An anti-inflammatory agent, structurally related to the SALICYLATES, which is active in INFLAMMATORY BOWEL DISEASE. It is considered to be the active moiety of SULPHASALAZINE. (From Martindale, The Extra Pharmacopoeia, 30th ed)
Anti-inflammatory agents that are non-steroidal in nature. In addition to anti-inflammatory actions, they have analgesic, antipyretic, and platelet-inhibitory actions.They act by blocking the synthesis of prostaglandins by inhibiting cyclooxygenase, which converts arachidonic acid to cyclic endoperoxides, precursors of prostaglandins. Inhibition of prostaglandin synthesis accounts for their analgesic, antipyretic, and platelet-inhibitory actions; other mechanisms may contribute to their anti-inflammatory effects.
Inflammation of the COLON that is predominantly confined to the MUCOSA. Its major symptoms include DIARRHEA, rectal BLEEDING, the passage of MUCUS, and ABDOMINAL PAIN.
INFLAMMATION of the MUCOUS MEMBRANE of the RECTUM, the distal end of the large intestine (INTESTINE, LARGE).
Medicated dosage forms that are designed to be inserted into the rectal, vaginal, or urethral orifice of the body for absorption. Generally, the active ingredients are packaged in dosage forms containing fatty bases such as cocoa butter, hydrogenated oil, or glycerogelatin that are solid at room temperature but melt or dissolve at body temperature.
A drug that is used in the management of inflammatory bowel diseases. Its activity is generally considered to lie in its metabolic breakdown product, 5-aminosalicylic acid (see MESALAMINE) released in the colon. (From Martindale, The Extra Pharmacopoeia, 30th ed, p907)
A subtype of MICROSCOPIC COLITIS, characterized by chronic watery DIARRHEA of unknown origin, a normal COLONOSCOPY but abnormal histopathology on BIOPSY. Microscopic examination of biopsy samples taken from the COLON show larger-than-normal band of subepithelial COLLAGEN.
Drugs used for their effects on the gastrointestinal system, as to control gastric acidity, regulate gastrointestinal motility and water flow, and improve digestion.
A group of 2-hydroxybenzoic acids that can be substituted by amino groups at any of the 3-, 4-, 5-, or 6-positions.
The probability distribution associated with two mutually exclusive outcomes; used to model cumulative incidence rates and prevalence rates. The Bernoulli distribution is a special case of binomial distribution.
Dosage forms of a drug that act over a period of time by controlled-release processes or technology.
Diazo derivatives of aniline, used as a reagent for sugars, ketones, and aldehydes. (Dorland, 28th ed)
An antimetabolite antineoplastic agent with immunosuppressant properties. It interferes with nucleic acid synthesis by inhibiting purine metabolism and is used, usually in combination with other drugs, in the treatment of or in remission maintenance programs for leukemia.
Beryllium. An element with the atomic symbol Be, atomic number 4, and atomic weight 9.01218. Short exposure to this element can lead to a type of poisoning known as BERYLLIOSIS.
A form of pneumoconiosis caused by inhaled rare metal BERYLLIUM or its soluble salts which are used in a wide variety of industry including alloys, ceramics, radiographic equipment, and vacuum tubes. Berylliosis is characterized by an acute inflammatory reaction in the upper airway leading to BRONCHIOLITIS; PULMONARY EDEMA; and pneumonia.
A flammable, poisonous gas with a characteristic odor of rotten eggs. It is used in the manufacture of chemicals, in metallurgy, and as an analytical reagent. (From Merck Index, 11th ed)
The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.
A glucocorticoid used in the management of ASTHMA, the treatment of various skin disorders, and allergic RHINITIS.
An immunosuppressive agent used in combination with cyclophosphamide and hydroxychloroquine in the treatment of rheumatoid arthritis. According to the Fourth Annual Report on Carcinogens (NTP 85-002, 1985), this substance has been listed as a known carcinogen. (Merck Index, 11th ed)
Hard or soft soluble containers used for the oral administration of medicine.
Substances that reduce or suppress INFLAMMATION.
Therapeutic act or process that initiates a response to a complete or partial remission level.
A chronic transmural inflammation that may involve any part of the DIGESTIVE TRACT from MOUTH to ANUS, mostly found in the ILEUM, the CECUM, and the COLON. In Crohn disease, the inflammation, extending through the intestinal wall from the MUCOSA to the serosa, is characteristically asymmetric and segmental. Epithelioid GRANULOMAS may be seen in some patients.
Chemistry dealing with the composition and preparation of agents having PHARMACOLOGIC ACTIONS or diagnostic use.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Voluntary cooperation of the patient in taking drugs or medicine as prescribed. This includes timing, dosage, and frequency.

Mesalamine blocks tumor necrosis factor growth inhibition and nuclear factor kappaB activation in mouse colonocytes. (1/393)

BACKGROUND & AIMS: Derivatives of 5-aminosalicylic acid (mesalamine) represent a mainstay in inflammatory bowel disease therapy, yet the precise mechanism of their therapeutic action is unknown. Because tumor necrosis factor (TNF)-alpha is important in the pathogenesis of inflammatory bowel disease, we investigated the effect of mesalamine on TNF-alpha-regulated signal transduction and proliferation in intestinal epithelial cells. METHODS: Young adult mouse colon cells were studied with TNF-alpha, epidermal growth factor, or ceramide in the presence or absence of mesalamine. Proliferation was studied by hemocytometry. Mitogen-activated protein (MAP) kinase activation and IkappaBalpha expression were determined by Western blot analysis. Nuclear transcription factor kappaB (NF-kappaB) nuclear translocation was determined by confocal laser immunofluorescent microscopy. RESULTS: The antiproliferative effects of TNF-alpha were blocked by mesalamine. TNF-alpha and ceramide activation of MAP kinase were inhibited by mesalamine, whereas epidermal growth factor activation of MAP kinase was unaffected. TNF-alpha-stimulated NF-kappaB activation and nuclear translocation and the degradation of Ikappa-Balpha were blocked by mesalamine. CONCLUSIONS: Mesalamine inhibits TNF-alpha-mediated effects on intestinal epithelial cell proliferation and activation of MAP kinase and NF-kappaB. Therefore, it may function as a therapeutic agent based on its ability to disrupt critical signal transduction events in the intestinal cell necessary for perpetuation of the chronic inflammatory state.  (+info)

Intestinal metabolism and transport of 5-aminosalicylate. (2/393)

The purpose of this study was to determine the characteristics of intestinal absorption and metabolism of 5-aminosalicylic acid (5ASA). Regional perfusions of 5ASA in the anesthetized rat resulted in the appearance of N-acetyl-5-aminosalicylic acid in the intestinal lumen. Lumenal metabolite appearance was proportional to 5ASA permeability, which was 5-fold higher in the jejunum than in the ileum. Intestinal elimination significantly decreases 5ASA absorption at low lumenal drug concentrations and this process is saturated at high drug concentrations. Metabolite levels in intestinal tissue were higher than plasma levels at low perfusion drug concentrations, whereas the reverse was observed at high concentrations. Transport and metabolism of 5ASA was studied in Caco-2 monolayers. At low drug concentrations, 5ASA was preferentially transported in the basolateral (BL) to apical (AP) direction. With 5ASA incubation in either the AP or BL chamber, the N-acetyl metabolite appeared only in the AP compartment. Transport of N-acetyl-5-aminosalicylic acid was also exclusively observed in the BL to AP direction. Clinical data indicate that anti-inflammatory response to oral 5ASA correlates with the amount of 5ASA delivered to the intestinal tissue. This study shows that at lumenal levels below 200 microg/ml (concentrations that are typically achieved by controlled release dosage forms), intestinal secretion of 5ASA accounts for more than 50% of the total elimination and can significantly affect tissue levels and, therefore, may be an important factor in determining the response to 5ASA therapy.  (+info)

The systemic load and efficient delivery of active 5-aminosalicylic acid in patients with ulcerative colitis on treatment with olsalazine or mesalazine. (3/393)

BACKGROUND: There have been reports of nephrotoxic reactions in patients with ulcerative colitis treated with 5-aminosalicylic acid (5-ASA) preparations. AIM: To compare the efficacy in delivery of active 5-ASA to the colon and the systemic load as the basis for potential long-term toxicity during treatment with olsalazine or mesalazine in patients with ulcerative colitis in remission. PATIENTS AND METHODS: Fifteen patients with ulcerative colitis were treated with olsalazine or mesalazine, each for 7 days in an open, randomized, crossover design study. 5-ASA and acetyl-5-ASA (Ac-5-ASA) in plasma and urine were measured by high performance liquid chromatography. RESULTS: The plasma concentration of 5-ASA was 1.2 +/- 0.1 micromol/L (mean +/- S.E.M.) for olsalazine and 8.0 +/- 1.9 micromol/L for mesalazine, while the plasma concentration of Ac-5-ASA was 2.8 +/- 0.2 micromol/L for olsalazine and 10.8 +/- 1.6 micromol/L for mesalazine. The amount of 5-ASA excreted in the urine was 68 +/- 30 micromol/24 h for olsalazine and 593 +/- 164 micromol/24 h for mesalazine. The amount of Ac-5-ASA in the urine was 1260 +/- 102 micromol/24 h for olsalazine and 3223 +/- 229 micromol/24 h for mesalazine. The urinary recovery of total 5-ASA plus Ac-5-ASA (as a percentage of the given dose) was 23 +/- 2.1% for olsalazine and 39 +/- 3.6% for mesalazine. The ratio between the plasma concentrations of mesalazine and olsalazine differed significantly both for 5-ASA (5.1) and Ac-5-ASA (3.6); for 5-ASA (9. 9) and Ac-5-ASA (2.6) in urine, and for the urinary recovery of total 5-ASA plus Ac-5-ASA (1.7). Moreover, in the mesalazine group there was a large variation in the individual plasma concentrations of 5-ASA and Ac-5-ASA, with maximal values 5-6-fold higher than that in the olsalazine group. CONCLUSION: The systemic load of active 5-ASA is significantly higher for mesalazine than for olsalazine, when based on the dosages given and when calculated on an equimolar basis. Some of the patients in the mesalazine group showed unexpected high levels of plasma and urinary 5-ASA concentrations, a finding which may have long-term safety implications.  (+info)

Antioxidant effects of aminosalicylates and potential new drugs for inflammatory bowel disease: assessment in cell-free systems and inflamed human colorectal biopsies. (4/393)

BACKGROUND: The therapeutic efficacy of 5-aminosalicylic acid in inflammatory bowel disease may be related to its antioxidant properties. AIM: To compare in vitro the antioxidant effects of conventional drugs (5-aminosalicylic acid, corticosteroids, metronidazole), with new aminosalicylates (4-aminosalicylic acid, balsalazide) and other potential therapies (ascorbate, N-acetylcysteine, glutathione, verapamil). METHODS: Compounds were assessed for efficacy in reducing the in vitro production of reactive oxygen species by cell-free systems (using xanthine/xanthine oxidase, with or without myeloperoxidase) and by colorectal biopsies from patients with ulcerative colitis using luminol-amplified chemiluminescence. RESULTS: 5-aminosalicylic acid and balsalazide were more potent antioxidants than 4-aminosalicylic acid or N-acetyl-5-aminosalicylic acid in cell-free systems. 5-aminosalicylic acid (20 mM) and balsalazide (20 mM) inhibited rectal biopsy chemiluminescence by 93% and 100%, respectively, compared with only 59% inhibition by 4-aminosalicylic acid (20 mM). Hydrocortisone, metronidazole and verapamil had no significant effect on chemiluminescence in any system. Ascorbate (20 mM) inhibited chemiluminescence by 100% in cell-free systems and by 60% in rectal biopsies. N-acetyl cysteine (10 mM), and both oxidized and reduced glutathione (10 mM), completely inhibited chemiluminescence in cell-free systems, but not with rectal biopsies. CONCLUSIONS: The antioxidant effects of compounds varies between cell-free systems and inflamed colorectal biopsies. The effect of drugs on the chemiluminescence produced by these two assay systems is useful for screening potentially new antioxidant treatments for inflammatory bowel disease. Ascorbate seems worth further study as a novel therapy.  (+info)

Is maintenance therapy always necessary for patients with ulcerative colitis in remission? (5/393)

BACKGROUND: The efficacy of sulphasalazine and mesalazine in preventing relapse in patients with ulcerative colitis is well known. It is less clear how long such maintenance should be continued, and if the duration of disease remission is a factor that affects the risk of recurrence. AIM: To determine whether the duration of disease remission affects the relapse rate, by comparing the efficacy of a delayed-release mesalazine (Asacol, Bracco S.p.A., Milan, Italy) against placebo in patients with ulcerative colitis with short- and long-duration of disease remission. METHODS: 112 patients (66 male, 46 female, mean age 35 years), with intermittent chronic ulcerative colitis in clinical, endoscopic and histological remission with sulphasalazine or mesalazine for at least 1 year, were included in the study. Assuming that a lower duration of remission might be associated with a higher relapse rate, the patients were stratified according to the length of their disease remission, prior to randomization into Group A (Asacol 26, placebo 35) in remission from 1 to 2 years, or Group B (Asacol 28, placebo 23) in remission for over 2 years, median 4 years. Patients were treated daily with oral Asacol 1.2 g vs. placebo, for a follow-up period of 1 year. RESULTS: We employed an intention-to-treat analysis. In Group A, whilst no difference was found between the two treatments after 6 months, mesalazine was significantly more effective than placebo in preventing relapse at 12 months [Asacol 6/26 (23%), placebo 17/35 (49%), P = 0.035, 95% Cl: 48-2.3%]. In contrast, in Group B no statistically significant difference was observed between the two treatments, either at 6 or 12 months [Asacol 5/28 (18%), placebo 6/23 (26%), P = 0.35, 95% Cl: 31-14%] of follow-up. Patients in group B were older, and had the disease and remission duration for longer, than those in Group A. CONCLUSIONS: Mesalazine prophylaxis is necessary for the prevention of relapse by patients with ulcerative colitis in remission for less than 2 years, but this study casts doubt over whether continuous maintenance treatment is necessary in patients with prolonged clinical, endoscopic and histological remission, who are at very low risk of relapse.  (+info)

A new mesalazine gel enema in the treatment of left-sided ulcerative colitis: a randomized controlled multicentre trial. (6/393)

BACKGROUND: A new mesalazine rectal gel preparation (without propellant gas) has been recently developed to improve topical treatment in distal ulcerative colitis. AIM: To evaluate the efficacy, safety and patient tolerability of mesalazine gel enema compared with mesalazine foam enema in the treatment of patients with acute left-sided ulcerative colitis. METHODS: In a randomized multicentre investigator-blind parallel group trial, 103 patients with mild to moderate left-sided colitis or proctosigmoiditis were randomly allocated to mesalazine 2 g gel enema (n = 50 evaluable patients) and mesalazine 2 g foam enema (n = 53 evaluable patients) for 4 weeks. Clinical symptoms, endoscopic and histological findings were assessed at entry, 2 and 4 weeks. Patients' evaluation of treatment tolerability and acceptability was assessed at 2 and 4 weeks. RESULTS: After 4 weeks of treatment, clinical remission was achieved by 76% of mesalazine gel enema-treated patients and 69% of patients treated with mesalazine foam enema (P = 0.608). Endoscopic remission rates at week 4 were 51 and 52% for the mesalazine gel and foam enemas, respectively (P = 0.925). Histological remission was achieved by 30% of patients in both groups. Patients reported that the new mesalazine gel preparation was significantly better tolerated than the foam enema. Patients in the foam group had significantly more difficulty in retention (25% vs. 6%, P < 0.05), abdominal bloating (50% vs. 26%, P < 0.005) and discomfort during administration (48% vs. 26%, P < 0.05). CONCLUSION: The new mesalazine gel enema is efficacious and significantly better tolerated than the mesalazine foam enema.  (+info)

Evaluation of 5-aminosalicylic acid (5-ASA) for cancer chemoprevention: lack of efficacy against nascent adenomatous polyps in the Apc(Min) mouse. (7/393)

Recent experimental and epidemiological evidence suggests that nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in the prevention of colorectal cancer. However, the toxicity associated with the long-term use of most classical NSAIDs has limited their usefulness for the purpose of cancer chemoprevention. Inflammatory bowel disease (IBD) patients, in particular, are sensitive to the adverse side effects of NSAIDs, and these patients also have an increased risk for the development of intestinal cancer. 5-Aminosalicylic acid (5-ASA) is an anti-inflammatory drug commonly used in the treatment of IBD and may provide protection against the development of colorectal cancer in these patients. To directly evaluate the ability of 5-ASA to suppress intestinal tumors, we studied several formulations of 5-ASA (free acid, sulfasalazine, and Pentasa) at multiple oral dosage levels [500, 2400, 4800, and 9600 parts/million (ppm)] in the adenomatous polyposis coli (Apc) mouse model of multiple intestinal neoplasia (Min). Although the ApcMin mouse is not a model of colitis-associated neoplasia, it is, nonetheless, a useful model for assessing the ability of anti-inflammatory agents to prevent tumor formation in a genetically preinitiated population of cells. We used a study design in which drug was provided ad libitum through the diet beginning at the time of weaning (28 days of age) until 100 days of age. We included 200 ppm of piroxicam and 160 ppm of sulindac as positive controls, and the negative control was AIN-93G diet alone. Treatment with either piroxicam or sulindac produced statistically significant reductions in intestinal tumor multiplicity (95% and 83% reductions in tumor number, respectively; P < 0.001 versus controls). By contrast, none of the 5-ASA drug formulations or dosage levels produced consistent dose-progressive changes in polyp number, distribution, or size, despite high luminal and serum concentrations of 5-ASA and its primary metabolite N-acetyl-5-ASA. Thus, 5-ASA does not seem to possess direct chemosuppressive activity against the development of nascent intestinal adenomas in the ApcMin mouse. However, because intestinal tumor development in the ApcMin mouse is driven by a germline mutation in the Apc gene rather than by chronic inflammation, we caution that these findings do not definitively exclude the possibility that 5-ASA may exert a chemopreventive effect in human IBD patients.  (+info)

Prevention of post-operative recurrence of Crohn's disease requires adequate mucosal concentration of mesalazine. Gruppo Italiano per lo Studio del Colon e del Retto. (8/393)

BACKGROUND: Surgical resection of Crohn's disease is followed by early recurrence in a high percentage of patients. Mesalazine has been shown to be effective in the prevention of post-operative recurrence, but some 50% of patients under treatment recur at 3 years of follow-up. AIM: To establish whether the mucosal concentration of mesalazine might affect the development of post-operative recurrence. METHODS: Colon-ileoscopy was performed in 25 consecutive patients resected for Crohn's disease. The mean time from surgery was 14 months. After the operation, all patients were taking oral mesalazine (Asacol, 2.4 g/day). Ten patients showed signs of endoscopic recurrence (apthae, ulcers, narrowing of the lumen) in the neoterminal ileum, five of whom also showed juxta-anastomotic colonic involvement. Fifteen patients were free of recurrence. At endoscopy, four biopsies were taken from the perianastomotic area (two specimens at the ileal site and two specimens at the colonic site of the anastomosis). The specimens were weighed and immediately frozen at -80 degrees C. Mesalazine concentration (ng/mg) was measured in tissue homogenates by high- performance liquid chromatography with electrochemical detection. Fisher's exact test was used for the statistical analysis. RESULTS: The mean value of mucosal mesalazine concentration, expressed as ng/mg of tissue, was significantly lower in patients with recurrence than in those without recurrence both in the ileum (mean +/- s.d.: 21.6+/-28.3 vs. 70.9+/-47.4; P = 0.007) and in the colon (25.8+/-26.4 vs. 60.3+/-32.5; P = 0.010). CONCLUSIONS: The mucosal concentration of mesalazine in the juxta-anastomatic area is significantly lower in patients with recurrence than in those free of recurrence. These data could suggest an association between mucosal mesalazine concentrations and the clinical effectiveness of the drug.  (+info)

Mesalamine is an anti-inflammatory drug that is primarily used to treat inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn's disease. It works by reducing inflammation in the intestines, which can help alleviate symptoms like diarrhea, abdominal pain, and rectal bleeding.

Mesalamine is available in various forms, including oral tablets, capsules, suppositories, and enemas. The specific formulation and dosage may vary depending on the severity and location of the inflammation in the gut.

The drug's anti-inflammatory effects are thought to be mediated by its ability to inhibit the activity of certain enzymes involved in the inflammatory response, such as cyclooxygenase and lipoxygenase. By reducing inflammation, mesalamine can help promote healing and prevent recurrences of IBD symptoms.

It's important to note that mesalamine may cause side effects, including headache, nausea, vomiting, and abdominal pain. In rare cases, it may also cause more serious side effects like kidney damage or allergic reactions. Patients should talk to their healthcare provider about the potential risks and benefits of taking mesalamine.

Non-steroidal anti-inflammatory agents (NSAIDs) are a class of medications that reduce pain, inflammation, and fever. They work by inhibiting the activity of cyclooxygenase (COX) enzymes, which are involved in the production of prostaglandins, chemicals that contribute to inflammation and cause blood vessels to dilate and become more permeable, leading to symptoms such as pain, redness, warmth, and swelling.

NSAIDs are commonly used to treat a variety of conditions, including arthritis, muscle strains and sprains, menstrual cramps, headaches, and fever. Some examples of NSAIDs include aspirin, ibuprofen, naproxen, and celecoxib.

While NSAIDs are generally safe and effective when used as directed, they can have side effects, particularly when taken in large doses or for long periods of time. Common side effects include stomach ulcers, gastrointestinal bleeding, and increased risk of heart attack and stroke. It is important to follow the recommended dosage and consult with a healthcare provider if you have any concerns about using NSAIDs.

Ulcerative colitis is a type of inflammatory bowel disease (IBD) that affects the lining of the large intestine (colon) and rectum. In ulcerative colitis, the lining of the colon becomes inflamed and develops ulcers or open sores that produce pus and mucous. The symptoms of ulcerative colitis include diarrhea, abdominal pain, and rectal bleeding.

The exact cause of ulcerative colitis is not known, but it is thought to be related to an abnormal immune response in which the body's immune system attacks the cells in the digestive tract. The inflammation can be triggered by environmental factors such as diet, stress, and infections.

Ulcerative colitis is a chronic condition that can cause symptoms ranging from mild to severe. It can also lead to complications such as anemia, malnutrition, and colon cancer. There is no cure for ulcerative colitis, but treatment options such as medications, lifestyle changes, and surgery can help manage the symptoms and prevent complications.

Proctitis is a medical condition that refers to inflammation of the lining of the rectum, which is the lower end of the colon. The symptoms of proctitis may include rectal pain, discomfort, or a feeling of fullness; rectal bleeding, often in the form of mucus or blood; diarrhea; and urgency to have a bowel movement.

Proctitis can be caused by a variety of factors, including infections (such as sexually transmitted infections, foodborne illnesses, or inflammatory bowel diseases like Crohn's disease or ulcerative colitis), radiation therapy, trauma, or autoimmune disorders. The diagnosis of proctitis typically involves a physical examination, medical history, and sometimes endoscopic procedures to visualize the rectum and take tissue samples for further testing. Treatment depends on the underlying cause but may include antibiotics, anti-inflammatory medications, or other therapies.

A suppository is a solid medicinal formulation, often medicated, that is intended to be introduced into the rectum (rectal suppository), vagina (vaginal suppository), or urethra (urethral suppository) for absorption or for localized effect. Suppositories are designed to melt or dissolve at body temperature and release the active ingredients. They come in various shapes, such as cones, cylinders, or torpedo-shaped, and are typically made from a base of cocoa butter, polyethylene glycol, or other biocompatible materials that allow for controlled drug release. Common uses for suppositories include the treatment of constipation, hemorrhoids, local infections, menstrual cramps, and as an alternative method of administering medication for individuals who have difficulty swallowing pills or prefer not to use oral medications.

Sulfasalazine is defined as a medication that is commonly used to treat inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn's disease. It is also used in the treatment of rheumatoid arthritis. Sulfasalazine has an anti-inflammatory effect, which helps to reduce inflammation in the gut or joints.

The medication contains two components: sulfapyridine and 5-aminosalicylic acid (5-ASA). The sulfapyridine component is an antibiotic that may help to reduce the number of harmful bacteria in the gut, while the 5-ASA component is responsible for the anti-inflammatory effect.

Sulfasalazine works by being broken down into its two components after it is ingested. The 5-ASA component then acts directly on the lining of the gut to reduce inflammation, while the sulfapyridine component is absorbed into the bloodstream and excreted in the urine.

Common side effects of sulfasalazine include nausea, vomiting, heartburn, headache, and loss of appetite. Less common but more serious side effects may include allergic reactions, liver or kidney problems, and blood disorders. It is important to take sulfasalazine exactly as directed by a healthcare provider and to report any concerning symptoms promptly.

Collagenous colitis is a type of chronic inflammatory bowel disease that affects the colon. It is characterized by the abnormal accumulation of collagen, a protein that provides structure to the body's tissues, beneath the lining of the colon. This can cause symptoms such as chronic watery diarrhea, abdominal pain, and bloating. The exact cause of collagenous colitis is not known, but it may be associated with autoimmune disorders or the use of certain medications. In some cases, the condition may resolve on its own, while in others, treatment with medications such as anti-inflammatory drugs or immunosuppressants may be necessary to manage symptoms and prevent complications.

Gastrointestinal agents are a class of pharmaceutical drugs that affect the gastrointestinal (GI) tract, which includes the organs involved in digestion such as the mouth, esophagus, stomach, small intestine, large intestine, and anus. These agents can have various effects on the GI tract, including:

1. Increasing gastric motility (promoting bowel movements) - laxatives, prokinetics
2. Decreasing gastric motility (reducing bowel movements) - antidiarrheal agents
3. Neutralizing gastric acid - antacids
4. Reducing gastric acid secretion - H2-blockers, proton pump inhibitors
5. Protecting the mucosal lining of the GI tract - sucralfate, misoprostol
6. Relieving symptoms associated with GI disorders such as bloating, abdominal pain, and nausea - antispasmodics, antiemetics

Examples of gastrointestinal agents include:

* Laxatives (e.g., psyllium, docusate)
* Prokinetics (e.g., metoclopramide)
* Antacids (e.g., calcium carbonate, aluminum hydroxide)
* H2-blockers (e.g., ranitidine, famotidine)
* Proton pump inhibitors (e.g., omeprazole, lansoprazole)
* Sucralfate
* Misoprostol
* Antispasmodics (e.g., hyoscyamine, dicyclomine)
* Antiemetics (e.g., ondansetron, promethazine)

It is important to note that gastrointestinal agents can have both therapeutic and adverse effects, and their use should be based on a careful evaluation of the patient's condition and medical history.

Aminosalicylic acids are a group of medications that contain a chemical structure related to salicylic acid, which is the active ingredient in aspirin. These medications are primarily used to treat inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis. The most common aminosalicylates used for IBD include mesalamine, sulfasalazine, and olsalazine.

These drugs work by reducing the production of chemicals in the body that cause inflammation in the lining of the intestines. By decreasing inflammation, they can help alleviate symptoms such as diarrhea, abdominal pain, and rectal bleeding associated with IBD. Additionally, aminosalicylates may also have a protective effect on the lining of the intestines, helping to prevent further damage.

Aminosalicylates are available in various forms, including tablets, capsules, suppositories, and enemas, depending on the specific medication and the location of the inflammation within the digestive tract. While these medications are generally well-tolerated, they can cause side effects such as headache, nausea, vomiting, and abdominal pain in some individuals. It is essential to follow the prescribing physician's instructions carefully when taking aminosalicylates to ensure their safe and effective use.

Binomial distribution is a type of discrete probability distribution that describes the number of successes in a fixed number of independent Bernoulli trials with the same probability of success. It is called a "binomial" distribution because it involves the sum of two outcomes: success and failure. The binomial distribution is defined by two parameters: n, the number of trials, and p, the probability of success on any given trial. The possible values of the random variable range from 0 to n.

The formula for calculating the probability mass function (PMF) of a binomial distribution is:

P(X=k) = C(n, k) \* p^k \* (1-p)^(n-k),

where X is the number of successes, n is the number of trials, k is the specific number of successes, p is the probability of success on any given trial, and C(n, k) is the number of combinations of n items taken k at a time.

Binomial distribution has many applications in medical research, such as testing the effectiveness of a treatment or diagnostic test, where the trials could represent individual patients or samples, and success could be defined as a positive response to treatment or a correct diagnosis.

I couldn't find a medical definition specifically for "delayed-action preparations." However, in the context of pharmacology, it may refer to medications or treatments that have a delayed onset of action. These are designed to release the active drug slowly over an extended period, which can help to maintain a consistent level of the medication in the body and reduce the frequency of dosing.

Examples of delayed-action preparations include:

1. Extended-release (ER) or controlled-release (CR) formulations: These are designed to release the drug slowly over several hours, reducing the need for frequent dosing. Examples include extended-release tablets and capsules.
2. Transdermal patches: These deliver medication through the skin and can provide a steady rate of drug delivery over several days. Examples include nicotine patches for smoking cessation or fentanyl patches for pain management.
3. Injectable depots: These are long-acting injectable formulations that slowly release the drug into the body over weeks to months. An example is the use of long-acting antipsychotic injections for the treatment of schizophrenia.
4. Implantable devices: These are small, biocompatible devices placed under the skin or within a body cavity that release a steady dose of medication over an extended period. Examples include hormonal implants for birth control or drug-eluting stents used in cardiovascular procedures.

Delayed-action preparations can improve patient compliance and quality of life by reducing dosing frequency, minimizing side effects, and maintaining consistent therapeutic levels.

Phenylhydrazines are organic compounds that contain a phenyl group (a benzene ring with a hydrogen atom substituted by a hydroxy group) and a hydrazine group (-NH-NH2). They are aromatic amines that have been used in various chemical reactions, including the formation of azos and hydrazones. In medicine, phenylhydrazines were once used as vasodilators to treat angina pectoris, but their use has largely been discontinued due to their toxicity and potential carcinogenicity.

6-Mercaptopurine (6-MP) is a medication used primarily in the treatment of cancer, specifically acute lymphoblastic leukemia (ALL), and to prevent rejection in organ transplantation. It is an antimetabolite that works by interfering with the synthesis of DNA and RNA, thereby inhibiting cell division and growth.

6-MP is a prodrug, meaning it requires metabolic activation in the body to exert its therapeutic effects. Once absorbed, 6-MP is converted into several active metabolites, including thioguanine nucleotides (TGN), which are incorporated into DNA and RNA, leading to cytotoxicity and cell death.

Common side effects of 6-MP include nausea, vomiting, diarrhea, mouth sores, and increased susceptibility to infections. Long-term use of the medication can also lead to liver toxicity, pancreatitis, and anemia. Regular monitoring of blood counts, liver function tests, and TGN levels is necessary during treatment with 6-MP to minimize potential side effects and ensure safe and effective dosing.

Beryllium is a chemical element with the symbol Be and atomic number 4. It is a steel-gray, hard, brittle alkaline earth metal that is difficult to fabricate because of its high reactivity and toxicity. Beryllium is primarily used as a hardening agent in alloys, such as beryllium copper, and as a moderator and reflector in nuclear reactors due to its ability to efficiently slow down neutrons.

In the medical field, beryllium is most well-known for its potential to cause a chronic allergic lung disease called berylliosis. This condition can occur after prolonged exposure to beryllium-containing dusts or fumes, and can lead to symptoms such as cough, shortness of breath, and fatigue. In severe cases, it can cause scarring and thickening of the lung tissue, leading to respiratory failure.

Healthcare professionals should take appropriate precautions when handling beryllium-containing materials, including using protective equipment and following proper disposal procedures to minimize exposure.

Berylliosis is a chronic inflammatory disease that affects the lungs and, less commonly, other organs. It is caused by exposure to beryllium, a lightweight, strong metal used in various industries such as aerospace, electronics, and nuclear energy. The disease can be categorized into two types: acute and chronic.

Acute berylliosis is a rare form of the disease that occurs after high levels of exposure to beryllium, usually through inhalation. Symptoms typically develop within a few weeks to months after exposure and include cough, chest pain, shortness of breath, and fatigue. Acute berylliosis can be severe and may require hospitalization.

Chronic berylliosis, also known as beryllium sensitization or beryllium disease, is a more common form of the disease that occurs after long-term exposure to low levels of beryllium. It is characterized by the development of an immune response to beryllium, resulting in chronic inflammation and scarring of the lung tissue. Symptoms may not appear for several years after exposure and can include cough, shortness of breath, fatigue, weight loss, and joint pain.

Diagnosis of berylliosis typically involves a combination of medical history, physical examination, chest X-ray or CT scan, pulmonary function tests, and blood tests to detect the presence of beryllium sensitization. Treatment may include corticosteroids and other immunosuppressive medications to manage inflammation and scarring in the lungs. Avoiding further exposure to beryllium is essential to prevent disease progression.

Hydrogen sulfide (H2S) is a colorless, flammable, and extremely toxic gas with a strong odor of rotten eggs. It is a naturally occurring compound that is produced in various industrial processes and is also found in some natural sources like volcanoes, hot springs, and swamps.

In the medical context, hydrogen sulfide is known to have both toxic and therapeutic effects on the human body. At high concentrations, it can cause respiratory failure, unconsciousness, and even death. However, recent studies have shown that at low levels, hydrogen sulfide may act as a signaling molecule in the human body, playing a role in various physiological processes such as regulating blood flow, reducing inflammation, and protecting against oxidative stress.

It's worth noting that exposure to high levels of hydrogen sulfide can be life-threatening, and immediate medical attention is required in case of exposure.

The colon, also known as the large intestine, is a part of the digestive system in humans and other vertebrates. It is an organ that eliminates waste from the body and is located between the small intestine and the rectum. The main function of the colon is to absorb water and electrolytes from digested food, forming and storing feces until they are eliminated through the anus.

The colon is divided into several regions, including the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anus. The walls of the colon contain a layer of muscle that helps to move waste material through the organ by a process called peristalsis.

The inner surface of the colon is lined with mucous membrane, which secretes mucus to lubricate the passage of feces. The colon also contains a large population of bacteria, known as the gut microbiota, which play an important role in digestion and immunity.

Budesonide is a corticosteroid medication that is used to reduce inflammation in the body. It works by mimicking the effects of hormones produced naturally by the adrenal glands, which help regulate the immune system and suppress inflammatory responses. Budesonide is available as an inhaler, nasal spray, or oral tablet, and is used to treat a variety of conditions, including asthma, chronic obstructive pulmonary disease (COPD), rhinitis, and Crohn's disease.

When budesonide is inhaled or taken orally, it is absorbed into the bloodstream and travels throughout the body, where it can reduce inflammation in various tissues and organs. In the lungs, for example, budesonide can help prevent asthma attacks by reducing inflammation in the airways, making it easier to breathe.

Like other corticosteroid medications, budesonide can have side effects, particularly if used at high doses or for long periods of time. These may include thrush (a fungal infection in the mouth), hoarseness, sore throat, cough, headache, and easy bruising or skin thinning. Long-term use of corticosteroids can also lead to more serious side effects, such as adrenal suppression, osteoporosis, and increased risk of infections.

It is important to follow the dosage instructions provided by your healthcare provider when taking budesonide or any other medication, and to report any unusual symptoms or side effects promptly.

Azathioprine is an immunosuppressive medication that is used to prevent the rejection of transplanted organs and to treat autoimmune diseases such as rheumatoid arthritis, lupus, and inflammatory bowel disease. It works by suppressing the activity of the immune system, which helps to reduce inflammation and prevent the body from attacking its own tissues.

Azathioprine is a prodrug that is converted into its active form, 6-mercaptopurine, in the body. This medication can have significant side effects, including decreased white blood cell count, increased risk of infection, and liver damage. It may also increase the risk of certain types of cancer, particularly skin cancer and lymphoma.

Healthcare professionals must carefully monitor patients taking azathioprine for these potential side effects. They may need to adjust the dosage or stop the medication altogether if serious side effects occur. Patients should also take steps to reduce their risk of infection and skin cancer, such as practicing good hygiene, avoiding sun exposure, and using sunscreen.

A capsule is a type of solid pharmaceutical dosage form in which the drug is enclosed in a small shell or container, usually composed of gelatin or other suitable material. The shell serves to protect the drug from degradation, improve its stability and shelf life, and facilitate swallowing by making it easier to consume. Capsules come in various sizes and colors and can contain one or more drugs in powder, liquid, or solid form. They are typically administered orally but can also be used for other routes of administration, such as rectal or vaginal.

Anti-inflammatory agents are a class of drugs or substances that reduce inflammation in the body. They work by inhibiting the production of inflammatory mediators, such as prostaglandins and leukotrienes, which are released during an immune response and contribute to symptoms like pain, swelling, redness, and warmth.

There are two main types of anti-inflammatory agents: steroidal and nonsteroidal. Steroidal anti-inflammatory drugs (SAIDs) include corticosteroids, which mimic the effects of hormones produced by the adrenal gland. Nonsteroidal anti-inflammatory drugs (NSAIDs) are a larger group that includes both prescription and over-the-counter medications, such as aspirin, ibuprofen, naproxen, and celecoxib.

While both types of anti-inflammatory agents can be effective in reducing inflammation and relieving symptoms, they differ in their mechanisms of action, side effects, and potential risks. Long-term use of NSAIDs, for example, can increase the risk of gastrointestinal bleeding, kidney damage, and cardiovascular events. Corticosteroids can have significant side effects as well, particularly with long-term use, including weight gain, mood changes, and increased susceptibility to infections.

It's important to use anti-inflammatory agents only as directed by a healthcare provider, and to be aware of potential risks and interactions with other medications or health conditions.

Remission induction is a treatment approach in medicine, particularly in the field of oncology and hematology. It refers to the initial phase of therapy aimed at reducing or eliminating the signs and symptoms of active disease, such as cancer or autoimmune disorders. The primary goal of remission induction is to achieve a complete response (disappearance of all detectable signs of the disease) or a partial response (a decrease in the measurable extent of the disease). This phase of treatment is often intensive and may involve the use of multiple drugs or therapies, including chemotherapy, immunotherapy, or targeted therapy. After remission induction, patients may receive additional treatments to maintain the remission and prevent relapse, known as consolidation or maintenance therapy.

Crohn's disease is a type of inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal tract, from the mouth to the anus. It is characterized by chronic inflammation of the digestive tract, which can lead to symptoms such as abdominal pain, diarrhea, fatigue, weight loss, and malnutrition.

The specific causes of Crohn's disease are not fully understood, but it is believed to be related to a combination of genetic, environmental, and immune system factors. The disease can affect people of any age, but it is most commonly diagnosed in young adults between the ages of 15 and 35.

There is no cure for Crohn's disease, but treatments such as medications, lifestyle changes, and surgery can help manage symptoms and prevent complications. Treatment options depend on the severity and location of the disease, as well as the individual patient's needs and preferences.

Pharmaceutical chemistry is a branch of chemistry that deals with the design, synthesis, and development of chemical entities used as medications. It involves the study of drugs' physical, chemical, and biological properties, as well as their interactions with living organisms. This field also encompasses understanding the absorption, distribution, metabolism, and excretion (ADME) of drugs in the body, which are critical factors in drug design and development. Pharmaceutical chemists often work closely with biologists, medical professionals, and engineers to develop new medications and improve existing ones.

The double-blind method is a study design commonly used in research, including clinical trials, to minimize bias and ensure the objectivity of results. In this approach, both the participants and the researchers are unaware of which group the participants are assigned to, whether it be the experimental group or the control group. This means that neither the participants nor the researchers know who is receiving a particular treatment or placebo, thus reducing the potential for bias in the evaluation of outcomes. The assignment of participants to groups is typically done by a third party not involved in the study, and the codes are only revealed after all data have been collected and analyzed.

Medication adherence, also known as medication compliance, refers to the degree or extent of conformity to a treatment regimen as prescribed by a healthcare provider. This includes taking medications at the right time, in the correct dosage, and for the designated duration. Poor medication adherence can lead to worsening health conditions, increased hospitalizations, and higher healthcare costs.

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