RESUMEN
We evaluated the potential hepatic toxicity of ibuprofen, aspirin, and oxaprozin in 1468 patients with rheumatoid arthritis and osteoarthritis by slightly modifying an algorithm that was developed to evaluate the drug relatedness of renal toxicity associated with therapeutic doses of these agents in the same population. Ibuprofen proved to be the safest of these nonsteroidal antiinflammatory drugs; it was associated with no AST elevation that was considered probably drug related as determined by application of the algorithm to laboratory values and information from case report forms. The frequency of probably drug-related AST elevations was highest (5%) with aspirin; with oxaprozin, an investigational nonsteroidal antiinflammatory drug, the incidence (3%) fell between that for the other two agents. Thus our findings on the hepatic safety of ibuprofen are consistent with those in the medical literature.
Asunto(s)
Aspirina/efectos adversos , Ibuprofeno/efectos adversos , Hígado/efectos de los fármacos , Alanina Transaminasa/sangre , Humanos , Oxaprozina , Propionatos/efectos adversosRESUMEN
Ciramadol, a new analgesic with mixed narcotic agonist-antagonist actions, was compared with codeine and placebo in a double-blind study in 343 patients with postoperative pain. The patients received a single oral dose of either 30 or 60 mg of ciramadol, 60 mg of codeine, or placebo. As indicated by three efficacy measures (verbal and visual analog pain scores and pain relief scores), the three active treatments were superior to placebo in relieving pain, and 30 and 60 mg of ciramadol generally were equivalent and superior, respectively, to 60 mg of codeine. The group who took 60 mg of ciramadol had a significantly (P less than .05) lower cumulative remedication frequency than that for the other three groups and the highest proportion of satisfactory evaluations by patients and physicians. There was no statistically significant difference in the incidence of side effects (4% to 11%) among the treatment groups. Demonstrated safety and efficacy suggest a role for ciramadol in the treatment of postoperative pain.
Asunto(s)
Aminas/uso terapéutico , Bencilaminas/uso terapéutico , Codeína/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Administración Oral , Adulto , Bencilaminas/administración & dosificación , Ensayos Clínicos como Asunto , Codeína/administración & dosificación , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Anithistamines that specifically block the gastric and secretory action of histamine have recently been developed. One of these H2-receptor blockers, metiamide, has been found to increase lower esophageal sphincter (LES) pressure in the opossum. Because of reported agranulocytosis with metiamide, another H2-receptor blocking agent, cimetidine, was developed. To determine its effect on LES pressure, 8 normal volunteers received placebo or oral doses of cimetidine (50, 100, 200, and 400 mg) in a random, blinded manner. Indicative of adequate absorption, significant serum levels were achieved with all doses of cimetidine (50 mg = 0.17 mug per ml; 100 mg = 0.33 mug per ml; 200 mg = 0.76 mug per ml; and 400 mg = 1.61 mug per ml). Although these serum levels have been found to produce marked inhibition of gastric acid secretion, no discernible effect was found on LES pressure when compared to placebo. Thus cimetidine does not increase LES pressure. It does not decrease sphincter pressure either and is therefore not contraindicated in patients with reflux esophagitis.
Asunto(s)
Unión Esofagogástrica/efectos de los fármacos , Antagonistas de los Receptores H2 de la Histamina/farmacología , Administración Oral , Adulto , Ensayos Clínicos como Asunto , Antagonistas de los Receptores H2 de la Histamina/administración & dosificación , Humanos , Masculino , Manometría , Placebos , PresiónRESUMEN
Human gastrin I heptadecapeptide was administered by constant intravenous infusion to 7 adult male volunteers without gastrointestinal disease, and serum gastrin concentrations and responses of the lower esophageal sphincter (LES) pressure and gastric acid output were measured and compared. Significant responses in LES pressure were found at gastrin infusion rates which produced submaximal gastric acid output. These LES pressure responses were quantitatively smaller than those occurring concomitantly with similar total immunoreactive gastrin levels evoked by administration of a protein meal in the same subjects. These observations suggest that, although increases in serum gastrin concentrations may contribute to increases in LES pressure seen under physiological conditions after feeding, the increase in LES pressure produced by feeding cannot be explained exclusively on the basis of endogenous gastrin release.