J Appl Biomed 2:141-150, 2004 | DOI: 10.32725/jab.2004.017

Fluorine in medicine

Anna Strunecká1,*, Jiří Patočka2, Paul Connett3
1 Department of Physiology and Developmental Physiology, Faculty of Sciences, Charles University, Praha, Czech Republic
2 Department of Toxicology, Military Medical Academy, Hradec Králové and Faculty of Health and Social Studies, University of South Bohemia, České Budějovice, Czech Republic
3 St. Lawrence University, Canton, New York, USA

Fluoride has long been known to influence the activity of various enzymes in vitro. Latterly it has been demonstrated that many effects primarily attributed to fluoride are caused by a synergistic action of fluoride plus aluminum. Fluorinated chemicals are of growing importance, with applications in medicine. Fluorine substitution has profound effects on the properties of organic compounds. The very high electronegativity of fluorine can modify electron distribution in the molecule, affecting its absorption, distribution and metabolism. Fluorine-containing drugs are used in medicine as anesthetics, antibiotics, anti-cancer and anti-inflammatory agents, psychopharmaceuticals, and in many other applications. The potential contribution of fluorinating pharmaceuticals to human fluoride exposure is discussed.

Keywords: fluoride; aluminofluoride complexes; fluorine-containing drugs; health effects

Received: June 4, 2004; Published: July 31, 2004  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Strunecká A, Patočka J, Connett P. Fluorine in medicine. J Appl Biomed. 2004;2(3):141-150. doi: 10.32725/jab.2004.017.
Download citation

References

  1. Abdel-Rahman R.M.: Synthesis and anti human immune virus activity of some new fluorine containing substituted -3-thioxo-1,2,4-triazin-5-ones. Il Farmaco 46: 379-389, 1991. Go to original source... Go to PubMed...
  2. Alkorta I., I. Rozas, J. Elguero: Effect of fluorine substitution on hydrogen bond interactions. J. Fluor. Chem. 101: 233-238, 2000. Go to original source...
  3. Anonymous: FTC (emtricitabine, Emtriva). Proj. Inf. Perspect. 36: 6-7, 2003.
  4. Arellano M., M. Malet-Martino, R. Martino, P. Gires: The anticancer drug 5-fluorouracil is metabolized by the isolated perfused rat liver and in rats into highly toxic fluoroacetate. Br. J. Cancer 77: 79-86, 1998. Go to original source... Go to PubMed...
  5. Bertino J. Jr. and D. Fish: The safety profile of the fluoroquinolones. Clin. Ther. 22: 798-817, 2000. Go to original source... Go to PubMed...
  6. Bohatyrewicz A.: Effects of fluoride on mechanical properties of femoral bone in growing rats. Fluoride 32: 47-54, 1999.
  7. Boiteau H.L., A. Prost, F. Rossel-Renac, M. Audran, J.P. Hamelin, N. Carlier: Ionized fluorine in the plasma and urine of subjects treated with organofluorine drugs prescribed in rheumatology (In French). Rev. Rhum. Mal. Osteoartic. 46: 123-32, 1979. Go to PubMed...
  8. Bryson Ch.: The fluoride deception. Seven Stories Press US 2004, 1-272.
  9. Bush I.E. and V.B. Mahesh: Metabolism of 11-oxygenated steroids 3. Some 1-dehydro and 9 alpha-fluoro steroids. Biochem. J. 93: 236-255, 1964. Go to original source... Go to PubMed...
  10. Carlsson A.: Current problems relating to the pharmacology and toxicology of fluorides. J. Swedish Med. Assoc. 14: 1338-1392, 1978.
  11. Caverzasio J., G. Palmer, J.P. Bonjour: Fluoride: mode of action. Bone 22: 585-589, 1998. Go to original source... Go to PubMed...
  12. Chabre M.: Aluminofluoride and beryllofluoride complexes: new phosphate analogues in enzymology. Trends Biochem. Sci. 15: 6-10, 1990. Go to original source... Go to PubMed...
  13. Chignell C.F.: Mechanisms of chemically induced photosensitivity. Crisp. Data Base National Institutes of Health, CRISP/99/ES50046-20, 1998.
  14. Conzen P.F., E.D. Kharasch, S.F. Czerner, A.A. Artru, F. Reichle, P. Michalowski: Low-flow sevoflurane compared with low-flow isoflurane anesthesia in patients with stable renal insufficiency. Anesthesiology 97: 578-584, 2002. Go to original source... Go to PubMed...
  15. Crandell W.B., S.G. Pappas, A. MacDonald: Nephrotoxicity associated with methoxyflurane anesthesia. Anesthesiology 27: 591-607, 1966. Go to original source... Go to PubMed...
  16. Dean H.T.: The investigation of physiological effects by the "epidemiological method". In FR Moulton (ed.): Fluorine and dental health, AAAS, Washington, 1942, p. 23
  17. Edwards J.G. and I. Anderson: Systematic review and guide to selection of selective serotonin reuptake inhibitors. Drugs 57: 507-533, 1999. Go to original source... Go to PubMed...
  18. FCDSW: Oral Health Fact Sheet, Flagstaff Citizens for Safe Drinking Water, USA, 1984.
  19. Feng J.Y., E. Murakami, S.M. Zorca, et al.: Relationship between antiviral activity and host toxicity: comparison of the incorporation efficiencies of 2',3'-dideoxy-5-fluoro-3'-thiacytidine-triphosphate analogs by human immunodeficiency virus type 1 reverse transcriptase and human mitochondrial DNA polymerase. Antimicrob. Agents Chemother. 48: 1300-1306, 2004. Go to original source... Go to PubMed...
  20. Franke J.: Overview of 35 years of research in fluoride as treatment of osteoporosis. Fluoride 30: 117-118, 1997.
  21. Fried J., E.A. Hallinan, M.J. Szwedo: Synthesis and properties of 7,7-difluoro derivatives of the 2,6-dioxa[3.1.1]bicyclo-heptane ring-system present in thromboxane A2. J. Am. Chem. Soc. 106: 3871-3872, 1984. Go to original source...
  22. Fried J., D.K. Mitra, M. Nagarajan, M.M. Mehrotra: 10,10-Difluoro-13-dehydroprostacyclin: a chemically and metabolically stabilized potent prostacyclin, J. Med. Chem. 23: 234-247, 1980. Go to original source... Go to PubMed...
  23. Fuchs S., Z. Simon, M. Brezis: Fatal hepatic failure associated with ciprofloxacin. Lancet 343: 738-739, 1994. Go to original source... Go to PubMed...
  24. Furberg C.D. and B. Pitt: Withdrawal of cerivastatin from the world market. Curr. Control. Trials Cardiovasc. Med. 2: 205-207, 200l.
  25. Gentz B.A., T.P. Malan Jr.: Renal toxicity with sevoflurane: a storm in a teacup? Drugs 61: 2155-2162, 2001. Go to original source... Go to PubMed...
  26. Gilman A.G.: G proteins: transducers of receptor-generated signals. Annu. Rev. Biochem. 56: 615-649, 1987. Go to original source... Go to PubMed...
  27. Gray J.L., J.I. Almstead, C.P. Gallagher, et al.: Synthesis and biological testing of non-fluorinated analogues of levofloxacin. Bioor. Med. Chem. Lett. 13: 2373-2375, 2003. Go to original source... Go to PubMed...
  28. Harrison A.C., B.K. Park, P.M. O'Neil, R.C. Storr, N.R. Kitteringham: Metabolic defluorination of 5-fluoro-amodiaquine in the rat. Br. J. Clin. Pharmacol. 34: 148, 1992.
  29. JPAB: Information on Adverse Reactions to Drugs No.128, October 1994
  30. Kharasch E.D. and K.E. Thummel: Identification of cytochrome P450 2E1 as the predominant enzyme catalyzing human liver microsomal defluorination of sevoflurane, isoflurane, and methoxyflurane. Anesthesiology 79: 795-807, 1993. Go to original source... Go to PubMed...
  31. Kharasch E.D.: Metabolism and toxicity of the new anesthetic agents. Acta Anaesthesiol. Belg. 47: 7-14, 1996. Go to PubMed...
  32. Kubota T.: 5-fluorouracil and dihydropyrimidine dehydrogenase Int. J. Clin. Oncol. 8: 127-131, 2003. Go to original source... Go to PubMed...
  33. Kusume Y.: Inorganic fluoride concentrations and their sequential changes in the five layers of the kidney in rabbits after sevoflurane or methoxyflurane anesthesia (In Japanese). Masui 48: 1202-1210, 1999. Go to PubMed...
  34. Lubkowska A., B. Zyluk, D. Chlubek: Interactions between fluoride and aluminum. Fluoride 35: 73-77, 2002.
  35. Machoy Z.: Wpływ zwi±zków fluoru na enzymy oddechowe. Postępy Biochem 27: 327-337, 1981. Go to PubMed...
  36. Marquez V.E., C.K. Tseng, H. Mitsuya, S. Aoki, J.A. Kelley, H. Ford Jr, J.S. Roth, S. Broder, D.G. Johns, J.S. Driscoll: Acid-stable 2'-fluoro purine dideoxynucleosides as active agents against HIV. J. Med. Chem. 33: 978-985, 1990. Go to original source... Go to PubMed...
  37. Matthes E., C. Lehmann, D. Scholz, H.A. Rosenthal, P. Langen: Phosphoralytion, anti-HIV activity and cyto-toxicity of 3'-fluorothymidine. Biochem. Biophys. Res. Commun. 153: 825-831, 1988. Go to original source... Go to PubMed...
  38. McClure F.J.: A review of fluorine and its physiological effects. Physiol. Rev. 13: 277-300, 1933. Go to original source...
  39. Morgan P., J.L. Maggs, P.C. Bulman-Page, F. Hussain, B.K. Park: The metabolism of 2- and 4-fluoro-17β-estradiol in the rat and its fluorinated analogs with tumor-induction in syrian-hamsters. Mol. Pharmacol. 43: 983-984, 1992. Go to original source...
  40. Morris A.J. and C.C. Malbon: Physiological Regulation of G Protein-Linked Signalling. Physiol. Rev. 79: 1373-1430, 1999. Go to original source... Go to PubMed...
  41. O'Hagan D., C. Schaffrath, S.L. Cobb, J.T. Hamilton, C.D. Murphy: Biochemistry: biosynthesis of an organofluorine molecule. Nature 416: 279, 2002. Go to original source... Go to PubMed...
  42. Orhan H., N.P. Vermelen, G. Sabin, J.N. Commandeur: Characterization of thioether compounds formed from alkaline degradation products of enflurane. Anesthesiology 95: 165-175, 2001. Go to original source... Go to PubMed...
  43. Panner B.J., R.B. Freeman, L.A. Roth-Moyo, W. Markowitch Jr.: Toxicity following methoxyflurane anesthesia. I. Clinical and pathological observations in two fatal cases. JAMA 214: 86-90, 1970. Go to original source... Go to PubMed...
  44. Park B.K. and N.R. Kitteringham: Effects of fluorine substitution on drug-metabolism pharmacological and toxicological implications. Drug. Metab. Rev. 26: 605-643, 1994. Go to original source... Go to PubMed...
  45. Park B.K., N.R. Kitteringham, P.M. O'Neill: Metabolism of fluorine-containg drugs. Annu. Rev. Pharmacol. Toxicol. 41: 443-470, 2001. Go to original source... Go to PubMed...
  46. Patocka J. and J. Cabal: Toxicology of fluoroacetic acid and similar organofluorine aliphatic compounds. ASA Newslett. 99: 16-18, 1999.
  47. Pradhan K.M., N.K. Arora, A. Jena, A.K. Susheela, M.K. Bhan: Safety of ciprofloxacin therapy in children: magnetic resonance images, body fluid levels of fluoride and linear growth. Acta Paediatr. 84: 555-560, 1995. Go to original source... Go to PubMed...
  48. Ramanujam T.R.: Fluoroquinolones - A Review (2001). http://www.mcsindia.org/doctors/epharma/january.asp
  49. Resnati G.: Aspects of the medicinal chemistry of fluoroorganic compounds. Part 1. Il Farmaco 45: 1043-1066, 1990. Go to original source... Go to PubMed...
  50. Rodbell M.: Nobel lecture. Signal transduction: evolution of an idea. Biosci. Rep. 15: 117-133, 1995. Go to original source... Go to PubMed...
  51. Roholm K.: Fluorine Intoxication, A Clinical-Hygienic Study. HK Lewis, London 1937.
  52. Rubinstein E.: History of quinolones and their side effects. Chemotherapy 47 (Suppl 3: discussion) 44-48, 2001. Go to original source... Go to PubMed...
  53. Sannicandro T.J., M.C. Farrar, J.S. Markowitz: Selective serotonin reuptake inhibitor-induced rash: case report and review of the literature. Pharmacotherapy 22: 516-518, 2001. Go to original source...
  54. Schlesinger E.R., D.E Overton, H.C. Chase, K.T. Cantwell: Newburgh-Kingston caries-fluorine study: XIII. Pediatric findings after ten years. J. Am. Dent. Assoc. 52: 296, 1956. Go to original source... Go to PubMed...
  55. Stahlmann R.: Clinical toxicological aspects of fluoroquinolones. Toxicol. Lett. 127: 269-277, 2002. Go to original source... Go to PubMed...
  56. Sternbach H.: Danger of MAOI therapy after fluoxetine withdrawal. Lancet 2: 850-851, 1988. Go to original source... Go to PubMed...
  57. Sternweis P.C. and A.G. Gilman: Aluminum, a requirement for activation of the regulatory component of adenylate cyclase by fluoride. Proc. Natl. Sci. USA 79: 4888-4891, 1982. Go to original source... Go to PubMed...
  58. Strunecká A. and J. Patočka: Aluminofluoride complexes: A useful tool in laboratory investigations, but a hidden danger for living organisms? In Shapiro P. and D. Atwood (eds) Group 13 Chemistry: From Fundamentals to Application. ACS symposium Series 822, Washington 2002, p. 271-282. Go to original source...
  59. Strunecká A. and J. Patočka: Aluminofluoride complexes in the etiology of Alzheimer's disease. Struct. Bond. 104: 139-81, 2003. Go to original source...
  60. Strunecká A. and J. Patočka: Pharmacological and toxicological effects of aluminofluoride complexes. Fluoride 32: 230-242, 1999.
  61. Strunecká A., O. Strunecký, J. Patočka: Fluoride plus aluminum: The useful tools in laboratory investigations, but messengers of the false information. Physiol. Res. 51: 557-564, 2002.
  62. Thomas D.M. and J.R. Zalcberg: 5-Fluorouracil: a pharmacological paradigm in the use of cytotoxics. Clin. Exp. Pharmacol. Physiol. 25: 887-895, 1998. Go to original source... Go to PubMed...
  63. Thompson D.C., K. Perera, R. London: Spontaneous hydrolysis of 4-trifluoromethylphenol to a quinone methide and subsequent protein alkylation. Chem. Biol. Interact. 126: 1-14, 2000. Go to original source... Go to PubMed...
  64. Varner J.A., K.F. Jensen, W. Horvath, R.L. Isaacson: Chronic administration of aluminum-fluoride or sodium-fluoride to rats in drinking water. alterations in neuronal and cerebrovascular integrity. Brain Res. 784: 284-298, 1998. Go to original source... Go to PubMed...
  65. Wakselman C.: Fluorinated organic compounds: synthesis and biological applications (In French). Ann. Pharm. Fr. 57: 108-115, 1999.
  66. Waldbott G.L., A.W. Burgstahler, H.L. McKinney: Fluoridation: the great dilemma. Lawrence, Coronado Press, Kansas 1978, pp. 1-152.
  67. Welsch M., J.G. Bloch, D. Stephan, R. Bloch, J.L. Imbs: Iatrogenic fluorosis. 2 cases (In French). Therapie 45: 419-422, 1990. Go to PubMed...
  68. Zimpfer A., A. Propst, G. Mikuz, W. Vogel, L. Terracciano, S. Stadlmann: Ciprofloxacin-induced acute liver injury: case report and review of literature. Virchows Arch. 444: 87-89, 2004. Go to original source... Go to PubMed...