The Effect of Ibuprofen, Ponstan and Panadol Oral Suspensions on the Gastrointestinal Mucosal Layer in Mice

Subject Areas : Journal of Chemical Health Risks

Seeham Ali  Alkafajy ¹ (Lecturers, Biology Department, Science College, Mustansiriyah University, Baghdad, Iraq)
Abeer Salih  Ali ² (Lecturers, Biology Department, Science College, Mustansiriyah University, Baghdad, Iraq)

Received: 2021-08-05 Accepted : 2021-11-10 Published : 2022-09-01

Keywords: Antipyretic, Prostaglandins, Antiinflammatory, Pediatric, Non-selective,

Abstract :

Antipyretic drugs such as suspensions of Mefenamic acid (Ponstan), Ibuprofen and paracetamol (acetaminophen) are the most common drugs that wildly used in children to decrease the fever, pain and inflammation, and from clinical observations of children using these drugs, found they cause gastrointestinal complications and from this, the idea of this research was to find the effect of these drugs on the mucous membrane of the gastrointestinal tract in Swiss albino mice.In the present study, we used 30 mice classified into five groups which are G1 as control group, G2 receive 15 mg kg -1day-1 panadol, G3 receive 30 mg kg-1day-1ibuprofen, G4 receive 5 mg kg-1 day-1 Ponestan and G5 receive a combination of panadol and ibuprofen in same the previously doses respectively for 7 days. The gastric histological sections of G2 were normal mucosal, G4 shown mild mucosal glandular hyperplasia, while G3 and G5 groups appear flat mucosal surface with submucosal hyperplasia of gland mild atypical cells, and G2 showing mucosal glandular hyperplasia. The intestine histological sections of G2 appears normal intestinal villi with mild inflammatory cells infiltration, G3 shown dispersed slight shortening of intestinal villi with mild inflammatory cells infiltration, finally G4 and G5 shown villi hyperplasia with a slight widening of villi with mild inflammatory cells infiltration. NSAIDs are available over-the-counter drugs for adult and in pediatric population And it is considered a safe medicine if used in properly dose in the short-term, the decision to pick an antipyretic should be dictated by safety, efficacy, effectiveness, duration of action and the integrity of the patient gut.

References:

1. Eefje G.P de B, Julie M.M.L., Dagmar A.S.H., Nicole L., Yvonne G.H., Geert-Jan D., Jochen W.L.C., 2015.Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study, BMJ Open.5(5):e007365.doi:10.1136/ bmjopen-2014-007365.


2. El-Radhi A.S., 2019. Pathogenesis of Fever. Clinical Manual of Fever in Children. 53–68 doi: 10.1007/978-3-319-92336-9_3.


3. Alexander K.C.L., Kam L.H., Theresa N.H.L., 2018. Febrile seizures:an overview, Drugs Context.7, 212536.doi: 10.7573/dic .212536.


4. Chiappini E., Parretti A., Becherucci P., Pierattelli M., Bonsignori F., Galli L., de Martino M., 2012. Parental and medical knowledge and management of fever in Italian pre-school children. BMC Pediatric. 12(1), 97. [http://dx.doi.org/10.1186/1471-2431-12-97].


5. Huang C., Lu B., Yi-Hong F., Zhang L., Jiang N., Zhang S., Li- Na M., 2014,Muscovite is protective against non-steroidal anti-inflammatory drug- induced small bowel injury. World J Gastroenterol. 20(31), 11012.


6. Struct B.J., 2016. The structure of ibuprofen bound to cyclooxygenase-2, J Struct Biol. 189(1), 62–66.doi:10.1016/j.jsb .2014.11.005.


7. Charles N.F., Estella T.F, Kechia F., Bathelemy N., 2018. Bonaventure N., Overview of non-steroidal anti-inflammatory drugs (nsaids) in resource limited countries, MOJ Toxicol. 4(1), 5‒13. DOI:10.15406/mojt.04.00081


8. Klotz U., 2012.Paracetamol (Acetaminophen) - a Popular and Widely Used Nonopioid Analgesic, Arzneimittel-Forschung. 62(8), 355 -9. DOI: 10.1055/s 0032-1321785.


9. Balasubramanian S., Sumanth A., 2010. Mefenamic acid – Role as Antipyretic Indian paediatrics. 17(47), 453.


10. Woessner K.M., Castells M., 2013. NSAID single–drug–induced reactions" Immunol Allergy Clin North Am. 33(2), 237–249.


11. Marginean C.O., Meliţ L.E., Chinceşan M., 2017 Communication skills in pediatrics - the relationship between pediatrician and child. Medicine (Baltimore). 96, e8399.


12. Singla N.K., Parulan C., Samson R., 2012. Plasma and cerebrospinal fluip harmacokinetic parameters after single-dose administration of in travenousi, oral, or rectal acetaminophen. Pain Pract. 12(7), 523-532.doi:10.1111/j.15332500.2012.00556.x.


13. Ghanem C.I., Perez M.J., Manautou  J.E., Mottino A.D., 2016  Acetaminophen from  liver to brain: New insights into drug pharmacological action and toxicity. PharmacolRes. 109, 119-31.


14. Bunchorntavakul C., Reddy K.R., 2013. Acetaminophen-related hepatotoxicity Clin Liver Dis. 17(4), 587-607.


15. Kanabar D.J.A., 2017. Clinical and safety review of paracetamol and ibuprofen in children, Inflammopharmacology. 25(1), 1–9.


16. Kunkulol R.R., Sonawane A., Ashok K.Ch., 2013. (evalution of efficacy and tolerability of acetaminophen (paracetamol) and meffenamic acid as antipyretic in patients with febrile illness: Acomparative study. Int JMe Res Health Sci. 2(1), 23-29.


17. Bancroft J.D., Stevens A.,Turner D.R. Theory and Practice of Histological Techniques, 4th ed., Churchill Livingstone,1996. London, Toronto.


18. Singgih M.F., Achmad H., Sukmana B.I., Carmelita A.B., Putra A.P., Ramadhany S., Putri A.P., 2020.A Review of Nonsteroidal Anti- Inflammatory Drugs (NSAIDs) Medications in Dentistry: Uses and Side Effects, Sys Rev Pharm.11(5), 293-298.


19. Maria O.M., Lorena E.M., Simona M., Vladuț S., 2018. Ibuprofen, a Potential Cause of Acute Hemorrhagic Gastritis in Children - A Case Report, J Crit Care Med (Targu Mures). 4(4), 143–146, doi: 10.2478/jcc 2018-0022.


20. Bernard B., 2004. Gastrointestinal safety of paracetamol: Is there any cause for concern? J Expert Opinion on Drug Safety. 3(4), 269-72.


21. Ito Y., Yukinari T., Yanagawa A., Nakagawa T., 1992. NSAIDs (non- steroidal anti-inflammatory drugs) for the treatment of rheumatoid arthritis.Nihon rinsho. Japanese Journal of Clinical Medicine. 50(3), 509-514.


22. Bjarnason I., Scarpignato C., Erik H., Michael O., Kim D.R., Angel L., 2018,Mechanisms of Damage to the Gastrointestinal Tract From Nonsteroidal Anti-Inflammatory Drugs, Gastroenterology 154, 500–514.


23. Rostom A., Dube C., Wells G.A., Tugwell P., Welch V., Jolicoeur E., Lanas A, 2002. Prevention of NSAID induced gastroduodenal ulcers. Cochrane Database Syst Rev. 4, CD002296. 


24. Rao C.V, Sairam K., Goel R.K., 2000. Experimental evaluation of Bocopa monniera on rat gastric ulceration and secretion. Indian J Physiol Pharmacol. 44(4), 435–441.


25. Wallace J.L., 2008. Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn't the stomach digest itself? Physiological reviews. 88(4), 1547-1565.


26. Ahluwalia A., Jones M.K., Hoa N., Tarnawski A.S., 2019, Mito-chondria in gastric epithelial cells is the key targets for NSAIDs induced injury and NGF cyto-protection. Journal of Cellular Biochemistry. 120 (7), 11651- 11659.


27. Falavigna M., Stein P.C., Flaten G.E., Di Cagno M.P., 2020. Impact of Mucin on Drug Diffusion: Development of a Straightforward in Vitro Method for the Determination of Drug Diffusivity in the Presence of Mucin Pharma - ceutics, 12(2), 168.


28. Kalra B.S., Chaturvedi S., Tayal V.,Gupta U., 2009. Evaluation of gastric tolerability, antinociceptive and antiinflammatory activity of combination NSAIDs in rats. Indian Journal of Dental Research. 20(4), 418.


29. Sostres C., Gargallo C.J., Lanas A., 2013. Nonsteroidalanti-inflammatory drugs and upper and lower gastrointestinal mucosal damage. Arthritis research & therapy. 15 Suppl 3(Suppl3), S3. https://doi.org/10.1186/ar4175.