Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sulindac (Clinoril; Frosst-MSD), a non-steroidal anti-inflammatory drug was compared with aspirin in a randomized double-blind cross-over controlled study in 30 patients with juvenile chronic arthritis. Sulindac was found to be safe and effective. Although it has the advantage of a twice-a-day dose regimen, both patient and doctor may prefer to be guided by pain relief and cost.
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PMID:Double-blind study of sulindac and aspirin in juvenile chronic arthritis. 353 50

Prostaglandins are ubiquitous biologically active compounds that are involved in inflammatory reactions, hemostasis, and, under certain circumstances, the maintenance of renal function. NSAIDs, which inhibit PG synthesis, are used therapeutically most often as antiinflammatory agents in conditions of inflammation and pain, mostly of a nonurologic nature. However, since NSAIDs inhibit systemic PG synthesis, administration of NSAIDs can lead to adverse side effects. For example, the gastrointestinal irritation caused by NSAIDs probably reflects removal of a cytoprotective effect of gastrointestinal PGs. Similarly, the kidney may be especially susceptible to adverse effects of NSAIDs. In diseases such as peptic ulcers, diabetes, hypertension, congestive heart failure, liver disease with ascites, and renal insufficiency, PGs seem to play a protective role in the kidney. This protective role, which results from increased synthesis of vasodilator PGs in the face of elevated vasoconstrictors, is diminished in the presence of NSAIDs. Other side effects include the antagonism by NSAIDs of the action of diuretics, such that the dose of the diuretic must be adjusted accordingly. The diuretic triamterene should not be used in conjunction with indomethacin due to several reported cases of toxicity. Another drug interaction involves the salicylates, which have been shown to diminish the uricosuric effects of probenecid and sulfinpyrazone. Likewise, since corticosteroids increase the renal clearance of salicylates, it is important to monitor the patient carefully following termination of steroid treatment in patients receiving large doses of salicylates, since this change in elimination can precipitate toxicity. In addition, the NSAIDs bind to plasma proteins and, as such, can displace or be displaced by other drugs that bind in the same manner and can result in either decreased efficacy or toxicity. Despite the fact that the kidney may not be the target of NSAID therapy, renal function may be adversely affected by NSAID treatment. It has therefore been proposed that a renal-sparing NSAID would be a very useful therapeutic agent. Sulindac (Clinoril) has been suggested to be such an agent, eg, able to inhibit systemic PG synthesis (usually monitored by measuring serum thromboxane synthesis) without an apparent effect on renal PG synthesis (monitored by measurement of urinary PGs). However, recent data have suggested that Sulindac does inhibit renal PG synthesis and does not exhibit selectivity. The reasons for the discrepancy are not clear, but may relate to the doses or time intervals examined.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Indications and contraindications for the use of nonsteroidal antiinflammatory drugs in urology. 393 61

Sulindac (Clinoril) was tested in an open clinical-therapeutical study with regard to its analgesic effect and the improvement of function in 20 patients of both sexes suffering from periarthropathy of the hip or shoulder. The treatment lasted 4 weeks. The therapeutic effect was judged on the basis of the influence on the spontaneous pain and on the pain by pressure, on the functional improvement and on the daily habits of the patients. It was noted, that there was a lasting improvement due to the analgesic effect already in the first week of therapy and an improvement of function in the second week of therapy in the majority of the cases. Sulindac was well tolerated. Laboratory findings in the beginning and at the end of the four weeks treatment period revealed no toxic effects on organs, particularly on hematopoietic system.
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PMID:[Sulindac in the treatment of soft tissue rheumatism (periarthropathy of the hip and shoulder (author's transl)]. 742 40