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THE PHENACETIN ENIGMA
Author(s) -
Pribe Walter A.
Publication year - 1970
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1970.tb02817.x
Subject(s) - phenacetin , medicine , ingestion , etiology , pharmacology , physiology
A bstract The unregulated sale of phenacetin‐containing anodynes frequently has led to abuse of this drug by consumers. The demonstration of renal papillary necrosis in persons who habitually use excessive amounts (3.5 kg or more as the cumulative lifetime dose) has been corroborated in extensive animal studies. It is not known whether phenacetin itself or one of its metabolites causes the damage. The mechanism of damage is probably inhibition of cellular enzymes and direct anoxia induced by interference with hemoglobin metabolism. The clinical diagnosis is difficult, but is aided by alertness for a history of phenacetin ingestion, even in the remote past. Further study can be expected to demonstrate an association between phenacetin ingestion and several renal disease processes of obscure etiology.