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PubMed1980

Modification by antiplatelet drugs of acute EEG changes induced in the rat by sodium arachidonate.

It can be readily shown in vitro that various compounds inhibit platelet aggregation but it has been difficult to demonstrate in vivo. A method is suggested here to enable in vivo testing of these compounds; the method utilizes relatively low doses of sodium arachidonate, made possible by the ligation of the pterygopalatine artery. Adenosine, ATP and sulfinpyrazone, agents known to inhibit platelet aggregation in vitro, were effective in varying degrees in inhibiting in vivo platelet aggregating response as suggested by their ability to antagonize arachidonate-induced EEG depression.

Adenosine↗

PubMed1975

Pharmacologic approach to the maintenance of urate homeostasis.

A reduction in the serum urate concentration in hyperuricemic subjects can be achieved by increasing the renal excretion of uric acid, by inhibiting its synthesis, or by a combination of both modalities. The three most commonly used hypouricemic drugs are probenecid, sulfinpyrazone and allopurinol. Each drug has been considered in detail with regard to its mechanism of action, metabolism, diverse metabolic effects, side effects and interaction with other drugs. In addition, guidelines for the use of these drugs in hyperuricemic subjects are proposed.

Allopurinol↗

PubMed1983

Hypouricemia related to a hypersecretional tubulopathy.

We present 1 patient with hypouricemia and hyperuricosuria. Serum uric acid level ranged between 1.5 and 1.9 mg/dl and uric acid fractional excretion between 20 and 28%. Apart from that the renal function was normal. The pyrazinamide suppression test gave a normal response showing nearly complete suppression of urate excretion. The uricosuric response to sulfinpyrazone was normal too. The renal tubular response to extracellular fluid volume contraction induced by furosemide indicated a normal tubular sensitivity to extracellular fluid volume variations. From these results we conclude that our patient has a specific tubulopathy characterized by uric acid hypersecretion.

Adult↗

PubMed1985

Mechanisms of hypouricemia in the syndrome of inappropriate secretion of antidiuretic hormone.

Hypouricemia seen with hyponatremia related to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) results from an increase in uric acid renal clearance. We studied the mechanism of the increase of uric acid excretion in 6 SIADH patients through pyrazinamide (PZA), which decreases tubular secretion of uric acid, and sulfinpyrazone (SPZ) which decreases post-secretory reabsorption of uric acid. 3 g of PZA decreased the absolute uric acid excretion from 428 +/- 244 to 105 +/- 47 micrograms/min (mean +/- SD, p less than 0.01), and 300 mg of SPZ increased the uric acid to creatinine clearance ratio from 0.31 +/- 0.05 to 0.52 +/- 0.05 mg/dl glomerular filtration rate (mean +/- SEM, p less than 0.001), which represent an increment about half of that observed in the control group. The increase of uric acid clearance in SIADH seems to result from a decrease in the post-secretory reabsorption of uric acid. After SPZ, we saw a decrease of natriuresis from 5.6 +/- 1.4 to 1.8 +/- 0.3 mmol/h (p less than 0.001), without any change of urinary flow or urinary potassium excretion.

Glomerular Filtration Rate↗

PubMed1977

Platelet survival time in patients with hypoxemia and pulmonary hypertension.

Platelet survival time (autologous labeling with 51chromium) was measured in 63 patients in order to evaluate the role of platelets in the thromboembolic complications of patients with hypoxemia and pulmonary hypertension. Thirty-eight of these patients had chronic obstructive airways disease; 13, primary pulmonary hypertension; seven, recurrent pulmonary embolism; four, the Eisenmenger syndrome; and one, multiple pulmonary arteriovenous fistula. Forty-three patients were hypeakly associated with arterial oxygen tension ( r = 0.50), but not with the arterial carbon dioxide tension or the level of pulmonary artery pressure. Sulfinpyrazone lengthened platelet survival in 12 of 24 (50%) treated patients but this drug did not alter either arterial oxygen tension arterial carbon dioxide tension, or pulmonary artery pressure. Our results suggest that hypoxemia is associated with shortened platelet survival time and that platelets may, therefore, be involved in the thromboembolic complications that develop in patients with hypoxemia.

Blood Platelets↗

PubMed1979

Platelet survival time and thromboembolism in patients with mitral valve prolapse.

Thromboembolism (TE) occurs in about 20% of patients with rheumatic mitral valve disease, and platelet survival time in these patients has correlated with TE. In patients with mitral valve prolapse, TE appears to occur very infrequently. Platelet survival (autologous labeling with chromium-51) was performed in 26 patients with mitral prolapse. Five patients had a history of stroke, as well as normal cerebrovascular arteriography and shortened platelet survival (average half-time +/- SEM 2.3 +/- 0.18 days; normal half-time 3.7 +/- 0.03 days; n = 26; p less than 0.01). Platelet survival was shortened in seven of 21 patients without TE (33%) (3.3 +/- 0.06 days; p less than 0.01 vs patients with TE). In 138 patients with rheumatic heart disease, platelet survival was shortened in 40 of 41 (98%) with a history of TE (2.3 +/- 0.08 days) and in 76 of 97 (78%) without TE (2.9 +/- 0.07 days; p less than 0.001 vs patients with TE). In patients with mitral prolapse, sulfinpyrazone increased platelet survival (2.4 +/- 0.16 to 2.7 +/- 0.19 days; n = 7; p less than 0.05). Our results suggest that platelet survival time is shortened in patients with mitral prolapse and rheumatic heart disease who have had TE. Of those without TE there is an increased frequency of shortened platelet survival in patients with rheumatic heart disease (78%) compared with those with mitral prolapse (33%), consistent with the infrequency of TE in mitral prolapse.

Adult↗

PubMed1985

Clinical pharmacology of platelet cyclooxygenase inhibition.

Nonsteroidal anti-inflammatory drugs and sulfinpyrazone compete dose-dependently with arachidonate for binding to platelet cyclooxygenase. Such a process closely follows systemic plasma drug concentrations and is reversible as a function of drug elimination. Peak inhibition and extent of its reversibility at 24 hr varies consistently with individual pharmacokinetic profile. Inhibition of platelet cyclooxygenase activity by these agents is associated with variable effects on prostaglandin (PG) synthesis in the gastric mucosa and the kidney. Aspirin acetylates platelet cyclooxygenase and permanently inhibits thromboxane (TX) A2 production in a dose-dependent fashion when single doses of 0.1 to 2.0 mg/kg are given. Acetylation of the enzyme by low-dose aspirin is cumulative on repeated dosing. The fractional dose of aspirin necessary to achieve a given level of acetylation by virtue of cumulative effects approximately equals the fractional daily platelet turnover. Serum TXB2 measurements obtained during long-term dosing with 0.11, 0.22, and 0.44 mg/kg aspirin in four healthy subjects could be fitted by a theoretical model assuming identical acetylation of platelet (irreversible) and megakaryocyte (reversible) cyclooxygenase. For a given dose within this range, both the rate at which cumulative acetylation occurs and its maximal extent largely depend upon the rate of platelet turnover. Continuous administration of low-dose aspirin (20 to 40 mg/day) has no statistically significant effect on urinary excretion of either 6-keto-PGF1 alpha or 2,3-dinor-6-keto-PGF1 alpha, i.e., indexes of renal and extrarenal PGI2 biosynthesis in vivo. Whether a selective sparing of extraplatelet cyclooxygenase activity by low-dose aspirin will result in increased antithrombotic efficacy, fewer toxic reactions, or both remains to be established in prospective clinical trials.

Aspirin↗

PubMed1986

Clinical trials evaluating platelet-modifying drugs in patients with atherosclerotic cardiovascular disease and thrombosis.

Aspirin has been convincingly shown to reduce stroke and death in men with transient ischemic attacks (it may possibly be beneficial to women also), myocardial infarction and death in patients with unstable angina, thromboembolic complications associated with artificial heart valves in patients receiving oral anticoagulants (although gastrointestinal bleeding is prohibitive with this combination), and thrombotic occlusion of silicone rubber arteriovenous cannulae in uremic patients undergoing hemodialysis. In addition, aspirin may possibly decrease occlusion of saphenous vein aortocoronary grafts and venous thrombosis in men after hip replacement, although these reports require confirmation. Aspirin is ineffective in the secondary prevention of stroke and has unproven benefit in the secondary prevention of myocardial infarction. Dipyridamole in combination with oral anticoagulation decreases the thromboembolic complications associated with mechanical heart valves. The combination of aspirin and dipyridamole prevents both early and late occlusion of saphenous vein aortocoronary bypass grafts and protects renal function in patients with membranoproliferative glomerulonephritis. The relative importance of combining aspirin and dipyridamole compared with either agent used singly remains to be established. Sulfinpyrazone reduces the thrombotic occlusion of arteriovenous cannulae and early occlusion of saphenous vein aortocoronary grafts. The reported benefit in the secondary prevention of myocardial infarction is controversial.

Anticoagulants↗

PubMed1979

Experimental arterial thromboembolism in baboons. Mechanism, quantitation, and pharmacologic prevention.

A quantitative primate model of arterial thromboembolism has been characterized with respect to mechanism and usefulness in evaluating modifying variables. The model involved the kinetic measurements of (51)Cr-platelets and (125)I-fibrinogen consumption by femoral arteriovenous cannulae in chaired baboons. Cannula platelet consumption correlated directly with exposed cannular area for irradiated Silastic and polyurethane (correlation coefficients of 0.940 and 0.901, respectively; P < 0.001) and remained steady state for months. Nonirradiated Silastic was only minimally reactive with platelets. Despite increased rates of platelet consumption circulating fibrinogen was not measurably destroyed by any of the cannulae tested. Cannula platelet consumption was independent of cannula flow rate, platelet count, heparin anti-coagulation, and ancrod defibrinogenation.(111)In-platelet imaging of irradiated Silastic cannulae demonstrated luminal accumulation and subsequent embolization of irregular platelet masses. When irradiated Silastic cannulae were inserted as extension segments in the renal arteries of four animals the glomerular vessels became progressively occluded with nonfibrin-containing platelet thromboemboli. Nonirradiated Silastic cannulae in control arteries produced no significant vascular occlusion. Because the survival of platelets from animals with consumptive cannulae was not shortened in normal recipient animals we concluded that platelets were either irreversibly removed through thromboembolic consumption or unaffected in their viability. Oral administration of dipyridamole and sulfinpyrazone decreased cannula platelet consumption in a dose-dependent manner with complete interruption at 20 and 250 mumol/kg body wt per d (in three divided doses), respectively, whereas oral acetylsalicylic acid (10-330 mumol/kg per d) had no measurable effect on cannula platelet consumption. We conclude that this primate model simulates arterial thrombotic processes in man and that this model is suitable for the in vivo evaluation of biomaterials and of drugs that modify platelet behavior.

Animals↗

PubMed1980

Receptor-directed inhibition of chemotactic factor-induced neutrophil hyperactivity by pyrazolon derivatives. Definition of a chemotactic peptide antagonist.

The two pyrazolon derivatives, phenylbutazone and sulfinpyrazone, selectively inhibit chemotactic peptide-induced effects on neutrophils. As they antagonize the induction of acute neutropenia in vivo and of cellular hyperadhesiveness, lysosomal enzyme release, hexose monophosphate shunt activity, and superoxide production in vitro, these effects occur with a specificity not shared with other prostaglandin biosynthesis inhibition by these drugs resembles the competitive type of antagonism and occurs at concentrations attainable in vivo under clinical conditions. The locomotory machinery, the direction-finding mechanisms, and the basic metabolic machinery of the cell are unaffected. These drugs interfere with specific binding of the formylpeptide to its receptor on neutrophils.

Agranulocytosis↗

PubMed1985

Action of drugs and chemical agents on rat liver regeneration.

Chemical agents and drugs of widely differing pharmacological activity have been administered to partially hepatectomized male rats and the extent of liver regeneration ascertained over a period of 10 days. Of the large number investigated, the following fed ad lib in diets supplemented in a basal ration at the weight percentages indicated, proved to be hepatotrophic: anticonvulsants - mephenytoin (0.15), methsuximide (0.15), phensuximide (0.15) and primidone (0.10); benzodiazepines - clobazam (0.10), flurazepam hydrochloride (0.12), halazepam (0.070), oxazepam (0.030) and temazepam (0.10); anti-inflammatory agents - benoxaprofen (0.040), ibuprofen (0.10 and 0.20), naproxen (0.040) and sulindac (0.075); sedatives and hypnotics - ethinamate (0.75), glutethimide (0.075), methaqualone (0.030 and 0.10) and methprylon (0.30) and the analgesic and antipyretic, aminopyrine (0.15); antifungal - griseofulvin (0.50); anti-androgen - cyproterone acetate (0.020 and 0.050); uricosuric - sulfinpyrazone (0.050 and 0.20); skeletal muscle relaxant - chlorzoxazone (0.20); hydrocholeretic - florantyrone (0.30); anti-hypertensive - prazosin hydrochloride (0.010) and the thyroid inhibitor, methimazole (0.025). The feeding of several of the stimulants at the given levels to intact males elicited wet and dry liver enlargement. Most of the current test agents as screened in operated rats, had little effect on the regeneration and in fact, tended to depress the process when higher levels were fed or injected.

Animals↗

PubMed1986

Countergradients of nonchemotactic ligands for N-formylmethionylleucylphenylalanine (FMLP) receptors promote FMLP-induced chemotaxis.

Using the under-agarose chemotaxis assay, addition of compounds known to inhibit chemotaxis of leukocytes toward N-f-Met-Leu-Phe (FMLP) was made to the first well in a line of three wells, leukocytes to the middle well, and a slight excess of FMLP to the third well. The compounds included rifampin, fusidic acid, carbobenzoxy Phe-Met, phenylbutazone, sulfinpyrazone, sulfasalazine, and sulfapyridine. The countergradients created in this system markedly stimulated, not inhibited, locomotion toward FMLP. These results, based on functional responses, confirm data using radiolabeled FMLP and support the hypothesis that these compounds are nonchemotactic ligands for FMLP receptors.

Binding, Competitive↗

PubMed1975

The effect of platelet function inhibitors on experimental venous thrombosis formation in rabbits.

Inhibitors of the platelet functions, collagen-induced aggregation and release reaction (ASA and sulfinpyrazone) and ADP-induced aggregation (dipyridamole and VK 744), were investigated as potential preventive agents against venous thrombosis formation in rabbits. An experimental model combining endothelial damage (sodium morrhuate) and controlled stasis of the femoral venous flow was used. None of the agents showed any significant protective effect against venous thrombosis, a finding which is in keeping with the results of recent clinical investigation.

Adenosine Diphosphate↗

PubMed2001

Resistance to mitoxantrone in multidrug-resistant MCF7 breast cancer cells: evaluation of mitoxantrone transport and the role of multidrug resistance protein family proteins.

We examined the role of multidrug resistance protein (MRP) 1 (ABCC1) in the emergence of mitoxantrone (MX) cross-resistance in a MCF7 breast cancer cell line selected for resistance to etoposide. The resistant cell line, MCF7/VP, expresses high levels of MRP1, whereas the parental cell line, MCF7/WT, does not. MCF7/VP cells are 6-10-fold cross-resistant to MX when compared with MCF7/WT cells. Drug transport studies in intact MCF7/VP cells revealed that MX resistance is associated with reduced MX accumulation due to enhanced MX efflux. MX efflux is ATP dependent and inhibited by sulfinpyrazone and cyclosporin A. Inhibition of MX efflux with these agents sensitizes cells to MX cytotoxicity and partially reverses MX resistance in MCF7/VP cells. Whereas resistance is partially attributable to increased MX efflux in MRP1-expressing MCF7/VP cells, we found no evidence for glutathione or other conjugates of MX in these cells. Moreover, glutathione depletion with buthionine sulfoximine had no effect on MX transport or sensitivity in MCF7/VP cells. MRP1 substrates are generally amphiphilic anions such as glutathione conjugates or require the presence of physiological levels of glutathione for MRP1-mediated transport. Therefore we conclude that MRP1 overexpression is unlikely to be responsible for increased MX efflux and resistance in MCF7/VP cells. In considering the potential involvement of other MRP family isoforms, a 3-fold increase in the expression of MRP5 was observed in MCF7/VP cells. However, stable expression of a transduced MRP5 expression vector in MCF7/WT cells failed to confer MX resistance. Because other transporters known to be associated with MX resistance, including P-glycoprotein and BCRP/MXR (ABCG2), are not expressed in MCF7/VP cells, we conclude that increased MX efflux and resistance in MCF7/VP cells is attributable to a novel transport mechanism or that MX represents a novel class of cationic, glutathione-independent MRP1 substrates.

ATP-Binding Cassette Transporters↗

PubMed1975

The pharmacology of hypouricemic effect of benzbromarone.

The hypouricemic effect of benzbromarone has been investigated in six subjects. Benzbromarone increased urate: creatinine by 371 per cent over control values at two to four hours after administration. Over a 24 hour period, the mean serum uric acid decreased from a control value of 7.8 +/- 0.8 to 4.3 +/- 0.6 mg/dl. This uricosuric effect was completely reversed by pyrazinamide, partially inhibited by acetylsalicyclic acid and sulfinpyrazone, and was not accompanied by an elevation of the creatinine clearance or an inhibition of urate binding to plasma protein. In vitro studies showed only 22 per cent inhibition of urate binding by benzbromarone five muM, a concentration which is transiently reached in man. Kinetic studies of human liver xanthine oxidase demonstrated non-competitive inhibition with variable hypoxanthine and a Ki slope of 8.5 muM. The Ki slopes for benzarone and allopurinol were 19.0 muM and 0.05 muM respectively. There was no elevation of the urinary oxypurines following benzbromarone ingestion. These observations suggest that only the renal tubular activity of benzbromarone is relevant to its hypouricemic effects in man. (J Rheumatol 2: 437-445, 1975).

Adult↗

PubMed1992

Monoisoamyl meso-2,3-dimercaptosuccinate: interaction with metallothionein-bound cadmium in vitro and evidence of active transport into renal and hepatic cells in vivo.

Monoisoamyl meso-2,3-dimercaptosuccinate (Mi-ADMS) and the unesterified 2,3-dimercaptosuccinic acid (DMSA) were evaluated for relative reactivities against metallothionein (MT)-bound cadmium (Cd) in vitro by elution of the reaction products through Sephadex G-75 gel. After 3 hr of incubation, Mi-ADMS removed about 70% of the Cd from Cd-MT, and a new peak emerged which corresponded to that obtained by elution of a 2:1 molar mixture of Mi-ADMS and Cd. Only about 15% of the Cd was removed from Cd-MT by DMSA. After 24 hr of incubation with Mi-ADMS, no evidence remained of the presence of Cd-MT; all of the Cd was recovered in a very high molecular weight fraction and in a fraction corresponding to Cd ion. In contrast, after 24 hr of incubation with DMSA, 25% of the Cd was still present as Cd-MT, while the remainder eluted in a fraction corresponding to a 2:1 molar complex of DMSA and Cd. When Mi-ADMS was administered to Cd-bearing mice which had received an inhibitor of organic anion transport, probenecid (PBC) or sulfinpyrazone (SPZ), prior to administration of the monoester, there was a marked attenuation of the Cd mobilizing actions of Mi-ADMS as reflected in whole body Cd levels. Analysis of organ Cd concentrations revealed that PBC blocked primarily the mobilization of renal Cd by Mi-ADMS, while the principal action of SPZ in antagonizing the action of Mi-ADMS was on hepatic Cd mobilization. It was concluded that Mi-ADMS has a higher affinity for Cd in Cd-MT than does DMSA, and that the access of Mi-ADMS to intracellular Cd is, at least in part, mediated by the organic anion transport system.

Animals↗

PubMed1991

Aspirin in transient ischemic attacks and minor stroke: a meta-analysis.

An overview analysis of seven randomized controlled trials testing the effectiveness of aspirin in the treatment of patients with transient ischemic attacks and minor strokes was performed. A total of 6409 patients from the seven trials was entered in the analysis; 2182 patients received only aspirin; 1598 patients received an aspirin-combination regimen with either sulfinpyrazone or dipyridamole; and 2629 subjects received a placebo. Aspirin alone produced an 18% decrease in all strokes and cardiovascular deaths. The pooling of studies examining aspirin-combination regimens and the larger grouping of studies of aspirin and aspirin-combination regimens led to more striking results. Indeed, significant risk reductions were observed for three of the four outcomes, namely, total deaths, total strokes, and total strokes and cardiovascular deaths, with odds ratios ranging from 0.59 to 0.78. Suggestive, albeit more modest, results were obtained when examining the impact of these regimens on total cardiovascular mortality. The same tendencies have also been observed in three previously published meta-analyses.

Adult↗

PubMed1991

Use of Rabenid for different indications.

Rabenid (sulfinpyrazone) was used in 95 patients suffering from different diseases and treated at the departments could be demonstrated in association with or as a primary cause of the disease. Serum uric acid level was measured as an objective parameter. In response to Rabenid a drastic fall of this value could be observed. The drug influences favourably the serum cholesterol and triglyceride values as well. In patients exposed to the risk of thrombosis, new or recurrent thrombosis did not develop during the observation period and Rabenid was, in general, well tolerated by all patients. Attention has been called to the close correlation between hyperuricaemia, obesity, diabetes, atherosclerosis, hypertensions, and hyperlipaemia and the therapeutic and prophylactic value of the examined drug has been emphasized from this respect.

Adult↗