ABSTRACT
To study the frame of reference within which marriage counselling is generally practiced is also to define the conditions in which it is applicable as well as the methods to be used and their limitations. The history of marriage counselling, its "object" (the marriage relationship), its theoretical bases and its specific interest in interpersonal relationship disorders rather than individual pathology will be discussed. At the intersection between the personal and the interpersonal, couples and their problems confront us with some basic questions which require clarification as to the meaning and impact of our activity.
Subject(s)
Counseling , Interpersonal Relations , Marriage , Communication , Female , Humans , Male , Sexual Dysfunction, Physiological/therapySubject(s)
Physician-Patient Relations , Time , Adolescent , Adult , Aged , Child , Child, Preschool , Family Practice , Female , Humans , Infant , Male , Middle Aged , Periodicity , Practice Management, Medical , Time PerceptionABSTRACT
The urinary metabolites of methylphenidate in the dog and rat were investigated. After oral administration of 14C-labeled methylphenidate, approximately 86% and 63% of the dose was recovered in the urine of the dog and rat, respectively. Less than 1% of the dose was excreted as unchanged drug. Metabolism involved oxidation, hydrolysis, and conjugation processes. The primary hydrolytic product was alpha-phenyl-2-piperidineacetic acid (24%, dog; 35-40%, rat). The primary metabolites of oxidation were methyl 6-oxo-alpha-phenyl-2-piperidineacetate (3%, dog; 1.5%, rat) and the glucuronide of alpha-(p-hydroxyphenyl)-2-piperidineacetic acid (10%, rat). The former also underwent extensive biotransformation, including: 1) hydrolysis to the lactam acid (27%, dog; 7-10%, rat) and subsequent carboxylic acid O-glucuronidation (15%, dog); or 2) hydroxylation at the 5-position (1%, dog; 2%, rat) and subsequent hydrolysis (4%, dog; 15-17%, rat); or 3) 5-O-glucuronidation (12%, dog). Additional minor metabolites from methyl-6-oxo-alpha-phenyl-2-piperidineacetate were the phenolic O-glucuronide of methyl alpha-(p-hydroxyphenyl)-6-oxo-2-piperidineacetate (1%, dog), and the 4-O-glucuronide of methyl 4-hydroxy-6-oxo-alpha-phenyl-2-piperidineacetate (1%, dog), and the taurine amide conjugate of alpha-(p-hydroxyphenyl)-6-oxo-2-piperidineacetic acid (1%, dog). Additional products from methylphenidate conjugation included methyl 1-carbamoyl-alpha-phenyl-2-piperidineacetate (1%, dog or rat) and its carboxylic acid hydrolysis product (1%, rat). The chirality of the major metabolites isolated from dog urine showed that metabolism was partially stereoselective in all investigated cases, except in the formation of alpha-phenyl-2-piperidineacetic acid.
