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Comparison of meclofenamate sodium with buffered aspirin and placebo for the relief of postoperative dental pain.

The analgesic effect of meclofenamate sodium at two dose levels (100 mg and 200 mg) was compared with the effects of buffered aspirin (600 mg) and placebo in a double-blind, randomized study of 105 dental outpatients with acute pain following third-molar extraction. Meclofenamate sodium at either dose level was significantly superior to both buffered aspirin and placebo, resulting in significantly greater relief of pain. All four treatments were well tolerated, and side effects were minimal. Meclofenamate sodium is a safe, highly effective analgesic for the relief of acute pain.

Adolescent↗

Effect of meclofenamate on lithium excretion in response to changes in renal perfusion pressure.

Previous studies in dogs have demonstrated that inhibition of prostaglandin synthesis markedly impairs the ability of the kidney to alter sodium excretion in response to changes in renal perfusion pressure (RPP). The objectives of the present study were to determine whether renal prostaglandins play a role in the urinary sodium excretory response to alterations in RPP in the rat and to determine the role of the proximal tubule in this response. RPP was changed from 127 to 109 mm Hg and then to 91 mm Hg with a servo-controlled cuff on the abdominal aorta. Fractional lithium excretion (FELi) was used as an index of ractional sodium reabsorption by the proximal tubule. As a function of increases in RPP, FELi increased, suggesting that fractional sodium reabsorption by the proximal tubule was decreased in response to increases in RPP in control animals. In meclofenamate-treated rats, increases in fractional sodium excretion and FELi in response to increases in RPP were attenuated compared with levels in control animals. The blunted response of FELi in meclofenamate-treated rats suggests that the attenuated increase in urinary sodium excretion observed during increases in RPP reflects an increase in proximal sodium reabsorption mediated by blockade of renal prostaglandins.

Animals↗

Urinary inhibitor of the ammoniagenic response to acute acidosis is a prostaglandin.

Both acute respiratory acidosis and acute metabolic acidosis stimulate NH3 production by the isolated perfused rat kidney. This stimulatory effect is abolished if the urine is drained back into the recirculating perfusate rather than collected. To determine whether the urinary inhibitor is a cyclooxygenase product, studies were carried out using prostaglandin synthetase inhibitors. Kidneys perfused with 0.5 mmol/L glutamine and urine reinfusion were subjected to acute respiratory acidosis (30% CO2, pH 6.8). With either indomethacin (20 mumol/L) or meclofenamate (20 mumol/L) in the perfusate, NH3 production increased significantly in response to acute respiratory acidosis despite urine reinfusion. The increment in NH3 production was comparable to that in studies with urine collection, indicating that a cyclooxygenase product can account completely for the urinary inhibitor. To further characterize the urinary prostaglandin inhibitor, studies were performed with both the isolated perfused kidney and renal cortical tubules. Prostaglandin E2 (PGE2) did not exhibit an inhibitory effect on NH3 production with either experimental model. Prostaglandin F2 alpha at low doses inhibited NH3 production in response to acute acidosis by the isolated kidney, but an effect was not apparent with higher concentrations. PGF2 alpha inhibited the stimulatory effect of a low pH (7.1) on NH3 production by isolated tubules, and had no effect on ammoniagenesis at pH 7.4. Thus a prostaglandin, which is not PGE2 and may be PGF2 alpha, appears to be the previously unidentified urinary inhibitor of the ammoniagenic response to acute acidosis found with the isolated perfused kidney.

Acidosis, Respiratory↗

A dual effect of nonsteroidal anti-inflammatory drugs on renal water handling in humans.

The role of renal prostaglandins (PGs) in the induction and maintenance of a sustained water diuresis was studied by using two different nonsteroidal anti-inflammatory drugs (NSAIDs), indomethacin and meclofenamate given either before or during the diuresis. Urinary PGE2 excretion increased with the initiation of a water diuresis (from 2.5 +/- 0.7 to 6.1 +/- 1 pg/kg/min during the 2nd hr, P less than .01) but then fell back to control levels when water diuresis was established. Pretreatment with NSAIDs abolished the initial increase in PGE excretion and delayed the onset of the water diuresis so that 1 hr after the initiation of the diuresis, the urine osmolality in the control subjects was 205 +/- 50 mosm/kg as compared with 440 +/- 55 mosm/kg (P less than .05) for the NSAID-treated subjects. In contrast, the urine osmolality did not change when subjects were given the NSAIDs 5 hr after the onset of the water diuresis. However, the NSAIDs did decrease urine volume and free water clearance for as long as the urinary PG excretion was suppressed, regardless of when the drugs were given. This action of the NSAIDs to decrease the urine volume and free water clearance was due to a decrease in delivery of water and solute to the diluting segments of the nephron. These data imply that the transient increase in urinary PGE excretion occurring at the onset of a water diuresis has functional significance, as NSAIDs block the increase in PG synthesis and also interfere with the onset of a water diuresis by delaying the attainment of a maximally dilute urine.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents↗

Non-steroidal anti-inflammatory drugs in combination. Experimental observations.

Diflunisal in combinations with oxaprozin, indomethacin and sodium meclofenamate produced significant synergistic suppression of carrageenan-induced oedema of the rat foot-pad. Oxaprozin, benoxaprofen, indomethacin, diflunisal, sodium meclofenamate and auranofin in some paired combinations but not in others were associated with a greater effect than the component drugs used alone. Antagonism was demonstrated with other combinations of these drugs.

Animals↗

Cardiovascular adrenoreceptor balance during hemorrhagic hypotension and shock.

The primary aim of this study was to examine the hypothesis that the ability of the cardiovascular system to compensate for hemorrhagic hypotension is controlled by a balance between the relative influence of the alpha 1 and extrasynaptic alpha 2 adrenoreceptors. Previous studies have implied that, although both receptors participate in the baroreceptor response to hypotension, only the extrasynaptic alpha 2 receptors are able to maintain the compensatory vasoconstrictor effort for a prolonged period of time. In each experiment two Sprague-Dawley rats were anesthetized and subjected to a modified Wiggers hemorrhagic shock protocol. One rat in each pair was pretreated with either 25 mg/kg of the cyclooxygenase inhibitor sodium meclofenamate or 0.5 mg/kg of the selective alpha 1 antagonist prazosin. The results indicate that neither drug interfered with the normal maximum compensatory effort as defined by the maximum blood loss (ie, reduced total vascular capacitance) when mean arterial pressure (MAP) was reduced to 30 mmHg by hemorrhage. In fact, when normalized for pre-hemorrhage MAP, it was apparent that prazosin, which lowered pre-hemorrhage MAP, may have actually improved the compensatory response. Sodium meclofenamate increased the time to reach the maximum compensatory effort (comp time), while prazosin increased the time to reach 20% uptake from the blood reservoirs (decomp time). Since both drugs enhanced the total time (comp + decomp) and both are known to interfere with alpha 1 function, these studies support the hypothesis stated above.

Animals↗

The influence of chronic treatment with psychotropic drugs on behavioral changes by social isolation.

Neurobiological changes induced by social isolation of mice are affected by several drugs in different manner. Lithium is able to prevent changes in head-twitches seen after short term isolation as well as enhanced aggressivity and enhanced spontaneous locomotion demonstrable after long term isolation. Similar to lithium are the effects of carbamazepine, whereas the other tested substances: Ca-valproate, diazepam, desipramine, clomipramine as well as piracetam, methylglucaminorotate and meclofenoxate show different effects. The model of social isolation is discussed in view of its ability to differentiate the qualities of chronic drug administration during functional dynamic changes of the CNS in animals.

Aggression↗

Effect of indomethacin and meclofenamate on canine mesenteric and celiac blood flow.

Two nonsteriodal antiinflammatory agents, indomethacin and meclofenamate, were found to produce a marked decrease in mesenteric blood flow, an increase in blood presure and no significant change in celiac blood flow. The initial effect of indomethacin on mesenteric blood flow differed from that seen with meclofenamate. Whereas meclofenamate induced a fall in mesenteric blood flow that was gradual in onset, indomethacin induced a marked vasoconstriction of the mesenteric bed that was immediate in onset and of short duration, which was followed by a decrease of slower onset similar to that seen with meclofenamate.

Animals↗

Stimulation of breathing movements in fetal sheep by inhibitors of prostaglandin synthesis.

We studied the effects of inhibitors of prostaglandin synthesis on fetal breathing movements on 17 occasions in 11 lambs (gestational age 125-141 days). We gave 12 h infusions of sodium mechlofenamate (8.6-22.2 mg.kg-1) in 13 studies and indomethacin (21.8-38.8 mg.kg-1) in four studies. Results were similar with both agents and did not correlate with drug dosage. There were no changes in fetal arterial blood pressure, pH or blood gas tensions. We assessed fetal breathing movements by measurements of tracheal pressure for a control period of 224 h prior to and 208 h during the infusion of inhibitors of prostaglandin synthesis; their administration caused a marked stimulation of fetal breathing movements judged from the following four variables: (1) incidence of fetal breathing movements increased from 38.4 to 69.2% of the time (P < 0.001); (2) average amplitude of change in tracheal pressure during fetal breathing movements increased from 4.1 to 6.0 torr (P < 0.01); (3) maximal amplitude of change in tracheal pressure during fetal breathing movements increased from 8.8 to 13.4 torr (P < 0.01); and (4) the duration of the longest continuous episode of fetal breathing movements increased from 37 to 229 min (P < 0.05). Two fetuses had electrocorticogram (ECoG) recordings. In control periods, fetal breathing movements occurred only during low voltage, high frequency ECoG activity; however, during infusions of inhibitors of prostaglandin synthesis, fetal breathing movements occurred also during high voltage, low frequency ECoG activity. We conclude that inhibitors of prostaglandin synthesis stimulate fetal breathing movement in fetal sheep. These results suggest that a component of the prostaglandin system is a factor which inhibits breathing movements during fetal life.

Animals↗

Effect of second tumors and of prostaglandin-leukotriene inhibitors on radiation therapy of transplanted rodent tumors.

The prostaglandin and leukotriene inhibitor sodium meclofenamate (SM) failed to influence radiation therapy induced regression of 6C3HED Gardner lymphosarcoma in C3H mice. Recurrence after radiation therapy, however, was reduced by treatment with SM. During these experiments, we observed that if a tumor was "cured" by radiation therapy, it required inoculation of a larger number of cells to establish a second tumor. Presumably, a certain degree of immunity has developed. On the other hand, if a second tumor was already established, less tumor cells were needed to establish a third tumor. This may be related to immuno-suppressor products of the second tumor. This effect could be partly inhibited by SM, suggesting that prostaglandins and leukotrienes may be involved in this phenomenon.

Animals↗