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["在“减肥疗法”中使用食欲抑制剂的药理学、毒理学、道义学及法医学方面"]

[Pharmacological, toxicological, deontologic, and medico-legal aspects of the use of appetite suppressant agents in "weight-loss cures"].

作者信息

Carolei L, Ermio G, Accorinti N, Meo G, Lamberti V, De Sarro G

机构信息

Dipartimento di Medicina Sperimentale e Clinica, Scuola di Specializzazione in Medicina Legale e delle Assicurazioni, Università degli Studi, Reggio Calabria.

出版信息

Minerva Med. 1997 Jul-Aug;88(7-8):317-26.

PMID:9304076
Abstract

The pharmacological, deontologic and medico-legal aspects in the use of appetite suppressant drugs have been evaluated. Appetite suppressant drugs used in the treatment of obesity are divided into 2 broad pharmacological categories: those acting via brain catecholamine pathways and those acting via serotonin pathways. Of the former group, amphetamines and phenimetrazines are no longer used because of their stimulant properties and addictive potential. The remaining drugs of this group have some sympathomimetic and stimulant properties. Anorectic drugs which promote serotonin neurotransmission have no such stimulant or sympathomimetic properties. They reduce appetite and food intake and are effective in the treatment of obesity. If they are not used appropriately, appetite suppressants can be of no therapeutic benefit and cause marked health risks. As regards to anorectic drugs, the 13/4/1995 act "Rules and limits in preparing drugs containing anorectic substances", precisely defines rules about selling and use of those substances. Behavior of health care personnel neglecting observance of the rule, could be interpreted as "imprudence", "negligence" and "inexpertness" in designing and managing a fat-reducing diet, that may imply, in case of damage to the patient, a professional fault.

摘要

对食欲抑制药物使用中的药理学、道义学和医学法律方面进行了评估。用于治疗肥胖症的食欲抑制药物分为两大类药理学类别:通过脑儿茶酚胺途径起作用的药物和通过血清素途径起作用的药物。在前一组中,由于其兴奋特性和成瘾潜力,苯丙胺和苯甲吗啉不再使用。该组其余药物具有一些拟交感神经和兴奋特性。促进血清素神经传递的食欲抑制药物没有这种兴奋或拟交感神经特性。它们可降低食欲和食物摄入量,对肥胖症治疗有效。如果使用不当,食欲抑制药物可能没有治疗益处,并会造成明显的健康风险。关于食欲抑制药物,1995年4月13日的“含食欲抑制物质药物制备的规则和限制”法案精确地规定了这些物质销售和使用的规则。医护人员忽视遵守该规则的行为,在设计和管理减肥饮食时可能被解释为“轻率”、“疏忽”和“不专业”,如果对患者造成损害,可能意味着专业过失。

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