I diopathic pulmonary arterial hypertension (IPAH) used to be called primary pulmonary hypertension. Both terms indicate that we do not yet fully understand the aetiology of the disease. A clue to the underlying mechanisms lies in the observation that the appetite-suppressant drugs aminorex [1, 2] and fenfluramine [3] were both associated with a marked increase in the incidence of pulmonary art...

BACKGROUND The incidence of pulmonary arterial hypertension secondary to the use of indirect serotinergic agonists such as aminorex and dexfenfluramine led to the "serotonin hypothesis" of pulmonary arterial hypertension; however, the role of serotonin in dexfenfluramine-induced pulmonary arterial hypertension remains controversial. Here, we used novel transgenic mice lacking peripheral seroton...

4,4'-DMAR is an analogue of the known psychostimulants 4-methylaminorex and aminorex. In the light of reports of deaths associated with its abuse, and the easy access from Internet vendors, the EU Council recently decided on control measures across member states. Here we describe a validated method for measuring plasma levels of cis-4,4'-DMAR, crucial for preclinical studies and analysis in hum...

n engl j med 367;17 nejm.org october 25, 2012 1577 are manifold, potentially involving all major organ systems and contributing to reduced quality of life. The goal of all obesity therapies is negative energy balance. Drugs have long been used in an attempt to achieve this goal. However, numerous oncepromising weight-loss drugs have been abandoned because of serious toxic effects: aminorex (whi...

Collectively, of approximately 2,650 clinical articles published so far, 32% are related to chemotherapeutic agents: bleomycin (226 papers); busulphan (58); cyclophosphamide (75); methotrexate (129); and nitrosoureas (46). Adverse pulmonary effects from: amiodarone (214 articles); ergolines (54); gold salts (133); minocycline (35); nitrofurantoin (135); nonsteroidal anti-inflammatory drugs (NSA...

Serotonin (5-HT, 5-hydroxytryptamine) has long been recognized as one of the most potent naturally occurring pulmonary vasoconstrictors.1 It was first implicated in the pathogenesis of pulmonary arterial hypertension (PAH) after an outbreak of the disease in Switzerland in the 1960’s among patients taking aminorex fumarate, an appetite suppressant that inhibits serotonin uptake by platelets.2 S...

Background: Evidence-based medicine (EBM) may be used to discard valuable data under the pretext that it does not correspond to the “best” criteria of proof, even when no results complying with these “best” criteria are available. Since their infrequent occurrences make it impossible to assess most adverse effects using randomised clinical trials (RCTs), drug safety offers frequent examples of ...

The purpose of this group is to provide information regarding individual cases, collect and update literature on drug-induced lung disease, publish updated lists of offending compounds, and formulate warnings when new side-effects of drugs are recognized. Thus, the present table may be subjected to update in the future in this Journal. The number of drugs which have been shown to damage the res...