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Meptazinol diminishes the Jarisch-Herxheimer reaction of relapsing fever.
- Source :
-
Lancet (London, England) [Lancet] 1983 Apr 16; Vol. 1 (8329), pp. 835-9. - Publication Year :
- 1983
-
Abstract
- Naloxone, an opioid antagonist, and meptazinol, an opioid antagonist with agonist properties, were tested in a double-blind placebo-controlled trial in 24 Ethiopian patients with louse-borne relapsing fever. The potentially fatal Jarisch-Herxheimer reaction (J-HR), which invariably follows tetracycline treatment of the disease, was unaffected by naloxone, 30-40 mg intravenously, but was diminished by meptazinol, 300-500 mg intravenously. Compared with naloxone and placebo, meptazinol reduced the clinical severity of the reaction, significantly delayed and shortened its chill phase, delayed the rise in temperature, and reduced peak temperature and changes in pulse and respiratory rates and leucocyte count. High-dose corticosteroids given before or at the time of tetracycline treatment failed to alter the reaction, which is thought to result from release of endotoxin-like substances. Meptazinol is the first effective treatment for the J-HR of louse-borne relapsing fever. This finding suggests a role for endogenous opioids in the pathogenesis of the J-HR.
- Subjects :
- Adolescent
Adult
Clinical Trials as Topic
Double-Blind Method
Endotoxins metabolism
Fever prevention & control
Humans
Infusions, Parenteral
Meptazinol administration & dosage
Meptazinol pharmacology
Naloxone therapeutic use
Prednisolone administration & dosage
Spirochaeta drug effects
Spirochaeta metabolism
Tetracycline antagonists & inhibitors
Azepines therapeutic use
Meptazinol therapeutic use
Relapsing Fever drug therapy
Tetracycline adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 0140-6736
- Volume :
- 1
- Issue :
- 8329
- Database :
- MEDLINE
- Journal :
- Lancet (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 6132178
- Full Text :
- https://doi.org/10.1016/s0140-6736(83)91384-3