1 Pharmacokinetic and Duration Of

Total Page:16

File Type:pdf, Size:1020Kb

1 Pharmacokinetic and Duration Of PHARMACOKINETIC AND DURATION OF CYCLOOXYGENASE INHIBITION STUDIES OF PHENYLBUTAZONE, KETOPROFEN AND FLUNIXIN MEGLUMINE IN ATHLETIC THOROUGHBRED HORSES By JENNIFER NOELLE HATZEL A THESIS PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE UNIVERSITY OF FLORIDA 2011 1 © 2011 Jennifer Noelle Hatzel 2 To the horses, without which, none of this would be possible 3 ACKNOWLEDGMENTS I thank my committee members: Dr. Patrick Colahan, for the initial concept and subsequent support through the Racing Medication Testing Consortium (RMTC) for completion of these studies, Dr. Alison Morton for her constant encouragement and Dr. Tom Vickroy for his thoughts and ideas, always in the nick of time. I thank Dr. David Hurley and Natalie Norton from the University of Georgia for their patient guidance in assisting me with learning to perform the assays. I thank Dr. Richard Sams for bestowing me with a very basic knowledge of pharmacokinetics and Marc Rumpler for his unwavering support and mentorship through every aspect of this process. I thank Dan Neal, from the department of biostatistics for not only teaching me the basics, but also assisting me when I was way over my head. This project would have never been possible without the help of the entire staff of the University of Florida Equine Performance Laboratory: Brett Rice, Allie Hreha, Amber Davidson and Megan Davidson, for whom I am very grateful. Finally, I owe a great deal of support and encouragement from Jeremiah, always. 4 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 4 LIST OF TABLES ............................................................................................................ 8 LIST OF FIGURES .......................................................................................................... 9 LIST OF EQUATIONS ................................................................................................... 10 LIST OF ABBREVIATIONS ........................................................................................... 11 ABSTRACT ................................................................................................................... 12 CHAPTER 1 INTRODUCTION .................................................................................................... 15 The Eicosanoids ..................................................................................................... 15 History .............................................................................................................. 15 The Inflammatory Cascade .............................................................................. 16 Pharmaceutical Intervention ................................................................................... 19 The History and Mechanism of NSAIDs ........................................................... 19 Adverse Effects Affiliated with NSAID Administration ....................................... 22 Novel Classes of Selective NSAIDs ................................................................. 23 NSAID Use in Veterinary Medicine ......................................................................... 26 Equine NSAID Administration ........................................................................... 26 Drug Doping in the Performance Horse ........................................................... 29 Monitoring Drug Abuse ..................................................................................... 31 Summary and Objectives ........................................................................................ 37 2 THE PHARMACOKINETICS OF PHENYLBUTAZONE, KETOPROFEN AND FLUNIXIN MEGLUMINE FOLLOWING A SINGLE ADMINISTRATION ................. 41 Background ............................................................................................................. 41 Materials and Methods ............................................................................................ 42 Animals ............................................................................................................. 42 Standard Training Regimen for the University of Florida Equine Performance Lab ........................................................................................... 42 Incremental Exercise Test to Exhaustion ......................................................... 43 Standard Condition Test to Verify the Ability to Gallop One Mile in Two Minutes.......................................................................................................... 43 Drug Administration and Sample Collection ..................................................... 44 Drug Analysis .......................................................................................................... 44 Chemicals and Reagents ................................................................................. 44 Phenylbutazone ................................................................................................ 45 5 Sample preparation .................................................................................... 45 Instrumentation .......................................................................................... 46 Data analysis ............................................................................................. 47 Ketoprofen ........................................................................................................ 48 Sample preparation .................................................................................... 48 Instrumentation .......................................................................................... 49 Data analysis ............................................................................................. 50 Flunixin Meglumine .......................................................................................... 50 Sample preparation .................................................................................... 50 Instrumentation .......................................................................................... 51 Data analysis ............................................................................................. 53 Pharmacokinetic Modeling ............................................................................... 53 Results .................................................................................................................... 54 Phenylbutazone ................................................................................................ 54 Ketoprofen ........................................................................................................ 54 Flunixin Meglumine .......................................................................................... 55 Discussion .............................................................................................................. 55 3 THE DURATION OF CYCLOOXYGENASE INHIBITION FOR PHENYLBUTAZONE, KETOPROFEN AND FLUNIXIN MEGLUMINE FOLLOWING A SINGLE ADMINISTRATION ......................................................... 69 Background ............................................................................................................. 69 Materials and Methods ............................................................................................ 70 Animals ............................................................................................................. 70 Standard Training Regimen for the University of Florida Equine Performance Lab ........................................................................................... 71 Drug Administration and Sample Collection ..................................................... 71 Ex vivo COX-1 Assay ....................................................................................... 73 Ex vivo COX-2 Assay ....................................................................................... 73 Statistical Analysis ............................................................................................ 74 Results .................................................................................................................... 74 Ex vivo Inhibition of Phenylbutazone ................................................................ 74 Ex vivo Inhibition of Ketoprofen ........................................................................ 75 Discussion .............................................................................................................. 75 4 UTILIZING A BIOSTATISTICAL APPROACH TO MODEL COMPARISONS OF PHENYLBUTAZONE, KETOPROFEN, AND FLUNIXIN MEGLUMINE WITH SUPRESSED CONCENTRATIONS OF PGE2 AND TXB2 ..................................... 92 Background ............................................................................................................. 92 Materials and Methods ............................................................................................ 94 Animals ............................................................................................................. 94 Method of Analysis ........................................................................................... 94 Results .................................................................................................................... 95 Relating Phenylbutazone Concentrations to Prostaglandin (PGE) Concentrations
Recommended publications
  • Synthesis and Pharmacological Evaluation of Fenamate Analogues: 1,3,4-Oxadiazol-2-Ones and 1,3,4- Oxadiazole-2-Thiones
    Scientia Pharmaceutica (Sci. Pharm.) 71,331-356 (2003) O Osterreichische Apotheker-Verlagsgesellschaft m. b.H., Wien, Printed in Austria Synthesis and Pharmacological Evaluation of Fenamate Analogues: 1,3,4-Oxadiazol-2-ones and 1,3,4- Oxadiazole-2-thiones Aida A. ~l-~zzoun~'*,Yousreya A ~aklad',Herbert ~artsch~,~afaaA. 2aghary4, Waleed M. lbrahims, Mosaad S. ~oharned~. Pharmaceutical Sciences Dept. (Pharmaceutical Chemistry goup' and Pharmacology group2), National Research Center, Tahrir St. Dokki, Giza, Egypt. 3~nstitutflir Pharmazeutische Chemie, Pharrnazie Zentrum der Universitilt Wien. 4~harmaceuticalChemistry Dept. ,' Organic Chemistry Dept. , Helwan University , Faculty of Pharmacy, Ein Helwan Cairo, Egypt. Abstract A series of fenamate pyridyl or quinolinyl analogues of 1,3,4-oxadiazol-2-ones 5a-d and 6a-r, and 1,3,4-oxadiazole-2-thiones 5e-g and 6s-v, respectively, have been synthesized and evaluated for their analgesic (hot-plate) , antiinflammatory (carrageenin induced rat's paw edema) and ulcerogenic effects as well as plasma prostaglandin E2 (PGE2) level. The highest analgesic activity was achieved with compound 5a (0.5 ,0.6 ,0.7 mrnolkg b.wt.) in respect with mefenamic acid (0.4 mmollkg b.wt.). Compounds 6h, 61 and 5g showed 93, 88 and 84% inhibition, respectively on the carrageenan-induced rat's paw edema at dose level of O.lrnrnol/kg b.wt, compared with 58% inhibition of mefenamic acid (0.2mmoll kg b.wt.). Moreover, the highest inhibitory activity on plasma PGE2 level was displayed also with 6h, 61 and 5g (71, 70,68.5% respectively, 0.lmmolkg b.wt.) compared with indomethacin (60%, 0.01 mmolkg b.wt.) as a reference drug.
    [Show full text]
  • Comparative Study of the Efficacy of Flunixin, Ketoprofen and Phenylbutazone in Delman Horses with Mild Colic
    Sys Rev Pharm 2020; 11(5): 464 468 A multifaceted review journal in the field of pharmacy E-ISSN 0976-2779 P-ISSN 0975-8453 Comparative Study of the Efficacy of Flunixin, Ketoprofen and Phenylbutazone in Delman Horses with Mild Colic Agus Purnomo1, Arya Pradana Wicaksono2, Dodit Hendrawan2, Muhammad Thohawi Elziyad Purnama3* 1Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, Universitas Gadjah Mada, DI Yogyakarta, 55281, Indonesia 2Postgraduate Studies, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, 60115, Indonesia 3Department of Veterinary Anatomy, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, 60115, Indonesia *Corresponding author E-mail: [email protected] Article History: Submitted: 26.02.2020 Revised: 16.04.2020 Accepted: 21.05.2020 ABSTRACT This study aimed to evaluate the efficacy of flunixin, ketoprofen and multiple range test. The results showed a significant alleviation in all phenylbutazone on serum biochemistry, plasma catecholamines and observed variables on Day 13, although the use of various NSAIDs serum cortisol in Delman horses with mild colic. During the study showed no significant difference. period, 32 horses were evaluated due to mild colic. Flunixin, Keywords: serum biochemical, catecholamine, cortisol, colic, NSAIDs ketoprofen, and phenylbutazone were administered intravenously at Correspondence: the recommended dose rates of 1.0; 2.2 and 4.4 mg/kg, respectively. Muhammad Thohawi Elziyad Purnama Administration of the NSAIDs commenced on Day 1 and continued Department of Veterinary Anatomy, Faculty of Veterinary Medicine, every 12 h for 12 days. Blood samples collected between days 2, 5, 9 Universitas Airlangga, Surabaya, 60115, Indonesia and 13 to evaluate AST, ALP, GGT, creatinine, urea, epinephrine, E-mail: [email protected] norepinephrine, and cortisol level.
    [Show full text]
  • Non-Steroidal Anti-Inflammatory Drugs (Nsaids)
    NON-STEROIDAL ANTI-INFLAMMATORY DRUGS ANALYSIS IN MILK BY QUECHERS AND LC-MS: LOW AND HIGH RESOLUTION DETECTION AND CONFIRMATION APPROACHES A. Rúbies1, L. Guo2, I. Beguiristain1, F. Centrich1, M. Granados2 1. Laboratori Agència de Salut Pública de Barcelona, 2. Departament de Química Analítica - Universitat de Barcelona. * INTRODUCTION NON-STEROIDAL ANTI-INFLAMATORY DRUGS (NSAIDs) Non-steroidal anti-inflammatory drugs (NSAIDs) are used as anti-inflammatory, analgesic and OXICAMS ANTHRANILIC ACID DERIVATIVES ACETIC ACID antipyretic drugs in medicine and veterinary. Their action mechanism is based on the blocking of PROPIONIC ACID DERIVATIVES DERIVATIVES the biosynthesis of prostaglandins. NSAIDs are highly effective and extensively used, but they have some adverse side effects, such as hepatotoxicity, renal disorders or allergic reactions. In the European Union, to assure food safety and protect consumers, maximum residue limits have been established for some authorised NSAIDs in food products. Therefore, high throughput and reliable analytical methodology is required for the effective control of NSAIDs in food from animal Flufenamic acid origin. Liquid chromatography (LC) coupled to mass spectrometry (MS) is currently the technique of choice in confirmatory analysis of NSAIDs residues. We present a new method for the determination of representative NSAIDs in milk based on QuEChERS methodology, LC-MS/MS and UHPLC-HRMS. Meloxicam Ketoprofen Diclofenac EU Maximum Residue Limits (MRLs) Recommended NSAIDs concentrations for NSAIDs in milk.
    [Show full text]
  • United States Patent (19) 11 4,360,518 Rovee Et Al
    United States Patent (19) 11 4,360,518 Rovee et al. 45) Nov. 23, 1982 54 TOPICAL ANTI-INFLAMMATORY DRUG Primary Examiner-Stanley J. Friedman THERAPY . 57) ABSTRACT 75) Inventors: David T. Rovee, Bridgewater; John A pharmaceutical composition for topical treatment of R. Marvel; James A. Mezick, both of cutaneous disorders or disruptions characterized by East Brunswick, all of N.J. skin inflammation or hyperproliferative epidermal ac 73) Assignee: Johnson & Johnson, New Brunswick, tivity comprises the combination of a topically active N.J. anti-inflammatory corticosteroid and a non-steroidal 21 Appl. No.: 244,569 anti-inflammatory agent which is an inhibitor of prosta glandin synthetase selected from the group consisting of 22 Filed: Mar. 17, 1981 the hydratropic acid derivatives; acetylsalicylic acid; the pyrazolone derivatives; the fenamic acid deriva Related U.S. Application Data tives; the aroyl-substituted pyrroles and the substituted 60) Division of Ser. No. 64,311, Aug. 6, 1979, abandoned, arylacetohydroxamic acids in a pharmaceutically ac which is a division of Ser. No. 788,453, Apr. 20, 1977, ceptable topical vehicle. Treatment of above cutaneous Pat. No. 4,185, 100, which is a continuation-in-part of disorders may also be effected by concurrent therapy Ser. No. 685,942, May 13, 1976, abandoned. using separate applications of corticosteroid and non 51) Int. Cl. ...................... A61K 31/19; A61K 31/56 steroid. (52) U.S. Cl. ..................................... 424/240; 424/317 58) Field of Search ................................ 424/317, 240 18 Claims, No Drawings 4,360,518 1 2 Ziboh, V. A. and Snyder, D. S. 1974 Naturally occur TOPICAL ANTI-NFLAMMATORY ORUG ring and synthetic inhibitors of prostaglandin synthetase THERAPY of the skin.
    [Show full text]
  • Nonsteroidal Anti-Inflammatory Agents Differ in Their Ability to Suppress
    Oncogene (2004) 23, 9247–9258 & 2004 Nature Publishing Group All rights reserved 0950-9232/04 $30.00 www.nature.com/onc Nonsteroidal anti-inflammatory agents differ in their ability to suppress NF-jB activation, inhibition of expression of cyclooxygenase-2 and cyclin D1, and abrogation of tumor cell proliferation Yasunari Takada1, Anjana Bhardwaj1, Pravin Potdar1 and Bharat B Aggarwal*,1 1Cytokine Research Laboratory, Department of Experimental Therapeutics, The University of Texas M.D. Anderson Cancer Center, Box 143, 1515 Holcombe Boulevard, Houston, TX 77030, USA Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Introduction aspirin have been shown to suppress transcription factor NF-jB, which controls the expression of genes such as Owing to its analgesic and anti-inflammatory effects, cyclooxygenase (COX)-2 and cyclin D1, leading to aspirin (acetylsalicylic acid), first synthesized in 1897, inhibition of proliferation of tumor cells. There is no was approved for the treatment of rheumatoid arthritis systematic study as to how these drugs differ in their ability in 1899 (Botting, 1999). Since then several other to suppress NF-jB activation and NF-jB-regulated gene nonsteroidal anti-inflammatory drugs (NSAIDs) have expression or cell proliferation. In the present study, we been synthesized and approved for human use. The anti- investigated the effect of almost a dozen different commonly inflammatory and analgesic effects of NSAIDs have used NSAIDs on tumor necrosis factor (TNF)-induced NF- been shown to be due to their ability to inhibit the jB activation and NF-jB-regulated gene products, and on enzymatic activity of cyclooxygenases (COXs), which cell proliferation. Dexamethasone, an anti-inflammatory convert arachidonic acid to prostaglandins (PGs) (Vane, steroid, was included for comparison with NSAIDs.
    [Show full text]
  • Topical NSAID for Osteoarthritis Safe and Effective (Print)
    The Horse: Study: Topical NSAID for Osteoarthritis Safe and Effective (print) Study: Topical NSAID for Osteoarthritis Safe and Effective by: Stacey Oke, DVM, MSc February 26 2009 Article # 13686 Move over, Bute. In a new independent study, researchers at Colorado State University's Gail Holmes Equine Orthopaedic Research Center concluded that diclofenac liposomal cream (1% diclofenac sodium, trade name Surpass) is safer and more effective than phenylbutazone for treating discomfort associated with osteoarthritis in horses. Phenylbutazone, commonly known as "Bute," is a non-steroidal anti-inflammatory (NSAID) drug administered systemically (i.e., intravenously or orally) to help control the pain and inflammation caused by osteoarthritis in horses. "Considering that phenylbutazone and other NSAIDs are known to have important adverse effects in horses when used long-term and that these drugs are not able to alter the course of OA but only help control clinical signs, alternatives are needed," explained researcher David Frisbie, DVM, PhD, Dipl. ACVS. One such alternative is diclofenac liposomal cream--an NSAID that is applied to the skin overlying the affected joint(s) to control pain and inflammation of the tarsal, carpal, metacarpophalangeal, metatarsophalangeal and proximal interphalangeal joints. This product is approved by the Food and Drug Administration and is the first product of its kind manufactured for horses. Results of this study were presented at the 2007 annual American Association of Equine Practitioners' conference and were recently published in the study, "Evaluation of topically administered diclofenac liposomal cream for treatment of horses with experimentally induced osteoarthritis," in the February edition of the American Journal of Veterinary Research.
    [Show full text]
  • (12) United States Patent (10) Patent No.: US 6,221,377 B1 Meyer (45) Date of Patent: Apr
    USOO6221377B1 (12) United States Patent (10) Patent No.: US 6,221,377 B1 Meyer (45) Date of Patent: Apr. 24, 2001 (54) ADMINISTRATION MEDIA FOR (56) References Cited ANALGESIC, ANTI-INFLAMMATORY AND ANT-PYRETC DRUGS CONTAINING FOREIGN PATENT DOCUMENTS NITROUS OXDE AND PHARMACEUTICAL 2 277 264 10/1994 (GB). COMPOSITIONS CONTAINING SUCH MEDIA AND DRUGS OTHER PUBLICATIONS (75) Inventor: Petrus Johannes Meyer, Randburg Chemical ABstracts AN 1985:464783, Hertz et al., Jan. (ZA) 1985.* Chemical Abstracts AN 1978:44978, Berkowitz et al., Jan. (73) Assignee: Pitmy International N.V., Bonaire 1977.* (NL) International Publication No. WO93/25213, published Dec. 23, 1993. (*) Notice: Subject to any disclaimer, the term of this Mikrochim. Acta, vol. 2, No. 5-6, 1980 pp. 464–474, Stahl patent is extended or adjusted under 35 et al., Extraction of natural Substances using Supercritical U.S.C. 154(b) by 0 days. and liquified gases. (21) Appl. No.: 09/068,543 Reynolds J.E.F. et al., “Martindale', 1989, The Pharmaceu tical Press. (22) PCT Filed: Nov. 13, 1996 Science, vol. 194, No. 4268, 1976, pp. 967–968, Berkowitz (86) PCT No.: PCT/IB96/01366 et al., "Nitrous oxide “analgesia': resemblance to opiate action'. S371 Date: May 13, 1998 Steinegger et al., “Lehrbuch der Pharmakognosie und Phy S 102(e) Date: May 13, 1998 topharmazie', Edition 4, 1988. (87) PCT Pub. No.: WO97/17978 * cited by examiner PCT Pub. Date: May 22, 1997 Primary Examiner Jyothsna Venkat (30) Foreign Application Priority Data ASSistant Examiner-Grace Hsu (74) Attorney, Agent, or Firm-Arent Fox Kintner Plotkin Nov. 13, 1995 (ZA) ...................................................
    [Show full text]
  • List Item Frequently Asked Questions on Phenylbutazone in Horsemeat
    15 April 2013 Frequently asked questions on Phenylbutazone in horsemeat 1. What is phenylbutazone? 2. What is the situation regarding phenylbutazone in food in the EU? 3. Why was phenylbutazone banned for use in food-producing animals? 4. What are the known toxic effects of phenylbutazone? 5. What is the likelihood of consumers being exposed to phenylbutazone in horsemeat? 6. What were EFSA and EMA asked to do by the European Commission? 7. What information did EFSA and EMA consider in their risk assessment of phenylbutazone? 8. What are the main conclusions of the joint statement? 9. What did the report conclude with regard to the potential risk for consumers? 10. What recommendations did EFSA and EMA make to further reduce the risk of phenylbutazone entering the food chain? 11. What is EFSA’s role with regards to the management of issues such as the contamination of beef products with horsemeat? 12. What is EMA’s contribution to this joint risk assessment regarding the public health implications of phenylbutazone in horsemeat? 1. What is phenylbutazone? Phenylbutazone – sometimes also referred to as “bute” – is a substance that falls into the class of drugs known as non steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are routinely used as painkillers in human and veterinary medicine. Phenylbutazone was introduced in 1949 as a human medicine for the treatment of rheumatoid arthritis and gout. These days it is used only under specialist supervision in patients who suffer from a severe form of arthritis where other treatments have not worked. Phenylbutazone is used for the treatment of pain and fever in horses and dogs.
    [Show full text]
  • Original Paper Enhancement of Chemotherapeutic Drug Toxicity To
    European Journal of Cancer, Vol. 34, No. 8, pp. 1250±1259, 1998 # 1998 Elsevier Science Ltd. All rights reserved Pergamon Printed in Great Britain 0959-8049/98 $19.00+0.00 PII: S0959-8049(98)00045-8 Original Paper Enhancement of Chemotherapeutic Drug Toxicity to Human Tumour Cells In Vitro by a Subset of Non-steroidal Anti-in¯ammatory Drugs (NSAIDs) C.P. DuVy, C.J. Elliott, R.A. O'Connor, M.M. Heenan, S. Coyle, I.M. Cleary, K. Kavanagh, S. Verhaegen, C.M. O'Loughlin, R. NicAmhlaoibh and M. Clynes National Cell and Tissue Culture Centre, Dublin City University, Glasnevin, Dublin 9, Ireland The eVect on cytotoxicity of combining a range of clinically important non-steroidal anti-in¯amma- tory drugs (NSAIDs) with a variety of chemotherapeutic drugs was examined in the human lung cancer cell lines DLKP, A549, COR L23P and COR L23R and in a human leukaemia line HL60/ADR. A speci®c group of NSAIDs (indomethacin, sulindac, tolmetin, acemetacin, zomepirac and mefenamic acid) all at non-toxic levels, signi®cantly increased the cytotoxicity of the anthracyclines (doxorubicin, daunorubicin and epirubicin), as well as teniposide, VP-16 and vincristine, but not the other vinca alkaloids vinblastine and vinorelbine. Asubstantial number of other anticancer drugs, including methotrexate, 5-¯uorouracil, cytarabine, hydroxyurea, chlorambucil, cyclophosphamide, cisplatin, carboplatin, mitoxantrone, actinomycin D, bleomycin, paclitaxel and camptothecin, were also tested, but displayed no synergy in combination with the NSAIDs. The synergistic eVect was concentration dependent. The eVect appears to be independent of the cyclo-oxygenase inhibitory ability of the NSAIDs, as (i) the synergistic combination could not be reversed by the addition of prostaglandins D2 or E2; (ii) sulindac sulphone, a metabolite of sulindac that does not inhibit the cyclooxygenase enzyme, was positive in the combination assay: and (iii) many NSAIDs known to be cyclo-oxygenase inhibitors, e.g.
    [Show full text]
  • Objective Salicylate Propionic Acid Derivatives Acetic Acid
    Semester-IV Sub Name-medicinal chemistry-I (sub code-BP-402T) Objective Sodium salicylate, Aspirin, Mefenamic acid*, Meclofenamate, Indomethacin, Sulindac, Tolmetin, Zomepriac, Diclofenac, Ketorolac, Ibuprofen*, Naproxen, Piroxicam, Phenacetin, Acetaminophen, Antipyrine, Phenylbutazone. 1. INTRODUCTION A drug or substance that reduces inflammation (redness, swelling, and pain) in the body. Anti- inflammatory agents block certain substances in the body that cause inflammation. They are used to treat many different conditions. Some anti-inflammatory agents are being studied in the prevention and treatment of cancer. 1.1 CLASSIFICATION NSAIDs can be classified based on their chemical structure or mechanism of action. Older NSAIDs were known long before their mechanism of action was elucidated and were for this reason classified by chemical structure or origin. Newer substances are more often classified by mechanism of action. Salicylate • Aspirin (acetylsalicylic acid) • Diflunisal (Dolobid) • Salicylic acid and its salts Propionic acid derivatives • Ibuprofen • Dexibuprofen • Naproxen • Fenoprofen • Ketoprofen • Dexketoprofen Acetic acid derivatives • Indomethacin • Tolmetin • Sulindac • Ketorolac • Diclofenac • Aceclofenac • Nabumetone (drug itself is non-acidic but the active, principal metabolite has a carboxylic acid group) Enolic acid (oxicam) derivatives • Piroxicam • Meloxicam • Tenoxicam • Droxicam • Lornoxicam • Isoxicam (withdrawn from market 1985) • Phenylbutazone Anthranilic acid derivatives (fenamates) The following NSAIDs are
    [Show full text]
  • Non Steroidal Anti-Inflammatory Drugs
    Non Steroidal Anti‐inflammatory Drugs (NSAIDs) 4 signs of inflammation • Redness ‐ due to local vessel dilatation • Heat ‐ due to local vessel dilatation • Swelling – due to influx of plasma proteins and phagocytic cells into the tissue spaces • Pain – due to local release of enzymes and increased tissue pressure NSAIDs • Cause relief of pain ‐. analgesic • Suppress the signs and symptoms of inflammation. • Exert antipyretic action. • Useful in pain related to inflammation. Esp for superficial/integumental pain . Classification of NSAIDs • Salicylates: aspirin, Sodium salicylate & diflunisal. • Propionic acid derivatives: ibuprofen, ketoprofen, naproxen. • Aryl acetic acid derivatives: diclofenac, ketorolac • Indole derivatives: indomethacin, sulindac • Alkanones: Nabumetone. • Oxicams: piroxicam, tenoxicam Classification of NSAIDs ….. • Anthranilic acid derivatives (fenamates): mefenamic acid and flufenamic acid. • Pyrazolone derivatives: phenylbutazone, oxyphenbutazone, azapropazone (apazone) & dipyrone (novalgine). • Aniline derivatives (analgesic only): paracetamol. Clinical Classif. • Non selective Irreversible COX inhibitors • Non slective Reversible COX inhibitors • Preferential COX 2 inhibitors • 10‐20 fold cox 2 selective • meloxicam, etodolac, nabumetone • Selective COX 2 inhibitors • > 50 fold COX ‐2 selective • Celecoxib, Etoricoxib, Rofecoxib, Valdecoxib • COX 3 Inhibitor? PCM Cyclooxygenase‐1 (COX‐1): -constitutively expressed in wide variety of cells all over the body. -"housekeeping enzyme" -ex. gastric cytoprotection, hemostasis Cyclooxygenase‐2 (COX‐2): -inducible enzyme -dramatically up-regulated during inflammation (10-18X) -constitutive : maintains renal blood flow and renal electrolyte homeostasis Salicylates Acetyl salicylic acid (aspirin). Kinetics: • Well absorbed from the stomach, more from upper small intestine. • Distributed all over the body, 50‐80% bound to plasma protein (albumin). • Metabolized to acetic acid and salicylates (active metabolite). • Salicylate is conjugated with glucuronic acid and glycine. • Excreted by the kidney.
    [Show full text]
  • Indomethacin in Rheumatic Diseases a Controlled Clinical Trial By
    Ann Rheum Dis: first published as 10.1136/ard.23.3.218 on 1 May 1964. Downloaded from Ann. rheum. Dis. (1964), 23, 218. INDOMETHACIN IN RHEUMATIC DISEASES A CONTROLLED CLINICAL TRIAL BY J. WANKA, L. I. JONES, PHILIP H. N. WOOD,* AND ALLAN ST. J. DIXON From the Rheumatism Departments of St. Stephen's Hospital, St. Mary Abbots Hospital, and Hammersmith Hospital, London Indomethacin (l-(p-chlorbenzoyl)-5-methoxy-2- In trials of this drug on ourselves and in patients we methylindole-3-acetic acid) (Fig. 1) is a compound noticed that a disabling headache could sometimes which has been shown to have anti-inflammatory occur. and antipyretic action in experimental animals (I) THE DOUBLE-BLIND TRIAL (Hodgkinson, 1963). Enthusiastic but largely un- controlled studies of its action in rheumatoid 22 patients with definite rheumatoid arthritis arthritis and other disorders have been reported (see (A.R.A. criteria-Ropes, Bennett, Cobb, Jacox, and Proceedings of the American Rheumatism Associa- Jessar, 1957) with inflammation (as judged by heat, tion, 1963) and more recently reports of its thera- swelling, redness, and tenderness) of one or more peutic value have been published in Great Britain joints were admitted to the trial. They were (Hart and Boardman, 1963). This paper reports allocated at random to start treatment with either experiences with this drug over the last year in the placebo or indomethacin; fourteen patients (Cases 3, 4, 5, 8, 11, 12, 13, 14, 15, 16, 18, 19, 20, 21) started treatment of rheumatoid arthritis and other condi- copyright. tions. The study was conducted in three parts: on active tablets and eight (Cases 1, 2, 6, 7, 9, 10, 17, 22) on placebo therapy (Fig.
    [Show full text]