Clinical Toxicology of Snakebite in Asia
Jürg Meier, Julian White in Handbook of: Clinical Toxicology of Animal Venoms and Poisons, 2017
Early reactions begin 10–60 minutes after starting intravenous administration of antivenom. Cough, tachycardia, itching (especially of the scalp), urticaria, fever, nausea, vomiting and headache are common symptoms. More than 5% of patients with early reactions develop systemic anaphylaxis – hypotension, bronchospasm and angio-oedema; but there are few reports of deaths reliably attributed to these reactions. The incidence of these reactions varies from 3–54% depending on manufacturer, refinement, dose and route of administration. The vast majority of early anaphylactic antivenom reactions are not immediate type I hypersensitivity reactions but result from complement activation by IgG aggregates present in the antivenom. Adrenaline (epinephrine) 0.1% (1 in 1000) should be given subcutaneously or intramuscularly in a dose of 0.5–1.0 ml for adults, 0.01 mg/kg for children. This should be followed by an intravenous injection of an H1 antagonist (antihistamine) such as chlorpheniramine maleate (10 mg for adults, 0.2 mg/kg for children).
The Child with Fever or a Rash
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
It is essential to identify and treat the child and young person’s household and contacts – this may be especially challenging in refugee camp settings. Apply 5% permethrin once weekly for two doses over the whole body from the chin and ears downwards. The application should be washed off 12 hours after application. Children younger than 2 years should have the treatment applied and washed off under medical supervision. Children and young people who are immunosuppressed and infants should also have permethrin applied to the face and scalp (avoiding the eyes). Sedative antihistamines such as chlorphenamine maleate provide symptomatic relief. Consider antibiotics for secondary bacterial infection.3 Bed linen, blankets, towels and clothing should be washed at high temperatures to remove mites or put in a sealed plastic bag for four days in the sun.
Chlorpheniramine
Anton C. de Groot in Monographs in Contact Allergy, 2021
A 70-year-old man presented with itchy erythema and papules on the genitals and inguinal region, which had started 1 week earlier. The patient had applied a cream containing chlorpheniramine maleate to treat an itchy sensation there for 4 weeks. Patch tests were positive to chlorpheniramine maleate 1% and 0.1% pet. (negative at D2 and D3, positive at D7), but negative to the cream (which contained prednisolone acetate) and the other ingredients (11).
Gustatory rhinitis in multiple system atrophy
Published in Acta Oto-Laryngologica Case Reports, 2021
Kaoru Yamakawa, Kenji Kondo, Akihiko Unaki, Hideto Saigusa, Kyohei Horikiri, Tatsuya Yamasoba
A 56-year-old man was referred to our department with a chief complaint of bilateral copious nasal discharge while eating. His symptoms first appeared 3 years ago. The watery nasal secretion was so excessive that he lost his appetite. Endoscopic and CT examinations in the previous clinic revealed a left nasal polyp at the uncinate process and mild opacity in bilateral maxillary and ethmoid sinuses. He therefore underwent left nasal polypectomy, but his symptom did not improve. Oral administration of antihistamines, including d-chlorpheniramine maleate and azelastine hydrochloride, failed to improve his condition. A fixed-dose combination of fexofenadine hydrochloride/pseudoephedrine hydrochloride, which was prescribed for sympathetic stimulation, was temporarily effective. However, the symptom recurred within a month.
Formulation, characterization, optimization, and in-vivo performance of febuxostat self-nano-emulsifying system loaded sublingual films
Published in Drug Delivery, 2021
Basant A. Habib, Amina S. Abd El-Samiae, Boushra M. El-Houssieny, Randa Tag
Generally, plasticizers improve the elasticity by decreasing film stiffness. PG had the best plasticizing effect confirmed by having the significantly highest percent elongation and lowest elastic modulus though equivalent folding endurance to PEG (both in higher Duncan’s group) (Figure 2(a,b,e,f)) This could be attributed to PG having the lowest molecular weight of 42.08 g/mol. compared to 278.34 g/mol. for DBP and 300 g/mol. for PEG. Its smaller size allows it to be inserted easily within the polymer chains altering their densely packed structure (Tayel et al., 2016). Comparable findings were observed by Bourtoom T., who found that plasticizers with small molecular weights as glycerol and PEG can be easily inserted between the polymer chains in biodegradable blend films from rice starch-chitosan, and eventually have more influence on the mechanical properties than plasticizers with bigger molecules as sorbitol (Bourtoom, 2008). Despite lower molecular weight of DBP with respect to PEG 300, it had the least plasticizing effect. It resulted in the significantly lowest percent elongation and folding endurance and highest elastic modulus (Figure 2(a,b,e,f)). This was in accordance with the findings of Mahmood et al. who made an optimization and evaluation of chlorpheniramine maleate oral strip for pediatric use (Mahmood et al., 2018).
Determination of galantamine in human plasma by LC-MS/MS using carbamazepine as an internal standard: Method validation and application to a pharmacokinetic study of galantamine hydrobromide prolonged-release capsules in healthy Thai volunteers
Published in Cogent Medicine, 2020
Darunee Hongwiset, Songwut Yotsawimonwat, Chokchai Wongsinsup, Saowarunee Sangsrijan, Chuleegone Sornsuvit
The specificity and selectivity were studied in six blank plasma samples obtained from six different subjects. Co-medication with caffeine, chlorpheniramine maleate and paracetamol was also investigated by adding these drugs to the plasma samples. The obtained chromatograms should also have been free of the interference peaks appearing at the retention times of galantamine and IS. The matrix factors (MFs) of the galantamine and IS were calculated for each source of the matrix, as the ratio of the peak area in the presence of the matrix (measured by analyzing the blank matrix spiked after extracting the galantamine) to the peak area in the absence of the matrix (a pure solution of galantamine). The IS normalized MF was calculated by dividing the MF of the galantamine by the MF of the IS. The CV of the IS-normalized MF calculated from the eight matrix sources should not have been greater than 15%. This determination was conducted with the LQC and HQC samples.
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