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https://www.readbyqxmd.com/read/29772289/nose-to-brain-drug-delivery-an-update-on-clinical-challenges-and-progress-towards-approval-of-anti-alzheimer-drugs
#1
REVIEW
Mukta Agrawal, Swarnlata Saraf, Shailendra Saraf, Sophia G Antimisiaris, Mahavir Chougule, Sunday A Shoyele, Amit Alexander
According to the Alzheimer Association Report (2017), Alzheimer's disease (AD) is the 6th primary cause of death in the USA, which affects nearly 5.5 million people. In the year 2017 itself, the cost of AD treatment in the USA has been reported to rise to $259 billion. This statistic shows the severity of the disease in the USA which is very much similar across the globe. On the other hand, the treatment remains limited to a few conventional oral medications (approved by FDA). These are mainly acting superficially from mild to the moderate AD...
May 14, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29767298/-complications-and-side-effects-of-conservative-treatment-of-rhinological-diseases
#2
REVIEW
I Küster, C Rudack, A Beule
BACKGROUND: The spectrum of rhinological diseases is wide, as is that of their drug-based treatment. Only 1272 compounds coded R01 (nasal preparations) are listed in the ATC group (Anatomical Therapeutic Chemical Classification). Conservative therapy of rhinological diseases additionally includes systemic (often oral) application of corticosteroids, antibiotics and immunomodulators. OBJECTIVE: The aim of this paper is to outline possible complications of medication (subdivided into classes of ingredients) commonly used to treat rhinological diseases in hospitals...
May 16, 2018: HNO
https://www.readbyqxmd.com/read/29765168/mucosal-delivery-systems-of-antihypertensive-drugs-a-practical-approach-in-general-practice
#3
Lukasz P Bialy, Cezary Wojcik, Izabela Mlynarczuk-Bialy
Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries...
May 15, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29760572/breath-powered-sumatriptan-dry-nasal-powder-an-intranasal-medication-delivery-system-for-acute-treatment-of-migraine
#4
REVIEW
Stewart J Tepper, Merrilee R Johnstone
There is a need for fast-acting, non-oral medication options for migraine because some attacks develop rapidly and some are accompanied by nausea, vomiting, and gastroparesis, which can hinder oral medication uptake and absorption. The most commonly prescribed migraine medications are oral triptans, with sumatriptan as the most common. However, oral triptans are associated with adverse events (AEs) of atypical sensations that may be problematic for patients. Subcutaneous (SC) injectable sumatriptan and conventional liquid triptan nasal spray formulations are also available, but the frequency of atypical sensations is the highest with SC sumatriptan, and the intense bitter taste of conventional liquid triptan nasal spray discourages use...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29720907/sedation-and-analgesia-using-medications-delivered-via-the-extravascular-route-in-children-undergoing-laceration-repair
#5
REVIEW
Jamie L Miller, Amanda C Capino, Amber Thomas, Kevin Couloures, Peter N Johnson
OBJECTIVES: To describe the method of delivery, dosage regimens, and outcomes of sedatives and analgesics administered via the extravascular route for laceration repair in children. METHODS: Medline, Embase, and International Pharmaceutical Abstracts were searched using the keywords "child," "midazolam," "ketamine," dexmedetomidine," "fentanyl," "nitrous oxide" (N2 O), and "laceration repair." Articles evaluating the use of extravascular sedation in children for laceration repair published in the English language between 1946 and June 2017 were included...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29697655/-about-the-safety-of-application-of-nasal-decongestants-in-the-practice-of-pediatricians
#6
E P Karpova, D A Tulupov, M P Vorob'eva, F A Fedotov, D M Dolginov, M V Bykov, V A Grabovskaya
Undesirable effects of the application of the intransal vasoconstricting medications are a frequent occurrence in the pediatric practice. The objective of the present study was to evaluate the role of the intranasal vasoconstricting medications in the structure of the means and methods currently available for the treatment of toxicological pathologies based at a multi-field clinical hospital. The retrospective analysis of the medical histories of the patients admitted to the toxicological department and annual reports for the period from 2015 to 2016 was undertaken...
2018: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/29679606/regulatory-pitfalls-and-opportunities-when-repurposing-for-inhalation-therapy
#7
Svetlana Lyapustina
This article reviews regulatory considerations for companies wishing to develop drugs for delivery via the respiratory tract (e.g., by oral inhalation or intranasally) using molecules previously approved for a different therapeutic indication and/or a different delivery route. Conceptually, such repurposing has many medical and business advantages, but turning promising ideas into real products requires overcoming a number of practical challenges. Obtaining regulatory approval to market a candidate product comes at the end of a product development, but being aware of the regulatory requirements is necessary before the development even starts...
April 18, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29675345/comparison-of-endoscopic-and-external-dacryocystorhinostomy-for-treatment-of-primary-acquired-nasolacrimal-duct-obstruction
#8
Pei-Yuan Su
PURPOSE: The purpose of this study is to compare the success rates of endoscopic endonasal dacryocystorhinostomy (EN-DCR) and external DCR (EX-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANLDO). DESIGN: This was a retrospective, comparative, nonrandomized clinical study. METHODS: Reviewed medical records of PANLDO underwent DCR at Far-Eastern Memorial Hospital from May 2011 to June 2017. Data regarding the lacrimal passage system, comorbidities, surgical outcomes, and postoperative complications were analyzed...
January 2018: Taiwan Journal of Ophthalmology
https://www.readbyqxmd.com/read/29673431/the-aeromedical-management-of-allergic-rhinitis
#9
Nicole Powell-Dunford, Charles Reese, Alaistair Bushby, Berit H Munkeby, Sébastien Coste, Višnja Livajić Pezer, Lars Rosenkvist
INTRODUCTION: Allergic rhinitis is a prevalent condition warranting special aeromedical consideration due to its potential for acute and painful manifestations involving the middle ear or paranasal sinuses during rapid barometric pressure changes. Although second generation antihistamines and intranasal steroids are safe and effective treatments for this common condition, aeromedical management varies. METHODS: An aeromedical policy review of 14 public access civil and military data repositories was undertaken...
May 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29669663/nonprescription-medications-for-respiratory-symptoms-facts-and-marketing-fictions
#10
Miles Weinberger, Leslie Hendeles
BACKGROUND: There are many nonprescription (over-the-counter [OTC]) medications available on pharmacy shelves marketed for relief of respiratory symptoms. The number of such medications has been increasing. OBJECTIVE: This review provides an evidence-based examination of OTC products used for respiratory symptoms. METHODS: Antihistamines, decongestants, mucolytics, antitussives, and intranasal steroids were selected as the most common OTC medications taken by adults and children for various respiratory symptoms...
May 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29652110/intranasal-glucagon-for-hypoglycaemia-in-diabetic-patients-an-old-dream-is-becoming-reality
#11
REVIEW
Antonio E Pontiroli, Valerio Ceriani
In 1983 it was shown that glucagon administered intranasally (IN) was absorbed through the nasal mucosa and increased blood glucose in healthy subjects. Shortly thereafter, it was shown that IN glucagon counteracts hypoglycaemia in insulin-treated diabetic patients. In spite of this evidence, IN glucagon has not been developed by any pharmaceutical company before 2010, when renewed interest led to intensive evaluation as a possible remedy for hypoglycaemia in insulin-treated diabetic adults and children. IN glucagon is now being developed as a needle-free device delivering glucagon powder for treating severe hypoglycaemia; the ease of using this device stands in stark contrast to the difficulties in preparing and injecting the current intramuscular glucagon emergency kits...
April 13, 2018: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29625751/naloxone-formulation-for-overdose-reversal-preference-among-patients-receiving-opioids-for-pain-management
#12
Kelly E Dunn, Frederick S Barrett, George E Bigelow
BACKGROUND: Opioid-related overdose has increased 137% in the past decade. Training nonmedical bystanders to administer naloxone (Narcan™) is a widely-researched intervention that has been associated with decreases in overdose rates in the communities in which it has been implemented. A recent review advocated for noninjectable formulations of naloxone, however patient preference for naloxone formulations has not yet been examined (Strang et al., 2016). METHODS: Two cohorts of respondents (N1  = 501, N2  = 172) who reported currently being prescribed an opioid for pain management were recruited through the crowd-sourcing program Amazon Mechanical Turk (MTurk) to assess their preference for naloxone formulations...
March 28, 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/29578274/desmopressin-stimulation-testing-response-to-intravenous-and-intranasal-forms
#13
M C McCormick, N Siripong, J D Cooper
INTRODUCTION: Desmopressin is commonly used to reduce bleeding in patients with mucocutaneous bleeding disorders and is available in both intravenous and intranasal forms. Given the variability in response to desmopressin at an individual level, its effectiveness should be assessed with a test dose prior to being advised for use. At this time, no trial has extensively compared the use of intranasal desmopressin to intravenous desmopressin. AIMS: To determine whether both forms of desmopressin are equally effective in yielding a positive response in laboratory assays in paediatric patients with von Willebrand disease or probable von Willebrand disease...
March 26, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29538786/acute-pediatric-pain-management-in-the-primary-care-office
#14
Sindy Villacres, Corrie E Chumpitazi
Pain is a chief complaint in children seeking medical care, yet it may also be experienced in evaluation and treatment during office visits. Inadequate relief of children's procedural pain and distress not only affects the experience of the children and their parents, but also adversely affects procedural outcomes. Despite increasing awareness and research, management of procedural pain and anxiety in children is often inadequate. In addition, parent and patient satisfaction is often tied to pain management...
March 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29517178/the-effect-of-medical-treatments-on-the-bacterial-microbiome-in-patients-with-chronic-rhinosinusitis-a-pilot-study
#15
Ravi Jain, Michael Hoggard, Melissa Zoing, Yannan Jiang, Kristi Biswas, Michael W Taylor, Richard G Douglas
BACKGROUND: Antibiotics and corticosteroids are prescribed to patients with chronic rhinosinusitis (CRS) to reduce bacterial burden and mucosal inflammation. Unfortunately, clinical improvement is often short-lived and symptoms frequently recur following cessation of treatment. The impact of these systemic therapies on bacterial communities is not well understood. Improved knowledge of how medical therapies influence the intranasal ecosystem may allow for more effective prescribing and the development of more targeted treatments...
March 8, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29509911/live-attenuated-respiratory-syncytial-virus-vaccine-candidate-with-deletion-of-rna-synthesis-regulatory-protein-m2-2-is-highly-immunogenic-in-children
#16
Elizabeth J McFarland, Ruth A Karron, Petronella Muresan, Coleen K Cunningham, Megan E Valentine, Charlotte Perlowski, Bhagvanji Thumar, Devasena Gnanashanmugam, George K Siberry, Elizabeth Schappell, Emily Barr, Vivian Rexroad, Ram Yogev, Stephen A Spector, Mariam Aziz, Nehali Patel, Mikhaela Cielo, Cindy Luongo, Peter L Collins, Ursula J Buchholz
Background: Live respiratory syncytial virus (RSV) candidate vaccine LIDΔM2-2 is attenuated by deletion of the RSV RNA regulatory protein M2-2, resulting in upregulated viral gene transcription and antigen expression but reduced RNA replication. Methods: RSV-seronegative children ages 6-24 months received a single intranasal dose of 105 plaque forming units (PFU) of LIDΔM2-2 (n = 20) or placebo (n = 9) (NCT02237209, NCT02040831). RSV serum antibodies, vaccine infectivity, and reactogenicity were assessed...
April 11, 2018: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29473493/current-limitations-in-the-treatment-parkinson-s-and-alzheimer-s-diseases-state-of-the-art-and-future-perspective-of-polymeric-carriers
#17
Chiara Tonda-Turo, Nicola Origlia, Clara Mattu, Alice Accorroni, Valeria Chiono
Alzheimer's and Parkinson's disease are the most common neurodegenerative diseases worldwide and their incidence is increasing due to the aging population. At the moment, the available therapies are not disease modifying and have several limitations, some of which are discussed in this review. One of the main limitations of these treatments is the low concentration that drugs reach in the central nervous system after systemic administration. Indeed, the presence of biological barriers, particularly the blood brain barrier (BBB), hinders the effective drug delivery to the brain, reducing the potential benefit coming from the administration of the medication...
February 21, 2018: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/29471055/brain-insulin-signalling-glucose-metabolism-and-females-reproductive-aging-a-dangerous-triad-in-alzheimer-s-disease
#18
REVIEW
A I Duarte, M S Santos, C R Oliveira, P I Moreira
Alzheimer's disease (AD) constitutes a major socioeconomic challenge due to its disabling features and the rise in prevalence (especially among (peri)menopausal women and type 2 diabetes patients). The precise etiopathogenesis of AD remains poorly understood. Importantly, its neurodegenerative perspective has been challenged towards a more "systemic" view. Amyloid-β (Aβ) and hyperphosphorylated Tau protein (P-Tau) (the main AD neuropathological features) affect and are affected by peripheral and brain insulin signalling dysfunction, leading to glucose dysmetabolism, synaptic loss and AD-related cognitive deficits...
February 20, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#19
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29432074/an-opioid-overdose-curriculum-for-medical-residents-impact-on-naloxone-prescribing-knowledge-and-attitudes
#20
Jessica L Taylor, Alison B Rapoport, Christopher F Rowley, Kenneth J Mukamal, Wendy Stead
BACKGROUND: Despite escalating opioid overdose death rates, addiction medicine is underrepresented in residency curricula. Providing naloxone to at-risk patients, relatives, and first responders reduces overdose deaths, but rates of naloxone prescribing remain low. The goal of this study is to examine the impact of a brief curricular intervention for internal medicine residents on naloxone prescribing rates, knowledge, and attitudes. METHODS: Internal medicine residents (N = 160) at an urban, tertiary care medical center received two 1-hour didactic sessions addressing overdose prevention, including intranasal naloxone...
February 12, 2018: Substance Abuse
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