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Pharmaceutisch Weekblad

, Volume 2, Issue 1, pp 1133–1142 | Cite as

Zijn combinaties van niet-narcotische analgetica rationeel?

  • A. J. M. Seegers
Oorspronkelijke Artikelen

Samenvatting

Het dierexperimenteel onderzoek beschreven in dit proefschrift had tot doel de interacties tussen de bestanddelen van niet-narcotische analgeticacombinaties met betrekking tot hun maagbeschadigende, ontstekingsremmende, pijnstillende en koortsremmende werking op te helderen.

Coffeïne versterkt de maagbeschadigende werking van acetylsalicyizuur en van de combinatie acetylsalicylzuur met fenacetine; paracetamol daarentegen verzwakt de maagbeschadigende werking van acetylsalicylzuur en van de combinatie acetylsalicylzuur met coffeïne. Mogelijke oorzaken van deze interacties worden besproken.

De anti-inflammatoire, analgetische en antipyretische activiteiten van twee-en drievoudige combinaties van acetylsalicylzuur, paracetamol, fenacetine en coffeïne zijn tenminste gelijk aan die welke men op grond van additie kan verwachten.

De conclusies uit het experimentele deel van dit proefschrift worden in relatie met de effectiviteit en toxiciteit van de niet-narcotische analgetica bij de mens geëvalueerd. Geconcludeerd wordt dat coffeïnebevattende combinaties met acetylsalicylzuur als irrationeel moeten worden beschouwd, terwijl toevoeging van fenacetine geen voordelen biedt. Open blijft de vraag of bij de mens net zoals bij de rat een gunstige interactie tussen acetylsalicylzuur en paracetamol wat betreff maagbeschadiging kan worden waargenomen.

Are non-narcotic analgesic drug mixtures rational?

Abstract

The main purpose of the animal experiments described in this thesis was to elucidate the manner in which interactions between non-narcotic analgesics contribute to the gastric erosive activity of some of their combinations, and to evaluate these interactions in relation to the antiinflammatory, analgesic and antipyretic activities of the drugs concerned.

Caffeine potentiates the erosive activity of acetylsalicylic acid and of the combination of acetylsalicylic acid with phenacetin; on the other hand, paracetamol antagonises the erosive activity of acetylsalicylic acid and of the combination of acetylsalicylic acid with caffeine. Possible mechanisms underlying these interactions are discussed.

The anti-inflammatory, analgesic and antipyretic activities of dual and triple combinations of acetylsalicylic acid, paracetamol, phenacetin and caffeine at least equal addition of the activities of the individual component drugs.

The observed interactions are evaluated in relation to the current status of compound analgesics in clinical medicine; it is concluded that mixtures containing acetylsalicylic acid and caffeine are to be regarded as irrational whereas addition of phenacetin does not appear to offer any advantages. Whether a beneficial interaction between acetylsalicylic acid and paracetamol such as demonstrated on gastric mucosal damage in rats occurs in man remains to be established.

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De in het proefschrift beschreven onderzoekingen zijn inmiddels vastgelegd in enkele artikelen:

  1. Seegers, A. J. M., L. P. Jager enJ. Van Noordwuk (1978) Gastric erosions induced by analgesic drug mixtures in the rat.J. Pharm. Pharmacol. 30, 84–87.Google Scholar
  2. Seegers, A. J. M., L. P. Jager enJ. Van Noordwuk (1979) Effects of phenacetin, paracetamol and caffeine on the erosive activity of acetylsalicylic acid in the rat stomach: Dose-response relationships, time course of erosion development and effects on acid secretion.J. Pharm. Pharmacol. 31, 840–848.Google Scholar
  3. Seegers, A. J. M., L. P. Jager enJ. Van Noordwijk (1980) An hypothesis concerning the protective action of paracetamol against the erosive activity of acetylsalicylic acid in the rat stomach. In:Advances in Prostaglandin and Tromboxane Research, Vol 8 (Samuelsson, B., P. W. Ramwell enR. Paoletti, Eds.). Raven Press, New York, 1547–1551.Google Scholar
  4. Jager, L. P., A. J. M. Seegers enJ. Van Noordwijk (1980) Interactions between aspirin and other compounds in analgesic medicines on gastric mucosal damage in rats. In:Advances in Endoperoxide, Prostacyclin and Tromboxane Research, Vol 2 (Bertie, F., enG. P. Velo, Eds.). Plenum Press, New York — Londen, in druk.Google Scholar
  5. Seegers, A. J. M., M. Olling, L. P. Jager enJ. Van Noordwijk (1980) Interactions of aspirin with acetaminophen and caffeine in the rat stomach: Pharmacokinetics of absorption and accumulation in gastric mucosa.J. Pharm. Sci. 69, in druk.Google Scholar
  6. Seegers, A. J. M., L. P. Jager, P. Zandberg enJ. Van Noordwijk (1980) The anti-inflammatory, analgesic and antipyretic activities of non-narcotic analgesic drug mixtures in rats.J. Pharm. Pharmacol. 32, in druk.Google Scholar

Copyright information

© Bohn, Scheltema & Holkema 1980

Authors and Affiliations

  • A. J. M. Seegers
    • 1
    • 2
  1. 1.Laboratorium voor FarmacologieRijksinstituut voor de VolksgezondheidBilthoven
  2. 2.Vakgroep Farmacologie, Subfaculteit FarmacieRijksuniversiteit UtrechtUtrecht

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