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UA Agent Manual Glossary P.O. Box 8080 • McKinney, Texas 75070 • www.unitedamerican.com AMDL Glossary UAI0548 0810 TABLE OF CONTENTS TABLE OF CONTENTS TERMINOLOGY DEFINITIONS MEDICAL GLOSSARY Abbreviations: COMMON MEDICATIONS AND THEIR USAGE AUTOIMMUNE DISEASES Diseases With A Complete Or Partial Autoimmune Etiology: Diseases Suspected To Be Linked To Autoimmunity Are: PREMALIGNANT CONDITIONS AND CANCER DRUGS Premalignant Conditions Anti-neoplastics (Cancer Drugs) PREMALIGNANT LESIONS Some Precancerous Lesions: PERIPHERAL VASCULAR DISORDERS (PVD) 2 2 3 6 12 13 19 19 21 22 22 22 23 23 24 TERMINOLOGY DEFINITIONS Application/Brochure – A printed form designed to provide the summary of benefits, policy limitations and exclusions, and features of a UA product, a conditional receipt, the insurance policy application form. Also referred to as an “app-brochure”. The perforated design allows the Applicant to keep the brochure portion; the Agent submits the completed application portion to the Home Office. Available from Supply. Plans and benefits vary by state. Check your applicable state Compliance sheet. COBRA – Consolidated Omnibus Budget Reconciliation Act of 1986. An amendment to ERISA. Provides some workers and their families with the right to continue their employee-sponsored health coverage after certain events, such as the loss of a job. See also UA’s Privacy & Disclosure Information Booklet. See also The U.S. Department of Labor (www.dol.gov). Commission – A loan advance paid by United American to a contracted Insurance Agent based on the sale of United American’s products and/or services. Accelerated Benefit Rider – Allows an Insured to receive a portion of the Death Benefit upon proof of terminal illness. Compliance Sheet – A list of state-approved products. Includes instructions for forms required to complete a new application and critical to ensuring proper submission of new business. Maintained by UA’s Compliance Department. Available from Supply or the internet. AD&D – Accidental Death and Dismemberment insurance provides additional funds in the event of a fatal accident or an accident that results in the loss of a limb or eyesight. Attained Age Premium Rate – Based on a policyholder’s current age. Rates increase yearly (as the policyholder’s age increases) on the policy anniversary date, usually up to age 80. Eligible Dependents – Include, in addition to spouse and children, any relative living with and dependent on the Applicant for support. A separate application is required for a nondependent (EXAMPLE: a fiancé). Identify the family member responding to a health question by referring to the number in sequence listed on the application. ●● Since statures regarding eligible dependents vary from state to state, please refer to the specific policy in question to determine eligibility of dependents subsequent to the issuance of the policy. ●● Natural, newborn children are eligible for coverage on their date of birth for the first 31 days. However, to ensure continuous coverage beyond the first 31 days a Miscellaneous Change Form must be received within 31 days from birth. The Miscellaneous Change Form is to be mailed to the Reissue Department “Automatic” Claims Filing (ACF®) – Feature of UA Partners® for Medicare Supplement policyholders. There are no claim request forms to file. Doctors, providers and/or hospitals will submit claims directly to United American. Upon verification of benefits, UA responds with the payment. In most cases, these transactions are electronic. The policyholder can verify claims and payments on Medicare’s Medicare Summary Notice (MSN). Automatic Payment Plan / Bank Draft – See Method of Payment. Buyer’s Guide – a consumer’s guide to purchasing insurance products specific to Annuity, Life and Medicare Supplement. Guides are available from Supply. Child ●● ●● ●● ●● ERISA – The Employee Retirement Income Security Act of 1974. This federal law sets minimum standards for most voluntary established pension and health plans in private industry to provide protection for individuals in these plans. See also The U.S. Department of Labor (www.dol.gov). A natural child of the Applicant; or A legally adopted child of the Applicant (including a child living with the adopting parents during the period of probation); or A stepchild whose primary residence is the Applicant’s household; or A child of the Applicant’s child who is dependent upon the Applicant for more than one-half of his/her support; or A grandchild whose primary residence is in the Applicant’s household, to whom the Applicant is legal guardian or related by blood or marriage, regardless of whether the Applicant treats the grandchild as a dependent for federal income tax purposes A child for whom the Applicant has received a court order requiring the Applicant to have financial responsibility for providing health insurance for such child. Exclusion Rider – (Not available: CA, ID or OR) Optional - applies to underage health only. Places an exclusion on the policy’s coverage for a particular health condition. Alters or changes the policy’s coverage or terms. Foreign Applicants – Coverage is not issued to foreign nationals unless the Applicant verifies in writing (separate note attached to the application) that such Applicant is a permanent resident of the United Sates or Canada. Graded Benefit – A lower than standard life insurance death benefit during the first few years, on an Insured who is classified as having an above average potential for loss, such as a person having a particular health condition. Guaranteed Issue – Policy issue is not subject to or dependent upon the underwriting process. 3 TERMINOLOGY DEFINITIONS CONTINUED HIPAA – Health Insurance Portability and Accountability Act of 1996. An amendment to ERISA. Offers protections that improve portability and continuity of health insurance coverage. See also UA’s Privacy & Disclosure Information booklet and Consumer form 3728. See also The U.S. Department of Labor (www.dol.gov). Plan Code – A unique alphanumeric code used to identify policy form and/or premium rate. A required entry on all applications. Plan codes are located in Rate books/cards and, in some cases, pre-printed on the application. Point Value Conversion Chart – Regarding the Select Benefit Rider, a point system method is used to factor the insurance risk associated with a health condition and determine the Sub-Standard premium. See page 62-66. HMO – Health Maintenance Organization. An HMO plan that provides health care from specific doctors and hospitals that contract with the plan. People enrolled in HMOs must choose a primary care physician (PCP) from a list of participating doctors. For any nonemergency hospital or specialty care, enrollees must get a referral from their primary care physicians. Policy Fee – There is a $20 annual fee on life policies, usually included in the rates. Premium Conversion Table – Sub-Standard Premium. Also referred to as “Rate-Up”. Applicable to Underage health plans issued with the Select Benefit Rider for existing health conditions. See pages 67-71. HMO Disenrollee – A person whose HMO coverage has terminated. Rate Card/Brochure – Reference booklet (or card) for UA product premium rates and plan codes. Available from Supply. IHM – In-Hospital Medical. Physician’s treatment performed in a hospital. Issue Age Premium Rates – Based on the policyholder’s age at the time of application. Recovery Period – A standardized period of time determined by the insurance company in which an insured should totally recover from a particular illness or injury. If the insured is outside the standardized recovery period, there would no longer be need of treatment for the condition. There must be medical confirmation of corrective surgery or treatment with complete recovery and no recurrence for removal of any policy rider associated with the illness or injury. Lapse (policy) – A break in coverage - usually the result of non-payment of premium. Material Misrepresentation – A false or misleading statement of fact on an application for insurance policy that influences the insured’s Insurability; such statements may serve as a basis for voiding the policy. MIB – Medical Information Bureau. MIB’s fraud protection services protect insurers, policyholders and Applicants from attempts to conceal or omit information material to the sound and equitable underwriting of life, health, disability, and long term care insurance. See also UA’s Privacy & Disclosure Information booklet. See also MIB Group, Inc. (www.mib.com). Reformations and Rescissions – Sometimes, after a policy is issued, additional information will be received from the Applicant, Agent, or other source that would change the way we would have issued the policy. 1. Rescissions – If adverse medical or other information is received, after issue of a policy, that would have made Applicants ineligible for coverage, we will rescind the policy. Once a policy has been rescinded, that individual is no longer eligible for any type of coverage with United American Insurance Company. If the information is received from the Insured, the policy will not be a rescission, but a canceled issue date. We reserve the rescission for those Applicants who knowingly omitted health history that would have been a basis for rescission. 2. Reformation – If information is received that would have changed our basis of issue, we will offer a reformation or rescission. The Applicant will be offered an opportunity to accept an amended policy (reformation) with Exclusion or Select Benefit Riders. If they do not accept the reformation, the policy will be rescinded. Monthly Premium – The cost of an insurance policy due, on a monthly basis, to United American. Premium refers only to the cost of an insurance policy. OHE – Outpatient Hospital Expense. Medical/Surgical services performed within the confines of a hospital or surgical facility that do not require an overnight stay. Open Enrollment – With regard to Medicare Supplement insurance, the 6 month period beginning with the Part B effective date. Payment Mode (Mode of Payment) – The manner in which a policyholder submits premium payments to United American. Payment Mode options include: 1. Bank Draft (also referred to as Automatic Payment Plan). Premiums are automatically deducted from the policyholder’s checking account monthly, quarterly, semi-annually or annually. 2. Direct bill – a premium notice is mailed to the policyholder monthly, quarterly, semi-annually or annually. Registration Fee – Health policies, excluding MedSupp have a one time $6 registration fee. Re-issue (policy) – When revisions and changes of any kind are made to an in force policy, it is termed a re-issue policy. Pended Status – A temporary status of a new application awaiting verification, required forms, etc. Unable to issue. 4 TERMINOLOGY DEFINITIONS CONTINUED Replacement – The act of terminating an insurance policy or a portion of the coverage in order to purchase another policy. SBR – Select Benefit Rider. (Not available: CA, ID, MD or OR) Optional. An attachment to an underage health policy that limits, alters or adjusts the policy’s coverage for a certain health condition. State Approved – Filed and Approved by a State Department of Insurance. State Special – Non-standard; Unique. Meets the requirements of one, or more, state(s). Sub-Standard Premium – A higher than standard premium charged on an insured who is classified as having an above average potential for loss, such as a person having a particular health condition. UA Partners® – Not available in Kansas. Optional discount and health services program for life and health policies. Stand alone available. Includes “Automatic” Claims Filing (ACF®) for Medicare Supplement policyholders. Not an insurance policy. Nominal fee is required. Unadmitted Health History – Significant health history obtained by Underwriting Department, that was not admitted on the application for insurance, which would have affected our decision on whether the policy should have been issued with riders or whether the Applicant was an uninsurable risk. Unadmitted health history would be a basis for reformation or rescission. Underwriting – Methods and procedures used to determine an Applicant’s eligibility for insurance coverage. Uninsurable – Not eligible for a United American insurance policy. See Uninsurable Hazardous Occupation Chart (pages 11). Additionally, any policyholder who has lapsed three or more times in a 2-year period is not eligible for any new coverage. 5 MEDICAL GLOSSARY Abnormality – Malfunction or deformity, contrary to normal. Autoimmune Hepatitis – A long-term disease in which your body’s immune system attacks liver cells. Acute – Describes a disease that is brief, severe, and quickly comes to a crisis. Bariatric Surgery – Surgery on the stomach and/or intestines to help a person with extreme obesity to lose weight. Bariatric surgery is an option for people who have a body mass index (BMI) above 40. Surgery is also an option for people with a BMI between 25 and 40 who have health problems like Type 2 Diabetes or heart disease. Adrenal Gland Disorders – Endocrine gland located above each kidney. The inner part (medulla) of each gland secretes epinephrine and the outer part (cortex) secretes steroids. Addison’s Disease: ●● A wasting disease characterized by bronzing of the skin, low blood pressure, and weakness. It is caused by underactivity of the adrenal glands. Blood Disorders – Anemia: ●● A common Blood disorder condition that is caused by an acquired or inhered abnormality of red Blood cells to provide adequate oxygen supplies to body tissues. Anemia may, in some cases, be a manifestation of an non-hematologic disorder. The condition may be due to decreased number of red Blood cells, decreased amount of substance in red Blood cells which transports oxygen hemoglobin, or decreased volume of red Blood cells. There are several diseases properly known as Anemia. These include: anemia of B12 deficiency, anemia of chronic disease, anemia of folate deficiency, drug-induced immune hemolytic anemia, hemolytic anemia, hemolytic anemia due to g6pd deficiency, idiopathic aplastic anemia, idiopathic autoimmune hemolytic anemia, immune hemolytic anemia, iron deficiency anemia, megaloblastic anemia, pernicious anemia, secondary aplastic anemia, and sickle cell anemia. Cushing’s Syndrome: ●● A condition caused by excessive production of corticosteroids by the adrenal cortex or pituitary gland and marked by obesity, muscular weakness, hypertension, striated skin, and fatigue. Congenital Adrenal Hyperplasia: ●● Refers to a group of inherited adrenal gland disorders. People with this condition do not produce enough of the hormones cortisol and aldosterone, and produce too much of androgen. Albuminuria – presence of albumin or protein in the urine. Amenorrhea – absence of menses. Anorexia – lack or loss of appetite for food. Aphasia – loss of ability to communicate orally or in writing and the ability to understand spoken or written language. Blood Cholesterol: An important attribute in deciding a person’s risk of getting coronary heart disease. When you have too much cholesterol in your Blood, the excess builds up on the walls of the arteries that carry Blood to the heart. This buildup is called “atherosclerosis” or “hardening of the arteries.” It narrows the arteries and can slow down or block Blood flow to the heart. With less Blood, the heart gets less oxygen. With not enough oxygen to the heart, there may be chest pain, heart attack, or even death. Cholesterol buildup is the most common cause of heart disease, and it happens so slowly that you are not even aware of it. The higher your Blood cholesterol, the greater your chance of this buildup. Apnea – cessation of breathing. Atrophy – wasting away of an organ, muscle or tissue. ●● Asymptomatic – There are no symptoms. A person is asymptomatic if an illness or condition is present without recognizable symptoms. Acquired Immune Deficiency Syndrome – (AIDS) A disease caused by the human immunodeficiency virus (HIV). People with AIDS are at an increased risk for developing certain cancers and for infections that usually occur in individuals with a weak immune system. Autism – brain disorder that begins in early childhood and persists throughout adulthood; affects three crucial areas of development: communication, social interaction, and creative or imaginative play. Hemochromatosis: A most often hereditary Blood disorder that causes body tissue to absorb and store too much iron. Hemochromatosis is not “caught.” The disease (which is actually many diseases) has also been known to develop as a result of dietary iron intake in sufficient quantity. Its worst effects are preventable, by early diagnosis and treatment, but, if the patient is not found in time, it is crippling and potentially fatal Autoimmune Disease – One job of the immune system is to protect the body from viruses, bacteria, and other living organisms. Usually, the immune system does not react against the body’s own cells. However, sometimes it mistakenly attacks the cells it is supposed to protect. This response is called autoimmunity. Researchers speculate that certain bacteria, viruses, toxins, and drugs trigger an autoimmune response in people who are genetically susceptible to developing an autoimmune disorder. See Autoimmune Diseases (Appendix D) for additional information. ●● 6 MEDICAL GLOSSARY CONTINUED Hemophilia: (also Haemophilia) A genetic Blood disease that causes the Blood to be unable to form a firm clot normally and quickly. doctor while putting the patient at a higher risk of Blood clots and stroke. Women under the age of 40 are at particular risk for clotting complications. ●● Sepsis: ●● Also known as gram-negative bacteremia and grampositive bacteremia, Sepsis is an overwhelming and life-threatening bacterial infection of the Blood and body organs caused by bacteria that has entered body tissue, most often through a wound or incision, that leads to the formation of pus, and/or to the spread of the sepsis bacteria throughout the Blood stream. Sepsis is often caused by organisms that are resistant to most standard antibiotics and more often than not, is found in people with a weakened immune systems. Commonly affected areas are the lungs, the genitourinary tract, the liver or liver secretion tract, the gastrointestinal tract, surgical wounds or drains, and spots of skin disturbance known as decubitus ulcers or bedsores. Sepsis infection can lead to a form of shock, known as septic shock. HIV/AIDS: ●● A Blood-borne disease of the human immune system that is characterized cytologically especially by a reduction in the numbers of CD4-bearing helper T cells, to 20% or less of normal, rendering the subject highly vulnerable to life-threatening conditions, such as pneumonia. There are others that become life-threatening (such as Kaposi’s sarcoma) and that are caused by infection with HIV. HIV has been found in Blood, semen, saliva, tears, nervous system tissue, breast milk, and female genital tract secretions; however, only Blood, semen, female genital tract secretions, and breast milk have been proven to transmit HIV to others. It is most commonly transmitted in infected Blood and bodily secretions (e.g. semen), commonly during illicit IV drug use and/or sexual intercourse. Sickle Cell Disease: ●● A hereditary Blood disease resulting from a single amino acid mutation of the red Blood cells. A Blood condition of anemia. People with sickle cell disease have red Blood cells that contain mostly hemoglobin S, an abnormal type of hemoglobin. Sometimes these red Blood cells become crescent shaped “sickle shaped” and have difficulty passing through small Blood vessels. There is currently no universal cure for Blood borne sickle cell disease. Leukemia: ●● Often referred to as cancer of the Blood, a malignant condition affecting the immature Blood-forming cells in the bone marrow. Lymphatic Filariasis: Lymphatic filariasis is a debilitating Blood disease caused by nematode worms of the genera Wucheriaand Brugia. Larval worms circulate in the Bloodstream of infected persons, and adult worms live in the lymphatic vessels. Lymphatic filariasis is not life threatening, but it does cause extreme discomfort, swelling of the limbs and genitals, damage to the kidneys and lymphatic system, impairment of the body’s ability to fight infection, and general malaise. In addition, it produces immeasurable emotional and economic costs in terms of the disruption of family and community life. Approximately 120 million people in 73 endemic countries world-wide located primarily throughout tropical and subtropical regions of South America, Asia, the Pacific Islands and Africa. Although designated by the World Health Organization (WHO) as the world’s second leading cause of permanent and long-term disability, this mosquito-transmitted Blood borne disease is “potentially eradicable” through drug therapy and vector control. Infection rates are increasing with the continued expansion of urbanization that is underway in the tropics. ●● Thalassemia: ●● An inherited blood disorder that causes mild to severe anemia. The anemia is due to reduced hemoglobin and fewer red blood cells then normal. Hemoglobin is the protein in red blood cells that carries oxygen to all parts of the body. Blood Study – a scientific test/analysis of any of the bloods components. Bone Disorder – abnormal condition, disease, or impairment of any bone. Bradycardia – slowness of the heart rate, usually measured as fewer than 60 beats per minute in an adult human. Brain Disorder – abnormal condition, diseases, or impairment of the brain. Breast Aspiration – fluid removed by needle within a sac or cyst in the breast(s). Bursitis – inflammation of a fluid-filled sac (bursa) of the body, particularly at the elbow, knee, or shoulder.. Polycythemia Vera: ●● Occurs in one to five of every 100,000 people. With this Blood disorder, patients not only have more red cells, that is, hematocrits can almost double in some cases, but there is also a slow, steady buildup of white cells and platelets. Blood volume also increases, which masks the disease from the Calculus – a stone like mass. Cancer – a malignant tumor or growth caused when cells multiply uncontrollably, destroying healthy tissue. 7 MEDICAL GLOSSARY CONTINUED Cardiospasm – a sustained tight contraction of the muscle sphincter at the lower end of the throat that obstructs the passage of food. Connective Tissue Disease, Mixed – First described in 1972, is “classically” considered as an “overlap,” or mix, of three specific connective tissue diseases; systemic lupus erythematosus, scleroderma, and polymyositis. Patients with this pattern of illness (that is, with MCTD) have features of each of these three diseases Cephalgia – a general term referring to headache from any cause. Cesarean Section – surgical abdominal delivery of a newborn. It is now known, however, that overlap syndromes can involve any combination of the connective tissue diseases. Cholecystitis – inflammation or infection of the gallbladder. Chronic – Having a particular long-term illness or condition. Counseling – Meetings with a counselor to receive help with personal or psychological problems. Claudication – usually referred to as intermittent claudication and characterized by severe pain in the legs during walking and relieved by rest. Counselor – Somebody, usually a professional, who helps others with personal, social, or psychological problems. Cocaine – an addictive narcotic drug obtained from the leaves of the coca plant, taken illegally as a stimulant. Cretinism– Arrested physical and mental development with dystrophy of bones and soft tissue, due to congenital lack of thyroid function. Congenital disorders – disorders or defects present at birth and originating during the gestational period. . Degenerative Joint Disease – Also known as Osteoarthritis or Degenerative Arthritis, this type of arthritis is caused by inflammation, breakdown and eventual loss of the cartilage of the joints. Among the over 100 different types of arthritis conditions, osteoarthritis is the most common, affecting usually the hands, feet, spine, and large weight bearing joints, such as the hips and knees. Congenital Heart Disease – abnormal condition of the heart or blood vessels supplying it, existing at or prior to birth, impairing cardiac function. Connective Tissue Disease – Also Collagen Disease and LUPUS. A disease (autoimmune or otherwise) that attacks the collagen or other components of connective tissue. The classic connective tissue diseases include systemic lupus erythematosus, rheumatoid arthritis, scleroderma, pollymyositis, and dermatomyositis. Dementia – Dementia is significant loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning. Dementia is not temporary confusion or forgetfulness that might result from a self-limited infection, underlying illness, or side effects of medications. Dementia typically progresses to become worse over time. There are a number of causes of dementia. In general dementia is more frequent with increasing age. The connective tissues are the structural portions of our body that essentially hold the cells of the body together. These tissues form a framework, or matrix, for the body. The connective tissues are composed of two major structural protein molecules, collagen and elastin. There are many different types of collagen protein that vary in amount in each of the body’s tissues. Elastin has the capability of stretching and returning to its original length - like a spring or rubber band. Elastin is the major component of ligaments (tissues that attach bone to bone) and skin. In patients with connective tissue diseases, it is common for collagen and elastin to become injured by inflammation. Diseases in which inflammation of collagen tends to occur are also referred to as collagen diseases Alzheimer’s disease is the most common form of dementia. Among other causes are medical conditions (thyroid disease, drug toxicity, thiamine deficiency with alcoholism, and others), brain injury, strokes, multiple sclerosis, infection of the brain (such as meningitis and syphilis), HIV infection, hydrocephalus, Pick’s disease, and brain tumors. Developmental Delay – Retarded growth both mentally and physically that causes late mental and physical achievement. Connective tissue diseases are a special group of rheumatic diseases (diseases that feature abnormalities of the muscles and/or joints) that can be associated with arthritis. Diagnosis – The identifying of an illness or disorder in a patient through an interview, physical examination, and medical tests and other procedures. When these conditions have not developed the classic features of a particular disease, doctors will often refer to the condition as “undifferentiated connective tissue disease,” or UCTD. This designation implies that the characteristic features that are used to define the classic connective tissue diseases are not present, but that some symptoms or signs of a connective tissue disease exist. Disease – A disorder with recognizable signs and often having a known cause. Disorder – A derangement or abnormality of function. Dysmenorrhea – Painful menstruation; from any of a wide variety of causes. Dysphagia – Pain or difficulty swallowing. Dyspnea – Difficult or distressed breathing. Dysuria – Painful or difficult urination.. 8 MEDICAL GLOSSARY CONTINUED Effusion – The escape of a fluid from anatomical vessels by rupture or exudation. Heart Valve Disease – Disorder or Abnormal findings within a heart valve. Elevated Blood Glucose – Blood sugar higher than normal. Hematoma – A semisolid mass of blood in the tissues, caused by injury, disease, or a clotting disorder. Endocrinology – a branch of medicine dealing with disorders of the endocrine system and its specific secretions called hormones. Hormones are molecules that act as signals from one type of cells to another. Most hormones reach their targets via the blood. Although every organ system secretes and responds to hormones (including the lungs, heart, intestine, skin, and the kidney), the clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include the pituitary, thyroid, adrenals, ovaries and testes, and pancreas. Immune System – The interacting combination of all the body’s ways of recognizing cells, tissues, objects, and organisms that are not part of itself, and initiating the immune response to fight them. Implants – Something inserted or embedded in the tissues or organs of the body during a surgical procedure, for prosthetic, therapeutic, or cosmetic and diagnostic uses. Indication – A medical sign or symptom that shows the presence of a disease or a remedy for it. Inflammatory Bowel Disease – Chronic disease of the bowel of unknown etiology such as Crohn’s Disease, ileitis and ulcerative colitis. Euthyroid – Normally functioning thyroid gland or normal thyroid hormone level. Febrile – Having a fever or feverish. Infusion – A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. It is the continuous slow introduction of a solution, especially into a vein. Fixation Device – Substance, Agent, object used to repair or mend a part of the body.. Functional – Of, connected with, or being a function affecting physiological or psychological functions but not organic structure 1. A functional heart disease 2. A functional psychosis 3. Compare Structural or Organic Insidious – Of a disease: Developing so gradually as to be well established before becoming apparent. Internal Fixation Device – Pin, plate, wire, nail, or screws used to mend a fracture or injury to a joint. Intermittent Claudication – Pain while walking that abates during rest is the most common symptom. Other symptoms include numbness or weakness in the legs, aching pain in the feet or toes while at rest, nonhealing ulcers on the leg or foot, cold legs or feet and skin color changes of the legs or feet (particularly dependent redness). Some patients, however, are asymptomatic. Functional Disease – A disease of which the symptoms cannot be referred to any appreciable lesion or change of structure; the derangement of an organ arising from a cause, often unknown, external to itself as opposed to “organic” disease, in which the organ itself is affected. Functional Mental or Nervous Disorders – Those such as schizophrenia, major depressive disorder, manic disorder, psychosis, neurotic disorders. Irregular Heartbeat – abnormal electrical conduction through the heart’s specialized pathways causing irregular beats. Gaucher Disease – An inherited, enzyme deficiency, disorder. Symptoms range from mild to severe and can appear at any time, from infancy to old age. These Gaucher symptons may include anaemia, fatigue, easy bruising and a tendency to bleed. An enlarged spleen and liver may also occur in Gaucher disease as well as bone pain, degeneration and fractures. Lymphadenopathy – Swelling of one or more lymph nodes. It is a recognized symptom of many different diseases, some of which are: reactive: acute infection (e.g. bacterial, or viral), or chronic infections (tuberculous lymphadenitis, cat-scratch disease) tumoral: Hodgkin lymphoma, non-Hodgkin lymphoma, metastasis unknown etiology: sarcoidosis. The most common form of Gaucher disease (Type 1) affects 1 in 100,000 of the general population although it is estimated that not all those who have Gaucher disease will show symptoms. In the rarer Type 2 and Type 3 Gaucher disease, neurological problems will occur. Lymphoma – a neoplastic, malignant disease of the lymphoid tissue. Maintenance – therapeutic regimen intended to preserve a normal quality or status and considered an activity incorporated into a good life style without evidence of a disease or disorder. Glucose Intolerance – having some degree of resistance to insulin, so you can’t move glucose into cells efficiently and use it as an efficient body fuel. Inability to withstand normal metabolism of glucose. Impaired glucose tolerance (IGT) is a major risk factor in the development of type 2 diabetes. Manipulation Therapy – skillful or dexterous treatment as with the hands such as massage or chiropractic treatment. Glycosuria – presence of glucose in the urine. 9 MEDICAL GLOSSARY CONTINUED Mental Illness, Severe – As defined by the American Psychiatric Association in the Diagnostic and Statistical Manual (DSM), severe mental illness includes the following diagnoses: schizophrenia; schizo-affective disorder; bipolar disorder (manic-depressive illness); major depressive disorders; panic disorders; obsessivecompulsive disorder; pervasive developmental disorder or autism; anorexia nervosa; and bulimia nervosa. Nocturia – Excessive urination at night. Opiate – A drug such as morphine or heroin that contains opium or an opium derivative. Organic – 1. Of, relating to, or arising in a bodily organ 2. Affecting the structure of the organism 3. An organic disease Morbidity – The relative frequency of occurrence of a particular disease in a particular area. Organic Mental or Nervous Disorders – Those such as Parkinson’s disease or epilepsy. Motor Skill Delay – late or retarded development in ability to execute learned physical tasks. Organic Personality Syndrome or Organic Mental Syndrome – A mental disorder characterized by a shortterm or long-term personality disturbance largely due to brain dysfunction. The ability to reason, remember, imagine, and learn may not be affected, but the individual’s judgment may be so poor that continual supervision may be necessary. Left unattended, he or she may behave in ways that could cause difficult or dangerous problems. Musculoskeletal System – All muscles of the body collectively and the ligaments, tendons, or bones that interconnect . Musculoskeletal Disorder – Abnormal condition, disease or impairment of the musculoskeletal system. Myalgia – Pain or tenderness in a muscle or group of muscles. Organic Brain Syndrome – Also called Organic Mental Disorder. Psychiatric or Neurological symptoms, including problems with attention, concentration and memory, confusion, anxiety, and depression, arising from damage or disease in the brain. Necrosis – The death of cells in a tissue or organ caused by disease or injury. Nervous Disorder – Abnormality of the brain, spinal cord, and neural elements. Nervous System – Comprised of the brain, spinal cord, and neural elements. A general term referring to physical disorders that cause decreased mental function (usually not psychiatric disorders). Neuritis – Inflammation of a nerve with pain and tenderness, paresthesia and lack of reflexes. Organic mental or nervous disorders are those such as Parkinson’s Disease. Neuromuscular Disorders – Conditions that affect components of a motor unit (motor neuron cells of the spinal cord, nerve, neuromuscular junction, and muscle fibers), sensory and autonomic nerves or their supportive structure are included in the broad category od neuromuscular disorders. Organic Personality Syndrome or Organic Mental Syndrome is a mental disorder characterized by a short-term personality disturbance largely due to brain dysfunction. The ability to reason, remember, imagine, and learn may not be affected, but the individual’s judgement may be so poor that continual supervision may be necessary. Left unattended, he or she may behave in ways that could cause difficult or dangerous problems. Myopathies: ●● Polymyositis ●● Dermatomyositis ●● Inclusion Body Myositis ●● Muscular Dystrophies ●● Metabolic Myopathies Palliative Treatment – Alleviating pain and symptoms without eliminating the cause. (See also Treatment) Paranoia – A psychiatric disorder involving systematized delusion, usually of persecution. Disorders of Neuromuscular Junction: ●● Myasthenia Gravis ●● Eaton-Lambert Syndrome Parathyroid Disorder – Abnormal condition, disease, or impairment of the parathyroid gland. Neuropathies: Guillain Barre Syndrome ●● Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) ●● Diabetic Neuropathy ●● Hereditary Neuropathies Peripheral Arterial Disease – (PAD) Also known as Perhpheral Vascular Disease (PVD). See Peripheral Vascular Disease (PVD) for additional information (Appendix F). ●● Peripheral Vascular Disorder – (PVD) Disorders affecting the arteries, veins and lymphatics of the extremities, including any of various diseases, especially arteriosclerosis, occurring in blood vessels outside the heart and the brain. See Peripheral Vascular Disease (PVD) for additional information (Appendix F). Motor Neuron Disorder: ●● Amyotrophic Lateral Sclerosis (ALS) 10 MEDICAL GLOSSARY CONTINUED Pituitary Gland Disorders – A small oval gland at the base of the brain in vertebrates, producing hormones that control other glands and influence growth of the bone structure, sexual maturing, and general metabolism. 1. Acromegaly – A disease of adults that is caused by overproduction of growth hormones, resulting in enlargement of the bones of the hands, feet, jaw, nose and ribs. 2. Growth Hormone Deficiency – The medical condition of inadequate production of growth hormone (GH) and its effects on children and adults. Growth hormone, also called somatotropin, is a polypeptide hormone which stimulates growth and cell reproduction. 3. Pituitary Tumors – An abnormal growth in the pituitary gland, the part of the brain that regulates the body’s balance of hormones. Stimulant – A drug or other Agent that produces a temporary increase in functional activity of a body organ or part. Structural – Relating to the way that the parts of something are put together or how they work together affecting physiological or psychological functions but not organic structure (i.e., a functional heart disease or a functional psychosis) Surgery – Medical treatment that involves operations or manipulations on the patient’s body and, usually, cutting the body open to perform these. Surgical Advice – Recommendation by a doctor to have surgery to improve or heal a medical condition. Symptom – Any subjective evidence (what the patient feels) of disease. Anxiety, lower back pain, fatigue are all symptoms. They are sensations only the patient can perceive. Syndrome – A medical condition characterized by a collection of symptoms (what the patient feels) and signs (what a doctor can observe or measure). Premalignant Conditions – See Premalignant Conditions for additional information (Appendix E). Prognosis – The likely outcome or course of a disease; the chance of recovery or recurrence. Thrombosis – When the platelets try to patch up an injury within a small Blood vessel and completely plug it up instead. This plug obstructs the normal flow of Blood and can result in a heart attack or stroke. Psychologist – A professional who studies behavior and experience, usually either licensed to provide therapeutic services to the public or working in an academic setting. Treatment – Management, consultation and care for the purpose of combating or controlling a disease or disorder. This includes any therapy, prescribed medications or over the counter medications taken to control or treat the disorder. Psychological Treatment – Assistance rendered by mental health care services. Reactive Airway Disease – Acute constrictive breathing disorder caused by the hypersensitivity to external Agent Treatment, Palliative – To palliate a disease is to treat it partially and insofar as possible, but not cure it completely. Palliation cloaks a disease. Also sometimes called Symptomatic Treatment. Recurrent – Returning after remission returning or happening repeatedly. Relapse – The return of a disease after it’s apparent cessation. Severe –Causing great discomfort by being extreme. Tremors – Involuntary trembling or quivering. Severe Mental Illness – See Mental Illness, Severe, above Tumor – Abnormal growth of tissue with multiplication of abnormal cells. Sexually Transmitted Disease – (STD) A disease such as syphilis or genital herpes that is normally passed from one person to another through sexual activity. Valve Prosthesis – Artificial Agent used to replace a diseased or nonfunctioning heart valve or other valve. Sign – Objective evidence (what a doctor can measure or observe) of disease. A bloody nose is a sign. It is evident to the patient, doctor, nurse and other observers. Speech Disorder – Abnormality in ability to speak in normal fashion, such as stutter. Spleen disorder – Abnormal condition, disease, or impairment of the spleen. Stenosis – An abnormal constriction or narrowing of a duct, passage, or opening in the body. Stent – An open tubular structure of stainless steel or plastic used to prevent arteries and other body tubes from becoming blocked by disease. 11 MEDICAL GLOSSARY CONTINUED ABBREVIATIONS: S – Standard D – Decline IC – Individual Consideration PP – Postpone SBR – Select Benefit Rider EBR – Exclusion Benefit Rider APR – Additional Premium Rider RFC– Rate For Cause U – Uninsurable AODM – Adult Onset Diabetes Mellitus BX – Biopsy CA – Cancer CABG – Heart Bypass Surgery (Coronary Artery Bypass Graft) CP – Chest Pain CVA – Stroke (Cerebral Vascular Accident) CXR – Chest X-ray DX – Diagnosis ER – Emergency Room ETOH – Alcohol FX – Fracture HBP – High Blood Pressure HTN – Hypertension H/O – History Of HT/WT – Height/weight HOSP – Hospitalization HX – History IDDM – Insulin Dependent Diabetes Melitis MI – Heart Attack (Myocardial Infarction) NIDDM – Diabetes With Diet Or Oral Meds PTCA – Angioplasty - Percutaneous Transluminal Coronary Angioplasty / Stent RX – Medication SX – Symptoms SZ – Seizure TIA – Mini Stroke (Transient Ischemic Attack) TX – Treatment 12 COMMON MEDICATIONS AND THEIR USAGE COMMON MEDICATION USAGE COMMON MEDICATION USAGE A.S.A. (Asprin) Pain, fever Avapro Hypertension Accupril High Blood Pressure Avonex Multiple Sclerosis Aciphex GERD, peptic ulcers, dyspepsia Axid GERD, upper GI disorder Aclovate Skin disorders, dermatitis Azmacort Asthma Actonel Osteoporosis AZT AIDS Acyclovir Herpes Infection, AIDS Azulfidine Gastrointestinal/Colitis, Inflamed Bowel Adalat High Blood Pressure Baclofen Multiple sclerosis, spinal cord disorders Adderall Attention Deficit Disorder Bactrim Urinary Tract Infection/Antibiotic Adipex Obesity, Weight Control Baycol Lowers Cholesterol Advair Asthma, respiratory Beclomethasone Asthma Aerobid Asthma BEclovent Asthma Albuterol Asthma Beconase Inhaler Asthma, allergies Aldactazide High Blood Pressure Belladonna Rectal, bladder, urethral spasm Aldomet High Blood Pressure Benadryl Allergies, motion sickness Aldoril High Blood Pressure Benemid Gout/Hyperuricemia/Gouty Arthritis Alesse Anxiety, panic disorder, depression Bentyl Irritable bowel syndrome Allopurinol Gout Benzac Acne Altace Hypertension/Heart/Cardiovascular Betaseron Multiple Sclerosis Alupent Asthma Betimol Hypertension, angina, glaucoma Amaryl Diabetes Mellitus Bextra Arthritis, colon polyps, pain, dysmenorrhea Ambien Insomnia/Sleep Disorder Biaxin Antibiotic/Infectious Process Amerge Migraine Attack/Headaches Bicillin Infectious disorders Amitriptyline Anxiety/Depression Blocadren Myocardial infarction, angina Amoxicillin Antibiotic-many types of infections Brethine Asthma Anafranil OCD, depression Buspar Anxiety Anaprox Non Steroid Anti-Inflammatory, pain Byetta Diabetes Anaspaz Ulcer, irritable bowel, neurogenic bladder Calan Cardiovascular/Hypertension Ansamycin HIV infection Calcitonin Osteoporosis, bone disease Antabuse Alcohol Abuse Calcitriol Hypoparathyroidism, renal failure Antivert Dizziness Capoten Hypertension Apresoline High Blood Pressure Capozide Hypertension Arava Rheumatoid Arthritis Captopril Hypertension Aricept Alzheimer’s Disease/Dementia Carac Skin disorder, keratoses, skin cancer Arthrotec Osteo & Rheumatoid Arthritis Carafate Ulcer Asacol Ulcerative Colitis & Proctitis Cardizem Cardiovascular/Hypertension Asprin (A.S.A.) Pain, fever Cardura Hypertension Atacand Hypertension Catapres Hypertension Atarax Antihistamine/Depression/Sleep Ceftin Antibiotic/Infectious Process Atenonol Cardiovascular/Hypertension Cefzil Antibiotic/Infectious Process Ativan Anxiety/Depression Celebrex Osteo/Rheumatoid Arthritis Atromid Lowers Cholesterol Celecoxib Osteo/Rheumatoid Arthritis Atrovent COPD, emphysema, bronchitis, allergies Celestone Dermatitis psoriasis, allergies, asthma Avalide Hypertension Celexa Depression Avandia Diabetes Mellitus/Hyperglycemia Cephlasporin Many infections, bronchitis, URI, sinusitis 13 COMMON MEDICATIONS AND THEIR USAGE CONTINUED COMMON MEDICATION USAGE COMMON MEDICATION USAGE Chlorothiazide Diuretic, edema, hypertension Detrol Urinary tract disorders, incontinence Chlorpromazine Psychotic Disorder/Nausea/Vomiting Dexedrine Attention Deficit Disorder/Narcolepsy Cimitidine Ulcer Disease/Gastrointestinal Reflux Diabenese Diabetes Mellitus Cipro Antibiotic, URI’s, UTI’s, PID, acne Diabeta Diabetes Mellitus Claritin Allergic Rhinitis/Chronic Urticaria Diamox Glaucoma, fluid retention Cleocin Antibiotic/Infectious Process Diazapam Tranquilizer Clindamycin Infectious disorders Dibent Urinary tract disorders, incontinence, IBS Clinoril Neuromuscular/Arthritis Dicyclomine IBS, gastrointestinal symptoms Clofibrate Lowers Cholesterol Diflucan Fungus Infections Clomid Infertility Digoxin Heart Disease/Cardiovascular Clonazepam Seizure & Panic disorder Dilantin Seizure/Convulsive disorder Clonidine Hypertension/Cardiovascular Diovan Hypertension Cogentin Parkinson’s Disease Dipentium Ulcerative colitis Cognex Alzheimer’s Disease Diphenoxylate Diarrhea Colbenemid Gout Dipyridamole Cardiovascular Disorder Colchicine Acute Gout/Chronic Gouty Arthritis Disalcid Pain, fever, arthritis Compazine Anxiety, nausea, vomiting Disopyramide Cardiovascular Disorder Concerta Attention Deficit Disorder Ditropan Urinary Urgency/Incontinence Contuss Decongestant, cough, bronchitis, URI’s Domperidone Gastrointestinal disorder, gastritis Copegus Hepatitis C Donnatal Gastrointestinal/Ulcer Corgard Cardiovascular/High Blood Pressure Doxepin Antidepressant Cortef Adrenal insufficiency, dermatitis Doxycycline Antibiotic, URI’s, UTI’s, PID, acne Cortisol Adrenal disorder, Cushing’s Syndrome Dramamine Nausea, motion sickness, vertigo Coumadin Blood thinner, Stroke, Heart Disease Duracef Infectious disorders Cozaar Hypertension Dur-a-gest Congestion, URI’s Cyclobenzaprine Musculoskeletal -skeletal disorders, spasms Dynacirc Hypertension Cylert Attention Deficit Disorder Effexor Anxiety/Depression Cystospaz Ulcer, irritable bowel, neurogenic bladder Efudex Actinic Keratosis/Basal Cell/Skin Dis. Cytomel Thyroid Replacement Elavil Depression Dalmane Sleeping Aid/Hypnotic Eligard Prostate Cancer Danocrine Endometriosis/Severe Fibrocystic Breast Elmiron Bladder pain, interstitial cystitis Daraprim Malaria Enbrel Rheumatoid Arthritis Darvocet Moderate Pain Relief/Analgesic Enduron Diuretic Daypro Osteo and Rheumatoid Arthritis Entex Allergies, nasal congestion/sinusitis DDAVP Diabetes Insipidus, Enuresis Erythromycin Acne, pneumonia, gastroenteritis Decadron (Steriod) Musculoskeletal, respiratory Esidrix Hypertension/Diuretic Deltasone Arthritis, respiratory disorder, colitis Eskalith Manic Depression Demerol Pain Killer, analgesic Estradiol Menopause/Abnormal Uterine Bleeding Demulen Contraceptive Ethambutal Tuberculosis Depakene Seizure/Convulsive disorder Etrafon Anxiety, depression Depakote Seizure/Convulsive disorder Euthroid Thyroid Disorders Depo provera Abnormal uterine bleeding, amenorrhea Evista Osteoporosis prevention Desogen Oral Contraceptive Exelon Alzheimer’s Disease/dementia Desyrel Depression/Sedative Famcyclovir Genital Herpes, zoster, shingles 14 COMMON MEDICATIONS AND THEIR USAGE CONTINUED COMMON MEDICATION USAGE COMMON MEDICATION USAGE Famvir Viral Infections/Herpes/AIDS Inderal Cardiovascular/HBP, Migraine Feldene Musculoskeletal/Pain Indocin (NSAID) Musculoskeletal Fioricet Analgesic/Pain Indomethacin Arthritis, bursitis, tendonitis Fiorinal Analgesic/Pain Inspra Hypertension Flagyl Vaginitis/Yeast Infection Insulin Diabetes Mellitus Flexeril Musculoskeletal Pain and disorders Intal Bronchitis/Asthma Flovent Asthma Interferon Hepatitis, cancer, liver disease Floxin Antibiotics/Infectious Disease Isoniazide Tuberculosis Fluoroqunolones Infections of bone, intestine, respiratory Isoptin Cardiovascular/Hypertension Fluoxetine Depression, panic disorder, OCD, bulimia, PMDD(Premenstrual Dysphoric Disorder) Isordil Cardiovascular/Hypertension Isosorbide Dinitrate Cardiovascular/Hypertension Flurouacil Cancer, keratose, skin cancer Keflex Infection Fosamax Treatment or Preventive Osteoporosis Keftabs Antibiotic/Infectious process Furosemide Diuretic Kefurox Otitis media, respiratory infections Glipizide Diabetes Mellitus/Hyperglycemia Kerlone Hypertension Glucophage Diabetes Mellitus/Hyperglycemia Ketoprophen Osteo/Rheumatoid arthritis, dysmenorrhea pain Glucotrol Diabetes Mellitus/Hyperglycemia Klonopin Anxiety/Panic Disorders Glyburide Diabetes Mellitus/Hyperglycemia Klotrix Potassium Supplement Guanethidine High Blood Pressure Lamisil Fungus Infection Habitro Smoking Cessation Lanoxin Cardiovascular/Heart Disease Halcion Hypnotic/Sleeping Aid Lasix Diuretic, edema Haldol Psychosis Lescol Cholesterol, elevated lipids Humbid Respiratory Infection/Sinusitis/Bronchitis Levaquin Sinusitis, URI’s, UTI’s, skin infections Humira Rheumatoid arthritis, inflammatory bowel Levbid Ulcer, IBS, neurogenic bladder Humulin Diabetes Mellitus Levo Dopa Parkinson’s Disease Hycort Skin disorders, ulcerative colitis, asthma Levsin Ulcer, IBS, neurogenic bladder Hydralazine Diuretic, hypertension Levsinex Ulcer, IBS, neurogenic bladder Hydro-Chlorothiazide Diuretic Librax Gastrointestinal Hydrocodone Analgesic, pain relief Librium Anxiety Hydrodiuril Diuretic Lipitor High Cholesterol/Elevated lipids Hygroton Hypertension/Urinary Retention Lithium Manic Depression Hyosine Motion sickness, nausea, gastrointestinal Lodine Pain, inflammation, arthritis Hyrdocortisone Adrenal insufficiency, dermatitis, ileitis Lomotil Diarrhea Hytrin Hypertension/Urinary Retention Lopid Hyperlipidemia Hyzaar Hypertension Lopressor Cardiovascular/High Blood Pressure Ibuprophen Arthritis, gout, fever, pain, headaches Lorazepam Anxiety/Depression Iletin Insulin Diabetes Mellitus Lortrel Diuretic/High Blood Pressure Imipramine Panic Disorders/Depression/Bed Wetting Lovastin Elevated lipids/Hyperlipidemia Imitrex Migraine Headaches Lozol Hypertension Imodium Diarrhea Ludiomil Anti-Depressant Imuran Rheumatoid arthritis, immune disorders, MS, Crohn’s disease Lumigan Glaucoma, ocular hypertension Lupron Endometriosis/Hormone Alteration/Infertility Macrobid UTI Macrodantin UTI 15 COMMON MEDICATIONS AND THEIR USAGE CONTINUED COMMON MEDICATION USAGE COMMON MEDICATION USAGE Mavik Hypertension, heart disease, angina Nitro-Dur Cardiovascular Heart Disease Maxair Asthma Nitroglycerine Cardiovascular/Heart Disease/Angina Maxitrtol Eye Disease/Glaucoma Norethindrone Amenorrhea, endometriosis, abnormal uterine bleeding Maxolon Nausea and vomiting, GERD Norinyl Hormone/Contraceptive Maxzide High Blood Pressure/Diuretic Normodyne Cardiovascular/Hypertension Meclizine Dizziness/Vertigo Norpace Anti-Arrhythmic/Hypertension Meclomen (NSAID) Musculoskeletal Nortriptyline Anxiety Medrol Asthma/Arthritis/Allergies/Colitis Norvasc Cardiovascular/Hypertension Medroxyprogesterone Abnormal uterine bleeding, amenorrhea, menopause NPH Insulin Diabetes Mellitus Mellaril Anti-Psychotic Ocufen Arthritis, eye inflammation Meridia Weight loss/Diet Control Olanzapine Psychotic Disorders Mesalamine Ulcerative colitis Orasone Arthritis, respiratory disorders, allergies Methotrexate Cancer/Rheumatoid Arthritis, Psoriasis Orinase Diabetes Mellitus Methyldopa High Blood Pressure Ortho-Cyclen Birth Control Meticorten Arthritis, respiratory disorders, allergies, colitis Ortho-Novum Hormone/Birth Control MetroGel Skin infections, vaginosis, Crohn’s Disease, colitis Orudis Arthritis, dysmenorrhea, pain Mevacor Lowers cholesterol, hyperlipidemia Oruvail Rheumatoid/Osteoarthritis Miacalcin Osteoporosis Pamelor Anxiety Micronar Amenorrhea, endometriosis, abnormal uterine bleeding Parlodel Hormone/Cocaine Abuse/Infertility Micronase Diabetes Mellitus Paxil Anxiety/Panic Disorders Minipress High Blood Pressure Penicillin Mobic Osteoarthritis Many types of infections, tonsillitis, otitis, cystitis, gonorrhea, botulism Moduretic Diuretic, edema Pentasa Ulcerative colitis Monopril Hypertension Pepcid Gastrointestinal Disorders Mycoleutin HIV infection Percocet Moderate Pain Relief Myochrysine Rheumatoid & psoriatic arthritis, pemphigus Percodan Pain Killer/Analgesic Mysoline Anti-Convulsant, seizure disorder Peri-Colace Gastrointestinal Nadolol Cardiovascular Disorder Permax Parkinson’s Disease Naldecon Antihistamine/Allergies Persantine Anti-Angina/Heart Disease/Vascular Disorder Naprelan Arthritis, pain, headache, fever Phenergan Allergy/Nausea/Vomiting/Sedation Naprosyn (NSAID) Musculoskeletal Disorders Phenobarbitol Convulsions/Seizures/Sedation Naproxen Inflammation, arthritis, gout, bursitis Piperacillin Skin infections, respiratory infections Nasacort Allergic Rhinitis Pitressin Diabetes insipidus Nasalide Allergies Plaquenil Lupus Erythematosus/Rheumatoid arthritis Neoral Rheumatoid arthritis, psoriasis, tissue rejection Plavix Atherosclerosis/Stroke/Myocardial infarction Neptazane Glaucoma Plendil Hypertension Neurontin Seizure/Convulsion Disorder Podophyllin Genital Warts Gastrointestinal disorders, GERD, esophagitis, duodenal ulcer, H-pylori Pravachol Cholesterol/Atherosclerosis/Lipidemia Precose Diabetes Mellitus Nifedipine Cardiovascular/Hypertension Prednisone (Steriod) Respiratory/Musculoskeletal/Colitis Nitro-Bid Cardiovascular Disorder Prelone (Steriod) Allergies/Breathing disorders Nexium 16 COMMON MEDICATIONS AND THEIR USAGE CONTINUED COMMON MEDICATION USAGE COMMON MEDICATION USAGE Premarin Hormone Roferon Hepatitis, cancer, liver disease, sarcoma Prevacid Upper Gastrointestinal Disorders Rowasa Ulcerative Colitis/Proctosigmoiditis Prilosec Upper Gastrointestinal Disorders Rufen (NSAID) Musculoskeletal Prilosec Ulcer disease, GERD, esophagitis Salflex Pain, fever, arthritis Prinivil Hypertension Sarafem Depression, panic disorders, OCD, PMDD, bulimia Prinizide Hypertension Scopolomine Motion sickness, nausea, gastrointestinal disorders Probenecid Arthritis, gout, hyperuricemia Sectrol Cardiovascular/Hypertension Procan Anti-Arrhythmic/Heart Disease Seldane Antihistamine, allergies Procardia Cardiovascular/High Blood Pressure Septrra Infectious Process/Otitis, UTI Progesterone Hormone male/female disorders Serevent Asthma/Respiratory Disorders Proloprim Urinary Tract infections, bronchitis Serzone Depression/Mental Disorders Promethazine Motion sickness, nausea, dizziness, sedation Sinemet Parkinson’s Disease Propranolol Cardiovascular/Hypertension Sinequan Anti-Depressant/Mental Disorders Propulcid Upper Gastrointestinal Disorder Singulair Asthma Propylthiouricil Thyroid Disorder Skelaxin Musculoskeletal Pain Proscar Prostate Disorder Slo-Bid Asthma/Bronchitis Protonix Esophagitis, GERD, heartburn SOMA (compound) Musculoskeletal Pain/Spasm/Arthritis Proventil Asthma, Bronchitis Sonata Insomnia/Sleep Disorder Provera Hormone Replacement Spironolactone Diuretic, edema, hypertension Provigil Multiple Sclerosis, narcolepsy Stelazine Anti-Psychotic, psychosis Prozac Anti-Depressant Sular Hypertension Questran Lowers cholesterol, hyperlipidemia Sulfamethoxazole Infectious process/Urinary/Ear/Colon Quiafenex Expectorant, URI’s, bronchitis, lung disorders Sulfapyridine Ulcerative colitis, rheumatoid arthritis Quidtix URI, sinusitis Sulfasalazine Ulcerative colitis, rheumatoid arthritis Quinidine Anti-Arrhythmic, heart disorder Sulfisoxazole Otitis media, respiratory infections, pelvic inflammation Ramipril HBP/Heart Failure/Heart attack/Stroke Sulindac Musculoskeletal=teal disorders Recaltrol Parathyroid Disease Symmetrel Parkinson’s Disease, viral disease Reglan Gastrointestinal Disorders, GERD, nausea Synthroid Thyroid Disorder Regroton High Blood Pressure Tagamet Gastrointestinal Disorders Relafen Rheumatoid arthritis Tarka Hypertension Relpax Migraine headaches Tavist Respiratory disorders Remeron Depression/Mental Disorders Tegretol Seizure disorder, convulsions Remicade Crohn’s Disease, rheumatoid arthritis Tenex Hypertension Respiradol Psychotic Disorders Tenorectic Hypertension Restasis Dry eye syndrome Tenormin Hypertension Restoril Sedative/Hypnotic, sleep disorder Tequin Infections Rhinocort Allergic Rhinitis Testosterone Hormone deficiency Rhythmid Atrial fibrillation/Tachycardia/Cardiac Arrhythmia Tetracycline Infection, acne Ridural Rheumatoid arthritis, psoriasis Theobid Respiratory disorders Rifabutin HIV infection Theo-Dur Respiratory disorders Ritalin Attention Deficit Disorder Thorazine Psychosis, mental disorders Rocaltrtol Hypoparathyroidism, renal failure Ticlid Stroke, TIA (transient ischemic attack) Rocephin Infections, URI’s, UTI’s, bone & joint Tigan Nausea and vomiting Rofecoxib Osteoarthritis/Dysmenorrhea Timoptic Glaucoma, ocular hypertension 17 COMMON MEDICATIONS AND THEIR USAGE CONTINUED COMMON MEDICATION USAGE COMMON MEDICATION USAGE Tofranil Enuresis, depression Ziac Hypertension Tolectin (NSAID) Musculoskeletal disorders Zithornax Infectious disorders Tolinase Diabetes Mellitus Zithromycin Infectious disorders Tramadol Pain Zocor Hyperlipidemia Tranxene Anxiety disorders Zoloft Mental/nervous disorders/depression Travatan Glaucoma, ocular hypertension Zomig Migraine and vascular headaches Trazadone Depression, insomnia Zostrix Arthritis, post herpetic neuralgia, diabetic neuropathy Trental PVD (Peripheral Vascular Disease) Zovirax Herpes Zoster Triamcinolone Arthritis, asthma, allergy, dermatitis Zyloprim Gout/gouty arthritis Triamterene Hypertension, fluid retention Zyprexia Psychosis Trichloroacetic Acid Warts and callous tissue removal Zyrtec Allergic Rhinitis/allergies/urticaria Trimpex Infectious processes Trinalin Respiratory disorders Ultram Pain Unipres Hypertension Univasc Hypertension Urex UTI (Urinary Tract Infection) Urispaz UTI (Urinary Tract Infection), incontinence Valium Anxiety, tension Valtrex Genital herpes, herpes zoster, shingles Vanceril Respiratory disorders Vantin Infectious processes Vasopressin Diabetes Insipidus Vasotec Hypertension Ventolin Respiratory disorders Verapamil Hypertension Viadur Prostate cancer Viagra Impotence Vicodin Pain Vioxx Rheumatoid Arthritis, Musculoskeletal disorders Visken Hypertension Vistaril Nausea, anxiety Vivactil Depression Warfarin Anticoagulant, Blood clots, stroke, heart disease Wellbutrin Mental/nervous disorders Wygesic Pain Wytensin Hypertension Xalatan Glaucoma, ocular hypertension Xanax Anxiety/manic disorders Zantac Gastrointestinal disorders Zarosolyn Hypertension, fluid retention Zebeta Hypertension Zestril Hypertension Zetia Hyperlipidemia 18 AUTOIMMUNE DISEASES Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. In other words, the body attacks its own cells. Today there are more than 40 human diseases classified as either definite or probable autoimmune diseases, and they affect 5% to 7% of the population. Almost all autoimmune diseases appear without warning or apparent cause, and most patients suffer from fatigue. The causes of autoimmune diseases are still obscure: Some are thought to be either examples of or precipitated by diseases of affluence. For example, arthritis and obesity are acknowledged to be related, and the World Health Organization states that arthritis is most common in developed countries. Most autoimmune diseases are probably the result of multiple circumstances, for example, a genetic predisposition triggered by an infection. Women tend to be affected more often by autoimmune disorders; nearly 79% of autoimmune disease patients in the USA are women. Also they tend to appear during or shortly after puberty. It is not known why this is the case, although hormone levels have been shown to affect the severity of some autoimmune diseases such as multiple sclerosis. Other causes may include the presence of fetal cells in the maternal bloodstream. DISEASES WITH A COMPLETE OR PARTIAL AUTOIMMUNE ETIOLOGY: Acute Disseminated Encephalomyelitis – (ADEM) is a form of encephalitis caused by an autoimmune reaction and typically occurring a few days or weeks after a viral infection or a vaccination. Addison’s Disease – often caused by autoimmune destruction of the adrenal cortex. Ankylosing Spondylitis – chronic, painful, progressive inflammatory arthritis primarily affecting spine and sacroiliac joints, causing eventual fusion of the spine. Antiphospholipid Antibody Syndrome – (APS) affects the blood-clotting process. It causes blood clots to form in veins and/or arteries. Aplastic Anemia – often caused by an autoimmune attack on the bone marrow. Autoimmune Hepatitis – a disorder wherein the liver is the target of the body’s own autoimmune system. Celiac Disease – a disease characterized by chronic inflammation of the proximal portion of the small intestine caused by exposure to certain dietary gluten proteins. Crohn’s Disease – a form of inflammatory bowel disease characterized by chronic inflammation of the intestinal tract. Major symptoms include abdominal pain and diarrhea. Diabetes Mellitus – (type 1) is the result of an autoimmune attack on the islet cells of the pancreas. Goodpasture’s Syndrome – a disease characterized by rapid destruction of the kidneys and hemorrhaging of the lungs through autoimmune reaction against an antigen found in both organs. Graves’ Disease – the most common form of hyperthyroidism, and is caused by anti-thyroid antibodies that have the effect of stimulating the thyroid into overproduction of thyroid hormone. Guillain-Barré Syndrome – (GBS) is an acquired immune‑mediated inflammatory disorder of the peripheral nervous system (i.e., not the brain and spinal column). It is also called acute inflammatory demyelinating polyneuropathy, acute idiopathic polyradiculoneuritis, acute idiopathic polyneuritis and Landry’s ascending paralysis. Hashimoto’s Disease – a common form of hypothyroidism, characterized by initial inflammation of the thyroid, and, later, dysfunction and goiter. There are several characteristic antibodies (e.g., anti-thyroglobulin). Idiopathic Thrombocytopenic Purpura – an autoimmune disease where the body produces anti-platelet antibodies resulting in a low platelet count 19 AUTOIMMUNE DISEASES CONTINUED Lupus Erythematosus – a chronic (long-lasting) autoimmune disease wherein the immune system, for unknown reasons, becomes hyperactive and attacks normal tissue. This attack results in inflammation and brings about symptoms. This is a “Non-organ-specific” type of autoimmune disease. Takayasu’s Arteritis – a disorder that results in the narrowing of the lumen of arteries. Temporal Arteritis – (also known as “giant cell arteritis”) is an inflammation of blood vessels, most commonly the large and medium arteries of the head. Untreated, the disorder can lead to significant vision loss. Multiple Sclerosis – a disorder of the central nervous system (brain and spinal cord) characterized by decreased nerve function due to myelin loss and secondary axonal damage. Warm Autoimmune Hemolytic Anemia – a disorder characterized by IgM attack against red blood cells. Myasthenia Gravis – a disorder of neuromuscular transmission leading to fluctuating weakness and fatigue. Weakness is caused by circulating antibodies that block acetylcholine receptors at the neuromuscular junction. Wegener’s Granulomatosis – a form of vasculitis that affects the lungs, kidneys and other organs. Opsoclonus Myoclonus Syndrome – (OMS) is a neurological disorder that appears to the result of an autoimmune attack on the nervous system. Symptoms include opsoclonus, myoclonus, ataxia, intention tremor, dysphasia, dysarthria, mutism, hypotonia, lethargy, irritability or malaise. About half of all OMS cases occur in association with neuroblastoma. Optic Neuritis – an inflammation of the optic nerve that may cause a complete or partial loss of vision. Ord’s Thyroiditis – a thyroiditis similar to Hashimoto’s disease, except that the thyroid is reduced in size. In Europe, this form of thyroid inflammation is more common than Hashimoto’s disease. Pemphigus – an autoimmune disorder that causes blistering and raw sores on skin and mucous membranes. Polyarthritis – is any type of arthritis which involves five or more joints, and inflammation of two, three or four joints is oligoarthritis. Polyarthritis is most often caused by an auto-immune disorder such as Rheumatoid Arthritis, Psoriatic Arthritis and Lupus Erythematosus but can also be caused by infection. Primary Biliary Cirrhosis – appears to be an autoimmune disease that affects the biliary epithelial cells (BECs) of the small bile duct in the liver. Although the cause is yet to be determined, most of the patients (>90%) appear to have auto-mitochondrial antibodies (AMAs) against pyruvate dehydrogenase complex (PDC), an enzyme that is found in the mitochondria. Psoriasis – a skin disorder in which rapidly-multiplying skin cells produce itchy, scaly inflamed patches on the skin. Rheumatoid Arthritis – an autoimmune disorder that causes the body’s immune system to attack the bone joints. Reiter’s Syndrome – seems to be an autoimmune attack on various body systems in response to a bacterial infection and the body’s confusion over the HLA-B27 marker Sjögren’s Syndrome – an autoimmune disorder in which immune cells attack and destroy the exocrine glands that produce tears and saliva. 20 AUTOIMMUNE DISEASES CONTINUED DISEASES SUSPECTED TO BE LINKED TO AUTOIMMUNITY ARE: Scleroderma – a chronic disease characterized by excessive deposits of collagen. Progressive systemic scleroderma, the serious type of the disease, can be fatal. The local type of the disease is not serious. Alopecia Universalis – a suspected autoimmune disease in which the body’s white blood cells attack hair and result in total baldness. Ulcerative Colitis – an inflammatory disease of the bowel that usually affects the distal end of the large intestine and rectum. It has no known cause, although there is a genetic component to susceptibility. Some medical authorities (such as the UK’s National Blood Donation Service which refuses donations from Colitis sufferers) class Colitis as an Autoimmune disease. Behçet’s Disease – exact cause is unknown in this multi-system condition, where the immune system, predominantly overactive, produces inflammation in bodily tissues, primarily causing vasculitis Chagas’ Disease – in the chronic phase is believed to result from homology of a T. Cruzi antigen to body tissue, resulting in a delayed autoimmune reaction leading to chagasic cardiopathy (cardiomegaly), volvulus or constipation, and ultimately death. Vitiligo – the spontaneous loss of pigment from areas of skin. The pigment-free areas have few or no melanocyte. Researchers have detected anti‑melanocyte antibodies in some cases of vitiligo, so it seems likely that at least some instances of this condition are the result of autoimmune problems. Chronic Fatigue Syndrome – a disorder whose primary symptom is usually intense fatigue. Though the syndrome likely has multiple causes, some maintain that autoimmune damage to the brain stem is the principal mechanism in a significant subset of cases. Vulvodynia – used to describe pain in the vulva, often severe, of unknown cause. “Vulvar vestibulitis” is a related term. Dysautonomia – a malfunction of the autonomic nervous system, including such disorders as postural orthostatic tachycardia syndrome (POTS). Though dysautonomia appears to have multiple causes, post-viral autoimmune damage appears to be a frequent cause. Endometriosis – a common medical condition wherein the tissue lining the uterus (endometrium) is found outside of the uterus, typically affecting other organs in the pelvis. The condition can lead to serious health problems, primarily pain and infertility. Hidradenitis Suppurativa – a rare skin disease in which apocrine sweat glands become severely inflamed. Researches have found an improvement in case studies with Remicade and other biologics. Interstitial Cystitis – a urinary bladder disease characterized by any of the following symptoms, though symptoms vary greatly from patient to patient: pelvic pain, urinary frequency (as often as every 30 minutes, or even fewer), urgency, pain with sexual intercourse, and pain with urination. Neuromyotonia – spontaneous muscular activity resulting from repetitive motor unit action potentials of peripheral origin. It develops as a result of both acquired and hereditary diseases. The acquired form is more frequent and is usually caused by antibodies against neuromuscular junction. Psoriasis – A skin disorder in which rapidly-multiplying skin cells produce itchy, scaly inflamed patches on the skin. Sarcoidosis – a disease wherein granulomas can form anywhere in the body but particularly in the lungs. 21 PREMALIGNANT CONDITIONS AND CANCER DRUGS A premalignant condition is a disease, syndrome, or finding that, if left untreated, may lead to cancer. A premalignant or precancerous lesion is an abnormality in a tissue area, which is just a step away from cancer. Not all premalignant lesions change to cancer, but most have greater potential for doing so than normal tissues. There are many varieties of premalignant conditions and/or lesions, some of which are listed below: PREMALIGNANT CONDITIONS ANTI-NEOPLASTICS (CANCER DRUGS) AIDS Alkeran® Tablet Actinic or solar keratosis Arimidex® Tablet Atypical cell Aromasin® Tablet Atypical hyperplasia Casodex® Tablet Atypical meningioma Ceenu® Capsule Atypical regeneration Cytoxan® Tablet Barrett’s esophagus Droxia® Capsule Bowen’s disease Emcyt® Capsule Chemical and other keratoses Fareston® Tablet Colon Adenoma Femara® Tablet Condylomata Acuminatum Gleevec® Tablet, Capsule Cutaneous horn Hexalen® Capsule Dysplasia Leukeran® Tablet Dysplasia Lysodren® Tablet Gastric Polyp Matulane® Capsule Inflammatory atypia Mesnex® Tablet In situ cancer Myleran® Tablet Keratoacanthoma Nolvadex® Tablet Leukoplakia Purinethol® Tablet Myelodysplasia Tarceva® Tablet Paget’s Disease of Bone Temodar® Capsule Papillary transitional cell carcinoma in situ Thioguanine® Tablet Premalignant Vesanoid® Capsule Preneoplastic state Xeloda® Tablet Radiation dermatitis Cyclophosphamide Tablet (Cytoxan®) Refractory Anemia with Excess Blasts Etoposide Capsule (Toposar®, Vepesid®) Squamous dysplasia of the uterine cervix (cervical dysplasia) Flutamide Capsule (Eulexin®) Tubular adenoma of colon (colon adenoma) Hydroxyurea Capsule (Hydrea®) Ulcerative colitis Leucovorin Tablet (Wellcovorin®) Megestrol Tablet, Syrup (Megace®) Tamoxifen Tablet (Nolvadex®) 22 PREMALIGNANT LESIONS Erythroplasia of Queyrat – a dark red, velvety, flat or slightly raised hard patch on the glans penis (the bulbous tip of the penis) or on the inner side of the prepuce (the retractile top skin of the penis). It may at times produce a discharge and become painful. 1. A premalignant or precancerous lesion is an abnormality in a tissue area which is just a step away form cancer. 2. Not all premalignant lesions change to cancer, but most have greater potential for doing so than normal tissues. 3. There are many varieties of premalignant lesions, but the most important one, especially for the Indian populace, is leukoplakia Other Premalignant Terms: 1. Squamous Dysplasia Of The Uterine Cervix (Cervical Dysplasia) 2. Tubular Adenoma Of Colon (Colon Adenoma) 3. Barrett’s Esophagus 4. Actinic Keratosis 5. Ulcerative Colitis Other premalignant lesions, although important in their own way, are not so dominating as leukoplakia. SOME PRECANCEROUS LESIONS: Acquired Small Or Microscopic Precancers 1. HGSIL (High Grade Squamous Intraepithelial Lesion Of Uterine Cervix) 2. AIN (Anal Intraepithelial Neoplasia) 3. Dysplasia Of Vocal Cord 4. Aberrant Crypts (Of Colon) 5. PIN (Prostatic Intraepithelial Neoplasia) Actinic or Solar Keratosis – These are common asymptotic lesions seen mostly on sun exposed areas of light skinned people. They are especially seen in those who ‘burn’ easily or tan poorly. Commonly seen on the back of the hands, the face, upper chest, upper back and lower lip. Chemical and other Keratoses – Skin lesions caused by exposure to arsenic, tar, polycyclic hydrocarbons, infrared radiation for a prolonged period at the work place (thermal keratosis) and scar keratosis, when a long standing scar develops a malignant potential. Acquired Large Lesions with Nuclear Atypia 1. Tubular Adenoma 2. AILD (Angioimmunoblastic Lymphadenopathy with Dysproteinemia) 3. Atypical Meningioma 4. Gastric Polyp 5. Large Plaque Parapsoriasis 6. Myelodysplasia 7. Papillary Transitional Cell Carcinoma In Situ 8. Refractory Anemia With Excess Blasts 9. Schneiderian Papilloma Large Cell Acanthoma – Usually single, but maybe multiple as well, usually on sun exposed skin in fair people. Rare. Chondrodermatitis Nodular Helicis – Usually seen in elderly people; they are tender, inflamed, scaly, reddish, slightly raised lesions. Cutaneous Horn – A hard, raised nodule with a reddish base, usually seen in sun exposed areas in pale persons. Precursor Lesions – Occurring with inherited hyperplastic syndromes that progress to cancer 1. Atypical Mole Syndrome 2. C Cell Adenomatosis 3. MEA Radiation Dermatitis – Skin damage due to exposure to X–rays or other sources of radiation, either occupational or accidental or due to treatment by radiotherapy. The skin is dry, scaly, reddish, thin and discolored. Bowen’s Disease – This is actually a cancer located totally within the top layer of the skin called the epidermis, and favors the sun exposed areas of the face, neck and extremities. Acquired Diffuse Hyperplasias and Diffuse Metaplasias 1. AIDS 2. Atypical Lymphoid Hyperplasia 3. Paget’s Disease Of Bone 4. Post-transplant Lymphoproliferative Disease 5. Ulcerative Colitis Sebaceous Naevi – They are present at birth or appear soon afterward, usually on the scalp. Super Class and Modifiers 1. Atypia 2. Atypical Cell 3. Atypical Hyperplasia 4. Atypical Regeneration 5. Dysplasia 6. Dysplastic 7. In Situ Cancer 8. Inflammatory Atypia 9. Mild Dysplasia 10. Premalignant 11. Preneoplastic State Parakeratosis – Describes a wide variety of skin disorders. Fibroepithelioma of Pinkus – Appear as flesh colored skin tags hanging from the back. Keratoacanthoma – A rapidly growing, red, raised lesion on the sun exposed areas of middle aged and elderly people. Condylomata Acuminatum – A virus induced lesion in the genitals, which appears as sharp pointed red, small finger like projections, either stuck at the base or suspended by a stalk. Buschke – Lowenstein’s tumor – a giant variety of condylomata acuminatum. 23 PERIPHERAL VASCULAR DISORDERS (PVD) Peripheral Vascular Disease – (PVD) Also known as Peripheral Arterial Disease (PAD) or Arteriosclerosis Obliterans is primarily the result of atherosclerosis. The atheroma consists of a core of cholesterol joined to proteins with a fibrous intravascular covering. The atherosclerotic process gradually may progress to complete occlusion of medium and large arteries. The disease typically is segmental, with significant variations from patient to patient. ALSO CALLED: COMMON DRUGS FOR PVD: Peripheral Arterial Disease (PAD) Abciximab-Injection Peripheral Artery Occlusive Disease Reopro Intermittent Claudication Cerivastatin Arteriosclerosis Obliterans Baycol Occlusive Arterial Disease Colesevelam Arterial Occlusion Welchol Peripheral Arterial Occlusion Cyclandelate-Oral Thromboangiitis Obliterans Cyclospasmol Vasospastic (Raynauld’s Phenomonon and Disease, Acrocyanosis) Ezetimibe and Simvastatin Vasodilatory (Erythromelalgia) Pentoxifylline Vytorin Trental Ticlopidine Ticlid Warfarin Coumadin What is Warfarin? – Warfarin is an anticoagulant (blood thinner). Warfarin reduces the formation of blood clots, which is important in the prevention of heart attacks, strokes, and blockage of major veins and arteries. Warfarin may also be used for purposes other than those listed here. Intermittent Claudication – Pain while walking that abates during rest is the most common symptom. Other symptoms include numbness or weakness in the legs, aching pain in the feet or toes while at rest, non-healing ulcers on the leg or foot, cold legs or feet and skin color changes of the legs or feet (particularly dependent redness). Some patients, however, are asymptomatic. 24