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Symptom Control in Hospice-State of the Art
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
J. Cameron Muir, Lisa M. Krammer, Jacqueline R. Cameron, Charles F. von Gunten
Oral stool softeners increase fecal bulk and lead to a reflexive stimulation of peristalsis. Surfactant laxatives (e.g. docusate sodium), act as detergents to increase water retention and subsequently soften stool. Osmotic laxatives (e.g., lactulose) exert an osmotic effect to retain water in the intestinal lumen; larger doses may cause bloating and colic. Bulk forming agents (methyl cellulose) soften hard stool and make loose stools firmer; in essence they are stool normalizers. These agents are less useful in terminally ill patients because of the large volume of water needed. Saline laxatives (magnesium sulfate) increase the intraluminal volume osmotically. Lubricant laxatives (mineral oil) coat the stool surface allowing for easier passage of stoo1.39,40
Exophthalmos (Proptosis)
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
Medical and surgical measures are available: Medical measures include: Sunglasses to protect eyes from dust and foreign bodies.Methyl cellulose eye drops to prevent corneal dryness.Diuretics to reduce orbital oedema.Steroids in high doses.Surgical measures: Tarsorrhaphy.Orbital decompression.
Development of an Oligodeoxynucleotide Pharmaceutical for the Treatment of Human Leukemia
Published in Eric Wickstrom, Clinical Trials of Genetic Therapy with Antisense DNA and DNA Vectors, 2020
Alan M. Gewirtz, Deborah Lee Sokol
To examine this issue, normal MNC were mixed (1:1) with primary acute myelogenous leukemia (AML) or chronic myelogenous leukemia (CML) blast cells and then exposed to the ODN using a slightly modified protocol designed to test the feasibility of a more intensive antisense exposure. With this in mind, an additional ODN dose (20 μg/ml) was given just prior to plating the cells in methylcellulose. In control growth factor-stimulated cultures leukemic cells formed 25·5±3·5 (mean ± SD) colonies and 157±8.5 clusters (per 2 x 105 cells plated). Exposure to c-myb sense ODN did not significantly alter these numbers (19-5±0.7 colonies and 140.5±7.8 clusters; p>0.1). In contrast, equivalent concentrations of antisense ODN totally inhibited colony and cluster formation by the leukemic blasts. Colony formation was also inhibited in the plates containing normal MNCs, but only by ~50% in comparison to untreated control plates (control colony formation, 296±40 per 2 x 105 cells plated; treated colony formation, 149±15.5 per 2 x 105 cells).
Poloxamer sols endowed with in-situ gelability and mucoadhesion by adding hypromellose and hyaluronan for prolonging corneal retention and drug delivery
Published in Drug Delivery, 2023
Ling-Chun Chen, Shyr-Yi Lin, Wei-Jie Cheng, Ming-Thau Sheu, Chi-Yun Chung, Chen-Hsuan Hsu, Hong-Liang Lin
Hyaluronic acid (HA) can relieve irritation, moisturize the ocular surface, and overcome the sodium hyaluronate deficiency in the tear film, thus alleviating DED symptoms. Hence, HA is the main ingredient in artificial tear formulations currently used for treating DED and Sjögren’s syndrome (Yang et al., 2021). Moreover, the mucoadhesive property and high viscosity of HA (Sudha & Rose, 2014) prevents the rapid washout of the drug by tears, thus prolonging the residence of drug and increasing ocular drug availability (Salwowska et al., 2016). Besides, the high molecular weight (MW) of HA inhibits inflammation by suppressing the production of inflammatory cytokines (Ruppert et al., 2014), which is beneficial for DED (Yamaguchi, 2018). The advantages of the cellulose derivatives of hydroxypropyl methylcellulose (HPMC) include safety, biocompatibility, and mucoadhesive property, which make them suitable for use as ODDS. Moreover, the mucoadhesive property of HPMC enables long contact time, allowing the drug to easily permeate the eye tissue (Tundisi et al., 2021). Therefore, we hypothesize that the addition of HPMC and HA would convert nongellable P407 aqueous solution into an in-situ gellable hydrogel with enhanced mucoadhesive characteristics. Accordingly, we developed P407-based thermosensitive in-situ hydrogels combined with HPMC and HA to reduce the desired concentration of P407 required for maintaining the formation of in-situ hydrogels with an enhanced mucoadhesive property to increase residence time for the continuing ocular delivery of solubilized testosterone in this study.
Phenolics-Enriched Fraction of Pterospermum Lanceifolium Roxb. efficiently Reverses the Hepatocellular Carcinoma in NDEA-Induced HCC Rats
Published in Nutrition and Cancer, 2022
Lal Chand Pal, Prateeksha, Brahma Nand Singh, Veena Pande, Chandana Venkateswara Rao
Sprague Dawley rat was used in the study by following regulations of the Institutional Animal Care Committee, CPCSEA, India (Reg. No. 1732/GO/Re/S/13/CPCSEA). Acute toxicity study was done by following the guidelines (OECD Guideline 423). Administration of PLE at doses of 300 (mg/kg body weight) by oral gavage indicates no mortality or gross abnormal behavior in the rats, hence the given test drug was found to be safe. The SD rats (120–180 gm body weight) used in this study were randomly categorized into five different groups (n = 5/group). Group I- received corboxy methyl cellulose (vehicle treated; 1% w/v CMC). Group II- induced with carcinogen (NDEA 200 mg/kg bw (once ip) + CCl4 (3 mL/kg/week sc.) for six week. Group III and Group IV HCC induced animals were treated with PLE (100 mg/kg/body weight/day) and (200 mg/kg/body weight/day) orally for 28 day. Group V- HCC induced animal were treated with silymarin (100 mg/kg/body weight/day) orally for 28 day (20). After 28 day treatment, rats were sacrificed on overnight fast by cervical dislocation. Blood and the vital organ were collected for the estimation of biochemical tumor markers and histopathological examination of liver tissue. The effect of PLE on carcinogenic nodule induced by NDEA were determined (Table S1).
Pharmaceutical, biomedical and ophthalmic applications of biodegradable polymers (BDPs): literature and patent review
Published in Pharmaceutical Development and Technology, 2022
Barzan Osi, Mouhamad Khoder, Ali A. Al-Kinani, Raid G. Alany
Poly (N-isopropyl acrylamide) is a water-soluble polymer at its low LCST (32 °C), above which a phase change occurs transforming the water-soluble liquid to a hydrophobic gel (Wu et al. 2019). Lai et al. developed a thermo-responsive system based on gelatin/poly (N-isopropyl acrylamide) for the intracameral administration of pilocarpine in the treatment of glaucoma (Vigani et al. 2020). Methylcellulose (MC), is a water-soluble natural polymer, derived from cellulose. At low concentrations (1–10% w/w), the liquid form of MC transfers into the gel phase when slightly high temperature (40–50 °C) is applied (Bennett 2016). Interestingly, the transition temperature of the MC can be reduced to the eye temperature by adding salts. The sol-gel transition temperature of MC depends on the MC concentration (Almeida et al. 2014; Vigani et al. 2020) and salt type. While, the salt-out salts, such as NaCl, Na2SO4, assist in the sol-gel transition, salt-in ones like KI and NaSCN tend to suppress the formation of the gel (Bromberg and Ron 1998; Xu et al. 2004; Al Khateb et al. 2016).