Nicorandil: from ulcer to fistula into adjacent organs

Autor: Jean Luc Schmutz, Philippe Trechot, Claire Guy, Annick Barbaud, Nadine Petitpain, Béatrice Marie, Lucie Javot, Astrid Pinzano
Přispěvatelé: Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Regional Pharmacovigilance Center, University Hospital of Saint Etienne, Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL)
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
Fistula
Vasodilator Agents
Nicotinamide adenine dinucleotide
Angina
030207 dermatology & venereal diseases
chemistry.chemical_compound
0302 clinical medicine
MESH: Aged
80 and over
Tissue Distribution
Nicorandil
Aged
80 and over
MESH: Aged
education.field_of_study
MESH: Middle Aged
MESH: Ulcer
Middle Aged
3. Good health
030220 oncology & carcinogenesis
Anesthesia
cardiovascular system
Female
medicine.drug
Population
Dermatology
03 medical and health sciences
Afterload
medicine
Humans
MESH: Tissue Distribution
[SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry
Molecular Biology/Biochemistry [q-bio.BM]
education
Ulcer
Aged
Wound Healing
MESH: Humans
Nicotinamide
MESH: Fistula
business.industry
[SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry
Molecular Biology/Molecular biology
Original Articles
medicine.disease
MESH: Male
MESH: Vasodilator Agents
Preload
MESH: Wound Healing
chemistry
MESH: Nicorandil
Surgery
business
MESH: Female
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Zdroj: International Wound Journal
International Wound Journal, Wiley, 2013, 10 (2), pp.210-213. ⟨10.1111/j.1742-481X.2012.00966.x⟩
Int Wound J
ISSN: 1742-4801
1742-481X
DOI: 10.1111/j.1742-481X.2012.00966.x⟩
Popis: International audience; Nicorandil is an original vasodilatator used to control angina by decreasing cardiac preload and afterload. Since 1997, many reports of single or multiple nicorandil-induced ulcerations have been published. To date, eight cases of nicorandil-induced fistula into adjacent organs have been described. The pathogeneses of nicorandil-induced ulceration and fistula into adjacent organs are not yet elucidated. The two main hepatic biotransformation pathways of nicorandil are denitration and reduction of the alkyl chain leading to nicotinamide and niconitic acid which merge into the endogenous pool of nicotinamide adenine dinucleotide/phosphate. This merging which is known as saturable, may contribute to a slow and abnormal distribution of nicotinamide and nicotinic acid out of the endogenous pool. Under these special conditions, providing these two molecules in situ, nicotinic acid associated with nicotinamide may ulcerate rather recent or maintained trauma. Ulcers and fistulae induced by nicorandil heal after withdrawal. Surgical intervention is unnecessary and inappropriate as it is ineffective and exacerbates morbidity. All practitioners should be correctly informed about these serious but preventable nicorandil side effects, which mostly occur in the elderly and fragile population. In the absence of corrective measures, withdrawal of this original and active drug should be considered.
Databáze: OpenAIRE
Externí odkaz: