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Introduction
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
This book provides monographs of all drugs in topical pharmaceuticals that have caused contact allergy/allergic contact dermatitis. Topical pharmaceuticals include products applied to the skin or mucous membranes of the eyes, nose, mouth, lower airways (by inhalation), genitals, or anal mucosa in the form of cream, ointment, lotion, spray, eye drops, nose drops, ear drops, inhalation preparation, transdermal therapeutic system, or any other form of drug delivery to the skin or mucosae affected by disease, the presence of signs such as itch or pain or as preventive measure. Vaginal tablets and suppositories and rectal suppositories are considered as topical drugs. Excluded are drugs administered by mouth or by injection (intralesional, subcutaneous, intra-articular, intravenous, intramuscular, intrathecal). These will be discussed in the next volume of the Monographs in Contact Allergy series on Systemic drugs.
Biogenic amines
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Nasal congestion is a frequent problem for AADC patients probably because of their deficit in catecholamines. Topical application of oxymetazoline or xylometazoline is necessary in most cases. The package insert, as well as major textbooks, warns that the use of the combination of MAO inhibitors and topical alpha-adrenoreceptor agonists nose drops may cause severe hypertensive crises. In AADC patients, however, catecholamines are reduced and in practice we are not aware of any such complication using this combination in our patients.
Drug Therapy in Otology
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Ear drops are solutions or suspensions of medicaments in water, glycerol, diluted alcohol, propylene glycol or other suitable solvent for instillation into the ear. A solution comprises a solute (drug) dissolved in the solvent, whereas a suspension consists of an insoluble drug distributed in a liquid. Some preparations used in otology are also used as eye or nose drops. Since these drops are in multiple-application containers, the vehicle contains a bactericidal and fungicidal agent such as benzalkonium chloride (0.01%). Other adjuvants in ear and eye drops include buffers such as sodium metabisulphite and disodium edetate. The buffers are used to maintain the pH to minimize breakdown of the active constituents or to increase comfort for the patient. Both sodium metabisulphite and disodium edetate are effective at retarding oxidation reactions and the latter can enhance the bactericidal activity of benzalkonium chloride and chlorhexidine acetate. Information on excipients contained in drops is found in the British National Formulary or its equivalent. This information is useful since some patients may be allergic to topical ear medication and this allergy may not be to the primary constituent but to the excipients.
Challenge of using Intranasal dexmedetomidine as a premedication modality in pediatric patients: A meta-analysis of randomized controlled trials
Published in Egyptian Journal of Anaesthesia, 2023
Mohamed Said Mostafa Elmeligy, Ahmed Mostafa Abdelhamid, Enas Wageh Mahdy
Many studies have examined the route and dosage of DEX, which can be delivered intravenously, orally, intranasally, and intramuscularly. The best way to administer DEX is yet unknown; however, research has demonstrated that intranasal administration is safe, effective, and less intrusive than intravenous administration. Yuen et al. revealed that using 1 μg/kg Dexmedetomidine nose drops prior to surgery had a good sedative effect in 62% of the children having surgery [16]. Li et al. utilized 1.0 μg/kg Dexmedetomidine nasal drops 45 to 60 min prior to the onset of pediatric anaesthesia, which was just as effective as 0.2 mg/kg midazolam nasal drops [53]. Intranasal Dexmedetomidine can be utilized as a sedative agent in pediatric instances and can provide safe and effective premedication, according to the current meta-analysis, which is consistent with meta-analysis carried out by Ex et al.
Airway tight junctions as targets of viral infections
Published in Tissue Barriers, 2021
Debra T. Linfield, Andjela Raduka, Mahyar Aghapour, Fariba Rezaee
Cigarette smoke leads to TJ disorganization, directly through the cleavage of occludin and claudin and indirectly through oxidative stress, which leads to the production of cytokines, most notably interleukins IL-6 and IL-8, which results in airway inflammation. There is a decrease in TEER following cigarette smoke extract (CSE) exposure in 16HBE cells.122 In one study, primary nasal epithelial cells and 16HBE cells were exposed to both CSE and HRV infection, and this resulted in an exaggerated decrease in barrier function in both systems.123 Interestingly, a single dose of betamethasone, the same amount used in commercially-available nose drops, showed significant protection of the barrier.123 CSE and poly(I:C) led to the secretion of IL-8, which was efficiently suppressed by both fluticasone propionate (FP) and budesonide (BUD).122 BUD and FP also attenuated ZO-1 disruption following CSE exposure alone. It is hypothesized that BUD interferes with epidermal growth factor (EGF) receptor activation, thus helping maintain the AJC barrier. Following poly(I:C) infection, there was a significant reduction in TEER, which was attenuated following BUD and FP exposure.122 Further research is warranted to determine the role of betamethasone, BUD, and FP in the treatment of HRV-induced asthma and COPD.
Current therapeutical strategies for allergic rhinitis
Published in Expert Opinion on Pharmacotherapy, 2019
Ludger Klimek, Annette Sperl, Sven Becker, Ralph Mösges, Peter Valentin Tomazic
Children with rhinitis are reluctant to use nose drops or nasal sprays. It would therefore be interesting to find out which factors lead to better compliance. Wong et al. collected data on the diagnosis and treatment, use of medication, and drug effect or preferred route of administration using a questionnaire among parents and caregivers of children aged 1–15 years [37]. The 194 evaluable documentation sheets showed that age plays a decisive role in the acceptance of treatment. Topical nasal sprays/nose drops showed better compliance in older children (7–15 years) than in younger patients (1–6 years) (odds ratio = 2,383). Overall, 24.7% of children completely rejected the nasal route of administration. Of the children who could comment on a preference (n = 75), 73% opted for oral medication.