Keywords : paracetamol


Experimental evaluation of the antinociceptive and anti-inflammatory effects of rosuvastatin and its interaction with celecoxib and paracetamol

Abdullah M. Jawad; Sarmad A. Kashmar

The Medical Journal of Basrah University, 2015, Volume 33, Issue 1, Pages 44-50
DOI: 10.33762/mjbu.2015.103875

Background: Studies revealed that statins can result in a larger mortality benefit than can be readily explained by their cholesterol-lowering effect alone. These benefits might be related to the anti-inflammatory and other effects statins may have.
Aim: To find out the extent to which rosuvastatin can be considered as an antinociceptive and anti-inflammatory drug in comparison to two standard drugs; paracetamol and celecoxib.
Methods: Mice (a total of 132) of either sex, 3-4 weeks of age, 20-25 gm body weight, were used. Tests for nociception: tail flick, hot plate and formalin tests; and for inflammation (formalin for chronic inflammation, carrageenan-induced paw edema, and TNF alpha level in blood) were used. Rosuvastatin (7mg/kg), paracetamol (40mg/kg), celecoxib (6mg/kg) or their combination were administered orally once daily in a volume of 0.2 ml. TNF alpha level in blood was measured using ELISA kit.
Results: The antinociceptive effect of rosuvastatin was mild and was much less than that of paracetamol and celecoxib when tested in the tail-flick, hot-plate and formalin tests. It increased the latency for tail flick by only 13.3% when compared to pre-treatment measurements, and in formalin test, it reduced the licking time by 20.9% in comparison to control. The administration of rosuvastatin with either paracetamol or celecoxib did not add to the antinociceptive effects of the latter two drugs except in formalin test for pain. None of the above mentioned drugs reduced hind-paw edema when measured 24 hours after formalin injection, while they produced a significant edema-reducing effect after 14 days. Again there was no additive effect between rosuvastatin and either paracetamol or celecoxib; in contrast, rosuvastatin reduced nearly all the effects of celecoxib when given in combination. Similar trend was found when edema-induced by carrageenan injection.
Conclusion: Rosuvastatin showed a significant antinociceptive effect in tail flick and in formalin test, but not in hot plate test in mice. It had anti-inflammatory and edema-reducing effects in models of inflammation but the effect was less than that of celecoxib and even paracetamol. These rosuvastatin effects did not add to those of paracetamol and had caused a reduction in celecoxib effects, when given in combination, except in formalin test for pain where there were additive effect.

The effect of diclofenac sodium given alone or in combination with paracetamol in ‎treatment of patients with type-2 diabetes mellitus‎

Maha J. A. Makki; Hussam J. Umran; Abdullah M. Jawad

The Medical Journal of Basrah University, 2014, Volume 32, Issue 1, Pages 22-29
DOI: 10.33762/mjbu.2014.94444

Background: Type-2 diabetes mellitus (T2DM), is becoming an important health problem worldwide. Diabetes ‎mellitus may be associated with low grade chronic inflammation and oxidative stress; both of them could contribute to ‎its pathogenesis. The use of anti-inflammatory and/or antioxidant drugs, therefore, represents a promising attempt for ‎treatment and/or prevention of this disease.‎
Objectives: To compare the effect of diclofenac sodium alone and when combined with paracetamol in type-2 diabetic ‎patients not achieving target HbA1c.‎
Patients and Methods: Twenty four, type-2 diabetic patients consulting the Center for Diabetes and Endocrinology in ‎Maysan, south of Iraq, had managed to complete the 3 month period of the first part of this study after meeting a set of ‎inclusion criteria. Their HbA1c was more than 7% despite the continuous use of oral antihyperglycemic drugs. The ‎effect of diclofenac was compared with another group (n=21) that received paracetamol in addition to diclofenac ‎sodium. Blood samples were taken from before, one month and three months after the start of treatments for ‎measurement of HbA1c, C-reactive protein, C-peptide level and more frequently plasma glucose level ‎‎(fasting/random). Another sixty patients of similar inclusion criteria were also followed for three months but without ‎treatment and served as a control group.‎
Results: The effect of one month treatment with diclofenac sodium alone or in combination with paracetamol resulted ‎respectively in a reduction in HbA1c by 9.4% and 11.4%, a reduction in CRP by 62.1% and 79.6%, an increase in C-‎peptide by 262.5% and 216%, a reduction in FPG by 11.2% and 18.1% and a reduction in RPG by 40.3% and 24.8% in ‎comparison to pre-treatment levels.‎
The HOMA- ß C-peptide measured in a limited number of patients treated with diclofenac sodium or its combination ‎with paracetamol showed an increase by 405.3% and 330.6% three months after start of treatment for the two groups ‎respectively. The control, non- intervention group did not show significant changes in the levels of HbA1c over the ‎three-month period. ‎
Conclusion: Diclofenac sodium 100mg SR capsule administered once daily for one month seems to be effective in ‎achieving a good glycemic control in patients not achieving target HbA1c. The addition of paracetamol to diclofenac did ‎not show a clear synergistic effect, despite paracetamol beneficial effect that had been shown in a previous study. ‎

The potential therapeutic benefit of paracetamol in treatment of patients with type-2 diabetes mellitus

Maha J. A. Makki; Hussam J. Umran; Abdullah M. Jawad

The Medical Journal of Basrah University, 2013, Volume 31, Issue 2, Pages 47-52
DOI: 10.33762/mjbu.2013.90707

Background: Oxidative stress may contribute to the pathogenesis of diabetes mellitus, and hyperglycemia and oxidative stress can reinforce each other. The use of antioxidant drugs, therefore, may be beneficial in treatment of diabetes mellitus and paracetamol had been shown to have antioxidant activity.
Objectives: To evaluate the potential role of paracetamol in type-2 diabetic patients not achieving target glycated hemoglobin (HbA1c).
Patients and Methods: Twenty four type-2 diabetic patients consulting the Center for Diabetes and Endocrinology in Maysan were included in this study after meeting a set of inclusion criteria. Their HbA1c was more than 7% despite the continuous use of oral antihyperglycemic drugs. Patients were treated with paracetamol 1000mg tablet once daily for one month. Blood samples were taken before, one month and three months after the start of treatments for measurement of HbA1c, C-reactive protein, C-peptide level, total antioxidant capacity and more frequently plasma glucose level (fasting/random). Another sixty patients of similar inclusion criteria were also followed for three months but without treatment with paracetamol and served as a control group.
Results: One month treatment with paracetamol (n=24) resulted in a beneficial effect particularly when measured two months after cessation of paracetamol treatment. Paracetamol significantly reduced HbA1c by 7.32% and random plasma glucose (RBG) by 22%, and greatly increased C-peptide by 443%. Total antioxidant capacity measured once after one month of paracetamol treatment increased by 20.2%. Unexpectedly, CRP was reduced significantly by 63.9%. The control, non- intervention group did not show significant changes in the levels of HbA1c over the three month period. Measurement of HOMA- ß C-peptide in a limited number of patients indicate that paracetamol significantly improve ß-cell function.
Conclusion: Paracetamol 1000mg tablet, when administered once daily for one month seem to be effective in achieving a good glycemic control in patients not achieving target HbA1c.