THE EFFECT OF IBUPROFEN ON HEPATIC GLUTAMIC PYRUVIC TRANSAMINASE (SGPT), GLUTAMIC OXALOACETIC TRANSAMINASE ( SGOT) AND ALKALINE PHOSPHATASE (ALP) IN DENTAL PATIENTS

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in dentistry as analgesics and antipyretics. In the vast majority of emergencies, dental pain can be controlled with paracetemol, aspirin and ibuprofen, there are various levels of toothache ranging from occasional discomfort caused by early tooth decay, or periodontal disease, to the more severe, constant pain caused by advanced tooth decay and dental abscesses. Ibuprofen has been frequently and widely employed as analgesic and as anti-inflammatory agent in dental patients. Ibuprofen relieves pain and reduces fever and inflammation. The liver eliminates ibuprofen from the body. The process may work too slowly in some people, or liver enzymes may be altered, by high doses of ibuprofen, mainly: glutamic pyruvic transaminase (SGPT), that catalyzes the transfer of an amino group from alanine to a-ketoglutarate, the products of this reversible transamination reaction being pyruvate and glutamate. Glutamic oxaloacetic transaminase (SGOT)- that facilitates the conversion of aspartate and alpha-ketoglutarate to oxaloacetate and glutamate, and vice-versa. Both enzymes are normally present in liver and heart cells. They are released into blood when the liver or heart is damaged, thus levels are elevated with liver damage (viral hepatitis) or with an insult to the heart (heart attack). Some medications can also raise SGOTand SGPT levels. Alkaline phosphatase (ALP)- is hydrolase enzyme in the cells lining the biliary ducts of the liver as well as in bone and placental tissue, the enzyme is responsible for removing phosphate groups from many types of molecules, including nucleotides, proteins, and alkaloids. ALP levels in plasma will rise with large bile duct obstruction, intrahepatic cholestasis or infiltrative diseases of the liver and active bone formation occurring as ALP is a byproduct of osteoblast activity (such as the case in Paget's disease of bone), as well as in people with untreated coeliac disease. The purpose of the study was to identify toxic effects of ibuprofen for short term-therapy (not less than 5days) on liver function by assessment of hepatic SGPT, SGOT and ALP in intact people, who are under dental procedures, as well as in medically compromised dental patients. About 57 patients are investigated and were given several doses of ibuprofen. The main finding is an increase in ALP, as well as moderate to high elevation of SGPT and SGOT hepatic enzymes, but they remain around their normal ranges.