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Gold Compounds

Gold Compounds Struktur
CAS-Nr.
Englisch Name:
Gold Compounds
Synonyma:
Gold Compounds
CBNumber:
CB61318715
Summenformel:
Molgewicht:
0
MOL-Datei:
Mol file

Gold Compounds Eigenschaften

Sicherheit

Giftige Stoffe Daten GOLD COMPOUNDS(Hazardous Substances Data)

Gold Compounds Chemische Eigenschaften,Einsatz,Produktion Methoden

Indications

Gold compounds (chrysotherapy) are the oldest of the DMARDs in use to treat rheumatoid arthritis. Parentally administered gold is generally believed to be somewhat less effective than methotrexate; oral gold is less effective than parenteral preparations. Gold compounds take several months to produce a measurable effect. Among patients who can tolerate this therapy, some benefit will be obtained in about 80%, and complete remission will be induced in 20% of cases. Remissions are maintained for varying periods after discontinuing therapy, with a relapse rate as high as 80%. Relapse is usually less severe in such patients, and a second course of gold therapy usually produces beneficial effects.

Pharmakologie

The gold preparations available in the United States include two preparations administered via intramuscular injection: gold sodium thiomalate (GSTM, Myochrysine, Aurolate) and aurothioglucose (gold sodium thioglucose, GSTG, Solganal), and an oral preparation, auranofin (Ridaura). Although called gold salts, these compounds contain monovalent gold bound to sulfur, a bond that is at least partly covalent.
The mechanism by which gold compounds produce their antiarthritic effects is not known. Since gold therapy can suppress the increased phagocytic activity that occurs in rheumatoid arthritis, the antirheumatic activity of gold preparations may involve the inhibition of either antigen processing by macrophages or lysosomal enzyme release in the joint. Gold preparations also directly inhibit certain lysosomal enzymes found in polymorphonuclear leukocytes and macrophages.
Generally, 2 months of multiple dosing of gold compounds is required to reach steady-state levels. Auranofin therapy produces lower steady-state blood gold concentrations than does treatment with parenteral gold compounds, but it also produces a lower incidence of adverse effects.

Nebenwirkungen

Toxic manifestations of gold therapy are most common after a minimal total amount (200–300 mg) of gold has been administered. Serious reactions necessitating discontinuance of therapy or antidotal therapy are encountered in perhaps 5% of the patients.
Both oral and parenteral gold therapy frequently produces dermatitis, usually preceded and accompanied by pruritus. Stomatitis may accompany dermatitis, which may be preceded by a metallic taste in the mouth of the patient. Blue or gray skin discoloration can arise from gold deposition in that tissue, and photosensitivity may also occur. Unlike parenteral gold compounds, auranofin does not accumulate appreciably in the skin. Auranofin, but not the parenteral gold preparations, most frequently causes diarrhea (about 50%), abdominal pain, nausea, and anorexia.
Mild proteinuria is fairly common and does not always require discontinuance of therapy; however, severe proteinuria may indicate a toxic nephritis.The proteinuria is usually reversible when gold administration is stopped. Hepatotoxicity has also been reported. Fatalities from gold therapy have been reported, usually a consequence of a blood dyscrasia. The most common hematological abnormality is eosinophilia. Serious blood dyscrasias, such as thrombocytopenia, agranulocytosis, and hypoplastic or aplastic anemia, are rare.
To complement steroidal and other measures used in treating gold toxicity, it may be necessary to hasten the elimination of gold from the body.

Vorsichtsma?nahmen

Gold compounds are contraindicated for use in patientswith systemic lupus erythematosus, Sjgren’s syndrome,severe debilitation, or uncontrolled congestive heartfailure or hypertension. Caution must be used in administeringgold compounds to individuals who haveconditions that might increase their susceptibility togold toxicity: blood dyscrasias, immunosuppression, renaldisease, hepatic disease, skin diseases, or inflammatorybowel disease.Animal studies have shown adverseeffects on reproduction; gold compounds may distributeto breast milk and are therefore contraindicated forwomen who are breast-feeding.
Gold should be used cautiously in patients receivingdrugs that can also cause nephrotoxicity. Interactionsbetween gold compounds and penicillamine may resultin severe hematological and renal side effects.

Gold Compounds Upstream-Materialien And Downstream Produkte

Upstream-Materialien

Downstream Produkte


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