Talk:Sulfasalazine
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[edit] NSAID?
The mode of action of sulfasalazine is through release of a metabolite, 5-amminosalicylic acid (5-ASA), which is an NSAID.
Aspirin (commonly abbreviated as "ASA") is acetylsalicylic acid, whereas 5-ASA is aminosalicylic acid. This may be your point of confusion.--69.180.214.43 18:57, 21 June 2007 (UTC)
Sulfasalazine does not have an analgesic effect. M dorothy
Drugbox doesn't work. Why?
[edit] Mechanism of action
Just some general mechanism/proposed mechanism info. Sulfasalazine, as discussed, has no inherent anti-inflammatory properties, but its metabolite, 5-ASA, does. Salicylates and other NSAIDS act via prostaglandin synthesis blockage, but aminosalicylates like 5-ASA vary in their inhibition of PG, so this isn't a complete explanation. A widely accepted theory is that 5-ASA attenuates the inflammatory products of the cyclooxygenase and lipoxygenase pathways. Another prominent theory is that 5-ASA appears to inhibit leukotriene and other inflammatory cytokine production, and has been proven to inhibit nuclear fcator kappa B, a primary transcription factor for inflammatory cytokines. Finally, 5-ASA may inibit functions of natural killer cells, mucosal lymphocytes, and macrophages (which release large quantities of inflammatory cytokines), and may scavenge oxygen radicals. These theories make sense in that ulcerative colitis and Crohn's disease are inflammatory diseases, and inflammation is caused by a response by the immune system. That is not to say that these diseases are autoimmune in nature; it's very possible that the disease are caused by an abnormally high production of proinflammatory cells, or that those cells produce abnormally large amounts of cytokines (I'm not putting that in the article because that's my own proposition based on my own research). This would also explain why patients presenting with ulcerative colitis can also have arthritic symptoms (arthritis is an inflammatory joint disorder). It is important to note that sulfasalazine, being a "prodrug" is not an analgesic, as M Dorothy stated, but 5-ASA can exhibit indirect analgesic properties (meaning it does not directly stop pain signals or reduce pain perception, but can decrease inflammation that is causing pain). There's a difference between the two. I hope this information is useful. It was taken primarily (not verbatim) from Basic and Clinical Pharmacology, 10th edition by Bertram G. Katzung, MD, PhD, with the particular chapter written by Kenneth R. McQuaid, MD. Just giving credit where it's due! I'm gonna bust out some randomized trials and then I'll make some edits. If anyone has any good trial info to contribute, that'd be helpful. Thanks! Ohnoitsthefuzz 05:32, 2 October 2007 (UTC)

