Literature concerning Bartter's syndrome, pseudo‐Bartter's syndrome, idiopathic edema, and diuretic abuse is reviewed. The authors suggest that many of the patients who present with the physiological disturbances associated with pseudo‐Bartter's syndrome or with diuretic abuse, and a subgroup of those who use diuretics for idiopathic edema, have an underlying eating disorder. The pharmacology and physiology of diuretics are reviewed.
This study examined whether longer duration on nicotine gum promoted dependence on nicotine gum. Subjects (N = 128) answering an advertisement for smoking cessation research and wanting to quit smoking cigarettes were randomly assigned to 1- or 3-month duration of nicotine gum use. Assessments were made weekly for smoking status (with biochemical verification) and withdrawal symptoms during and at the end of treatment. Follow-up was conducted at 1, 6 and 12 months to provide exploratory data on treatment outcome. The results showed minimal nicotine gum withdrawal symptoms after gum cessation with virtually no difference in gum withdrawal between the 1- and 3-month groups. Withdrawal symptoms from the nicotine gum included difficulty with concentration, increased variability on a reaction time task, and decreased vigor. The results also showed that continuous use of the gum at 1 year was observed in 1.5% of subjects and estimated to be as high as 14%. Finally, the 3-month group experienced a 2-fold increase in abstinence compared to the 1-month group, although this difference was not statistically significant. We conclude that there is minimal physical dependence on nicotine gum.
The majority of patients with bulimia report a history of having used over‐thecounter drugs for purposes of weight control. Diet pills are quite commonly used, but usually at low dosages. Laxative abuse is also relatively common and poses significant risks in terms of fluid and electrolyte abnormalities, gastrointestinal bleeding and other systemic effects. Diuretic abuse and use of ipecac are less common but are also associated with serious health consequences. Ipecac is of particular concern because of the risk of cardiomyopathy.
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