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Miscellaneous Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
The mainstay of therapy for both pregnant and non-pregnant women with rheumatoid arthritis is aspirin (Box 15.8). To achieve therapeutic blood levels of 15–25 mg/dL, patients may require up to 4 g of salicylates daily (Thurnau, 1983). However, during pregnancy lower doses of salicylates (up to 3 g per day) are recommended. Large-dose salicylate therapy during pregnancy may increase the risk for hemorrhagic complications in the fetus because salicylates cross the placenta. Hemorrhagic complications may also occur in newborns and/or mothers. Non-steroidal anti-inflammatory agents (NSAIDs) may be used in pregnant women with rheumatoid arthritis. NSAIDs may be associated with mild to moderate oligohydramnios, premature closure of the ductus arteriosus and persistent fetal circulation, as well as intracranial hemorrhage in the neonate (Chapter 8). The risk is dose-related, with higher doses conferring a higher risk. Hydroxychloroquine, as a mild immunosuppressant, was used to treat rheumatoid arthritis and SLE, but because of low efficacy, it is generally not recommended to treat pregnant women who have rheumatoid arthritis.
Monographs of fragrance chemicals and extracts that have caused contact allergy / allergic contact dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Methyl salicylate is rapidly absorbed from the gastrointestinal tract. Much of the ester is hydrolyzed to free salicylate. The onset of symptoms is rapid, usually within 2 hours of ingestion. Clinical manifestations are similar to those observed with poisoning by other salicylates. However, in view of its lipid solubility, methyl salicylate is expected to be more toxic. The major toxic effects of salicylates may be grouped as gastrointestinal, central nervous system, hematological, and metabolic and acid-base disturbances. In adult patients with severe salicylate poisoning, delayed presentation, coma, hyperpyrexia, and pulmonary edema and acidemia appear to be more common among the fatal cases (12).
Paediatric clinical pharmacology
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
The restriction of the use of salicylates for general antipyresis and analgesia in children aged 12 and under has resulted in a dramatic reduction in the incidence of Reye’s syndrome [11]. Several cases have subsequently been reported of salicylates associated with Reye’s syndrome in children between the ages of 12 and 16 [12, 13]. In the UK, it is now recommended that salicylates are avoided in children under the age of 16 years with a febrile illness. The mechanism of the toxicity is unknown.
Efficacy and Safety of Nutraceutical on Menopausal Symptoms in Post-Menopausal Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Published in Journal of Dietary Supplements, 2022
Teerapong Rattanatantikul, Mart Maiprasert, Pansak Sugkraroek, Akkarach Bumrungpert
Black Cohosh has several bioactive compounds including phytosterols, triterpenoid glycosides, actein, cimifugosides, cinnamic acid esters, alkaloids, ferulic acid, and salicylates. Previous studies have reported that black cohosh can significantly alleviate all symptoms of menopause including vasomotor effects, anxiety, depression, vaginal atrophy as well as other physical and psychological symptoms (Bai et al. 2007; Mohammad-Alizadeh-Charandabi et al. 2013; Osmers et al. 2005). Further benefits include improvement of sleep quality in post-menopausal women with disordered sleep patterns (Jiang et al. 2015), as well as improvement of vaginal maturity and increased osteoblast activity (Wuttke et al. 2006). A review of 21 randomized controlled studies revealed that black cohosh significantly improved menopause symptom greater than control or placebo (Beer et al. 2013). Though black cohosh extracts are generally not considered to contain analogs, they can show mild estrogenic effects (Seidlova-Wuttke et al. 2003) via hypothalamic control. Several of the constituents have serotonergic properties, which help to control thermoregulation, mood and the balance of LH and GnRH under estrogen withdrawal. Other components activate the central opioid system (binding to μ-opioid receptors) to provide pain and symptomatic relief during estrogen imbalance. Salicylates provide further relief of pain via COX enzyme inhibition. The triterpene glycosides exert antioxidant and anti-inflammatory properties, which help to reduce symptom severity (Burdette et al. 2003).
Risk of toxicity from pediatric topical salicylate ingestions
Published in Clinical Toxicology, 2021
Topical salicylate products often contain excipients and additional active ingredients to promote analgesia and encourage dermal absorption. These components may inhibit or delay gastrointestinal absorption or salicylate activation. Data from a mouse study suggests that concurrent topical administration of camphor and menthol may increase the absorption of MS through the skin while simultaneously inhibiting in vivo hydrolysis of MS to the active salicylic acid [8]. It is unclear if this holds true in humans with oral ingestions, as the absorption environment of the dermis and the gut differ greatly. One small, open-label, crossover study conducted by Wolowich et al. highlights a pharmacokinetics question: how much MS is systemically absorbed when a topically formulated product is ingested? After observing plasma salicylate concentrations from four adult volunteers who ingested various quantities of a non-liquid salicylate product and OoW, the authors of the study concluded that the oral bioavailability of non-liquid preparations may be close to 50% [9].
A review of auditory gain, low-level noise and sound therapy for tinnitus and hyperacusis
Published in International Journal of Audiology, 2020
Adam Sheppard, Christina Stocking, Massimo Ralli, Richard Salvi
Sodium salicylate, the active ingredient in aspirin, has been an invaluable tool in investigating the perceptual, biochemical and electrophysiological aspects of tinnitus and hyperacusis. When administered in low doses in one or two aspirin tablets, salicylate serves as an effective antipyretic, analgesic and anti-inflammatory drug. However, extremely large doses of salicylate can induce temporary hearing loss and tinnitus in humans and animals, and hyperacusis like behaviour in animals (Cazals 2000; Chen et al. 2013; Day et al. 1989; McFadden, Plattsmier, and Pasanen 1984; Radziwon et al. 2016; Radziwon et al. 2017; Sheppard et al. 2014; Stolzberg, Salvi, and Allman 2012a). Temporarily inducing tinnitus/hyperacusis for approximately 12–15 h makes salicylate a powerful tool to investigate the neurophysiological changes correlated with tinnitus and behavioural metrics of tinnitus and hyperacusis.