Flufenamic Acid
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Colitis Caused by Non-Steroidal Anti-Inflammatory Drugs
Postgrad Med J: first published as 10.1136/pgmj.62.730.773 on 1 August 1986. Downloaded from Postgraduate Medical Journal (1986) 62, 773-776 Colitis caused by non-steroidal anti-inflammatory drugs S. Ravi', A.C. Keat2 and E.C.B. Keat1 'Cuckfield Hospital, Cuckfield, West Sussex, and2Westminster Hospital, Horseferry Road, London SWIP2AP, UK. Summary: Four cases of acute proctocolitis associated with non-steroidal anti-inflammatory drug therapy are presented. The drugs implicated were flufenamic acid, mefenamic acid, naproxen and ibuprofen. After resolution of symptoms and signs of proctocolitis three of the four patients were subsequently rechallenged with the implicated drug: in each there was a rapid relapse. Introduction Ulcerative colitis is a disease of unknown aetiology Case reports with characteristic clinical features and a protracted course. A similar clinical picture, but running a shorter Case I and usually benign course, is occasionally seen follow- ing the administration of certain drugs. This was first A 77 year old woman was referred with intermittent noticed following the administration of antibiotics, bleeding per rectum for 6 months, associated for the often with pseudomembrane formation. Later, this last 2 months with bloody diarrhoea up to eight times was shown to be associated with infection by toxigenic daily. Previously, she had had troublesome symptoms Clostridium difficile. Until 1978, most cases were from osteoarthritis of her back and knees for which copyright. associated with treatment with clindamycin but since she had been prescribed flufenamic acid 200 mg thrice that time nearly all antibiotics have been implicated. daily. Her general health had remained good but she Other drugs capable of causing proctocolitis, though appeared pale and her haemoglobin was reduced to by different mechanisms, include phenindione (Keat & 8 g/dl. -
Table S1: Sensitivity, Specificity, PPV, NPV, and F1 Score of NLP Vs. ICD for Identification of Symptoms for (A) Biome Developm
Table S1: Sensitivity, specificity, PPV, NPV, and F1 score of NLP vs. ICD for identification of symptoms for (A) BioMe development cohort; (B) BioMe validation cohort; (C) MIMIC-III; (D) 1 year of notes from patients in BioMe calculated using manual chart review. A) Fatigue Nausea and/or vomiting Anxiety Depression NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.99 (0.93- 0.59 (0.43- <0.00 0.25 (0.12- <0.00 <0.00 0.54 (0.33- Sensitivity 0.99 (0.9 – 1) 0.98 (0.88 -1) 0.3 (0.15-0.5) 0.85 (0.65-96) 0.02 1) 0.73) 1 0.42) 1 1 0.73) 0.57 (0.29- 0.9 (0.68- Specificity 0.89 (0.4-1) 0.75 (0.19-1) 0.68 0.97 (0.77-1) 0.03 0.98 (0.83-1) 0.22 0.81 (0.53-0.9) 0.96 (0.79-1) 0.06 0.82) 0.99) 0.99 (0.92- 0.86 (0.71- 0.94 (0.79- 0.79 (0.59- PPV 0.96 (0.82-1) 0.3 0.95 (0.66-1) 0.02 0.95 (0.66-1) 0.16 0.93 (0.68-1) 0.12 1) 0.95) 0.99) 0.92) 0.13 (0.03- <0.00 0.49 (0.33- <0.00 0.66 (0.48- NPV 0.89 (0.4-1) 0.007 0.94 (0.63-1) 0.34 (0.2-0.51) 0.97 (0.81-1) 0.86 (0.6-0.95) 0.04 0.35) 1 0.65) 1 0.81) <0.00 <0.00 <0.00 F1 Score 0.99 0.83 0.88 0.57 0.95 0.63 0.82 0.79 0.002 1 1 1 Itching Cramp Pain NLP (95% ICD (95% CI) P NLP (95% CI) ICD (95% CI) P NLP (95% CI) ICD (95% CI) P CI) 0.98 (0.86- 0.24 (0.09- <0.00 0.09 (0.01- <0.00 0.52 (0.37- <0.00 Sensitivity 0.98 (0.85-1) 0.99 (0.93-1) 1) 0.45) 1 0.29) 1 0.66) 1 0.89 (0.72- 0.5 (0.37- Specificity 0.96 (0.8-1) 0.98 (0.86-1) 0.68 0.98 (0.88-1) 0.18 0.5 (0-1) 1 0.98) 0.66) 0.88 (0.69- PPV 0.96 (0.8-1) 0.8 (0.54-1) 0.32 0.8 (0.16-1) 0.22 0.99 (0.93-1) 0.98 (0.87-1) NA* 0.97) 0.98 (0.85- 0.57 (0.41- <0.00 0.58 (0.43- <0.00 NPV 0.98 (0.86-1) 0.5 (0-1) 0.02 (0-0.08) NA* 1) 0.72) 1 0.72) 1 <0.00 <0.00 <0.00 F1 Score 0.97 0.56 0.91 0.28 0.99 0.68 1 1 1 *Denotes 95% confidence intervals and P values that could not be calculated due to insufficient cells in 2x2 tables. -
Investigating the Influence of Polymers on Supersaturated
Page 1 of 45 Molecular Pharmaceutics 1 2 3 4 5 6 7 Investigating the Influence of Polymers on 8 9 10 11 12 Supersaturated Flufenamic Acid Cocrystal Solutions 13 14 15 16 1 1 2 2 1 17 Minshan Guo , Ke Wang , Noel Hamill , Keith Lorimer and Mingzhong Li * 18 19 20 1School of pharmacy, De Montfort University, Leicester, UK 21 22 23 2Almac Science, Seagoe Industrial Estate, Craigavon, UK 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ACS Paragon Plus Environment 1 Molecular Pharmaceutics Page 2 of 45 1 2 3 4 5 6 7 Table of contents graphic 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ACS Paragon Plus Environment 2 Page 3 of 45 Molecular Pharmaceutics 1 2 3 Abstract 4 5 6 7 The development of enabling formulations is a key stage when demonstrating the effectiveness 8 9 10 of pharmaceutical cocrystals to maximize the oral bioavailability for poorly water soluble drugs. 11 12 Inhibition of drug crystallization from a supersaturated cocrystal solution through a fundamental 13 14 understanding of the nucleation and crystal growth is important. In this study, the influence of 15 16 17 the three polymers of polyethylene glycol (PEG), polyvinylpyrrolidone (PVP) and a copolymer 18 19 of N-vinly-2-pyrrodidone (60%) and vinyl acetate (40%) (PVP-VA) on the flufenamic acid 20 21 22 (FFA) crystallization from three different supersaturated solutions of the pure FFA and two 23 24 cocrystals of FFA-NIC CO and FFA-TP CO has been investigated by measuring nucleation 25 26 induction times and desupersaturation rates in the presence and absence of seed crystals. -
Could Mycolactone Inspire New Potent Analgesics? Perspectives and Pitfalls
toxins Review Could Mycolactone Inspire New Potent Analgesics? Perspectives and Pitfalls 1 2 3, 4, , Marie-Line Reynaert , Denis Dupoiron , Edouard Yeramian y, Laurent Marsollier * y and 1, , Priscille Brodin * y 1 France Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR8204-CIIL-Center for Infection and Immunity of Lille, F-59000 Lille, France 2 Institut de Cancérologie de l’Ouest Paul Papin, 15 rue André Boquel-49055 Angers, France 3 Unité de Microbiologie Structurale, Institut Pasteur, CNRS, Univ. Paris, F-75015 Paris, France 4 Equipe ATIP AVENIR, CRCINA, INSERM, Univ. Nantes, Univ. Angers, 4 rue Larrey, F-49933 Angers, France * Correspondence: [email protected] (L.M.); [email protected] (P.B.) These three authors contribute equally to this work. y Received: 29 June 2019; Accepted: 3 September 2019; Published: 4 September 2019 Abstract: Pain currently represents the most common symptom for which medical attention is sought by patients. The available treatments have limited effectiveness and significant side-effects. In addition, most often, the duration of analgesia is short. Today, the handling of pain remains a major challenge. One promising alternative for the discovery of novel potent analgesics is to take inspiration from Mother Nature; in this context, the detailed investigation of the intriguing analgesia implemented in Buruli ulcer, an infectious disease caused by the bacterium Mycobacterium ulcerans and characterized by painless ulcerative lesions, seems particularly promising. More precisely, in this disease, the painless skin ulcers are caused by mycolactone, a polyketide lactone exotoxin. In fact, mycolactone exerts a wide range of effects on the host, besides being responsible for analgesia, as it has been shown notably to modulate the immune response or to provoke apoptosis. -
Epithelial Delamination Is Protective During Pharmaceutical-Induced Enteropathy
Epithelial delamination is protective during pharmaceutical-induced enteropathy Scott T. Espenschieda, Mark R. Cronana, Molly A. Mattya, Olaf Muellera, Matthew R. Redinbob,c,d, David M. Tobina,e,f, and John F. Rawlsa,e,1 aDepartment of Molecular Genetics and Microbiology, Duke University School of Medicine, Durham, NC 27710; bDepartment of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; cDepartment of Biochemistry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599; dDepartment of Microbiology and Immunology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599; eDepartment of Medicine, Duke University School of Medicine, Durham, NC 27710; and fDepartment of Immunology, Duke University School of Medicine, Durham, NC 27710 Edited by Dennis L. Kasper, Harvard Medical School, Boston, MA, and approved July 15, 2019 (received for review February 12, 2019) Intestinal epithelial cell (IEC) shedding is a fundamental response to in mediating intestinal responses to injury remains poorly un- intestinal damage, yet underlying mechanisms and functions have derstood for most xenobiotics. been difficult to define. Here we model chronic intestinal damage in Gastrointestinal pathology is common in people using phar- zebrafish larvae using the nonsteroidal antiinflammatory drug maceuticals, including nonsteroidal antiinflammatory drugs (NSAID) Glafenine. Glafenine induced the unfolded protein response (NSAIDs) (11). While gastric ulceration has historically been a (UPR) and inflammatory pathways in IECs, leading to delamination. defining clinical presentation of NSAID-induced enteropathy, Glafenine-induced inflammation was augmented by microbial colo- small intestinal pathology has also been observed, although the nizationandassociatedwithchanges in intestinal and environmental incidence may be underreported due to diagnostic limitations microbiotas. -
Non-Steroidal Anti-Inflammatory Drugs Inhibit Bone Healing: a Review S
Review Article © Schattauer 2010 385 Non-steroidal anti-inflammatory drugs inhibit bone healing: A review S. Barry Washington State University, Department of Veterinary Clinical Sciences, Veterinary Teaching Hospital, Pullman, Wash- ington, USA crine and autocrine activity, have since Keywords stems from prostaglandin inhibition and is been shown to regulate constitutive and in- Non-steroidal anti-inflammatory drugs, likely multifactorial. In human medicine ducible functions throughout the body, in- NSAID, bone healing NSAID are known to prevent heterotopic ossi- cluding bone healing (5–9). The mech- fication, however the clinical importance of anism of NSAID inhibition to bone healing Summary their effects on bone healing remains contro- is unknown, but is likely multifactorial. Re- The ability of non-steroidal anti-inflammatory versial. Although a small handful of reports searchers have suggested that NSAID affect drugs (NSAID) to inhibit bone healing has suggest that NSAID suppress bone healing in normal bone healing in multiple ways, with been established in experimental animal dogs and horses, there is little published infor- emphasis often (but not exclusively) placed models using mice, rats, and rabbits. The mation to direct veterinary practice in do- on processes related to the inflammatory mechanism of action is largely unknown but mestic species. stage. Deciphering the mechanism of NSAID inhibition requires an understanding of Correspondence to: Vet Comp Orthop Traumatol 2010; 23: 385–392 Sabrina Barry, DVM doi:10.3415/VCOT-10-01-0017 fracture healing. Fracture healing presents Washington State University Received: January 31, 2010 an exquisitely orchestrated series of coor- Department of Veterinary Clinical Sciences Accepted: June 23, 2010 dinated molecular and cellular events. -
Latest Administration Hour Prior to Competition Max Dosage Per Pound of Body Weight Medication Trade Name Medication Generic Name
MEDICATION MEDICATION MAX DOSAGE PER POUND LATEST ADMINISTRATION HOUR ADMINISTRATION METHOD GENERIC NAME TRADE NAME OF BODY WEIGHT PRIOR TO COMPETITION (single dose per 24 hours unless specified otherwise) Dexamethasone Azium® 2.0 mg/100Lb >12 hours IV, IM (20 mg/1000Lb) or 0.5 mg/100Lb >6 hours IV (5.0 mg/1000Lb) or 1.0 mg/100LB >6 hours Oral (10 mg/1000Lb) Diclofenac Surpass® 5 inch ribbon, 1⁄2 inch thick, >12 hours Topical, 2 doses each day 12 hours apart one site Firocoxib Equioxx® 0.1 mg/kg >12 hours Oral (0.0455 mg/Lb) (45.5 mg/1000Lb) Phenylbutazone (“bute”) * Butazolidin® 2.0 mg/Lb >12 hours Oral, IV (2.0 grams/1000Lb) or 1.0 mg/Lb AM & PM feed Oral, 2 doses each day, 12 hours apart (1.0 grams/1000Lb) Flunixin meglumine * Banamine® 0.5 mg/Lb >12 hours Oral, IV (500 mg/1000Lb) Ketoprofen Ketofen® 1.0 mg/Lb >4 hours, but IV (1.0 gram/1000Lb) >6 hours is recommended Meclofenamic acid Arquel® 0.5 mg/Lb Oral, 2 doses each day, 12 hours apart (500 mg/1000Lb) Naproxen Naprosyn® 4.0 mg/Lb >12 hours Oral (4.0 grams/1000Lb) Eltenac Not yet approved Telzenac® 0.25 mg/Lb (250 mg/1000Lb) 12 hours IV Methocarbamol Robaxin® 5.0 mg/Lb >6 hours Oral, IV, 2 doses each day, 12 hours apart (5.0 grams/1000Lb) * Do not administer phenylbutazone and flunixin at the same time (Unless used according to The maximum treatment time for any of the above permitted medication is five days, with the Section 8). -
Big Pain Assays Aren't a Big Pain with the Raptor Biphenyl LC Column
Featured Application: 231 Pain Management and Drugs of Abuse Compounds in under 10 Minutes by LC-MS/MS Big Pain Assays Aren’t a Big Pain with the Raptor Biphenyl LC Column • 231 compounds, 40+ isobars, 10 drug classes, 22 ESI- compounds in 10 minutes with 1 column. • A Raptor SPP LC column with time-tested Restek Biphenyl selectivity is the most versatile, multiclass-capable LC column available. • Achieve excellent separation of critical isobars with no tailing peaks. • Run fast and reliable high-throughput LC-MS/MS analyses with increased sensitivity using simple mobile phases. The use of pain management drugs is steadily increasing. As a result, hospital and reference labs are seeing an increase in patient samples that must be screened for a wide variety of pain management drugs to prevent drug abuse and to ensure patient safety and adherence to their medication regimen. Thera- peutic drug monitoring can be challenging due to the low cutoff levels, potential matrix interferences, and isobaric drug compounds. To address these chal- lenges, many drug testing facilities are turning to liquid chromatography coupled with mass spectrometry (LC-MS/MS) for its increased speed, sensitivity, and specificity. As shown in the analysis below, Restek’s Raptor Biphenyl column is ideal for developing successful LC-MS/MS pain medication screening methodologies. With its exceptionally high retention and unique selectivity, 231 multiclass drug compounds and metabolites—including over 40 isobars—can be analyzed in just 10 minutes. In addition, separate panels have been optimized on the Raptor Biphenyl column specifically for opioids, antianxiety drugs, barbiturates, NSAIDs and analgesics, antidepressants, antiepileptics, antipsychotics, hallucinogens, and stimulants for use during confirmation and quantitative analyses. -
Simultaneous Determination of Residues of Non-Steroidal Anti-Inflammatory Drugs and Glucocorticosteroids in Animal Muscle By
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector Food Anal. Methods (2016) 9:1837–1848 DOI 10.1007/s12161-015-0352-y Simultaneous Determination of Residues of Non-Steroidal Anti-Inflammatory Drugs and Glucocorticosteroids in Animal Muscle by Liquid Chromatography-Tandem Mass Spectrometry Piotr Jedziniak1 & Małgorzata Olejnik1 & Konrad Pietruk1 & Edyta Protasiuk1 & Teresa Szprengier-Juszkiewicz1 & Jan Żmudzki1 Received: 11 February 2015 /Accepted: 4 November 2015 /Published online: 21 November 2015 # The Author(s) 2015. This article is published with open access at Springerlink.com Abstract A method for the determination of a wide range Introduction residues of anti-inflammatory drugs (16 acidic non-steroidal anti-inflammatory drugs and four metamizole metabolites and Non-steroidal anti-inflammatory drugs (NSAIDs) and five corticosteroids) has been was developed. In the first step glucocorticosteroids (GCs) are widely used in veterinary medi- of sample preparation, acetate buffer was added to minced cine as well as in treatment of diseases in food-producing ani- muscle samples and 15-min ultrasound-assisted enzymatic mals. Despite its effectiveness, the important drawback of phar- hydrolysis was performed. Next, the samples were extracted macotherapy is drug residues in animal tissues. It became an twice with acetonitrile, freezed and analysed. The analytes important issue in the food safety. Potential toxicity of medicinal were separated on a C18 column with a 25-min gradient of veterinary products has to be evaluated before the drug registra- methanol/acetonitrile (8:2) and 0.05 M ammonium formate at tion. When necessary, maximum residue limits (MRLs) in food pH 5.0 and determined by liquid chromatography-tandem are established. -
Health Reports for Mutual Recognition of Medical Prescriptions: State of Play
The information and views set out in this report are those of the author(s) and do not necessarily reflect the official opinion of the European Union. Neither the European Union institutions and bodies nor any person acting on their behalf may be held responsible for the use which may be made of the information contained therein. Executive Agency for Health and Consumers Health Reports for Mutual Recognition of Medical Prescriptions: State of Play 24 January 2012 Final Report Health Reports for Mutual Recognition of Medical Prescriptions: State of Play Acknowledgements Matrix Insight Ltd would like to thank everyone who has contributed to this research. We are especially grateful to the following institutions for their support throughout the study: the Pharmaceutical Group of the European Union (PGEU) including their national member associations in Denmark, France, Germany, Greece, the Netherlands, Poland and the United Kingdom; the European Medical Association (EMANET); the Observatoire Social Européen (OSE); and The Netherlands Institute for Health Service Research (NIVEL). For questions about the report, please contact Dr Gabriele Birnberg ([email protected] ). Matrix Insight | 24 January 2012 2 Health Reports for Mutual Recognition of Medical Prescriptions: State of Play Executive Summary This study has been carried out in the context of Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross- border healthcare (CBHC). The CBHC Directive stipulates that the European Commission shall adopt measures to facilitate the recognition of prescriptions issued in another Member State (Article 11). At the time of submission of this report, the European Commission was preparing an impact assessment with regards to these measures, designed to help implement Article 11. -
Short Reports
Br Med J (Clin Res Ed): first published as 10.1136/bmj.287.6395.798 on 17 September 1983. Downloaded from 798 BRITISH MEDICAL JOURNAL VOLUME 287 17 SEPTEMBER 1983 SHORT REPORTS analgesic properties. The usual daily dosage is 400 mg. The amount Piroxicam poisoning of fentiazac absorbed after gastric lavage would probably be small and of little importance. Piroxicam is a potent non-steroidal anti-inflammatory drug. Ex- The main signs were altered consciousness and muscle twitchings. perience with overdosage is limited. We describe a patient who took The exact causes of these were unknown, but griseofulvin has been a large dose of piroxicam. associated with dizziness, mental confusion, irritability, and impaired coordination.2 Side effects of piroxicam have occasionally included headache and dizziness, although their incidences in double blind Case report comparative studies have been lower than those reported with indomethacin.3 Thus the drowsiness and muscle twitchings could not A 25 year old Chinese man weighing 46 kg was admitted to hospital be definitely attributed to piroxicam. about two hours after ingesting 56 capsules of 10 mg piroxicam, 97 tablets Gastrointestinal bleeding is usually the major side effect of most of 125 mg griseofulvin, and about 10 tablets of 100 mg fentiazac. He had been drugs. Piroxicam seemed to be well suffering from psoriatic arthropathy affecting both knee and ankle joints non-steroidal anti-inflammatory and had been taking piroxicam 30 mg daily for nine months. Other anal- tolerated since the patient did not complain of gastric discomfort or gesics, including aspirin, paracetamol, fentiazac, and indomethacin, had gastrointestinal bleeding despite a history of gastric erosions. -
NINDS Custom Collection II
ACACETIN ACEBUTOLOL HYDROCHLORIDE ACECLIDINE HYDROCHLORIDE ACEMETACIN ACETAMINOPHEN ACETAMINOSALOL ACETANILIDE ACETARSOL ACETAZOLAMIDE ACETOHYDROXAMIC ACID ACETRIAZOIC ACID ACETYL TYROSINE ETHYL ESTER ACETYLCARNITINE ACETYLCHOLINE ACETYLCYSTEINE ACETYLGLUCOSAMINE ACETYLGLUTAMIC ACID ACETYL-L-LEUCINE ACETYLPHENYLALANINE ACETYLSEROTONIN ACETYLTRYPTOPHAN ACEXAMIC ACID ACIVICIN ACLACINOMYCIN A1 ACONITINE ACRIFLAVINIUM HYDROCHLORIDE ACRISORCIN ACTINONIN ACYCLOVIR ADENOSINE PHOSPHATE ADENOSINE ADRENALINE BITARTRATE AESCULIN AJMALINE AKLAVINE HYDROCHLORIDE ALANYL-dl-LEUCINE ALANYL-dl-PHENYLALANINE ALAPROCLATE ALBENDAZOLE ALBUTEROL ALEXIDINE HYDROCHLORIDE ALLANTOIN ALLOPURINOL ALMOTRIPTAN ALOIN ALPRENOLOL ALTRETAMINE ALVERINE CITRATE AMANTADINE HYDROCHLORIDE AMBROXOL HYDROCHLORIDE AMCINONIDE AMIKACIN SULFATE AMILORIDE HYDROCHLORIDE 3-AMINOBENZAMIDE gamma-AMINOBUTYRIC ACID AMINOCAPROIC ACID N- (2-AMINOETHYL)-4-CHLOROBENZAMIDE (RO-16-6491) AMINOGLUTETHIMIDE AMINOHIPPURIC ACID AMINOHYDROXYBUTYRIC ACID AMINOLEVULINIC ACID HYDROCHLORIDE AMINOPHENAZONE 3-AMINOPROPANESULPHONIC ACID AMINOPYRIDINE 9-AMINO-1,2,3,4-TETRAHYDROACRIDINE HYDROCHLORIDE AMINOTHIAZOLE AMIODARONE HYDROCHLORIDE AMIPRILOSE AMITRIPTYLINE HYDROCHLORIDE AMLODIPINE BESYLATE AMODIAQUINE DIHYDROCHLORIDE AMOXEPINE AMOXICILLIN AMPICILLIN SODIUM AMPROLIUM AMRINONE AMYGDALIN ANABASAMINE HYDROCHLORIDE ANABASINE HYDROCHLORIDE ANCITABINE HYDROCHLORIDE ANDROSTERONE SODIUM SULFATE ANIRACETAM ANISINDIONE ANISODAMINE ANISOMYCIN ANTAZOLINE PHOSPHATE ANTHRALIN ANTIMYCIN A (A1 shown) ANTIPYRINE APHYLLIC