Acute pain and medical disorders
Pamela E Macintyre, Suellen M Walker, David J Rowbotham in Clinical Pain Management, 2008
Acute sore throat due to pharyngitis is usually the result of viral (including infectious mononucleosis) or streptococcal infection and is effectively treated with NSAIDs or COX-2-selective inhibitors, aspirin, paracetamol, tramadol, or opioids, either alone or in combination, based on studies of post-tonsillectomy pain168[II] and data from a topical review.169 A single dose of ibuprofen (200–400 mg) reduced sore throat intensity by 32–80 percent at four hours compared with placebo. Paracetamol (approximately 15 mg per kg) reduced pain by 31–50 percent at three hours.168[II] Aspirin was also effective in the treatment of sore throat and other symptoms associated with an upper respiratory tract infection170[II] and the addition of caffeine further improved analgesia for sore throat.171[II] Topical agents such as local anesthetic gargles may be helpful. Benzydamine HCl 0.15 percent anti-inflammatory spray reduced the mean pain score for sore throat by 42 percent compared with placebo169[I] and flurbiprofen lozenges provided effective pain relief without any adverse effects.172[II]
Benzydamine
Anton C. de Groot in Monographs in Contact Allergy, 2021
Benzydamine is an indazole non-steroidal anti-inflammatory drug with analgesic, antipyretic, and anti-edema properties. Available as a liquid mouthwash, spray for mouth and throat, topical cream, and vaginal irrigation (formerly also available in tablets, suppositories and intramuscular injections), benzydamine is most frequently employed for the relief of painful inflammatory conditions of the mouth and the musculoskeletal system, respectively. It is also said to promote healing. In pharmaceutical products, benzydamine is employed as benzydamine hydrochloride (CAS number 132-69-4, EC number 205-076-0, molecular formula C19H24ClN3O) (1).
Oral problems
Mervyn Dean, Juan-Diego Harris, Claud Regnard, Jo Hockley in Symptom Relief in Palliative Care, 2018
Some topical agents can offer mucosal protection. Carmellose (Orabase) paste is an effective protective for local lesions. There is no evidence that benzydamine, sucralfate or chlorhexidine ease oral pain.48–50 Choline salicylate gel can help but can cause pain on application. In the US, gel preparation can be obtained via a Compounding Pharmacy. Lidocaine (cream, gel or spray) can help acutely painful lesions at the expense of numbness, but toxicity has been reported with frequent use.51 In very severe pain, systemic analgesia is required. Topical opioids may help, but in very severe pain systemic opioids are required. Ketamine may have a role in extensive mucositis.64
Radiotherapy-induced severe oral mucositis: pharmacotherapies in recent and current clinical trials
Published in Expert Opinion on Investigational Drugs, 2023
Alessandro Villa, Stephen T. Sonis
While OM has long been acknowledged as a leading toxicity among patients receiving RT for cancers of the head and neck, available treatment interventions have been essentially palliative and have had little effect on the course, severity, or impact of OM [1,2]. Amifostine, a free radical scavenger, was approved by the FDA for the treatment of radiation-associated salivary gland damage in 1999 and has been intermittently used off-label as an OM preventive option with mixed results. Benzydamine HCl, an anti-inflammatory rinse, was first reported to reduce OM-associated pain in patients receiving radiation therapy in 1986, but has not received FDA approval and is not available in the U.S. [5]. Data from additional trials suggest that benzdamine may have utility in symptom management for patients at risk of developing OM with less rigorous radiation (and concomitant chemoradiation) regimens. Photobiomodulation (PBM; low-level laser therapy) has been studied and advocated as a non-pharmacological approach to OM management, but the limited results of large, multi-institutional, randomized trials confirm the need for additional investigation [6].
Functional assessment of rat pulmonary flavin-containing monooxygenase activity
Published in Xenobiotica, 2019
Yildiz Yilmaz, Gareth Williams, Nenad Manevski, Markus Walles, Stephan Krähenbühl, Gian Camenisch
CLlung estimated using rat lung microsomes was low (16 ± 0.6 mL/min/kg; Table 2) and equated to approximately 5% of pulmonary blood flow. The detection of such a low first pass extraction in vivo may be confounded by analytical and inter-animal variability and as such, the in vivo data obtained following i.a and i.v. dosing failed to show a significant difference in benzydamine exposure (Figure 6 and Table 3). Although the mean benzydamine N-oxide exposure observed after i.v. dosing was slightly higher than after i.a. dosing, the variability in the data preclude a confident attribution to pulmonary metabolism. The predicted CLliver estimated from in vitro data was 46 ± 1.1 mL/min/kg, equivalent to approximately 83% hepatic blood flow (Table 2). This suggests that, in rat, benzydamine clearance is predominantly mediated by hepatic metabolism. The predicted CLlung using rat lung microsomes corresponded to approximately 35% of rat CLliver, also suggesting that the lung makes only a small contribution to the whole body clearance of benzydamine. Despite these findings, there may still be value in investigating the pulmonary metabolism of further FMO substrates.
Wrong administration route of medications in the domestic setting: a review of an underestimated public health topic
Published in Expert Opinion on Pharmacotherapy, 2021
Maria Rosaria Gualano, Giuseppina Lo Moro, Gianluca Voglino, Dario Catozzi, Fabrizio Bert, Roberta Siliquini
A report from Ballesteros et al. [31] in 2009 studied the in-depth ingestion of benzydamine-containing vaginal preparations through calls addressed to the Spanish Poison Control Center (SPCC) from 1991 to 2003. As mentioned above [10], people who use these gynecological formulations might make administration route errors by ingesting these medications. Indeed, 724 cases were recognized: 94.3% occurred in a home setting, and 52.9% occurred in a general public setting with no health-care professional involved as an intermediary figure. Specifically, 86.2% of the patients were older than 14 years of age; among these, 80.9% were female. These errors are probably associated with the confounding effect of finding the same active substance in OTC solutions for oropharyngeal diseases. In particular, the authors reported that female adults (80.9% of adults) confused the route of administration of the drug, whereas male patients confused the medication with the oral antiseptic with the same active substance but different doses. The clinical effect of benzydamine poisoning was mild: 72.9% of cases were considered asymptomatic with minor symptoms, 25.7% with a moderate presentation, and 1.4% with severe symptomatology, none of which resulted in death [31].
Related Knowledge Centers
- Dentistry
- Gingivitis
- Mouth
- Stomatitis
- NONsteroidal Anti-Inflammatory Drug
- Anesthetic
- Analgesic
- Throat
- Indazole
- Oral Medicine