Phenylbutazone and Salivary Glands

Rechenberg, H. K. v.

doi:10.1136/bmj.2.5517.831-f

Cited by 7 publications

(7 citation statements)

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“…Frequently cold weather aggravated the pain. The administration of phenylbutazone aggravated the symptoms (rather than relieving pain, as was the intent) in one case: this is of interest because the drug has an antithyroid effect and also antagonizes thyroxine peripherally (von Rechenberg, 1962).…”

Section: Discussionmentioning

confidence: 94%

Hypothyroidism presenting with musculoskeletal symptoms.

Golding¹

1970

Annals of the Rheumatic Diseases

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Section: Discussionmentioning

confidence: 94%

Hypothyroidism presenting with musculoskeletal symptoms.

Golding¹

1970

Annals of the Rheumatic Diseases

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“…In earlier studies about 25 % of patients with active ankylosing spondylitis were unable to complete a period of 5 days without a major anti-inflammatory drug. Because the mean half-life of naproxen in man is 13 hours (Segre, 1975) and phenylbutazone 48 to 72 hours (von Rechenberg, 1962), the length of the trial periods, i.e. 35 days each, was thought sufficient to eliminate completely the possible carry-over effects of preceding treatment.…”

Section: Discussionmentioning

confidence: 99%

Double-blind trial of naproxen and phenylbutazone in ankylosing spondylitis.

Gerwen¹,

Korst²,

Gribnau³

1978

Annals of the Rheumatic Diseases

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SUMMARY In a double-blind double-placebo crossover study naproxen (500-750 mg daily) was found to be equivalent to phenylbutazone (400-600 mg daily) in the control of disease activity in 20 patients suffering from ankylosing spondylitis during a two times 5-week trial period. No serious side effects were observed during the trial period. Gastric complaints occurred twice as often under phenylbutazone as under naproxen. Naproxen has been claimed to be a potent analgesic and anti-inflammatory drug with a relatively low incidence of side effects (Roszkowski et al., 1971;Hill et al., 1974;Huskisson et al., 1976). A few preliminary studies have shown a beneficial effect in ankylosing spondylitis (Hill and Hill, 1975;Peter and Veress, 1975). To our knowledge, naproxen has not been compared with phenylbutazone, which is considered the main therapy in this disease. We therefore undertook a double-blind double-placebo crossover study to assess the efficacy and safety of naproxen against phenylbutazone in active ankylosing spondylitis. Patients and methodsOf 160 outpatients with definite ankylosing spondylitis already under treatment, only 22 fulfilled the admission criteria of (1) definite ankylosing spondylitis attested by radiographic evidence of bilateral sacroiliitis; (2) age 18 to 65 inclusive; (3) clear evidence of active spondylitis (when not treated with anti-inflammatory or analgesic drugs); with at least 2 of the 5 signs of disease progress: (a) nocturnal pain with morning predominance and/or morning stiffness; (b) pain and stiffness in low back, or dorsolumbar junction or in either or both buttocks of over 3 months' duration and not relieved by rest; (c) pain and stiffness in thoracic region, of over 3 months' duration; (d) limitation of chest expansion (<5 but >2 cm); (e) limitation in spinal anterior and lateral flexion and in spinal extension; (4) ESR >20 mm in the first hour.

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“…Salivary gland enlargement has been reported, but infrequently with phenylbutazone and oxyphenbutazone (Fowler 1979;von Rechenberg 1962b). Parotid and submandibular glands may both be affected and the condition may be associated with eosinophilia and pyrexia.…”

Section: Sialadenitismentioning

confidence: 99%

Aspirin, Paracetamol and Non-Steroidal Anti-Inflammatory Drugs

Fowler¹

1987

Medical Toxicology

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Non-steroidal anti-inflammatory drugs (NSAIDs) effectively control the symptoms of many of the rheumatic diseases although they have little effect on the underlying causes. Their effect is mainly on the mediators of the inflammatory process. Unfortunately, these mediators have important physiological roles in the maintenance of health, particularly in the gastrointestinal tract and the kidney, so that their inhibition results in many unwanted reactions of varying severity. The mechanisms underlying these reactions are described. Their occurrence varies, both qualitatively and quantitatively, and an attempt is made to assess these differences, although it may be that they are related directly to differences in dosage and therapeutic efficacy. In addition, immunologically mediated adverse reactions occur. These mechanisms are outlined and related to the clinical picture. There are considerable differences in frequency of reactions between the compounds: in particular there is a wide variation in the rate of dermatological reactions of this type. Agranulocytosis has been particularly associated with the pyrazolone compounds, although it has been reported with most others. Aplastic anaemia, which may not be an immune-mediated reaction, is also thought of as a pyrazolone reaction, but the incidence with indomethacin approaches a similar level. Although all drugs analysed may cause hepatic reactions, these are rare except with the now withdrawn benoxaprofen. Several types of immunologically mediated renal reactions occur and these rarities are also described. Paracetamol does not have any effect on the inflammatory mediators. Anxieties about this substance relates to the parent compound phenacetin and its necrotic effect on the renal papillae. There is extensive literature on this subject concerning not only paracetamol, but also aspirin and other NSAIDs. This is also assessed and summarised. The danger of paracetamol as a direct hepatic toxin in self-poisoning is discussed. Novel NSAIDs are introduced and others withdrawn with frequent and monotonous regularity. Sometimes the reasons have some medical or scientific plausibility, but often they are over-reactions by registration authorities or pharmaceutical companies in response to uninformed media publicity. The problems of the numerically and scientifically accurate collection and assessment of adverse reaction data are legion and as a result useful agents have been lost. Some of these difficulties are described, and some non-drug 'adverse reactions' are described.(ABSTRACT TRUNCATED AT 400 WORDS)

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Phenylbutazone and Salivary Glands

Cited by 7 publications

References 0 publications

Hypothyroidism presenting with musculoskeletal symptoms.

Hypothyroidism presenting with musculoskeletal symptoms.

Double-blind trial of naproxen and phenylbutazone in ankylosing spondylitis.

Aspirin, Paracetamol and Non-Steroidal Anti-Inflammatory Drugs

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