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Nutritional and Dietary Supplementation during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Ulcerative colitis, a chronic disease of unknown etiology, is associated with two life-threatening conditions: fulminant disease and adenocarcinoma of the colon. Ulcerative colitis therapy includes sulfasalazine (Azulfidine), glucocorticoids, azathioprine, and mercaptopurine. Sulfasalazine is comprised of sulfapyridine and aminosalicylic acid, and usually used for mild or moderate disease (Hanauer, 1996). Sulfapyridine, a sulfanilamide, crosses the placenta (Azad and Truelove, 1979) and theoretically could cause hyperbilirubinemia or kernicterus. However, no published cases of these theoretical complications are available. According to sulfapyridine’s package insert, usual initial treatment dose is 0.5–1 g orally q.i.d. for active disease; for asymptomatic maintenance, doses are usually lower.
Immunosuppressants, rheumatic and gastrointestinal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
The toxicity of sulfazalazine is much higher than with other 5-ASA preparations and adverse reactions are seen in 20 to 25% of patients. Most of the adverse reactions are due to the sulfapyridine component. They are dose related (digestive symptoms, headache, haemolysis), reflecting the acetylator status or due to an hypersensitivity (fever, exanthems, pulmonary fibrosis, hepatotoxicity and rarely agranulocytosis). Ninety percent of patients intolerant or allergic to sulfazalazine will usually tolerate other 5-ASA preparations [5].
Blistering diseases in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
Subcorneal pustular dermatosis (SCPD), also known as Sneddon–Wilkinson syndrome, is a benign bullous disease which affects four times as many women as men78. The lesions present as crops of sterile pustular eruptions in an annular pattern that have a serpiginous outline. These lesions are most commonly seen in the cornea, groin, axillary and inframammary areas, and extensor aspects of upper and lower limbs78. On histology, subcorneal bullae are seen with an inflammatory infiltrate made mainly of neutrophils. SCPD is treated systemically with dapsone at 50–150 mg daily. Sulfapyridine and high dose systemic corticosteroids can be used as an alternative. The disease runs a chronic recurrent course lasting up to eight years78.
Effect of capsaicin on breast cancer resistance protein (BCRP/Abcg2) and pharmacokinetics of probe substrates in rats
Published in Xenobiotica, 2022
Fen Chen, Liu Wang, Xuejia Zhai, Nanxi Wang, Yanjie Qin, Chaoran Zhu, Sanlan Wu, Yongning Lu
Sulfasalazine is indicated for patients with rheumatoid arthritis who have not responded adequately with salicylates or other non-steroidal anti-inflammatory drugs (Choi and Fenando 2021). The toxicity of sulphapyridine, a metabolite of sulfasalazine, which is responsible for its side effects in nearly 30% of patients, and the sulfasalazine-induced inhibition of the reduced folate carrier at clinically relevant plasma concentrations (Jelicic et al. 2021). This inhibition leads to a folate deficiency in patients, which increases the chances of developing colorectal cancer and megaloblastic anaemia, as well as defects in newborns (Jelicic et al. 2021). To reduce the side effects, we should focus on the change of plasma concentration of sulfasalazine when it is used. Considering the frequent consumption of CAP and its current therapeutic application, it is necessary to study the effect of CAP on sulfasalazine.
Role of oxidative stress in pathophysiology of rheumatoid arthritis: insights into NRF2-KEAP1 signalling
Published in Autoimmunity, 2021
Gurjasmine Kaur, Aman Sharma, Archana Bhatnagar
Molecular hydrogen appeared to be a promising therapeutic candidate for diseases associated with ROS due to its ability to detoxify hydroxyl radicals, without the formation of other radicals [64]. Sulfasalazine, a prodrug composed of a molecule of 5-aminosalicylic acid and sulfapyridine, is an extensively used disease-modifying anti-rheumatic drug (DMARD), also exhibits ROS scavenging property [65]. Besides, Manganese ferrite and ceria nanoparticle-anchored mesoporous silica nanoparticles simultaneously generate O2 and scavenge ROS, and subsequently drive inflammatory macrophages to the anti-inflammatory subtype [66]. Natural phytochemicals including phenols (tocopherols, tocotrienols, resveratrol) act as chain-breaking antioxidants while carotenoids (β-cryptoxanthin, xanthines, lycopenes) act as scavengers of singlet oxygen and peroxynitrite.
Treatment and outcome of ulcerative colitis during the first 10 years after diagnosis in a prospectively followed population-based cohort
Published in Scandinavian Journal of Gastroenterology, 2021
Anders Rönnblom, Urban Karlbom
Sulfasalazine has been the corner stone in the long time treatment of UC since its invention in the early forties [5], and the substance was further developed in to mesalazine (5-ASA)whereby the side effects related to sulfapyridine could be avoided [6]. During the sixties, observations were presented that IMM could be a new group of drugs for the treatment of UC [7,8]. It has been shown that azathioprine is significantly more effective than 5-ASA at achieving remission in steroid-dependent UC [9] and it was early demonstrated in a withdrawal study that patients in remission on a combination therapy with 5-ASA and azathioprine suffered significantly more often a relapse in case of withdrawal of azathioprine [10]. The effects of infliximab for the treatment of UC was demonstrated in the ACT 1 and ACT 2 trials [11] but also in the treatment of acute severe UC [12]. Furthermore, to combine azathioprine and infliximab has been shown to be more effective in order to achieve steroid free remission than the drugs individually [13].