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Tumor promoting potential in male F344 rats and mutagenicity in Salmonella typhimurium of dipyrone.

For assessment of the carcinogenic potential and the mutagenicity of dipyrone, an antipyretic anodyne, -[(2,3-dihydro-1,5-dimethyl-3-oxo-2-phenyl-1H-pyrazol-4-yl) methylamino]-methanesulfonic acid sodium salt monohydrate, three experiments were conducted using dipyrone A produced in Japan and/or dipyrone B obtained from the Federal Republic of Germany. (i) Carcinogenic potential of dipyrone A for rat liver: 8 week old male F344 rats were pretreated with 0.01% diethylnitrosamine (DEN) in drinking water for 2 weeks and, after 1 week of resting, administered 0.4% dipyrone in drinking water, 5 days a week, for 72 weeks. After an 8 week recovery period, all surviving rats were killed at 83 weeks. Hepatocellular carcinomas developed at a higher incidence in the DEN + dipyrone group (18 of 29 rats, 62%) than in the DEN alone group (9 of 29 rats, 31%), the difference being statistically significant (P less than 0.05). No carcinogenic activity of dipyrone was demonstrated in the groups given 0.4% dipyrone for 72 weeks or 0.4% dipyrone for 25 weeks, followed by 0.05% phenobarbital (PB) for 50 weeks. However, glutathione S-transferase P positive (GST-P+) preneoplastic hepatic foci in these groups were observed at a higher incidence than in the untreated control group (P less than 0.01). (ii) Effect of dipyrone A and dipyrone B on induction of DEN-initiated GST-P+ hepatic foci in a medium-term bioassay system: 0.4% dipyrone A in drinking water and 0.57% dipyrone A or dipyrone B in powdered diet after DEN initiation had similar enhancing effects on the development of GST-P+ foci (P less than 0.001). (iii) The Ames mutation test in Salmonella: both dipyrone A and dipyrone B proved weakly mutagenic for strain TA100 in the presence or absence of S9 fraction.

Animals

Comparative study of the efficacy of dipyrone, diclofenac sodium and pethidine in acute renal colic. Collaborative Group of the Spanish Society of Clinical Pharmacology.

A randomized, double-blind, multicentre clinical trial was designed to compared the analgesic efficacy of i.m. dipyrone 1 and 2 g, i.m. diclofenac sodium and i.m. pethidine in acute renal colic. The study was carried out in 451 patients in 13 Spanish hospitals. Ureteric colic was diagnosed by the clinical features, urinalysis, or when the presence of a ureteric calculus was confirmed. The severity of pain was assessed by the physicians and by patients using visual analogue scales. The main parameter of drug efficacy was the need for rescue treatment-pethidine 100 mg i.m. 30 min after the experimental treatment. Rescue treatment was required in 93 patients: they represented 24.1% of the group given dipyrone 1 g; 22.3% of those on dipyrone 2 g; 16.4% of those given diclofenac sodium; and 19.5% of those on pethidine. The differences between the groups were not significant. In the remaining 358 patients, no difference between treatments was observed. The results suggest that in acute renal colic the use of dipyrone 2 g is unjustified as dipyrone 1 g is equally effective. Diclofenac sodium is a valid alternative, which shows similar analgesic efficacy.

Adolescent

Inhibition of ADP-induced platelet aggregation by dipyrone in patients with acute myocardial infarction.

ADP induced platelet aggregation was investigated in 48 patients within three days of the first signs of acute myocardial (AMI). Thirty six of them received 1 gram of dipyrone. Twelve patients who did not receive dipyrone served as controls. Platelet aggregation was found severely inhibited in 11 patients who had received dipyrone up to 12 hours before investigation and moderately inhibited among 25 patients who were given the drug 12-24 hours prior to the investigation. All the patients with AMI who did not receive dipyrone, exhibited a state of hyperaggregability evidenced by the presence of a second phase of aggregation even with 0.5 microM ADP. The inhibitory activity of dipyrone on the second phase of platelet aggregation resembles that of other non steroidal anti-inflammatory drugs.

Acute Disease

Investigation of rociverine + dipyrone for antispasmodic and analgesic interactions.

The study was designed to elicit any interference on the part of dipyrone with the antispasmodic activity of 2-(diethylamino)-1-methylethyl cis-1-hydroxy(bicyclohexyl)-2-carboxylate (rociverine) and on the part of rociverine with the analgesic activity of dipyrone. No evidence of any reciprocal inhibition of the specific pharmacodynamic activities of the two drugs emerged. Further, dipyrone exerted remarkable antispasmodic effect which in some experimental conditions supplements that of rociverine. The nature of this antispasmodic effect contributed by dipyrone could not be identified from the in vivo work, though in in vitro tests dipyrone revealed appreciable antihistaminic activity and weak muscle-relaxant activity. The value of an association in which neither activity is diminished and one is actually augmented is obvious.

Aminopyrine

Formation and excretion of dipyrone metabolites in man.

The formation and urinary excretion of the dipyrone metabolites, methylaminoantipyrine (MAA), aminoantipyrine (AA), formylaminoantipyrine (FAA) and acetylaminoantipyrine (AAA) were determined following administration of a single oral 1.0 g dose of dipyrone to 12 healthy volunteers. The AAA/AA plasma ratio showed that 3 subjects were slow and 9 were rapid acetylators. Pharmacokinetic parameters were determined separately for each group. A good correlation was found between the plasma and urine AAA/AA ratios. The renal clearance of the four metabolites was similar for both phenotypes. A significant difference in the rate of formation of dipyrone metabolites was found for AA, 0.25 (slow) vs 0.1 ml.min-1.kg-1 (rapid), and for AAA 0.75 (slow) vs 7.53 ml.min-1.kg-1 (rapid). There were comparable differences between slow and rapid acetylators in the AUC and the urinary excretion extrapolated to infinity for AA and AAA. The present results show that the kinetics of dipyrone metabolites in plasma and urine can provide a useful measure of the activity of the enzymes involved in their production.

Administration, Oral

Analgesic and spasmolytic effects of dipyrone, hyoscine-N-butylbromide and a combination of the two in ponies.

The analgesic and spasmolytic effects of dipyrone (Novalgin) (2500 mg/100 kg bodyweight) hyoscine-N-butylbromide (Buscopan) (20 mg/100 kg bodyweight) and a combination of both drugs were evaluated in a balloon-induced model of colic, using five ponies with caecal fistulae. The drugs were given intravenously and 0.9 per cent sodium chloride solution (5 ml/100 kg bodyweight) was used as a control. The physiological saline solution and dipyrone had no effect on caecal contractions. After the injection of hyoscine-N-butylbromide and the drug combination caecal contractions ceased within 30 seconds and for 20 and 24 minutes, respectively (P less than 0.05). The results on pain relief were not statistically significant for any of the drugs. Dipyrone had a good analgesic effect in only two of the ponies, starting after eight to 10 minutes and lasting for 50 minutes. The drug combination relieved pain within 30 seconds after injection and the relief lasted for 50 minutes in three of the ponies and for 20 minutes in the other two. Hyoscine-N-butylbromide alone produced an analgesic effect within 30 seconds after injection which lasted for 20 minutes.

Analgesia

Determination of the "chromatographic pattern" for the identification of dipyrone urinary metabolites.

Sodium [N-(1,5-dimethyl-3-oxo-2-phenylpyrazolin-4-yl)-N-methylamino] methanesulfonate (dipyrone) cannot be detected as such in biological fluids since absorption is preceded by hydrolysis to 4-methylaminoantipyrine, which is actually absorbed and further metabolized. In the present work standardized TLC Rf values and gas chromatographic retention indices for the four main urinary metabolites of dipyrone were determined. Inclusion of these parameters in the principal component analysis "scores plot" allows dipyrone to be included as a possible candidate in the not oriented search for unknown drug assumption in cases of overdose intoxication or poisoning.

Adult

Dipyrone enhances intracellular accumulation and cytotoxicity of adriamycin in human chronic myeloid leukemia cells.

The cytotoxicity induced by dipyrone alone, or in combination with adriamycin (ADR) was studied in human chronic myeloid leukemia (CML) cells. The inhibition of 3H-thymidine incorporation into DNA was taken as a measure of cytotoxicity. While dipyrone alone indicated marginal inhibition, its combination with ADR demonstrated a potentiating effect (p less than 0.001), which was found to be irreversible. The enhanced cytotoxicity of the combination was a result of an increased drug accumulation as studied by the uptake of 14C-adriamycin. Observations indicate that dipyrone can be used to enhance the cytotoxicity of ADR in human CML patients.

Cell Survival

Generalized oedema of newborn associated with the administration of dipyrone.

In fourteen infants, aged 9--60 days, with generalized oedema seen during a one year period the common denominator was the administration of dipyrone one to two days prior to the development of oedema. None of the other causes of oedema in early life could be incriminated in any of these babies. Pediatricians should be aware of this iatrogenic cause whenever they encounter a young infant with generalized oedema. Oedema disappeared in all the cases following discontinuation of dipyrone but anuria lasted for more than four days in one case. This stydy re-emphasizes the need to without this potentially dangerous drug, especially during the neonatal period.

Aminopyrine

Differential effects of dipyrone, ibuprofen, and paracetamol on experimentally induced pain in man.

In a double-blind cross-over study on 22 healthy subjects the analgesic efficacies of the antipyretic analgesic drugs ibuprofen, dipyrone and paracetamol were tested against placebo using a model of experimentally induced pain. To this purpose interdigital webs were pinched repeatedly for 2 min periods. The painfulness of these stimuli was assessed by the subjects on an electronically controlled visual analogue scale at 10 sec intervals. In addition to the subjective pain ratings the stimulus induced reflex diminution of the blood flow in the stimulated hand was measured with photoplethysmography and laser Doppler flow analysis. The flare response around the stimulated area was assessed with infrared thermography. In this assay system ibuprofen and dipyrone, but not paracetamol, showed statistically significant analgesic effects by preventing hyperalgesia which is normally induced by the repeated stimulation of a skin site. This hypoalgesic effect was not related to the subjective impression of the subjects of the analgesic potency of the respective drug. Sympathetic reflex vasoconstriction was not quantitatively related to the drug induced hypoalgesia. Ibuprofen and, to a minor extent, the other antipyretic analgesic drugs also diminished the stimulus induced flare reaction around the stimulated skin sites.

Acetaminophen

The incidence of dipyrone-induced agranulocytosis in Greece during 1975.

A retrospective epidemiological study was conducted in Greece during 1975 to assess the incidence of agranulocytosis following treatment with dipyrone. Twenty-four cases of agranulocytosis were reported, of which fifteen were possibly associated with medication. If all fifteen cases are attributed to dipyrone, the incidence of agranulocytosis following treatment with this drug lies between one case in every 133,000 and one case in every 466,000 treatments.

Adult

Modification by dipyrone (noramidopyrine methanesulphonate) of stone-induced ureteric hyperperistalsis in the dog.

Implantation of a stone in the ureter of the dog by ureterotomy results in focal hyperperistalsis which is accentuated by administration of norepinephrine, and reduced by administration of phenoxybenzamine or isoproterenol. Administration of dipyrone reduces the hyperperistalsis, but this action does not appear to be that of either a beta-agonist of an alpha-antagonist.

Aminopyrine

Excitation of afferent fibres in the cardiac sympathetic nerves induced by coronary occlusion and injection of bradykinin. The influence of acetylsalicylic acid and dipyron.

Afferent impulse activity was recorded in single fibres of the inferior cardiac sympathetic nerve of the cat. When the descending branch of the left coronary artery was ligated for 60 sec an enhancement of afferent impulses was recorded. Elevations in discharge frequency were also induced by injecting bradykinin, epinephrine, and isoprenaline or by general hypoxia due to interruption of the artificial ventilation. When these procedures were after pretreatment with the analgesic agents, acetylsalicylic acid or dipyron a reduction in spike discharge was observed only with bradykinin after application of acetylsalicylic acid. No influence of these pretreatments on the effects of coronary occlusion, general hypoxia and injection of epinephrine and isoprenaline could be observed. These results suggest that bradykinin does not predominate as mediator substance in eliciting ischemic heart pain.

Aminopyrine

[Biochemical study of nucleic acids of placenta and fetal liver and caryometric of trophoblastic giant cells and fetal hepatocytes of Rattus norvegicus albinus, during action of sodium 1-phenyl-2, 3-dimethyl-5-pyrazolon-methane sulfonate (Dipyrone) (author's transl)].

Female pregnant rats of 2BAW strain were divided in 2 groups: the 1st, received 50 mg/kg corporal weight of sodium 1-phenyl-2,3-dimethyl-5-pyrazolon-4-methylamino-methane sulfonate (Dipyrone), single dose daily, by i.p. injections, from 16th to 20th day of pregnancy; the 2nd, received 0,5 ml of distilled water, single dose daily, by i.p. injections, during the same period. All the animals were sacrificed 2 hours after the last injection. The biochemical results of nucleic acids in the placentas and fetal livers, and the caryometric data of trophoblastic giant cells and fetal hepatocytes, demonstrated that: 1. When compared the 2 groups, as much the nucleic acids levels (RNA and DNA) of placentas as the nuclear size of trophoblastic giant cells, do not presented statistical differences; 2. The biochemical levels of nucleic acids (RNA and DNA) of fetal livers decreased, while the nuclear size of hepatocytes increased in the experimental group, with reference to control group.

Aminopyrine