Sodium aurothiomalate

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Sodium aurothiomalate
Sodium aurothiomalate.svg
Systematic (IUPAC) name
Sodium 2-(auriosulfanyl)-3-carboxypropanoate
Clinical data
Trade names Myocrisin
AHFS/Drugs.com
Licence data US FDA:link
Pregnancy cat. B2 (AU) C (US)
Legal status Prescription Only (S4) (AU) -only (CA) POM (UK) -only (US)
Routes Intramuscular
Pharmacokinetic data
Protein binding High[1]
Half-life 6-25 days[1]
Excretion Urine (60-90%), faeces (10-40%)[1]
Identifiers
ATC code M01CB01
PubChem CID 16760302
ChemSpider 7827788 YesY
UNII E4768ZY6GM N
ChEBI CHEBI:35863 YesY
Chemical data
Formula C4H4AuNaO4S 
Mol. mass 367.939350590
 YesY (what is this?)  (verify)

Sodium aurothiomalate (INN, known in the United States as gold sodium thiomalate) is a gold compound that is used for its immunosuppressive anti-rheumatic effects.[2][3] Along with an orally-administered gold salt, auranofin, it is amongst the only gold compound currently employed in western medicine.[4]

Medical uses[edit]

It is primarily given as a once or twice weekly by intramuscular injection for moderate-severe rheumatoid arthritis although it has also proven itself effective in treating tuberculosis.[5]

Adverse effects[edit]

Its most common side effects are digestive (mostly dyspepsia, mouth swelling, nausea, vomiting and taste disturbance), vasomotor (mostly flushing, fainting, dizziness, sweating, weakness, palpitations, shortness of breath and blurred vision) or dermatologic (usually itchiness, rash, local irritation near to the injection site and hair loss) in nature, although conjunctivitis, blood dyscrasias, kidney damage, joint pain, muscle aches/pains and liver dysfunction are also common.[6] Less commonly, it can cause GI bleeds, dry mucous membranes and gingivitis.[6] Rarely it can cause: aplastic anaemia, ulcerative enterocolitis, difficulty swallowing, angiooedema, pneumonitis, pulmonary fibrosis, hepatotoxicity, cholestatic jaundice, peripheral neuropathy, Guillain-Barre syndrome, encephalopathy, encephalitis and photosensitivity.[6]

Pharmacology[edit]

Its precise mechanism of action is unknown but is known that it inhibits the synthesis of prostaglandins.[4] It also modulates phagocytic cells and inhibits Class II major histocompatibility complex-peptide interactions.[4] It is also known that it inhibits the following enzymes:[4][7]

References[edit]

  1. ^ a b c "aurothiomalate, sodium, Myochrysine (gold sodium thiomalate) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 March 2014. 
  2. ^ Jessop, J. D.; O'Sullivan, M. M.; Lewis, P. A.; Williams, L. A.; Camilleri, J. P.; Plant, M. J.; Coles, E. C. (1998). "A long-term five-year randomized controlled trial of hydroxychloroquine, sodium aurothiomalate, auranofin and penicillamine in the treatment of patients with rheumatoid arthritis". British journal of rheumatology 37 (9): 992–1002. doi:10.1093/rheumatology/37.9.992. PMID 9783766.  edit
  3. ^ Iqbal, M. S.; Saeed, M.; Taqi, S. G. (2008). "Erythrocyte Membrane Gold Levels After Treatment with Auranofin and Sodium Aurothiomalate". Biological Trace Element Research 126 (1–3): 56–64. doi:10.1007/s12011-008-8184-x. PMID 18649049.  edit
  4. ^ a b c d Kean, WF; Kean, IRL (4 June 2008). "Clinical pharmacology of gold". Inflammopharmacology 16 (3): 112–125. doi:10.1007/s10787-007-0021-x. PMID 18523733. 
  5. ^ Benedek, TG (January 2004). "The history of gold therapy for tuberculosis.". Journal of the History of Medicine and Allied Sciences 59 (1): 50–89. doi:10.1093/jhmas/jrg042. PMID 15011812. 
  6. ^ a b c Rossi, S, ed. (2013). Australian Medicines Handbook (2013 ed.). Adelaide: The Australian Medicines Handbook Unit Trust. ISBN 978-0-9805790-9-3.  edit
  7. ^ Berners-Price, SJ; Filipovska, A (September 2011). "Gold compounds as therapeutic agents for human diseases.". Metallomics 3 (9): 863–73. doi:10.1039/c1mt00062d. PMID 21755088.