DRAGONS2B <dragon…@aol.com> wrote:
>A friend of mine without access to the net is taking Phendimetrazine
>for appetite suppression.  How does this differ from Phentermine
>(Fastin)?  I have read that Fastin is a Class 4 controlled substance,
>but this bottle of hers says that this drug is a Class 3.  Is this
>more dangerous than Fastin? More effective?  She is taking a 35mg
>pill 3x/day.  Does it work also as a metabolic stimulant (i.e. would
>she burn calories faster on this with the same amount of calories per
>day, as she would without the drug, but with the same amount of
>calories???)  Thanks for your replies!  

Ignore the chemical details here if you get snowed.

Phenmetrazine is a cyclicized form of amphetamine, with the
phenylisopropylamine moiety forming one side of a morpholine
ring.  (Basically, ignoring the stereochemistry for the moment,
take phenylpropanolamine and bridge the hydroxy and amino groups
with an ethylene group.)  This is a secondary amine, with a single
free hydrogen on the nitrogen atom.  Phenmetrazine is a C-II drug,
in the same DEA schedule as amphetamine and methamphetamine.
It was essentially a "me too" drug introduced in the 60’s by
CIBA-Geigy to treat obesity, but it has about as much euphoriant
and abuse potential as the prototype drugs.

Phendimetrazine substitutes a methyl group on the nitrogen,
so it’s a tertiary amine.  In the same way that N,N-dimethyl-
amphetamine is a less potent stimulant than methamphetamine,
so too is phendimetrazine less potent a stimulant than
phenmetrazine.  As I mentioned last week, phentermine (Fastin)
is also an amphetamine-like drug, but it has an extra methyl
group on the alpha carbon, which also seems to cut the stimulant
and euphoriant effects somewhat (though not entirely.)

Is phendimetrazine more effective an anorectic drug than phentermine?
Probably not.  They’re all more similar than different.  35mg 3x/day
is a standard dose for phendimetrazine.  Is it more "dangerous"
than phentermine?  The DEA scheduling choices are based on reports
of abuse all over the world, so there’s probably some reason why
phendimetrazine is C-III but phentermine is C-IV.  On the other hand,
amphetamine abusers would probably enjoy access to either drug, and
people who won’t have such problems probably wouldn’t discern a big
difference between the two.

Part of their effects in promoting weight loss may be due to metabolic
stimulation, but the degree to which this contributes to the drugs’
actions isn’t really very clear.

–
Steve Dyer
d…@ursa-major.spdcc.com

>     As a Pharmacist I am depressed to find out that people still are not
>sure of what  they are taking and why.  You mentioned that your doctor
>didn’t have much info for you, but how about your pharmacist.  I give out
>a lot of info every day to people even if they didn’t get the drugs at my
>pharmacy, I even offer reference books for people to read.  I would advise
>talking to your pharmacist if they seem to busy try evenings or weekends
>when business is slower.  If your Pharmacy doesn’t give this kind of
>service find a new one !

I think you screwed up the attribution here, since I wasn’t the person
complaining about lacking drug info.  However, I think you have a wonderful
attitude–all pharmacists should be so helpful and forthcoming!

–
Steve Dyer
d…@ursa-major.spdcc.com

Schendlinger) wrote:

> I was wondering if anyone has any experience with or in-depth knowledge of
> a medication named Propulsid from Janssen.  My doctor has prescribed it

> What does Propulsid do?  I can’t get a good explanation from my Dr.  Why

That’s a shame! Here’s some info I have from a Computer-based training
program regarding GERD and its treatment:

Treatment for the patient with Gastroesophageal reflux disease (GERD) must
be individualized based upon the degree of symptoms, the severity of
esophagitis, and the presence of complications (such as ulcer, stricture or
Barrett’s esophagus).  Generally, however, physicians follow a stepwise
approach.  

Initial therapy for all patients generally involves lifestyle modifications
aimed at reducing reflux.  Antacids are routinely used to provide
symptomatic relief of heartburn.

While these measures may be sufficient for patients with mild symptoms,
those with moderate to severe symptoms of esophagitis or complications will
require more intensive drug therapy.

Several types of agents are now available to treat GERD.  These include H2
antagonists and proton pump inhibitors (which reduce gastric acidity),
prokinetic agents (which improve upper GI motility), and mucosal
protectants (which enhance mucosal defenses against errosive refluxate).
PROPULSID is a unique prokinetic agent, developed by Janssen, with a
specific mechanism of action.

PROPULSID may be classified as an indirect cholinergic agonist.  It
selectively enhances the release of acetylcholine from cholinergic nerves
in the myenteric plexus.  This action directly stimulates muscle cells in
the gut wall.

Drug therapy has historically started with an H2  antagonist for acid
suppression, because metoclopramide, the only available prokinetic agent,
produces a variety of undesirable side effects.  With the availability of
safer, more specific prokinetic agents like PROPULSID, physicians will now
be able to treat GERD by direct action on the physiologic defects that
allow reflux to occur.  Because of their extreme potency, proton pump
inhibitors are reserved for patients with severe esophagitis complicated by
ulcer, stricture, or Barrett’s esophagus, or those who are unresponsive to
conventional medications.

> Along the same lines, is there any internet source (Telnet, FTP, Gopher,
> etc.) for the equivalent of the PDR to get info on medications and
> interactions?

Keep an eye on MecklerWeb, a WWW site (under construction at:
http://www.mecklerweb.com/demo.html), which will have an area devoted to
medicine and a sub-domain specific to pharmaceutical information.

Hope this helps.

Al Schendlinger <alan.r.schendlin…@cdev.com> wrote:
>Greetings…
>I was wondering if anyone has any experience with or in-depth knowledge of
>a medication named Propulsid from Janssen.  My doctor has prescribed it
>for my reflux and I have been using samples for a week or so and seem to
>be feeling a lot better (I had been using Zantac for about 2 mo. then
>Prilosec, another, more powerful acid inhibitor, for 2 mo., then Zantac
>again for 1 mo.).
>What does Propulsid do?  I can’t get a good explanation from my Dr.  Why
>wouldn’t Propulsid be used initially rather than treating the symptoms
>with acid inhibitors for so long?

Propulsid (cisapride), among other things, increases the tone of the
esophageal sphincter, making it more likely to stay shut and avoid acid
reflux up into the esophagus.  It also reduces the time food stays in
the stomach (increases gastric emptying).

Speaking generally, these drugs (others are Reglan [metoclopramide]
and Motilium [domperidone]) don’t work quite as well alone to treat
GERD as more traditional acid-suppressive drugs.  They’re useful as
adjuncts.  Good that it works for you.

–
Steve Dyer
d…@ursa-major.spdcc.com

Greetings…
I was wondering if anyone has any experience with or in-depth knowledge of
a medication named Propulsid from Janssen.  My doctor has prescribed it
for my reflux and I have been using samples for a week or so and seem to
be feeling a lot better (I had been using Zantac for about 2 mo. then
Prilosec, another, more powerful acid inhibitor, for 2 mo., then Zantac
again for 1 mo.).  I was pretty queasy for the 1st day I started on
Propulsid, but that problem was gone by the 2nd day.  I’m still taking the
Zantac.  I’ve also modified my diet somewhat to reduce fried foods, REAL
spicy foods, Pop, late-night snacks, etc.

What does Propulsid do?  I can’t get a good explanation from my Dr.  Why
wouldn’t Propulsid be used initially rather than treating the symptoms
with acid inhibitors for so long?

Along the same lines, is there any internet source (Telnet, FTP, Gopher,
etc.) for the equivalent of the PDR to get info on medications and
interactions?

———————————————————————-
Al Schendlinger                   |Email: alan.r.schendlin…@cdev.com
Computing Devices International   |Phone: (612) 921-6307
8800 Queen Ave. South             |Fax: (612) 921-6869
Bloomington, MN  55431            |       "This Space For Rent"
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