"Sulpha-combination"--A New Chemotherapeutic Principle

Frisk, A. Rune; Hagerman, G; Helander, S; Sjögren, Benita

doi:10.1136/bmj.1.4487.7

Cited by 14 publications

(4 citation statements)

References 2 publications

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“…Furthermore, Dowling et al increased the dosage of the combination arbitrarily by " 25 to 33 % " above the generally accepted routine dosage of sulphonamides. Thus adult patients received [8][9] g. of the sulphadiazine-sulphamerazine combination daily, as contrasted with the 6 g. maintenance dose used by these authors in previous series with the separate compounds. Consequently each patient on combination therapy received an additional amount of at least 21 g. of sulphonamide in the average 10-day treatment period.…”

Section: Commentsmentioning

confidence: 99%

Lowered Incidence of Sensitization with Sulphonamide Combinations

Lehr¹

1948

BMJ

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Section: Commentsmentioning

confidence: 99%

Lowered Incidence of Sensitization with Sulphonamide Combinations

Lehr¹

1948

BMJ

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“…They concluded that for the prevention of crystalluria the use of the mixture was as effective as the administration of sodium bicarbonate at the rate of 12 g. a day with either sulphadiazine or sulphamerazine. Finally, Hagerman and-his co-workers (Frisk et al, 1946(Frisk et al, , 1947, in Sweden, using a combination of sulphathiazole, sulphadiazine, and sulphamerazine, arrived independently at confimiatory animal-experimental and clinical results.…”

Section: Results Of the Therapeutic Use Of Sulphonamide Combinationsmentioning

confidence: 99%

Prevention of Renal Damage by Mixtures of Sulphonamides

Lehr¹

1947

BMJ

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A new and simple approach to the prevention of concrement formation in the urinary tract caused by sulphonamides emerged from the obEervation that a saturated aqueous or urinary solution of one derivative of sulphanilamide could still be fully saturated with a second and third sulphonamide even if only of slightly different molecular structure, each of the compounds behaving as though it were present alone and exerting no influence on the solubility of the others. Consequently, in solutions containing several sulphonamides the maximum obtainable concentration appeared expressed by the additive solubilities of all individual drugs present (Lehr, 1945). This principle is illustrated in diagrammatic form in Fig The figure elucidates the theoretical explanation of the phenomenon-namely, the specifically different molecular distribution in space of chemically different compounds. It also makes it clear that precipitation due to oversaturation will not occur more readily in the solution containing three sulphonamides, with a total concentration of 61 mg. per 100 ml., than in any one of the three individual solutions, with necessarily much lower maximum sulphonamide levels. Hence, at equal total sulphonamide concentrations the danger of precipitation will be significantly smaller in solutions of sulphonamide mixtures; it follows, in addition, that any increase in the number of components comprising a sulphonamide mixture will further diminish the chances of precipitation.It was reasoned on the basis of this observation that the danger of the formation of sulphonamide crystals in the renal tubules could be considerably reduced by employing combinations of partial dosages of two or three

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“…Sulphamezathine 0.5 g., total 27 g., was given every foui hours for 9 days in addition to the sulphathiazole, on the principle expounded by Frisk et al (1947). Sulphamezathine, 0.5 g. four-hourly, was also given from the 19th to 32nd day, (total, 42 g.) and from the 39th to 42nd day (total, 12 g.), making a combined total of 81 g.…”

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confidence: 99%

“…A new chemotherapeutic principle, involving the use of two or more sulphonamides simultaneously, expounded by Frisk et al (1947), has opened the way to increased doses of sulphonamides without unduly ihcreasing the risk, and is worthy of a trial in resistant cases.…”

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confidence: 99%