Heart-valve damage

After many health problems and deaths, the FDA removed Pondimin and Redux from market. Since then, there have been 200 reported cases of primary pulmonary hypertension relating to fen-phen and dexfen-phen. Of those cases, 40 have resulted in death. The FDA has received more than 100 reports of heart valve damage directly related to fen-phen or fenfluramine therapy there are no reports from individuals taking phentermine alone for weight loss. 

Uses Rapid anticoagulation (intensive) for thromboses, emboli, unstable angina, disseminated intravascular coagulation (DIC), open-heart surgery, etc. Longer-term anticoagulation (controlled) for thromboses, emboli, post-MI, heart valve damage, atrial arrhythmias, etc. 

Gangrene and loss of limbs due to inadvertent intra-arterial injection of material Heart valve damage due to injection of infected material... 

Warfarin (initially 10 to 15 mg p.o. for three days) is indicated as an anticoagnlant in pntmonary emboli, deep-vein thrombosis (DVT), myocardial infarction (Ml), rhenmatic heart disease with heart valve damage, and atrial arrhythmias. 

Following is an outline for a synthesis of the anorexic (appetite suppressant) fenfluramine. This compound was one of the two ingredients in Phen-Fen, a weight-loss preparation now banned because of its potential to cause irreversible heart valve damage. 

Patients at risk for infection are those with damaged heart valves or joint prostheses on which the bacteria may seed and respectively cause endocarditis and arthritis of the joint. 

The amphetamines were replaced by amphetamine analogs—substances somewhat less potent than amphetamines. Fen-Phen, the combination of fenfluramine and phentermine, was a popular appetite suppressant in the 1990s, but was associated with severe health problems such as pulmonary hypertension, heart valve dysfunction, and nerve damage. As a result, both drugs were withdrawn from the market. 

The S enantiomer was sold independently under the name dexfenfluramine. Which enantiomer is dexfenfluramine (Fen-Phen was withdrawn from the market in 1997, after it was shown to damage heart valves in some patients.) ... 

Polymer-based heart valves are widely used as replacements for diseased or damaged human heart valves. Most mechanical heart valves are made from metals, silicone, or polyesters, although some work has gone into incorporating biocompatible coatings such as PEO into these systems. 

Rheumatic heart disease, which is relatively rare in Western countries today, is characterized by damaged (scarred and deformed) heart valves. It is always a result of rheumatic fever, which is an infection caused by group A p-hemolytic streptococci. Children aged 5 to 15 are the usual victims. This is a preventable condition, if the initial attack of rheumatic fever is correctly diagnosed and treated. Treatment and prevention of a relapse is carried out by long-term (years) administration of penicillin G, V, or erythromycin (if allergic) and occasionally sulfonamides. 

Fenfluramine was a popular diet drug until it was discovered that it damaged heart valves. Fenfluramine increases the amounts of serotonin, which gives the feeling of fullness after a meal. 

The mechanical damage to the blood elements, as well as to the endothelial tissue of the adjacent vessel wall, may in addition trigger the complex biochemical reactions which could lead to the excess fibrous tissue overgrowth observed on some recovered heart valves. Therefore, large wall and bulk turbulent shear stresses could cause serious problems and complications in vivo. 

Phosphocreatine is an effective treatment for acute myocardial infarction and greatly reduces ventricular tachycardia paroxysms [123], It has been prepared in cardioplegic solutions for use during heart valve replacement operations where it significantly reduced ischaemic damage [124]. Phosphocreatinine, although less well investigated, also has a beneficial effect on the ischaemic heart [125,126]. 

Kafesjian, R., Howanec, M., Ward, G.D., Diep, L., Wagstaff, L.S., and Rhee, R. 1994. Cavitation damage of pyrolytic carbon in mechanical heart valves. /. Heart Valve Dis. 3 (Suppl. 1) S 2-S 7. 

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