(2): 292-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9589820

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Pharmacokinetic/pharmacodynamic assessment of the effects of E4031, cisapride, terfenadine and terodiline on monophasic action potential duration in dog. Author(s): Webster R, Allan G, Anto-Awuakye K, Harrison A, Kidd T, Leishman D, Phipps J, Walker D. Source: Xenobiotica; the Fate of Foreign Compounds in Biological Systems. 2001 August-September; 31(8-9): 633-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11569530

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Pharmacokinetics and pharmacodynamics of cisapride in patients undergoing hemodialysis. Author(s): Gladziwa U, Bares R, Klotz U, Dakshinamurty KV, Ittel TH, Seiler KU, Sieberth HG. Source: Clinical Pharmacology and Therapeutics. 1991 December; 50(6): 673-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1752111

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Pharmacokinetics of sparfloxacin and interaction with cisapride and sucralfate. Author(s): Zix JA, Geerdes-Fenge HF, Rau M, Vockler J, Borner K, Koeppe P, Lode H. Source: Antimicrobial Agents and Chemotherapy. 1997 August; 41(8): 1668-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9257738

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Physiologic effects of cisapride on gastric emptying after pylorus-preserving gastrectomy for early gastric cancer. Author(s): Tomita R, Takizawa H, Tanjoh K. Source: World Journal of Surgery. 1998 January; 22(1): 35-40; Discussion 40-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9465759

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Placebo-controlled trial of cisapride and nizatidine in unselected patients with functional dyspepsia. Author(s): Hansen JM, Bytzer P, Schaffalitzky de Muckadell OB. Source: The American Journal of Gastroenterology. 1998 March; 93(3): 368-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9517642

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Placebo-controlled trial of cisapride in postgastrectomy patients with duodenogastroesophageal reflux. Author(s): Vaezi MF, Sears R, Richter JE. Source: Digestive Diseases and Sciences. 1996 April; 41(4): 754-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8674397

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Placebo-controlled trial of cisapride in postoperative ileus. Author(s): Boghaert A, Haesaert G, Mourisse P, Verlinden M. Source: Acta Anaesthesiol Belg. 1987; 38(3): 195-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3321849

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Population pharmacokinetics of cisapride in neonates. Author(s): Odoul F, Le Guellec C, Henrot A, Saliba E, Levron JC, Saux MC, Paintaud G, Autret-Leca E. Source: European Journal of Clinical Pharmacology. 2002 November; 58(8): 507-13. Epub 2002 October 18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12451427

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Population pharmacokinetics of enterally administered cisapride in young infants with gastro-oesophageal reflux disease. Author(s): Preechagoon Y, Charles B, Piotrovskij V, Donovan T, Van Peer A. Source: British Journal of Clinical Pharmacology. 1999 November; 48(5): 688-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10594470

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Position of aromatic residues in the S6 domain, not inactivation, dictates cisapride sensitivity of HERG and eag potassium channels. Author(s): Chen J, Seebohm G, Sanguinetti MC. Source: Proceedings of the National Academy of Sciences of the United States of America. 2002 September 17; 99(19): 12461-6. Epub 2002 Sep 03. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12209010

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Possible interaction between cisapride and bromperidol. Author(s): Ishida M, Otani K, Yasui N, Inoue Y, Kaneko S. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 1997 January; 21(1): 235-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9075269

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Possible interaction between cisapride and digoxin. Author(s): Kubler PA, Pillans PI, McKay JR. Source: The Annals of Pharmacotherapy. 2001 January; 35(1): 127-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11197577

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Postmarketing reports of QT prolongation and ventricular arrhythmia in association with cisapride and Food and Drug Administration regulatory actions. Author(s): Wysowski DK, Corken A, Gallo-Torres H, Talarico L, Rodriguez EM. Source: The American Journal of Gastroenterology. 2001 June; 96(6): 1698-703. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11419817

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Post-necrotising enterocolitis pseudo-obstruction treated with Cisapride. Author(s): Vanderwinden JM, Dassonville M, Van der Veken E, Cadranel S, De Laet MH. Source: Z Kinderchir. 1990 October; 45(5): 282-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2126653

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Postprandial antropyloroduodenal motility and gastric emptying in gastroparesis-effects of cisapride. Author(s): Fraser RJ, Horowitz M, Maddox AF, Dent J. Source: Gut. 1994 February; 35(2): 172-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8307466

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Predicting the clinical response to cisapride in children with chronic intestinal pseudo-obstruction. Author(s): Hyman PE, Di Lorenzo C, McAdams L, Flores AF, Tomomasa T, Garvey TQ 3rd. Source: The American Journal of Gastroenterology. 1993 June; 88(6): 832-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8503375

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Prepulsid withdrawn from UK & US markets. Author(s): Griffin JP. Source: Adverse Drug Reactions and Toxicological Reviews. 2000 August; 19(3): 177. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11059358

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Prevention of aspiration pneumonia during long-term feeding by percutaneous endoscopic gastrostomy: might cisapride play any role? An open pilot study. Author(s): Sartori S, Trevisani L, Tassinari D, Nielsen I, Gilli G, Donati D, Malacarne P. Source: Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer. 1994 May; 2(3): 188-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8032705

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Proarrhythmia associated with cisapride in children. Author(s): Hill SL, Evangelista JK, Pizzi AM, Mobassaleh M, Fulton DR, Berul CI. Source: Pediatrics. 1998 June; 101(6): 1053-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9606235

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Prognostic factors for relapse and maintenance treatment with cisapride in gastrooesophageal reflux disease. Author(s): Tytgat GN, Blum AL, Verlinden M. Source: Alimentary Pharmacology & Therapeutics. 1995 June; 9(3): 271-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7654889

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Prokinetic drug treatment (cisapride) is as effective as H2-blocking agent (ranitidine) in the treatment of gastric ulcer. Author(s): Simon B, Bergemann W, Bouzo H, Huttemann W, Hotz F, Muller P, Rosch W. Source: Hepatogastroenterology. 1991 December; 38 Suppl 1: 41-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1823066

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Prokinetic drugs: metoclopramide and cisapride. Author(s): Dowling PM. Source: Can Vet J. 1995 February; 36(2): 115-6. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7728729

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Prokinetic effect of cisapride on pedicled stomach, small bowel and colon grafts replacing the esophagus after esophageal resection. Author(s): Kalmar K, Vereczkei, Zambo K, Poto L, Horvath OP. Source: Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus / I.S.D.E. 2003; 16(4): 291-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14641291

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Prolongation of the QT interval and cardiac arrhythmias associated with cisapride: limitations of the pharmacoepidemiological studies conducted and proposals for the future. Author(s): Layton D, Key C, Shakir SA. Source: Pharmacoepidemiology and Drug Safety. 2003 January-February; 12(1): 31-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12616845

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Prolongation of the QT interval related to cisapride-diltiazem interaction. Author(s): Thomas AR, Chan LN, Bauman JL, Olopade CO. Source: Pharmacotherapy. 1998 March-April; 18(2): 381-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9545159

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Propulsid (cisapride). Author(s): Claussen DW. Source: Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates. 1994 April; 16(5): 235-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8193188

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QT interval effects of cisapride in the clinical setting. Author(s): Wang SH, Lin CY, Huang TY, Wu WS, Chen CC, Tsai SH. Source: International Journal of Cardiology. 2001 September-October; 80(2-3): 179-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11578711

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QT interval in children and infants receiving cisapride. Author(s): Levine A, Fogelman R, Sirota L, Zangen Z, Shamir R, Dinari G. Source: Pediatrics. 1998 March; 101(3): E9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9481028

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QT prolongation and torsades de pointes associated with concurrent use of cisapride and erythromycin. Author(s): Kyrmizakis DE, Chimona TS, Kanoupakis EM, Papadakis CE, Velegrakis GA, Helidonis ES. Source: American Journal of Otolaryngology. 2002 September-October; 23(5): 303-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12239699

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QTc interval in infants receiving cisapride. Author(s): Chhina S, Peverini RL, Deming DD, Hopper AO, Hashmi A, Vyhmeister NR. Source: Journal of Perinatology : Official Journal of the California Perinatal Association. 2002 March; 22(2): 144-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11896520

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Randomised controlled trial of cisapride in feed intolerance in preterm infants. Author(s): Enriquez A, Bolisetty S, Patole S, Garvey PA, Campbell PJ. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 1998 September; 79(2): F110-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9828736

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Randomised controlled trial of cisapride in preterm infants. Author(s): Vandenplas Y. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2000 July; 83(1): F75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10917722

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Randomised controlled trial of cisapride in preterm infants. Author(s): McClure RJ, Kristensen JH, Grauaug A. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 1999 May; 80(3): F174-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10212076

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Randomised controlled trial of cisapride in preterm neonates for gastric emptying time. Author(s): Deorari AK, Reddy PS, Paul VK, Bal CS. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 1999 September; 81(2): F159. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10507879

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Randomised controlled trial of the effect of cisapride on the pyloric muscle in preterm infants. Author(s): Pezzati M, Dani C, Biadaioli R, Gambi B, Lachina L, Rubaltelli FF. Source: European Journal of Pediatrics. 2001 September; 160(9): 572-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11585082

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Randomised double-blind comparison of simethicone with cisapride in functional dyspepsia. Author(s): Holtmann G, Gschossmann J, Karaus M, Fischer T, Becker B, Mayr P, Gerken G. Source: Alimentary Pharmacology & Therapeutics. 1999 November; 13(11): 1459-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10571602

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Randomized trial assessing gastric emptying in patients with chronic hepatitis C during interferon-alpha or -beta therapy and effect of cisapride. Author(s): Nishiguchi S, Shiomi S, Kurooka H, Iwata Y, Sasaki N, Tamori A, Habu D, Takeda T, Kawabe J, Ochi H. Source: Digestive Diseases and Sciences. 2002 January; 47(1): 73-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11837736

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Randomized, multicentre comparison of sodium alginate and cisapride in the symptomatic treatment of uncomplicated gastro-oesophageal reflux. Author(s): Poynard T, Vernisse B, Agostini H. Source: Alimentary Pharmacology & Therapeutics. 1998 February; 12(2): 159-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9692690

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Rationale for the development of a novel gastrointestinal prokinetic, cisapride. Author(s): Reyntjens A. Source: Scandinavian Journal of Gastroenterology. Supplement. 1989; 165: 1-6; Discussion 27-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2690319

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Red wine-cisapride interaction: comparison with grapefruit juice. Author(s): Offman EM, Freeman DJ, Dresser GK, Munoz C, Bend JR, Bailey DG. Source: Clinical Pharmacology and Therapeutics. 2001 July; 70(1): 17-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452240

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Relation between gastroduodenal interdigestive migrating motor complex and postoperative gastrointestinal symptoms before and after cisapride therapy following distal gastrectomy for early gastric cancer. Author(s): Tomita R, Tanjoh K, Fujisaki S, Fukuzawa M. Source: World Journal of Surgery. 2000 October; 24(10): 1250-6; Discussion 1256-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11071471

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Relationship between the effects of cisapride on gastric emptying and plasma glucose concentrations in diabetic gastroparesis. Author(s): Horowitz M, Jones KL, Harding PE, Wishart JM. Source: Digestion. 2002; 65(1): 41-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11961342

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Relatively low doses of cisapride in the treatment of nausea in patients treated with venlafaxine for treatment-refractory depression. Author(s): Russell JL. Source: Journal of Clinical Psychopharmacology. 1996 February; 16(1): 35-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8834416

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Relief of epigastric pain in nonulcer dyspepsia: controlled trial of the promotility drug cisapride. Author(s): De Nutte N, Van Ganse W, Witterhulghe M, Defrance P. Source: Clinical Therapeutics. 1989; 11(1): 62-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2655906

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Repeated consumption of grapefruit juice considerably increases plasma concentrations of cisapride. Author(s): Kivisto KT, Lilja JJ, Backman JT, Neuvonen PJ. Source: Clinical Pharmacology and Therapeutics. 1999 November; 66(5): 448-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10579471

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Report from the NASPGN Therapeutics Subcommittee. Cisapride and the attack of the P-450s. Author(s): Shulman RJ. Source: Journal of Pediatric Gastroenterology and Nutrition. 1996 November; 23(4): 3957. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8956172

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Retrospective analysis of cisapride-induced QT changes in end-stage renal disease patients. Author(s): Hentges MJ, Gunderson BW, Lewis MJ. Source: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association. 2000 November; 15(11): 1814-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11071970

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Retrospective analysis of the effects of cisapride on the QT interval and QT dispersion in chronic hemodialysis patients. Author(s): Mathis AS, Costeas C, Barone JA. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2001 December; 38(6): 1284-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11728962

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Reversal of gastric electrical dysrhythmias by cisapride in children with functional dyspepsia. Report of three cases. Author(s): Cucchiara S, Minella R, Riezzo G, Vallone G, Vallone P, Castellone F, Auricchio S. Source: Digestive Diseases and Sciences. 1992 July; 37(7): 1136-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1618063

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Risk factors, co-medication, and concomitant diseases: their influence on the outcome of therapy with cisapride. Author(s): Fehr HF. Source: Scandinavian Journal of Gastroenterology. Supplement. 1993; 195: 40-5; Discussion 45-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8516657

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Risks and benefits of cisapride. Author(s): Jones SW, Wagstaff M. Source: Archives of Disease in Childhood. 1999 June; 80(6): 582. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10523257

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Role of cisapride in preterm infants. Author(s): Craig JS, McClure BG, Tubman TR. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 1999 May; 80(3): F253. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744431

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Rumination-treatment with cisapride. Author(s): Sood AK, Malhotra RC, Sood S. Source: J Assoc Physicians India. 1995 April; 43(4): 304-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8713284

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Salivary function in patients with reflux esophagitis: effect of cisapride. Author(s): Chen SD, Kao CH, Chang CS, Chen GH. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 1998 August; 39(8): 1449-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9708526

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Secretion of the gastrokinetic agent cisapride in human milk. Author(s): Hofmeyr GJ, Sonnendecker EW. Source: European Journal of Clinical Pharmacology. 1986; 30(6): 735-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3770067

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Segmental gut transit in diabetes mellitus: effect of cisapride. Author(s): Kawagishi T, Nishizawa Y, Okuno Y, Sekiya K, Morii H. Source: Diabetes Research and Clinical Practice. 1992 August; 17(2): 137-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1425148

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Sequential single doses of cisapride, erythromycin, and metoclopramide in critically ill patients intolerant to enteral nutrition: a randomized, placebo-controlled, crossover study. Author(s): MacLaren R, Kuhl DA, Gervasio JM, Brown RO, Dickerson RN, Livingston TN, Swift K, Headley S, Kudsk KA, Lima JJ. Source: Critical Care Medicine. 2000 February; 28(2): 438-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10708180

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Serious ventricular arrhythmias among users of cisapride and other QT-prolonging agents in the United States. Author(s): Enger C, Cali C, Walker AM. Source: Pharmacoepidemiology and Drug Safety. 2002 September; 11(6): 477-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12426932

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Should cisapride be avoided in patients with diabetic gastroparesis? Author(s): Evans AJ, Krentz AJ. Source: Journal of Diabetes and Its Complications. 1999 September-December; 13(5-6): 314-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10765008

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Should cisapride have been "blacklisted"? Author(s): Markiewicz M, Vanden Plas Y. Source: Archives of Disease in Childhood. Fetal and Neonatal Edition. 2000 January; 82(1): F3-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10634831

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Simultaneous noninvasive evaluation of gastric emptying and orocaecal transit times. Use in studying the actions of cisapride in diabetic patients. Author(s): Bergmann JF, Chassany O, Guillausseau PJ, Bayle M, Chagnon S, Caulin C, Sallenave JR. Source: European Journal of Clinical Pharmacology. 1992; 43(2): 121-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1425866

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Single oral dose of cisapride accelerates gastric antral emptying in healthy humans: an ultrasonographic study. Author(s): Takeda T, Konomi H, Naritomi G, Yoshida J, Matsunaga H, Akazawa K, Tanaka M. Source: Journal of Gastroenterology. 1996 June; 31(3): 323-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8726821

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Slow gastric emptying induced by high fat content of meal accelerated by cisapride administered rectally. Author(s): Stacher G, Granser GV, Bergmann H, Kugi A, Stacher-Janotta G, Hobart J. Source: Digestive Diseases and Sciences. 1991 September; 36(9): 1259-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1893810

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Small bowel motility following major intra-abdominal surgery: the effects of opiates and rectal cisapride. Author(s): Benson MJ, Roberts JP, Wingate DL, Rogers J, Deeks JJ, Castillo FD, Williams NS. Source: Gastroenterology. 1994 April; 106(4): 924-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8143997

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Social phobia-related nausea relieved with adjunctive cisapride. Author(s): Bohn P, Sternbach H. Source: Journal of Clinical Psychopharmacology. 1997 February; 17(1): 56-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9004060

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Sorbitol in oral liquid cisapride. Author(s): Hoekstra JH. Source: Journal of Pediatric Gastroenterology and Nutrition. 1998 September; 27(3): 3745. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9740221

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Spontaneous adverse event reports of serious ventricular arrhythmias, QT prolongation, syncope, and sudden death in patients treated with cisapride. Author(s): Cochrane Database Syst Rev. 2003;(4):CD002300 Source: Journal of Cardiovascular Pharmacology and Therapeutics. 2002 April; 7(2): 6576. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14583950

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Stability of an extemporaneously compounded cisapride suspension. Author(s): Horn JR, Anderson GD. Source: Clinical Therapeutics. 1994 March-April; 16(2): 169-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8062312

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Stability of cisapride in a liquid dosage form at two temperatures. Author(s): Nahata MC, Morosco RS, Hipple TF. Source: The Annals of Pharmacotherapy. 1995 February; 29(2): 125-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7756708

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Stereoselective determination of cisapride, a prokinetic agent, in human plasma by chiral high-performance liquid chromatography with ultraviolet detection: application to pharmacokinetic study. Author(s): Desta Z, Soukhova NV, Morocho A, Park J, Mahal SK, Flockhart DA. Source: J Chromatogr B Biomed Sci Appl. 2000 July 21; 744(2): 263-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10993514

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Stereoselective metabolism of cisapride and enantiomer-enantiomer interaction in human cytochrome P450 enzymes: major role of CYP3A. Author(s): Desta Z, Soukhova N, Morocho AM, Flockhart DA. Source: The Journal of Pharmacology and Experimental Therapeutics. 2001 August; 298(2): 508-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11454912

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Stereoselective pharmacokinetics of cisapride in healthy volunteers and the effect of repeated administration of grapefruit juice. Author(s): Desta Z, Kivisto KT, Lilja JJ, Backman JT, Soukhova N, Neuvonen PJ, Flockhart DA. Source: British Journal of Clinical Pharmacology. 2001 October; 52(4): 399-407. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11678783

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Study of the drug-drug interaction between simvastatin and cisapride in man. Author(s): Simard C, O'Hara GE, Prevost J, Guilbaud R, Massee R, Turgeon J. Source: European Journal of Clinical Pharmacology. 2001 June; 57(3): 229-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11497338

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Study on gastric empty disorder after the gastric ulcer healing and therapeutic effect of cisapride. Author(s): Zou K, Liu S, Liu J, Liu Y, Hou X, Yi C. Source: J Tongji Med Univ. 2000; 20(1): 57-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12845759

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Study with two prokinetics in functional dyspepsia and GORD: domperidone vs. cisapride. Author(s): Halter F, Staub P, Hammer B, Guyot J, Miazza BM. Source: Journal of Physiology and Pharmacology : an Official Journal of the Polish Physiological Society. 1997 June; 48(2): 185-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9223023

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Successful management of idiopathic intestinal pseudo-obstruction with cisapride. Author(s): Cohen NP, Booth IW, Parashar K, Corkery JJ. Source: Journal of Pediatric Surgery. 1988 March; 23(3): 229-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3357139

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Symptomatic improvement with one-year cisapride treatment in neuropathic chronic intestinal dysmotility. Author(s): Camilleri M, Balm RK, Zinsmeister AR. Source: Alimentary Pharmacology & Therapeutics. 1996 June; 10(3): 403-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8791970

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Symptomatic, radionuclide and therapeutic assessment of chronic idiopathic dyspepsia. A double-blind placebo-controlled evaluation of cisapride. Author(s): Jian R, Ducrot F, Ruskone A, Chaussade S, Rambaud JC, Modigliani R, Rain JD, Bernier JJ. Source: Digestive Diseases and Sciences. 1989 May; 34(5): 657-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2653742

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Syncopal episodes associated with cisapride and concurrent drugs. Author(s): Gray VS. Source: The Annals of Pharmacotherapy. 1998 June; 32(6): 648-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9640482

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The effect of a single rectal dose of cisapride on delayed gastric emptying. Author(s): Brummer RJ, Schoenmakers EA, Kemerink GJ, Heidendal GA, Sanders DG, Stockbrugger RW. Source: Alimentary Pharmacology & Therapeutics. 1997 August; 11(4): 781-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9305489

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The effect of cisapride in maintaining symptomatic remission in patients with gastrooesophageal reflux disease. Author(s): Hatlebakk JG, Johnsson F, Vilien M, Carling L, Wetterhus S, Thogersen T. Source: Scandinavian Journal of Gastroenterology. 1997 November; 32(11): 1100-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9399390

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The effect of cisapride on duodenal acid exposure in the proximal duodenum in healthy subjects. Author(s): Verhagen MA, Roelofs JM, Edelbroek MA, Smout AJ, Akkermans LM. Source: Alimentary Pharmacology & Therapeutics. 1999 May; 13(5): 621-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10233185

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The effect of cisapride on dysmotility-like functional dyspepsia: reduction of the fasting and postprandial area, but not of the postprandial antral expansion. Author(s): Eberl T, Barnert J, Dumitrascu DL, Fischer J, Wienbeck M. Source: European Journal of Gastroenterology & Hepatology. 1998 December; 10(12): 991-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9895043

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The effect of cisapride on dyspepsia symptoms and the electrogastrogram in patients with non-ulcer dyspepsia. Author(s): Besherdas K, Leahy A, Mason I, Harbord M, Epstein O. Source: Alimentary Pharmacology & Therapeutics. 1998 August; 12(8): 755-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9726389

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The effect of cisapride on gallbladder contractility in type II diabetic patients. Author(s): Gursoy M, Guvener N, Isiklar I, Tutal E, Ozin B, Boyacioglu S. Source: Hepatogastroenterology. 2001 September-October; 48(41): 1262-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11677942

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The effect of cisapride on oesophageal motility and lower sphincter function in patients with gastro-oesophageal reflux disease. Author(s): Finizia C, Lundell L, Cange L, Ruth M. Source: European Journal of Gastroenterology & Hepatology. 2002 January; 14(1): 9-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11782569

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The effect of cisapride on oral and intravenous glucose tolerance in normal subjects. Author(s): Wishart JM, Horowitz M, Campbell J, Jones KL. Source: Journal of Gastroenterology and Hepatology. 1997 December; 12(12): 795-800. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9504888

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The effect of cisapride on the corrected QT interval and QT dispersion in premature infants. Author(s): Cools F, Benatar A, Bougatef A, Vandenplas Y. Source: Journal of Pediatric Gastroenterology and Nutrition. 2001 August; 33(2): 178-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11568520

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The effect of cisapride on the success of early feeding after elective open colon resection. Author(s): Camberos A, Cymerman J, DiFronzo LA, O'Connell TX. Source: The American Surgeon. 2002 December; 68(12): 1093-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12516816

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The efficacy of a 40-mg extended-release formulation of cisapride in the treatment of patients with gastro-oesophageal reflux. Author(s): Katschinski M, Schirra J, Arnold R. Source: Alimentary Pharmacology & Therapeutics. 2000 January; 14(1): 113-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10632654

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The efficacy of cisapride vs. placebo and diet in patients with chronic constipation. Author(s): Altabas K, Bilic A, Jurcic D, Dorosulic Z, Mihanovic M, Sunic-Omejc M, Restek-Petrovic B, Tolj N. Source: Coll Antropol. 2003 June; 27(1): 197-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12974147

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The efficacy of cisapride: what is needed for digestion? Author(s): Nurko S. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 March; 30(3): 230-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10749403

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The efficacy of cisapride; time to review not regurgitate. Author(s): Bourke B, Drumm B. Source: Journal of Pediatric Gastroenterology and Nutrition. 2000 March; 30(3): 230. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10749402

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The influence of cisapride and clarithromycin on QT intervals in healthy volunteers. Author(s): van Haarst AD, van 't Klooster GA, van Gerven JM, Schoemaker RC, van Oene JC, Burggraaf J, Coene MC, Cohen AF. Source: Clinical Pharmacology and Therapeutics. 1998 November; 64(5): 542-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9834046

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The influence of cisapride on gastric tone and the perception of gastric distension. Author(s): Tack J, Broeckaert D, Coulie B, Janssens J. Source: Alimentary Pharmacology & Therapeutics. 1998 August; 12(8): 761-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9726390

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The risks and benefits of cisapride in premature neonates, infants, and children. Author(s): Lander A, Desai A. Source: Archives of Disease in Childhood. 1998 December; 79(6): 469-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10210987

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The role of cisapride in the treatment of pediatric gastroesophageal reflux. The European Society of Paediatric Gastroenterology, Hepatology and Nutrition. Author(s): Vandenplas Y, Belli DC, Benatar A, Cadranel S, Cucchiara S, Dupont C, Gottrand F, Hassall E, Heymans HS, Kearns G, Kneepkens CM, Koletzko S, Milla P, Polanco I, Staiano AM. Source: Journal of Pediatric Gastroenterology and Nutrition. 1999 May; 28(5): 518-28. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10328131

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The role of motilin and cisapride in the enteric nervous system of the lower esophageal sphincter in humans. Author(s): Tomita R, Tanjoh K, Munakata K. Source: Surgery Today. 1997; 27(11): 985-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9413048

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The symptomatic effect of cisapride in patients with irritable bowel syndrome and constipation. Author(s): Farup PG, Hovdenak N, Wetterhus S, Lange OJ, Hovde O, Trondstad R. Source: Scandinavian Journal of Gastroenterology. 1998 February; 33(2): 128-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9517521

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The T wave as a marker of dispersion of ventricular repolarization in premature infants before and while on treatment with the I(Kr) channel blocker cisapride. Author(s): Benatar A, Cools F, Decraene T, Bougatef A, Vandenplas Y. Source: Cardiology in the Young. 2002 January; 12(1): 32-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11922439

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The use of cisapride in children. The North American Society for Pediatric Gastroenterology and Nutrition. Author(s): Shulman RJ, Boyle JT, Colletti RB, Friedman RA, Heyman MB, Kearns G, Kirschner BS, Levy J, Mitchell AA, Van Hare G. Source: Journal of Pediatric Gastroenterology and Nutrition. 1999 May; 28(5): 529-33. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10328132

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Torsade de pointes induced by cisapride/clarithromycin interaction. Author(s): Piquette RK. Source: The Annals of Pharmacotherapy. 1999 January; 33(1): 22-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9972380

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Understanding drug/drug interactions: cisapride. Author(s): Mege J. Source: Pa Med. 1999 October; 102(10): 16. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10540905

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Urinary disorders associated with cisapride. Adverse Drug Reactions Advisory Committee. Author(s): Boyd IW, Rohan AP. Source: The Medical Journal of Australia. 1994 May 2; 160(9): 579-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8164559

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Use of cisapride in treatment of constipation in children. Author(s): Odeka EB, Sagher F, Miller V, Doig C. Source: Journal of Pediatric Gastroenterology and Nutrition. 1997 August; 25(2): 199-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9252908

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Use of cisapride in treatment of idiopathic constipation in children. Author(s): Odeka EB, Miller V. Source: Journal of Pediatric Gastroenterology and Nutrition. 1997 August; 25(2): 250. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9252925

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Use of cisapride with contraindicated drugs in The Netherlands. Author(s): De Bruin ML, Panneman MJ, Leufkens HG, Hoes AW, Herings RM. Source: The Annals of Pharmacotherapy. 2002 February; 36(2): 338-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11847959

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Use of cisapride with magnesium oxide in chronic pediatric constipation. Author(s): Ni YH, Lin CC, Chang SH, Yeung CY; Taiwan Pediatric Constipation Study Group. Source: Acta Paediatr Taiwan. 2001 November-December; 42(6): 345-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11811223

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Use of cisapride. Author(s): Mathew A. Source: Indian Pediatrics. 2000 December; 37(12): 1402-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11119361

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Use of metoclopramide, domperidone, and cisapride in the management of diabetic gastroparesis. Author(s): Brown CK, Khanderia U. Source: Clin Pharm. 1990 May; 9(5): 357-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2190745

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Wide gastric antrum in patients with non-ulcer dyspepsia. Effect of cisapride. Author(s): Hausken T, Berstad A. Source: Scandinavian Journal of Gastroenterology. 1992 May; 27(5): 427-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1529280

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

Finding Nutrition Studies on Cisapride The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “cisapride” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

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

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

A randomised clinical trial comparing the efficacy of a herbal preparation STW 5 with the prokinetic drug cisapride in patients with dysmotility type of functional dyspepsia. Author(s): Medical Department - North West Hospital, Steinbacher Hohl 2-26, 60488 Frankfurt, Germany. Source: Rosch, W Vinson, B Sassin, I Z-Gastroenterol. 2002 June; 40(6): 401-8 0044-2771

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An evaluation of the use of cisapride in horses with chronic grass sickness (equine dysautonomia). Source: Milne, E.M. Doxey, D.L. Woodman, M.P. Cuddeford, D. Pearson, R.A. Br-vet-j. London : Bailliere Tindall. Sept 1996. volume 152 (5) page 537-549. 0007-1935

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Design and evaluation of a two-layer floating tablet for gastric retention using cisapride as a model drug. Author(s): Division of Pharmaceutics, Shenyang Pharmaceutical University, People's Republic of China. [email protected] Source: Wei, Z Yu, Z Bi, D Drug-Dev-Ind-Pharm. 2001 May; 27(5): 469-74 0363-9045

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Effects of cisapride on distal esophageal motility in humans. Author(s): Cattedra di Gastroenterologia I, Clinica Medica II, Universita, La Sapienza, Rome, Italy. Source: Corazziari, E Bontempo, I Anzini, F Dig-Dis-Sci. 1989 October; 34(10): 1600-5 0163-2116

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Effects on the lower oesophageal sphincter of cisapride given before the combined administration of atropine and neostigmine. Author(s): University Department of Anaesthesia, Leicester Royal Infirmary. Source: Jones, M J Mitchell, R W Hindocha, N Br-J-Anaesth. 1989 February; 62(2): 124-8 0007-0912

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LY353433, a potent, orally effective, long-acting 5-HT(4) receptor antagonist: comparison to cisapride and RS23597-190. Author(s): Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA. Source: Cohen, M L Bloomquist, W Schaus, J M Thompson, D C Susemichel, A D Calligaro, D A Cohen, I J-Pharmacol-Exp-Ther. 1996 April; 277(1): 97-104 0022-3565

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The effect and mechanism of the prokinetic action of cisapride on gastrointestinal smooth muscle. Author(s): Department of Internal Medicine, Taipei Medical College Hospital, Taiwan. Source: Chen, H T Goh, M H Pan, S Gastroenterol-Jpn. 1993 April; 28(2): 218-23 04351339

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The effect of cisapride on defaecation in normal human subjects--lack of effect on faecal excretion of water, fat, and bile acids. Author(s): Marbachtalklinik der LVA Oldenburg-Bremen und LaboKlin, Bad Kissingen, FRG. Source: Berger, V Armbrecht, U Heusinger, A Wienbeck, M Stockbrugger, R AlimentPharmacol-Ther. 1989 December; 3(6): 547-52 0269-2813

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The influence of rectal cisapride on morphine-induced gastric stasis. Author(s): Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Adelaide, South Australia.

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Source: Kluger, M T Plummer, J L Owen, H Anaesth-Intensive-Care. 1991 August; 19(3): 346-50 0310-057X

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A comparison between Zhishi Xiaopiwan and cisapride in treatment of functional dyspepsia. Author(s): Lin J, Cai G, Xu JY. Source: World Journal of Gastroenterology : Wjg. 1998 December; 4(6): 544-547. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11819367

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A randomised clinical trial comparing the efficacy of a herbal preparation STW 5 with the prokinetic drug cisapride in patients with dysmotility type of functional dyspepsia. Author(s): Rosch W, Vinson B, Sassin I. Source: Zeitschrift Fur Gastroenterologie. 2002 June; 40(6): 401-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12055663

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Advances in the management of pediatric constipation. Author(s): Nurko S.

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Source: Current Gastroenterology Reports. 2000 June; 2(3): 234-40. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10957935 •

An evaluation of the use of cisapride in horses with chronic grass sickness (equine dysautonomia) Author(s): Milne EM, Doxey DL, Woodman MP, Cuddeford D, Pearson RA. Source: Br Vet J. 1996 September; 152(5): 537-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8885464

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Childhood constipation. Author(s): Rubin GP. Source: American Family Physician. 2003 March 1; 67(5): 1041-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12643364

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Constipation. Author(s): Rubin G. Source: Clin Evid. 2002 June; (7): 292-6. Review. No Abstract Available. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12230652

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Consultation-liaison psychiatry drug--drug interactions update. Author(s): Armstrong SC, Cozza KL, Cole MA. Source: Psychosomatics. 2000 July-August; 41(4): 375-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10906369

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Control of gastric emptying in the pig: influence of cholecystokinin, somatostatin and prokinetic agents. Author(s): Gregory PC, McFadyen M, Rayner DV. Source: Experimental Physiology. 1995 January; 80(1): 159-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7734135

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Current concepts in the management of the irritable bowel syndrome. Author(s): Snape WJ Jr. Source: Revista De Gastroenterologia De Mexico. 1994 April-June; 59(2): 127-32. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7991965

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Effect of peppermint oil and caraway oil on gastrointestinal motility in healthy volunteers: a pharmacodynamic study using simultaneous determination of gastric and gall-bladder emptying and orocaecal transit time. Author(s): Goerg KJ, Spilker T. Source: Alimentary Pharmacology & Therapeutics. 2003 February; 17(3): 445-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12562459

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Efficacy of a herbal preparation in patients with functional dyspepsia: a metaanalysis of double-blind, randomized, clinical trials. Author(s): Gundermann KJ, Godehardt E, Ulbrich M. Source: Adv Ther. 2003 January-February; 20(1): 43-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12772817

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Gastroesophageal reflux in children: pathogenesis, prevalence, diagnosis, and role of proton pump inhibitors in treatment. Author(s): Gold BD, Freston JW. Source: Paediatric Drugs. 2002; 4(10): 673-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12269842

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Gastrointestinal involvement in patients with diabetes mellitus: Part II (second of two parts). Diagnostic procedures, pharmacological and nonpharmacological therapy. Author(s): Folwaczny C, Riepl R, Tschop M, Landgraf R. Source: Zeitschrift Fur Gastroenterologie. 1999 September; 37(9): 817-26. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10522368

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Grapefruit juice-drug interactions. Author(s): Bailey DG, Malcolm J, Arnold O, Spence JD. Source: British Journal of Clinical Pharmacology. 1998 August; 46(2): 101-10. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9723817

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Irritable bowel syndrome. Author(s): Wald A. Source: Current Treatment Options in Gastroenterology. 1999 February; 2(1): 13-19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11096567

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Liu-Jun-Zi-Tang, a kampo medicine, promotes adaptive relaxation in isolated guinea pig stomachs. Author(s): Hayakawa T, Arakawa T, Kase Y, Akiyama S, Ishige A, Takeda S, Sasaki H, Uno H, Fukuda T, Higuchi K, Kobayashi K. Source: Drugs Exp Clin Res. 1999; 25(5): 211-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10568209

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Lopinavir/ritonavir: a review of its use in the management of HIV infection. Author(s): Cvetkovic RS, Goa KL. Source: Drugs. 2003; 63(8): 769-802. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12662125

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Management of faecal incontinence and constipation in adults with central neurological diseases. Author(s): Wiesel PH, Norton C, Brazzelli M.

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Source: Cochrane Database Syst Rev. 2001; (4): Cd002115. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11687140 •

New therapeutic agents marketed in 1993. Author(s): Hussar DA. Source: Pa Med. 1994 July; 97(7): 16-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7936695

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Observation on frequency spectrum of electrogastrogram (EGG) in acupuncture treatment of functional dyspepsia. Author(s): Chen R, Kang M. Source: J Tradit Chin Med. 1998 September; 18(3): 184-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10453609

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Ping wei san, a Chinese medicine for gastrointestinal disorders. Author(s): Riedlinger JE, Tan PW, Lu W. Source: The Annals of Pharmacotherapy. 2001 February; 35(2): 228-35. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11215844

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Potentially serious drug interactions with grapefruit juice. Author(s): Gunston GD, Mehta U. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 2000 January; 90(1): 41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10721388

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Role of colonic motility in guiding therapy in patients with constipation. Author(s): Snape WJ Jr. Source: Digestive Diseases (Basel, Switzerland). 1997; 15 Suppl 1: 104-11. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9177949

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The herbal medicine Dai-kenchu-to and one of its active components [6]-shogaol increase intestinal blood flow in rats. Author(s): Clin Evid. 2002 Dec;(8):313-8 Source: Life Sciences. 2002 March 15; 70(17): 2061-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12603885

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Treatment of functional dyspepsia with a fixed peppermint oil and caraway oil combination preparation as compared to cisapride. A multicenter, referencecontrolled double-blind equivalence study. Author(s): Madisch A, Heydenreich CJ, Wieland V, Hufnagel R, Hotz J.

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Source: Arzneimittel-Forschung. 1999 November; 49(11): 925-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10604046 •

Treatment of Functional Dyspepsia. Author(s): Delgado-Aros S, Cremonini F, Talley NJ. Source: Current Treatment Options in Gastroenterology. 2004 April; 7(2): 121-131. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15010026

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

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

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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

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

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

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

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

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

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

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

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

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

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

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

General Overview Irritable Bowel Syndrome Source: Healthnotes, Inc.; www.healthnotes.com

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Herbs and Supplements Cisapride Source: Healthnotes, Inc.; www.healthnotes.com

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

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CHAPTER 4. PATENTS ON CISAPRIDE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “cisapride” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on cisapride, we have not necessarily excluded non-medical patents in this bibliography.

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

8Adapted

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

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will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on cisapride: •

Cisapride extended release Inventor(s): Gilis; Paul Marie Victor (Beerse, BE), Jans; Eugene Marie Jozef (Meerhout, BE) Assignee(s): Janssen Pharmaceutic N.V. (BE) Patent Number: 6,153,623 Date filed: April 23, 1997 Abstract: The present invention concerns extended release formulations comprising cisapride-(L)-tartrate, in particular an oral formulation, the use thereof as a medicine, especially in treating gastrokinetic disorders. Excerpt(s): The present invention concerns extended release formulations comprising cisapride-(L)-tartrate, in particular for oral administration, the use thereof as a medicine, especially in treating gastro-intestinal disorders. The systematic chemical name of cisapride is cis-4-amino-5-chloro-N-[1-[3-(4-fluorophenoxy)propyl]-3-methoxy-4piperidi nyl]-2-methoxybenzamide. Cisapride is a racemic mixture of two enantiomers. Cisapride has excellent gastro-intestinal motility stimulating properties and is reported to be devoid of antidopaminergic activity. Its utility in a variety of gastro-intestinal disorders has already been reported extensively. Useful extended release formulations of cisapride for oral administration should release the active ingredient, i.e. cisapride, over a long period of 15 to 24 hours, that is through the whole gastro-intestinal tract with its varying pH values. However, the solubility of cisapride depends very much on the surrounding pH. The solubility of cisapride is the highest in a strongly acidic medium at pH 1 to 2, such as for example in gastric juice. The solubility diminishes rapidly when the pH of the (physiological) medium increases, for example in the intestines. An effective sustained release formulation of cisapride should therefore function not only in highly acidic but also in less acidic or neutral media. Moreover an extended release formulation should release the active ingredient as soon as the formulation is administered and should release the active ingredient in a constant manner, preferably following zero order to first order kinetics. This profile is desired because it provides relief to the patient very soon after administration and overdosing is avoided when administering the formulation for a consecutive time. Web site: http://www.delphion.com/details?pn=US06153623__

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Cisapride mini-tablet formulations Inventor(s): Clancy; Maurice Joseph Anthony (Athlone, IE), Cumming; Kenneth Iain (Dublin, IE) Assignee(s): Elan Corporation, plc (Dublin, IE) Patent Number: 6,110,494 Date filed: December 22, 1997 Abstract: A sustained release cisapride oral dosage formulation suitable for once-daily administration comprises a plurality of mini-tablets containing cisapride or a salt thereof with an organic acid and capable of releasing cisapride at different sites along the gastrointestinal tract. The mini-tablets include a proportion of immediate release

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tablets and a proportion of tablets which release cisapride in response to the pH environment at a given site in the distal regions of the gastrointestinal tract and which include cisapride or a salt thereof embedded in a matrix of hydrophilic polymer, said matrix being coated with a pH dependent polymer, the formulation having a Cmax/Cmin ratio under steady state conditions of 2:1 or less as evidenced by a substantially flat plasma profile in vivo. Excerpt(s): This invention relates to a controlled release cisapride formulation for oral administration. Cisapride is a stimulant of gastrointestinal motility which is used for the symptomatic relief of gastroesophageal reflux disease (GORD) and thus is effective as a gastroprokinetic agent. Cisapride is the subject of EP 0 076 530B. Cisapride is poorly soluble and thus may be administered as a salt, such as the tartrate salt, for oral administration or, alternatively, formulated in a way which increases solubility of the base in an aqueous environment as found in the gastrointestinal tract. Web site: http://www.delphion.com/details?pn=US06110494__ •

Compositions of optically pure (-) norcisapride Inventor(s): Aberg; A. K. Gunnar (Westborough, MA), McCullough; John R. (Worcester, MA) Assignee(s): Sepracor, Inc. (Marlborough, MA) Patent Number: 6,313,144 Date filed: October 23, 2000 Abstract: Compositions are disclosed utilizing the optically pure (-) isomer of norcisapride. This compound is a potent drug for the treatment of gastro-esophageal reflux disease, emesis, dyspepsia and other conditions while substantially reducing the concomitant liability of adverse effects associated with cisapride. The (-) isomer of norcisapride also avoids the adverse drug interactions associated with racemic cisapride and other therapeutic agents. Excerpt(s): This invention relates to novel compositions of matter containing optically pure (-) norcisapride. These compositions possess potent activity in treating gastroesophageal reflux disease while substantially reducing adverse effects associated with the administration of racemic cisapride including but not limited to diarrhea, abdominal cramping, cardiac depression, and elevations of blood pressure and heart rate. Additionally, these novel compositions of matter containing optically pure (-) norcisapride are useful in treating emesis and such other conditions as may be related to the activity of (-) norcisapride as a prokinetic agent, including but not limited to dyspepsia, gastroparesis, constipation, and intestinal pseudo-obstruction, while substantially reducing adverse effects associated with the administration of racemic cisapride. Also disclosed are methods for treating the above-described conditions in a human while substantially reducing adverse effects that are associated with cisapride, by administering the (-) isomer of norcisapride to a human in need of such treatment. Further disclosed are methods of treating various disease states in humans by coadministering optically pure (-) norcisapride and another therapeutic agent, while unexpectedly avoiding the adverse effects associated with administering cisapride and a therapeutic agent. The active compound of these compositions and methods is an optically pure isomer of a metabolic derivative of cisapride, which is described in Meuldermans, W. et al., Drug Metab. Dispos. 16(3): 410-419, 1988 and Meuldermans, W. et al., Drug Metab. Dispos. 16(3): 403-409, 1988. Chemically, the active compound, of the

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presently disclosed compositions and methods, is the (-) isomer of the metabolic derivative of cis-4-amino-5-chloro-N-[1-[3-(4-fluorophenoxy) propyl]-3-methoxy-4piperidinyl]-2-methoxybenzamide (hereinafter referred to as "cisapride"), known as 4amino-5-chloro-N-(3-methoxy-4-piperidinyl)-2 methoxybenzamide hereinafter referred to as "(-) norcisapride." The term "(-) isomer of norcisapride" and particularly the term "() norcisapride" encompass optically pure and substantially optically pure (-) norcisapride. Similarly, as used herein, the terms "racemic cisapride", "racemic norcisapride" or "racemic mixture of cisapride" or "racemic mixture of norcisapride" refer to the cis diastereomeric racemates. Web site: http://www.delphion.com/details?pn=US06313144__ •

Immediate release pH-independent solid dosage form of cisapride Inventor(s): Gijs; Guido Jozef Maria (Arendonk, BE), Gilis; Paul Marie Victor (Beerse, BE), Smans; Guido Franciscus (Lille, BE) Assignee(s): Janssen Pharmaceutica, N.V. (Beerse, BE) Patent Number: 6,030,988 Date filed: March 20, 1997 Abstract: The present invention concerns oral dosage forms of some particular salts of cisapride, more particularly cisapride-(L)-tartrate, cisapride-(D)-tartrate, cisapridesulfate, or cisapride citrate, which avoid drugfood interaction and which allow comedication of agents that increase the pH of the stomach. The invention particularly relates to solid oral dosage forms suitable for rapid dissolution. The present invention also concerns tablets which can be prepared via direct compression. Excerpt(s): The present invention concerns solid dosage forms of particular salts of cisapride, more particularly cisapride-(L)-tartrate, cisapride-(D)-tartrate, cisapridesulfate, or cisapride citrate, which avoid drugfood interaction and which allow comedication of agents that increase the pH of the stomach. The invention particularly relates to solid oral dosage forms suitable for rapid disintegration and dissolution. The present invention also concerns tablets which can be prepared via direct compression. In general, it is known that the absorption and bioavailability of any particular therapeutic agent can be affected by numerous factors when dosed orally. Such factors include the presence of food in the gastrointestinal (GI) tract because, in general, the gastric residence time of a drug is usually significantly longer in the presence of food than in the fasted state. If the bioavailability of a drug is affected beyond a certain point due to the presence of food in the GI tract, the drug is said to exhibit a "food effect" or show a drugfood interaction. The risk involved with taking drugs exhibiting a food-effect derives from the fact that absorption into the bloodstream may be adversely affected by not taking the drug on the correct point in time so that the patient risks insufficient absorption to remedy the condition for which the drug was administered. Cisapride in its monohydrate form has a pH-dependent solubility and dissolution profile. Hence the bioavailability of cisapride or cisapride monohydrate is pH dependent. Cisapride monohydrate has a low solubility and low dissolution when present in a neutral or basic environment. Therefore, the information leaflet of cisapride monohydrate mentions that the drug should be taken 15 to 30 minutes before meals. The rationale being that the solid dosage form comprising cisapride monohydrate arrives in a more or less empty stomach, where the pH is reasonably low and hence the cisapride can dissolve. Subsequently, when the patient takes a meal 15 to 30 minutes after the solid oral dosage form was administered, the solid dosage form remains somewhat longer in the acid

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environment of the stomach. Once cisapride monohydrate enters the more or less neutral environment of the gut the solubility of cisapride monohydrate decreases rapidly. Web site: http://www.delphion.com/details?pn=US06030988__ •

Methods for treating gastro-esophageal reflux disease and emesis with optically pure (-) cisapride Inventor(s): Gray; Nancy M. (Marlborough, MA), Young; James W. (Palo Alto, CA) Assignee(s): Sepracor, Inc. (Marlborough, MA) Patent Number: 5,618,828 Date filed: October 12, 1993 Abstract: Methods are disclosed utilizing the optically pure (-) isomer of cisapride. This compound is a potent drug for the treatment of gastro-esophageal reflux disease while substantially reducing the concomitant liability of adverse effects associated with the racemic mixture of cisapride. This compound is also useful in treating or preventing emesis while substantially reducing adverse effects associated with racemic cisapride. Excerpt(s): This invention relates to novel compositions of matter containing optically pure (-) cisapride. These compositions possess potent activity in treating gastroesophageal reflux disease while substantially reducing adverse effects associated with the administration of the racemic mixture of cisapride including but not limited to diarrhea, abdominal cramping and elevations of blood pressure and heart rate. Additionally, these novel compositions of matter containing optically pure (-) cisapride are useful in treating emesis and such other conditions as may be related to the activity of (-) cisapride as a prokinetic agent, including but not limited to dyspepsia, gastroparesis, constipation, and intestinal pseudo-obstruction, while substantially reducing adverse effects associated with the administration of the racemic mixture of cisapride. Also disclosed are methods for treating the above-described conditions in a human while substantially reducing adverse effects that are associated with the racemic mixture of cisapride, by administering the (-) isomer of cisapride to a human in need of such treatment. The active compound of these compositions and methods is an optical isomer of racemic cis-cisapride, which is described in European Patent Application No. 0,076,530 A2 published Apr. 13, 1983 and U.S. Pat. Nos. 4,962,115 and 5,057,525. Chemically, the active compound, of the presently disclosed compositions and methods, is the (-) isomer of cis-4-amino-5-chloro-N-[1-[3-(4-fluorophenoxy) propyl]-3-methoxy-4piperidinyl]-2-methoxybenzamide, hereinafter referred to as (-) cisapride. The term "(-) isomer of cisapride" and particularly the term "(-) cisapride" encompass optically pure and substantially optically pure (-) cisapride. Similarly, as used herein, the terms "racemic cisapride" or "racemic mixture of cisapride" refer to the cis diastereomeric racemate. Cisapride, which is the subject of the present invention, is available commercially only as the 1:1 racemic mixture of the cis diastereomeric racemate. Cisapride is available only as a mixture of optical isomers, called enantiomers, i.e., a mixture of cis(+) and cis(-) cisapride. Web site: http://www.delphion.com/details?pn=US05618828__

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Oral cisapride dosage forms with an extended duration Inventor(s): Chang; Hui-Fang (Taipei, TW), Chao; Shouchung (Taipei, TW), Chen; David (Taipei, TW), Lu; Shu-Bin (Taipei, TW), Tseng; Wen-Pao (Taipei, TW) Assignee(s): Development Center for Biotechnology (Taipei, TW) Patent Number: 6,221,396 Date filed: July 7, 1999 Abstract: The present invention provides sustained release oral solid dosage forms of cisapride by using a multi-particulate system, which are bioavailable and can provide efficient blood level of cisapride over 24 hours. Unit dosage forms of cisapride which comprise a plurality of substrates containing sustained release cisapride, as well as pharmaceutical compositions containing the dosage forms, are also disclosed herein. Excerpt(s): The present invention relates to bioavailable sustained release cisapride formulations which provide an extended duration of effect when orally administered. Formulations which can provide sustained release (slow release) of pharmacologically active substances when administrated orally to humans or animals are well-known in the pharmaceutical art. A sustained release formulation is used to delay absorption of an active substance until it has reached a desired area in the gastrointestinal tract. Sustained release preparations provide a longer period of the drug substances in blood after the administration of the substance than traditional rapid release dosage forms. There are many inherent advantages on the development of long-term effective sustained release formulations. Among the advantages, sustained release dosage forms increase the compliance of patients. It is more convenient for patients to receive longterm effective sustained release cisapride dosage forms once or twice a day than the conventional cisapride dosage forms administered four times a day. Another advantage of sustained release formulations is to greatly reduce various adverse side effects caused by drug administration. A desired modulation of local or systemic drug concentrations in patients would be resulted from the slow release of the sustained release dosage forms. Appropriate modulation of the adverse effects upon administering conventional cisapride dosage forms, such as diarrhea and colic, can be alleviated to a great extent. Web site: http://www.delphion.com/details?pn=US06221396__

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Prepration of cisapride Inventor(s): Lu; Yee-Fung (Aurora, CA), Ngooi; Teng-Ko (Richmond Hill, CA), Oudenes; Jan (Thornhill, CA), Slemon; Clarke (Willowdale, CA), So; Raymond (Richmond Hill, CA) Assignee(s): Torcan Chemical Ltd. (Aurora, CA) Patent Number: 5,585,387 Date filed: October 7, 1994 Abstract: Cisapride, i.e. cis-4-amino-5-chloro-N-[1-[3-(4 fluoro-phenoxy)propyl]-3methoxy-4-piperidinyl]-2-methoxy-benzamide, and similar benzamide derivatives, are prepared from novel 1-aryloxyalkyl- or 1-aralkyl-3-arylcarbonyloxy-4-oxo-piperidines, by nuclear substituent re arrangement involving acyl transfer under animal forming conditions, to give the corresponding 1-aryloxyalkyl- or 1-aralkyl-3-hydroxy-4-lower alkoxy-4-arylamido piperidine. This in turn is readily converted to the corresponding 3-

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oxo-4-arylamido-piperidine by reaction with strong organic acid, which can then be reduced, deprotected and 3-methylated to give the final compound, e.g. cisapride. Excerpt(s): This invention relates to synthesis of pharmaceutically active compounds, and to intermediates for use in such synthesis. From a more specific aspect, it relates to methods for making the pharmaceutical cisapride, intermediates useful in such a synthesis and methods for making such intermediates. In all of these general formulae, L, R' and R each represent one of a wide variety of radicals according to the patent, but in the specific case of cisapride preparation, they represent respectively 3-(4fluorophenoxy) propyl, methyl and hydrogen or an amino protectant group. Other syntheses involving the conversion of one member of the class of benzamide derivatives of Canadian patent 1,183,847 to another member of the same class, and syntheses for compounds of the class having groupings different from those of cisapride, are also disclosed in the aforesaid Canadian patent. Web site: http://www.delphion.com/details?pn=US05585387__ •

Synthesis of cisapride Inventor(s): De Knaep; Alfons Gaston Maria (Turnhout, BE), Moens; Luc Jozef Raphael (Lille, BE), Rey; Max (Zurich, CH) Assignee(s): Jenssen Pharmaceutica N.V. (BE) Patent Number: 6,218,542 Date filed: April 14, 1999 Abstract: A new Process of preparing cisapride, and the pharmaceutically acceptable acid addition salts thereof, by reductively aminating 1-[3-(4-fluorophenoxy)-propyl]-3methoxy-4-piperidinone in the presence of benzylamine under hydrogen in a reactioninert solvent, yielding 1-[3-(4-fluorophenoxy)-propyl]-3-methoxy-4-piperidinamine having a cis/trans ratio of about 93/7, which is enriched in the amount of cisstereoisomer by converting it into its acid addition salt, by treatment with a suitable inorganic acid, in an appropriate solvent, subsequent crystallisation and conversion to its free base form by treatment with an appropriate base, yielding 1-[3-(4fluorophenoxy)-propyl]-3-methoxy-4-piperidinamine having a cis/trans ratio of equal to or higher than 98/2. Excerpt(s): This application is a 371 of PCT/EP97/05692 filed Oct. 9, 1997. and is pharmaceutically acceptable acid addition salts thereof. European Patent No. 0,076,530 discloses the gastroprokinetic agent cisapride, classic compositions thereof and processes for its preparation. The systematic chemical name of cisapride is cis-4-amino5-chloro-N-[1-[3-(4-fluorophenoxy)-propyl]-3-methoxy-4-piperid inyl]-2methoxybenzamide. Cisapride is a racemic mixture of two enantiomers. Cisapride has excellent gastrointestinal motility stimulating properties and is reported to be devoid of antidopaminergic activity. Its utility in a variety of gastro-intestinal disorders has already been reported extensively. Web site: http://www.delphion.com/details?pn=US06218542__

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Patent Applications on Cisapride As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to cisapride: •

Materials and methods for the treatment of gastroesophageal reflux disease Inventor(s): Becker, Cyrus; (Menlo Park, CA), Druzgala, Pascal; (Santa Rosa, CA), Milner, Peter G.; (Los Altos Hills, CA), Pfister, Jurg; (Los Altos, CA) Correspondence: Saliwanchik Lloyd & Saliwanchik; A Professional Association; 2421 N.W. 41st Street; Suite A-1; Gainesville; FL; 326066669 Patent Application Number: 20020025970 Date filed: June 7, 2001 Abstract: The subject invention provides novel compounds and compositions for the safe and effective treatment of gastroesophageal reflux and related conditions. In a preferred embodiment, the compositions of the subject invention comprise esterified cisapride derivatives. These compositions possess potent activity in treating gastroesophageal reflux disease and substantially reduce adverse effects associated with the administration of cisapride. These adverse effects include, but are not limited to, diarrhea, abdominal cramping and elevations of blood pressure and heart rate. Excerpt(s): The subject application claims priority to provisional application U.S. Ser. No. 60/209,926, filed Jun. 7, 2000. Cisapride is one of a class of compounds known as benzamide derivatives, the parent compound of which is metoclopramide. U.S. Pat. Nos. 4,962,115 and 5,057,525 (collectively "Van Daele" and incorporated by reference in their entireties) disclose N-(3-hydroxy-4-piperidenyl) benzamides of cisapride. Van Daele discloses that these compounds, the pharmaceutically acceptable acid addition salts thereof and the stereochemically isomeric forms thereof, stimulate the motility of the gastrointestinal system. As a class, these benzamide derivatives have several prominent pharmacological actions. The prominent pharmacological activities of the benzamide derivatives are due to their effects on the neuronal systems which are modulated by the neurotransmitter serotonin. The role of serotonin, and thus the pharmacology of the benzamide derivatives, has been broadly implicated in a variety of conditions for many years. Thus, research has focused on locating the production and storage sites of serotonin as well as the location of serotonin receptors in the human body in order to determine the connection between these sites and various disease states or conditions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with cisapride, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: 9

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

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Under “Issued Patents,” click “Quick Search.” Then, type “cisapride” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on cisapride. You can also use this procedure to view pending patent applications concerning cisapride. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON CISAPRIDE Overview This chapter provides bibliographic book references relating to cisapride. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on cisapride include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “cisapride” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “cisapride” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “cisapride” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Progress in the Treatment of Gastrointestinal Motility Disorders: The Role of Cisapride : Proceedings of a Symposium Frankfurt, 15 November 1988 (Cu) by G. Lux, A.G. Johnson; ISBN: 0444905006; http://www.amazon.com/exec/obidos/ASIN/0444905006/icongroupinterna

Chapters on Cisapride In order to find chapters that specifically relate to cisapride, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and cisapride 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 “cisapride” (or

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synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on cisapride: •

Gastroesophageal Reflux Disease Source: in McDonald, J.W.D.; Burroughs, A.K.; Feagan, B.G., eds. Evidence Based Gastroenterology and Hepatology. London, UK: BMJ Publishing Group. 1999. p. 16-65. Contact: Available from BMJ Publishing Group. BMA Books, BMA House, Tavistock Square, London WCIH 9JR. Fax 44 (0)20 7383 6402. E-mail: [email protected]. Website: www.bmjbooks.com. PRICE: Contact publisher for price. Summary: Gastroesophageal reflux occurs physiologically in all persons, when gastric (stomach) contents reflux (go back up) into the esophagus. However, due to acid neutralization by saliva and prompt esophageal clearance of the refluxed material, symptoms occur in only a minority of people. This chapter on gastroesophageal reflux disease (GERD) is from a book that emphasizes the approaches of evidence based medicine in gastroenterology (the study of the gastrointestinal tract and gastrointestinal diseases) and hepatology (the study of the liver and liver diseases). The authors of this chapter note that with inconsistency of definitions and methods of diagnosis, it is difficult to determine the current prevalence of GERD in the general population. The incidence of GERD is estimated to be 4.5 per 100,000, with a dramatic increase in persons over the age of 40. Complications of GERD include bleeding (less than 2 percent), ulceration (around 5 percent), and strictures (from 1.2 to 20 percent). Barrett's esophagus has been identified in 10 to 20 percent of GERD patients. The typical symptoms of GERD include heartburn, acid regurgitation, and dysphagia (swallowing difficulties). The authors consider the role of different diagnostic tests including symptom description, manometry and lower esophageal pressure measurement, radiology, scintigraphy, upper gastrointestinal endoscopy, Bernstein test (which measures esophageal acid sensitivity), 24 hour ambulatory pH monitoring, and acid suppression (as a diagnostic test). The goals of therapy are to provide adequate symptom relief in all patients and to prevent complications. Treatment options include antacids and lifestyle modifications, acid suppression therapy, H2 receptor antagonists, prokinetic drugs (i.e., cisapride and sucralfate), and treatment of GERD complications, including esophageal peptic stricture (narrowing). Maintenance therapy is required in most patients with GERD. The authors also discuss the treatment of endoscopy negative reflux disease, the use of surgery to treat GERD, the effect of GERD on quality of life, and Barrett's esophagus. 6 figures. 8 tables. 324 references.

•

Gastric Motor Disorders Source: in Snape, W.J., ed. Consultations in Gastroenterology. Philadelphia, PA: W.B. Saunders Company. 1996. p. 247-259. 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: $125.00. ISBN: 0721646700. Summary: Motor disorders of the stomach are common, varied in their clinical presentation, and may present with symptoms suggestive of impaired storage or impaired emptying of chyme. This chapter, from a gastroenterology yearbook, reviews the disorders associated with delayed gastric emptying and the treatment approach in these patients. The authors focus on established prokinetic agents in the treatment of gastric motor disorders. Remarkable technologic advances over the past decade have provided an expanding number of diagnostic and therapeutic modalities, which

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warrant a systematic approach in their use. Therapy is symptomatic and should be directed at the underlying pathologic process whenever possible. In addition to addressing nutritional and antiemetic needs, therapy frequently includes use of one or more of an expanding number of prokinetic drugs to enhance and coordinate gastroduodenal motility. Drugs discussed include metoclopramide (Reglan), domperidone (Motilium), cisapride (Propulsid), erythromycin, 5-HT3 receptor antagonists and 5-HT4 receptor agonists, opiate receptor antagonists, gonadotropinreleasing hormone agonists, and cholecystokinin receptor antagonists. 3 tables. 68 references. (AA-M). •

Medications Used To Treat Complications of Diabetes Source: in Carlisle, B.A.; Kroon, L.A.; Koda-Kimble, M.A. 101 Medication Tips for People with Diabetes. Alexandria, VA: American Diabetes Association. 1999. p. 66-75. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $14.95 plus shipping and handling. ISBN: 1580400329. Order number 483301. Summary: This chapter answers questions about the meditations used to treat diabetes complications, including nonprescription analgesics, tricyclic antidepressants, capsaicin cream, angiotensin converting enzyme (ACE) inhibitors, laxatives, and calcium channel blockers. Nonprescription analgesics, antidepressants, and narcotic analgesics can be used to treat the pain associated with diabetic neuropathy. Capsaicin cream, a chemical found in hot chili peppers, can be applied to the feet to relieve pain. ACE inhibitors can be used to treat microalbuminuria, an early sign of kidney damage. The symptoms of gastroparesis, a condition that affects the nerves of the stomach, can be treated with metoclopramide, cisapride, and erythromycin. These medications increase the stomach's ability to contract and aid in digestion. Constipation can be treated by increasing the amount of fluid and fiber in a person's diet. Laxatives may also be useful in treating constipation. Men who have diabetes and experience impotence can use the medications alprostadil and sildenafil to maintain an erection. People who have diabetes and high blood pressure can be treated with ACE inhibitors, diuretics, and calcium channel blockers. Angiotensin receptor II antagonists and calcium channel blockers can be used to treat kidney disease. People who have diabetes should take any medications their doctor prescribes for other conditions, such as high blood pressure, heart disease, high cholesterol or triglycerides, obesity, and insulin resistance.

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Controversial Therapies Source: in Manu, P. Pharmacotherapy of Common Functional Syndromes: EvidenceBased Guidelines for Primary Care Practice. Binghamton, NY: Haworth Medical Press. 2000. p. 131-152. Contact: Available from Haworth Medical Press, an imprint of Haworth Press, Inc. 10 Alice Street, Binghamton, New York 13904-1580. (800) HAWORTH or (800) 429-6784. Outside United States and Canada (607) 722-5857. Fax (800) 895-0582. E-mail: [email protected]. Website: www.haworthpressinc.com. PRICE: $69.95 plus shipping and handling. ISBN: 0789005883. Summary: This chapter is from a book that evaluates drug therapies for each of the four major functional disorders: chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome (IBS), and premenstrual syndrome. In this chapter, the third of six short chapters that focus on IBS, the author introduces and reviews controversial drug

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therapies used for the condition. The author focuses on bulking agents, including ispaghula husk, psyllium, and calcium polycarbophil; smooth muscle relaxants, including dicyclomine hydrochloride, mebeverine, trimebutine, and octylonium bromide; calcium channel blocking agents, including diltiazem, pinaverium, and cisapride (recently found to be associated with heart rhythm abnormalities). The author discusses some of the basic research on each drug's use in patients with IBS. Treatment with ispaghula was no better than placebo with regard to the principal symptoms of abdominal pain, abdominal distention, and the presence of frequent bowel movements; subjective improvement was noted by the patients, however. An eight week study of treatment with psyllium noted an improvement in the severity of abdominal pain and the number of normal stools in both treatment groups (drug and placebo groups) as compared with baseline; there was no difference between placebo and psyllium in the proportion of patients who considered themselves 'much better' after treatment. In the study of calcium polycarbophil, there were no statistically significant differences between the active agent and placebo as measured by global scores, by the specific symptom scores for abdominal pain, abdominal distention, nausea, and stool consistency, or by the proportion of patients who favored one of the treatments over the other. In studies of dicyclomine, 94 percent of patients treated with the drug improved (compared with 54 percent of those who took placebo). Mebeverine, widely used in the United Kingdom to treat IBS, fared no better than placebo for symptom relief. Treatment with 200 mg of trimebutine three times daily was considered superior to placebo, based primarily on patient preference for the drug; however, side effects at clinical dosage levels remain problematic. Octylonium bromide resulted in a slight statistical advantage over placebo (65 percent improvement compared with 50 percent improvement, respectively). Diltiazem appeared to be slightly more effective than placebo when it was the first treatment used in the crossover sequence of the trial, but the overall outcome after nine weeks indicated no meaningful advantage. Of the two calcium channel blocking agents tested in clinical trials, pinaverium but not diltiazem appears to offer short term benefit. •

Dysphagia Source: in Vogel, D.; Carter, J.E.; Carter, P.B. Effects of Drugs on Communication Disorders. 2nd ed. San Diego, CA: Singular Publishing Group, Inc. 1999. p. 199-200. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 347-7707. Fax (800) 774-8398. E-mail: [email protected]. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 1565939964. Summary: This chapter on dysphagia (swallowing disorders) is from a handbook that gives communication specialists information about prescription drugs and their use with patients who suffer neurogenic or psychogenic communication disorders. The book was designed for communication specialists who work in medical centers, rehabilitation clinics, private practice, public schools, or any setting in which drug therapy may influence a client's communication. This chapter includes a list of drugs that have caused dysphagia along with a discussion of drugs that have been used to treat dysphagia. Drugs covered include buspirone, nifedipine, and cisapride (Propulsid). 2 references.

•

Gastroesophageal Reflux During Infancy and Childhood Source: in Snape, W.J., ed. Consultations in Gastroenterology. Philadelphia, PA: W.B. Saunders Company. 1996. p. 207-211.

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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: $125.00. ISBN: 0721646700. Summary: This chapter, from a gastroenterology text, provides a guide to the diagnostic and therapeutic considerations in the management of gastroesophageal reflux disease (GERD) in infancy and childhood. Topics include the clinical presentation, the diagnostic evaluation, therapy guidelines, pharmacotherapy, and indications for surgery. Drug agents discussed include gastric acid-neutralizing agents, metoclopramide, and cisapride. The majority of infants with GERD become symptomatic during the first few months of life, and usually the overt symptoms resolve by 1 to 2 years of age. The author concludes that most infants with symptoms of GERD benefit from no invasive diagnostic or therapeutic maneuvers. However, infants and older children with profound central nervous system (CNS) dysfunction are likely to have severe GERD, which requires more aggressive or possibly surgical management. 10 references. (AA-M). •

Diagnosis and Management of Gastric Emptying Disorders Source: in Cameron, J.L., et al., eds. Advances in Surgery. Vol 27. St. Louis, MO: MosbyYear Book, Inc. 1994. p. 233-255. Contact: Available from Mosby Year-Book, Inc. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 426-4545. Fax (800) 535-9935. E-mail: [email protected]. PRICE: Contact directly for current price. ISBN: 815114923. ISSN: 00653411. Summary: This chapter, from a textbook on surgery, describes the relevant physiology and pathophysiology of gastric emptying. In addition, the authors discuss the diagnosis and management of gastric emptying disorders. Gastric emptying, the final common pathway for gastric secretory and motor events, is the net result of coordinated contraction and relaxation of the stomach, pylorus, and duodenum. Functional changes in the gastroduodenal musculature may result from primary neuromuscular disorders or systemic metabolic diseases, while surgical denervation, bypass, and resection results in structural and mechanical changes in the gastroduodenum. Gastric emptying disorders covered include dumping syndrome and delayed gastric emptying. Dumping symptoms may occur in up to 50 percent of postgastrectomy patients, but most patients are treated satisfactorily by dietary manipulation or, in the rare incapacitated patient, by the long-acting somatostatin analogue octreotide. Reconstructive gastric surgery may rarely be indicated to slow gastric emptying and alleviate the dumping syndrome. Pharmacologic therapy of delayed gastric emptying has seen the introduction of several new and promising prokinetic agents, including bethanechol, metoclopramide, cisapride, domperidone, motilin, and erythromycin. In addition, surgical intervention for mechanical causes of gastric outlet obstruction is readily justified. 4 figures. 1 table. 106 references. (AA-M).

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

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

Mississippi judge cuts award in Propulsid case Source: Reuters Health eLine Date: March 05, 2002

•

UK takes JJ's Prepulsid off market Source: Reuters Industry Breifing Date: July 21, 2000

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Coroner says cisapride may have been involved in infant's death Source: Reuters Industry Breifing Date: May 01, 2000

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Consumer group urges FDA to accelerate Propulsid withdrawal Source: Reuters Industry Breifing Date: April 13, 2000

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JJ shares fall in wake of Propulsid withdrawal Source: Reuters Medical News Date: March 27, 2000

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Janssen to pull Propulsid from US market Source: Reuters Health eLine Date: March 24, 2000

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Janssen to pull cisapride from US market Source: Reuters Medical News Date: March 24, 2000 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “cisapride” (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

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you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “cisapride” (or synonyms). If you know the name of a company that is relevant to cisapride, 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 “cisapride” (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 “cisapride” (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 cisapride: •

FDA Approval of Cisapride Source: APHS Newsletter. American Pseudo-Obstruction and Hirschsprung's Disease Society, Inc. Newsletter. 6(1): 1-2. Winter 1993-1994. Contact: Available from APHS. 158 Pleasant Street, North Andover, MA 01845-2797. (508) 685-4477. Fax (508) 685-4488. E-mail: [email protected]. Summary: This article discusses the FDA approval of cisapride (Propulsid, Janssen Pharmaceutica) for use in children with impaired gastrointestinal motility. The author notes that cisapride has been approved for use in adults who have nighttime heartburn due to gastroesophageal reflux disease (GERD). Topics include the symptoms of GERD in children; associated diseases and conditions; initial therapy for GERD in infants; results with cisapride in pediatric patients; the use of cisapride in children with chronic intestinal pseudo-obstruction (CIP); other prokinetic drugs; the use of cisapride in the treatment of chronic constipation; the pharmaceutical development of cisapride; and the anticipated progress through the FDA approval process.

•

Focus on Cisapride Source: Reflux Digest. 2(4): 1-6. Winter 1998. Contact: Available from Pediatric-Adolescent Gastroesophageal Reflux Association, Inc. (PAGER). P.O. Box 1153, Germantown, MD 20875-1153. (301) 601-9541 or (760) 747-5001. E-mail: [email protected]. Website: www.reflux.org. Summary: This issue of the Reflux Digest newsletter is devoted to information about the use of cisapride, one of the newer medications used to treat gastroesophageal reflux disease (GERD), especially in children. The authors provide an overview of current

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discussions and a background that can help readers understand why the use of cisapride has become so controversial. The issue begins with a brief editorial introduction explaining that some of the information presented in the issue is anecdotal and provided by parents with experience with the drug. The newsletter then offers an article outlining recent concerns about cisapride (Propulsid or Prepulsid). A number of people taking cisapride have experienced changes in their heart rhythms; 38 people taking cisapride have died. This has caused a lot of concern and some outright panic among parents of children with GERD and motility disorders. The article also reports on interactions with medications in several categories, including some very common prescription and nonprescription medications. High doses of cisapride alone can be dangerous; in children who are growing and changing, dosage must be recalculated carefully and regularly. Dehydration can also contribute to arrhythmias and can cause blood levels of cisapride to rise. The article also reports how the various news reports are affecting the use of cisapride and what professional societies recommend. The article notes that the safest approach is not to use cisapride. All motility medications have limitations and it may be more appropriate to address acid levels before treating any motility issues. The issue concludes with a list of recommendations for parents who choose to allow their children to use cisapride.

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

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

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

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

Systemic - U.S. Brands: Propulsid http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202672.html

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

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

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APPENDICES

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

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

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

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

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

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

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

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

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

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

10

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

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

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

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

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

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

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

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

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

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

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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

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

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

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

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

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

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

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

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 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:12 •

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

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

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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

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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/

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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

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

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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/

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

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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

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

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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

11

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). 12 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 Gateway13 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.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “cisapride” (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 1789 5 491 3 16 2304

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 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.17 Simply search by “cisapride” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

13

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

14

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). 15 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 16 17

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

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

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Coffee Break: Tutorials for Biologists18 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.19 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.20 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/.

18 Adapted 19

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. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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

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Drug and Medical Device Safety http://www.nlm.nih.gov/medlineplus/drugandmedicaldevicesafety.html Hepatitis C http://www.nlm.nih.gov/medlineplus/hepatitisc.html Medicines http://www.nlm.nih.gov/medlineplus/medicines.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 cisapride. 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: •

Recommendations of Various Authors Regarding Pediatric Dosing of Cisapride (Propulsid) Source: Atlanta, GA: Children's Motility Disorder Foundation. 1997. 2 p. Contact: Available from Children's Motility Disorder Foundation. 225 Peachtree Street, NE, Suite 1430, Atlanta, GA 30303. (800) 809-9492 or (404) 529-9200. Fax (404) 529-9202. E-mail: [email protected]. PRICE: Single copy free. Summary: This fact sheet consists of a chart that summarizes the recommendations of various authors regarding pediatric dosing of cisapride (Propulsid). The fact sheet reminds readers that Propulsid is not approved by the U.S. Food and Drug Administration (FDA) for pediatric use. Therefore, a safe and effective pediatric dose has not been established. The chart lists the researchers of each study, the therapeutic area covered, the age of children in the study, and the dosage of cisapride used. Therapeutic areas include reflux (gastroesophageal reflux disease), pseudoobstruction, intractable constipation, cystic fibrosis, reflux associated with bronchopulmonary disease, and excessive regurgitation. Dosages ranged from 0.1 to 0.33 mg per kilogram of body weight, three times per day (t.i.d.). The reverse side of the fact sheet lists the bibliographic references for each of the eleven research studies listed, as well as for two review articles on this topic. 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

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ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to cisapride. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

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

•

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

•

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

•

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

•

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

•

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

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to cisapride. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with cisapride. 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 cisapride. 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.

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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 “cisapride” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “cisapride”. 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 “cisapride” (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 “cisapride” (or a synonym) into the search box, and click “Submit Query.”

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

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

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

21

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)22: •

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/

22

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

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•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

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•

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

•

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

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

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

•

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

•

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

•

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

•

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

•

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

•

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

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

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

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

•

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

•

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

•

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

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CISAPRIDE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] 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] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Glands: Paired glands situated in the retroperitoneal tissues at the superior pole of each kidney. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] 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] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH]

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Aldosterone: (11 beta)-11,21-Dihydroxy-3,20-dioxopregn-4-en-18-al. A hormone secreted by the adrenal cortex that functions in the regulation of electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergic Rhinitis: Inflammation of the nasal mucous membrane associated with hay fever; fits may be provoked by substances in the working environment. [NIH] Alprostadil: A potent vasodilator agent that increases peripheral blood flow. It inhibits platelet aggregation and has many other biological effects such as bronchodilation, mediation of inflammation, etc. [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] Amenorrhea: Absence of menstruation. [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] 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] Amniotic Fluid: Amniotic cavity fluid which is produced by the amnion and fetal lungs and kidneys. [NIH] Ampulla: A sac-like enlargement of a canal or duct. [NIH] Amyloidosis: A group of diseases in which protein is deposited in specific organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause) or secondary (caused by another disease, including some types of cancer). Generally, primary amyloidosis affects the nerves, skin, tongue, joints, heart, and liver; secondary amyloidosis often affects the spleen, kidneys, liver, and adrenal glands. [NIH] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance

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of surgery or other painful procedures. [NIH] Anginal: Pertaining to or characteristic of angina. [EU] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]

Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antiarrhythmic: An agent that prevents or alleviates cardiac arrhythmia. [EU] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

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

Antigen: Any substance which is capable, under appropriate conditions, of inducing a 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] Antihypertensive: An agent that reduces high blood pressure. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including

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phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antispasmodic: An agent that relieves spasm. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Apnea: A transient absence of spontaneous respiration. [NIH] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atrial: Pertaining to an atrium. [EU] Atrial Fibrillation: Disorder of cardiac rhythm characterized by rapid, irregular atrial impulses and ineffective atrial contractions. [NIH] Atropine: A toxic alkaloid, originally from Atropa belladonna, but found in other plants, mainly Solanaceae. [NIH] Autonomic Neuropathy: A disease of the nerves affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves are not under a person's conscious control and function automatically. Also called visceral neuropathy. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [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]

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Bacterial Translocation: The passage of viable bacteria from the gastrointestinal tract to extra-intestinal sites, such as the mesenteric lymph node complex, liver, spleen, kidney, and blood. Factors that promote bacterial translocation include overgrowth with gram-negative enteric bacilli, impaired host immune defenses, and injury to the intestinal mucosa resulting in increased intestinal permeability. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. [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] Barium: An element of the alkaline earth group of metals. It has an atomic symbol Ba, atomic number 56, and atomic weight 138. All of its acid-soluble salts are poisonous. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Belladonna: A species of very poisonous Solanaceous plants yielding atropine (hyoscyamine), scopolamine, and other belladonna alkaloids, used to block the muscarinic autonomic nervous system. [NIH] Benzamides: Benzoic acid amides. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bethanechol: A slowly hydrolyzed muscarinic agonist with no nicotinic effects. Bethanechol is generally used to increase smooth muscle tone, as in the GI tract following abdominal surgery or in urinary retention in the absence of obstruction. It may cause hypotension, cardiac rate changes, and bronchial spasms. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile duct: A tube through which bile passes in and out of the liver. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH]

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Biliary Tract: The gallbladder and its ducts. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological response modifier: BRM. A substance that stimulates the body's response to infection and disease. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biosynthesis: The building up of a chemical compound in the physiologic processes of a living organism. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Regions: Anatomical areas of the body. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH]

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Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Breath Tests: Any tests done on exhaled air. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchial Spasm: Spasmodic contraction of the smooth muscle of the bronchi. [NIH] Bronchopulmonary: Pertaining to the lungs and their air passages; both bronchial and pulmonary. [EU] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bulking Agents: Laxatives that make bowel movements soft and easy to pass. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Bypass: A surgical procedure in which the doctor creates a new pathway for the flow of body fluids. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cell membranes or on the release and binding of calcium in intracellular pools. Since they are inducers of vascular and other smooth muscle relaxation, they are used in the drug therapy of hypertension and cerebrovascular spasms, as myocardial protective agents, and in the relaxation of uterine spasms. [NIH] Calcium Signaling: Signal transduction mechanisms whereby calcium mobilization (from outside the cell or from intracellular storage pools) to the cytoplasm is triggered by external stimuli. Calcium signals are often seen to propagate as waves, oscillations, spikes or puffs. The calcium acts as an intracellular messenger by activating calcium-responsive proteins. [NIH]

Capsaicin: Cytotoxic alkaloid from various species of Capsicum (pepper, paprika), of the Solanaceae. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates

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are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [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 Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [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] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Chyme: A thick liquid made of partially digested food and stomach juices. This liquid is made in the stomach and moves into the small intestine for further digestion. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2

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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] Cirrhosis: A type of chronic, progressive liver disease. [NIH] CIS: Cancer Information Service. The CIS is the National Cancer Institute's link to the public, interpreting and explaining research findings in a clear and understandable manner, and providing personalized responses to specific questions about cancer. Access the CIS by calling 1-800-4-CANCER, or by using the Web site at http://cis.nci.nih.gov. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clamp: A u-shaped steel rod used with a pin or wire for skeletal traction in the treatment of certain fractures. [NIH] Clarithromycin: A semisynthetic macrolide antibiotic derived from erythromycin that is active against a variety of microorganisms. It can inhibit protein synthesis in bacteria by reversibly binding to the 50S ribosomal subunits. This inhibits the translocation of aminoacyl transfer-RNA and prevents peptide chain elongation. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coagulation: 1. The process of clot formation. 2. In colloid chemistry, the solidification of a sol into a gelatinous mass; an alteration of a disperse phase or of a dissolved solid which causes the separation of the system into a liquid phase and an insoluble mass called the clot or curd. Coagulation is usually irreversible. 3. In surgery, the disruption of tissue by physical means to form an amorphous residuum, as in electrocoagulation and photocoagulation. [EU] Coenzyme: An organic nonprotein molecule, frequently a phosphorylated derivative of a water-soluble vitamin, that binds with the protein molecule (apoenzyme) to form the active enzyme (holoenzyme). [EU] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Colic: Paroxysms of pain. This condition usually occurs in the abdominal region but may occur in other body regions as well. [NIH] Colitis: Inflammation of the colon. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The

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remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Colonoscopy: Endoscopic examination, therapy or surgery of the luminal surface of the colon. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Surgery: A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the colon, rectum, and anal canal. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH]

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Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjugation: 1. The act of joining together or the state of being conjugated. 2. A sexual process seen in bacteria, ciliate protozoa, and certain fungi in which nuclear material is exchanged during the temporary fusion of two cells (conjugants). In bacterial genetics a form of sexual reproduction in which a donor bacterium (male) contributes some, or all, of its DNA (in the form of a replicated set) to a recipient (female) which then incorporates differing genetic information into its own chromosome by recombination and passes the recombined set on to its progeny by replication. In ciliate protozoa, two conjugants of separate mating types exchange micronuclear material and then separate, each now being a fertilized cell. In certain fungi, the process involves fusion of two gametes, resulting in union of their nuclei and formation of a zygote. 3. In chemistry, the joining together of two compounds to produce another compound, such as the combination of a toxic product with some substance in the body to form a detoxified product, which is then eliminated. [EU] Conjunctivitis: Inflammation of the conjunctiva, generally consisting of conjunctival hyperaemia associated with a discharge. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contractility: Capacity for becoming short in response to a suitable stimulus. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] 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

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cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytoplasm: The protoplasm of a cell exclusive of that of the nucleus; it consists of a continuous aqueous solution (cytosol) and the organelles and inclusions suspended in it (phaneroplasm), and is the site of most of the chemical activities of the cell. [EU] Cytotoxicity: Quality of being capable of producing a specific toxic action upon cells of special organs. [NIH] Defaecation: The act or process of defecating, discharge of feces. [EU] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dialyzer: A part of the hemodialysis machine. (See hemodialysis under dialysis.) The dialyzer has two sections separated by a membrane. One section holds dialysate. The other holds the patient's blood. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Dicyclomine: A muscarinic antagonist used as an antispasmodic and in urinary incontinence. It has little effect on glandular secretion or the cardiovascular system. It does have some local anesthetic properties and is used in gastrointestinal, biliary, and urinary tract spasms. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of the calcium ion in membrane functions. It is also teratogenic. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disposition: A tendency either physical or mental toward certain diseases. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense

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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] Distention: The state of being distended or enlarged; the act of distending. [EU] Diuresis: Increased excretion of urine. [EU] Domperidone: A specific blocker of dopamine receptors. It speeds gastrointestinal peristalsis, causes prolactin release, and is used as antiemetic and tool in the study of dopaminergic mechanisms. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Double-blinded: A clinical trial in which neither the medical staff nor the person knows which of several possible therapies the person is receiving. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Dumping Syndrome: Gastrointestinal nonfunctioning pylorus. [NIH]

symptoms

resulting

from

an

absent

or

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] Dyspepsia: Impaired digestion, especially after eating. [NIH] Dysphagia: Difficulty in swallowing. [EU]

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Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] 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] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emboli: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Embolism: Blocking of a blood vessel by a blood clot or foreign matter that has been transported from a distant site by the blood stream. [NIH] Embolization: The blocking of an artery by a clot or foreign material. Embolization can be done as treatment to block the flow of blood to a tumor. [NIH] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Encopresis: Incontinence of feces not due to organic defect or illness. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] 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] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. [NIH] Enteric Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH]

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Enterocolitis: Inflammation of the intestinal mucosa of the small and large bowel. [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] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erectile: The inability to get or maintain an erection for satisfactory sexual intercourse. Also called impotence. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Estrogens: A class of sex hormones associated with the development and maintenance of secondary female sex characteristics and control of the cyclical changes in the reproductive cycle. They are also required for pregnancy maintenance and have an anabolic effect on protein metabolism and water retention. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] Excitation: An act of irritation or stimulation or of responding to a stimulus; the addition of energy, as the excitation of a molecule by absorption of photons. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exocrine: Secreting outwardly, via a duct. [EU]

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Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fistula: Abnormal communication most commonly seen between two internal organs, or between an internal organ and the surface of the body. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Functional Disorders: Disorders such as irritable bowel syndrome. These conditions result from poor nerve and muscle function. Symptoms such as gas, pain, constipation, and diarrhea come back again and again, but there are no signs of disease or damage. Emotional stress can trigger symptoms. Also called motility disorders. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gallbladder Emptying: A process whereby bile is delivered from the gallbladder into the duodenum. The emptying is caused by both contraction of the gallbladder and relaxation of the sphincter mechanism at the choledochal terminus. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrectomy: An operation to remove all or part of the stomach. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Balloon: An inflatable device implanted in the stomach as an adjunct to therapy of morbid obesity. Specific types include the silicone Garren-Edwards Gastric Bubble (GEGB), approved by the FDA in 1985, and the Ballobes Balloon. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH]

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Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Outlet Obstruction: The hindering of output from the stomach to the small intestine. The source varies: peptic ulcer, foreign bodies, aging, neoplasms, etc. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastroduodenal: Pertaining to or communicating with the stomach and duodenum, as a gastroduodenal fistula. [EU] Gastroenterology: A subspecialty of internal medicine concerned with the study of the physiology and diseases of the digestive system and related structures (esophagus, liver, gallbladder, and pancreas). [NIH] 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] Gastrointestinal tract: The stomach and intestines. [NIH] Gastrointestinal Transit: Passage of food (sometimes in the form of a test meal) through the gastrointestinal tract as measured in minutes or hours. The rate of passage through the intestine is an indicator of small bowel function. [NIH] Gastroparesis: Nerve or muscle damage in the stomach. Causes slow digestion and emptying, vomiting, nausea, or bloating. Also called delayed gastric emptying. [NIH] Gastrostomy: Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. [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]

Genital: Pertaining to the genitalia. [EU] Gestational: Psychosis attributable to or occurring during pregnancy. [NIH] Gestational Age: Age of the conceptus. In humans, this may be assessed by medical history, physical examination, early immunologic pregnancy tests, radiography, ultrasonography, and amniotic fluid analysis. [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] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen

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frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH]

Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Glycoproteins: Conjugated protein-carbohydrate compounds including mucins, mucoid, and amyloid glycoproteins. [NIH] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] 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] Gravis: Eruption of watery blisters on the skin among those handling animals and animal products. [NIH] Haematemesis: The vomiting of blood. [EU] Haloperidol: Butyrophenone derivative. [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] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heartbeat: One complete contraction of the heart. [NIH] Heartburn: Substernal pain or burning sensation, usually associated with regurgitation of gastric juice into the esophagus. [NIH]

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Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatology: The field of medicine concerned with the functions and disorders of the liver. [NIH]

Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] 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] 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] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hyperaldosteronism: Aldosteronism. [EU] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH]

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Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Ileus: Obstruction of the intestines. [EU] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immunofluorescence: A technique for identifying molecules present on the surfaces of cells or in tissues using a highly fluorescent substance coupled to a specific antibody. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Impotence: The inability to perform sexual intercourse. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infancy: The period of complete dependency prior to the acquisition of competence in walking, talking, and self-feeding. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH]

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Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Interferon: A biological response modifier (a substance that can improve the body's natural response to disease). Interferons interfere with the division of cancer cells and can slow tumor growth. There are several types of interferons, including interferon-alpha, -beta, and gamma. These substances are normally produced by the body. They are also made in the laboratory for use in treating cancer and other diseases. [NIH] Interferon-alpha: One of the type I interferons produced by peripheral blood leukocytes or lymphoblastoid cells when exposed to live or inactivated virus, double-stranded RNA, or bacterial products. It is the major interferon produced by virus-induced leukocyte cultures and, in addition to its pronounced antiviral activity, it causes activation of NK cells. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestinal Pseudo-Obstruction: Obstruction of the intestines that is functional, not mechanical. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Jejunostomy: Surgical formation of an opening through the abdominal wall into the jejunum, usually for enteral hyperalimentation. [NIH]

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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] Kidney Disease: Any one of several chronic conditions that are caused by damage to the cells of the kidney. People who have had diabetes for a long time may have kidney damage. Also called nephropathy. [NIH] Kidney Failure: The inability of a kidney to excrete metabolites at normal plasma levels under conditions of normal loading, or the inability to retain electrolytes under conditions of normal intake. In the acute form (kidney failure, acute), it is marked by uremia and usually by oliguria or anuria, with hyperkalemia and pulmonary edema. The chronic form (kidney failure, chronic) is irreversible and requires hemodialysis. [NIH] Kinetics: The study of rate dynamics in chemical or physical systems. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Linkages: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loperamide: 4-(p-Chlorophenyl)-4-hydroxy-N.N-dimethyl-alpha,alpha-diphenyl-1piperidine butyramide hydrochloride. Synthetic anti-diarrheal agent with a long duration of action; it is not significantly absorbed from the gut, has no effect on the adrenergic system or central nervous system, but may antagonize histamine and interfere with acetylcholine release locally. [NIH] Lovastatin: A fungal metabolite isolated from cultures of Aspergillus terreus. The compound is a potent anticholesteremic agent. It inhibits 3-hydroxy-3-methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It also stimulates the production of low-density lipoprotein receptors in the liver. [NIH] Lower Esophageal Sphincter: The muscle between the esophagus and stomach. When a person swallows, this muscle relaxes to let food pass from the esophagus to the stomach. It stays closed at other times to keep stomach contents from flowing back into the esophagus. [NIH]

Lymph: The almost colorless fluid that travels through the lymphatic system and carries

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

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Magnesium Hydroxide: Magnesium hydroxide (Mg(OH)2). An inorganic compound that occurs in nature as the mineral brucite. It acts as an antacid with cathartic effects. [NIH] Magnesium Oxide: Magnesium oxide (MgO). An inorganic compound that occurs in nature as the mineral periclase. In aqueous media combines quickly with water to form magnesium hydroxide. It is used as an antacid and mild laxative and has many nonmedicinal uses. [NIH] Maintenance therapy: Treatment that is given to help a primary (original) treatment keep working. Maintenance therapy is often given to help keep cancer in remission. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Manometry: Tests that measure muscle pressure and movements in the GI tract. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Staff: Professional medical personnel who provide care to patients in an organized facility, institution or agency. [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 Glycoproteins: Glycoproteins found on the membrane or surface of cells. [NIH] Membrane Proteins: Proteins which are found in membranes including cellular and intracellular membranes. They consist of two types, peripheral and integral proteins. They include most membrane-associated enzymes, antigenic proteins, transport proteins, and drug, hormone, and lectin receptors. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated

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during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mesenteric: Pertaining to the mesentery : a membranous fold attaching various organs to the body wall. [EU] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] 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] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motilin: A 22-amino acid polypeptide (molecular weight 2700) isolated from the duodenum. At low pH it inhibits gastric motor activity, whereas at high pH it has a stimulating effect. [NIH]

Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Muscle Contraction: A process leading to shortening and/or development of tension in muscle tissue. Muscle contraction occurs by a sliding filament mechanism whereby actin filaments slide inward among the myosin filaments. [NIH]

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Muscle relaxant: An agent that specifically aids in reducing muscle tension, as those acting at the polysynaptic neurons of motor nerves (e.g. meprobamate) or at the myoneural junction (curare and related compounds). [EU] Muscle Relaxation: That phase of a muscle twitch during which a muscle returns to a resting position. [NIH] Muscle Spindles: Mechanoreceptors found between skeletal muscle fibers. Muscle spindles are arranged in parallel with muscle fibers and respond to the passive stretch of the muscle, but cease to discharge if the muscle contracts isotonically, thus signaling muscle length. The muscle spindles are the receptors responsible for the stretch or myotactic reflex. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Myasthenia: Muscular debility; any constitutional anomaly of muscle. [EU] Myocardial infarction: Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nasogastric: The process of passing a small, flexible plastic tube through the nose or mouth into the stomach or small intestine. [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] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Neonatal: Pertaining to the first four weeks after birth. [EU] Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. [NIH] Neostigmine: A cholinesterase inhibitor used in the treatment of myasthenia gravis and to reverse the effects of muscle relaxants such as gallamine and tubocurarine. Neostigmine, unlike physostigmine, does not cross the blood-brain barrier. [NIH] Nephropathy: Disease of the kidneys. [EU] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH]

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Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Neutralization: An act or process of neutralizing. [EU] Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful antianginal agent that also lowers blood pressure. The use of nifedipine as a tocolytic is being investigated. [NIH] 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] Nonulcer Dyspepsia: Constant pain or discomfort in the upper GI tract. Symptoms include burning, nausea, and bloating, but no ulcer. Possibly caused by muscle spasms. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include fluid therapy which normalizes body fluids to restore water-electrolyte balance. [NIH] Octreotide: A potent, long-acting somatostatin octapeptide analog which has a wide range of physiological actions. It inhibits growth hormone secretion, is effective in the treatment of hormone-secreting tumors from various organs, and has beneficial effects in the management of many pathological states including diabetes mellitus, orthostatic hypertension, hyperinsulinism, hypergastrinemia, and small bowel fistula. [NIH]

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Odds Ratio: The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. [NIH] Oesophagitis: Inflammation of the esophagus. [EU] Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Omeprazole: A highly effective inhibitor of gastric acid secretion used in the therapy of gastric ulcers and Zollinger-Ellison syndrome. The drug inhibits the H(+)-K(+)-ATPase (H(+)-K(+)-exchanging ATPase) in a pH-dependent manner. This ATPase is considered the proton pump in the secretory membrane of the parietal cell. [NIH] Opiate: A remedy containing or derived from opium; also any drug that induces sleep. [EU] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidation-Reduction: A chemical reaction in which an electron is transferred from one molecule to another. The electron-donating molecule is the reducing agent or reductant; the electron-accepting molecule is the oxidizing agent or oxidant. Reducing and oxidizing agents function as conjugate reductant-oxidant pairs or redox pairs (Lehninger, Principles of Biochemistry, 1982, p471). [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatic Juice: The fluid containing digestive enzymes secreted by the pancreas in response to food in the duodenum. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Parietal: 1. Of or pertaining to the walls of a cavity. 2. Pertaining to or located near the parietal bone, as the parietal lobe. [EU] Partial remission: The shrinking, but not complete disappearance, of a tumor in response to therapy. Also called partial response. [NIH] Partnership Practice: A voluntary contract between two or more doctors who may or may not share responsibility for the care of patients, with proportional sharing of profits and

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losses. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] 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: An ulceration of the mucous membrane of the esophagus, stomach or duodenum, caused by the action of the acid gastric juice. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Peptide Chain Elongation: The process whereby an amino acid is joined through a substituted amide linkage to a chain of peptides. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Percutaneous: Performed through the skin, as injection of radiopacque material in radiological examination, or the removal of tissue for biopsy accomplished by a needle. [EU] Perfusion: Bathing an organ or tissue with a fluid. In regional perfusion, a specific area of the body (usually an arm or a leg) receives high doses of anticancer drugs through a blood vessel. Such a procedure is performed to treat cancer that has not spread. [NIH] Periodicity: The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peristalsis: The rippling motion of muscles in the intestine or other tubular organs characterized by the alternate contraction and relaxation of the muscles that propel the contents onward. [NIH] Peritoneal: Having to do with the peritoneum (the tissue that lines the abdominal wall and covers most of the organs in the abdomen). [NIH] Peritoneal Cavity: The space enclosed by the peritoneum. It is divided into two portions, the greater sac and the lesser sac or omental bursa, which lies behind the stomach. The two sacs are connected by the foramen of Winslow, or epiploic foramen. [NIH]

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Peritoneal Dialysis: Dialysis fluid being introduced into and removed from the peritoneal cavity as either a continuous or an intermittent procedure. [NIH] Peritoneum: Endothelial lining of the abdominal cavity, the parietal peritoneum covering the inside of the abdominal wall and the visceral peritoneum covering the bowel, the mesentery, and certain of the organs. The portion that covers the bowel becomes the serosal layer of the bowel wall. [NIH] Peroral: Performed through or administered through the mouth. [EU] Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenytoin: An anticonvulsant that is used in a wide variety of seizures. It is also an antiarrhythmic and a muscle relaxant. The mechanism of therapeutic action is not clear, although several cellular actions have been described including effects on ion channels, active transport, and general membrane stabilization. The mechanism of its muscle relaxant effect appears to involve a reduction in the sensitivity of muscle spindles to stretch. Phenytoin has been proposed for several other therapeutic uses, but its use has been limited by its many adverse effects and interactions with other drugs. [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH]

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Physical Examination: Systematic and thorough inspection of the patient for physical signs of disease or abnormality. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Physostigmine: A cholinesterase inhibitor that is rapidly absorbed through membranes. It can be applied topically to the conjunctiva. It also can cross the blood-brain barrier and is used when central nervous system effects are desired, as in the treatment of severe anticholinergic toxicity. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Piperidines: A family of hexahydropyridines. Piperidine itself is found in the pepper plant as the alkaloid piperine. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Platelet Aggregation: The attachment of platelets to one another. This clumping together can be induced by a number of agents (e.g., thrombin, collagen) and is part of the mechanism leading to the formation of a thrombus. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polypeptide: A peptide which on hydrolysis yields more than two amino acids; called tripeptides, tetrapeptides, etc. according to the number of amino acids contained. [EU] Postoperative: After surgery. [NIH] Postoperative Period: The period following a surgical operation. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Potassium: An element that is in the alkali group of metals. It has an atomic symbol K, atomic number 19, and atomic weight 39.10. It is the chief cation in the intracellular fluid of muscle and other cells. Potassium ion is a strong electrolyte and it plays a significant role in the regulation of fluid volume and maintenance of the water-electrolyte balance. [NIH] Potassium Channels: Cell membrane glycoproteins selective for potassium ions. [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] Pregnancy Tests: Tests to determine whether or not an individual is pregnant. [NIH] Preload: The tension in the heart muscle at the end of diastole (before the contraction). [EU]

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Premedication: Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (antibiotic prophylaxis) and anti-anxiety agents. It does not include preanesthetic medication. [NIH] Premenstrual Syndrome: A syndrome occurring most often during the last week of the menstrual cycle and ending soon after the onset of menses. Some of the symptoms are emotional instability, insomnia, headache, nausea, vomiting, abdominal distension, and painful breasts. [NIH] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Private Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prokinetic Drugs: Medicines that cause muscles in the GI tract to move food. An example is cisapride (SIS-uh-pryd) (Propulsid). [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Prostaglandin: Any of a group of components derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway that are extremely potent mediators of a diverse group of physiologic processes. The abbreviation for prostaglandin is PG; specific compounds are designated by adding one of the letters A through I to indicate the type of substituents found on the hydrocarbon skeleton and a subscript (1, 2 or 3) to indicate the number of double bonds in the hydrocarbon skeleton e.g., PGE2. The predominant naturally occurring prostaglandins all have two double bonds and are synthesized from arachidonic acid (5,8,11,14-eicosatetraenoic acid) by the pathway shown in the illustration. The 1 series and 3 series are produced by the same pathway with fatty acids having one fewer double bond (8,11,14-eicosatrienoic acid or one more double bond (5,8,11,14,17-eicosapentaenoic acid) than arachidonic acid. The subscript a or ß indicates the configuration at C-9 (a denotes a substituent below the plane of the ring, ß, above the plane). The naturally occurring PGF's have the a configuration, e.g., PGF2a. All of the prostaglandins act by binding to specific cell-surface receptors causing an increase in the level of the intracellular second messenger cyclic AMP (and in some cases cyclic GMP also). The effect produced by the cyclic AMP increase depends on the specific cell type. In some cases there is also a positive feedback effect. Increased cyclic AMP increases prostaglandin synthesis leading to further increases in cyclic AMP. [EU] Prostaglandins A: (13E,15S)-15-Hydroxy-9-oxoprosta-10,13-dien-1-oic acid (PGA(1)); (5Z,13E,15S)-15-hydroxy-9-oxoprosta-5,10,13-trien-1-oic acid (PGA(2)); (5Z,13E,15S,17Z)-15hydroxy-9-oxoprosta-5,10,13,17-tetraen-1-oic acid (PGA(3)). A group of naturally occurring secondary prostaglandins derived from PGE. PGA(1) and PGA(2) as well as their 19hydroxy derivatives are found in many organs and tissues. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU]

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Protective Agents: Synthetic or natural substances which are given to prevent a disease or disorder or are used in the process of treating a disease or injury due to a poisonous agent. [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] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proton Pump: Integral membrane proteins that transport protons across a membrane against a concentration gradient. This transport is driven by hydrolysis of ATP by H(+)transporting ATP synthase. [NIH] Proton Pump Inhibitors: Medicines that stop the stomach's acid pump. Examples are omeprazole (oh-MEH-prah-zol) (Prilosec) and lansoprazole (lan-SOH-prah-zol) (Prevacid). [NIH]

Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Psyllium: Dried, ripe seeds of Plantago psyllium, P. indica, and P. ovata (Plantaginaceae). Plantain seeds swell in water and are used as demulcents and bulk laxatives. [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] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Embolism: Embolism in the pulmonary artery or one of its branches. [NIH] Purgative: 1. Cathartic (def. 1); causing evacuation of the bowels. 2. A cathartic, particularly one that stimulates peristaltic action. [EU] Pylorus: The opening in a vertebrate from the stomach into the intestine. [EU] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH]

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Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Racemic: Optically inactive but resolvable in the way of all racemic compounds. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Radiography: Examination of any part of the body for diagnostic purposes by means of roentgen rays, recording the image on a sensitized surface (such as photographic film). [NIH] Radiological: Pertaining to radiodiagnostic and radiotherapeutic procedures, and interventional radiology or other planning and guiding medical radiology. [NIH] Radiology: A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized Controlled Trials: Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply controlled clinical trials. [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] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Rectal: By or having to do with the rectum. The rectum is the last 8 to 10 inches of the large intestine and ends at the anus. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [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] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractory: Not readily yielding to treatment. [EU] 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]

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Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Resection: Removal of tissue or part or all of an organ by surgery. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Rhythmicity: Regular periodicity. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Rod: A reception for vision, located in the retina. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Sepsis: The presence of bacteria in the bloodstream. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis,

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and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Simethicone: A mixture of dimethyl polysiloxanes and silica gel used as an antiflatulent. Without the addition of silica gel (dimethicone), it is used as an ointment base ingredient and skin protectant. [NIH] Simvastatin: A derivative of lovastatin and potent competitive inhibitor of 3-hydroxy-3methylglutaryl coenzyme A reductase (hydroxymethylglutaryl CoA reductases), which is the rate-limiting enzyme in cholesterol biosynthesis. It may also interfere with steroid hormone production. Due to the induction of hepatic LDL receptors, it increases breakdown of LDL-cholesterol (lipoproteins, LDL cholesterol). [NIH] Singultus: Hiccup. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Security: Government sponsored social insurance programs. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Sotalol: An adrenergic beta-antagonist that is used in the treatment of life-threatening arrhythmias. [NIH] Spasmolytic: Checking spasms; antispasmodic. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with

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heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Stabilization: The creation of a stable state. [EU] Stasis: A word termination indicating the maintenance of (or maintaining) a constant level; preventing increase or multiplication. [EU] Statistically significant: Describes a mathematical measure of difference between groups. The difference is said to be statistically significant if it is greater than what might be expected to happen by chance alone. [NIH] Steady state: Dynamic equilibrium. [EU] Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stenosis: Narrowing or stricture of a duct or canal. [EU] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or

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tension. Stress may be either physical or psychologic, or both. [NIH] Stricture: The abnormal narrowing of a body opening. Also called stenosis. [NIH] Stupor: Partial or nearly complete unconsciousness, manifested by the subject's responding only to vigorous stimulation. Also, in psychiatry, a disorder marked by reduced responsiveness. [EU] Subacute: Somewhat acute; between acute and chronic. [EU] 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] Sublingual: Located beneath the tongue. [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, 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] Sudden death: Cardiac arrest caused by an irregular heartbeat. The term "death" is somewhat misleading, because some patients survive. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatic treatment: Therapy that eases symptoms without addressing the cause of disease. [NIH] 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] Syncope: A temporary suspension of consciousness due to generalized cerebral schemia, a faint or swoon. [EU] Systemic: Affecting the entire body. [NIH] Tachycardia: Excessive rapidity in the action of the heart, usually with a heart rate above 100 beats per minute. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Teratogenic: Tending to produce anomalies of formation, or teratism (= anomaly of formation or development : condition of a monster). [EU] Terfenadine: A selective histamine H1-receptor antagonist devoid of central nervous system depressant activity. The drug is used in the treatment of seasonal allergic rhinitis, asthma,

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allergic conjunctivitis, and chronic idiopathic urticaria. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonus: A state of slight tension usually present in muscles even when they are not undergoing active contraction. [NIH] Topical: On the surface of the body. [NIH] Torsades de Pointes: A ventricular tachycardia characterized by periodic twisting of the points of the QRS complexes and rates between 200 and 250 beats per minute. It may be selflimited or may progress to ventricular fibrillation. [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] Toxicologic: Pertaining to toxicology. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Traction: The act of pulling. [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] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocating: The attachment of a fragment of one chromosome to a non-homologous chromosome. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH]

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Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trimebutine: Proposed spasmolytic with possible local anesthetic action used in gastrointestinal disorders. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubocurarine: A neuromuscular blocker and active ingredient in curare; plant based alkaloid of Menispermaceae. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH] Ulceration: 1. The formation or development of an ulcer. 2. An ulcer. [EU] Ultrasonography: The visualization of deep structures of the body by recording the reflections of echoes of pulses of ultrasonic waves directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary Retention: Inability to urinate. The etiology of this disorder includes obstructive, neurogenic, pharmacologic, and psychogenic causes. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venlafaxine: An antidepressant drug that is being evaluated for the treatment of hot flashes in women who have breast cancer. [NIH]

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Venous: Of or pertaining to the veins. [EU] Venous Thrombosis: The formation or presence of a thrombus within a vein. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Ventricular: Pertaining to a ventricle. [EU] Ventricular fibrillation: Rapid, irregular quivering of the heart's ventricles, with no effective heartbeat. [NIH] Vertebrae: A bony unit of the segmented spinal column. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] War: Hostile conflict between organized groups of people. [NIH] Warfarin: An anticoagulant that acts by inhibiting the synthesis of vitamin K-dependent coagulation factors. Warfarin is indicated for the prophylaxis and/or treatment of venous thrombosis and its extension, pulmonary embolism, and atrial fibrillation with embolization. It is also used as an adjunct in the prophylaxis of systemic embolism after myocardial infarction. Warfarin is also used as a rodenticide. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

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INDEX A Abdomen, 107, 112, 121, 127, 128, 134, 142 Abdominal, 17, 21, 47, 67, 69, 72, 78, 107, 111, 115, 127, 133, 134, 135, 137 Abdominal Pain, 78, 107, 127 Acetylcholine, 7, 9, 107, 128, 132 Actin, 107, 130, 131 Acyl, 70, 107 Adenosine, 107, 113, 135 Adrenal Cortex, 107, 108 Adrenal Glands, 107, 108 Adrenergic, 107, 109, 110, 119, 121, 128, 141 Adverse Effect, 5, 6, 13, 18, 67, 69, 70, 72, 107, 135, 141 Affinity, 8, 12, 33, 107, 141 Age of Onset, 107, 145 Agonist, 13, 24, 25, 107, 110, 111, 113, 119 Agoraphobia, 107, 135 Aldosterone, 24, 25, 108 Alertness, 108, 113 Algorithms, 108, 112 Alimentary, 4, 11, 13, 14, 16, 20, 21, 23, 26, 28, 32, 34, 35, 36, 41, 43, 49, 50, 51, 52, 60, 108, 120 Alkaline, 108, 111, 113 Alkaloid, 108, 110, 113, 130, 136, 145 Allergic Rhinitis, 108, 143 Alprostadil, 77, 108 Alternative medicine, 82, 108 Aluminum, 108, 143 Amenorrhea, 108, 109 Amino Acids, 108, 121, 134, 136, 138, 144 Amniotic Fluid, 108, 123 Ampulla, 108, 120 Amyloidosis, 33, 108 Anal, 108, 116 Analgesic, 108, 130, 133 Analog, 108, 132 Anatomical, 108, 112, 114, 140 Anesthesia, 16, 108, 109 Anginal, 109, 132 Anions, 109, 127 Anorexia, 11, 28, 33, 109 Anorexia Nervosa, 11, 28, 33, 109 Antagonism, 109, 113, 118 Anti-Anxiety Agents, 109, 137 Antiarrhythmic, 8, 109

Antibacterial, 109, 142 Antibiotic, 109, 115, 121, 137, 142 Antibiotic Prophylaxis, 109, 137 Antibody, 107, 109, 116, 124, 126, 129, 142 Anticoagulant, 109, 146 Anticonvulsant, 109, 135 Antidepressant, 109, 122, 145 Antidopaminergic, 66, 71, 109 Antiemetic, 77, 109, 110, 119, 130 Antigen, 107, 109, 116, 126, 129 Antihypertensive, 32, 109 Antipsychotic, 109, 132 Antispasmodic, 110, 118, 133, 141 Antiviral, 110, 127 Anus, 108, 110, 113, 116, 139 Anxiety, 109, 110, 133, 135 Anxiolytic, 110, 113 Apathy, 110, 132 Apnea, 30, 110 Aqueous, 67, 110, 111, 118, 129 Arachidonic Acid, 110, 137 Arteries, 110, 112, 131 Aspiration, 40, 110 Assay, 13, 110 Atrial, 110, 146 Atrial Fibrillation, 110, 146 Atropine, 56, 110, 111 Autonomic Neuropathy, 28, 32, 110 B Baclofen, 31, 110 Bacteria, 107, 109, 110, 111, 115, 117, 120, 121, 122, 123, 124, 130, 140, 142, 144, 145 Bacterial Translocation, 23, 111 Bactericidal, 111, 121 Bacteriostatic, 111, 121 Barium, 17, 111 Basal Ganglia, 110, 111, 126 Basal Ganglia Diseases, 111, 126 Base, 14, 67, 71, 111, 128, 141, 143 Belladonna, 110, 111 Benzamides, 72, 111 Benzodiazepines, 111, 113 Bethanechol, 79, 111 Bilateral, 19, 37, 111 Bile, 56, 111, 122, 123, 128, 142, 143 Bile Acids, 56, 111, 123, 142 Bile Acids and Salts, 111 Bile duct, 111

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Cisapride

Biliary, 7, 111, 112, 118 Biliary Tract, 7, 112 Bioavailability, 15, 17, 25, 30, 68, 112 Bioavailable, 70, 112 Biochemical, 112, 140 Biological response modifier, 112, 127 Biopsy, 27, 112, 134 Biosynthesis, 110, 112, 128, 141 Biotechnology, 10, 70, 82, 91, 112 Biotransformation, 19, 112 Bladder, 13, 23, 25, 60, 110, 112, 116, 126, 131, 145 Bloating, 112, 123, 127, 132 Blood Coagulation, 112, 113 Blood Glucose, 4, 112, 125, 127 Blood Platelets, 112, 140 Blood pressure, 67, 69, 72, 77, 109, 112, 126, 130, 132, 141 Blood vessel, 112, 114, 120, 134, 141, 145 Blood-Brain Barrier, 112, 131, 136 Body Fluids, 112, 113, 119, 132, 141 Body Regions, 112, 115 Bowel, 4, 15, 17, 26, 41, 47, 61, 78, 108, 112, 113, 118, 121, 123, 127, 128, 132, 135, 142 Bowel Movement, 4, 78, 113, 118, 142 Breath Tests, 32, 113 Bronchi, 113, 121 Bronchial, 29, 111, 113, 125 Bronchial Spasm, 111, 113 Bronchopulmonary, 96, 113 Bulimia, 9, 113 Bulking Agents, 78, 113 Buspirone, 78, 113 Bypass, 79, 113 C Caffeine, 22, 113 Calcium, 7, 77, 78, 113, 116, 118, 132 Calcium Channel Blockers, 77, 113 Calcium Signaling, 7, 113 Capsaicin, 77, 113 Capsules, 113, 119 Carbohydrate, 113, 124 Cardiac, 6, 7, 12, 15, 20, 27, 41, 67, 109, 110, 111, 113, 114, 121, 131, 142, 143 Cardiovascular, 48, 110, 114, 118, 141 Cardiovascular System, 110, 114, 118 Catecholamine, 114, 119, 135 Cations, 114, 127 Cell Cycle, 114, 115 Cell membrane, 113, 114, 135, 136 Central Nervous System, 79, 107, 113, 114, 122, 124, 128, 130, 136, 140, 143

Cerebellar, 114, 145 Cerebellar Diseases, 114, 145 Cerebral, 111, 112, 114, 121, 141, 143 Cerebrovascular, 111, 113, 114 Chin, 62, 114, 129 Cholecystokinin, 9, 60, 77, 114 Cholesterol, 77, 111, 114, 128, 141, 142 Chronic Disease, 9, 114 Chronic Fatigue Syndrome, 77, 114 Chyme, 31, 76, 114 Cimetidine, 21, 114 Cirrhosis, 23, 115 CIS, 66, 68, 69, 70, 71, 115 Cisplatin, 37, 115 Clamp, 8, 115 Clarithromycin, 51, 53, 115 Clinical study, 115, 117 Clinical trial, 6, 9, 56, 59, 61, 78, 91, 115, 117, 119, 138, 139 Cloning, 112, 115 Coagulation, 112, 115, 125, 146 Coenzyme, 115, 128, 141 Cognition, 115, 132 Cohort Studies, 11, 115 Colic, 70, 115 Colitis, 115, 127 Colon, 41, 51, 115, 116, 127, 128 Colonoscopy, 14, 116 Colorectal, 12, 116 Colorectal Surgery, 12, 116 Combination Therapy, 31, 116 Communication Disorders, 78, 90, 116 Complement, 116 Complementary and alternative medicine, 59, 64, 116 Complementary medicine, 59, 116 Complete remission, 116, 140 Compliance, 23, 70, 116 Computational Biology, 91, 117 Concomitant, 45, 67, 69, 117 Confusion, 117, 132 Conjugated, 111, 117, 118, 124 Conjugation, 112, 117 Conjunctivitis, 117, 144 Connective Tissue, 117, 122, 129 Consciousness, 108, 109, 117, 119, 138, 143 Constipation, 4, 21, 51, 52, 53, 54, 59, 60, 61, 62, 67, 69, 77, 83, 96, 110, 117, 122, 127 Contractility, 50, 117 Contraindications, ii, 6, 117 Controlled clinical trial, 27, 117, 139

149

Controlled study, 4, 11, 21, 23, 117 Cortical, 117, 121, 140 Curative, 117, 144 Cyclic, 113, 117, 137 Cytochrome, 16, 17, 19, 30, 33, 48, 115, 117 Cytoplasm, 113, 114, 118 Cytotoxicity, 115, 118 D Defaecation, 56, 118 Degenerative, 118, 125 Deuterium, 118, 125 Diabetes Mellitus, 4, 14, 29, 46, 61, 118, 124, 125, 132 Diagnostic procedure, 61, 65, 82, 118 Dialyzer, 118, 125 Diarrhea, 67, 69, 70, 72, 118, 122, 127 Diastole, 118, 136 Dicyclomine, 78, 118 Digestion, 30, 44, 51, 77, 108, 111, 112, 114, 118, 119, 123, 127, 128, 134, 142 Digestive system, 118, 123 Digestive tract, 5, 110, 118, 141 Diltiazem, 41, 78, 118 Dimethyl, 118, 128, 141 Direct, iii, 5, 68, 85, 118, 119, 139 Disinfectant, 118, 121 Disposition, 16, 19, 33, 118 Dissociation, 107, 118 Distal, 14, 44, 56, 67, 119, 123, 138 Distention, 78, 119 Diuresis, 113, 119 Domperidone, 20, 49, 54, 77, 79, 119 Dopamine, 109, 110, 119, 130, 132 Dosage Forms, 15, 68, 70, 119 Double-blind, 9, 11, 12, 13, 20, 21, 23, 27, 35, 37, 43, 49, 61, 62, 119 Double-blinded, 12, 119 Drug Interactions, 5, 6, 31, 53, 60, 61, 62, 67, 86, 119 Drug Tolerance, 119, 144 Duct, 108, 119, 121, 140, 142 Dumping Syndrome, 79, 119 Duodenal Ulcer, 14, 119, 132 Duodenum, 50, 79, 111, 119, 120, 122, 123, 130, 133, 134, 142 Dyspepsia, 4, 5, 11, 12, 13, 20, 22, 24, 26, 27, 34, 38, 43, 45, 49, 50, 54, 56, 59, 61, 62, 63, 67, 69, 119 Dysphagia, 76, 78, 119 E Effector, 107, 116, 120 Efficacy, 26, 34, 35, 51, 56, 59, 61, 113, 120

Elective, 51, 120 Electrocardiogram, 5, 120 Electrolyte, 108, 120, 132, 136, 141 Electrons, 111, 120, 127, 133, 139 Emboli, 120, 146 Embolism, 120, 138, 146 Embolization, 120, 146 Emesis, 67, 69, 120 Encopresis, 4, 120 Endorphins, 120, 132 Endoscope, 120 Endoscopic, 40, 116, 120 Endoscopy, 76, 120 End-stage renal, 33, 45, 120 Enkephalins, 120, 132 Enteral Nutrition, 18, 46, 120 Enteric Nervous System, 52, 120 Enterocolitis, 40, 121 Environmental Health, 90, 92, 121 Enzymatic, 113, 116, 121, 125 Enzyme, 77, 115, 120, 121, 128, 134, 137, 139, 141, 143, 146 Epigastric, 44, 121, 133 Epinephrine, 107, 119, 121, 132 Erectile, 121 Erection, 77, 121 Erythromycin, 24, 42, 46, 77, 79, 115, 121 Esophageal, 5, 21, 41, 56, 67, 69, 76, 121, 123 Esophagitis, 3, 5, 21, 46, 121, 123, 143 Esophagus, 5, 41, 76, 118, 121, 123, 124, 128, 133, 134, 135, 139, 142 Estrogens, 121, 124 Ethanol, 31, 121 Ether, 8, 33, 121 Evacuation, 117, 121, 122, 128, 138 Excitability, 8, 121, 131 Excitation, 7, 121, 132 Excitatory, 7, 9, 110, 121, 124 Exocrine, 114, 121, 133 Exogenous, 112, 122, 145 Extracellular, 117, 122, 141 F Faecal, 56, 61, 122 Family Planning, 91, 122 Fat, 27, 47, 56, 110, 111, 120, 122, 128 Fatigue, 114, 122 Fatty acids, 122, 137 Feces, 117, 118, 120, 122, 142 Fibrosis, 13, 96, 122, 140 Fistula, 122, 123, 132 Fluorescence, 14, 122

150

Cisapride

Fluoxetine, 32, 122 Forearm, 112, 122 Functional Disorders, 77, 122 G Gallbladder, 7, 14, 16, 24, 27, 36, 50, 107, 111, 112, 114, 118, 122, 123 Gallbladder Emptying, 16, 24, 122 Ganglia, 107, 111, 120, 122, 131, 134 Gas, 122, 125, 127 Gastrectomy, 14, 38, 44, 122 Gastric Acid, 5, 16, 79, 115, 122, 132, 133 Gastric Balloon, 9, 122 Gastric Emptying, 4, 5, 9, 11, 14, 18, 19, 20, 21, 22, 27, 29, 31, 32, 33, 36, 38, 40, 43, 44, 47, 49, 60, 76, 79, 122, 123 Gastric Juices, 123, 134 Gastric Outlet Obstruction, 79, 123 Gastrin, 115, 123, 125 Gastritis, 123, 143 Gastroduodenal, 23, 44, 77, 79, 123 Gastroesophageal Reflux, 5, 14, 18, 23, 24, 28, 36, 52, 67, 72, 76, 78, 79, 83, 96, 123 Gastroesophageal Reflux Disease, 5, 18, 23, 24, 67, 72, 76, 79, 83, 96, 123 Gastrointestinal, 3, 4, 5, 8, 11, 13, 15, 20, 29, 43, 44, 56, 60, 61, 62, 66, 67, 68, 70, 71, 72, 75, 76, 83, 111, 114, 118, 119, 120, 121, 123, 139, 140, 143, 145 Gastrointestinal tract, 3, 66, 67, 70, 76, 111, 121, 123, 140 Gastrointestinal Transit, 4, 123 Gastroparesis, 3, 4, 5, 20, 29, 33, 34, 36, 37, 40, 44, 46, 54, 67, 69, 77, 123 Gastrostomy, 40, 120, 123 Gene, 33, 112, 123 Genital, 110, 123 Gestational, 35, 123 Gestational Age, 35, 123 Gland, 107, 123, 129, 133, 140, 142 Glucose, 12, 29, 44, 50, 112, 118, 123, 124, 125, 127 Glucose Intolerance, 118, 123 Glucose tolerance, 50, 123, 124 Glucose Tolerance Test, 123, 124 Glutamic Acid, 124, 132 Glycine, 111, 124, 132 Glycoproteins, 124, 127, 129, 136 Gonadotropin, 77, 124 Governing Board, 124, 136 Grade, 30, 124 Gram-negative, 111, 124 Gravis, 124, 131

H Haematemesis, 120, 124 Haloperidol, 37, 124 Haptens, 107, 124 Headache, 113, 124, 137 Hearing Disorders, 116, 124 Heartbeat, 124, 143, 146 Heartburn, 5, 76, 83, 124 Hemodialysis, 38, 45, 118, 125, 128 Hemoglobin, 4, 125 Hemostasis, 125, 140 Hepatic, 124, 125, 128, 141 Hepatitis, 19, 43, 96, 125 Hepatocytes, 125 Hepatology, 16, 23, 36, 50, 52, 76, 125 Heredity, 123, 125 Heterogeneity, 107, 125 Histamine, 110, 114, 125, 128, 132, 139, 143 Hormone, 77, 108, 121, 123, 125, 127, 129, 132, 137, 141 Hydrogen, 71, 111, 113, 118, 125, 130, 133, 138 Hydrolysis, 112, 115, 125, 136, 138 Hydrophilic, 67, 125 Hyperaldosteronism, 25, 125 Hyperplasia, 19, 37, 125 Hypertension, 113, 124, 126, 132 Hypertrophy, 125, 126 Hypokinesia, 27, 126 Hypotension, 110, 111, 126 I Idiopathic, 15, 31, 36, 37, 49, 53, 126, 144 Ileus, 39, 126 Imidazole, 125, 126, 139 Immunofluorescence, 9, 126 Immunologic, 123, 126 Immunology, 107, 126 Impotence, 77, 121, 126 In vitro, 6, 19, 30, 126 In vivo, 16, 17, 19, 67, 126 Incision, 126, 127 Incompetence, 123, 126 Incontinence, 61, 118, 120, 126 Induction, 110, 126, 137, 141 Infancy, 11, 78, 79, 126 Infection, 61, 112, 126, 129, 132, 143, 145 Inflammation, 108, 115, 117, 121, 122, 123, 125, 126, 133, 136 Ingestion, 9, 124, 126, 136 Inorganic, 71, 115, 126, 129 Insomnia, 126, 137 Insulin, 4, 12, 77, 124, 127, 145

151

Insulin-dependent diabetes mellitus, 12, 127 Interferon, 19, 43, 127 Interferon-alpha, 19, 43, 127 Intermittent, 127, 135 Internal Medicine, 5, 31, 34, 56, 123, 127 Intestinal, 23, 25, 26, 27, 31, 33, 35, 40, 49, 62, 66, 67, 69, 71, 83, 111, 114, 121, 124, 127 Intestinal Mucosa, 111, 114, 121, 127 Intestinal Pseudo-Obstruction, 40, 49, 67, 69, 83, 127 Intestine, 4, 111, 112, 123, 127, 128, 134, 138 Intoxication, 127, 146 Intracellular, 113, 126, 127, 129, 136, 137, 139 Intravenous, 33, 50, 127 Intrinsic, 107, 127 Invasive, 79, 127 Involuntary, 111, 127, 131 Ion Channels, 8, 127, 135 Ions, 8, 111, 118, 120, 125, 127, 130, 136 Irritable Bowel Syndrome, 21, 26, 52, 60, 63, 77, 122, 127 J Jejunostomy, 120, 127 K Kb, 90, 128 Kidney Disease, 45, 77, 90, 128 Kidney Failure, 120, 128 Kinetics, 8, 13, 66, 128 L Language Disorders, 116, 128 Large Intestine, 118, 127, 128, 139, 141 Laxative, 4, 128, 129 Lesion, 128, 145 Lethal, 6, 111, 128 Linkages, 125, 128, 134 Lipid, 127, 128 Liver, 23, 35, 76, 107, 108, 110, 111, 115, 118, 122, 123, 124, 125, 128 Liver Cirrhosis, 35, 128 Localized, 9, 108, 126, 128, 136, 145 Loperamide, 32, 128 Lovastatin, 128, 141 Lower Esophageal Sphincter, 5, 52, 123, 128 Lymph, 111, 128, 129 Lymph node, 111, 129 Lymphatic, 126, 128, 129, 142

M Magnesium Hydroxide, 129 Magnesium Oxide, 54, 129 Maintenance therapy, 5, 35, 76, 129 Malignant, 30, 129, 131 Manometry, 15, 76, 129 Mediate, 119, 129, 139 Mediator, 114, 129, 141 Medical Staff, 119, 129 MEDLINE, 91, 129 Membrane, 8, 108, 114, 116, 118, 121, 124, 127, 129, 130, 133, 134, 135, 138 Membrane Glycoproteins, 129 Membrane Proteins, 129, 138 Memory, 109, 129 Meninges, 114, 129 Menstrual Cycle, 129, 137 Mental Disorders, 126, 129, 138 Mental Retardation, 116, 129 Mesenteric, 111, 130 Meta-Analysis, 61, 130 Metabolite, 13, 112, 118, 128, 130 Metoclopramide, 14, 17, 18, 25, 30, 32, 41, 46, 54, 72, 77, 79, 130 Microbe, 130, 144 Microcirculation, 128, 130 Mobilization, 113, 130 Modification, 9, 130, 138 Molecular, 8, 91, 93, 112, 117, 130, 137, 139, 144, 145 Molecular Structure, 130, 145 Molecule, 109, 111, 115, 116, 118, 120, 121, 125, 130, 133, 139 Monitor, 130, 132 Morphine, 56, 130, 131, 133 Motilin, 52, 79, 130 Motion Sickness, 130, 131 Motor Activity, 130 Mucins, 124, 130, 140 Mucosa, 130, 137, 143 Muscle Contraction, 7, 130 Muscle relaxant, 109, 131, 135 Muscle Relaxation, 7, 131 Muscle Spindles, 131, 135 Musculature, 79, 126, 131 Myasthenia, 131 Myocardial infarction, 131, 146 Myocardium, 6, 131 Myosin, 130, 131 N Narcosis, 131 Narcotic, 77, 130, 131

152

Cisapride

Nasogastric, 120, 131 Nausea, 44, 47, 78, 109, 110, 119, 123, 131, 132, 137 NCI, 1, 89, 115, 131 Neonatal, 14, 18, 42, 43, 45, 47, 131 Neoplasms, 123, 131 Neostigmine, 56, 131 Nephropathy, 128, 131 Nervous System, 111, 114, 129, 131, 132, 134 Neurogenic, 78, 131, 145 Neuroleptic, 30, 109, 132 Neuromuscular, 79, 107, 132, 145 Neuromuscular Junction, 107, 132 Neuronal, 72, 131, 132 Neurons, 121, 122, 131, 132, 143 Neuropathy, 3, 4, 77, 110, 132 Neurosis, 132, 135 Neurotransmitter, 9, 72, 107, 119, 124, 125, 127, 132, 143 Neutralization, 76, 132 Nifedipine, 32, 78, 132 Nizatidine, 34, 36, 38, 132 Nonulcer Dyspepsia, 12, 28, 44, 132 Nonverbal Communication, 116, 132 Norepinephrine, 107, 119, 132 Nuclear, 46, 70, 111, 117, 120, 132 Nutritional Support, 123, 132 O Octreotide, 79, 132 Odds Ratio, 4, 133 Oesophagitis, 11, 23, 29, 30, 35, 133 Ointments, 119, 133 Omeprazole, 31, 133, 138 Opiate, 77, 130, 133 Opium, 130, 133 Orthostatic, 110, 132, 133 Oxidation, 112, 117, 133 Oxidation-Reduction, 112, 133 P Palliative, 133, 144 Pancreas, 107, 118, 123, 127, 133 Pancreatic, 114, 123, 133 Pancreatic Juice, 123, 133 Panic, 84, 133 Parietal, 133, 135 Partial remission, 133, 140 Partnership Practice, 133, 137 Patch, 8, 134 Pathologic, 77, 112, 134 Pathophysiology, 9, 79, 134 Patient Education, 96, 100, 102, 105, 134

Pepsin, 115, 134 Pepsin A, 115, 134 Peptic, 76, 123, 134, 143 Peptic Ulcer, 123, 134 Peptide, 9, 114, 115, 134, 136, 137, 138 Peptide Chain Elongation, 115, 134 Perception, 52, 124, 134, 140 Percutaneous, 40, 134 Perfusion, 6, 134 Periodicity, 134, 140 Peripheral blood, 108, 127, 134 Peripheral Nervous System, 120, 132, 134, 143 Peristalsis, 5, 24, 119, 134 Peritoneal, 23, 134, 135 Peritoneal Cavity, 134, 135 Peritoneal Dialysis, 23, 135 Peritoneum, 134, 135 Peroral, 27, 135 Pharmaceutical Solutions, 119, 135 Pharmacodynamic, 37, 38, 60, 135 Pharmacokinetic, 30, 34, 37, 38, 48, 135 Pharmacologic, 79, 108, 135, 144, 145 Pharmacotherapy, 18, 32, 33, 34, 39, 41, 48, 49, 53, 62, 77, 79, 135 Pharynx, 123, 135 Phenytoin, 34, 135 Phobia, 47, 135 Phobic Disorders, 135 Phospholipids, 122, 135 Phosphorus, 113, 135 Physical Examination, 123, 136 Physiologic, 38, 107, 112, 126, 129, 136, 137, 139, 145 Physiology, 8, 15, 21, 49, 60, 79, 123, 136 Physostigmine, 131, 136 Pilot study, 29, 40, 136 Piperidines, 70, 136 Plants, 108, 110, 111, 123, 132, 136, 144 Plasma, 8, 9, 14, 20, 25, 44, 48, 67, 114, 123, 124, 125, 128, 136 Platelet Aggregation, 108, 136 Pneumonia, 40, 117, 136 Poisoning, 127, 131, 136 Polypeptide, 130, 134, 136, 137 Postoperative, 16, 19, 26, 39, 44, 136 Postoperative Period, 26, 136 Postprandial, 4, 13, 24, 40, 50, 136 Potassium, 7, 10, 12, 33, 39, 108, 136 Potassium Channels, 10, 39, 136 Practice Guidelines, 92, 136 Pregnancy Tests, 123, 136

153

Preload, 27, 136 Premedication, 27, 137 Premenstrual Syndrome, 77, 137 Presynaptic, 132, 137 Prevalence, 9, 29, 61, 76, 133, 137 Private Practice, 78, 137 Progressive, 25, 115, 119, 137 Prokinetic Drugs, 76, 77, 83, 137 Prolactin, 119, 137 Prophylaxis, 137, 146 Prostaglandin, 26, 137 Prostaglandins A, 137 Protease, 116, 137, 140 Protective Agents, 113, 138 Protein S, 112, 115, 121, 138 Proteins, 108, 109, 113, 114, 116, 121, 129, 130, 134, 136, 138, 139, 141 Protocol, 28, 138 Proton Pump, 61, 133, 138 Proton Pump Inhibitors, 61, 138 Protons, 125, 138, 139 Proximal, 15, 50, 119, 137, 138 Psychiatric, 116, 129, 138 Psychiatry, 8, 28, 39, 60, 138, 143 Psychic, 129, 132, 138, 140 Psychoactive, 138, 146 Psychogenic, 78, 138, 145 Psyllium, 78, 138 Public Policy, 91, 138 Publishing, 10, 76, 78, 138 Pulmonary, 27, 112, 113, 128, 138, 146 Pulmonary Artery, 112, 138, 146 Pulmonary Embolism, 138, 146 Purgative, 128, 138 Pylorus, 19, 38, 79, 119, 138 Q Quality of Life, 12, 76, 138 R Race, 19, 66, 67, 69, 71, 139 Racemic, 19, 66, 67, 69, 71, 139 Radiation, 122, 139, 146 Radioactive, 125, 132, 139 Radiography, 123, 139 Radiological, 32, 134, 139 Radiology, 24, 76, 139 Randomized, 9, 12, 13, 21, 28, 36, 37, 43, 46, 61, 120, 139 Randomized Controlled Trials, 36, 139 Ranitidine, 11, 25, 41, 139 Receptor, 24, 25, 56, 76, 77, 109, 113, 119, 132, 139, 141, 143 Receptors, Serotonin, 139, 141

Rectal, 47, 49, 56, 139 Rectum, 110, 113, 116, 118, 122, 126, 128, 139 Reductase, 128, 139, 141 Refer, 1, 68, 69, 116, 120, 132, 139, 144 Refraction, 139, 142 Refractory, 44, 139 Regimen, 120, 135, 139 Regurgitation, 76, 96, 123, 124, 139 Relapse, 14, 29, 41, 140 Remission, 50, 129, 140 Resection, 41, 51, 79, 140 Respiration, 110, 130, 140 Rhythmicity, 7, 140 Ritonavir, 61, 140 Rod, 115, 140 S Saliva, 76, 140 Salivary, 36, 46, 118, 140 Salivary glands, 118, 140 Schizoid, 140, 146 Schizophrenia, 140, 146 Schizotypal Personality Disorder, 140, 146 Sclerosis, 25, 140 Screening, 115, 140 Secretion, 16, 24, 25, 36, 46, 115, 118, 125, 127, 130, 132, 133, 139, 140 Secretory, 79, 133, 140 Seizures, 135, 140 Semisynthetic, 115, 140 Sepsis, 111, 140 Serotonin, 24, 72, 110, 113, 122, 132, 135, 139, 140, 145 Serum, 25, 34, 116, 124, 141 Side effect, 70, 78, 85, 107, 110, 141, 144 Signs and Symptoms, 140, 141 Simethicone, 13, 43, 141 Simvastatin, 48, 141 Singultus, 15, 141 Skeletal, 115, 131, 141 Skeleton, 107, 137, 141 Skull, 141, 143 Small intestine, 114, 119, 123, 125, 127, 131, 141 Smooth muscle, 7, 8, 56, 78, 111, 113, 125, 130, 141, 143 Social Environment, 138, 141 Social Security, 139, 141 Sodium, 30, 43, 108, 141 Solvent, 71, 121, 135, 141 Sotalol, 13, 141 Spasmolytic, 141, 145

154

Cisapride

Spastic, 127, 141 Spasticity, 110, 141 Specialist, 97, 142 Species, 111, 113, 121, 139, 142, 145, 146 Specificity, 107, 142 Spectrum, 62, 142 Sphincter, 23, 50, 56, 122, 142 Spinal cord, 29, 110, 114, 120, 129, 131, 132, 134, 142 Spleen, 108, 111, 129, 142 Stabilization, 135, 142 Stasis, 56, 142 Statistically significant, 78, 142 Steady state, 67, 142 Steel, 115, 142 Stenosis, 142, 143 Steroid, 111, 141, 142 Stimulant, 15, 67, 113, 125, 142 Stimulus, 117, 121, 127, 135, 142, 144 Stool, 78, 116, 126, 127, 128, 142 Stress, 24, 27, 114, 122, 127, 131, 142, 145 Stricture, 76, 142, 143 Stupor, 131, 143 Subacute, 126, 143 Subclinical, 126, 140, 143 Sublingual, 13, 143 Substance P, 121, 130, 140, 143 Substrate, 17, 143 Sucralfate, 10, 38, 76, 143 Sudden death, 48, 143 Suppression, 76, 143 Supraspinal, 110, 143 Symptomatic, 35, 43, 49, 50, 52, 67, 77, 79, 109, 143 Symptomatic treatment, 43, 109, 143 Synaptic, 132, 143 Syncope, 48, 143 Systemic, 25, 70, 79, 86, 108, 111, 112, 121, 126, 143, 146 T Tachycardia, 143, 144 Temporal, 19, 124, 143 Teratogenic, 118, 143 Terfenadine, 6, 38, 143 Threshold, 121, 126, 144 Tolerance, 18, 124, 144 Tone, 7, 52, 111, 141, 144 Tonus, 144 Topical, 121, 144 Torsades de Pointes, 42, 144 Toxic, iv, 110, 117, 118, 132, 144 Toxicity, 6, 119, 132, 136, 143, 144

Toxicologic, 7, 144 Toxicology, 13, 15, 92, 144 Toxin, 144 Traction, 115, 144 Transduction, 113, 144 Transfection, 112, 144 Translation, 121, 144 Translocating, 111, 144 Translocation, 111, 115, 121, 144 Transmitter, 107, 119, 127, 129, 132, 145 Transplantation, 31, 45, 145 Trauma, 111, 121, 124, 145 Tremor, 14, 145 Tricyclic, 77, 145 Trimebutine, 78, 145 Tryptophan, 140, 145 Tubocurarine, 131, 145 Type 2 diabetes, 16, 145 U Ulcer, 5, 20, 41, 49, 50, 54, 119, 132, 143, 145 Ulceration, 76, 134, 145 Ultrasonography, 123, 145 Urethra, 145 Urinary, 13, 53, 111, 118, 126, 145 Urinary Retention, 111, 145 Urine, 13, 112, 119, 126, 145 Urticaria, 144, 145 V Vaccine, 138, 145 Vascular, 113, 126, 128, 130, 145 Vasodilator, 108, 119, 125, 132, 145 Vein, 127, 132, 145, 146 Venlafaxine, 44, 145 Venous, 138, 146 Venous Thrombosis, 146 Ventricle, 138, 146 Ventricular, 7, 40, 46, 48, 52, 144, 146 Ventricular fibrillation, 144, 146 Vertebrae, 142, 146 Veterinary Medicine, 91, 146 Virulence, 144, 146 Virus, 127, 144, 146 Visceral, 8, 110, 135, 146 Vitro, 146 Vivo, 6, 146 W War, 27, 146 Warfarin, 27, 30, 146 Withdrawal, 15, 82, 146 X X-ray, 122, 132, 139, 146

155

156

Cisapride

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