Acometimento hepático na síndrome sulfona dapsona-induzida durante tratamento de hanseníase / Hepatic involvement in sulfone dapsone-induced syndrome during treatment of leprosy

A hanseníase é uma doença endêmica no Brasil e constitui grave problema de saúde pública. Em números absolutos, o Brasil é o segundo país que mais registra novos casos da doença por ano no mundo. O tratamento da hanseníase compreende: quimioterapia específica, supressão dos surtos reacionais, prevenção de incapacidades físicas, reabilitação física e psicossocial. A síndrome sulfona é uma condição multissistêmica potencialmente grave que pode ocorrer durante o tratamento de algumas dermatoses, entre elas a hanseníase. Relatamos um caso de síndrome de hipersensibilidade à dapsona (SHD) em um paciente masculino, de 32 anos, ocorrida durante o tratamento de hanseníase multibacilar...

Should sildenafil be available over the counter?

INTRODUCTION: This article considers the process of re-classification of prescription drugs from prescription-only medications to over-the-counter (OTC) prescription drugs. SOURCES OF DATA: The recent change in classification for emergency contraception and simvastatin is explored in detail with similarities and differences being considered for a similar argument to be made for sildenafil. AREAS OF AGREEMENT: The benefits for patients, physicians and other healthcare professionals are considered in detail. AREAS OF CONTROVERSY: We raise concerns about recently developed and existing patient group directions that, although extensive in their assessment, may omit to identify significant contributory factors which would necessitate appropriate medical intervention. GROWING POINTS: While the decision for re-classification to OTC would depend on a number of factors, we argue that, with the proviso of proper assessments being made, sildenafil should be made available as an OTC medication. AREAS TIMELY FOR DEVELOPING RESEARCH: The safety and use of OTC medications for erectile dysfunction at a time when many first line prescription agents are reaching generic status.

Preparation of 2-deoxy-2-C-p-tolylsulfonyl-beta-D-glucopyranosyl p-tolylsulfones having non-chair conformation and their elimination reactions.

When the title sulfones, which have non-chair conformations, were stirred with silica gel, elimination of sulfinic acid occurred to give a 1-enitol derivative, if the hydroxyl group at C-6 was protected, whereas such an elimination did not proceed if the hydroxy group was free.

Blood and urine concentrations of free and hydrolyzed sulfones in leprosy patienmts under treatment

A total of 275 determinations of the concentrations of free and hydrolized sulfones in the blood and urine were made in 137 patients over a period of three months. Analyses were made 24 hours after the last dose, and after a rest period of 14 days. In all of the 43 patients under promin treatment, the drug existed in the blood in the free form only, while in the urine it was found in both the free annnd conjugated forms after the 14-day rest period. The ratio between the free and conjugated drug in the urine varied considerably in different individuals. Of the 55 patients taking diasone, 26, or 47.3 per cent, showed conjugation of the drug in the blood 24 hours after the last dose, while in 29, or 52.7 per cent, there was no conjugation in the blood. No form of the drug was present in the blood of any of the patients after a rest period of 14 days. Conjugation in the urine occurred in 52 of the cases, 24 hour after the last oral dose and after the rest period. Concentrations of free and conjugated sulphetrone were noted in the blood and urine in the 15 cases studied, 24 hours after the last dose. This drug was not present in the blood after the rest period. Conjugation of sulphetrone in the urine occurred in 8 of the cases after the rest period, while free sulphetrone was eliminated in all of the cases. When the bloods and urines of 24 patients receiving promacetin were analyzed by directdiazotization and by acid hydrolysis the values for free and total sulfone were identical, which indicates that this drug was unaltered in the body of the patients studied.