title: D-penicillamine: chemistry and clinical use in rheumatic disease.
abstract: The discovery of D-penicillamine and its uses in medicine are reviewed. Chemical-physical properties are discussed, and the molecular structure of D-penicillamine and several of its reaction products are illustrated. Examples of its three main types of biochemical reactions--sulfhydryl-disulfide exchange, thiazolidine formation, and metal chelation are included. Trials of D-penicillamine in RA patients are reviewed critically. The administration of the drug is discussed in detail, including dosages, clinical and laboratory responses, patterns of adverse side effects or toxicity, drug-induced autoimmune diseases, indications and contraindications, and the monitoring and management of patients.
mesh_terms: D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000139:chemically induced; D003875:Drug Eruptions / Q000209:etiology; D006052:Gold Sodium Thiomalate / Q000627:therapeutic use; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D007700:Kinetics; D008968:Molecular Conformation; D010396:Penicillamine / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D012216:Rheumatic Diseases / Q000188:drug therapy*; D012595:Scleroderma, Systemic / Q000188:drug therapy; D013166:Spondylitis / Q000188:drug therapy; D013329:Structure-Activity Relationship; D013651:Taste Disorders / Q000139:chemically induced
chemical_list: D006052:Gold Sodium Thiomalate; D010396:Penicillamine