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Ophthalmic Adverse Effects of Nasal Decongestants on an Experimental
A RQUIVOS B RASILEIROS DE ORIGINAL ARTICLE Ophthalmic adverse effects of nasal decongestants on an experimental rat model Efeitos oftálmicos adversos de descongestionantes nasais em modelo experimental com ratos Ayse Ipek Akyuz Unsal1, Yesim Basal2, Serap Birincioglu3, Tolga Kocaturk1, Harun Cakmak1, Alparslan Unsal4, Gizem Cakiroz5, Nüket Eliyatkın6, Ozden Yukselen7, Buket Demirci5 1. Department of Ophthalmology, Medical Faculty, Adnan Menderes University, Aydin, Turkey. 2. Department of Otorhinolaringology, Medical Faculty, Adnan Menderes University, Aydin, Turkey. 3. Department of Pathology, Veterinary Faculty, Adnan Menderes University, Aydin, Turkey. 4. Department of Radiology, Medical Faculty, Adnan Menderes University, Aydin, Turkey. 5. Department of Medical Pharmacology, Medical Faculty, Adnan Menderes University, Aydin, Turkey. 6. Department of Medical Pathology, Medical Faculty, Adnan Menderes University, Aydin, Turkey. 7. Department of Pathology, Aydin State Hospital, Aydin, Turkey. ABSTRACT | Purpose: To investigate the potential effects of cause ophthalmic problems such as dry eyes, corneal edema, chronic exposure to a nasal decongestant and its excipients cataracts, retinal nerve fiber layer, and vascular damage in on ocular tissues using an experimental rat model. Methods: rats. Although these results were obtained from experimental Sixty adult male Wistar rats were randomized into six groups. animals, ophthalmologists should keep in mind the potential The first two groups were control (serum physiologic) and ophthalmic adverse effects of this medicine and/or its excipients Otrivine® groups. The remaining four groups received the and exercise caution with drugs containing xylometazoline, Otrivine excipients xylometazoline, benzalkonium chloride, ethylene diamine tetra acetic acid, benzalkonium chloride and sorbitol, and ethylene diamine tetra acetic acid. Medications sorbitol for patients with underlying ocular problems. -
Pharmacy Phacts in This Issue Pharmd Candidates Discuss Oral Health and Preventing Eye Strain at Work
Pharmacy Phacts In this issue PharmD candidates discuss Oral Health and Preventing Eye Strain At Work Oral Health Landon Forrest Stewart, PharmD Candidate 2021 Why is Oral Health important? Oral health is an important part of our overall health. Oral health issues can cause oral pain, increased costs in healthcare, and less productivity. Recent developments in oral hygiene have led to improved outcomes for patients. Many oral health issues are still prevalent today, but the good news is that many are preventable with daily healthy habits. Healthy habits are required to maintain good oral health and many oral health issues are still prevalent today. One of the most common oral health problems is decay in the tooth also known as a cavity. The outer layer of the tooth is a tough mineral layer called the enamel. Bacteria group together on teeth to form plaques that can erode the enamel and the deeper layers of your teeth, causing cavities. Cavities are present and untreated in up to 26% up American adults. (1) If left untreated, they can lead to pain in the tooth and more severe infections known as an abscess. Another common oral health problem is gum disease. When bacteria group together on the teeth, it causes the immune system to respond and causes inflammation in the mouth. The initial inflammation is called gingivitis and makes your gums swell and bleed more easily. Untreated gingivitis can progress to a more severe gum disease called periodontitis. Periodontitis can damage the structure that holds your teeth in place and is a common cause of tooth loss. -
Fee-For-Service Preferred Drug List
Prescription Drug Program Apple Health Medicaid: Fee-for-Service Preferred Drug List What is new in this version of the preferred drug list? Effective for dates of service on and after October 1, 2018, the Health Care Authority will make the following changes: Change Due to the implementation of the Apple Health Preferred Drug List (PDL), a PDL that applies to fee-for-service (FFS) clients as well as Apple Health managed care enrollees, the following changes have occurred: On the Fee-For-Service only Preferred Drug List • Drug classes that are currently on the Apple Health PDL have been removed. These classes and the drug statuses can be found on the Apple Health Preferred Drug List. On the Apple Health Preferred Drug List • New drug classes have been added. This means drugs not previously on the PDL have been added with preferred and nonpreferred statuses. Some drugs may also have additional prior authorization (PA) requirements. • For existing drug classes, preferred statuses may have changed. Some drugs may have additional PA requirements that did not previously require PA. October 25, 2018 Correction • Two drug classes were erroneously removed and have been added back to the list: Asthma – Leukotriene Modifiers Skeletal Muscle Relaxants (Rev. 10/24/2018) (Eff. 10/1/2018) – 1 – Apple Health Medicaid PDL Prescription Drug Program What is the preferred drug list? The Health Care Authority (the agency) has developed a list of preferred drugs within a chosen therapeutic class that are selected based on clinical evidence of safety, efficacy, and effectiveness. The drugs within a chosen therapeutic class are evaluated by the Drug Use Review Board, which makes recommendations to the agency regarding the selection of the preferred drugs. -
Viscotears Liquid Gel Later Than Four Weeks After First Opening
Viscotears® Liquid Gel carbomer (polyacrylic acid) Patient Information Leaflet This product will be called Viscotears in this leaflet. Please read this leaflet carefully before you start to use Viscotears. It contains important information. Keep the leaflet in a safe place because you may want to read it again. Do not share these eye drops with anyone else just in case you have an eye infection which you could pass on. If you have any other questions, or if there is something you don’t understand, please ask your pharmacist. If any of the side effects gets serious, or if you notice any side effects not listed in this leaflet, please tell your doctor or pharmacist. In this leaflet: 1. What Viscotears is and what it’s used for 2. Things to consider before you start to use Viscotears 3. How to use Viscotears 4. Possible side effects 5. How to store Viscotears 6. Further information 1. What Viscotears is and what it’s used for Viscotears contains the active ingredient, carbomer (polyacrylic acid). Viscotears is used to make your eyes more comfortable when they feel dry. It is one of a group of eye drops called ‘artificial tears’. 2. Things to consider before you start to use Viscotears DO NOT use Viscotears if: If you are allergic to carbomer or any of the other ingredients of this medicine (listed in section 6). Take special care: In children and adolescents aged to 18 years, the safety and efficacy of Viscotears at the posology recommended in adults has been established by clinical experience, but no clinical trial data are available. -
Formulary Drug List
AMLODIPINE ORAL SUSPENSION Products Affected Step 2: • KATERZIA 1 MG/ML ORAL SUSPENSION Details Criteria PRIOR CLAIM FOR GENERIC AMLODIPINE TABLETS WITHIN THE PAST 120 DAYS. 1 ANTIBACTERIALS (EENT) Products Affected Step 2: • BESIVANCE 0.6 % EYE DROPS,SUSPENSION Details Criteria PRIOR CLAIM FOR FORMULARY VERSION OF CIPROFLOXACIN OPHTHALMIC OR OFLOXACIN OPHTHALMIC DROPS WITHIN THE LAST 120 DAYS. 2 ANTIDEPRESSANTS Products Affected Step 2: • FETZIMA 120 MG CAPSULE,EXTENDED RELEASE CAPSULE,EXTENDED RELEASE • FETZIMA 40 MG • FETZIMA 20 MG (2)-40 MG (26) CAPSULE,EXTENDED RELEASE CAPSULE,EXTENDED RELEASE,24 • FETZIMA 80 MG HR,DOSE PACK CAPSULE,EXTENDED RELEASE • FETZIMA 20 MG Details Criteria PRIOR CLAIM FOR TRINTELLIX AND VIIBRYD WITHIN THE PAST 365 DAYS. 3 ANTIPSYCHOTIC AGENTS Products Affected Step 2: • aripiprazole 10 mg disintegrating tablet • FANAPT 4 MG TABLET • aripiprazole 15 mg disintegrating tablet • FANAPT 6 MG TABLET • asenapine 10 mg sublingual tablet • FANAPT 8 MG TABLET • asenapine 2.5 mg sublingual tablet • SECUADO 3.8 MG/24 HOUR • asenapine 5 mg sublingual tablet TRANSDERMAL 24 HOUR PATCH • CAPLYTA 42 MG CAPSULE • SECUADO 5.7 MG/24 HOUR • clozapine 100 mg disintegrating tablet TRANSDERMAL 24 HOUR PATCH • clozapine 12.5 mg disintegrating tablet • SECUADO 7.6 MG/24 HOUR • clozapine 150 mg disintegrating tablet TRANSDERMAL 24 HOUR PATCH • clozapine 200 mg disintegrating tablet • VERSACLOZ 50 MG/ML ORAL • clozapine 25 mg disintegrating tablet SUSPENSION • FANAPT 1 MG TABLET • VRAYLAR 1.5 MG (1)-3 MG (6) • FANAPT 10 MG TABLET CAPSULES -
Topical Management of Chronic Rhinosinusitis
Open Access Advanced Treatments in ENT Disorders Review Article Topical Management of chronic rhinosinusitis - A literature review ISSN 1 2 2640-2777 Aremu Shuaib Kayode * and Tesleem Olayinka Orewole 1ENT Department, Federal Teaching Hospital, Ido-Ekiti/Afe Babalola University, Ado Ekiti, Nigeria 2Department of Anaesthesia, Federal Teaching Hospital, Ido Ekiti/Afe Babalola University, Ado Ekiti, Nigeria *Address for Correspondence: Dr. Aremu Shuaib Introduction Kayode, ENT Department, Federal Teaching Chronic rhinosinusitis (CRS) is an inlammatory condition involving nasal passages Hospital, Ido-Ekiti/Afe Babalola University, Ado Ekiti, Nigeria, Tel: +2348033583842; and the paranasal sinuses for 12 weeks or longer [1]. It can be subdivided into three Email: [email protected] types: CRS with nasal polyposis (CRS with NP), CRS without nasal polyposis (CRS Submitted: 08 April 2019 without NP), and Allergic fungal rhinosinusitis (AFRS). To diagnose CRS we require Approved: 25 April 2019 at least two of four of its cardinal signs/symptoms (nasal obstruction, mucopurulent Published: 26 April 2019 discharge, facial pain/pressure, and decreased sense of smell). In addition, direct Copyright: © 2019 Aremu SK, et al. This is visualization or imaging for objective documentation of mucosal inlammation is an open access article distributed under the required. CRS therapy is aimed to reduce its symptoms and improve quality of life as it Creative Commons Attribution License, which cannot be cured in most patients. Thus, the goals of its therapy include the following: permits unrestricted use, distribution, and reproduction in any medium, provided the 1: Control mucosal edema and inlammation of nasal and paranasal sinuses original work is properly cited 2: Maintain adequate sinus ventilation and drainage 3: Treat any infecting or colonizing micro-organisms, if present 4: Reduce the number of acute exacerbations Mucosal remodeling is the most likely underlying mechanism causing irreversible chronic sinus disease, similar to that occur in severe asthma. -
7.Inhalation Testing
Analytical Challenges in Implementing Effective QC/Stability testing of Inhalation Drug Products Wayland Rushing, Ph.D. Director, Scientific Affairs Eurofins BioPharma Product Testing www.Eurofins.com Inhalation Overview Delivery of one or more drug products to the lungs or nasal mucosa Benefits: § Directly targets the lungs § Rapid onset of drug action • Quick absorption into bloodstream § Low doses required § Fewer side effects 2 Drug/Device Combination Devices Orally Inhaled and Nasal Drug Products (OINDP) § Metered Dose Inhaler (pMDI or simply MDI) • HFA propellant Driven § Dry Powder Inhaler (DPI) • Patient driven § Nebulizer • Aerosolizes solutions for constant delivery § Nasal Spray • Liquid or powder delivery to nasal cavity 3 Regulatory Guidance FDA Guidances § Guidance for Container Closure Systems for Packaging Human Drugs and Biologics (1999) § Reviewers Guidance for Nebulizers, Metered Dose Inhalers, Spacers and Actuators (1993) § Metered Dose Inhalers (MDI) and Dry Powder Inhalers (DPI) (revised 2018) § Nasal Spray and Inhalers Solution, Suspension, and Spray Drug Products (2002) § Drug Products Packaged in Semipermeable Container Closure Systems (2002) USP Chapters § USP <5>: Inhalation and Nasal Drug Products—General Information and Product Quality Tests § USP <601>: Inhalation and Nasal Drug Products: Aerosols, Sprays, and Powders— Performance Quality Tests § USP <1602>: Spacers and Valved Holding Chambers Used with Inhalation Aerosols— Characterization Tests § USP <1664.1>: Orally Inhaled and Nasal Drug Products 4 Revise -
Handbook ESRA
TECHNIQUES HEAD & NECK 4 Intracranial surgery p. 3 Eye blocks p. 5 Face anatomy p. 16 Face particularity p. 23 Ophtalmic nerve blocks p. 27 Maxillary nerve blocks p. 33 Mandibular nerve blocks p. 46 THORAX & ABDOMEN 50 Epidural anaesthesia in Cardio-thoracic surgery p. 50 Ilioinguinal-Iliohypogastric block p. 55 Peri-umbilical & Rectus sheath block p. 57 Pudendal block p. 58 UPPER LIMB 61 Choice of a technique p. 61 Brachial plexus anatomy p. 65 Interscalen block p. 68 Supraclavicular blocks p. 73 Infraclavicular blocks p. 80 Axillary block p. 83 LOWER LIMB 90 Lumbar plexus block p. 90 Iliofascial block p. 100 Obturator block p. 102 Sciatic blocks o Sciatic blocks - parasacral nerve approach p. 109 o Sciatic blocks - posterior popliteal approach p. 115 Ankle blocks p. 119 AXIAL BLOCKS 123 Lumbar epidural p. 123 OBSTETRICS AXIAL BLOCKS 126 Epidural p. 126 PERIPHERAL BLOCKS Pudendal block p. 58 2 Aknowledgement The provenience of the materials included in this handbook is from the Learning Zone on the official site of “European Society of Regional Anesthesia and Pain Therapy”. http://www.esra-learning.com/ 2007 3 HEAD & TABLE OF CONTENTS NECK • Intracranial surgery • Eye blocks • Face anatomy • Face particularity • Ophtalmic nerve blocks • Maxillary nerve blocks • Mandibular nerve blocks • Cervical plexus blocks HEAD & INTRACRANIAL SURGERY NECK Paul J. Zetlaoui, M.D. Kremlin-Bicetre - France In intra-cranial neurosurgery, scalp infiltration aims to prevent systematic and cerebral hemodynamic variations, contemporary of skin incision. The potential morbidity of these hypertension-tachycardia episodes, even in patients profoundly anaesthetized, is secondary in the increase of the cerebral blood flow and in its deleterious consequences on intra-cranial pressure in these compromised patients. -
Nasal and Sinus Surgery After Care
ENT SURGICAL CONSULTANTS 2201 Glenwood Ave., Joliet, IL 60435 (815) 725-1191, (815) 725-1248 fax Michael G. Gartlan, MD, FAAP, FACS 1890 Silver Cross Blvd, Pavilion A, Suite 435, New Lenox, IL 60451 Rajeev H. Mehta, MD, FACS 815-717-8768 Scott W. DiVenere, MD Sung J. Chung, MD 900 W. Rte 6, Suite 960., Morris, IL 60450 (815) 941-1972 Ankit M. Patel, MD Walter G. Rooney, MD www.entsurgicalillinois.com NASAL & SINUS SURGERY (7/13) Nasal Drainage and Bleeding Immediately after surgery, you will have drainage from your nose. At first, there may be a small amount of bright red bleeding, but do not be alarmed. A small amount is normal and may continue through the first week. A gauze dressing will be place on your upper lip to absorb this drainage. It may be necessary to change this dressing several times on the day of your surgery. Any bright red bleeding that lasts more than ten minutes, orEar, is heavy, Nose &spray Throat two Diseases puffs of over-the-counter Afrin decongestant nasal spray (or generic equivalent) in each nostril every ten minutesOtolaryngology until the bleeding-Head & subsides. Neck Surgery This should only be used for active bleeding. This medication is available. Facial Plastic & Reconstructive Surgery Relax with your head elevated,Thyroid tilt your and headParathyroid forward Surgery and gently pinch your nostrils with an ice pack over the bridge of your nose. Persistent bleeding should be reportedPediatric to Otolaryngologyyour doctor immediately. Old blood, which accumulated during surgery, is dark reddish-brown and will drain for a week or more. -
FLONASE (Fluticasone Propionate) Nasal Spray Bacterial, Viral, Or Parasitic Infection; Ocular Herpes Simplex)
HIGHLIGHTS OF PRESCRIBING INFORMATION • Hypersensitivity reactions (e.g., anaphylaxis, angioedema, urticaria, These highlights do not include all the information needed to use contact dermatitis, rash) have been reported after administration of FLONASE safely and effectively. See full prescribing information for FLONASE nasal spray. Discontinue FLONASE nasal spray if such FLONASE. reactions occur. (5.3) • Potential worsening of infections (e.g., existing tuberculosis; fungal, FLONASE (fluticasone propionate) nasal spray bacterial, viral, or parasitic infection; ocular herpes simplex). Use with Initial U.S. Approval: 1994 caution in patients with these infections. More serious or even fatal course --------------------------- RECENT MAJOR CHANGES --------------------------- of chickenpox or measles can occur in susceptible patients. (5.4) • Hypercorticism and adrenal suppression may occur with very high Warnings and Precautions, Glaucoma and Cataracts (5.2) 1/2019 dosages or at the regular dosage in susceptible individuals. If such --------------------------- INDICATIONS AND USAGE ---------------------------- changes occur, discontinue FLONASE nasal spray slowly. (5.5) FLONASE nasal spray is a corticosteroid indicated for the management of the • Monitor growth of pediatric patients. (5.7) nasal symptoms of perennial nonallergic rhinitis in adult and pediatric patients ------------------------------ ADVERSE REACTIONS ------------------------------ aged 4 years and older. (1) The most common adverse reactions (>3%) are headache, pharyngitis, ----------------------- DOSAGE AND ADMINISTRATION ----------------------- epistaxis, nasal burning/nasal irritation, nausea/vomiting, asthma symptoms, For intranasal use only. Recommended starting dosages: and cough. (6.1) • Adults: 2 sprays per nostril once daily (200 mcg per day). (2.1) To report SUSPECTED ADVERSE REACTIONS, contact • Adolescents and children aged 4 years and older: 1 spray per nostril once GlaxoSmithKline at 1-888-825-5249 or FDA at 1-800-FDA-1088 or daily (100 mcg per day). -
A Potential Alternative Orodispersible Formulation to Prednisolone Sodium Phosphate Orally Disintegrating Tablets
pharmaceutics Article A Potential Alternative Orodispersible Formulation to Prednisolone Sodium Phosphate Orally Disintegrating Tablets Essam A. Tawfik 1,2,* , Mariagiovanna Scarpa 2, Hend E. Abdelhakim 2 , Haitham A. Bukhary 2,3, Duncan Q. M. Craig 2 , Susan A. Barker 4 and Mine Orlu 2 1 National Center for Pharmaceutical Technology, Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh 11442, Saudi Arabia 2 Department of Pharmaceutics, UCL School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK; [email protected] (M.S.); [email protected] (H.E.A.); [email protected] (H.A.B.); [email protected] (D.Q.M.C.); [email protected] (M.O.) 3 Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah 24381, Saudi Arabia 4 Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Anson Building Central Avenue, Chatham, Kent ME4 4TB, UK; [email protected] * Correspondence: etawfi[email protected] Abstract: The orally disintegrating tablet (ODT) has shown vast potential as an alternative oral dosage form to conventional tablets wherein they can disintegrate rapidly (≤30 s) upon contact with saliva fluid and should have an acceptable mouthfeel as long as their weight doesn’t exceed 500 mg. However, owing to the bitterness of several active ingredients, there is a need to find a suitable alternative to ODTs that maintains their features and can be taste-masked more simply and inexpensively. Therefore, electrospun nanofibers and solvent-cast oral dispersible films (ODFs) are used in this study as potential OD formulations for prednisolone sodium phosphate (PSP) that is Citation: Tawfik, E.A.; Scarpa, M.; commercially available as ODTs. -
Can Pilocarpine Eye Drops Be Used to Treat Dry Mouth?
Page 1 of 5 Question: Can pilocarpine eye drops be used to treat dry mouth? July 2019 Summary Pilocarpine is not recommended as a first line treatment for dry mouth (xerostomia). However, saliva stimulants are generally more effective than saliva substitutes (unless a main salivary duct is blocked) 1, and are preferred by patients.2 Other saliva stimulants such as sugar-free chewing gum should be tried prior to the initiation of pilocarpine. Pilocarpine tablets (Salagen®) are unlicensed in Ireland but are licensed in the UK for the treatment of dry mouth following irradiation for head and neck cancer and for patients with Sjögren's syndrome.3 There is limited information available to support the oral use of pilocarpine eye drops as an alternative. The use of pilocarpine eye drops to treat a dry mouth is unlicensed. For cost/reimbursement reasons, pilocarpine eye drops administered orally are favored over the use of Salagen® oral tablets (unlicensed). A recommended dose of 5mg - 10mg three times daily of oral pilocarpine tablets is approximately equivalent to pilocarpine 4% w/v, 3 - 5 drops (6mg-10mg) taken orally three times daily. 1 - 6 Palliative Meds Info: Terms and Conditions The information outlined above is intended for healthcare professionals only. The information outlined above is believed to accurately reflect the medical literature at the time of writing. Healthcare professionals must use their own judgment to determine the accuracy and relevance of the information. See www.olh.ie for full terms and conditions. Page 2 of 5 Availability Pilocarpine tablets are indicated for the treatment of dry mouth following irradiation for head and neck cancer and for dry mouth and dry eyes in Sjogren’s syndrome.