40:
810:
483:
49:
617:. It enters all tissues, reaching cartilage within two hours. When PSGAG reaches the synovial fluid, it is then taken up by the cartilage matrices, with osteoarthritic cartilage showing a stronger preference for taking it up. It reaches its peak levels in the joints at 48 hours, and lasts up to 96 hours, before leaving and being excreted by the
522:. The glycosaminoglycan side chains are polyanionic, which causes adjacent side chains to push each other away and create a "bottle brush", where hyaluronic acid is the stem and the side chains are the bristles. When pressure is exerted on the joint, fluids move between the
329:
studies have shown it to inhibit the enzymes that degrade cartilage and bone, as well as suppress inflammation and stimulate the synthesis of replacement cartilage. While it can cause an increased risk of bleeding, it is relatively safe and has a high
604:
PSGAG also stimulates the synthesis of glycosaminoglycans, hyaluronic acid, and collagen, which increase synovial viscosity. It cannot, however, completely reverse the disappearance of cartilage, nor can it reverse bone loss caused by arthritis.
354:, though some studies say that its effectiveness in acute cases is still limited if degenerative enzymes have not played a role. While it is currently only FDA-approved for dogs and horses, PSGAG is also used off-label to treat
533:
In degenerative joint disease, the proteoglycan complexes start disappearing, and the hyaluronate becomes poorer in quality and scarcer. This lowers the viscosity of the synovial fluid (which increases friction) and causes
337:
While it is widely used, some studies still show conflicting results in terms of efficacy, causing some to claim that PSGAG is not solely responsible for the significant mitigation of arthritis seen in success cases.
432:
to dogs. Signs of overdose include exacerbated side effects such as joint pain, swelling, and lameness. When dogs received three times the normal dose intramuscularly twice a week for 13 weeks, they had increased
417:. In dogs, this may manifest as bleeding from the nose or as bloody stools. The increased risk of bleeding has some advising not to give PSGAG to animals with bleeding disorders, though its only
542:
that are released as a result kill the chondrocytes. The remaining chondrocytes have trouble exchanging nutrients with the synovial fluid, which would allow them to repair some damages.
405:
Side effects from intra-articular administration can include joint pain, swelling, lameness, and, rarely, infection of the joint. Intramuscular injection can cause dose-dependent
141:
370:
PSGAG is first administered as a series of injections over several weeks, and can be continued once or twice a month thereafter. It is normally injected
553:. PSGAG inhibits many of the catabolic enzymes that degrade cartilage, proteoglycans, and hyaluronic acid. The enzymes that are inhibited include
74:
1085:
601:. The inhibition of blood coagulation reduces resultant fibrinolysis, which would cause cell death and increase local inflammation.
1208:
1009:
589:, which is released upon joint injury and causes inflammation, increases the loss of proteoglycan, and reduces the threshold of
1051:
929:
864:
834:
750:
712:
680:
111:
1078:
162:
92:
613:
PSGAG reaches peak blood concentration in 20–40 minutes when injected intramuscularly; 30–40% of it binds to
946:
251:
1218:
1071:
347:
979:
226:
1213:
418:
134:
809:
130:
122:
64:
17:
196:
31:
1041:
854:
824:
740:
702:
359:
889:
558:
462:
260:
39:
640:
8:
1138:
515:
450:
1117:
826:
The USDF Guide to
Dressage: The Official Guide of the United States Dressage Foundation
598:
566:
507:
318:
1063:
794:
1098:
1047:
925:
860:
830:
798:
746:
708:
676:
594:
562:
491:
383:
177:
1143:
790:
586:
554:
535:
458:
188:
1155:
1150:
519:
511:
495:
375:
371:
216:
206:
84:
1094:
614:
590:
527:
487:
379:
1202:
802:
582:
429:
346:
PSGAG is mostly used in dogs and horses for treating traumatic arthritis and
282:
781:
White GW (1988-11-01). "Adequan: A review for the practicing veterinarian".
675:(7th ed.). Stockholm, Wisconsin; Ames, Iowa: Wiley. pp. 837–839.
574:
523:
503:
406:
394:
382:
in off-label uses. Giving PSGAG intra-articularily requires it to be given
306:
334:. PSGAG is one of the most widely prescribed joint treatments for horses.
297:, is an injectable drug for dogs and horses that is used to alleviate the
1133:
630:
578:
570:
454:
446:
314:
538:
and enzymes to enter and effect cartilage degradation and inflammation.
421:
is hypersensitivity to PSAGs when it is being given intra-articularily.
1112:
565:
that cause proteoglycans to dissociate from hyaluronic acid; elastase;
310:
276:
482:
466:
358:
in swine, as a chondroprotectant ("joint protector") or treatment of
351:
322:
302:
236:
78:
924:(2nd ed.). St. Louis, Mo: Saunders/Elsevier. pp. 537–538.
48:
539:
410:
387:
355:
106:
1171:
618:
442:
414:
1007:
635:
438:
856:
The Pet Lover's Guide to Canine
Arthritis & Joint Problems
434:
494:
are attached to proteins, which are attached to a strand of
671:
Plumb DC (2011). "Polysulfated glycosaminoglycan (PSGAG)".
425:
350:. It has shown to be better at treating acute than chronic
331:
298:
742:
1093:
506:
complexes, which are proteins with side chains made of
449:. At 11 times the normal dose, they also had increased
597:
further reduces inflammation, most likely by altering
704:
Pain
Management for Veterinary Technicians and Nurses
486:
The cartilage matrix. The joint space is filled with
920:
852:
413:, since PSGAG is an analogue of the anticoagulant
386:, and is sometimes supplemented by the antibiotic
974:
972:
970:
968:
966:
397:or human-labeled equivalents of PSGAG in the US.
1200:
738:
1008:US National Library of Medicine (2016-08-24).
963:
301:, pain, and lowered range of motion caused by
1079:
325:; PSGAG thus easily integrates itself there.
400:
362:in cats, and to treat arthritis in rabbits.
110:
1003:
1001:
999:
884:
882:
880:
878:
876:
734:
732:
730:
728:
726:
724:
573:, which degrade cartilage matrix proteins;
561:degradation of proteoglycans and collagen;
348:degenerative joint disease (osteoarthritis)
1086:
1072:
980:"Adequan Canine Injectable (Prescription)"
696:
694:
692:
47:
38:
859:. Elsevier Health Sciences. p. 192.
745:. Elsevier Health Sciences. p. 392.
259:
996:
915:
913:
873:
848:
846:
721:
700:
481:
424:Overdose on PSGAG is quite rare, as the
853:Schulz K, Beale B, Holsworth I (2005).
776:
774:
772:
770:
768:
766:
764:
762:
689:
666:
664:
662:
660:
658:
656:
378:(directly into the joint) in horses or
221:48 hours for peak levels in joints (IM)
14:
1201:
1035:
1033:
1031:
1029:
947:"Why I Love Adequan for Cats and Dogs"
919:
822:
707:. John Wiley & Sons. p. 140.
477:
291:Polysulfated glycosaminoglycan (PSGAG)
1067:
1043:Chronic Pain in Small Animal Medicine
944:
922:Saunders Handbook of Veterinary Drugs
910:
843:
780:
739:Wanamaker BP, Massey K (2014-03-25).
670:
549:is based on observations and studies
171:
101:
83:
938:
783:Journal of Equine Veterinary Science
759:
653:
1039:
1026:
608:
24:
829:. Storey Publishing. p. 285.
585:. PSGAG inhibits the synthesis of
365:
25:
1230:
341:
897:Doctor Foster and Smith Pharmacy
808:
673:Plumb's Veterinary Drug Handbook
502:Normally, joint cartilages have
53:Chemical structure and packaging
1046:. CRC Press. pp. 197–200.
472:
441:weight, as well as microscopic
1209:Drugs not assigned an ATC code
1188:Polysulfated glycosaminoglycan
816:
428:is over 1000 mg/kg when given
374:, though can also be injected
32:Polysulfated glycosaminoglycan
13:
1:
795:10.1016/S0737-0806(88)80096-0
646:
293:, sold under the brand name
7:
890:"Patient Information Sheet"
641:Osteoarthritis § Management
624:
557:, which play a role in the
498:to create a "bottle brush".
445:on the liver, kidneys, and
10:
1235:
701:Goldberg ME (2014-10-23).
461:(i.e. coagulation via the
271:Chemical and physical data
1180:
1164:
1126:
1106:Unsulfated, extracellular
1105:
419:absolute contraindication
401:Side effects and overdose
275:
270:
250:
245:
235:
225:
215:
205:
195:
187:
161:
156:
140:
121:
91:
73:
63:
58:
46:
37:
984:Doctors Foster and Smith
823:Bryant JO (2012-12-10).
530:, exchanging nutrients.
465:took longer), and fewer
1165:Sulfated, intracellular
1127:Sulfated, extracellular
545:The mechanism of PSGAG
518:attached to strands of
321:already present in the
305:. It is made of repeat
180: (by veterinarian)
945:Khuly P (2010-03-05).
499:
390:to prevent infection.
1040:Fox SM (2009-12-15).
485:
360:interstitial cystitis
317:), and is similar to
1139:Chondroitin sulfate
516:chondroitin sulfate
478:Mechanism of action
451:alanine transferase
34:
1219:Glycosaminoglycans
1118:Sodium hyaluronate
1099:glycosaminoglycans
599:C-reactive protein
595:complement pathway
567:metalloproteinases
508:glycosaminoglycans
500:
492:Glycosaminoglycans
376:intra-articularily
319:glycosaminoglycans
309:units (comprising
227:Duration of action
30:
1196:
1195:
593:. Inhibiting the
563:lysosomal enzymes
536:white blood cells
463:extrinsic pathway
288:
287:
175:
104:
16:(Redirected from
1226:
1214:Veterinary drugs
1144:Dermatan sulfate
1088:
1081:
1074:
1065:
1064:
1058:
1057:
1037:
1024:
1023:
1021:
1020:
1010:"Adequan Canine"
1005:
994:
993:
991:
990:
976:
961:
960:
958:
957:
942:
936:
935:
917:
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871:
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850:
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840:
820:
814:
813:
812:
806:
778:
757:
756:
736:
719:
718:
698:
687:
686:
668:
609:Pharmacokinetics
587:prostaglandin E2
555:serine proteases
459:prothrombin time
263:
173:
170:
114:
103:
100:
87:
51:
42:
35:
33:
29:
21:
1234:
1233:
1229:
1228:
1227:
1225:
1224:
1223:
1199:
1198:
1197:
1192:
1176:
1160:
1156:Keratan sulfate
1151:Heparan sulfate
1122:
1101:
1095:Polysaccharides
1092:
1062:
1061:
1054:
1038:
1027:
1018:
1016:
1006:
997:
988:
986:
978:
977:
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943:
939:
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844:
837:
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779:
760:
753:
737:
722:
715:
699:
690:
683:
669:
654:
649:
627:
611:
520:hyaluronic acid
512:keratan sulfate
496:hyaluronic acid
480:
475:
403:
372:intramuscularly
368:
366:Available forms
344:
266:
217:Onset of action
197:Protein binding
189:Pharmacokinetic
183:
152:
124:
117:
54:
28:
27:Injectable drug
23:
22:
15:
12:
11:
5:
1232:
1222:
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1216:
1211:
1194:
1193:
1191:
1190:
1184:
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1177:
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1174:
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1128:
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1123:
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1120:
1115:
1109:
1107:
1103:
1102:
1091:
1090:
1083:
1076:
1068:
1060:
1059:
1052:
1025:
995:
962:
937:
930:
909:
872:
865:
842:
835:
815:
789:(6): 463–468.
758:
751:
720:
713:
688:
681:
651:
650:
648:
645:
644:
643:
638:
633:
626:
623:
615:blood proteins
610:
607:
591:pain receptors
528:synovial fluid
488:synovial fluid
479:
476:
474:
471:
402:
399:
380:subcutaneously
367:
364:
343:
342:Medicinal uses
340:
315:hexuronic acid
286:
285:
279:
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125:administration
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118:
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97:
95:
89:
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85:Veterinary Use
81:
71:
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61:
60:
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55:
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44:
43:
26:
9:
6:
4:
3:
2:
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1125:
1119:
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1114:
1111:
1110:
1108:
1104:
1100:
1096:
1089:
1084:
1082:
1077:
1075:
1070:
1069:
1066:
1055:
1053:9781840765670
1049:
1045:
1044:
1036:
1034:
1032:
1030:
1015:
1011:
1004:
1002:
1000:
985:
981:
975:
973:
971:
969:
967:
952:
948:
941:
933:
931:9781416028888
927:
923:
916:
914:
898:
891:
885:
883:
881:
879:
877:
868:
866:9781416026143
862:
858:
857:
849:
847:
838:
836:9781612122748
832:
828:
827:
819:
811:
804:
800:
796:
792:
788:
784:
777:
775:
773:
771:
769:
767:
765:
763:
754:
752:9780323291705
748:
744:
743:
735:
733:
731:
729:
727:
725:
716:
714:9781118811160
710:
706:
705:
697:
695:
693:
684:
682:9780470959640
678:
674:
667:
665:
663:
661:
659:
657:
652:
642:
639:
637:
634:
632:
629:
628:
622:
620:
616:
606:
602:
600:
596:
592:
588:
584:
583:hyaluronidase
580:
576:
572:
568:
564:
560:
556:
552:
548:
543:
541:
537:
531:
529:
525:
521:
517:
513:
509:
505:
497:
493:
489:
484:
470:
468:
464:
460:
456:
452:
448:
444:
440:
436:
431:
430:intravenously
427:
422:
420:
416:
412:
408:
398:
396:
393:There are no
391:
389:
385:
381:
377:
373:
363:
361:
357:
353:
349:
339:
335:
333:
328:
324:
320:
316:
312:
308:
304:
300:
296:
292:
284:
281:3,000–15,000
280:
278:
274:
269:
262:
258:
257:
255:
253:
249:
244:
240:
238:
234:
231:96 hours (IM)
230:
228:
224:
220:
218:
214:
210:
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136:
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128:
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113:
108:
99:
98:
96:
94:
90:
86:
82:
80:
76:
72:
68:
66:
62:
59:Clinical data
57:
50:
45:
41:
36:
19:
1187:
1042:
1017:. Retrieved
1013:
987:. Retrieved
983:
954:. Retrieved
950:
940:
921:
901:. Retrieved
899:. 2007-09-14
896:
855:
825:
818:
786:
782:
741:
703:
672:
612:
603:
579:cathepsin B1
575:collagenases
550:
546:
544:
532:
524:chondrocytes
504:proteoglycan
501:
473:Pharmacology
423:
407:inflammation
404:
392:
369:
345:
336:
326:
307:disaccharide
294:
290:
289:
163:Legal status
157:Legal status
93:License data
1134:Chondroitin
631:Glucosamine
571:stromelysin
455:cholesterol
447:lymph nodes
384:aseptically
246:Identifiers
142:ATCvet code
65:Trade names
1203:Categories
1113:Hyaluronan
1019:2017-07-10
989:2017-07-10
956:2017-07-10
903:2017-07-10
647:References
311:hexosamine
277:Molar mass
261:268AW7000T
207:Metabolism
1181:Synthetic
803:0737-0806
467:platelets
352:arthritis
323:cartilage
303:arthritis
237:Excretion
123:Routes of
79:Drugs.com
1014:DailyMed
625:See also
577:such as
569:such as
551:in vitro
540:Steroids
510:such as
411:bleeding
388:amikacin
356:lameness
327:In vitro
299:limpness
129:Usually
112:b0fbf2e7
107:DailyMed
1172:Heparin
619:kidneys
547:in vivo
443:lesions
415:heparin
395:generic
295:Adequan
109::
69:Adequan
18:Adequan
1050:
928:
863:
833:
801:
749:
711:
679:
636:NSAIDs
581:; and
457:, and
439:kidney
201:30–40%
178:℞-only
176:
105:
951:PetMD
893:(PDF)
435:liver
241:Urine
211:Renal
1048:ISBN
926:ISBN
861:ISBN
831:ISBN
799:ISSN
747:ISBN
709:ISBN
677:ISBN
559:IL-1
526:and
514:and
437:and
426:LD50
409:and
332:LD50
313:and
252:UNII
191:data
149:none
75:AHFS
791:doi
133:or
1205::
1097::
1028:^
1012:.
998:^
982:.
965:^
949:.
912:^
895:.
875:^
845:^
797:.
785:.
761:^
723:^
691:^
655:^
621:.
490:.
469:.
453:,
283:Da
172:US
135:IA
131:IM
102:US
1087:e
1080:t
1073:v
1056:.
1022:.
992:.
959:.
934:.
906:.
869:.
839:.
805:.
793::
787:8
755:.
717:.
685:.
174::
77:/
20:)
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
