Analgesics during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
Phenylbutazone is an NSAID with analgesic, antipyretic, and anti-inflammatory actions commonly used to treat women with arthritic conditions (rheumatoid arthritis, degenerative joint disease). No scientific studies are published regarding the safety or efficacy of this medication in pregnant women. Unpublished data had 27 infants who were exposed to phenylbutazone during the first trimester, and two major birth defects were found (Rosa, personal communication, cited in Briggs et al., 2017). Some prostaglandin synthetase inhibitors are associated with premature closure of the ductus arteriosus in the newborn (Csaba et al., 1978; Levin et al., 1978). Theoretically, phenylbutazone may be associated with premature closure of ductus arteriosus because of known pharmacologic activity of the drug, and known effects of that pharmacologic effect. No reports of this association have been published to date.
The Diagnosis and Management of Lipoprotein Disorders
Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu in Medical Management of Diabetes Mellitus, 2000
Cholestyramine and colestipol are anion-exchange resins that bind bile acids, increase conversion of liver cholesterol to bile acids, and up-regulate LDL receptors in liver. This results in an increase in LDL catabolism, and a decrease in plasma LDL cholesterol by about 20%. Side effects include bloating and constipation, elevation of triglycerides, and interference with the absorption of digoxin, tetracycline, thyroxine, phenylbutazone, and warfarin (Coumadin) (give drugs 1 h before or 4 h after resin). Cholestyramine (4 g packets or scoops) or colestipol (5 g scoops) treatment can be started at one scoop or packet twice per day and gradually increased to two scoops twice per day (die scoops are half the price of the packets) or two scoops three times daily. Colestipol is available in 1-g tablet form as well, and a standard dosage is four to eight tablets twice daily. Constipation may require treatment. Cholestyramine (6 scoops/day) lowered LDL cholesterol by 12.5% and reduced CHD risk prospectively by 19% over 7 years in middle-aged, asymptomatic, hypercholesterolemic men in the large (n = 3806) prospective, randomized, placebo-controlled Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT; 22,23). Total mortality was reduced by 6%, angina by 20%, and need for bypass by 21%. Most subjects receiving the active medication took far less than the dose prescribed. The resins are now second-line drugs.
A
Anton Sebastian in A Dictionary of the History of Medicine, 2018
Anti-Inflammatory DrugsSalix alba, the white willow, the source of salicylic acid was a folk remedy for fever and rheumatism for centuries. Its anti-inflammatory properties were demonstrated by Franz Striker of Germany in 1875. Acetanilide followed in 1875 and phenacetin was introduced in 1886. Use of salicylates in acute rheumatism was shown by Peter W. Latham, who wrote On the Administration of Salicylates in Acute Rheumatism in 1895. Phenylbutazone was introduced for rheumatoid arthritis by J.P Currie, R.A.Brown and G.Will in 1953.The mechanism of anti-inflammatory action of aspirin and similar drugs through inhibition of prostaglandin formation was demonstrated by J.R.Vane and co-workers in 1970.
Recent updates in curcumin delivery
Published in Journal of Liposome Research, 2023
Mohammad A. Obeid, Manal Alsaadi, Alaa A. Aljabali
Since curcumin acts as an inflammatory mediator, several publications and clinical trials have investigated the potential use of curcumin in the treatment of arthritis, which is a chronic disease characterised by dysregulation of inflammatory cytokines such as interleukin (IL)-1, IL-6, and tumor necrosis factor (TNF), in addition to many chemokines and inflammatory enzymes. This will result in severe joint inflammation resulting from that with the subsequent joint damage and disability (Salehi et al. 2019). In this regard, the clinical study of the curcumin-treated done by Deodhar et al. showed comparable results between the group receiving curcumin with the group receiving the non-steroidal anti-inflammatory agent phenylbutazone regarding the disease signs and symptoms such as the morning stiffness and joint swelling (Dcodhar et al. 2013). In another study, diclofenac sodium was reported to have better anti-inflammatory effects when administered to patients with rheumatoid arthritis in combination with curcumin, and the group that received this combination showed better improvement in disease scores such as the American College of Rheumatology (ACR) score and the Disease Activity Score (DAS) compared to the groups that received either drugs alone (Chandran and Goel 2012).
Repeated dose of meloxicam induces genotoxicity and histopathological changes in cardiac tissue of mice
Published in Drug and Chemical Toxicology, 2022
Juliana Cyrillo Guimarães da Silva, Eliane Dallegrave, Gabriela Zimmermann Prado Rodrigues, Cassiana Bigolin, Taís Morgana Schoffen de Oliveira Neumann, Andriéli Carolina Schuster, Juliana Machado Kayser, Luciane Beatris Mentges Staudt, Melina Floriano Moraes, Débora Graziela Farias, Gabriela Schiling, Juliana Raquel Raasch, Magda Susana Perassolo, Luciano Basso da Silva, Günther Gehlen, Andresa Heemann Betti
Whereas that NSAIDs are drugs used for pathological conditions that often require long-term administration, these drugs may also cause genotoxic and carcinogenic effects (Ahmad et al.2018). Studies on the genotoxic potential of NSAIDs are limited; however, Tardieu et al. (2000) reported that nimesulide induced a significant increase in chromosome aberrations in vivo and in bone marrow cells. Recently, Ahmad et al. (2018) reported that naproxen induced the increase of micronucleus formation and DNA damage in Wistar rat cells. Abdel-Daim et al. (2018) also reported the effect of diclofenac sodium on potentiating tulathromycin-induced cardiotoxicity. In addition, a review study classified some NSAIDs as carcinogenic (phenazopyridine and phenylbutazone) and genotoxic (auranofin, dipyrone, ethenadamid, indomethacin, paracetamol and phenylbutazone) (Brambilla and Martelli 2009); and Arantes-Rodrigues et al. (2013) verified an increase in DNA damage on bladder-cancer cell lines treated with meloxicam (600 µM).
Risk characterisation of constituents present in jamu to promote its safe use
Published in Critical Reviews in Toxicology, 2021
Suparmi Suparmi, Dasep Wahidin, Ivonne M. C. M. Rietjens
For the case studies for which quantitative data were available, Figure 1 depicts the percentage of deviation (Δ) between the EDI of the API resulting from use of the jamu samples as compared to an existing RD. In general, it is noted that the EDI of NSAIDs, phenylbutazone, piroxicam, and paracetamol resulting from jamu consumption is lower than the RD for their pharmacological activity. Illegal presence of methampyrone, mefenamic acid, and prednisone in jamu is a public health issue because the EDIs of these API constituents were above their RDs, so that occurrence of a pharmaceutical effect cannot be excluded. Especially, the data for prednisone raise a concern given that the Δ value of 131955.6% indicates that the EDI exceeds the RD 1320.6-fold. The data presented in Figure 1 indicate that at the current levels at which APIs were detected in jamu the adulteration of sibutramine hydrochloride in slimming jamu and sildenafil citrate in jamu for erectile dysfunction are also unlikely to result in pharmacological effects. The use of antidiabetic jamu containing glibenclamide as recommended is not expected to produce toxic effects.
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