DOCSLIB.ORG

Clioquinol (Lodochlorhydroxyquin, Vioform) and Lodoquinol (Diiodohydroxyquin): Blindness and Neuropathy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Clioquinol (Lodochlorhydroxyquin, Vioform) and Lodoquinol (Diiodohydroxyquin): Blindness and Neuropathy Committee on Drugs 0 Clioquinol (lodochlorhydroxyquin, Vioform) and lodoquinol (Diiodohydroxyquin): Blindness and Neuropathy Clioquinol and iodoquinol are found in topical area of the forearm (1.1% of body surface area). compounds for dermatologic use. Their application The skin was occluded with Saran Wrap and gauze. in pediatrics has been for treatment of diaper der- Approximately 40% of the dose was absorbed dur- matitis, although the current labeling for these ing the 12 hours, ie, about 60 mg of clioquinol. products advises against their use in children Plasma concentrations of 0.37 to 0.56 mg/L were younger than 2 years of age. The Table lists a few detected within 2 hours. Although the remainder of of the many agents currently available that contain the cream was removed after 12 hours, plasma levels clioquinol or iodoquinol. Some nonprescription remained elevated for an additional 12 hours.9 products also contain clioquinol. The concentrations in this study are comparable Since our 1974 commentary on the toxicity of to the clioquinol plasma levels of 0.29 to 0.52 mg/ these drugs to children,’ additional reports of tox- L measured in five dogs on whom 3% clioquinol icity following skin application have become avail- cream (5 g twice daily) was applied topically for 28 able. Both clioquinol and iodoquinol have been days.’#{176}In this study, approximately 50% of the known to cause serious and irreversible optic atro- clioquinol was absorbed during a 16-hour period. phy and peripheral neuropathy.2 This class of drugs During a 28-day observation period, all dogs were 0 was associated with several thousand cases of sub- lethargic, less responsive to stimuli, and experi- acute myelo-optic neuropathy in Japan.35 The din- enced an average weight loss of 15%. Three of the ical picture was that of a subacute onset of periph- five dogs developed dermatitis; one dog died 15 days eral weakness and sensory loss, spastic paraparesis, after treatment ended. Examination of the liver and blindness, occurring in combination in various demonstrated diffuse centrilobular and midzonal degrees. The most common symptoms were mus- cell necrosis, suggesting hepatocellular toxicity. cular weakness of the lower extremities and dyses- Partial hind limb paralysis was seen in one dog. thesia spreading to the trunk. Use of these drugs in infants carries a risk of A World Health Organization committee con- toxicity. Application of 1 g of 3% clioquinol cream vened in 1977 to prepare a list of essential drugs three times a day to the skin of an infant weighing and excluded clioquinol because it considered the 10 kg would result in a dose of 9 mg/kg per day. risks of treatment greater than the potential bene- This is similar to the 17 mg/kg per day dose applied fit.6 Other authoritative sources of drug information to the dogs, and it is more than three times greater state that “clioquinol has limited topical antibac- than the single 2.5 mg/kg dose used in the clinical terial and antifungal activity”7 and that “routine study.#{176}Of additional concern is the well-known fact use of either compound (clioquinol or iodoquinol) that greater drug absorption occurs through in- is not recommended.”8 flamed skin than through normal skin. Drug ab- A recent clinical study examined the percuta- sorption also is enhanced when applied under an neous absorption of clioquinol.9 Five healthy male occlusive dressing, such as diapers. subjects received one application (5 g) of 3% cli- Alternative topical agents for dermatitis exist oquinol cream applied for 12 hours to a 200 cm2 that have less risk of toxicity. For primary irritant dermatitis in which evidence for prostaglandin gen- eration has been obtained,12 “frequent applications of a bland protective topical agent (petrolatum or The recommendations in this statement do not indicate an zinc oxide paste) following thorough gentle clean- exclusive course of treatment to be followed. Variations, taking sing may suffice to prevent dermatitis.”3 For sec- 0 into account individual circumstances, may be appropriate. PEDIATRICS (ISSN 0031 4005). Copyright © 1990 by the ondary infection, “Polysporin (polymixin B plus American Academy of Pediatrics. bacitracin) and bacitracin are probably the two Downloaded from www.aappublications.org/newsPEDIATRICS by guest on Vol. September 86 No. 28, 52021 November 1 990 797 TABLE. Partial List of Products Contain ing Clioquinol and Iodoquinol* Generic Name Trade Name Manufacturer Clioquinol cream, ointment Vioform CIBA Clioquinol and hydrocortisone cream, lotion, Vioform-Hydrocortisone CIBA 0 ointment lodoquinol and hydrocortisone cream Vytone Dermik lodoquinol and hydrocortisone lodo-Cortifair Pharmafair lodoquinol tablets Yodoxin Glenwood Source: PDR Physicians ‘ Desk Reference. 43rd ed. Oradell, NJ: Medical Economics Co; 1989. * More than 50 other products containing clioquinol or iodoquinol are registered with the Food and Drug Administration. most useful preparations for pyoderma.”13 Topi- Sumner J. Yaffe, MD, National In- cally applied nystatin is specific for Candida super- stitute of Child Health and Hu- ficial fungal skin infections. Haloprogin, micona- man Development zole, clotrimazole, and econazole are active against AAP Section Liaison Candida, Pityrosporum orbiculare, and the derma- Cheston M. Berlin, MD, Section on tophytes. Topical antibiotic combinations with Clinical Pharmacology other agents, such as corticosteroids, in general are inadvisable.’3 Consultants Mary Ellen Mortensen, MD Anthony R. Temple, MD CONCLUSION Clioquinol and iodoquinol are neurotoxic. Their use for topical application poses a potential risk of REFERENCES toxicity to infants and children. Since alternative 1. American Academy of Pediatrics, Committee on Drugs. effective treatments for dermatitis are available, we Blindness and neuropathy from diiodohydroxyquin-like drugs. Pediatrics. 1974;54:378-379 recommend that drug products containing cli- 2. Oakley GP. The neurotoxicity of the halogenated hydroxy- oquinol or iodoquinol not be used. quinolines. JAMA. 1973;225:395-397 3. Kono R. Review of subacute myelo-optic neuropathy (SMON) and studies done by the SMON research commis- COMMITTEE ON DRUGS, 1989-1990 sion. Jpn J Med Sci Biol. 1975;28(suppl):1-21 0 Ralph E. Kauffman, MD, Chairman 4. Shigematsu I. Subacute myelo-optic neuropathy (SMON) William Banner, Jr, MD and clioquinol. Jpn J Med Sci Biol. 1975;28(suppl):35-55 5. Rose FC, Gawel M. Clioquinol neurotoxicity: an overview. Jeffrey L. Blumer, MD Acta Neurol Scand. 1984;70(suppl 100):137-145 Richard L. Gorman, MD 6. World Health Organization. The selection ofessential drugs. George H. Lambert, MD WHO Tech Rep Ser. 1977;615:14 7. Bennett DR, Cranston JW, Evans RM, et al. Topical anti- Wayne Snodgrass, MD infective agents: drugs used on skin and mucous membranes. Liaison Representatives In: Drug Evaluations. 6th ed. Chicago, IL: American Medical Association; 1986:1511 Donald R. Bennett, MD, PhD, 8. Webster LT. Drugs used in the chemotherapy of protozoal American Medical Association infections. In: Gilman AG, Goodman LS, Rail TW, Murad Jose F. Cordero, MD, MPH, Cen- F, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 7th ed. New York, NY: Macmillan Publishing ters for Disease Control Co; 1985 Sharon Dooley, MD, American Col- 9. Stohs SF, Ezzedeen FW, Anderson AK, et al. Percutaneous lege of Obstetricians and Gyne- absorption of iodochlorhydroxyquin in humans. J Invest Dermatol. 1984;82:195-198 cologists 10. Ezzedeen FW, Stohs SJ, Kilzer KL, et a!. Percutaneous Sam A. Licata, MD, National absorption anddisposition of iodochlorhydroxyquin in dogs. Health & Welfare, Health Pro- J Pharm Sci. 1984;73:1369-1372 11. Kahn G. Principles oftreatment. In: Schachner LA, Hansen tection Branch, Canada RC, eds. Pediatric Dermatology. New York, NY: Churchill Robert Peterson, MD, Canadian Livingstone; 1988:196-197 Paediatric Society 12. Brain SD, Williams TJ. Prostaglandins, leukotrienes, re- lated compounds and their inhibitors. In: Greaves MW, John C. Petricciani, MD, Pharma- Shuster 5, eds. Pharmacology of the Skin 1. New York, NY: ceutical Manufacturers’ Associa- Springer-Verlag; 1989:352 tion 13. Esterly NB. The skin: diseases of the skin. In: Behrman RE, Vaughan VC, Nelson WE, et al, eds. Nelson Textbook of Gloria Troendle, MD, Food and Pediatrics. 13th ed. Philadelphia, Pa: WB Saunders Co; Drug Administration 1987:1405, 1445 0 798 BLINDNESS ANDDownloaded NEUROPATHY from www.aappublications.org/news by guest on September 28, 2021 Clioquinol (lodochlorhydroxyquin, Vioform) and lodoquinol (Diiodohydroxyquin): Blindness and Neuropathy Pediatrics 1990;86;797 Updated Information & including high resolution figures, can be found at: Services http://pediatrics.aappublications.org/content/86/5/797 Permissions & Licensing Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.aappublications.org/site/misc/Permissions.xhtml Reprints Information about ordering reprints can be found online: http://www.aappublications.org/site/misc/reprints.xhtml Downloaded from www.aappublications.org/news by guest on September 28, 2021 Clioquinol (lodochlorhydroxyquin, Vioform) and lodoquinol (Diiodohydroxyquin): Blindness and Neuropathy Pediatrics 1990;86;797 The online version of this article, along with updated information and services, is located on the World Wide Web at: http://pediatrics.aappublications.org/content/86/5/797 Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it has been published continuously since 1948. Pediatrics is owned, published, and trademarked by the American Academy of Pediatrics, 345 Park Avenue, Itasca, Illinois, 60143. Copyright © 1990 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 1073-0397. Downloaded from www.aappublications.org/news by guest on September 28, 2021.
Load more

Recommended publications
  • Antiseptics and Disinfectants for the Treatment Of
    Verstraelen et al. BMC Infectious Diseases 2012, 12:148 http://www.biomedcentral.com/1471-2334/12/148 RESEARCH ARTICLE Open Access Antiseptics and disinfectants for the treatment of bacterial vaginosis: A systematic review Hans Verstraelen1*, Rita Verhelst2, Kristien Roelens1 and Marleen Temmerman1,2 Abstract Background: The study objective was to assess the available data on efficacy and tolerability of antiseptics and disinfectants in treating bacterial vaginosis (BV). Methods: A systematic search was conducted by consulting PubMed (1966-2010), CINAHL (1982-2010), IPA (1970- 2010), and the Cochrane CENTRAL databases. Clinical trials were searched for by the generic names of all antiseptics and disinfectants listed in the Anatomical Therapeutic Chemical (ATC) Classification System under the code D08A. Clinical trials were considered eligible if the efficacy of antiseptics and disinfectants in the treatment of BV was assessed in comparison to placebo or standard antibiotic treatment with metronidazole or clindamycin and if diagnosis of BV relied on standard criteria such as Amsel’s and Nugent’s criteria. Results: A total of 262 articles were found, of which 15 reports on clinical trials were assessed. Of these, four randomised controlled trials (RCTs) were withheld from analysis. Reasons for exclusion were primarily the lack of standard criteria to diagnose BV or to assess cure, and control treatment not involving placebo or standard antibiotic treatment. Risk of bias for the included studies was assessed with the Cochrane Collaboration’s tool for assessing risk of bias. Three studies showed non-inferiority of chlorhexidine and polyhexamethylene biguanide compared to metronidazole or clindamycin. One RCT found that a single vaginal douche with hydrogen peroxide was slightly, though significantly less effective than a single oral dose of metronidazole.
    [Show full text]
  • Identification of Candidate Agents Active Against N. Ceranae Infection in Honey Bees: Establishment of a Medium Throughput Screening Assay Based on N
    RESEARCH ARTICLE Identification of Candidate Agents Active against N. ceranae Infection in Honey Bees: Establishment of a Medium Throughput Screening Assay Based on N. ceranae Infected Cultured Cells Sebastian Gisder, Elke Genersch* Institute for Bee Research, Department of Molecular Microbiology and Bee Diseases, Hohen Neuendorf, Germany * [email protected] Abstract OPEN ACCESS Many flowering plants in both natural ecosytems and agriculture are dependent on insect Citation: Gisder S, Genersch E (2015) Identification of Candidate Agents Active against N. ceranae pollination for fruit set and seed production. Managed honey bees (Apis mellifera) and wild Infection in Honey Bees: Establishment of a Medium bees are key pollinators providing this indispensable eco- and agrosystem service. Like all Throughput Screening Assay Based on N. ceranae other organisms, bees are attacked by numerous pathogens and parasites. Nosema apis is Infected Cultured Cells. PLoS ONE 10(2): e0117200. a honey bee pathogenic microsporidium which is widely distributed in honey bee popula- doi:10.1371/journal.pone.0117200 tions without causing much harm. Its congener Nosema ceranae was originally described Academic Editor: Wolfgang Blenau, Goethe as pathogen of the Eastern honey bee (Apis cerana) but jumped host from A. cerana to A. University Frankfurt, GERMANY mellifera about 20 years ago and spilled over from A. mellifera to Bombus spp. quite recent- Received: October 8, 2014 ly. N. ceranae is now considered a deadly emerging parasite of both Western honey bees Accepted: December 20, 2014 and bumblebees. Hence, novel and sustainable treatment strategies against N. ceranae are Published: February 6, 2015 urgently needed to protect honey and wild bees.
    [Show full text]
  • 4. Antibacterial/Steroid Combination Therapy in Infected Eczema
    Acta Derm Venereol 2008; Suppl 216: 28–34 4. Antibacterial/steroid combination therapy in infected eczema Anthony C. CHU Infection with Staphylococcus aureus is common in all present, the use of anti-staphylococcal agents with top- forms of eczema. Production of superantigens by S. aureus ical corticosteroids has been shown to produce greater increases skin inflammation in eczema; antibacterial clinical improvement than topical corticosteroids alone treatment is thus pivotal. Poor patient compliance is a (6, 7). These findings are in keeping with the demon- major cause of treatment failure; combination prepara- stration that S. aureus can be isolated from more than tions that contain an antibacterial and a topical steroid 90% of atopic eczema skin lesions (8); in one study, it and that work quickly can improve compliance and thus was isolated from 100% of lesional skin and 79% of treatment outcome. Fusidic acid has advantages over normal skin in patients with atopic eczema (9). other available topical antibacterial agents – neomycin, We observed similar rates of infection in a prospective gentamicin, clioquinol, chlortetracycline, and the anti- audit at the Hammersmith Hospital, in which all new fungal agent miconazole. The clinical efficacy, antibac- patients referred with atopic eczema were evaluated. In terial activity and cosmetic acceptability of fusidic acid/ a 2-month period, 30 patients were referred (22 children corticosteroid combinations are similar to or better than and 8 adults). The reason given by the primary health those of comparator combinations. Fusidic acid/steroid physician for referral in 29 was failure to respond to combinations work quickly with observable improvement prescribed treatment, and one patient was referred be- within the first week.
    [Show full text]
  • Clioquinol: Summary Report
    Clioquinol: Summary Report Item Type Report Authors Gianturco, Stephanie L.; Pavlech, Laura L.; Storm, Kathena D.; Yoon, SeJeong; Yuen, Melissa V.; Mattingly, Ashlee N. Publication Date 2020-01 Keywords Clioquinol; Compounding; Food, Drug, and Cosmetic Act, Section 503B; Food and Drug Administration; Outsourcing facility; Drug compounding; Legislation, Drug; United States Food and Drug Administration Rights Attribution-NoDerivatives 4.0 International Download date 24/09/2021 22:12:31 Item License http://creativecommons.org/licenses/by-nd/4.0/ Link to Item http://hdl.handle.net/10713/12091 Summary Report Clioquinol Prepared for: Food and Drug Administration Clinical use of bulk drug substances nominated for inclusion on the 503B Bulks List Grant number: 2U01FD005946 Prepared by: University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI) University of Maryland School of Pharmacy January 2020 This report was supported by the Food and Drug Administration (FDA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award (U01FD005946) totaling $2,342,364, with 100 percent funded by the FDA/HHS. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement by, the FDA/HHS or the U.S. Government. 1 Table of Contents REVIEW OF NOMINATIONS ................................................................................................... 4 METHODOLOGY ...................................................................................................................
    [Show full text]
  • Effect of 8-Hydroxyquinoline and Derivatives on Human Neuroblastoma SH-SY5Y Cells Under High Glucose
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Crossref Effect of 8-hydroxyquinoline and derivatives on human neuroblastoma SH-SY5Y cells under high glucose Wilasinee Suwanjang1, Supaluk Prachayasittikul2 and Virapong Prachayasittikul3 1 Center for Research and Innovation, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand 2 Center of Data Mining and Biomedical Informatics, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand 3 Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok, Thailand ABSTRACT 8-Hydroxyquinoline and derivatives exhibit multifunctional properties, including antioxidant, antineurodegenerative, anticancer, anti-inflammatory and antidiabetic activities. In biological systems, elevation of intracellular calcium can cause calpain activation, leading to cell death. Here, the effect of 8-hydroxyquinoline and derivatives (5-chloro-7-iodo-8-hydroxyquinoline or clioquinol and 8-hydroxy-5-nitroquinoline or nitroxoline) on calpain-dependent (calpain-calpastatin) pathways in human neu- roblastoma (SH-SY5Y) cells was investigated. 8-Hydroxyquinoline and derivatives ameliorated high glucose toxicity in SH-SY5Y cells. The investigated compounds, particularly clioquinol, attenuated the increased expression of calpain, even under high- glucose conditions. 8-Hydroxyquinoline and derivatives thus adversely affected the promotion of neuronal cell death by high glucose via the calpain-calpastatin
    [Show full text]
  • EAR, NOSE and OROPHARYNX Updated: October 2020
    Derbyshire Medicines Management, Prescribing and Guidelines DERBYSHIRE PRIMARY CARE FORMULARY CHAPTER 12: EAR, NOSE AND OROPHARYNX Updated: October 2020 The following prescribing guidelines are relevant to the ENT chapter and can be found here: • Allergic Rhinitis in adults and adolescents over 12 years of age • Management of chronic rhinosinusitis with or without nasal polyps 12.1 DRUGS ACTING ON THE EAR 12.1.1 Otitis externa Investigation is not routinely recommended for the initial diagnosis of otitis externa. Group Drug Astringent/acidic Acetic acid 2% ear spray preparations Self-care: patients are advised to purchase this over the counter Gentamicin 0.3% ear/eye drops* Antibiotic preparations Ciprofloxacin 2mg/ml ear drops 0.25ml unit dose PF Betnesol-N ear/eye/ nose drops* Combined corticosteroid (Betamethasone 0.1% & neomycin 0.5%) and aminoglycoside Otomize ear spray* antibiotic preparations (Dexamethasone 0.1%, neomycin 0.5% & acetic acid 2%) Corticosteroid Prednisolone 0.5% ear/eye drops Lower potency preparations Betamethasone 0.1% ear/eye/ nose drops Higher potency Antifungal preparations Clotrimazole 1% solution 20ml (with dropper) * In view of reports of ototoxicity, manufacturers contra-indicate treatment with topical aminoglycosides in patients with a perforated tympanic membrane (eardrum) or patent grommet. 1. The following are GREY, not for first line empirical use, and should only be used when sensitivity is confirmed through swab results- • Hydrocortisone acetate 1%/gentamicin 0.3% ear drops • Flumetasone pivalate 0.02%/clioquinol 1% ear drops 2. How should I treat acute diffuse otitis externa? (CKS) • Remove or treat any precipitating or aggravating factors. • Prescribe or recommend a simple analgesic for symptomatic relief.
    [Show full text]
  • Chemical Modulators of Fibrinogen Production and Their Impact on Venous Thrombosis
    Published online: 2020-12-10 Coagulation and Fibrinolysis 433 Chemical Modulators of Fibrinogen Production and Their Impact on Venous Thrombosis Rui Vilar1 Samuel W. Lukowski1,2 Marco Garieri1 Corinne Di Sanza1 Marguerite Neerman-Arbez1,3 Richard J. Fish1 1 Department of Genetic Medicine and Development, University of Address for correspondence Richard J. Fish, Department of Genetic Geneva Faculty of Medicine, Geneva, Switzerland Medicine and Development, Faculty of Medicine, University of 2 Institute for Molecular Bioscience, The University of Queensland, Geneva, 1, rue Michel-Servet, Geneva 1206, Switzerland Saint Lucia, Queensland, Australia (e-mail: [email protected]). 3 iGE3, Institute of Genetics and Genomics in Geneva, Geneva, Switzerland Thromb Haemost 2021;121:433–448. Abstract Thrombosis is a leading cause of morbidity and mortality. Fibrinogen, the soluble substrate for fibrin-based clotting, has a central role in haemostasis and thrombosis and its plasma concentration correlates with cardiovascular disease event risk and a prothrombotic state in experimental models. We aimed to identify chemical entities capable of changing fibrinogen production and test their impact on experimental thrombosis. A total of 1,280 bioactive compounds were screened for their ability to alter fibrinogen production by hepatocyte-derived cancer cells and a selected panel was tested in zebrafish larvae. Anthralin and all-trans retinoic acid (RA) were identified as fibrinogen-lowering and fibrinogen-increasing moieties, respectively. In zebrafish larvae, anthralin prolonged laser-induced venous occlusion times and reduced thrombocyte accumulation at injury sites. RA had opposite effects. Treatment with RA, a nuclear receptor ligand, increased fibrinogen mRNA levels. Using an antisense morpholino oligonucleotide to deplete zebra- fish fibrinogen, we correlated a shortening of laser-induced venous thrombosis times with RA treatment and fibrinogen protein levels.
    [Show full text]
  • Raised Serum Protein-Bound Iodine After Topical Clioquinol A. C
    Case reports 515 Postgrad Med J: first published as 10.1136/pgmj.47.549.515 on 1 July 1971. Downloaded from Raised serum protein-bound iodine after topical clioquinol A. C. UPJOHN H-J. B. GALBRAITH M.R.C.S., L.R.C.P. M.D., F.R.C.P. General Practitioner, Ongar Physician, Chelmsford Hospitals BETHEL SOLOMONS M.D., F.R.C.P.I. Dermatologist, Chelmsford Hospitals RAISED serum levels ofprotein-bound iodine (PBI) in hydrocortisone cream, and continued to do so for 17 patients with normal thyroid function have been weeks until her first out-patient visit to the skin observed on many occasions after oral treatment department (B. S.). Apart from her varicose condi- with 5-chloro-7-iodo-8-hydroxyquinoline (iodo- tion she. complained of constant nervousness. chlorhydroxyquinoline, clioquinol, Enterovioform) Further examination revealed some signs of thyro- (Thoren, 1960; Levin, Josephson & Grtnewald, toxicosis. The PBI was 22 tug/100 ml. She stopped 1966; Sonksen et al., 1968). It is less well appre- using the cream, and 3 weeks later her PBI was 5-2 Protected by copyright. ciated that clioquinol administered topically can [ug/100 ml. She agreed to use the cream again, and be absorbed in sufficient quantities to influence after 3 weeks, during which time she had used nearly the PBI and the uptake of radio-active iodine by the three 20 g tubes, her PBI was 13-4 [g/100 ml. She thyroid gland. then stopped using the cream and her PBI had returned to 5 0 tzg/100 ml a month later.
    [Show full text]
  • Effectiveness of 7.5 Percent Povidone Iodine in Comparison to 1 Percent Clotrimazole in the Treatment of Otomycosis
    EFFECTIVENESS OF 7.5 PERCENT POVIDONE IODINE IN COMPARISON TO 1 PERCENT CLOTRIMAZOLE IN THE TREATMENT OF OTOMYCOSIS A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF M.S BRANCH –IV (OTORHINOLARYNGOLOGY EXAMINATION OF THE DR.MGR. MEDICAL UNIVERSITY TO BE HELD IN APRIL 2012 ACKNOWLEDGEMENTS I wish to express my deep gratitude to Dr Anand Job, Professor and Head of Unit 1, Department of Otorhinolaryngology, Speech and Hearing, Christian Medical College and Hospital, Vellore for his able guidance and encouragement in conducting this study and preparing this dissertation. I wish to express my deep gratitude to Dr Achamma Balraj, Head of the Department of Otorhinolaryngology, Speech and Hearing, Christian Medical College and Hospital, Vellore for her able guidance and encouragement in conducting this study and preparing this dissertation. I would like to thank Dr Rita Ruby Albert, Dr Regi Thomas, and Dr Rajan Sundaresan from the Department of Otorhinolaryngology for being my co-investigators in this study. I am extremely thankful to Dr Shalini Anandan, Assistant professor, Department of Microbiology for her guidance in this study. I am thankful to Dr Selvaraj from the Department of Biostatistics for his able guidance in the statistical analysis of this study. I would like to thank the Fluid Research Committee, CMC Hospital for granting me financial assistance for conducting this study. Last but not the least; I would like to thank all my patients who participated with me in this study for their kind co-operation. CERTIFICATE This is to certify that the dissertation entitled “Effectiveness of 7.5 percent povidone iodine in comparison to 1 percent clotrimazole in the treatment of otomycosis” is a bonafide original work of Dr Ajay Philip, submitted in partial fulfillment of the rules and regulations for the MS Branch IV, Otorhinolaryngology examination of The Tamil Nadu Dr.
    [Show full text]
  • Vr Meds Ex01 3B 0825S Coding Manual Supplement Page 1
    vr_meds_ex01_3b_0825s Coding Manual Supplement MEDNAME OTHER_CODE ATC_CODE SYSTEM THER_GP PHRM_GP CHEM_GP SODIUM FLUORIDE A12CD01 A01AA01 A A01 A01A A01AA SODIUM MONOFLUOROPHOSPHATE A12CD02 A01AA02 A A01 A01A A01AA HYDROGEN PEROXIDE D08AX01 A01AB02 A A01 A01A A01AB HYDROGEN PEROXIDE S02AA06 A01AB02 A A01 A01A A01AB CHLORHEXIDINE B05CA02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D08AC02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D09AA12 A01AB03 A A01 A01A A01AB CHLORHEXIDINE R02AA05 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S01AX09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S02AA09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S03AA04 A01AB03 A A01 A01A A01AB AMPHOTERICIN B A07AA07 A01AB04 A A01 A01A A01AB AMPHOTERICIN B G01AA03 A01AB04 A A01 A01A A01AB AMPHOTERICIN B J02AA01 A01AB04 A A01 A01A A01AB POLYNOXYLIN D01AE05 A01AB05 A A01 A01A A01AB OXYQUINOLINE D08AH03 A01AB07 A A01 A01A A01AB OXYQUINOLINE G01AC30 A01AB07 A A01 A01A A01AB OXYQUINOLINE R02AA14 A01AB07 A A01 A01A A01AB NEOMYCIN A07AA01 A01AB08 A A01 A01A A01AB NEOMYCIN B05CA09 A01AB08 A A01 A01A A01AB NEOMYCIN D06AX04 A01AB08 A A01 A01A A01AB NEOMYCIN J01GB05 A01AB08 A A01 A01A A01AB NEOMYCIN R02AB01 A01AB08 A A01 A01A A01AB NEOMYCIN S01AA03 A01AB08 A A01 A01A A01AB NEOMYCIN S02AA07 A01AB08 A A01 A01A A01AB NEOMYCIN S03AA01 A01AB08 A A01 A01A A01AB MICONAZOLE A07AC01 A01AB09 A A01 A01A A01AB MICONAZOLE D01AC02 A01AB09 A A01 A01A A01AB MICONAZOLE G01AF04 A01AB09 A A01 A01A A01AB MICONAZOLE J02AB01 A01AB09 A A01 A01A A01AB MICONAZOLE S02AA13 A01AB09 A A01 A01A A01AB NATAMYCIN A07AA03 A01AB10 A A01
    [Show full text]
  • Metronidazole Neuropathy
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.39.4.403 on 1 April 1976. Downloaded from Journal ofNeurology, Neurosurgery, and Psychiatry, 1976, 39, 403-405 Metronidazole neuropathy A. COXON AND C. A. PALLIS From the Department of Medicine (Neurology), Royal Postgraduate Medical School, London SYN oP si s Two patients are described who developed sensory neuropathy after the ingestion of 30.6 and 114 g metronidazole respectively. The drug, widely used in gastroenterological and gynaecological practice, has not hitherto been considered neurotoxic. The implications are stressed in relation to the differential diagnosis of patients with gastroenterological disorders who develop peripheral neuropathy. In view of the recent advocacy, from Sweden, of ness in the toes. Within a few days this had spread to long-term metronidazole therapy for Crohn's involve the soles and the dorsa of the feet. She could disease (Ursing and Kamme, 1975) and of dis- not feel the ground under her properly, and was not sure whether she was wearing shoes or not. Distres- cussions as to whether the drug might prove Protected by copyright. sing paraesthesiae had developed in the wake of this useful as a 'radio-sensitizing' agent before the numbness. For a few days she had also been aware of administration of radiotherapy (Urtasun et al., ' soreness' in the fingers, which constantly felt cold. 1974), we feel it worth stressing the possible Neurological examination revealed no abnormali- neurotoxic effects of this substance. We here ties in the cranial nerves and no focal weakness or report two personally observed cases of sensory wasting in the limbs.
    [Show full text]
  • Known Bioactive Library: Microsource 1 - US Drug Collection
    Known Bioactive Library: Microsource 1 - US Drug Collection ICCB-L ICCB-L Vendor Vendor Compound Name Bioactivity Source CAS Plate Well ID antifungal, inhibits Penicillium 2091 A03 Microsource 00200046 GRISEOFULVIN 126-07-8 mitosis in metaphase griseofulvum 3505-38-2, 486-16-8 2091 A04 Microsource 01500161 CARBINOXAMINE MALEATE antihistaminic synthetic [carbinoxamine] 2091 A05 Microsource 00200331 SALSALATE analgesic synthetic 552-94-3 muscle relaxant 2091 A06 Microsource 01500162 CARISOPRODOL synthetic 78-44-4 (skeletal) antineoplastic, 2091 A07 Microsource 00210369 GALLIC ACID insect galls 149-91-7 astringent, antibacterial 66592-87-8, 50370-12- 2091 A08 Microsource 01500163 CEFADROXIL antibacterial semisynthetic 2 [anhydrous], 119922- 89-9 [hemihydrate] Rheum palmatum, 2091 A09 Microsource 00211468 DANTHRON cathartic 117-10-2 Xyris semifuscata 27164-46-1, 25953-19- 2091 A10 Microsource 01500164 CEFAZOLIN SODIUM antibacterial semisynthetic 9 [cefazolin] glucocorticoid, 2091 A11 Microsource 00300024 HYDROCORTISONE adrenal glands 50-23-7 antiinflammatory 64485-93-4, 63527-52- 2091 A12 Microsource 01500165 CEFOTAXIME SODIUM antibacterial semisynthetic 6 [cefotaxime] 2091 A13 Microsource 00300029 DESOXYCORTICOSTERONE ACETATE mineralocorticoid adrenocortex 56-47-3 58-71-9, 153-61-7 2091 A14 Microsource 01500166 CEPHALOTHIN SODIUM antibacterial semisynthetic [cephalothin] 2091 A15 Microsource 00300034 TESTOSTERONE PROPIONATE androgen, antineoplastic semisynthetic 57-85-2 24356-60-3, 21593-23- 2091 A16 Microsource 01500167 CEPHAPIRIN SODIUM
    [Show full text]