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Sample records for fentanyl buccal tablets

  1. Single-dose and steady-state pharmacokinetics of fentanyl buccal tablet in healthy volunteers.

    Science.gov (United States)

    Darwish, Mona; Kirby, Mary; Robertson, Philmore; Hellriegel, Edward; Jiang, John G

    2007-01-01

    This study evaluated the single-dose and steady-state pharmacokinetics of fentanyl buccal tablet 400 microg in healthy adult volunteers. After receiving naltrexone 50 mg to block opioid receptor-mediated effects of fentanyl, subjects received fentanyl buccal tablet 400 microg on day 1, then every 6 hours from day 4 to day 9 (21 doses). Naltrexone 50 mg was administered every 12 hours throughout the study. Plasma fentanyl concentrations were determined for 72 hours after administration of fentanyl buccal tablet 400 microg on day 1 and the last dose of fentanyl buccal tablet 400 microg on day 9. Following single- and multiple-dose administration of fentanyl buccal tablet, the median time to maximum concentration (tmax) was 52.2 and 49.8 minutes, respectively. Peak plasma concentration of fentanyl (Cmax) was 0.88 ng/mL for the single-dose regimen and 1.77 ng/mL for the multiple-dose regimen. Steady state was reached within 5 days, consistent with the observed median half-life of approximately 22 hours following multiple doses. Observed accumulation of fentanyl after multiple doses of fentanyl buccal tablet was slightly greater than would be expected based on the single-dose data. This was attributed to the redistribution of fentanyl from a deep tissue compartment into the plasma. This study indicates that fentanyl buccal tablet has predictable pharmacokinetics following multiple-dose administration.

  2. Comparison of equivalent doses of fentanyl buccal tablets and arteriovenous differences in fentanyl pharmacokinetics.

    Science.gov (United States)

    Darwish, Mona; Kirby, Mary; Robertson, Philmore; Hellriegel, Edward; Jiang, John G

    2006-01-01

    The fentanyl buccal tablet (FBT) is designed to enhance the rate and extent of fentanyl absorption through the buccal mucosa. To evaluate the bioequivalence of microg-equivalent doses of FBT administered as single and multiple tablets and assess differences in the arterial and venous pharmacokinetics of FBT in healthy volunteers. Twenty-seven healthy adults, aged 19-45 years, participated in the randomised, open-label, three-period, crossover study. In the first two periods, FBT was administered as four 100 microg tablets simultaneously or one FBT 400 microg to assess bioequivalence. Venous blood samples were obtained over a 72-hour period to measure plasma fentanyl concentrations. In the third period, arterial and venous blood samples were obtained simultaneously from before administration of one FBT 400 microg through 4 hours after administration to evaluate the impact of arterial versus venous sampling on the pharmacokinetic profile. As subjects were not opioid tolerant, naltrexone was administered to block opioid receptor-mediated effects of fentanyl. Adverse events were recorded throughout. Maximum plasma concentration (C(max)) and area under the plasma concentration-time curve from time zero to infinity (AUC(infinity)) on average were approximately 12% and 13% higher, respectively, for FBT administered as four 100 microg tablets simultaneously compared with one FBT 400 microg. Maximum plasma concentrations in the arterial circulation were approximately 60% higher and occurred 15 minutes earlier than those measured from the venous circulation. No serious adverse events were reported during the study. Despite small differences in C(max) and AUC(infinity) (on average 12% and 13%, respectively), FBT administered as four 100 microg tablets simultaneously compared with one 400 microg tablet did not meet the criteria for bioequivalence. An increased surface area exposure with four tablets compared with one tablet may account for the slightly higher maximum

  3. 芬太尼口腔泡腾片的临床研究进展%Research advances on fentanyl effervescent buccal tablets

    Institute of Scientific and Technical Information of China (English)

    朱维莉; 时杰; 陆林

    2008-01-01

    芬太尼(fentanyl)合成于1960年,为合成的苯基哌啶类药物,是当前临床上最常用的麻醉性镇痛药。芬太尼口腔泡腾片(fentanyl effervescent buccal tablets)是为采用新的给药技术而制成的枸缘酸芬太尼的新剂型,它利用口腔粘膜大量的表面积和有丰富的血管,高渗透性,恒定的温度产生泡腾反应,让患者透过口腔黏膜吸收,迅速、

  4. Tabletas bucales oravescentes de fentanilo en el dolor episódico: revisión de datos clínicos Fentanyl oravescentes buccal tablets for episodic pain: review of clinical data

    Directory of Open Access Journals (Sweden)

    M. Nabal

    2012-02-01

    Full Text Available Objetivos: revisar la literatura clínica sobre la presentación del fentanilo en tabletas bucales oravescentes con el objetivo de ofrecer una revisión crítica de los datos clínicos publicados, en dolor episódico. Material y método: revisión no sistemática de la literatura publicada en Medline complementada con una búsqueda manual de trabajos relacionados y literatura gris. Palabras clave: "Breakthrough pain" OR "Cancer pain" AND "Fentanyl bucal tablets" OR "Rapid onset opioids". Límites: idioma: inglés o español y estudios realizados en adultos mayores de 18 años. Criterios de inclusión: trabajos con contenido clínico relacionado con la presentación de fentanilo bucal "oravescente". Criterios de exclusión Trabajos que hacían referencia a farmacocinética o farmacodinámica del fármaco o su galénica, los trabajos de carácter epidemiológico general y aquellos que no se consiguieron en texto completo a pesar de la consulta a diversas bases de datos y bibliotecas nacionales. Resultados: de los 29 trabajos encontrados se incluyeron 12 trabajos, siguiendo los criterios de inclusión y exclusión. De ellos 4 fueron ensayos clínicos doble ciego randomizados, uno fue un estudio multicéntrico abierto, 1 revisión sistemática, 4 revisiones no sistemática y 2 comentarios de expertos. Los cuatro ensayos clínicos confirman que la actividad analgésica está presente a los 5 minutos de la administración del fármaco y presenta diferencias significativas con placebo a partir de los 10 minutos y se incrementa hasta los 90 minutos. Estas diferencias se mantienen a las 2 horas. La suma de las diferencias de intensidad del dolor (SPID es favorable al fármaco, en comparación al placebo a los 60 minutos de la administración de manera significativa (p Objectives: to review the clinical literature on the oravescentes presentation of fentanyl buccal tablets with the aim of providing a critical view of published clinical data in

  5. FORMULATION DEVELOPMENT AND EVALUATION OF TERBUTALINE SULPHATE MUCOADHESIVE BUCCAL TABLETS

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    Gururaj S.Kulkarni

    2013-03-01

    Full Text Available The main objective of developing any new dosage form is reduce the side effects and increase the therapeutic effect of drug in existing dose of dosage form. Mucoadhesive drug delivery system is oral dosage form, where the tablet, gel or patch is attached to the buccal region for direct absorption of drug into blood circulation. This route can prevent the metabolism of drug in G.I tract or liver and side effects of metabolites avoided. In this study, the attempt was made to prepare mucoadhesive buccal tablets of Terbutaline sulphate with natural polymer sodium alginate with one side absorption by backing layer with ethyl cellulose. The buccal tablets of Terbutaline sulphate studied in detail. I R Spectroscopy did the compatible study between polymers and Terbutaline sulphate and No interaction was found between drug and polymers. Different formulations of oral Mucoadhesive buccal tablets of Terbutaline Sulphate (TS were prepared using polymer sodium alginate, in different concentrations by direct compression. Post compressed evaluation studies, hardness, thickness, friability; weight variation and drug content, mucoadhesive strength of tablets were studied. The in-vitro release of TS was studied in buffer pH 6.8 at 370C. All parameters of TS buccal tablets are passed the standard of mucoadhesive buccal tablets. It was found that mucoadhesive natural polymers exhibited better adhesiveness and mucoadhesiveness. The in vitro study of TS exhibited greater drug release profile with release of in the range of 79.25 to 99.85%.

  6. In vivo bioavailability studies of sumatriptan succinate buccal tablets

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    B Jayakar

    2011-07-01

    Full Text Available    Back ground and the purpose of study: Sumatriptan succinate is a Serotonin 5- HT1 receptor agonist, used in treatment of migraine. It is absorbed rapidly but incompletely when given orally and undergoes first - pass metabolism, resulting in a low absolute bioavailability of about 15%. The aim of this work was to design mucoadhesive bilayered buccal tablets of sumatriptan succinate to improve its bioavailability. Methods:Mucoadhesive polymers carbopol 934 (Carbopol, HPMC K4M, HPMC K15M along with ethyl cellulose as an impermeable backing layer were used for the preparation of mucoadhesive bilayered tablets . In vivo bioavailability studies was also conducted in rabbits for optimized formulation using oral solution of sumatriptan succinate as standard. Results:Bilayered buccal tablets (BBT containing the mixture of Carbopol and HPMC K4M in the ratio 1:1 (T1 had the maximum percentage of in vitro drug release within 6 hrs. The optimized formulation (T1 followed non-Fickian release mechanism. The percentage relative bioavailability of sumatriptan succinate from selected bilayered buccal tablets (T1 was found to be 140.78%. Conclusions: Bilayered buccal tablets of sumatriptan succinate was successfully prepared with improved bioavailability.

  7. Development of buccal adhesive tablet with prolonged antifungal activity: Optimization and ex vivo deposition studies

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    Madgulkar A

    2009-01-01

    Full Text Available The purpose of the present work was to prepare buccal adhesive tablets of miconazole nitrate. The simplex centroid experimental design was used to arrive at optimum ratio of carbopol 934P, hydroxypropylmethylcellulose K4M and polyvinylpyrollidone, which will provide desired drug release and mucoadhesion. Swelling index, mucoadhesive strength and in vitro drug release of the prepared tablet was determined. The drug release and bioadhesion was dependent on type and relative amounts of the polymers. The optimized combination was subjected to in vitro antifungal activity, transmucosal permeation, drug deposition in mucosa, residence time and bioadhesion studies. IR spectroscopy was used to investigate any interaction between drug and excipients. Dissolution of miconazole from tablets was sustained for 6 h. based on the results obtained, it can be concluded that the prepared slow release buccoadhesive tablets of miconazole would markedly prolong the duration of antifungal activity. Comparison of in vitro antifungal activity of tablet with marketed gel showed that drug concentrations above the minimum inhibitory concentration were achieved immediately from both formulations but release from tablet was sustained up to 6 h, while the gel showed initially fast drug release, which did not sustain later. Drug permeation across buccal mucosa was minimum from the tablet as well as marketed gel; the deposition of drug in mucosa was higher in case of tablet. In vitro residence time and bioadhesive strength of tablet was higher than gel. Thus the buccoadhesive tablet of miconazole nitrate may offer better control of antifungal activity as compared to the gel formulation.

  8. Fentanyl transmucosal tablets: current status in the management of cancer-related breakthrough pain

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    Prommer E

    2012-06-01

    Full Text Available Eric Prommer, Brandy FicekDivision of Hematology/Oncology, Mayo Clinic College of Medicine, Mayo Clinic Hospital, Scottsdale, AZ, USAAbstract: Breakthrough pain is a newly recognized pain category that was first described by Portenoy and Hagen in 1990. The term describes pain that increases in intensity to “break through” chronic pain that is being controlled by a scheduled opioid regimen. The development of fluctuations in pain intensity is challenging due to their unpredictable nature, rapid onset, and need for rapid treatment intervention. Breakthrough pain has been treated by using an extra opioid dose in addition to the scheduled opioid being used for pain. Recommendations for dose and frequency are based on expert opinion only, and have included dosing based on a percentage of the total opioid dose. Other recommendations include increasing the regularly scheduled opioid dose. Clinical trials have now focused on delivery of opioids that have both potency and a rapid onset of action. Lipophilic opioids have received a substantial amount of study due to their quick absorption and rapid onset of analgesia. Lipophilic opioids that have been studied to date include transmucosal fentanyl, sublingual fentanyl, intranasal sufentanil, and oral and sublingual methadone. Initial clinical trials have established the superiority of transmucosal fentanyl as a breakthrough analgesic when compared with immediate-release oral opioid formulations. Problems with bioavailability have led to a search for newer formulations of transmucosal delivery. Newer formulations, such as fentanyl transmucosal tablets, have been developed to ensure superior delivery for the patient suffering from breakthrough pain. The purpose of this paper is to discuss the current status of transmucosal tablet formulations for cancer breakthrough pain.Keywords: fentanyl, transmucosal, tablets, pain, breakthrough, cancer

  9. Development of an ANN optimized mucoadhesive buccal tablet containing flurbiprofen and lidocaine for dental pain

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    Hussain Amjad

    2016-06-01

    Full Text Available A novel mucoadhesive buccal tablet containing flurbiprofen (FLB and lidocaine HCl (LID was prepared to relieve dental pain. Tablet formulations (F1-F9 were prepared using variable quantities of mucoadhesive agents, hydroxypropyl methyl cellulose (HPMC and sodium alginate (SA. The formulations were evaluated for their physicochemical properties, mucoadhesive strength and mucoadhesion time, swellability index and in vitro release of active agents. Release of both drugs depended on the relative ratio of HPMC:SA. However, mucoadhesive strength and mucoadhesion time were better in formulations, containing higher proportions of HPMC compared to SA. An artificial neural network (ANN approach was applied to optimise formulations based on known effective parameters (i.e., mucoadhesive strength, mucoadhesion time and drug release, which proved valuable. This study indicates that an effective buccal tablet formulation of flurbiprofen and lidocaine can be prepared via an optimized ANN approach.

  10. Conscious and anaesthetised Göttingen mini-pigs as an in-vivo model for buccal absorption - pH-dependent absorption of metoprolol from bioadhesive tablets

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Jacobsen, Jette; Andersen, Morten B

    2014-01-01

    significantly different to the buccal anaesthetised groups (120 ± 0 and 165 ± 15 min) for buccal tablet pH 6.2 and pH 8.9, respectively. Also, the absolute bioavailability from the anaesthetised buccal tablet pH 8.9 (20.7 ± 4.0%) had a significant increase compared to all other buccal tablet groups...

  11. Absorption and tolerability of fentanyl buccal soluble film (FBSF in patients with cancer in the presence of oral mucositis

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    Finn AL

    2011-09-01

    Full Text Available Andrew L Finn1, WD Charlie Hill2, Ignacio Tagarro3, Larry N Gever41Product Development, BioDelivery Sciences International, Inc, Raleigh, NC, USA; 2Co-founding partner, InVisions Consultants, LLC, San Antonio, TX, USA; 3Marketing Centre CIP CNS, Meda Pharma S.A.U., Madrid, Spain; 4Medical Affairs, Meda Pharmaceuticals, Inc, Somerset, NJ, USAPurpose: Fentanyl buccal soluble film (FBSF consists of a small, bilayered, water-soluble polymer film that adheres to the buccal mucosa and rapidly delivers fentanyl into the systemic circulation. The purpose of this study was to evaluate the absorption of fentanyl from FBSF in patients with cancer, with and without grade 1 oral mucositis, and to assess the tolerability of FBSF in this patient population.Patients and methods: In an open-label, single-dose study, two groups of opioid-naive patients (ie, not receiving opioids on a regular basis with cancer received a 200 µg dose of FBSF. Patients in cohort I (n = 7 had grade 1 mucositis, and patients in cohort II (n = 7 were age- and gender-matched controls without mucositis. The FBSF dose was placed on the area of mucositis in cohort I and on a matching location in cohort II. Blood samples were collected up to 4 hours after administration, and safety assessments were made throughout the study.Results: Peak plasma concentration and area under the concentration–time curve from time 0 to 4 hours post-dose values of patients in the grade 1 mucositis cohort were lower than those observed in patients without mucositis. There was no application site irritation reported in any patient, regardless of mucositis status. Mild somnolence was reported by two patients with mucositis. There were no deaths or serious adverse events reported in this study.Conclusion: The results of this study indicate that application of FBSF to an area of grade 1 mucositis does not result in increased fentanyl exposure or irritation of the mucosa. The 200 µg dose of FBSF was well

  12. In vitro evaluation of novel mucoadhesive buccal tablet of oxytocin prepared with Diospyros peregrina fruit mucilages.

    Science.gov (United States)

    Metia, Pulak Kumar; Bandyopadhyay, Amal Kumar

    2008-04-01

    Novel mucoadhesive buccal tablets (NMBTs) of oxytocin were prepared as cores in cup fashion to release and permeate the drug unidirectionally toward the buccal mucosa to reach the systemic circulation directly. Adhesive cups for NMBTs were prepared with mucilage (DPM) isolated from edible Diospyros peregrina fruit. Mucoadhesive properties like shear and tensile and peel strengths of the adhesive cups were estimated on freshly excised bovine buccal mucosa. Core tablets were formulated with oxytocin using two penetration enhancers, sodium taurocholate and sodium thioglycollate. In vitro permeability studies of NMBTs were conducted in a Franz diffusion cell containing 50 ml of phosphate buffer, pH 6.6, at 37+/-0.2 degrees C through excised bovine buccal mucosa, and the amount of drug permeated was estimated at 220 nm on reverse-phase HPLC using a BDS Hypersil C(8) column with acetonitrile and potassium dihydrogen orthophosphate buffer 0.05 M, pH 6.6, (20 : 80 v/v) as the mobile phase, at flow rate of 1.25 ml/m. The NMBTs containing 0.75% w/w sodium taurocholate showed 26% permeability without damaging the histology of the buccal mucosa. The results suggest that this formulation may be a suitable alternative to oxytocin injections.

  13. Formulation and evaluation of bioadhesive buccal drug delivery of repaglinide tablets

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    Dasharath M Patel

    2012-01-01

    Full Text Available The purpose of this research was to formulate and evaluate bioadhesive buccal tablets of repaglinide using HPMC K15M as a sustained release polymer, chitosan as a bioadhesive polymer and ethyl cellulose as an impermeable backing layer. The tablets were evaluated for weight variation, thickness, hardness, friability, surface pH, mucoadhesive strength, swelling index, in vitro drug release, ex vivo mucoadhesion time and ex vivo drug permeation. A 3 2 full factorial design was used in present study for optimization. Tablets containing HPMC K15M and chitosan in the ratio of 1:1 and lactose as a filler (F2 had the maximum percentage of in vitro drug release. The swelling index, friability and in vitro drug release was affected by type of filler as dicalcium phosphate (DCP had good binding ability compared to lactose. The surface pH of all tablets was found to be satisfactory (between 6.26 and 7.01, close to neutral pH; hence buccal cavity irritation should not occur with these tablets. F2 batch was considered optimum based on good bioadhesive strength (17.83±0.51 gm and maximum similarity factor (64.43. The drug release from optimum batch followed zero order kinetics with non-Fickian diffusion. Drug-excipients compatibility study showed no interaction between drug and excipients. Stability study of optimized formulation showed that tablets were stable at accelerated environment condition. Thus, buccal adhesive tablet of repaglinide could be an alternative route to bypass hepatic first pass metabolism and to improve bioavailability of repaglinide.

  14. DEVELOPMENT AND EVALUATION OF MUCOADHESIVE BUCCAL TABLETS OF SALBUTAMOL SULPHATE

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    Arya R. K

    2011-01-01

    Full Text Available Prime object of present study was to develop and evaluate mucoadhesive tablets of Salbutamol Sulphate by non aqueous granulation of polymers HPMC K-4M (Hydroxypropyl Methyl Cellulose and Chitosan in different ratios (1:1. 1:2 & 2:1. The tablets were evaluated for weight variation, hardness, thickness, drug content uniformity, mucoadhesion and swelling index. Swelling index of batches containing more HPMC K-4M was greater than that of containing less HPMC K-4M. In vitro bioadhesive strength studies showed that tablets containing more HPMC K-4M were excellent in bioadhesive nature. The in-vitro drug release was studied in phosphate buffer (pH 6.8. And all batches were subjected to release kinetics model fitting.

  15. Buccal mucoadhesive tablets of flurbiprofen: Characterization and optimization.

    Science.gov (United States)

    Darwish, M K; Elmeshad, A N

    2009-08-01

    The aim of this work was to develop and optimize sustained-release mucoadhesive tablets of flurbiprofen. Mucoadhesive polymers used were chitosan as primary polymer and hydroxypropylmethyl celluose, hydroxypropyl cellulose, or sodium carboxymethyl cellulose as secondary polymer. Tablets were evaluated in terms of weight variation, thickness, hardness, friability, swelling, surface pH, in vitro mucoadhesive force, and in vitro release. The compatibility between flurbiprofen and the tablet excipients was confirmed by fourier transfer infrared studies. Both the primary and secondary polymers were found to have synergistic effects on tablet swelling, bioadhesion, and in vitro drug release. Formulations containing sodium carboxymethyl cellulose (F(1)) showed a maximum swelling index of 4.144 after 8 h, maximum mucoadhesive force (0.27 N), and convenient in vitro release over 8 h. D-optimal design was employed to evaluate the effect of the ratio of the primary polymer (X(1)) and the type of secondary polymer (X(2)) on the swelling index after 8 h (Y(1)), drug release after 8 h (Y(2)) and time taken for 30% drug release (Y(3)).

  16. Evaluation of Calendula mucilage as a mucoadhesive and controlled release component in buccal tablets.

    Science.gov (United States)

    Sabale, V; Patel, V; Paranjape, A

    2014-01-01

    Mucoadhesive drug delivery systems were developed to sustain drug delivery via various mucus membranes for either local or systemic delivery of poorly absorbed drugs such as peptides and proteins as well as drugs that are subjected to high first-pass metabolism. The present study was undertaken to use isolated Calendula mucilage as a mucoadhesive agent and to formulate controlled release buccoadhesive tablets with an intention to avoid hepatic first-pass metabolism as well as to enhance residence time of drug in the buccal cavity. The mucilage was isolated from the Calendula petals by aqueous extraction method and characterized for various physiochemical parameters as well as for its adhesive properties. By using direct compression technique, tablets were prepared containing dried mucilage and chlorpheniramine maleate (CPM) as a model drug. Three batches of tablets were prepared and evaluated containing three mucoadhesive components namely Methocel K4M, Carbopol 974P and isolated Calendula mucilage in 16.66%, 33.33 % and 50 % (1:2:3 ratio) resulting in 9 different formulations. FTIR studies between mucilage and CPM suggested the absence of a chemical interaction between CPM and Calendula mucilage. The results of the study showed that the isolated mucilage had good physicochemical and morphological characteristics and tablets conformed to the pharmacopoeial specifications. Also in vitro release studies showed controlled action of drug with increasing the concentration of the isolated Calendula mucilage as a mucoadhesive agent in the formulations. Permeability studies indicated that permeability behavior was not statistically different (P>0.05) by changing the mucoadhesive component. The formulated mucoadhesive tablets for buccal administration containing 75 mg Calendula mucilage showed controlled drug release. Thus, mucoadhesive natural Calendula mucilage based buccal tablets for controlled release were successfully formulated.

  17. Preparation of fluconazole buccal tablet and influence of formulation expedients on its properties

    Institute of Scientific and Technical Information of China (English)

    MOHAMED Saifulla P; MUZZAMMIL Shariff; PRAMOD Kumar TM

    2011-01-01

    The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis.The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment.The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method.Microcrystalline cellulose was used as the filler and its effect was also studied.The prepared dosage forms were evaluated for physicochemical properties,in vitro release studies and mueoadhesive properties using sheep buccal mucosa as a model tissue.Tablets containing 50% of polymers(Carbopol & Noveon)were found to be the best with moderate swelling along with favorable bioadhesion force,residence time and in vitro drug release.The in vitro drug release studies revealed that drug released for 8 h,which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.

  18. Single-dose fentanyl sublingual spray for breakthrough cancer pain

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    Taylor DR

    2013-07-01

    Full Text Available Donald R Taylor Comprehensive Pain Care PC, Marietta, GA, USA Abstract: Breakthrough cancer pain (BTCP is defined as a transient exacerbation of pain that arises in patients with otherwise controlled persistent pain. BTCP typically has a rapid onset and relatively short duration, but it causes a significant amount of physical and psychological distress for patients. Several rapid-onset fentanyl formulations have been introduced in the USA to replace traditional oral opioids for the treatment of BTCP: a transmucosal lozenge, a sublingual orally disintegrating tablet, a buccal tablet, a buccal soluble film, a pectin nasal spray and, the newest formulation to enter the market, a sublingual spray. This article reviews the six rapid-onset formulations of fentanyl approved in the USA for the management of BTCP with emphasis on describing the published literature on fentanyl sublingual spray. The different fentanyl formulations vary in pharmacokinetic properties and ease of use, but all have a rapid onset and a relatively short duration of analgesia. Fentanyl sublingual spray has demonstrated absorption within 5 minutes of administration, with fentanyl plasma concentrations increasing over the first 30 minutes and remaining elevated for 60–90 minutes in pharmacokinetic studies in healthy subjects. Fentanyl sublingual spray shows linear dose proportionality, and changes in the temperature or acidity of the oral cavity do not alter its pharmacokinetic properties. In patients with BTCP, statistically significant pain relief is measurable at 5 minutes after administration of fentanyl sublingual spray, when compared with placebo, with significant pain relief lasting at least 60 minutes after administration. Adverse events are typical of opioid treatment and are considered mild to moderate in intensity. In summary, fentanyl sublingual spray provides rapid onset of analgesia and is a tolerable and effective treatment for BTCP. Keywords: breakthrough pain

  19. In vitro and in vivo evaluation of a novel mucoadhesive buccal oxytocin tablet prepared with Dillenia indica fruit mucilage.

    Science.gov (United States)

    Metia, P K; Bandyopadhyay, A K

    2008-04-01

    Novel mucoadhesive buccal tablets (NMBT) of oxytocin were prepared as core in cup fashion to release the drug unidirectionally towards the buccal mucosa. Adhesive cups were prepared with a mucilage isolated from edible Dillenia indica fruits (DIM). Shear, tensile and peel strengths of prepared adhesive cups were estimated on freshly excised bovine buccal mucosa. Core tablets were formulated with oxytocin using permeation enhancers viz. sodium taurocholate and sodium thioglycollate. In vitro permeability studies of NMBT were conducted in a Franz diffusion cell containing 50 mL of phosphate buffer pH 6.6 at 37 +/- 0.2 degrees C through excised bovine buccal mucosa. In vivo studies on anaesthetized New Zealand albino male rabbits were conducted and drug levels in plasma were estimated at 220 nm by reverse phase HPLC using BDS Hypersil C8 column using acetonitrile and 0.05 M potassium dihydrogen orthophosphate buffer pH 6.6 (20:80 v/v) as mobile phase, at a flow rate of 1.25 mL/ min. Optimized formulation showed C(max), T(max), t1/2 and AUC(total), 688 pg/mL, 2 h, 0.079 h, and 1999.72 h x pg/mL respectively. The NMBT containing 0.75% w/w sodium taurocholate showed 27% bioavailability without damaging the buccal mucosasuggesting its suitability as an alternative to noninvasive administration of oxytocin.

  20. Formulation and In-Vitro Evaluation of Chitosan Based Omeprazole Mucoadhesive Buccal Tablets

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    Amit E. Birari

    2014-10-01

    Full Text Available The present study is concerned with formulation and evaluation of mucoadhesive buccal tablets containing proton pump inhibitors drug, Omeprazole to circumvent the first pass effect and to improve its bioavailability with reduction in dosing frequency and dose related side effects. The tablets were prepared by direct compression method. Nine formulations were prepared with Chitosan as primary polymer and Carbopol 934, Hydroxy Propyl Methyl Cellulose (HPMC K4M and Xanthan gum as a secondary polymer. All formulations were evaluated for weight variation, hardness, surface pH, drug Content uniformity, swelling index, and bioadhesive strength and in-vitro drug dissolution study. Physical compatibility studies showed no evidence on interactions between drug, polymers, and excipients. The in vitro release of Omeprazole was performed under sink conditions (Phosphate buffer PH 6.8, 37±0.5ºC, rpm 50 using USP dissolution apparatus type II. The best in-vitro drug release profile was achieved with the formulation F8 which contains the Chitosan combine with Xanthan gum. The surface pH and swelling index of formulation F8 was found to be 6.8, and 60 %, respectively.

  1. 76 FR 19997 - Determination That FENTORA (Fentanyl Citrate) Buccal Tablet, 300 Micrograms, Was Not Withdrawn...

    Science.gov (United States)

    2011-04-11

    ... regulatory requirements are met. FOR FURTHER INFORMATION CONTACT: Reena Raman, Center for Drug Evaluation and... list as part of the ``Approved Drug Products With Therapeutic Equivalence Evaluations,'' which is known... listed in the ``Discontinued Drug Product List'' section of the Orange Book. Watson Laboratories,...

  2. Single-dose fentanyl sublingual spray for breakthrough cancer pain.

    Science.gov (United States)

    Taylor, Donald R

    2013-01-01

    Breakthrough cancer pain (BTCP) is defined as a transient exacerbation of pain that arises in patients with otherwise controlled persistent pain. BTCP typically has a rapid onset and relatively short duration, but it causes a significant amount of physical and psychological distress for patients. Several rapid-onset fentanyl formulations have been introduced in the USA to replace traditional oral opioids for the treatment of BTCP: a transmucosal lozenge, a sublingual orally disintegrating tablet, a buccal tablet, a buccal soluble film, a pectin nasal spray and, the newest formulation to enter the market, a sublingual spray. This article reviews the six rapid-onset formulations of fentanyl approved in the USA for the management of BTCP with emphasis on describing the published literature on fentanyl sublingual spray. The different fentanyl formulations vary in pharmacokinetic properties and ease of use, but all have a rapid onset and a relatively short duration of analgesia. Fentanyl sublingual spray has demonstrated absorption within 5 minutes of administration, with fentanyl plasma concentrations increasing over the first 30 minutes and remaining elevated for 60-90 minutes in pharmacokinetic studies in healthy subjects. Fentanyl sublingual spray shows linear dose proportionality, and changes in the temperature or acidity of the oral cavity do not alter its pharmacokinetic properties. In patients with BTCP, statistically significant pain relief is measurable at 5 minutes after administration of fentanyl sublingual spray, when compared with placebo, with significant pain relief lasting at least 60 minutes after administration. Adverse events are typical of opioid treatment and are considered mild to moderate in intensity. In summary, fentanyl sublingual spray provides rapid onset of analgesia and is a tolerable and effective treatment for BTCP.

  3. The Development of Seabuckthorn Cough-relieving Buccal Tablet%沙棘止咳含片的研制

    Institute of Scientific and Technical Information of China (English)

    山永凯

    2012-01-01

    On the basis of the traditional folk cough-relieving prescription, taking Qinghai seabuck- thorn as the main material, complementary with winter fruit pear juice, bulbus fritillariae cirrhosae as auxiliary material, makes seabuckthorn cough-relieving buccal tablet, discusses the production process, blend the best taste with the orthogonal experiment method; Therefore, we have tested the influence of seabuckthorn cough-relieving buccal tablet in stopping cough of mice caused by aqueous ammonia and eliminating phlegm. The results shows that seabuckthorn cough-relieving buccal tablet has obvious cough-relieving and eliminating phlegm effect.%在民间传统止咳偏方的基础上,以沙棘汁为主原料,辅以冬果梨汁、川贝母、薏苡仁浸提液,制作出沙棘止咳含片,探讨了生产工艺,用正交试验法调配出最佳口味;并且试验了沙棘止咳含片对小鼠氨水所致咳嗽的镇咳作用和小鼠祛痰作用测试,结果表明:沙棘止咳含片具有明显的止咳和祛痰作用。

  4. Development of polyethylene glycol and hard fat-based mucoadhesive tablets containing various types of polyvinyl alcohols as mucoadhesive polymers for buccal application.

    Science.gov (United States)

    Ikeuchi-Takahashi, Yuri; Kobayashi, Ayaka; Onishi, Hiraku

    2017-04-01

    Topical drug application has the advantage of avoiding systemic side effects. We attempted to develop a long-acting matrix-type tablet containing indomethacin (IM) with low physical stimulus and potent mucoadhesive force to treat pain caused by oral aphtha. A mixture of polyethylene glycol (PEG) and hard fat was used as the tablet base. Ethylcellulose was added to the base in an attempt to control drug release. Tablets with PEG as a base were also prepared for comparison. Polyvinyl alcohols (PVAs) with various degrees of saponification were added to increase the mucoadhesive force. From the optical microscopic observations, formulations using PEG and hard fat exhibit PEG/hard fat dispersions caused by the stabilizing effects of PVA. Although the tablets using PEG and hard fat showed sufficient adhesiveness and sustained drug release, those using PEG as the base did not. Drug release was controlled by the amount of hard fat and the saponification degree of PVA. The drug release rate was most increased in a tablet containing PVA with an intermediate degree of saponification, PEG and hard fat. From differential scanning calorimetry and powder X-ray diffraction, IM was considered to exist in the molecular phase. From the results of buccal administration of tablets to rats, highest tissue concentrations were observed in the tablet containing PVA with the intermediate degree of saponification using PEG and hard fat, and the plasma concentrations were sufficiently low in comparison.

  5. 盐酸利多卡因口腔黏附片的处方研究%Study on the Formula of Lidocaine Hydrochloride Buccal Adhesive Tablets

    Institute of Scientific and Technical Information of China (English)

    谢向阳; 李旸; 李银科; 李雪梅; 符旭东

    2012-01-01

    Objective: To prepare the lidocaine hydrochloride buccal adhesive tablets. Method: The buccal adhesive tablets were prepared using different proportions of dextrin, carbomer and CMC-Na. The expansion coefficients, adhesive ability, drug release in vitro and adhesive time in oral cavity were investigated. Result: The formula with dextrin and carbomer in the proportion of 23: 16 was optimal. The tablets prepared by the optimal formula could stick the No. 4 steel ball, reached the maximum expansion coefficient in 1h, 97% drug was released in 2 h, and the adhesive time in oral cavity was about 2 h. Conclusion: The formula of lidocaine hydrochloride buccal adhesive tablets is feasible.%目的:研制盐酸利多卡因口腔黏附片.方法:采用不同配比的糊精和卡波姆制备盐酸利多卡因口腔黏附片,考察其体外膨胀率、黏附力、释药性能和口腔滞留时间.结果:以糊精和卡波姆23:16为比例制得的口腔黏附片较符合要求,能粘住4号钢球,1 h达到最大膨胀率,体外释药2 h释放度为97%,在人口腔中约能滞留2 h.结论:盐酸利多卡因口腔黏附片处方是可行的.

  6. Novel buccal adhesive tablets using Aloe vera L and Sinapis alba--a promising option for improved bioavailability of diltiazem hydrochloride.

    Science.gov (United States)

    Sudhakar, Yajaman; Bandyopadhyay, A K

    2008-01-01

    In the current investigation, white mustard mucilage from whole seeds of Sinapis alba was evaluated for its physical properties and compared with the other mucoadhesive polymers such as hydroxy propyl methylcellulose 5Cps and Carbopol 934P. Further, methanol precipitable solids from whole leaves of Aloe Vera L were used as permeation enhancer. To achieve improved bioavailability of diltiazem, novel buccal adhesive tablets (NBATs) in cup and core fashion designed to achieve unidirectional release towards mucosa were prepared in a three-stage process using specially fabricated punches. The adhesive cups were studied for its shear, tensile, and peel strengths by specially designed apparatus using excised ruminant and porcine buccal mucosa as model substrates. Ex vivo permeation studies in a Franz diffusion cell were conducted through porcine buccal mucosa. Fourier transform infrared spectroscopy studies and differential scanning calorimetry thermographs showed no remarkable interactions. Histopathological studies showed no remarkable damage of buccal mucosa by the NBATs. In vivo studies were conducted on anaesthetized male New Zealand albino rabbits, estimated by reversed-phase high-performance liquid chromatography, and the pharmacokinetics were compared with the oral and intravenous bolus injection. NBATs exhibited a Cmax 74.6 ng/mL, Tmax 3.5 h, t(1/2) 4.36 h. The NBATs prevented salivary scavenging effect and exhibited 82.1% bioavailability.

  7. Preparation and Quality Evaluation of Clotrimazole Buccal Adhesive Tablets%克霉唑口腔黏附片的制备及质量评价

    Institute of Scientific and Technical Information of China (English)

    尹丽芳; 王静; 张友智

    2013-01-01

    Objective: To prepare and evaluate clotrimazole buccal adhesive tablets. Method: The tablets were prepared by direct compression process using carbopol (CP 934) , sodium alginate and sodium carboxymethylcellulose low viscosity (SCMC LV) as the main adjunvants. The quality of the tablets was evaluated by the parameters of drug content, swelling index, in vitro drug release and mucoadhesive strength. Result: The optimized formula was as follows; clotrimazole of 5 mg, CP 934 of 30 mg, SCMC LV of 155 mg, PEG 6000 of 40 mg, lactose of 10mg, microcrystalline cellulose of 8 mg,magnesium stearate of 0.5 mg and aspartame of 2 mg. Conclusion: The buccal adhesive tablets are prepared successfully, and can be used in the further in vivo and in vitro studies.%目的:制备克霉唑口腔黏附片并评价其质量.方法:采用黏膜粘着剂卡波姆(CP 934)、海藻酸钠、低黏度羧甲基纤维素钠(SCMC),用直接压片法压片制备克霉唑口腔黏附片,并对黏附片的不同参数如药物含量、体外溶胀百分率、药物体外释放度和黏附力进行评价.结果:筛选出最佳配方:克霉唑5 mg,CP 934 30 mg,SCMC 155 mg,聚乙二醇6000 40 mg,乳糖10mg,微晶纤维素8 mg,硬脂酸镁0.5 mg和阿斯巴甜2 mg.结论:成功制备了克霉唑口腔黏附片,其可用于进一步的体内、体外研究.

  8. Buccal drug delivery.

    Science.gov (United States)

    Smart, John D

    2005-05-01

    Buccal formulations have been developed to allow prolonged localised therapy and enhanced systemic delivery. The buccal mucosa, however, while avoiding first-pass effects, is a formidable barrier to drug absorption, especially for biopharmaceutical products (proteins and oligonucleotides) arising from the recent advances in genomics and proteomics. The buccal route is typically used for extended drug delivery, so formulations that can be attached to the buccal mucosa are favoured. The bioadhesive polymers used in buccal drug delivery to retain a formulation are typically hydrophilic macro-molecules containing numerous hydrogen bonding groups. Newer second-generation bioadhesives have been developed and these include modified or new polymers that allow enhanced adhesion and/or drug delivery, in addition to site-specific ligands such as lectins. Over the last 20 years a wide range of formulations has been developed for buccal drug delivery (tablet, patch, liquids and semisolids) but comparatively few have found their way onto the market. Currently, this route is restricted to the delivery of a limited number of small lipophilic molecules that readily cross the buccal mucosa. However, this route could become a significant means for the delivery of a range of active agents in the coming years, if the barriers to buccal drug delivery are overcome. In particular, patient acceptability and the successful systemic delivery of large molecules (proteins, oligonucleotides and polysaccharides) via this route remains both a significant opportunity and challenge, and new/improved technologies may be required to address these.

  9. Studies on Qualitative and Quantitative Methods for Qingliang Buccal Tablets%清凉含片定性定量方法考察

    Institute of Scientific and Technical Information of China (English)

    宋莉; 贾丽华; 乔蓉霞

    2012-01-01

    Objective: To establish the qualitative and quantitative methods for Qingliang buccal tablets to control the quality. Method: TLC was used to identify the three herbal medicines ( Menthae Haplocalycis Herba, menthol and Puerariae Lobatae Radix ) in the formulation. GC was used to determine the content of menthol with PEG-20M as the stationary phase and 140℃ as the determination temperature. Result: The three herbal medicines were distinguished exclusively with clear spots and good separation by TLC. Menthol showed good linear relationship ( r = 1. 000 0 ) within the range of 0. 099-2. 106 μg, and the average recovery was 96. 4% with RSD of 1. 8% ( n =6 ). Conclusion: The methods are specific, sensitive and repeatable, and can be used in the qualitative and quantitative analysis for the quality control of Qingliang buccal tablets.%目的:建立清凉含片的定性定量方法,更好地控制产品质量.方法:采用薄层色谱法对处方中的薄荷、薄荷脑和葛根进行鉴别,采用气相色谱法测定薄荷脑的含量,以聚乙二醇(PEG)-20M为固定相,在140℃柱温下检测.结果:薄层色谱鉴别方法专属性好,斑点清晰,分离度好,阴性样品无干扰;气相色谱法测定,薄荷脑在0.099~2.106 μg范围内线性关系良好(r=1.000 0);平均回收率为96.4%,RSD=1.8%(n=6).结论:本方法能准确地进行定性、定量,且专属性强,灵敏度高,重复性好,可用于清凉含片的质量控制.

  10. 猴头菇蛋白多糖口含片的研制%Development of Hericium erinaceus Proteoglycan Buccal Tablets

    Institute of Scientific and Technical Information of China (English)

    张鑫; 张海悦; 李震

    2016-01-01

    Hericium erinaceus proteoglycan was selected as the main raw material to develop buccal tablets. The optimum extraction technology of Hericium erinaceus proteoglycan was found to be 10%, 80℃, 60 min and 1∶25 (g/mL)for alkali concentration, temperature, extraction time and solid-to-liquid ratio, respectively. The yield of Hericium erinaceus proteoglycan was 53.6%. The formula optimization of Hericium erinaceus pro-teoglycan buccal tablets was determined for Hericium erinaceus proteoglycan 0.1 g, citric acid 0.02 g, xylitol 0.1 g, and starch 0.16 g by orthogonal experiment. The total antioxidant capacity of each piece of the product was 2 733.4 units. The technology had certain research meaning and applied worthiness as a result of good taste and operability.%选取猴头菇蛋白多糖为主要原料研制口含片。确定猴头菇蛋白多糖的最佳提取工艺:氢氧化钠质量分数为10%,提取温度为80℃,提取时间为60 min,料液比为1∶25(g/mL),此条件下猴头菇蛋白多糖的得率为53.6%。通过正交试验,确定口含片配方:按照0.38 g/片的规格,猴头菇蛋白多糖0.1 g,柠檬酸0.02 g,木糖醇0.1 g,0.16 g淀粉填充。总抗氧化能力(T-AOC)检测试剂盒检测该产品每片的总抗氧化能力达2733.4个单位。该产品酸甜可口,可操作性强,具有一定的研究意义。

  11. 响应面分析法优化余甘子含片配方%Optimizing formula of buccal tablets of emblica by response surface methodology

    Institute of Scientific and Technical Information of China (English)

    杜刚; 曾程; 余鹏; 王炯; 杨海英

    2011-01-01

    在单因子试验基础上,用响应面法对余甘子含片配方主要成分淀粉糊精、蔗糖、薄荷醇进行优化.结果表明,余甘子舍片的最佳配方为:余甘子粉10 g,淀粉糊精18.3 g,蔗糖9 g,薄荷醇0.05 g.产品具有余甘子特有风味,并较好去除了苦味,减少了涩味.%The formula of buccal tablets of emblic was optimized by response surface methodology(RSM) with starch dextrin , sucrose and menthol based on single factor tests. Results showed that the optimum formula is as follows: the power of emblica 10 g, starch dextrin 18.3 g, sucrose 9 g, menthol 0. 05 g. The product maintained the special flavor of emblica, removed the bitter and reduced astringency properly.

  12. Acyclovir Lauriad(®): a muco-adhesive buccal tablet for the treatment of recurrent herpes labialis.

    Science.gov (United States)

    Downing, Christopher; Moayyad, Jonathan; Tamirisa, Aparna; Tyring, Stephen

    2014-03-01

    The treatment of recurrent herpes labialis remains a challenge in the 21st century. The virus is ubiquitous and there is no vaccine against the disease. Although recurrence episodes are usually of shorter duration than the primary episode, they are debilitating to patients and there is significant stigma associated with the disease. Acyclovir Lauriad(®) is a new topical agent that was approved by the US FDA in 2013 for the treatment of recurrent herpes labialis, which affects approximately 20-40% of the population worldwide. The drug is a muco-adhesive tablet, applied to the upper gum at the onset of prodromal symptoms. Utilizing Lauriad(®) technology, a biologically active compound traverses the mucous membrane to deliver a high concentration of acyclovir directly to the site of the herpes simplex virus infection. Data from a Phase III clinical trial shows that this may be a promising therapy for patients with recurrent herpes labialis.

  13. 高血压亚急症含服硝苯地平片对心脑血管系统的影响(2例报告)%Influence of hypertensive urgencies buccal nifedipine tablet on cardiovascular system

    Institute of Scientific and Technical Information of China (English)

    武孟田; 李斌

    2015-01-01

    Described in the hypertensive crisis,it should avoid to use the buccal nifedipine method for treatment.Through three patients with hypertensive urgencies are treated by buccal nifedipine tablet,and the generated clinical consequences explain the adverse reactions and clinical limitations of this treatment method.Using buccal nifedipine tablet method treat hypertensive urgencies,this medication method is effective,makes blood pressure decreased rapidly,but there have myocardial ischemia and ischemic cerebral infarction performance.%阐述在发生高血压危象时,应避免使用含服硝苯地平的方法来治疗。通过3例高血压亚急症患者在治疗时含服硝苯地平片而产生的临床后果来说明此种治疗方法的不良反应和临床的局限性。用含服硝苯地平的方法治疗高血压亚急症虽然行之有效,使血压快速下降,但出现了心肌供血不足和缺血性脑梗死的表现。

  14. Fentanyl Sublingual Tablets Versus Subcutaneous Morphine for the Management of Severe Cancer Pain Episodes in Patients Receiving Opioid Treatment: A Double-Blind, Randomized, Noninferiority Trial.

    Science.gov (United States)

    Zecca, Ernesto; Brunelli, Cinzia; Centurioni, Fabio; Manzoni, Andrea; Pigni, Alessandra; Caraceni, Augusto

    2017-03-01

    Purpose Fentanyl sublingual tablets (FST) are a potentially useful alternative to parenteral opioids such as subcutaneous morphine (SCM) to treat severe cancer pain episodes. No direct comparison between FST and SCM is available. The aim of this study was to test noninferiority of FST versus SCM during the first 30 min postadministration. Methods Patients receiving stable opioid therapy and experiencing a severe pain episode were randomly assigned to either 100 µg FST or 5 mg SCM in a double-blind, double-dummy trial. Average pain intensity (PI) assessed on a 0 to 10 numerical rating scale at 10, 20, and 30 min postadministration was the main end point. Analysis of covariance, adjusted by baseline PI, was the main analysis. The noninferiority margin (NIm) for the between-group difference was set at -0.6, that is, equal to one third of the minimum clinically important PI difference of two points. Results A total of 114 patients were randomly assigned to either FST (n = 58) or SCM (n = 56). One patient (in the FST group) withdrew consent before drug administration and was excluded from analysis. Baseline mean PIs were 7.5 in both groups; mean average PIs assessed at 10, 20, and 30 min postadministration were 5.0 and 4.5 for FST and SCM, respectively, with the 95% CI of the between-group difference including the NIm (-0.49; 95% CI, -1.10 to 0.09). Patients taking FST received a second drug dose after 30 min more frequently than did patients taking SCM (51% v 37%, respectively; risk difference, -13%; 95% CI, -30% to 3%). Both treatments were well tolerated, with average follow-up adverse event scores below the response of "A Little." Ninety-three percent of patients preferred the sublingual administration. Conclusion This trial did not show noninferiority of FST versus SCM within the chosen NIm. Both treatments were safe, and patients preferred the sublingual route of administration. FST provides analgesia with modest to moderate increased risk of lower efficacy

  15. Comparison of the Efficacy of Watermelon Frost and Cydiodine Buccal Tablets in Treatment of Oral Ulcer%西瓜霜喷剂与西地碘含片治疗口腔溃疡的疗效比较

    Institute of Scientific and Technical Information of China (English)

    王宏峰

    2016-01-01

    目的:对比西瓜霜喷剂与西地碘含片治疗口腔溃疡的疗效。方法喷剂组、含片组各入选患者142例,分别采用西瓜霜喷剂、西地碘含片治疗。结果喷剂组痊愈率、愈显率高于含片组,差异具有统计学意义(P<0.05)。结论西瓜霜喷剂治疗口腔溃疡疗效更优。%Objective Comparison of watermelon frost spray and West iodine tablets in the treatment of oral ulcer curative effect. Methods Spray group, tablet group each selected 142 patients, respectively by watermelon frost spray, cydiodine buccal tablets in the treatment. Results Spray agent group, the cure rate, markedly rate is higher than the tablet group, the difference has statistical significance (P<0.05). Conclusion Watermelon frost spray in the treatment of oral cavity ulcer curative effect better.

  16. Clinical evaluation of cetylpyridinium chloride buccal tablets in treatment of recurrent aphthous ulcer%西吡氯铵口含片治疗复发性阿弗他溃疡临床疗效评价

    Institute of Scientific and Technical Information of China (English)

    冯靳秋; 吴岚; 葛姝云; 周永梅

    2012-01-01

    目的 评价西吡氯铵口含片局部治疗复发性阿弗他溃疡(轻型)的疗效.方法 本研究采用随机、阳性药物对照、单中心临床研究的方法,将74例复发性阿弗他溃疡患者分成试验组即西吡氯铵口含片组(37例),对照组即华素片组(37例),含化,疗程为7d.分别于初诊时(第1天)、首次用药后第7天,记录溃疡疼痛指数、平均溃疡期、溃疡面积、受试者使用印象.数据采用EpiData 3.0软件输入,SAS 8.2软件分析.结果 2组患者治疗后溃疡面积和疼痛强度均较治疗前有显著改善,2组患者治疗后溃疡面积和疼痛强度之间无显著差异,但试验组溃疡愈合天数较对照组短(P 0.05). But ulcer healing time in the experimental group was shorter than control group ( P < 0.05 ). Conclusions Cetylpyridinium chloride buccal tablets can effectively reduce ulcer pain and shorten healing time of light recurrent ulcer. The clinical effects of cetylpyridinium chloride buccal in the treatment of light recurrent ulcer are equivalent to those of chloride buccal tablets.

  17. Preparation and quality evaluation of Mucoadhesive Buccal Tablets of Tiazanidine Hydrochloride%盐酸替扎尼定口腔黏附片的研制及质量评价

    Institute of Scientific and Technical Information of China (English)

    杨晓艳; 张友智; 耿立坚

    2014-01-01

    目的:制备盐酸替扎尼定口腔黏附片并评价其质量。方法采用不同配比的羟丙甲基纤维素(H PM C )、羧甲基纤维素钠(SCMC)、β-环糊精和羟丙基-β-环糊精等辅料,用直接压片法压片制备盐酸替扎尼定口腔黏附片,并对黏附片的理化性质、药物含量、药物体外释放度和黏附力进行评价。结果得到各项指标均较适宜的处方:盐酸替扎尼定4.56 mg ,羟丙甲纤维素20 mg ,羧甲基纤维素钠75mg,羟丙基-β-环糊精27.36mg,甘露醇4mg,阿斯巴甜1mg,微粉硅胶1mg。结论成功制备了盐酸替扎尼定口腔黏附片,可用于进一步的体内、体外研究。%Objective To prepare and evaluate a buccal adhesive tablet containing tiazanidine hydrochloride .Methods The tablets were prepared by using hydroxypropyl methyl cellulose (HPMC ) ,sodium carboxymethylcellulose (SCMC ) ,β-cyclodextrin , hydroxypropyl-β-cyclodextrin ,etc as the auxiliary materials .Direct compression process was used to prepare the buccal adhesive tablets ,and different parameters such as physicochemical property ,drug content ,in vitro drug release ,and mucoadhesive strength were evaluated .Results The prescription was as follows :tiazanidine hydrochloride 4 .56 mg ,hydroxypropyl methyl cellulose 20 mg ,sodium carboxymethylcellulose 75 mg ,hydroxypropyl-β-cyclodextrin 27 .36 mg ,mannitol 4 mg ,aspartame 1 mg and aerosil 1 mg .Conclusion The buccal adhesive tablets of tiazanidine hydrochloride were prepared successfully ,and which can be used for the further study both in vivo and in vitro .

  18. Clinical Study on Compound Yejuhua Buccal Tablets in Treating Sore Throat Due to Wind-heat%复方野菊花含片治疗外感风热咽痛症临床研究

    Institute of Scientific and Technical Information of China (English)

    王勇; 林友平; 邓可斌; 刘同祥

    2012-01-01

    Objective To evaluate the efficacy and safety of Compound Yejuhua Buccal Tablets in the treatment of sore throat due to wind-heat. Methods A randomized, blind, positive parallel controlled, multi-center clinical trial was carried out in 567 patients. The trial group (426 cases) was given Compound Yejuhua Buccal Tablets and the contral group (141 cases) was given Yinhuang Buccal Tablets orally, 6 times per day (2 tablets/times), with the course of acpuei pharyngitis of 5 days and acute catarrhal tonsillitis of 7 days. Results For the treatment of acpuei pharyngitis, the total effective rate was 71.4% (152/213) in the trial group and 59.2% (42/71) in the control group. For the treatment of acute catarrhal tonsillitis, the total effective rate was 70.4% (150/213) in the trial group and 67.1% (47/70) in the control group, the difference was not statistically significant between the two groups (P>0.05). There were no significant changes of laboratory indexes and side effects related to trial drugs. Conclusion Compound Yejuhua Buccal Tablets can improve exogenous wind-heat-induced sore throat, painful swallowing, throat irritation, etc. It is safe and effective in the treatment of acpuei pharyngitis and acute catarrhal tonsillitis.%目的 评价复方野菊花含片治疗外感风热引起的咽痛症(急性咽炎、急性卡他性扁桃体炎)的临床疗效和安全性.方法 采用分层区组随机、盲法、阳性药平行对照、非劣效的、多中心临床试验方法,共观察病例567例.试验组426例,含化服复方野菊花含片.对照组141例,含化服银黄含化片.2组均2片/次,6次/d,急性咽炎5 d为1个疗程,急性卡他性扁桃体炎7 d为1个疗程.结果 对急性咽炎的治疗,试验组总有效率为71.4%(152/213)、对照组为59.2%(42/71);对急性卡他性扁桃体炎的治疗,试验组总有效率为70.4%(150/213),对照组为67.1%(47/70),组间疗效差异无统计学意义(P>0.05).试验期间未见有与试验药物相关的

  19. Analgesic Effect Observation of Shixin Buccal Tablets on Pericoronitis of Wisdom Tooth%石辛含片用于智齿冠周炎患者的镇痛效果观察

    Institute of Scientific and Technical Information of China (English)

    陈银丰; 陈丹琼

    2015-01-01

    OBJECTIVE:To observe analgesic effect and safety of Shixin buccal tablets on pericoronitis of wisdom tooth. METHODS:120 patients with pericoronitis of wisdom tooth were randomly divided into control group and observation group with 60 cases in each group. Control group received periodontal pocket irrigation combined with metronidazole;observation group was additionally given Shixin buccal tablets on the basis of control group,1 tablet/time,4 times/d. Clinical efficacy,medication compli-ance,pain score and ADR were compared between 2 groups. RESULTS:The effective rate of observation group(95.00%)was sig-nificantly higher than that of control group(73.33%),with statistical significance(P0.05);the pain score of observation group was significantly lower than that of control group,with statistically significant difference(P<0.05). No serious ADR was found in 2 groups. CONCLUSIONS:Shixin buccal tablets significantly alleviate the pain caused by pericoronitis of wisdom tooth.%目的:观察石辛含片用于智齿冠周炎患者的镇痛效果和安全性。方法:将120例智齿冠周炎患者按随机数字表法分为对照组和观察组,各60例。对照组患者接受冠周冲洗联合甲硝唑上药治疗;观察组患者在对照组治疗基础上加服石辛含片,每次1片,每天4次。比较两组患者临床疗效、用药依从性、疼痛计分及不良反应。结果:观察组患者临床有效率(95.00%)显著高于对照组(73.33%),差异有统计学意义(P<0.05);两组患者用药依从性比较差异无统计学意义(P>0.05);观察组患者疼痛计分显著低于对照组,差异有统计学意义(P<0.05)。两组患者均未出现严重不良反应。结论:石辛含片对智齿冠周炎患者的镇痛效果显著。

  20. 局部应用替硝唑含片治疗牙周炎和冠周炎的疗效分析%Efficacy of tinidazole buccal tablet local using on periodontitis and pericoronitis

    Institute of Scientific and Technical Information of China (English)

    张洪涛; 叶涛

    2012-01-01

    目的 探讨局部应用替硝唑含片治疗牙周炎和冠周炎的有效性及安全性.方法 70例牙周炎及冠周炎患者随机分成2组,对照组予口服替硝唑片,观察组予局部应用替硝唑含片,比较两组疗效及不良反应.结果 观察组牙周炎治疗有效率为100%,对照组为89.47%,两组比较,差异无统计学意义(P>0.05);观察组冠周炎治疗有效率为100%,对照组为93.75%,两组比较,差异无统计学意义(P>0.05);观察组不良反应发生率为5.71%,明显低于对照组的25.71%(P<0.05).结论 局部应用替硝唑含片治疗牙周炎及冠周炎具有良好的效果,明显减少了药物不良反应,并且操作方法简单,易于掌握,值得临床推广.%Objective To investigate the efficacy and safety of tinidazole buccal tablet local using on periodontitis and pericoronitis. Methods 70 patients with periodontitis and pericoronitis were randomly divided into two groups, the control group was given oral tinidazole tablets, and the observation group was treated with local application of tinidazole buccal tablet, then the therapeutic effects and adverse reactions between the two groups were compared. Results The effective rate of periodontitis in observation group was 100% , which was 89. 47% in control group,and there was no significant difference between the two grorps ( P > 0. 05 ) ; The effective rate of pericoronitis in observation group was 100% .which was 93. 75% in control group,and there was no significant difference between the two grorps (P >0. 05) ;The rate of adverse reactions was 5. 71% and 25. 71% in observation group and control group respectively , there were significant difference between the two grorps ( P < 0. 05 ). Conclusion The local application of the tini-dazole buccal tablet on periodontitis and pericoronitis is effective and safe,and the method is simple,easy to master,and it is worthy being promoted.

  1. Phase Ⅱ clinical trial of Shixinyatong buccal tablets in the treatment of gastropyretic toothache(pericoronitis)%石辛牙痛口含片治疗胃火牙痛(智齿冠周炎)Ⅱ期临床试验

    Institute of Scientific and Technical Information of China (English)

    吴军正; 李元聪; 胡开进; 卜献春; 温德升; 关素敏

    2009-01-01

    目的:研究石辛牙痛口含片治疗胃火牙痛(智齿冠周炎)的疗效及安全性.方法:随机双盲双模拟平行对照多中心法.纳入符合胃火牙痛(智齿冠周炎)试验组(石辛)、对照组(牛黄)各120 例.就诊当天行常规冠周袋冲洗.石辛组患者含化石辛牙痛口含片0.6 g×2, 4/d,口服牛黄解毒片的赋形剂0.3 g×3, 3/d;牛黄组患者口服牛黄解毒片0.3 g×3, 3/d,含化石辛牙痛口含片的赋形剂,0.6 g×2, 4/d.主症按0、2、4、6 分级计分;次症按0、1、2、3 分级计分.疗程5 d,用SAS 6.12软件统计分析.用药前后进行血、尿、粪常规及肝功、肾功、心电图检查,记录不良事件.结果:石辛组脱落(失访)3 例,牛黄组脱落2 例.受试者脱落率、人口学特征、病情基线组间差别均无统计学意义(P>0.05).第3 天和第5 天时主症、次症积分以及病情总积分均明显下降(P=0.000),其减少值石辛组大于牛黄组(P0.05),实验室检查全部患者治疗前未出现明显异常变化.3 例发生与研究药物有关不良事件,石辛组1 例,为"中度",停药后好转,退出试验.牛黄组2 例,为轻度,未影响试验.结论:石辛牙痛口含片治疗胃火牙痛(智齿冠周炎)疗效优于牛黄解毒片,安全性与牛黄解毒片相似.%Objective: To study the effects and safety of Shixinyatong buccal tablets in the treatment of gastropyretic toothache (perico-ronitis). Methods: Randemized, double-blinded, double-imitated, parallel-controlled and multi-center clinical study was employed. 120 cases of gastropyretic toothache (pericoronitis) was enrolled in the experimental group( SBT group) and another 120 in control group(CBD group). Pericoronal pocket rinsing was performed for each case at the first visit, then the patients in SBT group were treated by Shixin buccal tablets(SBT) , 0. 6 g×2, 4/d and oral adiministration of the vehicle of cow-bezoare detoxicating tablets,0.3 g×3, 3/ d. The patients in CBD group were

  2. HPLC法测定咽喉清口含片中哈巴俄苷及肉桂酸的含量%Determination of harpagoside and cinnamic acid in Yanhouqing Buccal Tablets by HPLC

    Institute of Scientific and Technical Information of China (English)

    李一圣; 李文周; 卫平; 邱书奇

    2016-01-01

    Objective To establish a method for the determination of harpagoside and cinnamic acid in Yanhouqing Buccal Tablets.Methods Separations were carried out on a Waters Symmetry C18 column(4.6 mm×250 mm,5μm)by gra-dient elution with 0. 3% acetic acid and acetonitrile,the detection wavelength was 279 nm,the flow rate was 1. 0 mL·min-1 ,and the column temperature was 30 ℃. Results Chromatographic peaks of harpagoside and cinnamic acid were well separated with good precision and stability.Then the standard curve of harpagoside was rectilinear within the range of 0.039 65~0.396 5 μg(r=0.999 8),and the average recovery was 98.13 % with RSD of 1.20 %(n=6).The standard curve of cinnamic acid was rectilinear within the range of 0.099 68~0.996 8μg( r=0.999 7),and the average recovery was 98.87 % with RSD of 1.17%(n=6).Conclusion The method was accurate and reproducible,and can be used for the de-termination of cinnamic acid and harpagoside in Yanhouqing Buccal Tablets.%目的:建立同时测定咽喉清口含片中哈巴俄苷和肉桂酸含量的高效液相色谱方法。方法采用Waters Symmetry C18(4.6 mm×250 mm,5μm)为固定相,以乙腈-0.3%醋酸水溶液为流动相进行梯度洗脱,检测波长为279 nm,流速为1.0 mL·min-1,柱温为30℃。结果哈巴俄苷进样量在0.03965~0.3965μg时,与峰面积呈良好线性关系( r=0.9998),平均回收率98.13%( n=6),RSD为1.20%;肉桂酸进样量在0.09968~0.9968μg范围内,线性关系良好( r=0.9997),平均回收率为98.87%( n=6),RSD为1.17%。结论所建立的方法准确可靠、重复性好,可用于咽喉清口含片中相关成分的测定,以控制该制剂质量。

  3. Effects of Shixinyatong buccal tablets against bateria in pericoronal pocket of patients with pericoronitis%石辛牙痛口含片对智齿冠周炎病人冠周盲袋细菌的抑制作用

    Institute of Scientific and Technical Information of China (English)

    吴军正; 杨聚才; 安银东; 李元聪; 胡开进; 卜献春; 关素敏; 温德升

    2011-01-01

    AIM: To study the effects of Shixinyatong buccal tablets(SBT) against bateria in pericoronalpocket of patients with pericoronitis. METHODS: Randomized, double-blinded, double-imitated, parallel-controlled and multi-centered clinical study was employed. One hunered and twenty cases of gastropyretic toothache ( pericoronitis) was enroled in the experimental group (SBT group) and another 120 in control (BBPD group). Pericoronal pocket rinsing was performed for each case at the first visit. Patients in SBT group were treated by SBT, 0.6g x 2, 4/d and oral adiministration of the vehicle of bovine bezoar pill for detoxification ( BBPD), 0.3g x 3, 3/d. Patients in BBPD group were treated by oral adiministration of BBPD, 0.3gx3, 3/d and the vehicle of SBT, 0.6gx2, 4/d, respectively. The bateria in pericoronal pocket of each case were examined and classified by Bergey's standard before and after treatment. RESULTS: In per protocol set (PPS) there were 112 cases in SBT group and 111 in BBPD group. After treatment, the decreacse rates (%) of total bacteria ( CFU/mL) were 59. 05 ± 25. 64 and 59. 67 ± 27. 25( P > 0.05 ) , the clearance rates ( % ) of the total bacteria in pericoronal pocket in SBT and BBPD groups were 75. 89 and 78.37 (P > 0. 05), the decreacse rates (% ) of total anaerobic bacteria ( CFU/mL) were 83. 48 ± 26. 87 and 82.34 ±24.61 ( P >0.05 ) , the decrease rates ( % ) of total facultative anaerobe( CFU/mL) were 41.57 ± 23. 89 and 40.86 ±30.47(P>0.05), respectively. The decrease rates (% ) of 16 identified bacteria (CFU/mL) were not statistically defferent ( P > 0.05 ). CONLUSION: Shixinyatong buccal tablet and bovine bezoar pill for detoxification have similar antiseptic effects against baterira in pericoronal pocket of patients with pericoronitis.%目的:探讨石辛牙痛口含片治疗胃火牙痛(智齿冠周炎)过程中对冠周盲袋细菌的抑制作用.方法:运用随机双盲双模拟平行对照多中心临床试验,纳入符合胃火牙痛(

  4. Inhibitory effects of cetylpyridinium chloride buccal tablets on dental plaque%西吡氯铵含片对牙菌斑抑制效果的临床试验研究

    Institute of Scientific and Technical Information of China (English)

    谭媛元; 张剑英; 张冠荣; 付云

    2014-01-01

    目的:探讨西吡氯铵含片(CCBT)对控制牙面菌斑堆积和牙龈炎症的效果。方法:采用随机单盲对照试验,纳入60名患有慢性龈炎、轻、中度慢性牙周炎患者。对全部患者卫生宣教后随机分为3组,对照组不用药,试验组使用CCBT,阳性对照组使用复方氯己定(CHX)含漱液。治疗前、治疗后第2周记录Quigley-Hein菌斑指数(PI)及出血指数(BI);酶联免疫吸附试验法检测龈沟液中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)表达水平的改变。结果:治疗前3组间比较PI、BI、龈沟液TNF-α和IL-1β含量均无显著差异(P>0.05)。治疗后CCBT组和CHX组PI和BI均明显下降(P<0.01),2组的下降值均无显著差异(P>0.05);龈沟液中TNF-α含量均下降(P<0.05)。对照组治疗后PI下降(P<0.05),其他指标无变化(P>0.05)。结论:西吡氯铵含片有抑制牙菌斑堆积作用,可改善牙龈炎症,降低龈沟液中TNF-α表达。%Objective:To investigate the effects of cetylpyridinium chloride buccal tablets(CCBT)on dental plaque control.Meth-ods:60 patients with gingivitis,mild or moderate,or chronic periodontitis were divided into control group(without drug treatment), CCBT group (treated with CCBT)and CHX group (treated with compound chlorhexidine gargle)according to the randomized con-trolled single-blind principle.Quigley-Hein plaque index (PI)and bleeding index (BI)of the subjects were recorded,tumor necro-sis factor (TNF-α)and interleukin (IL-1β)in gingival crevicular fluid (GCF)were measured by ELISA before and after 2 weeks'trial.Results:After 2-week treatment,PI and BI in CCBT and CHX groups decreased(P0.05). In control group PI was decreased(P005).Conclusion:CCBT is effective in inhibiting plaque accumulation and decreasing GCF TNF-αlevel.

  5. Influence of Rubrus Suarissimus S.Lee Dental Care Buccal Tablets on Glucosyltransferase and Water-insoluble Glucan%甜茶护齿含片对葡糖基转移酶和细胞外水不溶性多糖的影响

    Institute of Scientific and Technical Information of China (English)

    韦姗妮; 何克新; 黄丽微; 陈小芳

    2012-01-01

    目的 研究甜茶护齿含片对变形链球菌葡糖基转移酶和细胞外水不溶性多糖合成的影响.方法 将甜茶护齿含片磨成粉末,并采用二倍稀释法,用含1%蔗糖的胰蛋白胨-胰蛋白月示-酵母提取物(TTY)液体培养基,配制成5个浓度的实验组;并以含1%蔗糖的TTY液体培养基作为阴性对照组.加入变形链球菌菌液,厌氧培养48 h后离心,一份透析提取葡糖基转移酶,采用Somogyi法和考马斯亮蓝法分别测定还原糖和总蛋白含量,计算酶活性和比活力大小;另一份弃上清液留沉淀,采用蒽酮法测定水不溶性多糖的含量.结果 随着甜茶护齿含片混悬液浓度的升高,葡糖基转移酶活性和水不溶性多糖含量逐渐降低(P<0.05),除0.313 g/50 ml浓度组外,葡糖基转移酶各实验组与对照组酶活性及比活力之间差异有统计学意义(P<0.05),各实验组与对照组水不溶性多糖含量差异有统计学意义(P<0.05).结论 甜茶护齿含片对变形链球菌葡糖基转移酶和细胞外水不溶性多糖的合成具有显著抑制作用.%Objective To study the influence of Rubrus Suarissimus S. Lee dental care buccal tablets on glucosyltransferase( GTF ) and extra-cellular synthesis of water-insoluble glucan( WIG ) of Streptococcus mutans( S. Mutans ). Methods Rubrus Suarissimus S. Lee dental care buccal tablets were lapped into powder and used in the experimental group with 5 concentrations prepared with TTY which contained with 1% glucose,while TTY culture with 1% glucose as the negative control. S. Mutans was added into each group,and then centrifugation was performed after 48 hours' anaerobical culturing. One batch was that the supernatants were collected to extract GTF,which was used to measure the content of reducing sugar and total protein by Smoyi method and Bradford method,then figured out enzyme activity and the specific activity. The other batch was that the supernatants were abandoned and the

  6. Observation of the efficacy and safety of tinidazole buccal tablets in the treatment of periodontitis and pericoronitis%替硝唑含片治疗牙周炎和冠周炎的疗效及安全性观察

    Institute of Scientific and Technical Information of China (English)

    李凤英

    2015-01-01

    Objective:To explore the efficacy and safety of tinidazole buccal tablets in the treatment of periodontitis and pericoronitis.Methods:67 patients with periodontitis and 63 patients with pericoronitis were selected from 2012 March to 2014 May.The total number were 130 cases.According to the different treatments,they were divided into the study group and the control group with 65 cases in each group.The study group was treated with tinidazole tablets,and the control group was treated by metronidazole bioadhesive tablets.We compared the advantages and disadvantages of tinidazole buccal tablets.Results:In the study group,the total effective rate of periodontitis and pericoronitis patients respectively was 97.37% and 100%,and there was no adverse reaction;in the control group;the total efficiency was 82.76% and 88.89% respectively;the incidence of adverse reaction was 6.90% and 2.78% respectively;the difference was statistically significant(P<0.05).Conclusion:The efficacy of tinidazole buccal tablets in the treatment of periodontitis and pericoronitis was significant;adverse reaction was less;there was no complications basically;the security was high;the operation was simple,and it had significant clinical effect on improving the quality of life of patients.It was worthy of promotion and application.%目的:探究替硝唑含片治疗牙周炎和冠周炎的疗效及其安全性。方法:2012年3月-2014年5月收治牙周炎患者67例和冠周炎患者63例,共130例,根据治疗方式的不同分为研究组和对照组各65例,研究组服用替硝唑含片,对照组则服用甲硝唑黏附片,比较并确定替硝唑含片的优缺点。结果:研究组的牙周炎、冠周炎患者治疗总有效率分别为97.37%和100.00%,无患者出现不良反应;而对照组的治疗总有效率分别为82.76%和88.89%,不良反应发生率分别为6.90%和2.78%;差异有统计学意义(P<0.05)。结论:使用替硝唑含片治疗牙周炎和冠

  7. Buccal Mucosal Graft Urethroplasty

    Directory of Open Access Journals (Sweden)

    Angela M. Arlen

    2010-01-01

    Full Text Available At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases. Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%. The single-stage buccal graft success rate was 86.4% (19 of 22 cases. Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%, including superficial wound infection (one, superficial wound dehiscence (two, and abscess/fistula formation requiring reoperation (one. The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

  8. 芬太尼透皮贴剂与盐酸羟考酮缓释片治疗中重度癌痛疗效和安全性的Meta分析%Meta-analysis of Curative Effect and Safety of Transdermal Fentanyl and Oxycodone Hydrochloride Sustained-release Tablets in the Treatment of Moderate and Severe Cancer Pain

    Institute of Scientific and Technical Information of China (English)

    刘思; 余正; 胡霞

    2015-01-01

    Objective: To evaluate the curative effect and safety of transdermal fentanyl and oxycodone hy-drochloride sustained-release tablets in the treatment of moderate and severe cancer pain . Methods: Based on the literature review from CNKI and Wanfang database and med . Wanfang data , literature and information were ex-tracted according to certain inclusion and exclusion criteria. Data was analyzed using RevMan 5.3 software. Results:A total of 4 research papers involved 635 cases were included . The results of meta-analysis showed that the inci-dence of pain remission was not significantly different between the two groups using transdermal fentanyl and oxy-codone hydrochloride sustained-release tablets [ RR=0 . 99 , 95%CI ( 0 . 94 , 1 . 04 ) , P=0 . 72 ] . No significant difference was found between the two groups in the incidence of constipation [ RR=0 . 83 , 95%CI ( 0 . 53 , 1 . 28 ) , P=0 . 39 ] , dizzi-ness [ RR=0 . 85 , 95%CI ( 0 . 46 , 1 . 57 ) , P=0 . 61 ] , somnolence [ RR=0 . 49 , 95%CI ( 0 . 22 , 1 . 06 ) , P=0 . 07 ] , urinary reten-tion [ RR=0 . 53 , 95%CI ( 0 . 15 , 1 . 89 ) , P=0 . 33 ] and mental disorder [ RR=0 . 72 , 95%CI ( 0 . 29 , 1 . 78 ) , P=0 . 47 ] , except the incidence of nausea and vomitting [ RR=0 . 45 , 95%CI ( 0 . 26 , 0 . 76 ) , P=0 . 003 ] , with incidence of 6 . 03%( 17/282 ) and 11 . 33%( 40/353 ) respectively . Conclusion: Transdermal fentanyl and oxycodone hydrochloride sustained-release tablets had similar efficacy in the treatment of moderate and severe cancer pain . The incidence of nausea and vomit-ing caused by transdermal fentanyl was lower than oxycodone hydrochloride sustained-release tablets but the safety of the two drugs are similar .%目的:评价芬太尼透皮贴剂和盐酸羟考酮缓释片治疗中重度癌痛的临床疗效和安全性。方法:检索CNKI、万方数据库和万方医学网获得相关文献,按照一定的纳入和排除标准筛选文献并提取信息,采用RevMan 5.3软件进

  9. Study on Inhibitory of Rubrus Suarissimus S. Lee Dental Care Buccal Tablets on Adhesion and Acidogenicity of Streptococcus Mutans In Vitro%甜茶护齿含片对变形链球菌黏附与产酸影响的研究

    Institute of Scientific and Technical Information of China (English)

    陈小芳; 何克新; 黄丽微; 韦姗妮

    2011-01-01

    目的 研究甜茶护齿含片对口腔致龋变形链球菌的黏附与产酸的影响,探讨甜茶护齿含片的护齿机制.方法 采用二倍稀释法将甜茶护齿含片研磨成粉末,并配制5个浓度组,检测不同浓度甜茶护齿含片对变形链球菌黏附抑制效果,及其对致龋菌、变形链球菌产酸能力的影响,并设1%蔗糖TTY液体培养基作为对照.厌氧培养48 h后用分光光度计测OD值及采用pH酸度计测其pH值.结果 不同浓度甜茶护齿含片混悬液对变形链球菌黏附能力OD值比较差异有统计学意义(P<0.05),随着深度升高OD值逐渐减小.不同浓度甜茶护齿含片混悬液对变形链球菌产酸均有一定的抑制作用.结论 甜茶护齿含片具有影响变形链球菌的生长代谢能力,可作为一种健齿护齿的保健品.%Objective To investigate the effects of Rubrus Suarissimus S. Lee dental care buccal tablets ( RSL )on adhesion and acidogenicity of Streptococcus mutans and explore its anticariogenic activities. Methods The RSL was lapped into powder and diluted into five groups of different concentration by two-fold dilution, its inhibitory effects on adhesion and acidogenicity of Streptococcus mutans were detected. 1% sucrose tryptone-tryptose-yeast( TTY )medium was used as control. After Streptococcus mutans incubated under aerobic fementation circumstances for 48 hours,the optical density were detected by spectrophotometer and △pH with pH meter. Results Different concentrations of Rubrus Suarissimus S. Lee dental care buccal tablets had different effects on the optical density of adhesive capacity. The optical density increased significantly with the concentrations of Rubrus Suarissimus S. Lee dental care buccal tablets. The RSL could inhibit the adherence of Streptococcus mutans significantly and induce the acidogenicity of Streptococcus mutans.Conclusion The RSL could influence the metabolism of Streptococcus mutans and could be further researched as a

  10. Molecular modeling of fentanyl analogs

    Directory of Open Access Journals (Sweden)

    LJILJANA DOSEN-MICOVIC

    2004-11-01

    Full Text Available Fentanyl is a highly potent and clinically widely used narcotic analgesic. A large number of its analogs have been synthesized, some of which (sufentanil and alfentanyl are also in clinical use. Theoretical studies, in recent years, afforded a better understanding of the structure-activity relationships of this class of opiates and allowed insight into the molecular mechanism of the interactions of fentanyl analogs with their receptors. An overview of the current computational techniques for modeling fentanyl analogs, their receptors and ligand-receptor interactions is presented in this paper.

  11. Buccal delivery of metformin

    DEFF Research Database (Denmark)

    Sander, Camilla; Nielsen, Hanne Mørck; Jacobsen, Jette

    2013-01-01

    system. The in vitro TR146 cell culture model was used to study the effect of drug concentration (5-100mM) and the impact of a bioadhesive chitosan formulation (discs) and chitosan in solution (0-20mg/mL) acting as a permeation enhancer. The permeation of metformin occurred by passive diffusion via...... metformin discs and, metformin permeation may be increased due to a combination of bioadhesion and permeation enhancement induced by chitosan, although the permeation enhancing effect of chitosan was not statistically significant. The limited apparent buccal permeability of metformin observed in vitro...

  12. Pharmacokinetic interaction of intravenous fentanyl with ketoconazole.

    Science.gov (United States)

    Ziesenitz, Victoria C; König, Sonja K; Mahlke, Nina S; Skopp, Gisela; Haefeli, Walter E; Mikus, Gerd

    2015-06-01

    Fentanyl is primarily metabolized by CYP3A, but has also been suggested to act as a weak inhibitor of CYP3A. We investigated the influence of CYP3A inhibition by ketoconazole on the pharmacokinetics of intravenously administered fentanyl and the effect of fentanyl on CYP3A activity. A prospective, open-label, randomized, monocentre, crossover study was conducted in 16 healthy volunteers. They received fentanyl alone (5 microgram per kilogram) or fentanyl plus ketoconazole (200 milligram orally B.I.D. over 2 days). Naloxone (2 × 0.2 milligram i.v.) was given simultaneously with fentanyl to mitigate any opioid effect. Midazolam was administered as a CYP3A probe drug. Fentanyl and its metabolites were quantified by LC/MS/MS in blood and urine samples obtained over 24 hour. Exposure of fentanyl (AUC0- ∞ ) was significantly increased to 133% and systemic clearance was reduced to 78% by ketoconazole, norfentanyl formation was significantly delayed and partial metabolic clearance decreased to 18%. Fentanyl had no influence on midazolam exposure and CYP3A activity whereas ketoconazole decreased CYP3A activity to 13%. Although fentanyl N-dealkylation is substantially inhibited by ketoconazole, exposure of fentanyl itself increased by one third only. Clinically fentanyl dosage adjustments may become necessary when ketoconazole or other strong CYP3A inhibitors are given simultaneously. Fentanyl itself does not influence CYP3A activity.

  13. Efficacy of fentanyl transdermal patch in pain control after lower third molar surgery: A preliminary study

    Science.gov (United States)

    Vasovic, Miroslav; Andric, Miroslav; Todorovic, Ljubomir; Kokovic, Vladimir

    2016-01-01

    Background Surgical removal of impacted lower third molars is a common oral surgical procedure, generally followed by moderate to severe postoperative pain. Transdermal drug delivery as a concept offers interesting possibilities for postoperative pain control. The aim of this study was to evaluate the efficacy of transdermal system with fentanyl in relieving pain following impacted lower third molar surgery. Material and Methods Seventeen patients with bilateral impacted lower third molars were included in this preliminary study. For postoperative pain control, patients randomly received a fentanyl patch plus placebo tablet after the first operation and regular (placebo) patch and an analgesic, after the second operation. Analgesia was evaluated during first 24 hours postoperatively according to patients’ reports about time of first pain appearance and additional analgesic consumption. Pain severity was rated using a 10 cm long visual analogue scale (VAS). Results Intensity of postoperative pain and postoperative analgesic consumption were significantly lower after the Fentanyl Transdermal System (FTS) was applied (p<0.05). Duration of postoperative analgesia was significantly higher with FTS when compared to control treatment (p<0.05). Conclusions Based on the results of this preliminary study, transdermal system with fentanyl significantly reduced postoperative pain after third molar surgery. Key words:Analgesia, fentanyl, transdermal administration, third molar surgery, acute pain, postoperative care. PMID:27475691

  14. Transdermal fentanyl for cancer pain.

    Science.gov (United States)

    Hadley, Gina; Derry, Sheena; Moore, R Andrew; Wiffen, Philip J

    2013-10-05

    Opioid drugs have been used for many years to relieve pain. Transdermal fentanyl offers one option for delivering and maintaining pain relief in patients with moderate or severe cancer pain. To determine the analgesic efficacy of transdermal fentanyl for relief of cancer pain, and to assess the adverse events associated with the use of transdermal fentanyl for relief of cancer pain. The following databases were searched: Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 4 of 12); MEDLINE (1966 to May 2013); EMBASE (1974 to May 2013; CANCERLIT (PubMED) (November 2012); and ClinicalTrials.gov (May 2013). Published randomised controlled trials (RCTs) using placebo or active comparators reporting on the analgesic effect of transdermal fentanyl in adults and children with cancer pain. Studies with fewer than 10 participants were excluded. Data were extracted independently by two review authors. We extracted any available data on the number or proportion of patients with 'no worse than mild pain' or treatment success (very satisfied, or very good or excellent on patient global impression scales), together with information about adverse events and withdrawals. We identified nine studies meeting the inclusion criteria, including a Turkish study that is awaiting formal translation. There were 1244 participants randomised in classically designed RCTs, of whom 1197 had evaluable data, and 138 patients enrolled in an enriched enrolment, randomised withdrawal (EERW) trial. Overall, 600 participants were treated with transdermal fentanyl patches, 382 with various formulations of morphine, 36 with methadone, and 221 with paracetamol plus codeine. There were major sources of potential bias, including lack of blinding, small size, high levels of attrition, and inconsistent reporting.We could not compare data in a meaningful analysis regarding adverse events such as nausea, abdominal pain, gastrointestinal bleeding, and confusion. These

  15. Phase Ⅲ clinical trial of Shixinyatong buccal tablets in the treatment of pericoronitis of gastropyretic toothache type%石辛牙痛口含片治疗胃火牙痛智齿冠周炎Ⅲ期临床试验

    Institute of Scientific and Technical Information of China (English)

    吴军正; 李元聪; 胡开进; 卜献春; 向楠; 温德升; 关素敏

    2012-01-01

    Objective:To study the effects and safety of shixinyatong buccal tablets (SBT) in the treatment of pericoronitis of gastro-pyretic toothache type. Methods:432 cases of pericoronitis of gastropyretic toothache type were enrolled in a randemized, double-blinded, double-imitated, parallel-controlled and multi-center clinical trial. Pericoronal pocket rinsing was performed for each case at the first visit, then the patients in the experimental SBT) group were treated by SBT and oral administration of the vehicle of cow-be-zoar detoxicating tablet( CBDT). Those in the control ( CBDT) group were treated by oral adiministration of CBDT and the vehicle of SBT respectively. Pain was scored by VAS. The other major symptoms( MAS) , minor symptoms (MIS) , tongue manifestation, tongue coating and pulse manifestation were scored by grade. Treatment was continued for 5 days and data were statistically analysed with SAS 6. 12 soft ware. Cure was identified by the ≥90% decrease of total score of all the symptoms(TS) , significant effectiveness 70% ~ 89% ,effectiveness 30% ~69% and ineffectiveness ≤29% . Routine examinations of blood, urine and stool, function of liver and kidney and electrocardiogram were conducted before and after treatment. Adverse events(AE) were observed. Results; Per protocol set (PPS) included 309 in SBT group and 101 in CBDT. The demographic data and all the scores before treatment were not statistically different between groups (P>0.05). 3 and 5 days after treatment the TS, MAS and MIS scores were decreased(P = 0.000) in both groups, in SBT group decreased more than in CBDT ( P < 0. 000 1). The ratios ( % ) of cure and significant effectiveness in SBT group were 45.6 and 42.4, in CBDT group 8.9 and 33.7, respectively(P< 0.000 I). The lab examinations showed no abnormal findings with clinical significance, drug- related AE were observed in 9 cases in SBT group and 7 in CBDT group (P = 0.084 8). Conclusion: Shixinyatong buccal tablet is effective and safe

  16. Buccal health in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nora Sexto Delgado

    2003-04-01

    Full Text Available Background: Buccal health as integral and determinant part of general health makes us find different ways and methods to elevate life quality in the population. Objective: To establish the risk of suffering from dental cavities in asthmatic patients. Methods: A non match case and control study constituted by 100 children selected at simple random from the universe of asthmatic patients belonging to the General Comprehensive doctor offices number 7,9,10, 11, 43, and 44 from Area II in Cienfuegos municipality. The controlled group was selected in the same offices but from the universe of non asthmatic children. The age in both groups was from 6 to 15 years old. Visits to the children´s home were carried out for the record of the information through health oral dental and buccal health knowledge surveys. Results: The index of cavities, lost, and obturated permanent teeth was higher (3, 28 than in the control group (0, 44. The buccal hygiene indexes and the level of knowledge in both groups did not show significant differences. The most used drugs in asthma therapy were salbutamol and ketotifeno which change the buccal milieu. The odds ratio technique between asthmatic and non asthmatic patients showed 4, 9 times more at risk of suffering from dental cavities in the first group. Finally, it can be stated that the asthmatic patients are more at risk of suffering from cavities than the non asthmatic ones, so a program for buccal health in these patients should be performed.

  17. [Tablet splitting].

    Science.gov (United States)

    Quinzler, R; Haefeli, W E

    2006-06-01

    The splitting of scored tablets provides many advantages. One benefit is to achieve dose flexibility to account for the huge interindividual differences in dose requirements for instance in paediatric and geriatric patients, which are often not covered by the available strengths in the market. Moreover, large-sized tablets can easier be swallowed if broken before swallowing and medication costs can often be reduced by splitting brands with higher strength. But not all tablets, mostly unscored tablets, are suitable for splitting. Splitting of extended release formulations can result in an overdose by uncontrolled release of the active component and degradation of the compound can occur if an enteric coating is destroyed by the splitting process. Whether tablets are suitable for splitting depends on the properties of the active component (e.g. light sensitivity), the galenics, the shape of the tablet, and the shape of the scoreline. Moreover, not all patients are informed, able, or willing to split tablets and the majority of the elderly population is not capable to break tablets. When split tablets are prescribed it is therefore important to view the shape of the tablet, to assess the patients ability and willingness to break tablets, to properly inform the patient about the appropriate way of splitting, and if necessary to suggest (and instruct) the use of a tablet splitting device.

  18. Buccal and sublingual vaccine delivery.

    Science.gov (United States)

    Kraan, Heleen; Vrieling, Hilde; Czerkinsky, Cecil; Jiskoot, Wim; Kersten, Gideon; Amorij, Jean-Pierre

    2014-09-28

    Because of their large surface area and immunological competence, mucosal tissues are attractive administration and target sites for vaccination. An important characteristic of mucosal vaccination is its ability to elicit local immune responses, which act against infection at the site of pathogen entry. However, mucosal surfaces are endowed with potent and sophisticated tolerance mechanisms to prevent the immune system from overreacting to the many environmental antigens. Hence, mucosal vaccination may suppress the immune system instead of induce a protective immune response. Therefore, mucosal adjuvants and/or special antigen delivery systems as well as appropriate dosage forms are required in order to develop potent mucosal vaccines. Whereas oral, nasal and pulmonary vaccine delivery strategies have been described extensively, the sublingual and buccal routes have received considerably less attention. In this review, the characteristics of and approaches for sublingual and buccal vaccine delivery are described and compared with other mucosal vaccine delivery sites. We discuss recent progress and highlight promising developments in the search for vaccine formulations, including adjuvants and suitable dosage forms, which are likely critical for designing a successful sublingual or buccal vaccine. Finally, we outline the challenges, hurdles to overcome and formulation issues relevant for sublingual or buccal vaccine delivery.

  19. Transdermal fentanyl in cachectic cancer patients.

    Science.gov (United States)

    Heiskanen, Tarja; Mätzke, Sorjo; Haakana, Soile; Gergov, Merja; Vuori, Erkki; Kalso, Eija

    2009-07-01

    Fentanyl is an opioid with high lipid solubility, suitable for intravenous, spinal, transmucosal and transdermal administration. The transdermal fentanyl patch has become widely used in the treatment of both malignant and non-malignant chronic pain. The absorption of fentanyl from the patch is governed by the surface area of the patch, by skin permeability and by local blood flow. The aim of this study is to find out whether absorption of fentanyl in cachectic patients with cancer-related pain is different from that of normal weight cancer patients. We recruited ten normal weight (mean body mass index (BMI) 23 kg/m(2)) and ten cachectic (mean BMI 16 kg/m(2)) cancer pain patients. A transdermal fentanyl patch with a dose approximately equianalgesic to the patients' previous opioid dose was administered to the upper arm of the patient for 3 days. Prior to patch application, the height, weight and BMI of the patient, as well as upper arm skin temperature, local sweating, thickness of skin fold and local blood flow were measured. Plasma fentanyl concentrations were analyzed from blood samples taken at baseline, 4, 24, 48 and 72 h. Plasma fentanyl concentrations adjusted to dose were significantly lower at 48 and 72 h in cachectic patients than normal weight patients. The cachectic patients had a significantly thinner upper arm skin fold, but no differences were found in local blood flow, sweating, or skin temperature. Absorption of transdermal fentanyl is impaired in cachectic patients compared with that of normal weight cancer pain patients.

  20. Pharmacokinetics of subcutaneous fentanyl in Greyhounds.

    Science.gov (United States)

    KuKanich, Butch

    2011-11-01

    The purpose of the study was to describe the pharmacokinetics of subcutaneous fentanyl (15μg/kg) in six healthy Greyhound dogs. Fentanyl plasma concentrations were determined by a liquid chromatography with mass spectrometry method. Non-compartmental pharmacokinetic analysis was used. Fentanyl was rapidly absorbed with a mean peak concentration (C(MAX)) of 3.56ng/mL at 0.24h. The mean terminal half-life, volume of distribution per bioavailability, and clearance per bioavailability were 2.97h, 7.09L/kg, 27.60mL/min/kg, respectively. Pain occurred on injection in all six dogs, but addition of 8.4% sodium bicarbonate (1mL per 20mL fentanyl) resulted in no pain on injection in 3/3 dogs but similar C(MAX) values. The subcutaneous route may be an alternative route of fentanyl administration if intravenous administration is not practical.

  1. 21 CFR 522.800 - Droperidol and fentanyl citrate injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Droperidol and fentanyl citrate injection. 522.800... § 522.800 Droperidol and fentanyl citrate injection. (a) Specifications. Droperidol and fentanyl citrate injection is a sterile solution containing 20 milligrams of droperidol and 0.4 milligram of fentanyl...

  2. Design and evaluation of mucoadhesive buccal drug delivery systems containing metoprolol tartrate

    Directory of Open Access Journals (Sweden)

    Ramana M

    2007-01-01

    Full Text Available Mucoadhesive buccal tablets of metoprolol tartarate were fabricated with objective of avoiding first pass metabolism and prolonging duration of action. The mucoadhesive polymers used in formulation were Carbopol-934, hydroxypropylmethylcellulose, hydroxyethylcellulose and sodium carboxymethylcellulose. The formulations were characterized for physiochemical parameters, in vitro release studies and in vivo placebo studies. The best mucoadhesive performance and in vitro drug release profile were exhibited by the tablets containing hydroxyethylcellulose and Carbopol-934 in ratio 1:2. This product was more comfortable to the user due to absence of erosion, faster hydration rate and less viscosity of surrounding environment. In vivo placebo studies did not show any side effects.

  3. Efficacy and Safety of Oral or Nasal Fentanyl for Treatment of Breakthrough Pain in Cancer Patients: A Systematic Review.

    Science.gov (United States)

    Rogríguez, Dulce; Urrutia, Gerard; Escobar, Yolanda; Moya, Jordi; Murillo, Maite

    2015-09-01

    Formulations of fentanyl that use buccal, sublingual, or nasal transmucosal routes of administration have been developed for the treatment of BTP in opioid-tolerant patients with cancer. The purposes of this analysis were to identify and review published data describing the efficacy and safety of different oral or nasal transmucosal fentanyl formulations for treatment of cancer-related BTP, based on a critical analysis of scientific literature. Oral transmucosal or intranasal fentanyl is an effective treatment for management of BTP episodes due to a potent analgesic effect, rapid onset of action, and sustained effect. Furthermore, it is a reasonably safe treatment, causing generally mild adverse events not leading to treatment discontinuation. Nevertheless, further progress in standardizing methodology, definitions, and criteria used both in research and in clinical practice is needed in order to generate quality information allowing a better understanding of the comparable efficacy of available formulations of fentanyl. A more rigorous assessment of long-term safety is also needed to establish a balance between benefits and risks of the available options.

  4. Use of buccal mucosa in hypospadias repair.

    Science.gov (United States)

    Cruz-Diaz, Omar; Castellan, Miguel; Gosalbez, Rafael

    2013-08-01

    Hypospadias is an embryological disorder that results in an abnormal ventral positioning of the urethral meatus. Among multiple surgical techniques described to correct this anomaly, the use of buccal mucosa grafts has gained popularity among pediatric urologists, pediatric surgeons and plastic surgeons. Buccal mucosa grafts have shown favorable histological changes that result in an excellent scaffold for urethral reconstructive surgery. This review describes the evolution of the use of buccal mucosa grafts in hypospadias repair.

  5. Fentanyl

    Science.gov (United States)

    ... that do not exist); breathing problems such as asthma and chronic obstructive pulmonary disease (COPD; a group of lung diseases that includes chronic bronchitis and emphysema); or kidney or liver disease.tell your doctor ...

  6. Fentanyl

    Science.gov (United States)

    ... Anabolic) Synthetic Cannabinoids (K2/Spice) Synthetic Cathinones (Bath Salts) Tobacco/Nicotine Other Drugs Related Topics Addiction Science Adolescent Brain Comorbidity College-Age & Young Adults ...

  7. Tablet Weaving

    Science.gov (United States)

    Kren, Margo

    1976-01-01

    Article described a weaving technique called tablet weaving, an ancient textile process that provides opportunity for making a variety of items, such as guitar straps, belts, and decorative bands. (Author/RK)

  8. Buccal alterations in diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Negrato Carlos

    2010-01-01

    Full Text Available Abstract Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a increased concentration of mucin and glucose; b impaired production and/or action of many antimicrobial factors; c absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d bad taste; e oral candidiasis f increased cells exfoliation after contact, because of poor lubrication; g increased proliferation of pathogenic microorganisms; h coated tongue; i halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a tongue alterations, generally a burning mouth; b periodontal disease; c white spots due to demineralization in the teeth; d caries; e delayed healing of wounds; f greater tendency to infections; g lichen planus; h mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present.

  9. Preparation of Mucoadhesive Patches for Buccal Administration of ...

    African Journals Online (AJOL)

    Erah

    The development of bioadhesive buccal formulation for metoprolol ... a generation of many macromolecular drugs ... buccal drug delivery system should be ..... first order. Fig 2: Drug release profile of metoprolol succinate buccal patches made ...

  10. Synthetic Fentanyl Fueling Surge in Overdose Deaths: CDC

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160618.html Synthetic Fentanyl Fueling Surge in Overdose Deaths: CDC U.S. Surgeon ... News) -- Deaths from overdoses of the synthetic narcotic fentanyl have surged in recent years, U.S. health officials ...

  11. Fentanyl-Laced 'Norco' Is Lethal, Report Warns

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_160158.html Fentanyl-Laced 'Norco' Is Lethal, Report Warns New street ... study involving the drug. The street drug combines fentanyl -- the synthetic opioid painkiller linked to the death ...

  12. Particle size reduction to the nanometer range: a promising approach to improve buccal absorption of poorly water-soluble drugs

    Directory of Open Access Journals (Sweden)

    Rao S

    2011-06-01

    Full Text Available Shasha Rao, Yunmei Song, Frank Peddie, Allan M EvansSansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, South Australia, AustraliaAbstract: Poorly water-soluble drugs, such as phenylephrine, offer challenging problems for buccal drug delivery. In order to overcome these problems, particle size reduction (to the nanometer range and cyclodextrin complexation were investigated for permeability enhancement. The apparent solubility in water and the buccal permeation of the original phenylephrine coarse powder, a phenylephrine–cyclodextrin complex and phenylephrine nanosuspensions were ­characterized. The particle size and particle surface properties of phenylephrine nanosuspensions were used to optimize the size reduction process. The optimized phenylephrine nanosuspension was then freeze dried and incorporated into a multi-layered buccal patch, consisting of a small tablet adhered to a mucoadhesive film, yielding a phenylephrine buccal product with good dosage accuracy and improved mucosal permeability. The design of the buccal patch allows for drug incorporation without the need to change the mucoadhesive component, and is potentially suited to a range of poorly water-soluble compounds.Keywords: buccal drug delivery, nanosuspension, solubility, permeation enhancement, mucoadhesion

  13. Osteolipoma of the buccal mucosa.

    Science.gov (United States)

    de Castro, Alvimar-Lima; de Castro, Eni-Vaz-Franco-Lima; Felipini, Renata-Callestini; Ribeiro, Ana-Carolina-Prado; Soubhia, Ana-Maria-Pires

    2010-03-01

    Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among several described histological variants of lipomas, which are identified according to the predominant type of tissue. There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oral osteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis and overtreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient. This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis.

  14. Anaphylaxis related to fentanyl citrate

    Directory of Open Access Journals (Sweden)

    Gaurav Singh Tomar

    2012-01-01

    Full Text Available Anaphylaxis is a fulminant, unexpected, immunoglobulin E-mediated allergic reaction that can be triggered by multiple agents. Common causative agents include neuromuscular blocking drugs, latex, antibiotics, colloids, hypnotics, and opioids. Fentanyl citrate, however, is an extremely unusual cause of anaphylaxis. Pulmonary edema, although uncommon in anaphylaxis, can be a prominent feature, as was in one of the patient. An adverse drug reaction is a noxious or unintended reaction to a drug that is administered in standard doses by the proper route for the purpose of prophylaxis, diagnosis, or treatment. Reactions are classified into two major subtypes: type A, which are dose dependent and predictable; and type B, which are not dose dependent and unpredictable. Unpredictable reactions include immune (allergic or no immune drug hypersensitivity reactions and are related to genetic susceptibilities or undefined mechanisms (formally called idiosyncratic and intolerance reactions. A drug allergy is always associated with an immune mechanism for which evidence of drug-specific antibodies or activated T lymphocytes can be shown. In the last few years, many novel drugs have entered clinical practice (i.e., biologic agents generating novel patterns of drug hypersensitivity reactions. As old drugs continue to be used, new clinical and biologic techniques enable improvement in the diagnosis of these reactions.

  15. Seizure-like activity during fentanyl anesthesia. A case report.

    OpenAIRE

    Webb, M. D.

    1990-01-01

    Fentanyl induced seizures have been described previously in the literature. Clinical observations has labeled the movements seen in fentanyl anesthesia as seizure activity but electroencephalographic studies have not supported this. A case of seizure-like activity after the administration of fentanyl in a 20-year-old female is reported.

  16. Characterizing fentanyl use in methadone-maintained clients.

    Science.gov (United States)

    Arfken, Cynthia L; Suchanek, Jessica; Greenwald, Mark K

    2017-04-01

    Deaths attributed to fentanyl have increased in the United States. However, little is known about fentanyl use among substance abuse treatment clients. To fill this gap, we assessed prevalence of fentanyl exposure, characteristics of clients testing positive for fentanyl, other substances detected concurrently or simultaneously with fentanyl, and clients' perception of how many people are actively seeking to use fentanyl. A retrospective chart review was conducted of all clients at one methadone maintenance treatment clinic between January 2015 and May 2016 in Wayne County, Michigan. Urine drug screens (UDS) including fentanyl (and its metabolite norfentanyl) were conducted clinically. To obtain additional data, 113 clients in this clinic subsequently completed an anonymous survey. Of 368 unique clients with UDS, 38.0% had at least one and 26.1% had ≥2 fentanyl-positive UDS results. None had a fentanyl prescription. Clients ever testing positive for fentanyl were significantly (p<0.05) more likely to use cocaine, have multiple treatment admissions to the clinic, and leave treatment sooner. Fentanyl-positive UDS results coincided most commonly with metabolites of cocaine- and heroin-positive UDS results. Of the anonymously surveyed clients, most (67.3%) reported they did not know anyone seeking fentanyl, a proportion significantly higher than for heroin, cocaine, alprazolam, hydrocodone and morphine. Fentanyl was commonly detected during this period with some clients having multiple fentanyl-positive UDS. Most clients did not know anyone seeking to obtain fentanyl. Regardless, the high exposure underscores that naloxone training and distribution is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Azithromycin buccal patch in treatment of chronic periodontitis

    Science.gov (United States)

    Latif, Sajith Abdul; Vandana, K. L.; Thimmashetty, J.; Dalvi, Priyanka Jairaj

    2016-01-01

    Aim: This study aims to explore the clinical, microbiological, and biochemical impact of azithromycin (AZM) buccal patch in chronic generalized patients as a monotherapy as well as an adjunct to nonsurgical therapy. Materials and Methods: A parallel design was used forty periodontitis patients were randomly allocated into five groups, namely Group 1 scaling root planing (SRP) alone, Group 2 (SRP + AZM patch group), Group 3 (SRP + AZM tablet group), Group 4 (AZM patch monotherapy), and Group 5 (AZM tablet as monotherapy). Plaque index, gingival bleeding index, modified gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and 21 and 90 days. Subgingival pooled plaque sample was collected to assess periodontopathogens like Porphyromonas gingivalis and Prevotella intermedia (Pi) by anaerobic culture method. Tumor necrosis factor alpha (TNF-α) was also evaluated at baseline and 21 days. Periodontal maintenance was performed in Group 1 until 90th day, and clinical parameter was assessed at the end of 90th day. Results: SRP + AZM tablets showed greater reduction in clinical parameters (P < 0.05) AZM as monotherapy did not offer clinical benefits over SRP. Baseline data were compared at the end, i.e., 90th day a significant reduction in plaque scores, gingival bleeding, and PPD was observed however no significant gain in the clinical attachment was observed. Conclusion: The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients. PMID:27127325

  18. LONG-TERM SAFETY AND TOLERABILITY OF FENTANYL CITRATE NASAL SPRAY IN THE TREATMENT OF BREAK THROUGH CANCER PAIN (BTCP IN SUBJECTS TAKING REGULAR OPIOID THERAPY

    Directory of Open Access Journals (Sweden)

    Palanisamy P

    2012-02-01

    Full Text Available An ideal patient-controlled analgesic (PCA opioid would have rapid onset and longer duration of action when compared to the currently existing opioids including morphine. The purpose of this study was to verify the efficacy and safety in cancer patients experiencing breakthrough cancer pain. Selected patients with Break through Cancer Pain (BTCP episodes received the fentanyl citrate nasal spray. Pain relief score, pain intensity score and BTCP episodes per day were assessed directly by questionnaires, recorded data and analyzed statistically. Demographic and medical data were showed that only 18.5% of patients suffered from headache, 25.9% of patients suffered from dizziness, 25.9% of patients suffered from nausea and 33.3% of patients suffered from constipation. Fentanyl citrate nasal spray showed quick onset of action within 5 minutes. Fentanyl citrate nasal spray and morphine sulphate tablets were comparable in controlling BTCP episodes. However, fentanyl nasal spray was rated better than morphine sulphate tablets for its quick onset of action and ease of care by patients and nurses.

  19. Fentanyl-induced hyperalgesia in acute pain management.

    Science.gov (United States)

    Lyons, Pamela J; Rivosecchi, Ryan M; Nery, Jose P; Kane-Gill, Sandra L

    2015-06-01

    There are safety concerns with the use of fentanyl, including respiratory depression, nausea, constipation, and possibly opioid-induced hyperalgesia (OIH). The purpose of this review is to evaluate the occurrence and significance of opioid-induced hyperalgesia (OIH) after acute fentanyl exposure. A literature search was conducted from October 1995 through January 2015 using MEDLINE, Embase, and Scopus with the terms hyperalgesia, fentanyl, pronociceptive, acute tolerance, and acute. Published articles evaluating the adverse effects of fentanyl during acute pain management (≤96 hours) in humans were included. Opioid-induced hyperalgesia is a phenomenon defined by increasing pain after opioid exposure with the worsening of pain occurring when opioid doses are increased. Hyperalgesia has been described following remifentanil and morphine use, but the question remains about the associated risk with acute fentanyl exposure. Six randomized, controlled trials evaluating the effect of fentanyl on pain in the acute setting have been conducted. Two trials oppose whereas four trials support the occurrence of fentanyl-induced hyperalgesia. The data on OIH after acute fentanyl exposure are limited and conflicting. Hyperalgesia should be considered in patients with uncontrolled pain despite escalating fentanyl doses, since the possibility of fentanyl-induced OIH exists in the acute setting. Well-designed trials are needed to determine the clinical significance of this phenomenon.

  20. Development and evaluation of buccoadhesive tablet for selegiline hydrochloride based on thiolated polycarbophil.

    Science.gov (United States)

    Wasnik, Mangesh N; Godse, Rutika D; Nair, Hema A

    2014-05-01

    Selegiline hydrochloride (SHCl), a monoamine oxidase B inhibitor, is used as an adjunct in the therapy of Parkinson's disease. This study is concerned with the preparation and evaluation of mucoadhesive buccal tablet for controlled systemic delivery of SHCl. Buccal absorption of selegiline can bypass its first-pass metabolism and improve bioavailability accompanied by greatly reduced metabolite formation, which is potentially of enhanced therapeutic value in patients with Parkinson's disease. Polycarbophil-cysteine (PCP-cys) conjugate, which is a thiolated derivative of the mucoadhesive polymer polycarbophil, was synthesized by 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride-mediated amide bond coupling. Tablets of SHCl based on native and thiolated polycarbophil were prepared. The prepared tablets were evaluated for drug content, swelling behavior, mucoadhesive strength, in vitro drug release, ex vivo permeation and in vitro cytotoxicity. PCP-cys tablets showed enhanced mucoadhesion and retarded drug release compared to polycarbophil tablets. Permeation data of SHCl from matrices prepared using the PCP-cys polymer revealed a significantly higher value of apparent permeability in comparison to polycarbophil, which supported the information in literature that thiolation imparts permeation enhancing properties to mucoadhesive polymers. In vitro cytotoxicity studies on PCP-cys using L-929 mouse fibroblast cell line indicated that conjugation with cysteine does not impart any apparent toxicity to polycarbophil. The results from the study indicate that the buccal delivery of SHCl using thiolated polycarbophil tablet could provide a way for improved therapy of Parkinson's disease.

  1. Development and evaluation of novel trans-buccoadhesive bilayer tablets of Famotidine

    Directory of Open Access Journals (Sweden)

    M Alagusundaram

    2011-01-01

    Full Text Available The present investigation highlights the novel trans-buccoadhesive tablets of Famotidine, an H2-receptor antagonist used as an antiulcerative agent. The buccoadhesive tablets were prepared by direct compression method using bioadhesive polymers like sodium alginate, SCMC, HPMC-K100M, PVP-K30 either alone or in combinations with EC as a backing layer. The prepared formulations were evaluated for their physicochemical characteristics, swelling index, surface pH, ex vivo buccoadhesive strength, in vitro, in vivo drug release and ex vivo permeation studies. The distinguishable differences in the results were shown to be dependent on characteristics and composition of bioadhesive materials used. Stability studies were performed in natural human saliva and accelerated conditions showed no significant difference in physical appearance, drug content, buccoadhesive strength and the P-value statistically significant at <0.05. Ex vivo mucous irritation by histological examination reveals, the administration site of buccal tablet over the buccal mucosa did not cause any irritation, ulceration, inflammation and redness, and it resembles to controlled buccal mucosa. Good correlations were observed between in vitro and in vivo drug release, with a correlation coefficient of 0.996. Drug diffusion from buccal tablets showed apparently zero order kinetics and release mechanism was diffusion controlled after considerable swelling.

  2. Development and characterization of chitosan-polycarbophil interpolyelectrolyte complex-based 5-fluorouracil formulations for buccal, vaginal and rectal application

    Directory of Open Access Journals (Sweden)

    Pendekal Mohamed S

    2012-10-01

    Full Text Available Abstract Background of the study The present investigation was designed with the intention to formulate versatile 5-fluorouracil (5-FU matrix tablet that fulfills the therapeutic needs that are lacking in current cancer treatment and aimed at minimizing toxic effect, enhancing efficacy and increasing patient compliance. The manuscript presents the critical issues of 5-FU associate with cancer and surpasses issues by engineering novel 5-FU matrix tablets utilizing chitosan- polycarbophil interpolyelectrolyte complex (IPEC. Methods Precipitation method is employed for preparation of chitosan and polycarbophil interpolyelectrolyte complex (IPEC followed by characterization with Fourier transform infrared spectroscopy (FT-IR, Differential Scanning calorimeter (DSC and X-ray Diffraction (XRD. 5-FU tablets were prepared by direct compression using IPEC. Six formulations were prepared with IPEC alone and in combination with chitosan, polycarbophil and Sodium deoxycholate. The formulations were tested for drug content, hardness, friability, weight variation, thickness, swelling studies, in vitro drug release (buccal, vaginal and rectal pH, ex vivo permeation studies, mucoadhesive strength and in vivo studies. Results FT-IR studies represent the change in spectra for the IPEC than single polymers.DSC study represents the different thermo gram for chitosan, polycarbophil and IPEC whereas in X-ray diffraction, crystal size alteration was observed. Formulations containing IPEC showed pH independent controlled 5-FU without an initial burst release effect in buccal, vaginal and rectal pH. Furthermore, F4 formulations showed controlled release 5-FU with highest bioadhesive property and satisfactory residence in both buccal and vaginal cavity of rabbit. 3% of SDC in formulation F6 exhibited maximum permeation of 5-FU. Conclusion The suitable combination of IPEC, chitosan and polycarbophil demonstrated potential candidate for controlled release of 5-FU in buccal

  3. Development and Characterization of Chitosan-Polycarbophil Interpolyelectrolyte Complex-Based 5-Flurouracil Formulations for Buccal, Vaginal and Rectal Application

    Directory of Open Access Journals (Sweden)

    Mohamed S Pendekal

    2012-10-01

    Full Text Available Background of the study:The present investigation was designed with the intention to formulate versatile 5-flurouracil(5-FU matrix tablet that fulfills the therapeutic needs that are lacking in current cancer treatment and aimed at minimizing toxic effect, enhancing efficacy and increasing patient compliance. The manuscript presents the critical issues of 5-FU associate with cancer andsurpasses issues by engineering novel 5-FU matrix tablets utilizing chitosan- polycarbophil interpolyelectrolyte complex (IPECMethods:Precipitation method is employed for preparation of chitosan and polycarbophil interpolyelectrolyte complex (IPEC followed by characterization with Fourier transform infrared spectroscopy (FT-IR, Differential Scanning calorimeter (DSC and X-ray Diffraction (XRD. 5-FU tablets were prepared by direct compression using IPEC. Six formulations were prepared with IPEC alone and in combination with chitosan, polycarbophil and Sodium deoxycholate. The formulations were tested for drug content, hardness, friability,weight variation, thickness, swelling studies, in vitro drug release (buccal, vaginal and rectal pH, ex vivo permeation studies, mucoadhesive strength and in vivo studies.Results:FT-IR studies represent the change in spectra for the IPEC than single polymers.DSC study represents the different thermo gram for chitosan, polycarbophil and IPEC whereas in X-ray diffraction, crystal size alteration was observed. Formulations containing IPEC showed pH independent controlled 5-FU without an initial burst release effect in buccal, vaginal and rectal pH. Furthermore, F4 formulations showed controlled release 5-FU with highest bioadhesive property and satisfactory residence in both buccal and vaginal cavity of rabbit.3% of SDC in formulation F6 exhibited maximum permeation of 5-FU.Conclusion:The suitable combination of IPEC, chitosan and polycarbophil demonstrated potential candidate for controlled release of 5-FU in buccal, vaginal and

  4. Cerrobend shielding stents for buccal carcinoma patients

    Directory of Open Access Journals (Sweden)

    Karma Yangchen

    2016-01-01

    Full Text Available Buccal carcinoma is one of the most common oral malignant neoplasms, especially in the South Asian region. Radiotherapy, which plays a significant role in the treatment of this carcinoma, has severe adverse effects. Different types of prosthesis may be constructed to protect healthy tissues from the adverse effects of treatment and concentrate radiation in the region of the tumor mass. However, the technique for fabrication of shielding stent with Lipowitz's alloy (cerrobend/Wood's alloy has not been well documented. This article describes detailed technique for fabrication of such a stent for unilateral buccal carcinoma patients to spare the unaffected oral cavity from potential harmful effects associated with radiotherapy.

  5. Fentanyl Iontophoretic Transdermal System: A Review in Acute Postoperative Pain.

    Science.gov (United States)

    Scott, Lesley J

    2016-04-01

    Fentanyl iontophoretic transdermal system (ITS) [Ionsys(®)] is indicated for the management of acute postoperative pain in adults requiring opioid analgesia in the hospital setting. This article reviews the clinical use of fentanyl ITS for postoperative pain management, and summarizes the pharmacology of fentanyl and the characteristics of the two-component fentanyl ITS (Ionsys(®)) device. In well-designed, multicentre clinical trials, fentanyl ITS was an effective and generally well tolerated method for managing acute postoperative pain in inpatients who had undergone major abdominal, thoracic or orthopaedic surgery. Overall, fentanyl ITS provided equivalent analgesic efficacy to that with morphine patient-controlled intravenous analgesia (PCIA), but was perceived to be more convenient/easier to use than morphine PCIA by patients, nurses and physical therapists. Patients receiving fentanyl ITS also had a greater ability to mobilize after surgery than patients receiving morphine PCIA. In addition, relative to morphine PCIA, fentanyl ITS offers advantages in terms of the noninvasive administrative route (i.e. transdermal needle-free administration), pre-programmed delivery (no risk of programming errors/incorrect dosing) and improved tolerability with regard to the overall incidence of opioid-related adverse events (ORAEs) and some individual ORAEs. Hence, fentanyl ITS is a useful option for the management of acute postoperative pain in adults requiring opioid analgesia in the hospital setting.

  6. Fentanyl Synthetic Methodology: A Comparative Study

    Science.gov (United States)

    1992-03-01

    aluminum hydride (LiAIH 4 ) reduction of the intermediate Schiff base , 3, in ether gave compound 4. Subsequent acylation with propionyl anhydride in toluene... Schiff base , 13 gave a 65% of the product. Method D. 15 This method utilizes the commercially available 1-benzoyl-4-piperidone (15) (1 g/$15.00, Aldrich...as the starting material and the catalytic hydrogenation to reduce the Schiff base , 16. Acid hydrolysis of 17, followed by alkylation, gives fentanyl

  7. Formulation and evaluation of buccoadhesive tablets of clotrimazole

    Directory of Open Access Journals (Sweden)

    Reza Tahvilian

    2010-01-01

    Full Text Available The buccoadhesive tablet is one of delivery systems that can be used for different drugs in order to improve the efficacy of drugs in patients. Hydrophilic polymers are using to prepare these types of tablets with appropriate adhesion and stability in order to deliver the drug for a period of time and also in a specific place in month. The purpose of the study was to formulate and evaluate mucoadhesive buccal tablets of clotrimazole. The tablets were evaluated for weight variation, hardness, friability, disintegration, content uniformity, surface pH, mucoadhesive strength, swelling index and in vitro drug release.Increasing hydroxypropylmethylcellulose (HPMC concentration resulted in decreasing the swelling index and increasing surface pH. The surface pH of all tablets was found to be satisfactory, close to neutral pH; hence, no irritation would observe with these tablets. The maximum bioadhesive strength was observed in tablets formulated with high content of HPMC. Lower release rates were observed by increasing the content of HPMC in the formulation The in vitro release results demonstrated that drug is released by non-Fickian diffusion mechanism with zero-order kinetics.

  8. Buccal Transmucosal Delivery System of Enalapril for Improved ...

    African Journals Online (AJOL)

    Methods: Transmucosal drug delivery systems of enalapril maleate were formulated as buccal films by solvent casting .... Table1: Composition of transmucosal buccal films of enalapril maleate ... was fixed to the central shaft using an adhesive.

  9. Tablet Use within Medicine

    Science.gov (United States)

    Hogue, Rebecca J.

    2013-01-01

    This paper discusses the scholarly literature related to tablet computer use in medicine. Forty-four research-based articles were examined for emerging categories and themes. The most studied uses for tablet computers include: patients using tablets to complete diagnostic survey instruments, medical professionals using tablet computers to view…

  10. Development of polymer-bound fast-dissolving metformin buccal film with disintegrants

    Science.gov (United States)

    Haque, Shaikh Ershadul; Sheela, Angappan

    2015-01-01

    Fast-dissolving drug-delivery systems are considered advantageous over the existing conventional oral dosage forms like tablets, capsules, and syrups for being patient friendly. Buccal films are one such system responsible for systemic drug delivery at the desired site of action by avoiding hepatic first-pass metabolism. Metformin hydrochloride (Met), an antidiabetic drug, has poor bioavailability due to its high solubility and low permeability. The purpose of the study reported here was to develop a polymer-bound fast-dissolving buccal film of metformin to exploit these unique properties. In the study, metformin fast-dissolving films were prepared by the solvent-casting method using chitosan, a bioadhesive polymer. Further, starch, sodium starch glycolate, and microcrystalline cellulose were the disintegrants added to different ratios, forming various formulations (F1 to F7). The buccal films were evaluated for various parameters like weight variation, thickness, folding endurance, surface pH, content uniformity, tensile strength, and percentage of elongation. The films were also subjected to in vitro dissolution study, and the disintegration time was found to be less than 30 minutes for all formulations, which was attributed to the effect of disintegrants. Formulation F6 showed 92.2% drug release within 6 minutes due to the combined effect of sodium starch glycolate and microcrystalline cellulose. PMID:26491321

  11. Lubrication in tablet formulations.

    Science.gov (United States)

    Wang, Jennifer; Wen, Hong; Desai, Divyakant

    2010-05-01

    Theoretical aspects and practical considerations of lubrication in tablet compression are reviewed in this paper. Properties of the materials that are often used as lubricants, such as magnesium stearate, in tablet dosage form are summarized. The manufacturing process factors that may affect tablet lubrication are discussed. As important as the lubricants in tablet formulations are, their presence can cause some changes to the tablet physical and chemical properties. Furthermore, a detailed review is provided on the methodologies used to characterize lubrication process during tablet compression with relevant process analytical technologies. Finally, the Quality-by-Design considerations for tablet formulation and process development in terms of lubrication are discussed.

  12. NOOK tablet for dummies

    CERN Document Server

    Sandler, Corey

    2012-01-01

    The fun is just a tap away with the nifty NOOK Tablet! It's an e-reader, it's a tablet, and it's hot! The NOOK Tablet offers all the advantages of an Android-based tablet, and this small-trim book is packed with information about how to use it. Learn to set up your NOOK Tablet, navigate the touchscreen, download and read e-books, access the Internet, use all the cool Android apps that are included, and much more. Find out how to create your own e-books, share books with others, listen to music or watch streaming video on your NOOK Tablet, personalize your tablet, add accessories, and

  13. Formulation of unidirectional release buccal patches of carbamazepine and study of permeation through porcine buccal mucosa

    Directory of Open Access Journals (Sweden)

    Parthasarathy Govindasamy

    2013-12-01

    Conclusions: The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic delivery of carbamazepine.

  14. Clonidine versus fentanyl as adjuvants to bupivacaine in peribulbar anesthesia

    Directory of Open Access Journals (Sweden)

    Maha M.I. Youssef

    2014-07-01

    Conclusion: The addition of either clonidine or fentanyl to the local anesthetic during peribulbar block results in a faster onset and longer duration of the block with a longer period of postoperative analgesia. The addition of clonidine was found to prolong the duration of the block more than fentanyl.

  15. Assisted suicide by fentanyl intoxication due to excessive transdermal application.

    Science.gov (United States)

    Juebner, Martin; Fietzke, Mathias; Beike, Justus; Rothschild, Markus A; Bender, Katja

    2014-11-01

    Herein, we report a case of an assisted suicide committed by application of 34 matrix-based fentanyl-containing transdermal therapeutic systems (TTS) with different release rates. The TTS were supplied by the husband but administered by the deceased herself. Besides routine systematic toxicological analysis (STA), the concentrations of fentanyl and norfentanyl were determined in the blood (femoral and heart), urine, stomach content, brain, lung tissue, musculus iliopsoas, liver, kidney, bile and in some of the used TTS by LC-MS/MS. Blood levels of fentanyl were 60.6 μg/L in femoral blood and 94.1 μg/L in heart blood. These concentrations are in good concordance with levels described in cases with accidental or lethal suicidal fentanyl patch application. The organ distribution indicates an influence of post-mortem redistribution. The levels of residual fentanyl in the TTS were also determined. STA furthermore revealed supratherapeutic levels of bromazepam. Thus, the cause of death was a combination of fentanyl and bromazepam intoxication. However, considering the determined levels of fentanyl and norfentanyl in the entire set of specimens and the high toxicity in comparison to bromazepam, fentanyl was the leading toxic noxa.

  16. Clinical pharmacology of fentanyl in preterm infants. A review.

    Science.gov (United States)

    Pacifici, Gian Maria

    2015-06-01

    Fentanyl is a synthetic opioid that is very important in anesthetic practice because of its relatively short time to peak analgesic effect and the rapid termination of action after small bolus doses. The objective of this survey is to review the clinical pharmacology of fentanyl in preterm infants. The bibliographic search was performed using PubMed and EMBASE databases as search engines. In addition, the books Neofax: A manual of drugs used in neonatal care and Neonatal formulary were consulted. Fentanyl is N-dealkylated by CYP3A4 into the inactive norfentanyl. Fentanyl may be administered as bolus doses or as a continuous infusion. In neonates, there is a remarkable interindividual variability in the kinetic parameters. In neonates, fentanyl half-life ranges from 317 minutes to 1266 minutes and in adults it is 222 minutes. Respiratory depression occurs when fentanyl doses are >5 μg/kg. Chest wall rigidity may occur in neonates and occasionally is associated with laryngospasm. Tolerance to fentanyl may develop after prolonged use of this drug. Significant withdrawal symptoms have been reported in infants treated with continuous infusion for 5 days or longer. Fentanyl is an extremely potent analgesic and is the opioid analgesic most frequently used in the neonatal intensive care unit.

  17. Efficacy and safety of intravenous fentanyl administered by ambulance personnel

    DEFF Research Database (Denmark)

    Friesgaard, Kristian Dahl; Nikolajsen, Lone; Giebner, Matthias

    2016-01-01

    BACKGROUND: Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered...... by ambulance personnel. METHODS: Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival...... patients (1.3%) and hypotension observed in 71 patients (3.0%). CONCLUSION: Intravenous fentanyl caused clinically meaningful pain reduction in most patients and was safe in the hands of ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses...

  18. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue.

    Science.gov (United States)

    Al-Juboori, Mohammed Jasim

    2016-01-01

    Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

  19. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue

    Science.gov (United States)

    Al-Juboori, Mohammed Jasim

    2016-01-01

    Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist. PMID:27857817

  20. Formulation and Characterization of Cetylpyridinium Chloride Bioadhesive Tablets

    Directory of Open Access Journals (Sweden)

    Jafar Akbari

    2014-12-01

    Full Text Available Purpose: Bioadhesive polymers play an important role in biomedical and drug delivery applications. The aim of this study is to develop a sustained- release tablet for local application of Cetylpyridinium Chloride (CPC. This delivery system would supply the drug at an effective level for a long period of time, and thereby overcome the problem of the short retention time of CPC and could be used for buccal delivery as a topical anti-infective agent. Methods: CPC bioadhesive tablets were directly prepared using 7 mm flat-faced punches on a hydraulic press. The materials for each tablet were weighted, introduced into the die and compacted at constant compression pressure. The dissolution tests were performed to the rotation paddle method and the bioadhesive strength of the tablets were measured. Results: The results showed that as the concentration of polymer increased, the drug release rate was decreased. Also the type and ratio of polymers altered the release kinetic of Cetylpyridinium Chloride from investigated tablets. The bioadhesion strength increased with increasing the concentration of polymer and maximum bioadhesion strength was observed with HPMC K100M. Conclusion: The selected formulation of CPC bioadhesive tablet can be used as a suitable preparation for continuous release of CPC with appropriate bioadhesion strength.

  1. Formulation and Characterization of Cetylpyridinium Chloride Bioadhesive Tablets

    Science.gov (United States)

    Akbari, Jafar; Saeedi, Majid; Morteza-Semnani, Katayoun; Kelidari, Hamidreza; Lashkari, Maryam

    2014-01-01

    Purpose: Bioadhesive polymers play an important role in biomedical and drug delivery applications. The aim of this study is to develop a sustained- release tablet for local application of Cetylpyridinium Chloride (CPC). This delivery system would supply the drug at an effective level for a long period of time, and thereby overcome the problem of the short retention time of CPC and could be used for buccal delivery as a topical anti-infective agent. Methods: CPC bioadhesive tablets were directly prepared using 7 mm flat-faced punches on a hydraulic press. The materials for each tablet were weighted, introduced into the die and compacted at constant compression pressure. The dissolution tests were performed to the rotation paddle method and the bioadhesive strength of the tablets were measured. Results: The results showed that as the concentration of polymer increased, the drug release rate was decreased. Also the type and ratio of polymers altered the release kinetic of Cetylpyridinium Chloride from investigated tablets. The bioadhesion strength increased with increasing the concentration of polymer and maximum bioadhesion strength was observed with HPMC K100M. Conclusion: The selected formulation of CPC bioadhesive tablet can be used as a suitable preparation for continuous release of CPC with appropriate bioadhesion strength. PMID:25436196

  2. Mifepristone With Buccal Misoprostol for Medical Abortion

    OpenAIRE

    2015-01-01

    © 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved. Objective: To summarize clinical outcomes and adverse effects of medical abortion regimens consisting of mifepristone followed by buccal misoprostol in pregnancies through 70 days of gestation. Data Sources: We used PubMed, ClinicalTrials.gov, and reference lists from published reports to identify relevant studies published between November 2005 and January 2015 usi...

  3. In vivo human buccal permeability of nicotine

    DEFF Research Database (Denmark)

    Adrian, Charlotte L; Olin, Helle B D; Dalhoff, Kim

    2006-01-01

    The aim was to examine the in vivo buccal pH-dependent permeability of nicotine in humans and furthermore compare the in vivo permeability of nicotine to previous in vitro permeability data. The buccal permeability of nicotine was examined in a three-way cross-over study in eight healthy non......-smokers using a buccal perfusion cell. The disappearance of nicotine from perfusion solutions with pH 6.0, 7.4, and 8.1 was studied for 3h. The apparent permeability of nicotine (P(app)) was determined at each pH value. Parotid saliva was collected in an attempt to assess systemic levels of nicotine....... The disappearance rate of nicotine increased significantly as the pH increased, which resulted in P(app) values of 0.57+/-0.55 x 10(-4), 2.10+/-0.23 x 10(-4), and 3.96+/-0.54 x 10(-4)cms(-1) (mean+/-S.D.) at pH 6.0, 7.4, and 8.1, respectively. A linear relationship (R(2)=0.993) was obtained between the P...

  4. Efficacy and safety of intravenous fentanyl administered by ambulance personnel.

    Science.gov (United States)

    Friesgaard, K D; Nikolajsen, L; Giebner, M; Rasmussen, C-H; Riddervold, I S; Kirkegaard, H; Christensen, E F

    2016-04-01

    Management of pain in the pre-hospital setting is often inadequate. In 2011, ambulance personnel were authorized to administer intravenous fentanyl in the Central Denmark Region. The aim of this study was to evaluate the efficacy and safety of intravenous fentanyl administered by ambulance personnel. Pre-hospital medical charts from 2348 adults treated with intravenous fentanyl by ambulance personnel during a 6-month period were reviewed. The primary outcome was the change in pain intensity on a numeric rating scale (NRS) from before fentanyl treatment to hospital arrival. Secondary outcomes included the number of patients with reduction in pain intensity during transport (NRS ≥ 2), the number of patients with NRS > 3 at hospital arrival, and potential fentanyl-related side effects. Fentanyl reduced pain from before treatment (8, IQR 7-9) to hospital arrival (4, IQR 3-6) (NRS reduction: 3, IQR 2-5; P = 0.001), 79.3% of all patients had a reduction in > 2 on the NRS during transport, and 58.4% of patients experienced pain at hospital arrival (NRS > 3). Twenty-one patients (0.9%) had oxygen saturation ambulance personnel. Many patients had moderate to severe pain at hospital arrival. As the protocol allowed higher doses of fentanyl, feedback on effect and safety should be part of continuous education of ambulance personnel. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Electroosmotic flow as a result of buccal iontophoresis--buccal mucosa properties.

    Science.gov (United States)

    Moscicka-Studzinska, Aleksandra; Kijeńska, Ewa; Ciach, Tomasz

    2009-08-01

    The objective of this study was to investigate and to better understand the properties of buccal mucosa as a semipermeable membrane and a portal for drug administration by iontophoretic and electroosmotic means. In vitro experiments showed that buccal mucosa at the pH of about 7.4 behaved as a cation-exchange membrane and non-linear resistor. It had lower resistance and was more permeable for water than a skin. The electroosmotic volume flow through mucosa depended on current density, mucosa resistance and electrolyte concentration. Sodium dodecyl sulfate (in concentration range 0.001-0.005 mol L(-1)) and urea (in concentration range 0.42-1.67 mol L(-1)) did not promote a water transfer through buccal mucosa, however, both substances enhanced flow through the skin.

  6. Accuracy of tablet splitting.

    Science.gov (United States)

    McDevitt, J T; Gurst, A H; Chen, Y

    1998-01-01

    We attempted to determine the accuracy of manually splitting hydrochlorothiazide tablets. Ninety-four healthy volunteers each split ten 25-mg hydrochlorothiazide tablets, which were then weighed using an analytical balance. Demographics, grip and pinch strength, digit circumference, and tablet-splitting experience were documented. Subjects were also surveyed regarding their willingness to pay a premium for commercially available, lower-dose tablets. Of 1752 manually split tablet portions, 41.3% deviated from ideal weight by more than 10% and 12.4% deviated by more than 20%. Gender, age, education, and tablet-splitting experience were not predictive of variability. Most subjects (96.8%) stated a preference for commercially produced, lower-dose tablets, and 77.2% were willing to pay more for them. For drugs with steep dose-response curves or narrow therapeutic windows, the differences we recorded could be clinically relevant.

  7. Using support vector classification for SAR of fentanyl derivatives

    Institute of Scientific and Technical Information of China (English)

    Ning DONG; Wen-cong LU; Nian-yi CHEN; You-cheng ZHU; Kai-xian CHEN

    2005-01-01

    Aim: To discriminate between fentanyl derivatives with high and low activities.Methods: The support vector classification (SVC) method, a novel approach,was employed to investigate structure-activity relationship (SAR) of fentanyl derivatives based on the molecular descriptors, which were quantum parameters including △E [energy difference between highest occupied molecular orbital energy (HOMO) and lowest empty molecular orbital energy (LUMO)], MR(molecular refractivity) and Mr (molecular weight). Results: By using leave-oneout cross-validation test, the accuracies of prediction for activities of fentanyl derivatives in SVC, principal component analysis (PCA), artificial neural network (ANN) and K-nearest neighbor (KNN) models were 93%, 86%, 57%, and 71%, respectively. The results indicated that the performance of the SVC model was better than those of PCA, ANN, and KNN models for this data. Conclusion:SVC can be used to investigate SAR of fentanyl derivatives and could be a promising tool in the field of SAR research.

  8. Rationales behind the choice of administration form with fentanyl

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona

    2010-01-01

    BACKGROUND AND AIM: The aim of this study was to describe the rationale behind the choice of fentanyl administration forms among Danish general practitioners (GPs). METHODS: Thirty-eight Danish GPs were contacted via an Internet survey system to perform a Delphi survey. In the brainstorming phase...... in two rating rounds, respectively. The most important reason to choose fentanyl patches was that patients' clinical condition did not allow them to take analgesia orally. OTFCs were primarily seen as a self-administrative alternative to injections in case of breakthrough pain. The main reasons...... for not choosing OTFCs were intolerance to fentanyl and price. The most important possible rationale to choose fentanyl nasal spray was easy administration. The most important possible reasons to not choose fenanyl nasal spray were application side effects. CONCLUSIONS: The rationale behind the choice...

  9. Clinical pharmacokinetics of transdermal opioids: focus on transdermal fentanyl.

    Science.gov (United States)

    Grond, S; Radbruch, L; Lehmann, K A

    2000-01-01

    Transdermal delivery allows continuous systemic application of opioids through the intact skin. This review analyses the pharmacokinetic properties of transdermal opioid administration in the context of clinical experience, with a focus on fentanyl. A transdermal therapeutic system (TTS) for fentanyl has been developed. The amount of fentanyl released is proportional to the surface area of the TTS, which is available in different sizes. After the first application of a TTS, a fentanyl depot concentrates in the upper skin layers and it takes several hours until clinical effects are observed. The time from application to minimal effective and maximum serum concentrations is 1.2 to 40 hours and 12 to 48 hours, respectively. Steady state is reached on the third day, and can be maintained as long as patches are renewed. Within each 72-hour period, serum concentrations decrease gradually over the second and third days. When a TTS is removed, fentanyl continues to be absorbed into the systemic circulation from the cutaneous depot. The terminal half-life for TTS fentanyl is approximately 13 to 25 hours. The interindividual variability of serum concentrations, partly caused by different clearance rates, is markedly larger than the intraindividual variability. The effectiveness of TTS fentanyl was first demonstrated in acute postoperative pain. However, the slow pharmacokinetics and large variability of TTS fentanyl, together with the relatively short duration of postoperative pain, precluded adequate dose finding and led to inadequate pain relief or, especially, a high incidence of respiratory depression; such use is now contraindicated. Conversely, in cancer pain, TTS fentanyl offers an interesting alternative to oral morphine, and its effectiveness and tolerability in this indication has been demonstrated by a number of trials. Its usefulness in chronic pain of nonmalignant origin remains to be confirmed in controlled trials. In general, TTS fentanyl produces the same

  10. Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose.

    Science.gov (United States)

    Griswold, Matthew K; Chai, Peter R; Krotulski, Alex J; Friscia, Melissa; Chapman, Brittany; Boyer, Edward W; Logan, Barry K; Babu, Kavita M

    2017-07-06

    To compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose. This was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl. Participants also provided urine samples, which were analyzed using liquid chromatography coupled to quadrupole time-of-flight mass spectrometry to identify the presence of fentanyl, heroin metabolites, other clandestine opioids, common pharmaceuticals and drugs of abuse. Thirty participants were enrolled in the study period. Ten participants (33%) had never required naloxone for an overdose in the past, 20 participants (67%) reported recent abstinence, and 12 participants (40%) reported concomitant cocaine use. Naloxone was detected in all urine drug screens. Heroin or its metabolites were detected in almost all samples (93.3%), as were fentanyl (96.7%) and its metabolite, norfentanyl (93.3%). Acetylfentanyl was identified in nine samples (30%) while U-47700 was present in two samples (6.7%). Sixteen participants self-identified fentanyl in their heroin (sensitivity 55%); participants were inconsistent in their qualitative ability to identify fentanyl in heroin. Heroin users presenting to the ED after heroin overdose requiring naloxone are unable to accurately identify the presence of nonpharmaceutical fentanyl in heroin. Additionally, cutting edge drug testing methodologies identified fentanyl exposures in 96.7% of our patients, as well as unexpected clandestine opioids (like acetylfentanyl and U-47700).

  11. Neurotoxic effects of levobupivacaine and fentanyl on rat spinal cord

    Directory of Open Access Journals (Sweden)

    Yesim Cokay Abut

    2015-02-01

    Full Text Available BACKGROUND: The purpose of the study was to compare the neurotoxic effects of intrathecally administered levobupivacaine, fentanyl and their mixture on rat spinal cord. METHODS: In experiment, there were four groups with medication and a control group. Rats were injected 15 µL saline or fentanyl 0.0005 µg/15 µL, levobupivacaine 0.25%/15 µL and fentanyl 0.0005 µg + levobupivacaine 0.25%/15 µL intrathecally for four days. Hot plate test was performed to assess neurologic function after each injection at 5th, 30th and 60th min. Five days after last lumbal injection, spinal cord sections between the T5 and T6 vertebral levels were obtained for histologic analysis. A score based on subjective assessment of number of eosinophilic neurons - Red neuron - which means irreversible neuronal degeneration. They reflect the approximate number of degenerating neurons present in the affected neuroanatomic areas as follows: 1, none; 2, 1-20%; 3, 21-40%; 4, 41-60%; and 5, 61-100% dead neurons. An overall neuropathologic score was calculated for each rat by summating the pathologic scores for all spinal cord areas examined. RESULTS: In the results of HPT, comparing the control group, analgesic latency statistically prolonged for all four groups.In neuropathologic investment, the fentanyl and fentanyl + levobupivacaine groups have statistically significant high degenerative neuron counts than control and saline groups. CONCLUSIONS: These results suggest that, when administered intrathecally in rats, fentanyl and levobupivacaine behave similar for analgesic action, but fentanyl may be neurotoxic for spinal cord. There was no significant degeneration with levobupivacaine, but fentanyl group has had significant degeneration.

  12. Effect of fentanyl on awakening concentration of sevoflurane.

    Science.gov (United States)

    Katoh, T; Uchiyama, T; Ikeda, K

    1994-09-01

    This study was designed to determine if fentanyl altered MAC-awake (the end-tidal concentration of sevoflurane associated with eye opening to verbal command) in 30 healthy, ASA I patients. During anaesthesia, no other anaesthetics or drugs were given with the exception of sevoflurane. After surgery, end-tidal anaesthetic concentration was maintained constant for at least 15 min. If patients failed to respond to command, the end-tidal concentration was decreased and again maintained constant for 15 min. The anaesthetic concentration midway between the value permitting the response and that just preventing the response was recorded as MAC-awake. Fentanyl was administered at predicted plasma concentrations of 1 and 2 ng mg-1 using a computer-controlled continuous infusion and plasma concentrations of fentanyl were measured at the time of MAC-awake measurements. MAC-awake of the control group in which fentanyl was not administered was mean 0.67 (SD 0.12)% or 0.36 (0.03) MAC, being significantly higher than that of the fentanyl 2-ng ml-1 group (0.57 (0.09)% or 0.30 (0.04) MAC). In the fentanyl 1-ng ml-1 group, MAC-awake (0.65 (0.10)% or 0.34 (0.05) MAC) did not differ from that in the control group. Logistic regression analysis showed that increasing plasma concentration of fentanyl and increasing age significantly reduced the MAC-awake of sevoflurane. Because the reduction was very small relative to the overall scatter of the MAC-awake, a low plasma concentration of fentanyl did not significantly reduce the MAC-awake of sevoflurane.

  13. Serotonin Syndrome Induced by Fentanyl in a Child: Case Report.

    Science.gov (United States)

    Robles, Luis A

    2015-01-01

    Serotonin syndrome (SS) is a potentially fatal condition associated with increased serotonergic activity in the central nervous system that can be attributed to certain drugs or interactions between drugs. There are some published articles reporting this syndrome caused by the combination of fentanyl and selective serotonin reuptake inhibitors antidepressants in adult patients; however, there are no reports of SS associated to the use of fentanyl as a single causative agent. The author reports a case of a 7-year-old boy who was admitted to the emergency department with neurological deterioration secondary to an intracerebral hemorrhage. The patient was operated to remove the bleeding. Postoperatively, he experienced a diversity of progressive neurological signs (shivering, tremor, hypertonia, hyperreflexia, clonus, bilateral mydriasis, and intracranial hypertension), which were initially considered to be signs of neurological deterioration, but finally, it was proved that they were part of a SS caused by fentanyl.The absence of concomitant use of another medications known to induce SS and the dramatic improving observed after stopping fentanyl strongly indicates that fentanyl was the causative agent in this case of SS.Fentanyl is a medication used frequently, and therefore, clinicians should be aware of this potential adverse effect when this drug is administered.

  14. Effects of Morphine, Fentanyl and Tramadol on Human Immune Response

    Institute of Scientific and Technical Information of China (English)

    LIU Zhihen; GAO Feng; TIAN Yuke

    2006-01-01

    Morphine has been reported to suppress human immune response. We aimed to observe the effects of morphine, fentanyl and tramadol on NF- κ B and IL-2 from both laboratory and clinical perspective. Jurkat cells were incubated with ten times clinically relevant concentrations of morphine,fentanyl and tramadol before being stimulated with PMA. NF- κ B binding activity and IL-2 levels were measured. In the clinical study, 150 consenting patients were randomized into 3 groups according to the analgesics used in them, namely, group morphine (M), group fentanyl (F) and group tramadol (T). IL-2 was measured preoperatively and 1, 3 and 24 h after operation. Consequently, NF-κ B activation was suppressed by morphine and fentanyl but not by tramadol. IL-2 was significantly decreased by morphine and fentanyl but not by tramadol in vitro. In the PCA patients, IL-2 was decreased in group M and increased in group F postoperatively. Whereas in group T, IL-2 was unchanged 1 h after operation but was significantly elevated 3 and 24 h after operation. Our results showed that the inhibition of morphine on IL-2 was most probably related to its suppression on NF-κ B. Fentanyl had different effects on human immune response in vitro and in vivo. Tramadol may have immune enhancing effect.

  15. Comparison of dexmedetomidine/fentanyl with midazolam/fentanyl combination for sedation and analgesia during tooth extraction.

    Science.gov (United States)

    Yu, C; Li, S; Deng, F; Yao, Y; Qian, L

    2014-09-01

    Dexmedetomidine is an α2-adrenergic receptor agonist that causes minimal respiratory depression compared with alternative drugs. This study investigated whether combined dexmedetomidine/fentanyl offered better sedation and analgesia than midazolam/fentanyl in dental surgery. Sixty patients scheduled for unilateral impacted tooth extraction were randomly assigned to receive either dexmedetomidine and fentanyl (D/F) or midazolam and fentanyl (M/F). Recorded variables were patient preoperative anxiety scores, vital signs, visual analogue scale (VAS) pain scores, Observer's Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, surgeon and patient degree of satisfaction, and the duration of analgesia after surgery. The OAAS scores were significantly lower for patients administered D/F compared to those who received M/F. The duration of analgesia after the surgical procedure was significantly longer in patients who received D/F (5.3 h) than in those who received M/F (4.1 h; P=0.017). The number of surgeons satisfied with the level of sedation/analgesia provided by D/F was significantly higher than for M/F (P=0.001). Therefore, dexmedetomidine/fentanyl appears to provide better sedation, stable haemodynamics, surgeon satisfaction, and postoperative analgesia than midazolam/fentanyl during office-based unilateral impacted tooth extraction.

  16. Tablet Technologies and Education

    OpenAIRE

    Heidi L. Schnackenberg

    2013-01-01

    Recently, tablet technologies have grown tremendously in popularity. They lend themselves to a myriad of learning modalities and therefore may be well suited to use in schools and universities. While teachers work to find useful applications for tablets, students have already begun using them at home and, in secondary and higher education, in classes. Unfortunately, sometimes when students use tablets for courses they play with “apps,” rather than using the technology as a useful and powerful...

  17. Sequestration of fentanyl by the cardiopulmonary bypass (CPBP).

    Science.gov (United States)

    Koren, G; Crean, P; Klein, J; Goresky, G; Villamater, J; MacLeod, S M

    1984-01-01

    Immediately following the connection of pediatric patients to cardiopulmonary bypass we have consistently observed a steep decrease in fentanyl plasma concentration (74 +/- 8.7%) (mean +/- SD), much greater than would have been expected from hemodilution alone (50.6% +/- 12.0%) (p less than 0.0001). Priming of the pump with 20 ng/ml of fentanyl before connection to the patients did not prevent this phenomenon. In order to study the possibility that fentanyl is sequestered by the bypass, levels of the primed drug in the bypass were assessed before connecting the pump to the children and a steep fall from 20 ng/ml to zero was shown before initiation of bypass. Pharmacokinetic assessment of fentanyl in a closed pump circuit showed that levels of 120 ng/ml fall to 2 ng/ml within 3 min and remain stable at the lower concentration for at least 30 min. Further studies have identified the membrane oxygenator as the major site of fentanyl sequestration. Concentrations across the membrane fall from 120 ng/ml to 10 ng/ml. The attached siliconized tubing is associated with a minor binding effect sufficient to reduce concentrations from 110 to 84 ng/ml. The pvc tubing, aluminium heat exchanger and plastic reservoir had no binding effect on fentanyl. The possibility that a decrease in fentanyl protein binding caused the fall in serum concentration was checked in 5 patients undergoing open heart surgery. After initiation of the cardiopulmonary bypass, there was a significant decrease in albumin serum concentrations from 32.0 +/- 2.3 mM to 15.0 +/- 1.6 mM (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Fentanyl, dexmedetomidine, dexamethasone as adjuvant to local anesthetics in caudal analgesia in pediatrics: A comparative study

    Directory of Open Access Journals (Sweden)

    Elham M. El-Feky

    2015-04-01

    Conclusion: Both caudal dexmedetomidine and caudal dexamethasone added to local anesthetics are good alternatives in prolongation of postoperative analgesia compared to caudal local anesthetic alone or added to caudal fentanyl. Also they showed less side effects compared to caudal fentanyl.

  19. DEVELOPMENT AND IN VITRO EVALUATION OF BUCCOADHESIVE TABLETS OF LOSARTAN POTASSIUM

    Directory of Open Access Journals (Sweden)

    Raviteja Achanta

    2012-09-01

    Full Text Available Buccoadhesion, or the attachment of a natural or synthetic polymer to a biological substrate, is a practical method of drug immobilization or localization and an important new aspect of controlled drug delivery. The unique environment of the oral (buccal cavity offers its potential as a site for drug delivery. Because of the rich blood supply and direct access to systemic circulation. The Buccal route is suitable for drugs, which are susceptible to acid hydrolysis in the stomach or which are extensively metabolized in the liver (first pass effect. Oral controlled release (CR systems continue to be most popular once amongst all the drug delivery systems. Mucoadhesive delivery systems offer several advantages over other oral CR systems by virtue of prolongation of residence time of drug in buccal mucosa, and targeting and localization of the dosage form at a specific site. Also, these mucoadhesive systems are known to provide intimate contact between dosage form and the absorptive mucosa, resulting thereby in high drug flux through the absorptive tissue. Losartan potassium is an angiotensin II receptor (type AT1 antagonist. Administration of conventional tablets of Losartan potassium has been reported to exhibit fluctuations in the plasma drug levels, resulting either in manifestation of side effects or reduction in drug concentration at the receptor site. Losartan Potassium is having less bioavailability (25-35%. In order to increase the bioavailability to avoid the hepatic metabolism, the buccal tablets of Losartan potassium were prepared.

  20. Lugol's test reexamined again: buccal cells.

    Science.gov (United States)

    Jones, Edwin L; Leon, Julie A

    2004-01-01

    Lugol's iodine staining technique was used to examine oral samples from 10 men and 10 women. Examination of saliva samples before and after extraction with water shows that the low levels (49 positive cells and 3,951 negative cells) of glycogen in buccal epithelial cells become even lower after water extraction (0 positive cells and 4,000 negative cells). In addition to the 20 samples used in this paper, 40 oral swabs extracted with water were examined under classroom conditions with much less than 1% of the epithelial cells being positive for glycogen. Furthermore, 119 saliva samples from chewed gauze in sexual assault kits were extracted with water and all of them yielded less than 1% glycogen positive cells. This paper proposes that when more than 1% of the nucleated squamous epithelial cells are glycogen positive with Lugol's test after extraction in water, it is reasonable to eliminate the mouth as a source of these glycogen positive cells.

  1. Buccal microbiology analyzed by infrared spectroscopy

    Science.gov (United States)

    de Abreu, Geraldo Magno Alves; da Silva, Gislene Rodrigues; Khouri, Sônia; Favero, Priscila Pereira; Raniero, Leandro; Martin, Airton Abrahão

    2012-01-01

    Rapid microbiological identification and characterization are very important in dentistry and medicine. In addition to dental diseases, pathogens are directly linked to cases of endocarditis, premature delivery, low birth weight, and loss of organ transplants. Fourier Transform Infrared Spectroscopy (FTIR) was used to analyze oral pathogens Aggregatibacter actinomycetemcomitans ATCC 29523, Aggregatibacter actinomycetemcomitans-JP2, and Aggregatibacter actinomycetemcomitans which was clinically isolated from the human blood-CI. Significant spectra differences were found among each organism allowing the identification and characterization of each bacterial species. Vibrational modes in the regions of 3500-2800 cm-1, the 1484-1420 cm-1, and 1000-750 cm-1 were used in this differentiation. The identification and classification of each strain were performed by cluster analysis achieving 100% separation of strains. This study demonstrated that FTIR can be used to decrease the identification time, compared to the traditional methods, of fastidious buccal microorganisms associated with the etiology of the manifestation of periodontitis.

  2. A disguised tuberculosis in oral buccal mucosa.

    Science.gov (United States)

    Nanda, Kanwar Deep Singh; Mehta, Anurag; Marwaha, Mohita; Kalra, Manpreet; Nanda, Jasmine

    2011-01-01

    Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.

  3. Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery

    Directory of Open Access Journals (Sweden)

    Tuli Puneet

    2009-01-01

    Full Text Available Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.

  4. Acute Atrial Fibrillation Derived by Single-Doze Fentanyl Transdermal Usage

    Directory of Open Access Journals (Sweden)

    Mesut Gitmez

    2014-02-01

    Full Text Available Fentanyl is a selective and synthetic opiate agonist. Especially in cancer-derived pain treatment fentanyl transdermal usage is preferred. Clinic impacts occur related to several systems derived by fentanyl usage. However, respiratory failure, hypothermia and bradycardia are observed the most. In this article, we aimed at presenting a case which developed atrial fibrillation derived by single-dose fentanyl transdermal usage.

  5. Formulation of unidirectional release buccal patches of carbamazepine and study of permeation through porcine buccal mucosa

    Institute of Scientific and Technical Information of China (English)

    Parthasarathy Govindasamy; Bhaskar Reddy Kesavan; Jayaveera Korlakunta Narasimha

    2013-01-01

    Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches. Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using hydroxypropyl methyl cellulose, polyvinyl alcohol, polyvinyl pyrrolidone and ethyl cellulose by solvent casting method. Water impermeable backing layer (Pidilite® Biaxially-oriented polypropylene film) of patches provided unidirectional drug release. They were evaluated for thickness, mass uniformity, surface pH and folding endurance. Six formulations FA2, FA8, FA10, FB1, FB14 and FB16 (folding endurance above 250) were evaluated further for swelling studies, ex vivo mucoadhesive strength, ex vivo mucoadhesion time, in vitro drug release, ex vivo permeation, accelerated stability studies and FTIR and XRD spectral studies. Results: The ex vivo mucoadhesion time of patches ranged between 109 min (FA10) to 126 min (FB14). The ex vivo mucoadhesive force was in the range of 0.278 to 0.479 kg/m/s. The in vitro drug release studies revealed that formulation FA8 released 84%and FB16 released 99.01%of drug in 140 min. Conclusions: The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic delivery of carbamazepine.

  6. Transdermal fentanyl and its use in ovine surgery.

    Science.gov (United States)

    Christou, Chris; Oliver, Rema A; Rawlinson, John; Walsh, William R

    2015-06-01

    Fentanyl delivered via a transdermal patch has the potential to decrease the need for post-operative handling of sheep undergoing surgical procedures. Two studies were performed to test: (1) the ideal timing for the application of pre-emptive analgesic patches and (2) the efficacy of a 2 µg/kg/h dose, as extrapolated from other species. The first study had sheep divided into two groups. Group 1 had a fentanyl patch applied for 24 h prior to a patch change and group 2 had a fentanyl patch applied 72 h prior to a change. The second study applied the results obtained in the first and tested the efficacy of 2 µg/kg/h as an effective dose in an orthopaedic surgical environment. Results indicated that the ideal time for pre-emptive fentanyl patch administration is 24-36 h prior to surgery and that 2 µg/kg/h is an effective minimum therapeutic dose rate for the use of fentanyl as an analgesic in an orthopaedic surgical environment.

  7. Context-sensitive half-time of fentanyl in dogs.

    Science.gov (United States)

    Iizuka, Tomoya; Nishimura, Ryohei

    2015-05-01

    Context-sensitive half-times (CSHTs) of fentanyl in dogs were determined using pharmacokinetic models reported by Murphy et al. and Sano et al., and compared with a human model. The CSHT was defined as the time required for a 50% decrease in drug concentration in the central compartment after the termination of infusion. Although CSHTs increased gradually as the infusion time increased, the CSHTs in dogs were shorter than those in humans. The CSHTs at steady-state were 31.3 and 69.2 min in dogs, and 306.5 min in humans. The CSHTs of fentanyl in dogs are apparently shorter than those in humans; therefore, a continuous infusion of fentanyl may be a rational regimen in dogs, even if duration of infusion is extended.

  8. Mifepristone followed by home administration of buccal misoprostol for medical abortion up to 70 days of amenorrhoea in a general practice in Curaçao.

    Science.gov (United States)

    Boersma, Adriana A; Meyboom-de Jong, Betty; Kleiverda, Gunilla

    2011-04-01

    To evaluate the efficacy and safety of home administration of buccal misoprostol after mifepristone for medical abortion up to 70 days' gestation in a general practice in Curaçao, where induced abortion is severely restricted by law. In a prospective study 330 women received 200 mg mifepristone and were instructed to take four tablets (800 μg) of misoprostol via the buccal route 24-36 h later, at home. One week later, follow-up took place. The outcome could be evaluated in 307 of the 330 women. The efficacy of the mifepristone-buccal misoprostol procedure was 97.7% (300/307). In seven women vacuum aspirations for continuing pregnancy or incomplete abortion following treatment were required. Success rates at 64-70 days' gestation were the same as for gestations of less than 64 days duration. The main adverse effects were nausea and diarrhoea. Home administration of buccal misoprostol 24-36 h after mifepristone is a safe and effective method of medical abortion up to 70 days. It could be applied in a general practice in Curaçao, where induced abortion is legally restricted.

  9. Postmortem tissue distribution of acetyl fentanyl, fentanyl and their respective nor-metabolites analyzed by ultrahigh performance liquid chromatography with tandem mass spectrometry.

    Science.gov (United States)

    Poklis, Justin; Poklis, Alphonse; Wolf, Carl; Mainland, Mary; Hair, Laura; Devers, Kelly; Chrostowski, Leszek; Arbefeville, Elise; Merves, Michele; Pearson, Julia

    2015-12-01

    In the last two years, an epidemic of fatal narcotic overdose cases has occurred in the Tampa area of Florida. Fourteen of these deaths involved fentanyl and/or the new designer drug, acetyl fentanyl. Victim demographics, case histories, toxicology findings and causes and manners of death, as well as, disposition of fentanyl derivatives and their nor-metabolites in postmortem heart blood, peripheral blood, bile, brain, liver, urine and vitreous humor are presented. In the cases involving only acetyl fentanyl (without fentanyl, n=4), the average peripheral blood acetyl fentanyl concentration was 0.467 mg/L (range 0.31 to 0.60 mg/L) and average acetyl norfentanyl concentration was 0.053 mg/L (range 0.002 to 0.086 mg/L). In the cases involving fentanyl (without acetyl fentanyl, n=7), the average peripheral blood fentanyl concentration was 0.012 mg/L (range 0.004 to 0.027 mg/L) and average norfentanyl blood concentration was 0.001 mg/L (range 0.0002 to 0.003 mg/L). In the cases involving both acetyl fentanyl and fentanyl (n=3), the average peripheral blood acetyl fentanyl concentration was 0.008 mg/L (range 0.006 to 0.012 mg/L), the average peripheral blood acetyl norfentanyl concentration was 0.001 mg/L (range 0.001 to 0.002 mg/L), the average peripheral blood fentanyl concentration was 0.018 mg/L (range 0.015 to 0.021mg/L) and the average peripheral blood norfentanyl concentration was 0.002 mg/L (range 0.001 mg/L to 0.003 mg/L). Based on the toxicology results, it is evident that when fentanyl and/or acetyl fentanyl were present, they contributed to the cause of death. A novel ultrahigh performance liquid chromatography (UPLC) tandem mass spectrometry (MS/MS) method to identify and quantify acetyl fentanyl, acetyl norfentanyl, fentanyl and norfentanyl in postmortem fluids and tissues is also presented.

  10. Postmortem Tissue Distribution of Acetyl Fentanyl, Fentanyl and their Respective Nor-Metabolites Analyzed by Ultrahigh Performance Liquid Chromatography with Tandem Mass Spectrometry

    Science.gov (United States)

    Poklis, Justin; Poklis, Alphonse; Wolf, Carl; Mainland, Mary; Hair, Laura; Devers, Kelly; Chrostowski, Leszek; Arbefeville, Elise; Merves, Michele; Pearson, Julia

    2015-01-01

    In the last two years, an epidemic of fatal narcotic overdose cases has occurred in the Tampa area of Florida. Fourteen of these deaths involved fentanyl and/or the new designer drug, acetyl fentanyl. Victim demographics, case histories, toxicology findings and causes and manners of death, as well as, disposition of fentanyl derivatives and their nor-metabolites in postmortem heart blood, peripheral blood, bile, brain, liver, urine and vitreous humor are presented. In the cases involving only acetyl fentanyl (without fentanyl, n=4), the average peripheral blood acetyl fentanyl concentration was 0.467 mg/L (range 0.31 to .60 mg/L) and average acetyl norfentanyl concentration was 0.053 mg/L (range 0.002 to 0.086 mg/L). In the cases involving fentanyl (without acetyl fentanyl, n=7), the average peripheral blood fentanyl concentration was 0.012 mg/L (range 0.004 to 0.027 mg/L) and average norfentanyl blood concentration was 0.001 mg/L (range 0.0002 to 0.003 mg/L). In the cases involving both acetyl fentanyl and fentanyl (n=3), the average peripheral blood acetyl fentanyl concentration was 0.008 mg/L (range 0.006 to 0.012 mg/L), the average peripheral blood acetyl norfentanyl concentration was 0.001 mg/L (range 0.001 to 0.002 mg/L), the average peripheral blood fentanyl concentration was 0.018 mg/L (range 0.015 to 0.021 mg/L) and the average peripheral blood norfentanyl concentration was 0.002 mg/L (range 0.001 mg/L to 0.003 mg/L). Based on the toxicology results, it is evident that when fentanyl and/or acetyl fentanyl were present, they contributed to the cause of death. A novel ultrahigh performance liquid chromatography (UPLC) tandem mass spectrometry (MS/MS) method to identify and quantify acetyl fentanyl, acetyl norfentanyl, fentanyl and norfentanyl in postmortem fluids and tissues is also presented. PMID:26583960

  11. Saliva versus Plasma for Pharmacokinetic and Pharmacodynamic Studies of Fentanyl in Patients with Cancer.

    Science.gov (United States)

    Bista, Sudeep R; Haywood, Alison; Norris, Ross; Good, Phillip; Tapuni, Angela; Lobb, Michael; Hardy, Janet

    2015-11-01

    Fentanyl is widely used to relieve cancer pain. However there is great interpatient variation in the dose required to relieve pain and little knowledge about the pharmacokinetic and pharmacodynamic (PK/PD) relationship of fentanyl and pain control. Patients with cancer are fragile and there is reluctance on the part of health professionals to take multiple plasma samples for PK/PD studies. The relationship between plasma and saliva fentanyl concentrations was investigated to determine whether saliva could be a valid substitute for plasma in PK/PD studies. One hundred sixty-three paired plasma and saliva samples were collected from 56 patients prescribed transdermal fentanyl (Durogesic, Janssen-Cilag Pty Limited, NSW, Australia) at varying doses (12-200 µg/h). Pain scores were recorded at the time of sampling. Fentanyl and norfentanyl concentrations in plasma and saliva were quantified using HPLC-MS/MS. Saliva concentrations of fentanyl (mean = 4.84 μg/L) were much higher than paired plasma concentrations of fentanyl (mean = 0.877 μg/L). Both plasma and saliva mean concentrations of fentanyl were well correlated with dose with considerable interpatient variation at each dose. The relationship between fentanyl and norfentanyl concentrations was poor in both plasma and saliva. No correlation was observed between fentanyl concentration in plasma and saliva (r(2) = 0.3743) or free fentanyl in plasma and total saliva concentrations (r(2) = 0.1374). Pain scores and fentanyl concentration in either of the matrices were also not correlated. No predictive correlation was observed between plasma and saliva fentanyl concentration. However the detection of higher fentanyl concentrations in saliva than plasma, with a good correlation to dose, may allow saliva to be used as an alternative to plasma in PK/PD studies of fentanyl in patients with cancer. Copyright © 2015 Elsevier HS Journals, Inc. All rights reserved.

  12. Comparison of Fentanyl with Sufentanil for Chest Tube Removal

    Directory of Open Access Journals (Sweden)

    M Golmohammadi

    2008-11-01

    Full Text Available Background: After cardiac surgery, the chest tubes cause pain and their removal is painful and unpleasant forpatients. The aim of this research was to study and compare the analgesic effect of fentanyl and sufentanil on painrelief during chest tube removal in post-cardiac surgical patients.Patients and Methods: A total of 80 patients scheduled for elective cardiac surgery, were recruited in prospective,randomized and double-blind study. Patients received 1.5μg/kg fentanyl or 0.15μg/kg sufentanyl, intravenously10 minutes before removal of chest tube. Pain intensity was assessed by measuring visual analogscale (VAS pain score, 10 minutes before, during, and 5 and10 minutes after removing chest tubes. Level ofsedation, heart rate, arterial blood pressure, and oxygenation saturation were recorded at each stage by a blindedobserver.Results: Mean pain intensity scores 10 minutes before removal of chest tube in fentanyl, and sufentanil groupswere 29.5±12.1 and 31±11.2 respectively. Pain scores during chest tube removal were 38.5±11.6 in fentanylgroup and 44.7±12.8 in sufentanil group (P =0.02. In addition, pain scores during chest tube removal were significantly(P value=0.02 more reduced in fentanyl (17.21±7.5 than in sufentanil group (21.51±11.2. Sedationscores remained low in two groups. None of the patients showed any adverse side effects of opioids. No differenceswere seen in the heart rate or arterial blood pressure, but oxygenation saturation was significantly greaterin sufentanil group than in fentanyl group.Conclusion: Both fentanyl and sufentanil provide adequate analgesia for chest tube removal without increasinguntoward side effects.

  13. Calcification prevention tablets

    Science.gov (United States)

    Lindsay, Geoffrey A.; Hasting, Michael A.; Gustavson, Michael A.

    1991-01-01

    Citric acid tablets, which slowly release citric acid when flushed with water, are under development by the Navy for calcification prevention. The citric acid dissolves calcium carbonate deposits and chelates the calcium. For use in urinals, a dispenser is not required because the tablets are non-toxic and safe to handle. The tablets are placed in the bottom of the urinal, and are consumed in several hundred flushes (the release rate can be tailored by adjusting the formulation). All of the ingredients are environmentally biodegradable. Mass production of the tablets on commercial tableting machines was demonstrated. The tablets are inexpensive (about 75 cents apiece). Incidences of clogged pipes and urinals were greatly decreased in long term shipboard tests. The corrosion rate of sewage collection pipe (90/10 Cu/Ni) in citric acid solution in the laboratory is several mils per year at conditions typically found in traps under the urinals. The only shipboard corrosion seen to date is of the yellow brass urinal tail pieces. While this is acceptable, the search for a nontoxic corrosion inhibitor is underway. The shelf life of the tablets is at least one year if stored at 50 percent relative humidity, and longer if stored in sealed plastic buckets.

  14. Variation in buccal surface morphology of deciduous first molars

    Directory of Open Access Journals (Sweden)

    M Simratvir

    2012-01-01

    Full Text Available Background: The buccal bulge of the deciduous first molars has always been a restorative challenge to the pediatric dentist. Morphologically it may vary from a slight prominence to a well-developed cusp-like structure. Aim: This study was conducted to determine the variable buccal surface morphology of deciduous first molar and its clinical relevance. Materials and Methods: A prospective study was conducted whereby 2016 patients visiting the outpatient clinic of dental hospital over 1 year were evaluated. Any variation in buccal surface morphology of the deciduous first molars was recorded photographically or by replicating in dental stone. Results: Varied morphological patterns on buccal surface were observed for which a new classification scheme has been proposed. Conclusion: The surface morphology of deciduous teeth crowns must be studied carefully as it may be indicative of pulpal extensions and accessory roots, requiring consideration during restorative treatment planning.

  15. Oral Mucoadhesive Buccal Film of Ciprofloxacin for Periodontitis ...

    African Journals Online (AJOL)

    Keywords: Periodontitis, Ciprofloxacin, Buccal film, Mucoadhesive, Periodontitis, Sodium ... diseases. Periodontitis is an inflammatory disease of the gums that damages the soft ..... films containing chitosan-coated nanoparticles: a new strategy ...

  16. Speech and swallowing outcomes in buccal mucosa carcinoma

    Directory of Open Access Journals (Sweden)

    Sunila John

    2011-01-01

    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  17. [Dose-finding for treatment with a transdermal fentanyl patch : Titration with oral transmucosal fentanyl citrate and morphine sulfate].

    Science.gov (United States)

    Mücke, M; Conrad, R; Marinova, M; Cuhls, H; Elsner, F; Rolke, R; Radbruch, L

    2016-12-01

    To date, no studies investigating titration with oral transmucosal fentanyl for the dose-finding of transdermal fentanyl treatment have been published. In an open randomized study 60 patients with chronic malignant (n = 39) or nonmalignant pain (n = 21), who required opioid therapy according to step three of the guidelines of the World Health Organization (WHO), were investigated. In two groups of 30 patients each titration with immediate release morphine (IRM) or oral transmucosal fentanyl citrate (OTFC) was undertaken. For measurement purposes the Brief Pain Inventory (BPI) and Minimal Documentation System (MIDOS) were used. After a 24-h titration phase, in which patients documented the intensity of pain, nausea, and tiredness, treatment with transdermal fentanyl was evaluated over a 10-day period by means of the necessary dose adaptation (responder ≤ 1 dose adaptation; conversion formula 1:1 [OTFC group] vs 100:1 [IRM group]).The pain reduction over the first 24 h (titration phase) did not differ significantly between the groups. The number of responders (17 OTFC vs. 21 IRM) over the 10-day period did not show any difference either. In both groups there was a significant reduction in pain intensity (p IRM group (8 vs 1, p = 0.028).Oral transmucosal fentanyl citrate can be applied for the titration of transdermal fentanyl, but it does not show any clinically relevant advantage. For example, the risk of side effects-induced drop-outs was greater in the present study. Whether the unnecessary opioid switching to treat chronic pain and breakthrough pain is advantageous with regard to minimizing conversion errors cannot be definitively answered within the scope of this study.

  18. Amorphization within the tablet

    DEFF Research Database (Denmark)

    Doreth, Maria; Hussein, Murtadha Abdul; Priemel, Petra A.

    2017-01-01

    , the feasibility of microwave irradiation to prepare amorphous solid dispersions (glass solutions) in situ was investigated. Indomethacin (IND) and polyvinylpyrrolidone K12 (PVP) were tableted at a 1:2 (w/w) ratio. In order to study the influence of moisture content and energy input on the degree of amorphization......, tablet formulations were stored at different relative humidity (32, 43 and 54% RH) and subsequently microwaved using nine different power-time combinations up to a maximum energy input of 90 kJ. XRPD results showed that up to 80% (w/w) of IND could be amorphized within the tablet. mDSC measurements...

  19. Android tablets for dummies

    CERN Document Server

    Gookin, Dan

    2015-01-01

    Learn all you need to know about your Android tablet in one quick and easy reference! It's not a computer and it's not a smartphone-so what in the world is it? Whether you're new to Android or new to tablets altogether, you're about to experience mobile computing like never before with this fun, full-color guide! Inside, longtime and bestselling author Dan Gookin walks you through setting up your Android tablet, navigating the interface, browsing the web, setting up email, connecting to social media, finding plenty of apps, music, books, and movies to indulge your interests-and so much more.

  20. Development, validation and application of an HPLC-MS/MS method for the determination of fentanyl and nor-fentanyl in human plasma and saliva.

    Science.gov (United States)

    Bista, Sudeep R; Lobb, Michael; Haywood, Alison; Hardy, Janet; Tapuni, Angela; Norris, Ross

    2014-06-01

    Monitoring fentanyl concentration in saliva and plasma may be useful in pharmacokinetic/pharmacodynamic studies. Salivettes(®) have been used widely for collecting saliva samples. However due to its lipophilicity, fentanyl adsorbs to the cotton dental bud (CDB) used in this device. Furthermore, due to dry mouth being a common adverse effect seen in patients treated with opioids, obtaining enough saliva for analysis is often a challenge. Hence, a simple simultaneous method to quantify fentanyl and its metabolite in both human plasma and saliva was developed and validated. A novel extraction method was also developed and validated to recover fentanyl in saliva directly from the CDB. This extraction method utilises acetonitrile to recover the fentanyl directly from the CDB rather than recovery by centrifugation, which is not always possible. Reverse phase chromatographic separation was performed on a Shimadzu LC 20A HPLC system using gradient elution. The electrospray ion source (ESI) was operated in positive ion mode using an Applied Biosystems API 3200 LC/MS/MS as detector. Deuterated fentanyl (D5) and nor-fentanyl (D5) were used as internal standards (IS). The retention times for fentanyl and nor-fentanyl were 3.70 min and 3.20 min respectively. The lower limit of quantitation (LLOQ) was determined to be 0.030 μg/L in plasma and 0.045 in saliva for fentanyl and nor-fentanyl. Acceptable linearity for fentanyl and nor-fentanyl in both plasma and saliva was demonstrated from 0.02 to 10 μg/L (R(2) 0.9988-0.9994). Accuracy for fentanyl and nor-fentanyl in both plasma and saliva samples was between 96% and 108%. Total imprecision expressed as the co-efficient of variation was between 1.0 and 15.5% for both analytes in both matrices. The validated method was applied successfully in 11 paired plasma and saliva samples obtained from patients with cancer pain receiving transdermal fentanyl (Duragesic(®)) at doses from 25 μg to 100 μg.

  1. Long-term safety and analgesic efficacy of buprenorphine buccal film in patients with moderate-to-severe chronic pain requiring around-the-clock opioids

    Directory of Open Access Journals (Sweden)

    Hale M

    2017-01-01

    Full Text Available Martin Hale,1 Veronica Urdaneta,2 M Todd Kirby,3 Qinfang Xiang,4 Richard Rauck5 1Gold Coast Research, LLC, Plantation, FL, USA; 2Pharmacovigilance and Risk Management, 3Clinical Development, 4Biometrics, Endo Pharmaceuticals Inc., Malvern, PA, USA; 5Carolinas Pain Institute, Wake Forest Baptist Health, Winston Salem, NC, USA Background: This open-label, single-arm study was conducted to evaluate the long-term safety and efficacy of a novel buprenorphine formulation, buprenorphine buccal film, in the treatment of moderate-to-severe chronic pain requiring around-the-clock opioids.Methods: The primary purpose of this study was to evaluate the long-term safety and tolerability of buprenorphine buccal film. Five hundred and six patients who completed previous studies with buprenorphine buccal film (n=445; rollover patients or were recruited de novo for this study (n=61 were enrolled in this study. All patients underwent a dose titration period of ≤6 weeks, during which doses of buprenorphine buccal film were adjusted to a maximum 900 µg every 12 hours, depending on tolerability and the need for rescue medication. An optimal dose was defined as the dose that the patient found satisfactory for both pain relief and tolerability, without the need for rescue medication or with ≤2 tablets of rescue medication per day. Once the optimal dose was reached, treatment was continued for ≤48 weeks. Pain intensity was measured throughout the study using a 0–10 numerical rating scale.Results: Of 435 patients achieving an optimal dose of buprenorphine buccal film who commenced long-term treatment, 158 (36.3% completed 48 weeks of treatment. Treatment-related adverse events occurred in 116 patients (22.9% during the titration phase and 61 patients (14.0% during the long-term treatment phase, and adverse events leading to discontinuation of treatment occurred in 14 (2.8% and 14 (3.2% patients, respectively. The most common adverse events were those typically

  2. Grasp interaction with tablets

    CERN Document Server

    Wolf, Katrin

    2015-01-01

    This book presents guidelines for a future device type: a tablet that allows ergonomic front- and back-of-device interaction. These guidelines help designers and developers of user interfaces to build ergonomic applications for tablet devices, in particular for devices that enable back-of-device interaction. In addition, manufacturers of tablet devices obtain arguments that back-of-device interaction is a promising extension of the interaction design space and results in increased input capabilities, enriched design possibilities, and proven usability. The guidelines are derived from empirical studies and developed to fit the users’ skills to the way the novel device type is held. Three particular research areas that are relevant to develop design guidelines for tablet interaction are investigated: ergonomic gestures, interaction areas, and pointing techniques.

  3. Olaparib tablet formulation

    DEFF Research Database (Denmark)

    Plummer, Ruth; Swaisland, Helen; Leunen, Karin

    2015-01-01

    BACKGROUND: The oral PARP inhibitor olaparib has shown efficacy in patients with BRCA-mutated cancer. This Phase I, open-label, three-part study (Parts A-C) in patients with advanced solid tumours evaluated the effect of food on the pharmacokinetics (PK) of olaparib when administered in tablet...... formulation. METHODS: PK data were obtained in Part A using a two-treatment period crossover design; single-dose olaparib 300 mg (two 150 mg tablets) was administered in two prandial states: fasted and fed. In Part B, patients received olaparib tablets (300 mg bid) for 5 days under fasting conditions; in Part...... exposure to olaparib 300 mg tablets, although in the absence of an effect on the extent of olaparib absorption....

  4. Analysis of fentanyl in urine by DLLME-GC-MS.

    Science.gov (United States)

    Gardner, Michael A; Sampsel, Sheena; Jenkins, Werner W; Owens, Janel E

    2015-03-01

    Fentanyl is a synthetic narcotic anesthetic ∼80-100 times more potent than morphine. Owing to the potential for its abuse, the drug may be included in a forensic toxicology work-up, which requires fast, precise and accurate measurements. Here, the stability of fentanyl was assessed when stored at three different temperatures (-20, 4 and 25°C) in synthetic urine. Stability at those three temperatures was demonstrated over 12 weeks upon analysis by gas chromatography-mass spectrometry with a deuterated internal standard (fentanyl-D5) utilizing three different extraction techniques: liquid-liquid extraction (LLE), solid-phase extraction and dispersed liquid-liquid microextraction (DLLME). The DLLME method was then optimized before use in the analysis of fentanyl in urine samples obtained from autopsy cases at the El Paso County Coroner's Office. Accuracy of the DLLME method was assessed by completing spike and recovery studies at three different fortification levels (10, 100 and 250 ng/mL) with excellent recovery (89.9-102.6%). The excellent comparability between DLLME and LLE is demonstrated (Bland-Altman difference plot with a mean difference of 4.9 ng/mL) and the use of this methodology in the analysis of forensically relevant samples is discussed.

  5. Intrathecal tramadol versus intrathecal fentanyl for visceral pain ...

    African Journals Online (AJOL)

    2013-10-29

    Oct 29, 2013 ... In addition, the air conditioner in the operating room was switched off, ... Evaluation of non‑parametric data (norminal or ordinal) obtained .... VAS=Visual analogue scale, FB=Fentanyl group, TB=Tramadol group,. SB=Saline ...

  6. Nicotine permeability across the buccal TR146 cell culture model and porcine buccal mucosa in vitro

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, Margrethe Rømer

    2002-01-01

    The present study was conducted to investigate and compare the effect of pH and drug concentration on nicotine permeability across the TR146 cell culture model and porcine buccal mucosa in vitro. As a further characterization of the TR146 cell culture model, it was explored whether the results were...... comparable for bi-directional and uni-directional transport in the presence of a transmembrane pH gradient. Nicotine concentrations between 10(-5) and 10(-2) M were applied to the apical side of the TR146 cell culture model or the mucosal side of porcine buccal mucosa. Buffers with pH values of 5.5, 7.......4 and 8.1 were used to obtain different fractions of non- and mono-ionized nicotine. The apparent permeability (P(app)) of nicotine across both models increased significantly with increasing pH, and the P(app) values obtained with the two models could be correlated in a linear manner. With increasing...

  7. Tablets of pre-liposomes govern in situ formation of liposomes: concept and potential of the novel drug delivery system.

    Science.gov (United States)

    Vanić, Željka; Planinšek, Odon; Škalko-Basnet, Nataša; Tho, Ingunn

    2014-10-01

    The purpose of this study was to develop a novel drug delivery system for challenging drugs with potential for scale-up manufacturing and controlled release of incorporated drug. Pre-liposomes powder containing metronidazole, lecithin and mannitol, prepared by spray-drying, was mixed with different tableting excipients (microcrystalline cellulose, lactose monohydrate, mannitol, dibasic calcium phosphate, pregelatinized starch, pectin or chitosan) and compressed into tablets. The delivery system was characterized with respect to (i) dry powder characteristics, (ii) mechanical tablet properties and drug release, and (iii) liposomal characteristics. The pre-liposomes powder was free-flowing, and tablets of similarly high qualities as tablets made of physical mixtures were prepared with all excipients. Liposomes were formed in situ upon tablet disintegration, dissolution or erosion depending on the type of tablet excipient used. The liposomal characteristics and drug release were found to depend on the tablet excipient. The new delivery system offers a unique synergy between the ability of liposomes to encapsulate and protect drugs and increased stability provided by compressed formulations. It can be adjusted for drug administration via various routes, e.g. oral, buccal and vaginal.

  8. DEXMEDETOMIDINE AND FENTANYL FOR ENDOTRACHEAL INTUBATION: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Vishwanath R

    2015-10-01

    Full Text Available Severe cardiovascular response in the form of tachycardia and hypertension occur during induction of general anaesthesia and endotracheal intubation. This can cause deleterious effects in hypertensive and other cardiovascular disease patients. Alpha-2 (α-2 agonists are increasingly used as adjuncts in anaesthesia. Nowadays, dexmedetomidine, α-2 adrenoreceptor agonist, is gaining popularity for its sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilizing properties without significant respiratory depression. The stable hemodynamic and decreased oxygen consumption due to enhanced sympathoadrenal stability make dexmedetomidine very useful pharmacologic agent. The present study was undertaken to compare the effectiveness of dexmedetomidine and fentanyl in attenuating the response to laryngoscopy and endotracheal intubation during general anaesthesia. We enrolled 100 patients in age range 18-50 years of ASA I-II, and of either sex undergoing elective operation of short duration. Patients were randomly selected and allocated into two Groups. Group D: Received dexmedetomidine 1μg/kg intravenous (IV bolus and Group F: received fentanyl 1μg/kg IV bolus 10min before induction. All patients were induced with thiopentone sodium and vecuronium. Patients in both the Groups were continuously monitored for heart rate, systolic, diastolic and mean arterial pressure (MAP and data recorded. After induction and intubation HR, SBP, DBP and MAP were significantly lower in Group D than Group F (P<0.004, P=0.00, P<0.04, P<0.006 respectively. The need for thiopentone was decreased by 9% in the dexmedetomidine Group as compared to the fentanyl Group. Post-operative sedation and pain scores were comparably less in Group D than Group F. We conclude, Preoperative infusion of 1μg/kg of both dexmedetomidine and fentanyl are effective in attenuating the sympathetic responses to laryngoscopy and tracheal intubation however, dexmedetomidine blunts this

  9. Buccal Epithelium in treating Ocular Surface Disorders

    Directory of Open Access Journals (Sweden)

    Srinivas KR

    2008-11-01

    Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.

  10. Radioreceptor assay for analysis of fentanyl and its analogs in biological samples

    Energy Technology Data Exchange (ETDEWEB)

    Alburges, M.E.

    1988-01-01

    The assay is based on the competition of these drugs with ({sup 3}H) fentanyl for opioid receptors in membrane preparations of rat forebrain in vitro. The binding in stereospecific, reversible and saturable. Scatchard plots of saturation suggest the presence of high and low affinity binding sites. Morphine and hydromorphone complete with ({sup 3}H)fentanyl for the opioid receptor, but other morphine-like compounds were relatively weak displacers of ({sup 3}H)fentanyl. Many other commonly abused drugs do not compete with ({sup 3}H)fentanyl for the opioid receptors. Urine samples from animals injected with fentanyl, ({plus minus})-cis-3-methylfentanyl, alpha-methylfentanyl, butyrylfentanyl and benzylfentanyl were analyzed by radioreceptor assay, radioimmunoassay, and gas chromatography/mass spectrometry. Urinary analysis of fentanyl showed a good correlation with these three methods; however, discrepancies were observed in the analysis of fentanyl analogs. This radioreceptor assay is well-suited as an initial assay for the detection of active analogs of fentanyl in urine with good correlation with other techniques in the analysis of fentanyl; however, there is substantial disagreement between techniques in the quantitation of fentanyl analogs. The implications of these discrepancies are discussed.

  11. Comparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures.

    Science.gov (United States)

    Erden, I Aydin; Pamuk, A Gulsun; Akinci, Seda B; Koseoglu, Ayhan; Aypar, Ulku

    2009-05-01

    With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation. Sixty consenting American Society of Anesthesia physical status I-III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double-blinded, institutional review board approved protocol. Group 1 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + ketamine 0.5 mg.kg(-1), and group 2 received propofol 0.5 mg.kg(-1) + fentanyl 1 microg.kg(-1) + same volume of %0.9 NaCl intravenously. While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation (P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure (P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus. In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.

  12. Fentanyl tolerance in the treatment of cancer pain: a case of successful opioid switching from fentanyl to oxycodone at a reduced equivalent dose.

    Science.gov (United States)

    Sutou, Ichiro; Nakatani, Toshihiko; Hashimoto, Tatsuya; Saito, Yoji

    2015-06-01

    Opioids are not generally deemed to have an analgesic ceiling effect on cancer pain. However, there have been occasional reports of tolerance to opioid development induced by multiple doses of fentanyl. The authors report a case of suspected tolerance to the analgesic effect of opioid, in which an increasing dose of fentanyl failed to relieve the patient's cancer pain symptoms, but opioid switching to oxycodone injections enabled a dose reduction to below the equivalent dose conversion ratio. The patient was a 60-year-old man diagnosed with pancreatic body carcinoma with multiple metastases. The base dose consisted of 12 mg/day of transdermal fentanyl patches (equivalent to 3.6 mg/day, 150 μg/h fentanyl injection), and rescue therapy consisted of 10 mg immediate-release oxycodone powders. Despite the total daily dose of fentanyl reaching 5.6 mg (equivalent to 560 mg oral morphine), the analgesic effect was inadequate; thus, an urgent adjustment was necessary. Due to the moderate dose of fentanyl, the switch to oxycodone injection was done incrementally at a daily dose equivalent to 25% of the fentanyl injection. The total dose of oxycodone was replaced approximately 53.5% of the dose of fentanyl prior to opioid switching.

  13. Pre-emptive oral dexmethorphan reduces fentanyl-induced cough as well as immediate postoperative adrenocortico-tropic hormone and growth hormone level

    Directory of Open Access Journals (Sweden)

    Avik Mukherjee

    2011-01-01

    Full Text Available Background : Fentanyl-induced cough is not always benign and brief and can be remarkably troublesome, spasmodic, and explosive. Dextromethorphan, an opioid derivative with an antitussive action, may be effective in reducing the fentanyl-induced cough. Dextromethorphan, a N-methyl D aspartate receptor antagonist, may have some effect on diminishing the stress response to surgery. This study was undertaken to determine whether preoperative dextromethorphan could effectively attenuate its incidence, severity, and effect on postoperative stress hormone levels. Materials and Methods : Three hundred and twenty patients of American society of anesthesiologists I-II, aged 18-60 years, undergoing elective laparoscopic cholecystectomy or appendicectomy were randomly allocated into two groups (Group C, control; Group D, dextromethorphan consisting of 160 patients each. Patients in Group D received dextromethorphan 40 mg orally and in Group C received placebo tablets 60 minutes before induction of anesthesia. The incidence of cough was recorded for 1 minute after fentanyl injection and graded as none (0, mild (1-2, moderate (3-5, and severe (>5 cough. Blood samples were collected for estimation of stress hormone levels before surgery and again at 1 hour and 24 hours postoperatively and compared. The appearance of adverse reactions was recorded. Results : The incidence of reflex fentanyl cough was lower in dextromethorphan group (3.9% in comparison to placebo (59.8%. Five patients developed mild and one moderate cough in the dextromethorphan group. In the control group, 31 patients developed mild, 29 moderate, and 32 severe cough. The stress hormones were significantly higher at 1 hour and 24 hours postoperatively in both groups in comparison to its preoperative values. However, at 1 hour postoperatively, adrenocorticotropic hormone, epinephrine, and growth hormone values were significantly low in the dextromethorphan group (61.5 ± 21.1 pg/ ml, 142.1 ± 11

  14. A REVIEW ARTICLE ON MUCOADHESIVE BUCCAL DRUG DELIVERY SYSTEM

    Directory of Open Access Journals (Sweden)

    Jasvir Singh* and Pawan Deep

    2013-03-01

    Full Text Available ABSTRACT: As an alternative to injection pharmaceutical researcher and scientist are trying to explore transdermal and transmucosal route over the last few years. To overcome the deficiency associated with the other route of administration buccal region of oral cavity is an alternative target for the administration of choice of drug. The disadvantages relative with the oral drug delivery is the extensive presystemic metabolism, instability in acidic medium as a result inadequate absorption of the drugs. However parental route may overcome the drawback related with the oral route but these formulations have high cost, supervision is required and least patient compliance. By the buccal route the drug are directly pass through into systemic circulation, less hepatic metabolism and high bioavailability. The aim of the review article is an overview of buccal drug delivery, anatomy of oral mucosa, mechanism of drug penetration and their in-vitro and in-vivo mucoadhesion testing method.

  15. Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration

    OpenAIRE

    Eventov-Friedman, S; Rozin, I; Shinwell, E. S.

    2010-01-01

    The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.

  16. Case of chest-wall rigidity in a preterm infant caused by prenatal fentanyl administration.

    Science.gov (United States)

    Eventov-Friedman, S; Rozin, I; Shinwell, E S

    2010-02-01

    The inability to appropriately ventilate neonates shortly after their birth could be related in rare cases to chest-wall rigidity caused by the placental transfer of fentanyl. Although this adverse effect is recognized when fentanyl is administered to neonates after their birth, the prenatal phenomenon is less known. Treatment with either naloxone or muscle relaxants reverses the fentanyl effect and may prevent unnecessary excessive ventilatory settings.

  17. Accidental debondings: Buccal vs fully individualized lingual multibracket appliances.

    Science.gov (United States)

    Ziebura, Thomas; Hohoff, Ariane; Flieger, Stefanie; Stamm, Thomas

    2014-05-01

    The aim of this study was to retrospectively assess the frequency and localizations of bond failures (BFs) in patients treated with either lingual (TOP-Service für Lingualtechnik GmbH, a 3M Company, Bad Essen, Germany) or buccal (Mini Diamond brackets/Accent molar tubes; Ormco, Orange, Calif) full multibracket appliances in both dental arches. Data were acquired by an independent investigator from the patient records of 3 practitioners. To establish a standardized observation period, the first year of treatment was analyzed for each patient. Statistical analysis comprised the Kruskal-Wallis, Wilcoxon, Mann-Whitney U, and Fisher exact tests. The significance level was set at P <0.05. The mean number of BFs per patient in the first year of treatment did not differ significantly between the lingual group (n = 59; mean age, 31.1 years; mean BFs per patient, 2.63; SD, 2.77; minimum, 0; maximum, 13) and the buccal group (n = 44; mean age, 15.14 years; mean BFs per patient, 2.61; SD, 3.41; minimum, 0; maximum, 14) (P = 0.428) or with respect to sex (lingual group, P = 0.251; buccal group, P = 0.414) or practitioner (lingual group, P = 0.755; buccal group, P = 0.060), but molar attachments were more prone to BFs than were premolar brackets (lingual group, P = 0.015; buccal group, P = 0.049), and premolar brackets were more prone to BF than anterior brackets (lingual group, P = 0.005; buccal group, P = 0.004). With both appliances, a mean of 2.62 BFs per patient in the first year of treatment can be expected; this benchmark provides a reference for patient briefing, which is very important considering the large interindividual variances and budgeting considerations. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  18. Improvement of buccal delivery of morphine using the prodrug approach

    DEFF Research Database (Denmark)

    Christrup, Lona Louring; Jørgensen, A.; Christensen, C.B.

    1997-01-01

    The feasibility of achieving buccal delivery of morphine using the prodrug approach was assessed by studies of bioactivation, in vitro permeation and in vivo absorption. The bioactivation of various morphine-3-esters was studied in human plasma and saliva. The in vitro permeation of morphine...... of 0.2. This discrepancy could however be explained by the enzymatic stability of the two esters in saliva, since it was found that morphine-3-propionate was more rapidly hydrolysed in saliva than was morphine-3-acetate. The study demonstrates that the buccal delivery of morphine can be markedly...

  19. HGF is released from buccal fibroblasts after smokeless tobacco stimulation

    DEFF Research Database (Denmark)

    Dabelsteen, S; Christensen, S; Gron, B

    2005-01-01

    To investigate the effect of smokeless tobacco (ST) on (1) HGF, KGF and GM-CSF expression by buccal fibroblasts and (2) on keratinocyte and fibroblast proliferation. Buccal fibroblasts were stimulated with different concentrations of ST extracts in a double dilution from 0.50% w/v to 0.03% w...... on exposure time and on concentration of the tobacco extract. High concentration increased production of HGF 4-fold. KGF production was doubled when high concentration of tobacco was used, low concentration did not stimulate cells. GM-CSF production was low in both stimulated and non-stimulated cells...

  20. Three-dimensional pharmacophore screening for fentanyl derivatives

    Institute of Scientific and Technical Information of China (English)

    Ming Liu; Zhiguo Sun; Wenxiang Hu

    2012-01-01

    Fentanyl is a highly selective μ-opioid receptor agonist with high analgesic activity. Three-dimensional pharmacophore models were built from a set of 50 fentanyl derivatives. These were employed to elucidate ligand-receptor interactions using information derived only from the ligand structure to identify new potential lead compounds. The present studies demonstrated that three hydrophobic regions, one positive ionizable region and two hydrogen bond acceptor region sites located on the molecule seem to be essential for analgesic activity. The results of the comparative molecular field analysis model suggested that both steric and electrostatic interactions play important roles. The contributions from steric and electrostatic fields for the model were 0.621 and 0.379, respectively. The pharmacophore model provides crucial information about how well the common features of a subject molecule overlap with the hypothesis model, which is very valuable for designing and optimizing new active structures.

  1. The effect of titrated fentanyl on suppressed cough reflex in healthy adult volunteers.

    Science.gov (United States)

    Kelly, H E; Shaw, G M; Brett, C N; Greenwood, F M; Huckabee, M L

    2016-05-01

    Cough suppression is part of the pharmacodynamic profile of opioids. We investigated the impact of clinical doses of fentanyl on suppressing the cough reflex. Thirteen volunteers received 2 μg.kg(-1) of fentanyl in a divided administration protocol. Three minutes after each administration and at 10 min intervals during washout, suppressed cough reflex testing with nebulised citric acid was performed and compared with fentanyl effect-site concentration. Mean (SD) citric acid concentration provoking cough increased from 0.5 (0.28) mol.l(-1) at baseline to 1.2 (0.50) mol.l(-1) after 2 μg.kg(-1) of fentanyl (p = 0.01). Mean (SD) fentanyl effect-site concentration after the final dose of fentanyl was 1.89 (0.05) ng.ml(-1) . A strong positive correlation was found between suppressed cough reflex thresholds and fentanyl effect-site concentrations during both fentanyl administration and washout phases of the study (r(2) = 0.79, p = 0.01). The mean (SD) length of time for return of suppressed cough response was 44.6 (18.8) min. Clinically relevant doses of fentanyl produced cough reflex suppression in healthy volunteers.

  2. The Fentanyl Patch Boil-Up - A Novel Method of Opioid Abuse.

    Science.gov (United States)

    Schauer, Cameron K M W; Shand, James A D; Reynolds, Thomas M

    2015-11-01

    Fentanyl is a potent opioid analgesic used in the treatment of pain. Transdermal fentanyl patches are now widely utilized as an acceptable and efficacious method of medication delivery. Unfortunately, the potential for their abuse is well recognized. Previous case reports have documented deaths after intravenous (IV) misuse of fentanyl which had been extracted from Duragesic (liquid reservoir type) patches. We present a case of IV fentanyl abuse after the extraction from a Mylan (matrix type) patch. This method of abuse has not previously been described in the literature.

  3. Pharmacological Evaluation of 3-Carbomethoxy Fentanyl in Mice

    Science.gov (United States)

    Vuckovic, Sonja; Prostran, Milica; Ivanovic, Milovan; Dosen-Micovic, Ljiljana; Vujovic, Katarina Savic; Vucetic, Cedomir; Kadija, Marko; Mikovic, Zeljko

    2011-01-01

    In many animal species, as well as in humans, high doses of fentanyl (F) produce marked neurotoxic effects, such as muscular rigidity and respiratory depression. The antinociception (hot-plate test), impairment of motor coordination (rotarod test) and acute toxicity of intraperitoneal newly synthesized analogs, (±)cis-3-carbomethoxy- fentanyl (C) and (±)trans-3-carbomethoxyfentanyl (T) were evaluated in mice. The compounds tested induced antinociception, impairment of performance on the rotarod, and lethality in a dose-dependent manner. The relative order of antinociceptive potency was similar to motor impairment potency, as well as lethality: F > C > T. Naloxone hydrochloride (1 mg/kg; sc) abolished all the effects observed, suggesting that they are mediated via opioid receptors, most probably of μ type. There were no significant differences between the therapeutic indices of F, C and T. It is concluded, the introduction of 3-carbomethoxy group in the piperidine ring of the fentanyl skeleton reduced the potency, but did not affect tolerability and safety of the compound.

  4. Teach yourself visually Fire tablets

    CERN Document Server

    Marmel, Elaine

    2014-01-01

    Expert visual guidance to getting the most out of your Fire tablet Teach Yourself VISUALLY Fire Tablets is the comprehensive guide to getting the most out of your new Fire tablet. Learn to find and read new bestsellers through the Kindle app, browse the app store to find top games, surf the web, send e-mail, shop online, and much more! With expert guidance laid out in a highly visual style, this book is perfect for those new to the Fire tablet, providing all the information you need to get the most out of your device. Abundant screenshots of the Fire tablet graphically rich, touch-based Androi

  5. The Nebusarsekim Tablet

    NARCIS (Netherlands)

    Stadhouders, H.A.I.

    2008-01-01

    During the summer of 2007 an internet hype was unleashed by the breaking news that an Old Testament name of some importance, figuring in the Book of Jeremiah Ch. 39, had been positively identified on a cuneiform clay tablet, viz. a bill of receipt from the time of this prophet's floruit. Many a scho

  6. Effectiveness of fentanyl transdermal patch (fentanyl-TTS, durogegic) for radiotherapy induced pain and cancer pain: multi-center trial

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Seong Soo; Choi, Eun Kyung [University of Ulsan College of Medicine, Seoul (Korea, Republic of); Huh, Seung Jae [Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2006-12-15

    To evaluate the effectiveness and safety of fentanyl-TTS in the management of radiotherapy induced acute pain and cancer pain treated with radiotherapy. Our study was open labelled prospective phase IV multi-center study, the study population included patients with more 4 numeric rating scale (NRS) score pain although managed with other analgesics or more than 6 NRS score pain without analgesics. Patients divided into two groups: patients with radiotherapy induced pain (Group A) and patients with cancer pain treated with radiotherapy (Group B). All patients received 25 ug/hr of fentanyl transdermal patch. Primary end point was pain relief: second end points were change in patient quality of life, a degree of satisfaction for patients and clinician, side effects. Between March 2005 and June 2005, 312 patients from 26 participating institutes were registered, but 249 patients completed this study. Total number of patients in each group was 185 in Group A, 64 in Group B. Mean age was 60 years and male to female ratio was 76:24. Severe pain NRS score at 2 weeks after the application of fentanyl was decreased from 7.03 to 4.01, {rho} = 0.003. There was a significant improvement in insomnia, social functioning, and quality of life. A degree of satisfaction for patients and clinician was very high. The most common reasons of patients' satisfactions was good pain control. Ninety six patients reported side effect. Nausea was the most common side effect. There was no serious side effect. Fentanyl-TTS was effective in both relieving pain with good tolerability and improving the quality of life for patients with radiotherapy induced acute pain and cancer pain treated with radiotherapy. The satisfaction of the patients and doctors was good. There wa no major side effect.

  7. Genetic, pathological and physiological determinants of transdermal fentanyl pharmacokinetics in 620 cancer patients of the EPOS study

    DEFF Research Database (Denmark)

    Barratt, Daniel T; Bandak, Benedikte; Klepstad, Pål;

    2014-01-01

    This study aimed to investigate whether CYP3A4/5 genetic variants, together with clinical and patient factors, influence serum fentanyl and norfentanyl concentrations and their ratio in cancer pain patients receiving transdermal fentanyl....

  8. Buccal cortical bone thickness on CBCT for mini-implant

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Jong Gook; Lim, Sung Hoon; Lee, Byoung Jin; Kim, Jae Duk [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)

    2010-12-15

    Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of Ez3D2009TM (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p?0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

  9. A mechanistic based approach for enhancing buccal mucoadhesion of chitosan

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Muff-Westergaard, Christian; Sander, Camilla

    2014-01-01

    Mucoadhesive buccal drug delivery systems can enhance rapid drug absorption by providing an increased retention time at the site of absorption and a steep concentration gradient. An understanding of the mechanisms behind mucoadhesion of polymers, e.g. chitosan, is necessary for improving the muco......Mucoadhesive buccal drug delivery systems can enhance rapid drug absorption by providing an increased retention time at the site of absorption and a steep concentration gradient. An understanding of the mechanisms behind mucoadhesion of polymers, e.g. chitosan, is necessary for improving...... the mucoadhesiveness of buccal formulations. The interaction between chitosan of different chain lengths and porcine gastric mucin (PGM) was studied using a complex coacervation model (CCM), isothermal titration calorimetry (ITC) and a tensile detachment model (TDM). The effect of pH was assessed in all three models...... and the approach to add a buffer to chitosan based drug delivery systems is a means to optimize and enhance buccal drug absorption. The CCM demonstrated optimal interactions between chitosan and PGM at pH 5.2. The ITC experiments showed a significantly increase in affinity between chitosan and PGM at pH 5...

  10. [Enlargement of the buccal aperture via. Technical consideration (author's transl)].

    Science.gov (United States)

    Pons, J; Pasturel, A; Pochan, Y; Barbier, M

    1979-01-01

    For a long time we know that it is possible to take out from the mouth a part or all the mandibule which presents a local malignant tumour. When the tumour is too extensed, the buccal aperture can be enlarged. The authors describe a new surgical technique which resolves this problem with notable and faithful advantages.

  11. Management of anterior urethral strictures with buccal mucosa: Our ...

    African Journals Online (AJOL)

    Abdelwahab Elkassaby

    2016-03-02

    Mar 2, 2016 ... different uses of buccal mucosal graft as a reconstructive and replacement tool for anterior urethral .... of excessive mobilization and penile curvature. ... established that a strip of penile skin would inevitably form a tube if left in ...

  12. Do fentanyl and morphine influence body temperature after severe burn injury?

    Science.gov (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Fentanyl lacks the antiinflammatory properties of morphine. Morphine attenuates the inflammatory response through differential stimulation of μ-receptor subtypes. Patients who receive morphine during coronary artery bypass graft have been shown to experience less postoperative fever than those who receive fentanyl. Patients who receive continuous fentanyl infusions in increased room temperatures after thermal injury may be at increased risk to experience higher body temperature than those who receive morphine. The records of 28 patients with >20%TBSA burn in 30 intensive care unit rooms (13 received fentanyl and 15 received morphine or hydromorphone) and 12 trauma patients who received fentanyl in 22°C intensive care unit rooms were reviewed. Mean maximum core temperature and percentage of temperature recordings > 39°C in the first 48 hours of admission were compared between burn patients who received fentanyl, those who did not, and with trauma patients. Burn patients exposed to fentanyl experienced significantly higher temperatures (40.1 ± 0.9°C) compared with those given morphine (38.7 ± 0.8°C) and compared with trauma patients (37.5 ± 2.4°C), P Burn patients on fentanyl had temperatures > 39°C for a higher percentage of time (33 ± 27%) than those without fentanyl (7.2 ± 13%) and trauma patients (1 ± 2.8%), P Burn patients who receive fentanyl in 30°C rooms experience higher body temperatures and are febrile for a higher percentage of time than those receiving morphine only. Morphine has well-established antiinflammatory properties and likely attenuates the postburn inflammatory response more than fentanyl, resulting in lower body temperatures. This phenomenon needs to be further investigated in additional studies.

  13. The effects of fentanyl on sevoflurane requirements for loss of consciousness and skin incision.

    Science.gov (United States)

    Katoh, T; Ikeda, K

    1998-01-01

    Fentanyl produces a minimal reduction in the minimum alveolar concentration of sevoflurane to prevent response to a verbal command in 50% of patients (MAC[awake]) at low but analgesic plasma concentrations. The reduction in MAC(awake), however, is still unknown at higher fentanyl concentrations. The reduction in the MAC of sevoflurane by fentanyl has not been described accurately. The purpose of this study was to determine the MAC(awake) and MAC reduction of sevoflurane by fentanyl. Ninety-two patients were randomly allocated to seven fentanyl concentration groups (target plasma concentrations of 0, 1, 1.5, 3, 6, 10, and 14 ng/ml). Responses to verbal command were observed for MAC(awake) assessment at predetermined sevoflurane concentrations. Thereafter, in patients whose target fentanyl concentration was 0 to 10 ng/ml, responses to skin incision were observed for MAC assessment at new steady-state sevoflurane concentrations. The reduction in the MAC(awake) and MAC of sevoflurane by the measured fentanyl concentration was calculated. There was an initial steep reduction in the MAC of sevoflurane by fentanyl, with 3 ng/ml resulting in a 59% MAC reduction. A ceiling effect was observed, with 10 ng/ml providing only a further 17% reduction in MAC. The initial reduction in MAC(awake) was not as steep as that in MAC. Fentanyl reduced MAC(awake) by approximately 24% at a plasma concentration of 3 ng/ml. Although the reduction curve of MAC(awake) was parabolic, no manifest ceiling effect was observed at concentrations administered in the present study. The reduction in sevoflurane requirements for loss of consciousness and skin incision by fentanyl was determined. Fentanyl reduced both requirements, but the mode of the reduction was not comparable.

  14. Development and evaluation of buccoadhesive propranolol hydrochloride tablet formulations: effect of fillers.

    Science.gov (United States)

    Akbari, Jafar; Nokhodchi, Ali; Farid, Djavad; Adrangui, Massoud; Siahi-Shadbad, Mohammad Reza; Saeedi, Majid

    2004-02-01

    The buccal mucosa has been investigated for local and systemic delivery of therapeutic peptides and other drugs that are subjected to first-pass metabolism or are unstable within the rest of the gastrointestinal tract. Propranolol hydrochloride (propranolol HCl) is subjected to first-pass effect, therefore formulation of buccal-adhesive dosage form can circumvent this effect. The effect of lactose (a soluble excipient) and dicalcium phosphate (DCP) (an insoluble excipient) on dissolution rate, kinetic of release and adhesion force of buccal-adhesive tablets of propranolol HCl were evaluated. Each tablet composed of 80 mg propranolol HCl, 80 mg hydroxypropylmethylcellulose (HPMC) K4M, polycarbophil AA1 and lactose or DCP with different ratios. The results showed that the presence of the fillers increased dissolution rate of the drug. The release data also showed that the effect of lactose on the dissolution rate was greater than the DCP. Kinetic release of propranolol HCl from buccal-adhesive matrices was affected by the different ratios of polymers and fillers. The fillers reduced the bioadhesion force and this effect was more considerable in formulation containing DCP. In order to determine the mode of release, the data were analyzed based on the equation Q =kt(n). The results showed that an increase in the concentration of HPMC K4M resulted in a reduction in the value of n. The value of n was not significantly affected by an increase in the concentration of lactose or DCP. The values of n in this study were calculated to be between 0.461 and 0.619, indicating both diffusional release and erosional mechanism.

  15. A physiologically-based recirculatory meta-model for nasal fentanyl in man

    DEFF Research Database (Denmark)

    Upton, RN; Foster, DJR; Christrup, Lona Louring;

    2012-01-01

    Pharmacokinetic (PK) and pharmacodynamic (PD) data were available from a study of a nasal delivery system for the opioid analgesic fentanyl, together with data on the kinetics of fentanyl in arterial blood in man, and in the lung and brain of sheep. Our aim was to reconcile these data using...

  16. STUDIES ON MELOXICAM SOLID DISPERSION INCORPORATED BUCCAL PATCHES

    Directory of Open Access Journals (Sweden)

    Mohammed Jafar

    2011-05-01

    Full Text Available Arthritis is one of the most common chronic diseases in the world. Life style effects of arthritis includes; Depression, Anxiety, Feelings of helplessness, Limitations on daily activities, Job limitations etc. Meloxicam, a non-steroidal anti-inflammatory drug is widely used in the treatment of rheumatoid arthritis, ankylosing spondulytis and osteoarthritis. It is also indicated for the management of dental pain, Post-traumatic and post-operative pain, inflammation and swelling. Recently it is considered as a potential drug for prevention and treatment of colorectal polyps. One of the major problems with this drug is its low solubility in biological fluids, which results into poor bioavailability and GI-Side effects after oral administration. The present work was aimed at overcoming these limitations of the drug. The first problem i.e. Poor solubility of meloxicam was overcome by solid dispersion technique and the same work was than published in a reputed online journal. The present study was the continuation of the published work, in this study buccal patches were prepared using varying percentage of carbopol 934p, HPMC (muco adhesive polymers and 50% W/W of propylene glycol (Plasticizer by solvent casting technique, using 32 factorial design. Prepared blank buccal patches were evaluated for various physical and mechanical parameters, patches which comply with reported results were selected for meloxicam and its solid dispersion incorporation. Meloxicam solid dispersion incorporated buccal patches were prepared and evaluated for drug content, in-vitro diffusion, in-vivo release of meloxicam in rabbits and stability study. All solid dispersion incorporated patches showed increased in-vitro drug release (i.e. between 94% to 99.98% over an extended period of 8hrs as compared to plain drug incorporated buccal patch. Whereas plain drug incorporated buccal patch showed only 31.22% in-vitro drug release in 8hrs. Release of meloxicam was slightly

  17. A comparative study of intrathecal ropivacaine with fentanyl and L-bupivacaine with fentanyl in lower abdominal and lower limb surgeries

    Directory of Open Access Journals (Sweden)

    Prem Swarup Vampugalla

    2015-12-01

    Conclusion: This study revealed that the intrathecal ropivacaine with fentanyl provided adequate anesthesia for lower abdominal and lower limb surgeries. Ropivacaine achieved a shorter duration of sensory and motor blockade, and a lesser degree of motor blockade when compared to L-bupivacaine. Thus, ropivacaine was justified for short duration ambulatory surgeries of lower abdominal and lower limb surgeries. Furthermore, fentanyl as an adjuvant to both ropivacaine and L-bupivacaine enhanced the duration of the sensory block. Hence, ropivacaine with fentanyl in spinal anesthesia for lower abdominal and lower limb surgeries is a better alternative compared to L-bupivacaine with fentanyl favoring day care ambulatory surgeries. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1147-1155

  18. Intranasal fentanyl in the treatment of acute pain--a systematic review

    DEFF Research Database (Denmark)

    Hansen, M S; Mathiesen, O; Trautner, S

    2012-01-01

    demonstrated some analgesic effect of IN fentanyl following myringotomy, no analgesic effect following voiding cystourethrography, and finally, no significant analgesic difference after long bone fractures, in burns patients, and in post-operative pain relief when compared to IV morphine, oral morphine, or IV......Due to its non-invasive mode of administration, intranasal (IN) application of drugs may be a valuable alternative to non-invasive pain management. With characteristics that appear to be ideal for IN application, IN fentanyl may have a place in the out-of-hospital treatment and the paediatric....... No significant analgesic differences between IN fentanyl and intravenous (IV) fentanyl were demonstrated in treatment of acute and post-operative pain. Significant analgesic effect of IN fentanyl was demonstrated in the treatment of breakthrough pain in cancer patients. In the paediatric population, results...

  19. 改良腭弓矫治后牙锁节对后牙功能恢复的影响%Influence of promote palatine arch treating buccal teeth lock on occlusion function recovery of buccal teeth

    Institute of Scientific and Technical Information of China (English)

    马宁; 孙应明; 白槐延

    2002-01-01

    @@ Background: Buccal teeth occlusion lock is a kind of common malocclusion malformation in orthodonic clinic. Traditional treatment to buccal teeth occlusion lock is interactive traction of upper and lower buccal teeth.This treatment had shortcoming such as insufficient anchorage and elongation of buccal teeth.We adopted promote fix palatine arch therapy, which recovery patients' occlusion function by clinical observation.

  20. Tableting and tablet properties of alginates: characterisation and potential for Soft Tableting.

    Science.gov (United States)

    Schmid, Wolfgang; Picker-Freyer, Katharina M

    2009-05-01

    The aim of the study was to evaluate the suitability of alginates for Soft Tableting. For this purpose the compaction properties of alginates, varying in molecular weight, guluronic acid/mannuronic acid ratio and salt, were investigated and compared to MCC. Based on the mechanical properties, the suitability of the tested excipients for Soft Tableting was predicted. In order to test the prediction the tested materials were used to tablet enteric coated pellets, which served as a pressure sensitive material. The tableting behaviour was analysed by the 3-D modeling technique. The tablet properties were analysed by determining the elastic recovery and the compactibility. Alginates in general deformed elastically. The compression behaviour depended on the chemical composition of the alginates with sodium alginates being more elastic than potassium alginates. Tablets containing alginates with low guluronic acid content exhibited higher elasticity than tablets with alginates having a low mannuronic acid content. The plasticity of potassium alginates was higher than for sodium alginates. However, the plasticity of all tested alginates was lower than the plasticity of MCC. The compactibility of the tested alginates was sufficient. The proposed prediction, which states that tableting excipients with higher elasticity are more suitable for tableting sensitive materials than plastic excipients, was valid for the tested materials. The elastic alginates inflicted less damage on the pellets than the plastic MCC. Thus, all alginates were more appropriate for tableting pressure sensitive materials than MCC.

  1. Context-sensitive half-time of fentanyl in dogs

    OpenAIRE

    IIZUKA, Tomoya; NISHIMURA, Ryohei

    2015-01-01

    Context-sensitive half-times (CSHTs) of fentanyl in dogs were determined using pharmacokinetic models reported by Murphy et al. and Sano et al., and compared with a human model. The CSHT was defined as the time required for a 50% decrease in drug concentration in the central compartment after the termination of infusion. Although CSHTs increased gradually as the infusion time increased, the CSHTs in dogs were shorter than those in humans. The CSHTs at steady-state were 31.3 and 69.2 min in do...

  2. Formulation and characterization of mucoadhesive buccal films of glipizide

    Directory of Open Access Journals (Sweden)

    Semalty Mona

    2008-01-01

    Full Text Available Mucoadhesive buccal films of glipizide were prepared by solvent casting technique using hydroxypropylmethylcellulose, sodium carboxymethylcellulose, carbopol-934P and Eudragit RL-100. Prepared films were evaluated for weight, thickness, surface pH, swelling index, in vitro residence time, folding endurance, in vitro release, permeation studies and drug content uniformity. The films exhibited controlled release over more than 6 h. From the study it was concluded that the films containing 5 mg glipizide in 4.9% w/v hydroxypropylmethylcellulose and 1.5% w/v sodium carboxymethylcellulose exhibited satisfactory swelling, an optimum residence time and promising drug release. The formulation was found to be suitable candidate for the development of buccal films for therapeutic use.

  3. Nasal and buccal drug delivery: management forum conference.

    Science.gov (United States)

    Smart, John D

    2012-07-01

    The scope of the conference (Nasal and Buccal Drug Delivery Conference, Management Forum; Chairs Franz Merkus and Julie Suman) was to consider innovations in drug delivery via the nose and oral cavity, notably for the delivery of vaccines, antimalarials and rapidly acting sedatives. Presentations from experts from academia, government agencies and commercial organisations were made over the 2 days. The advantages of both routes were ease of application, patient acceptability and no requirement to produce sterile products. These routes worked best for drugs that are water soluble--but with some lipophilicity--only require low doses, are acceptable to the patient and have low irritancy (particulary for the nasal route). Challenges relate to the effectiveness of deposition from the delivery systems and the efficient clearance mechanisms. It was concluded that for many drugs, buccal and nasal delivery could become the route of choice for their application; vaccines, in particular, appear to show promise for nasal delivery.

  4. [Buccal bony exostoses induced by free gingival grafts].

    Science.gov (United States)

    Tal, H; Slutzkey, S

    2011-01-01

    Buccal Bony Exostoses (BBE) is a local benign osseous overgrowth continuous with the facial aspect of the jaw. Post operative BBE may be the result of dermal grafts used to restore the buccal vestibulum, of connective tissue graft placement, and of Free Gingival Grafts (FGG) procedures. In 46 patients in whom 72 FGG procedures were performed by the senior author (HT) over the past 12 years, BBE was clinically and radiographically diagnosed. In one case the tumor was surgically removed. The etiology, pathogenesis and frequency of BBE following FGG procedures was reviewed and discussed. We suggest that the BBE may develop owing to periosteal surgical trauma during FGG procedures, and suggest that this phenomenon receives further attention.

  5. Nevus of ota with buccal mucosal pigmentation: a rare case.

    Science.gov (United States)

    Shetty, Shishir Ram; Subhas, Babu G; Rao, Kumuda Arvind; Castellino, Renita

    2011-01-01

    Nevus of Ota is a condition wherein the typical pattern of the bluish black pigmentation is noticed along with the cutaneous distribution of the trigeminal nerve. This condition is most prevalent in Japanese population but comparatively rare among Indians. We report a case of 23-year-old female presented with unilateral pigmented areas over the skin of forehead, malar area, ear and periorbital area. Blackish-blue pigmented areas were also noticed on the sclera. Brownish-black diffuse pigmented areas were also noticed on the buccal mucosa of the same side. The presence of pigmentation on the skin over pinna and oral pigmentation made our case a rare incidence. Oral pigmentations associated with nevus of Ota especially on the buccal mucosa have rarely been reported in the past.

  6. Nevus of Ota with buccal mucosal pigmentation: A rare case

    Directory of Open Access Journals (Sweden)

    Shishir Ram Shetty

    2011-01-01

    Full Text Available Nevus of Ota is a condition wherein the typical pattern of the bluish black pigmentation is noticed along with the cutaneous distribution of the trigeminal nerve. This condition is most prevalent in Japanese population but comparatively rare among Indians. We report a case of 23-year-old female presented with unilateral pigmented areas over the skin of forehead, malar area, ear and periorbital area. Blackish-blue pigmented areas were also noticed on the sclera. Brownish-black diffuse pigmented areas were also noticed on the buccal mucosa of the same side. The presence of pigmentation on the skin over pinna and oral pigmentation made our case a rare incidence. Oral pigmentations associated with nevus of Ota especially on the buccal mucosa have rarely been reported in the past.

  7. Refractory cachexia is associated with increased plasma concentrations of fentanyl in cancer patients

    Directory of Open Access Journals (Sweden)

    Suno M

    2015-05-01

    Full Text Available Manabu Suno,1,* Yuriko Endo,1,* Hiroyuki Nishie,2 Makoto Kajizono,3 Toshiaki Sendo,3 Junji Matsuoka4 1Department of Oncology Pharmaceutical Care and Science, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2Department of Anesthesiology and Resuscitology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 3Department of Pharmacy, Okayama University Hospital, 4Faculty of Health Sciences, Okayama University Medical School, Okayama, Japan *These authors contributed equally to this work Background: An appropriate plasma concentration of fentanyl is the key to achieving good pain control in cancer patients. Cachexia, a multifactorial syndrome, is known to affect drug-metabolizing enzymes. However, the fentanyl concentrations in the blood of patients with cachexia have not been analyzed. The aim of this study was to evaluate the influence of cancer cachexia on dose-adjusted plasma fentanyl concentrations in cancer patients.Methods: Blood was collected from 21 Japanese cancer patients treated with a 24-hour transdermal fentanyl patch during the steady state of fentanyl plasma concentration. Plasma fentanyl concentrations were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS, and the levels were adjusted with the dose of fentanyl. Laboratory data were collected, and the cachexia stage was determined, based on study by Fearon et al. Multiple regression analysis was performed to identify the factors that affected fentanyl plasma concentrations.Results: Eight patients were classified as precachexia, nine as cachexia, and four as refractory cachexia, and the median dose-adjusted fentanyl concentrations (ng/mL per mg/kg/day were 27.5, 34.4, and 44.5, respectively. The dose-adjusted fentanyl concentration in patients with refractory cachexia was higher than that in patients with precachexia (Kruskal–Wallis test and post hoc Mann–Whitney U-test, P<0.01. The factors that

  8. Formulation and characterization of mucoadhesive buccal films of glipizide

    OpenAIRE

    2008-01-01

    Mucoadhesive buccal films of glipizide were prepared by solvent casting technique using hydroxypropylmethylcellulose, sodium carboxymethylcellulose, carbopol-934P and Eudragit RL-100. Prepared films were evaluated for weight, thickness, surface pH, swelling index, in vitro residence time, folding endurance, in vitro release, permeation studies and drug content uniformity. The films exhibited controlled release over more than 6 h. From the study it was concluded that the films containing 5...

  9. Mucoadhesive buccal films of tramadol for effective pain management

    OpenAIRE

    Xiao-Qin Li; Zhao-Ming Ye; Jian-Bing Wang; Cai-Rong Fan; Ai-Wu Pan; Cong Li; Ren-Bing Zhang

    2017-01-01

    Abstract Background and objectives: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. Methods: ...

  10. Dental prosthesis and buccal lesions in the elderly

    OpenAIRE

    Beatriz García Alpizar; Mikhail Benet Rodíguez; Eduardo Enrique Castillo Betancourt

    2010-01-01

    Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship...

  11. Human pharmacokinetics of intravenous, sublingual, and buccal buprenorphine.

    Science.gov (United States)

    Kuhlman, J J; Lalani, S; Magluilo, J; Levine, B; Darwin, W D

    1996-10-01

    Buprenorphine is a potent opioid analgesic used in the treatment of moderate to severe pain. At higher doses, it has demonstrated potential for treating heroin dependence. This study was undertaken to investigate buprenorphine pharmacokinetics by different routes of administration at dosages approximating those used in opioid-dependence studies. Six healthy men who were nondependent but who had a history of heroin use were administered buprenorphine in a crossover design study by intravenous (1.2 mg), sublingual (4.0 mg), and buccal (4.0 mg) routes of administration. Plasma samples were collected up to 96 h and assayed for buprenorphine and norbuprenorphine by negative chemical ionization tandem mass spectrometry. Plasma concentrations of buprenorphine and norbuprenorphine were analyzed by nonlinear regression analysis with standard noncompartmental methods. Buprenorphine biovailability by the sublingual and buccal routes was estimated as 51.4% and 27.8%, respectively, although there was considerable interindividual variability by both routes of administration. The terminal elimination half-lives were longer for the sublingual and buccal routes than for the intravenous route. The extended elimination half-lives may be due to a shallow depot effect involving sequestration of buprenorphine in the oral mucosa. Norbuprenorphine mean peak plasma concentrations were less than 1 ng/mL and were highly variable among different routes of administration and individuals. The terminal elimination half-life of norbuprenorphine was longer than buprenorphine.

  12. Incidence of bone metastasis in carcinoma buccal mucosa

    Directory of Open Access Journals (Sweden)

    Virendra Bhandari

    2016-01-01

    Full Text Available Introduction: Head and neck cancer is a leading health problem in India due to the habit of chewing tobacco and bad oral and dental hygiene. Carcinoma buccal mucosa is more common and is 2.5% of all malignancies at our center. Most of the patients present in stage III and IV and the survival in these cases is not very good. Bone metastasis in advanced cases of carcinoma buccal mucosa is rarely reported in the world literature. Materials and Methods: We present here cases developing bone metastasis in carcinoma buccal mucosa in last 5 years. These patients were young with loco-regionally advanced disease where bone metastasis developed within 1-year of definitive treatment. Results: The flat bones and vertebrae were mainly involved and the survival was also short after diagnosis of metastasis despite the treatment with local Radiotherapy and chemotherapy. Conclusion: The exact cause of metastasis cannot be proved, but the probability of subclinical seedling of malignant cells before the eradication of the primary tumor should be considered along with advanced local and nodal disease with high grade of tumor.

  13. Multiple Fentanyl Overdoses - New Haven, Connecticut, June 23, 2016.

    Science.gov (United States)

    Tomassoni, Anthony J; Hawk, Kathryn F; Jubanyik, Karen; Nogee, Daniel P; Durant, Thomas; Lynch, Kara L; Patel, Rushaben; Dinh, David; Ulrich, Andrew; D'Onofrio, Gail

    2017-02-03

    On the evening of June 23, 2016, a white powder advertised as cocaine was purchased off the streets from multiple sources and used by an unknown number of persons in New Haven, Connecticut. During a period of less than 8 hours, 12 patients were brought to the emergency department (ED) at Yale New Haven Hospital, experiencing signs and symptoms consistent with opioid overdose. The route of intoxication was not known, but presumed to be insufflation ("snorting") in most cases. Some patients required doses of the opioid antidote naloxone exceeding 4 mg (usual initial dose = 0.1-0.2 mg intravenously), and several patients who were alert after receiving naloxone subsequently developed respiratory failure. Nine patients were admitted to the hospital, including four to the intensive care unit (ICU); three required endotracheal intubation, and one required continuous naloxone infusion. Three patients died. The white powder was determined to be fentanyl, a drug 50 times more potent than heroin, and it included trace amounts of cocaine. The episode triggered rapid notification of public health and law enforcement agencies, interviews of patients and their family members to trace and limit further use or distribution of the fentanyl, immediate naloxone resupply and augmentation for emergency medical services (EMS) crews, public health alerts, and plans to accelerate naloxone distribution to opioid users and their friends and families. Effective communication and timely, coordinated, collaborative actions of community partners reduced the harm caused by this event and prevented potential subsequent episodes.

  14. Tramadol or fentanyl analgesia for ambulatory knee arthroscopy.

    Science.gov (United States)

    Cagney, B; Williams, O; Jennings, L; Buggy, D

    1999-03-01

    In a double-blind, randomized, controlled study, 61 patients who received a standardized anaesthetic for day case arthroscopic knee surgery were studied. Group T (n = 31) received tramadol 1.5 mg kg-1, and group F (n = 30) received fentanyl 1.5 micrograms kg-1 at the induction of anaesthesia. All patients also received 20 mL of intra-articular bupivacaine 0.5% at the end of surgery. Assessments were made of pain at rest and on movement, analgesic requirements and side-effects at hourly intervals up to 6 h and by means of a postal questionnaire at 24 h and 48 h post-operatively. Group F had higher pain scores than group T at 4 h only [VAS 3.3 (1.6-5.5) vs. 2.4 (1-4), P = 0.039, respectively; median (interquartile range)]. There were no other significant differences between the groups in terms of pain scores, supplemental analgesic requirements or incidence of side-effects. We conclude that tramadol offers little benefit clinically compared with fentanyl when used at induction of anaesthesia for day case arthroscopic knee surgery. Further studies are indicated in patients with more severe pain to determine the role of tramadol in post-operative analgesia.

  15. Optimization of the radioimmunoassays for measuring fentanyl and alfentanil in human serum

    Energy Technology Data Exchange (ETDEWEB)

    Schuettler, J.; White, P.F.

    1984-09-01

    Measurement of serum fentanyl and alfentanil concentrations by radioimmunoassay (RIA) may result in significant errors and high variability when the technique described in the available fentanyl and alfentanil RIA kits is used. The authors found a 29-94% overestimation of measured fentanyl and alfentanil serum levels when 3H-fentanyl or 3H-alfentanil was added lastly to the mixture of antiserum and sample. This finding is related to a reduction in binding sites for the labeled compounds after preincubation of sample and antiserum. If this sequence is used, it becomes necessary to extend the incubation period up to 6 h for fentanyl and up to 10 h for alfentanil in order to achieve equilibration between unlabeled and labeled drug with respect to antiserum binding. However, when antiserum is added lastly to the mixture of sample and labeled drug, measurement accuracy and precision for fentanyl and alfentanil serum concentrations are enhanced markedly. In addition, it is important to perform the calibration curves and sample measurements using the same medium (i.e., serum alone or a serum/buffer dilution). In summary, to optimize the RIA for fentanyl and alfentanil, the authors recommend the following: 1) adding the antiserum lastly to the mixture of sample and labeled drug; 2) performing calibration curves using patient's blank serum when possible; 3) carefully examining and standardizing each step of the RIA procedure to reduce variability, and, finally; 4) comparing results with those of other established RIA laboratories.

  16. Myocardial protection induced by fentanyl in pigs exposed to high-dose adrenaline.

    Science.gov (United States)

    da Luz, Vinicius Fernando; Otsuki, Denise Aya; Gonzalez, Maria Margarita Castro; Negri, Elnara Marcia; Caldini, Elia Garcia; Damaceno-Rodrigues, Nilsa Regina; Malbouisson, Luiz Marcelo Sá; Viana, Bruno Gonçalves; Vane, Matheus Fachini; Carmona, Maria Jose Carvalho

    2015-10-01

    The use of high doses of adrenaline is common in critical patients, especially during cardiac arrest. During these situations, myocardial dysfunction can be a result of multiple factors, including adrenaline use. In addition, opioids have been shown to have anti-arrhythmic and anti-ischemic mechanisms that may confer cardiac protection. This study aimed to evaluate the effects of fentanyl on myocardial function in pigs exposed to high-dose adrenaline. After institutional ethics committee approval, 26 pigs were randomly allocated to receive either 20 μg/kg fentanyl (n = 10; fentanyl group) administered 5 min before five doses of adrenaline (20 μg/kg), equivalent-volume saline (n = 10; saline group) using the same adrenaline dosing protocol, or neither fentanyl nor adrenaline (n = 6; sham group). The fentanyl group showed lower levels of troponin at the end of the sixth hour compared with the saline group (1.91 ± 1.47 vs 5.44 ± 5.35 ng/mL, P = 0.019). Transmission electron microscopy and immunohistochemistry also showed less myocardial injury in the fentanyl group. The conclusion was reached that fentanyl attenuates myocardial injury caused by high-dose adrenaline without blunting the hemodynamic effect of adrenaline.

  17. An Acute Butyr-Fentanyl Fatality: A Case Report with Postmortem Concentrations.

    Science.gov (United States)

    McIntyre, Iain M; Trochta, Amber; Gary, Ray D; Wright, Jennifer; Mena, Othon

    2016-03-01

    In this case report, we present an evaluation of the distribution of postmortem concentrations of butyr-fentanyl in a fatality attributed principally to the drug. A man who had a history of intravenous drug abuse was found unresponsive on the bathroom floor of his home. Drug paraphernalia was located on the bathroom counter. Toxicology testing, which initially screened positive for fentanyl by enzyme-linked immunosorbent assay, subsequently confirmed butyr-fentanyl, which was then quantitated by gas chromatography-mass spectrometry-specific ion monitoring (GC-MS SIM) analysis following liquid-liquid extraction. The butyr-fentanyl peripheral blood concentration was quantitated at 58 ng/mL compared with the central blood concentration of 97 ng/mL. The liver concentration was 320 ng/g, the vitreous was 40 ng/mL, the urine was 670 ng/mL and the gastric contained 170 mg. Acetyl-fentanyl was also detected in all biological specimens tested. Peripheral blood concentration was quantitated at 38 ng/mL compared with the central blood concentration of 32 ng/mL. The liver concentration was 110 ng/g, the vitreous was 38 ng/mL, the urine was 540 ng/mL and the gastric contained fentanyl, acetyl-fentanyl and cocaine intoxication, and the manner of death was certified as accident.

  18. In vitro and in vivo evaluation of a sublingual fentanyl wafer formulation

    Directory of Open Access Journals (Sweden)

    Lim SCB

    2013-04-01

    Full Text Available Stephen CB Lim,1,3 Michael J Paech,2 Bruce Sunderland,3 Yandi Liu3 1Pharmacy Department, Armadale Health Service, Armadale, 2School of Medicine and Pharmacology, University of Western Australia, and Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital for Women, Subiaco, 3School of Pharmacy, Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia Background: The objective of this study was to prepare a novel fentanyl wafer formulation by a freeze-drying method, and to evaluate its in vitro and in vivo release characteristics, including its bioavailability via the sublingual route. Methods: The wafer formulation was prepared by freeze-drying an aqueous dispersion of fentanyl containing sodium carboxymethylcellulose and amylogum as matrix formers. Uniformity of weight, friability, and dissolution testing of the fentanyl wafer was achieved using standard methods, and the residual moisture content was measured. The fentanyl wafer was also examined using scanning electron microscopy and x-ray diffraction. The absolute bioavailability of the fentanyl wafer was evaluated in 11 opioid-naïve adult female patients using a randomized crossover design. Results: In vitro release showed that almost 90% of the fentanyl dissolved in one minute. In vivo, the first detectable plasma fentanyl concentration was observed after 3.5 minutes and the peak plasma concentration between 61.5 and 67 minutes. The median absolute bioavailability was 53.0%. Conclusion: These results indicate that this wafer has potential as an alternative sublingual fentanyl formulation. Keywords: absolute bioavailability, fentanyl wafer, in vitro dissolution, in vivo study, pharmacokinetics, sublingual

  19. Fentanyl Pharmacokinetics in Pregnant Sheep after Intravenous and Transdermal Administration to the Ewe.

    Science.gov (United States)

    Heikkinen, Emma M; Voipio, Hanna-Marja; Laaksonen, Sakari; Haapala, Linnea; Räsänen, Juha; Acharya, Ganesh; Erkinaro, Tiina; Haapsamo, Mervi; Hautajärvi, Heidi; Kokki, Hannu; Kokki, Merja; Heikkinen, Aki T

    2015-09-01

    Fentanyl is used for pain treatment during pregnancy in human beings and animals. However, fentanyl pharmacokinetics during pregnancy has not been fully established. The aim of this study was to characterize fentanyl pharmacokinetics in pregnant sheep after intravenous and transdermal dosing during surgical procedure performed to ewe and foetus. Pharmacokinetic parameters reported for non-pregnant sheep and nominal transdermal dose rate were utilized for a priori calculation to achieve analgesic fentanyl concentration (0.5-2 ng/ml) in maternal plasma. A total of 20 Aland landrace ewes at 118-127 gestational days were used. In the first protocol, 1 week before surgery, 10 animals received 2 μg/kg fentanyl intravenous bolus, and on the operation day, transdermal fentanyl patches at nominal dose rate of 2 μg/kg/hr were applied to antebrachium, and ewes were then given a 2 μg/kg intravenous bolus followed by an intra-operative 2.5 μg/kg/hr infusion. In the second protocol, 10 animals received fentanyl only as transdermal patches on the operation day and oxycodone for rescue analgesia. The data were analysed with population pharmacokinetic modelling. Intra- and post-operative fentanyl concentrations were similar and slightly lower than the a priori predictions, and elimination and distribution clearances appeared slower during than before or after the surgery. Transdermal patches provided sustained fentanyl absorption for up to 5 days, but the absorption rate was slower than the nominal dose rate and showed a high interindividual variability. Further research is warranted to evaluate the clinical relevance of the observations made in sheep.

  20. The Effect of Transdermal Delivery of Fentanyl on Activity in Growing Pigs

    Directory of Open Access Journals (Sweden)

    Nyman G

    2005-09-01

    Full Text Available Abstract Recently, decreased activity levels have been observed in pigs treated postoperatively with transdermal delivery of fentanyl (TD-fentanyl after isoflurane anaesthesia. Whether the change in behaviour is related to opioid-induced sedation or to insufficient pain relief remains to be investigated. This study was therefore undertaken to evaluate the effect of TD-fentanyl 50 μg h-1 on the activity level with and without isoflurane anaesthesia. Eight pigs (25.4 ± 5.2 kg were submitted to a cross-over study and given two treatments; 1 fentanyl patch applied after 30 minutes of anaesthesia (treatment A/F and 2 fentanyl patch without anaesthesia (treatment F. The pigs' behaviour was observed from a video recording instantaneously every 10 minutes for 24 h before treatments and up to 72 h after the patch attachment. Venous blood samples were taken 1, 6, 12, 24, 48 and 72 h after the patch application. The behaviour recordings showed that TD-fentanyl did not produce sedation in any pig. No differences were found between the two treatments in activity level, weight gain or serum fentanyl concentration. This concentration measured after 24 h was 0.27 ± 0.11 ng ml-1 and 0.47 ± 0.40 ng ml-1 in the A/F and F group, respectively. In conclusion, transdermal delivery of 50 μg h-1 fentanyl did not cause inactivity in growing pigs. However, the large variations in serum fentanyl concentration indicate that drug absorption from transdermal patches is unpredictable and sometimes deficient.

  1. Comparison of remifentanil and fentanyl in patients undergoing modified radical mastectomy or total hysterectomy

    Institute of Scientific and Technical Information of China (English)

    郭向阳; 易杰; 叶铁虎; 罗爱伦; 黄宇光; 任洪智

    2003-01-01

    Objective To compare the efficacy and safety of remifentanil and fentanyl in patients undergoing a modified radical mastectomy or total hysterectomy.Methods Fifty-four patients were evenly randomised into remifentanil group and fentanyl group. Anesthesia was induced by propofol (1-2 mg/kg) and either remifentanil (2 μg/kg) or fentanyl (2.5 μg/kg), and was maintained with inhalation of nitrous oxide in oxygen (2∶1) and continuous infusion of either remifentanil (0.2 μg*kg-1*min-1) or fentanyl(0.03 μg*kg-1*min-1). Results The number of patients exhibiting light anesthesia responses in the remifentanil group during intubation and the maintenance of anesthesia was significantly less than that in the fentanyl group. Both systolic and diastolic blood pressures in the fentanyl group were significantly higher than those in the remifentanil group during intubation, skin incision, maintenance of anesthesia and extubation. The time to opening eyes on command and the time for extubation after surgery was comparable between the two groups. More patients in the remifentanil group (25 patients) required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (5 patients, P<0.05). There was no significant difference between the two groups in terms of side effects.Conclusions Under the condition of this study protocol, the anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability in comparison with fentanyl, and has no compromising recovery from anesthesia.

  2. Assessing Student Writing on Tablets

    Science.gov (United States)

    Davis, Laurie Laughlin; Orr, Aline; Kong, Xiaojing; Lin, Chow-Hong

    2015-01-01

    There is increasing expectation that schools should be able to use tablets for a range of instructional and assessment purposes. This article considers the comparability of student writing on tablets and laptops to ensure that writing assessment is conducted in a way that is fair to all students. Data were collected from a sample of 826 students…

  3. Tablet PCs: The Write Approach

    Science.gov (United States)

    Milner, Jacob

    2006-01-01

    This article discusses the transforming effects of tablet PCs in the classroom. As 1-to-1 computing becomes the goal on K-12 campuses, school districts are turning to this newer, pen-based technology. Saint Mary's School's new Lenovo ThinkPad X41 tablet PCs had transformed the way Saint Mary's teachers did their jobs. Teachers created outlines for…

  4. Bioequivalency of ranitidine tablets.

    Science.gov (United States)

    Alkaysi, H N; Salem, M A; Gharaibeh, A M; el-Sayed, Y M; Ali-Gharaibeh, K I; Badwan, A A

    1989-04-01

    The bioavailability of two brands of ranitidine tablets was studied in 10 healthy volunteers. Formulation factors were compared by performing disintegration, dissolution and content uniformity tests. Plasma concentrations of ranitidine were measured using a sensitive and precise high pressure liquid chromatographic (HPLC) procedure. Pharmacokinetic parameters were determined for both formulations and included: Cmax, AUCt, AUC infinity, tmax, t1/2 and the terminal rate of elimination (k). Statistical analysis revealed that differences between the brands were not significant. The two formulations can be considered to be bioequivalent.

  5. Tablets i skolen

    DEFF Research Database (Denmark)

    Lorentzen, Rasmus Fink

    2012-01-01

    Denne rapport afslutter CELMS undersøgelse af Odder Kommunes projekt med indførelse af iPads på alle kommunens skoler. Undersøgelsen har til formål at belyse om der er pædagogiske og læringsmæssige fordele forbundet med brugen af tablets i undervisningen i grundskolen og i givet fald hvilke...... designer og tablet’ens egenskaber i et generelt perspektiv. Rapporten afsluttes med en række anbefalinger til henholdsvis lærere og skoleledere med henblik på videre udvikling af indsatsen....

  6. Formulation and evaluation of mucoadhesive buccal patch of acyclovir utilizing inclusion phenomenon

    Directory of Open Access Journals (Sweden)

    Ankita Saxena

    2011-12-01

    Full Text Available Mucoadhesive buccal patch releasing drug in the oral cavity at a predetermined rate may present distinct advantages over traditional dosage forms, such as tablets, gels and solutions. A buccal patch for systemic administration of acyclovir in the oral cavity was developed using polymers hydroxy propyl methyl cellulose (K4M, hydroxy propyl methyl cellulose (K15M, sodium carboxy methyl cellulose and poly vinyl pyrolidone (K30, plasticizer poly ethylene glycol (400 and a backing membrane of Eudragit (RL100. The films were evaluated in terms of swelling, residence time, mucoadhesion, release, and organoleptic properties. The optimized films showed lower release as compared to controlled drug delivery systems. Hence, an inclusion complex of acyclovir was prepared with hydrophilic polymer hydroxylpropyl beta-cyclodextrin in the molar ratio of 1:1. The inclusion complex was characterized by optical microscopy, FAB mass spectroscopy, and FTIR spectroscopy. Patches formulated with the acyclovir inclusion complex were evaluated along the same lines as those containing acyclovir alone. The in vitro release data revealed a substantial increase from 64.35% to 88.15% in the case of PS I and PS II batches, respectively, confirming the successful use of inclusion complexes for the formulation of buccal patch of acyclovir.Mucoadesivos bucais liberadores de fármacos para a cavidade oral com taxa de liberação pré-determinada podem apresentar distintas vantagens em relação às formas farmacêuticas convencionais como comprimidos, géis e soluções. Neste trabalho, um adesivo bucal para administração sistêmica de aciclovir através da cavidade oral foi desenvolvido empregando-se os polímeros hidroxipropilmetil celulose (K4M, hidroxipropilmetil celulose (K15M, carboximetil celulose sódica e polivinil pirrolidona (K30, polietilenoglicol plastificado (400 e uma membrana suporte de Eudragit (RL100. Os filmes obtidos foram avaliados em termos de

  7. Windows for tablets for dummies

    CERN Document Server

    Rathbone, Andy

    2013-01-01

    Just for you--Windows 8 from the tablet user's perspective If you're an experienced Windows user, you don't need a guide to everything that Windows 8 can do, just to those tools and functions that work on your tablet. And so here it is. This new book zeros in on what you need to know to work best on your tablet with Windows 8. Topics include navigating the new Windows 8 interface and how it works on a touchscreen, how to safely connect to the Internet, how to work with apps or share your tablet in a group, and much more. If you're a new tablet user, you'll particularly appre

  8. A COMPARATIVE STUDY OF DEXMEDETOMIDINE AND FENTANYL COMBINED WITH ROPIVACAINE FOR EPIDURAL ANAESTHESIA IN LOWER LIMB ORTHOPAEDIC SURGERIES

    Directory of Open Access Journals (Sweden)

    Ravi Vasupalli

    2016-09-01

    Full Text Available BACKGROUND Intrathecal anaesthesia and epidural anaesthesia are the most popular regional anaesthesia techniques used for lower limb surgeries. Intrathecal anaesthesia also called as subarachnoid block. It has few limitations like short duration of anaesthesia, extension of anaesthesia cannot be made for prolonged surgeries, rapid onset of sympathetic blockade, shorter duration of postoperative analgesia and troublesome complication of Post-Dural Puncture Headache (PDPH. Hence, epidural anaesthesia is the most preferred anaesthetic technique for lower limb surgeries these days. METHODS TIME FRAME The study was conducted during period spanning December 2013 to November 2014. STUDY POPULATION Patients who met all inclusion criteria were randomly selected. No distinction is made between males and females. STUDY DESIGN A prospective, randomised, double blind, case control, observational, interventional comparative study is designed after getting the informed written consent was obtained from the patient. RANDOMISATION Randomisation was done using a computer generated random number table. One hundred patients scheduled for various elective lower limb surgical procedures belonging to ASA class I and II were included in the study. 1. Group RD (n=50 15 mL of 0.75% ropivacaine + 0.6 µg/kg of dexmedetomidine (Inj. DEXTOMID-1 mL=100 mcg, 1 mL ampoule; 2. Group RF (n=50 15 mL of 0.75% ropivacaine (ropivacaine 0.75% preservative free-ROPIN 0.75%, 20 mL ampoules-Neon Laboratories, India, fentanyl 1 µg/kg Inj. FENTANYL-1 mL=50 mcg, 2 mL ampoule. The patients were premedicated with tablet alprazolam 0.5 mg and tablet ranitidine 150 mg orally at bedtime on the previous night before surgery. They were kept nil orally 10 p.m. onwards on the previous night. On the day of surgery, patient’s basal pulse rate and blood pressure were recorded. A peripheral intravenous line with 18 gauge cannula after local anaesthesia was secured in one of the upper limbs. All the

  9. DEVELOPMENT AND IN VITRO EVALUATION OF BUCCOADHESIVE BILAYER TABLETS OF THIOCOLCHICOSIDE

    Directory of Open Access Journals (Sweden)

    NAGENDRARAO KUKALAKUNTA

    2013-01-01

    Full Text Available The main objective is to formulate the buccoadhesive bilayer tablets of thiocolchicoside which acts muscle relaxant with anti-inflammatory and analgesic effects.The tablets were prepared using bioadhesive polymers like Carbopol 934p, HPMC by direct compression method. Magnesium stearate were added to act as lubricant and ethyl cellulose used as impermeable backing layer which gives unidirectional buccal drug delivery. Buccal devices were evaluated for different parameters such as weight uniformity, content uniformity, hardness, surface pH, swelling index, mucoadhesive time and in vitro drug release. The results of study revealed that the formulation containing a combination of polymers like Carbopol 934p and HPMC K4M shows suitatble in vitro drug release. Invitro dissolution studies of the optimized formulation shows that the present drug release was 97.19% for 16 hrs for F3 formulation. Bioadhesive time, physicochemical properties, surface pH, swelling index were developed to a satisfactory level in terms of drug release.

  10. MOUTH DISSOLVING TABLET: AN OVERVIEW

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    Kulkarni S. D.

    2011-04-01

    Full Text Available Mouth dissolving Tablets disintegrate and/or dissolve rapidly in the saliva without the need for water. Some tablets are designed to dissolve in saliva extremely fast, within a few seconds, and are true fast-dissolving tablets. Others contain agents to enhance the rate of tablet disintegration in the oral cavity, and are more appropriately termed fast-disintegrating tablets, as they may take up to a minute to completely disintegrate. Mouth or Fast dissolving tablets have been formulated for pediatric, geriatric and bedridden patients and in the many elderly persons will have difficulties in taking conventional oral dosage forms because of hand tremors and dysphagia. The technologies used for manufacturing fast-dissolving tablets are freeze-drying, spray-drying, molding, sublimation, sugar-based excipients, compression, and disintegration addition. As a result of increased life expectancy, the elderly constitute a large portion of the worldwide population today. These people eventually will experience deterioration of their physiological and physical abilities.

  11. Chronological age affects the permeation of fentanyl through human skin in vitro

    DEFF Research Database (Denmark)

    Holmgaard, R; Benfeldt, E; Sorensen, J A

    2013-01-01

    AIM: To study the influence of chronological age on fentanyl permeation through human skin in vitro using static diffusion cells. Elderly individuals are known to be more sensitive to opioids and obtain higher plasma concentrations following dermal application of fentanyl compared to younger...... individuals. The influence of age - as an isolated pharmacokinetic term - on the absorption of fentanyl has not been previously studied. METHOD: Human skin from 30 female donors was mounted in static diffusion cells, and samples were collected during 48 h. Donors were divided into three age groups: ... and old age groups: 5,922 and 4,050 ng, respectively). Furthermore, the lag time and absorption rate were different between the three groups, with a significantly higher rate in the young participants versus the oldest participants. CONCLUSION: We demonstrate that fentanyl permeates the skin of young...

  12. Synthesis and analysis of the opioid analgesic [[sup 14]C]-fentanyl

    Energy Technology Data Exchange (ETDEWEB)

    Bagley, J.R.; Wilhelm, J.A. (Anaquest Inc., Murray Hill, NJ (United States))

    1992-11-01

    The synthesis of [[sup 14]C]-fentanyl, the radiolabelled congener of the potent opioid analgesic chosen for utilization in drug disposition studies, is described. [[sup 14]C]-Labelling was achieved in the first of two steps, a room temperature reduction of the in situ generated Schiff base from 1-phenylethyl-4-piperidone and [UL-[sup 14]C]-aniline hydrochloride with sodium triacetoxyborohydride. A nearly instantaneous production of fentanyl was accomplished at room temperature with the addition of propionyl chloride. The overall radiochemical yield was 18%. The method described is efficiently adaptable for submicromolar scale while yielding a product of sufficient specific activity for in vivo studies. Our solvent system for thin layer chromatography was superior to the USP system reported for chromatographic analysis of fentanyl. This is the first reported preparation of [[sup 14]C]-fentanyl with the radiolabel in the aniline benzene ring. (author).

  13. An epidemic of illicit fentanyl deaths in Cook County, Illinois: September 2005 through April 2007.

    Science.gov (United States)

    Denton, J Scott; Donoghue, Edmund R; McReynolds, Jennifer; Kalelkar, Mitra B

    2008-03-01

    Between September 2005 and April 2007, 350 fentanyl intoxication deaths were investigated and certified by the Cook County Medical Examiners Office. Investigations revealed that the majority of these fatalities were by intravenous injection of a white powder followed by a rapid collapse. The fentanyl was clandestinely produced in a lab in Toluca, Mexico and sold by the Mickey Cobra street gang. The term "Drop Dead" was coined for this "tainted heroin." Postmortem samples were screened by ELISA and confirmed by standard GC-MS methods. Fentanyl fatalities peaked at 47 per month in May and June 2006. Fifty-two percent were single fentanyl intoxications, with the remainder accompanied by either cocaine, morphine from heroin, or alcohol. This epidemic stressed the limited resources of the toxicology laboratory and autopsy service of the Medical Examiners Office. The clandestine lab was terminated, distributing gang members and leaders arrested, and the epidemic ceased in April 2007.

  14. Fentanyl-midazolam vs. midazolam-ketamine regarding patient sedation analgesia for emergency orthopedic procedures

    National Research Council Canada - National Science Library

    Ali Abdolrazaghnejad; Mohsen Banaie

    2017-01-01

    The aim of the present study was to investigate two pharmaceutical groups including fentanyl-midazolam and midazolam-ketamine used as patient seda-tion analgesia for the orthopedic emergency procedures...

  15. Transbuccal delivery of betahistine dihydrochloride from mucoadhesive tablets with a unidirectional drug flow: in vitro, ex vivo and in vivo evaluation

    Directory of Open Access Journals (Sweden)

    El-Nabarawi MA

    2016-12-01

    Full Text Available Mohamed A El-Nabarawi,1 Adel A Ali,2 Heba M Aboud,2 Amira H Hassan,2 Amany H Godah2 1Department of Pharmaceutics, Faculty of Pharmacy, Cairo University, Cairo, 2Department of Pharmaceutics, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt Objective: Betahistine dihydrochloride (BH.2HCl, an anti-vertigo histamine analog used in the treatment of Ménière’s disease, undergoes extensive first-pass metabolism and suffers from short biological half-life. The aim of the present work was to develop and estimate controlled release mucoadhesive buccal tablets of BH.2HCl with a unidirectional drug flow to overcome this encumbrance. Methods: A direct compression method was adopted for preparation of the tablets using mucoadhesive polymers like guar gum, hydroxypropyl methyl cellulose K4M, sodium carboxymethyl cellulose and their combinations. The tablets were coated from all surfaces except one surface with a solution of 5% (w/v cellulose acetate and 1% (w/v dibutyl phthalate. Different permeation enhancers like 2% sodium deoxycholate, 2% sodium cholate hydrate (SCH and 5% menthol were tested. Swelling index, ex vivo residence time, mucoadhesion strength, in vivo testing of mucoadhesion time, in vitro dissolution and ex vivo permeation were carried out. Furthermore, compatibility and accelerated stability studies were performed for the drug excipients. Finally, drug bioavailability of the BH.2HCl-optimized buccal mucoadhesive formulation was compared with that of the orally administered Betaserc® 24 mg tablet in six healthy male volunteers. Results: Formulation F10, which contained a combination of 35% guar gum and 5% sodium carboxymethyl cellulose, exhibited long adhesion time, high adhesion strength and diminished irritation to volunteers and showed zero-order release kinetics. SCH produced a significant enhancement in permeation of BH.2HCl across buccal mucosa. BH.2HCl-optimized buccal mucoadhesive formulation showed percentage relative

  16. Myoepithelial carcinoma of buccal mucosa: A rare tumor.

    Science.gov (United States)

    Lata, Jeevan; Ahmad, Fahad; Chand, Vimal

    2014-04-01

    Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  17. [Pharmaceutical technology of Cordaflex tablets].

    Science.gov (United States)

    Erdös, S

    1996-01-01

    First the possibilities of solubilization and the photosensibility of nifedipine (the active ingredient of Cordaflex tablets) were investigated. The technology of retard tablet involves the preparation of a coprecipitate through spraying a solution containing nifedipine, a hydrotropic and a reardizing substance on carrier. After drying the produced granulated material was blended with common auxiliary ingredients, compressed into tablet and coated. The ratio of the two types of coprecipitating substances has a direct effect on the dissolution, so it proved predictable. The reproducibility of technology was good.

  18. Epidural versus intravenous fentanyl for postoperative analgesia following orthopedic surgery: randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Marcelo Soares Privado

    Full Text Available CONTEXT AND OBJECTIVE: Controversy exists regarding the site of action of fentanyl after epidural injection. The objective of this investigation was to compare the efficacy of epidural and intravenous fentanyl for orthopedic surgery. DESIGN AND SETTING: A randomized double-blind study was performed in Hospital São Paulo. METHODS: During the postoperative period, in the presence of pain, 29 patients were divided into two groups: group 1 (n = 14 received 100 µg of fentanyl epidurally and 2 ml of saline intravenously; group 2 (n = 15 received 5 ml of saline epidurally and 100 µg of fentanyl intravenously. The analgesic supplementation consisted of 40 mg of tenoxicam intravenously and, if necessary, 5 ml of 0.25% bupivacaine epidurally. Pain intensity was evaluated on a numerical scale and plasma concentrations of fentanyl were measured simultaneously. RESULTS: The percentage of patients who required supplementary analgesia with tenoxicam was lower in group 1 (71.4% than in group 2 (100%: 95% confidence interval (CI = 0.001-0.4360 (P = 0.001, Fisher's exact test; relative risk, RR = 0.07. Epidural bupivacaine supplementation was also lower in group 1 (14.3% than in group 2 (53.3%: 95% CI = 0.06-1.05 (P = 0.03, Fisher's exact test; RR = 0.26. There was no difference in pain intensity on the numerical scale. Mean fentanyl plasma concentrations were similar in the two groups. CONCLUSION: Intravenous and epidural fentanyl appear to have similar efficacy for reducing pain according to the numerical scale, but supplementary analgesia was needed less frequently when epidural fentanyl was used. CLINICAL TRIAL REGISTRATION NUMBER: NCT00635986

  19. Fentanyl inhibits glucose-stimulated insulin release from β-cells in rat pancreatic islets

    Institute of Scientific and Technical Information of China (English)

    Tao-Lai Qian; Xin-Hua Wang; Sheng Liu; Liang Ma; Ying Lu

    2009-01-01

    AIM:To explore the effects of fentanyl on insulin release from freshly isolated rat pancreatic islets in static culture.METHODS: Islets were isolated from the pancreas of mature Sprague Dawley rats by common bile duct intraductal collagenase V digestion and were purified by discontinuous Ficoll density gradient centrifugation.The islets were divided into four groups according to the fentanyl concentration: control group (0 ng/mL),group Ⅰ (0.3 ng/mL), group Ⅱ (3.0 ng/mL), and group Ⅲ (30 ng/mL). In each group, the islets were co-cultured for 48 h with drugs under static conditions with fentanyl alone, fentanyl + 0.1 μg/mL naloxone or fentanyl + 1.0 μg/mL naloxone. Cell viability was assessed by the MTT assay. Insulin release in response to low and high concentrations (2.8 mmol/L and 16.7 mmol/L,respectively) of glucose was investigated and electron microscopy morphological assessment was performed.RESULTS: Low- and high-glucose-stimulated insulin release in the control group was significantly higher than in groups Ⅱ and Ⅲ (62.33 ±9.67 μIU vs 47.75 ±96.17 ± 14.17 μIU, 75.17 ± 13.57 μIU, respectively, P <0.01) and was lowest in group Ⅲ ( P < 0.01). After adding 1 μg/mL naloxone, insulin release in groups Ⅱ and Ⅲ was not different from the control group. Electron microscopy studies showed that the islets were damaged by 30 ng/mL fentanyl.CONCLUSION: Fentanyl inhibited glucose-stimulated insulin release from rat islets, which could be prevented by naloxone. Higher concentrations of fentanyl significantly damaged β-cells of rat islets.howed that the isl

  20. Effects of fentanyl on serotonin syndrome-like behaviors in rats.

    Science.gov (United States)

    Kitamura, Sonoe; Kawano, Takashi; Kaminaga, Satomi; Yamanaka, Daiki; Tateiwa, Hiroki; Locatelli, Fabricio M; Yokoyama, Masataka

    2016-02-01

    Emerging evidence from case reports suggests that fentanyl may precipitate potentially life-threatening serotonin syndrome in patients taking serotonergic drugs. However, the underlying mechanism of the association between serotonin syndrome and fentanyl remains under investigation. We therefore investigated the pharmacological effects of an analgesic dose of fentanyl (0.2 mg/kg) injected subcutaneously (s.c.) on serotonergic toxicity-like responses in rats. Rats were s.c. injected with 0.75 mg/kg 8-OH-DPAT, a full 5-HT1A agonist, as an animal model of serotonin syndrome. The 8-OH-DPAT-treated rats showed well-characterized serotonin syndrome-like behaviors (low body posture, forepaw treading), hyperlocomotion, and decreased body temperature. Rats injected s.c. with fentanyl alone showed no significant changes in any of the parameters measured, while concomitant administration of fentanyl + 8-OH-DPAT resulted in exaggerated 8-OH-DPAT-induced serototoxic responses. A separate dose-response experiment showed that the serototoxic effect of fentanyl was dose-dependent. Pretreatment with naloxone [2.0 mg/kg, intraperitoneal (i.p.) injection], an opioid receptor antagonist, failed to antagonize the fentanyl-induced exaggerated serotonin syndrome-like behaviors. In contrast, pretreatment with WAY-100653, a serotonin 5-HT1A receptor antagonist (0.5 mg/kg, i.p. injection) completely inhibited all responses. Our findings provide preclinical proof-of-concept that an analgesic dose of fentanyl enhances serotonin toxicity, likely via its serotonin-reuptake inhibitory activity, independently of interaction with the opioid receptors.

  1. Patient-Controlled Transdermal Fentanyl Versus Intravenous Morphine Pump After Spine Surgery.

    Science.gov (United States)

    Lindley, Emily M; Milligan, Kenneth; Farmer, Ryan; Burger, Evalina L; Patel, Vikas V

    2015-09-01

    Patient-controlled analgesia (PCA) is regularly used to manage pain following major surgery. The fentanyl hydrochloride iontophoretic transdermal system (ITS) was developed to overcome some of the limitations of intravenous (IV) PCA. The small, self-adhesive, needle-free disposable system is applied to the skin on the upper arm or chest and is controlled by patients clicking a button on the device. The authors identified patients who were underwent spinal surgery from 2 prior multicenter, randomized studies and analyzed their data. Of the 1296 patients in the original trials, 170 underwent spine surgery procedures: 90 were randomized to the fentanyl ITS (40 mcg/activation) and 80 to IV PCA morphine (1 mg/dose). More patients treated with the fentanyl ITS rated their method of pain control as "excellent" across all time points, but differences did not reach statistical significance. However, investigators' ratings of "excellent" satisfaction with study treatment were significantly higher for the fentanyl ITS. Discontinuation rates and overall adverse event rates were similar between groups. The only significant difference was that patients treated with the fentanyl ITS had a higher rate of application site reactions than infusion site reactions in the IV PCA morphine group; the reactions were typically mild-to-moderate erythema that resolved shortly after removal of the fentanyl ITS device and did not require further treatment. Ratings of satisfaction with pain control method were consistently higher for the fentanyl ITS than the IV PCA morphine. The 2 groups had a similar safety profile. These results suggest that the fentanyl ITS appears to be a safe, efficacious alternative to IV PCA in spine surgery patients.

  2. Cardiovascular and endocrine responses to cutaneous electrical stimulation after fentanyl in the ovine fetus.

    Science.gov (United States)

    Smith, Richard P; Miller, Suzanne L; Igosheva, Natalia; Peebles, Donald M; Glover, Vivette; Jenkin, Graham; Hanson, Mark A; Fisk, Nicholas M

    2004-03-01

    The purpose of this study was to determine whether physical stimulation is stressful to the ovine fetus, as judged from physiologic changes that are similar to those reported for other stressors (such as hypoxia); whether any stress response could be blocked by clinically used doses of fentanyl; and whether fentanyl alone had any potentially deleterious physiologic effects in the fetus. We investigated the effect of fentanyl analgesia on the cardiovascular and endocrine response to cutaneous electrical stimulation in the late gestation (>125 days) ovine fetus (n=7 fetuses). Chronically implanted catheters and blood flow probes were used to measure fetal arterial blood pressure, heart rate, carotid and femoral blood flow, pH, Po(2), Pco(2), lactate, cortisol, and beta-endorphin levels before, during, and for 1 hour after 5 minutes of cutaneous electrical stimulation to the lip, forelimb, and abdomen, in a crossover design. Clinically used 30 or 150 microg doses of fentanyl (which approximated 10 or 50 microg/kg estimated fetal weight) or saline solution were given intravenously to the fetus 2 minutes before stimulation. When compared with the control, stimulation caused a significant rise in fetal heart rate (P=.003; mean maximal rise, 48.6+/-14.0 beats/min, 0-10 minutes after the start of stimulation) but caused no change in any other parameters studied. Neither dose of fentanyl attenuated the changes in heart rate that were observed in response to stimulation alone. Fentanyl alone significantly increased fetal heart rate, carotid blood flow, and lactate and cortisol levels and significantly decreased pH and Po(2). Cutaneous electrical stimulation in the fetal sheep causes an increase in heart rate, which fentanyl does not block. Fentanyl itself has significant effects on the cardiovascular and endocrine system, which might adversely affect the fetus.

  3. Synergistic effect of intrathecal fentanyl and bupivacaine in spinal anesthesia for cesarean section

    Directory of Open Access Journals (Sweden)

    Srivastava Pratima

    2005-05-01

    Full Text Available Abstract Background Potentiating the effect of intrathecal local anesthetics by addition of intrathecal opiods for intra-abdominal surgeries is known. In this study by addition of fentanyl we tried to minimize the dose of bupivacaine, thereby reducing the side effects caused by higher doses of intrathecal bupivacaine in cesarean section. Methods Study was performed on 120 cesarean section parturients divided into six groups, identified as B8, B10 and B 12.5 8.10 and 12.5 mg of bupivacaine mg and FB8, FB10 and FB 12.5 received a combination of 12.5 μg intrathecal fentanyl respectively. The parameters taken into consideration were visceral pain, hemodynamic stability, intraoperative sedation, intraoperative and postoperative shivering, and postoperative pain. Results Onset of sensory block to T6 occurred faster with increasing bupivacaine doses in bupivacaine only groups and bupivacaine -fentanyl combination groups. Alone lower concentrations of bupivacaine could not complete removed the visceral pain. Blood pressure declined with the increasing concentration of Bupivacaine and Fentanyl. Incidence of nausea and shivering reduces significantly whereas, the postoperative pain relief and hemodynamics increased by adding fentanyl. Pruritis, maternal respiratory depression and changes in Apgar score of babies do not occur with fentanyl. Conclusion Spinal anesthesia among the neuraxial blocks in obstetric patients needs strict dose calculations because minimal dose changes, complications and side effects arise, providing impetus for this study. Here the synergistic, potentiating effect of fentanyl (an opiod on bupivacaine (a local anesthetic in spinal anesthesia for cesarian section is presented, fentanyl is able to reduce the dose of bupivacaine and therefore its harmful effects.

  4. Influence of fentanyl and morphine on intestinal circulation.

    Science.gov (United States)

    Tverskoy, M; Gelman, S; Fowler, K C; Bradley, E L

    1985-06-01

    The influence of fentanyl and morphine on the intestinal circulation was evaluated in an isolated loop preparation in 37 dogs anesthetized with pentobarbital intravenously. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mm Hg. A mixture of 86Rb and 9-micron spheres labeled with 141Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A strong correlation was found between the clearances of rubidium and microspheres (r = 0.97, P less than 0.0001), suggesting that the shunting of 9-micron spheres through the intestines reflects the shunting of blood through nonnutritive vessels. Intravenous fentanyl decreased oxygen uptake (O2up), and vascular resistance (VR), and increased blood flow (BF), rubidium and microsphere clearances (Cl-Rb, Cl-Sph, respectively), and permeability--surface area product (PS) in a dose-related fashion. Intravenous morphine in a dose of 1 mg X kg-1 increased Cl-Rb (nutritive BF) without changes in total (nutritive and nonnutritive) BF. This increase in nutritive BF is probably related to morphine-induced histamine release. Morphine in a dose of 5 mg X kg-1 was accompanied by vasoconstriction that was completely abolished by alpha-adrenoceptor blockade. The data suggest that morphine-induced intestinal vasoconstriction is mediated via a release of epinephrine, apparently from the adrenal medulla. It is concluded that changes in the intestinal circulation during anesthesia with narcotics might play a certain role in the cardiovascular homeostasis during anesthesia and surgery. An increase in oxygen content in portal venous blood, resulting from a decrease in intestinal oxygen uptake, should facilitate hepatic oxygenation.

  5. Influence of fentanyl and morphine on intestinal circulation

    Energy Technology Data Exchange (ETDEWEB)

    Tverskoy, M.; Gelman, S.; Fowler, K.C.; Bradley, E.L.

    1985-06-01

    The influence of fentanyl and morphine on the intestinal circulation was evaluated in an isolated loop preparation in 37 dogs anesthetized with pentobarbital intravenously. Selected intestinal segments were pumped with aortic blood at a constant pressure of 100 mm Hg. A mixture of /sup 86/Rb and 9-micron spheres labeled with /sup 141/Ce was injected into the arterial cannula supplying the intestinal loop, while mesenteric venous blood was collected for activity counting. A strong correlation was found between the clearances of rubidium and microspheres (r = 0.97, P less than 0.0001), suggesting that the shunting of 9-micron spheres through the intestines reflects the shunting of blood through nonnutritive vessels. Intravenous fentanyl decreased oxygen uptake (O/sub 2/up), and vascular resistance (VR), and increased blood flow (BF), rubidium and microsphere clearances (Cl-Rb, Cl-Sph, respectively), and permeability--surface area product (PS) in a dose-related fashion. Intravenous morphine in a dose of 1 mg X kg-1 increased Cl-Rb (nutritive BF) without changes in total (nutritive and nonnutritive) BF. This increase in nutritive BF is probably related to morphine-induced histamine release. Morphine in a dose of 5 mg X kg-1 was accompanied by vasoconstriction that was completely abolished by alpha-adrenoceptor blockade. The data suggest that morphine-induced intestinal vasoconstriction is mediated via a release of epinephrine, apparently from the adrenal medulla. It is concluded that changes in the intestinal circulation during anesthesia with narcotics might play a certain role in the cardiovascular homeostasis during anesthesia and surgery. An increase in oxygen content in portal venous blood, resulting from a decrease in intestinal oxygen uptake, should facilitate hepatic oxygenation.

  6. Comparative pharmacokinetics of intravenous fentanyl and buprenorphine in healthy greyhound dogs.

    Science.gov (United States)

    KuKanich, B; Allen, P

    2014-12-01

    The purpose of this study was to compare the pharmacokinetics of two highly protein-bound, lipophilic opioid drugs. Fentanyl (10 μg/kg) and buprenorphine (20 μg/kg) were administered intravenously (IV) to six healthy greyhound dogs (three males and three females). The doses were based on clinically administered doses for dogs. Plasma drug concentrations were determined using liquid chromatography with mass spectrometry, and noncompartmental pharmacokinetics were estimated with computer software. The volume of distribution (area) was larger for fentanyl (7.42 L/kg) compared to buprenorphine (3.54 L/kg). The plasma clearance of fentanyl (38.6 mL·min/kg) was faster than buprenorphine (10.3 mL·min/kg). The terminal half-life of fentanyl (2.22 h) was shorter than buprenorphine (3.96 h). Despite similar physicochemical properties including octanol-water partition coefficient and pKa, the pharmacokinetics of fentanyl and buprenorphine were not similar. Both fentanyl (84%) and buprenorphine (95-98%) are considered highly protein bound, but the differences in protein binding may contribute to the lack of similarity of pharmacokinetics in healthy dogs.

  7. Intrathecal sufentanil versus fentanyl for lower limb surgeries - A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Poonam Motiani

    2011-01-01

    Full Text Available Background:To compare the efficacy and safety of intrathecal sufentanil or fentanyl as adjuvants to hyperbaric bupivacaine in patients undergoing major orthopaedic lower limb surgeries in terms of onset and duration of sensory block, motor block and post-operative pain relief. Patients & Methods: Ninety patients were recruited in this Prospective, randomized double blind study to receive either intrathecal sufentanil 5 μg (Group S, fentanyl 25 μg (Group F or normal saline 0.5 ml (Group C as adjuvants to 15 mg of 0.5% hyperbaric bupivacaine. The onset and duration of sensory and motor block were assessed intraoperatively. The pain scores were assessed postoperatively. Duration of complete and effective analgesia was recorded. The incidence of side effects such as nausea, vomiting, pruritus, shivering and PDPH was recorded. Results: The Demographic data, hemodynamic and respiratory parameters were comparable in the three groups. There was a significantly earlier onset and prolonged duration of sensory block in the sufentanil and fentanyl groups. The duration of complete and effective analgesia were also significantly prolonged in the fentanyl and sufentanil groups. Pruritus was noticed in the study groups (Groups S&F. Conclusions: Intrathecal sufentanil (5 μg and fentanyl (25 μg, as adjuvants lead to an earlier onset and prolonged duration of sensory block. The duration of effective analgesia with intrathecal sufentanil and fentanyl as adjuvants to hyperbaric bupivacaine is longer than that of bupivacaine alone.

  8. Evaluation of the Coat-A-Count sup 125 I fentanyl RIA: Comparison of sup 12 5I RIA and GC/MS-SIM for quantification of fentanyl in case urine specimens

    Energy Technology Data Exchange (ETDEWEB)

    Watts, V.W.; Caplan, Y.H. (Mesa Police Crime Laboratory, AZ (USA))

    1990-09-01

    The Coat-A-Count solid phase {sup 125}I Fentanyl Radioimmunoassay was evaluated with respect to linearity and precision using equine urine fortified with fentanyl and then compared with a gas chromatographic/mass spectrometric method for quantification of fentanyl in urine. The RIA assay was found to be linear over the urine fentanyl concentration range of 0.25 to 7.5 ng/mL and precise with coefficients of variation (CV) ranging from 9.6 to 19.3%. The RIA calibrators, ranging in fentanyl concentrations from 0.25 to 7.5 ng/mL, and controls, at mean fentanyl concentrations of 0.46 and 1.32 ng/mL, were compared by both the RIA and GC/MS methods. The cross-reactivity with the {sup 125}I RIA test was determined for the fentanyl metabolites, norfentanyl and hydroxyfentanyl, and found to be 5% and 35%, respectively. The illicit fentanyl analogs were found to show significant cross-reactivity, ranging from 20 to 100%. The {sup 125}I RIA was compared to GC/MS quantifications of fentanyl in 35 positive and 20 negative case urine specimens.

  9. [Anesthesia with flunitrazepam/fentanyl and isoflurane/fentanyl. Unconscious perception and mid-latency auditory evoked potentials].

    Science.gov (United States)

    Schwender, D; Kaiser, A; Klasing, S; Faber-Züllig, E; Golling, W; Pöppel, E; Peter, K

    1994-05-01

    There is a high incidence of intraoperative awareness during cardiac surgery. Mid-latency auditory evoked potentials (MLAEP) reflect the primary cortical processing of auditory stimuli. In the present study, we investigated MLAEP and explicit and implicit memory for information presented during cardiac anaesthesia. PATIENTS AND METHODS. Institutional approval and informed consent was obtained in 30 patients scheduled for elective cardiac surgery. Anaesthesia was induced in group I (n = 10) with flunitrazepam/fentanyl (0.01 mg/kg) and maintained with flunitrazepam/fentanyl (1.2 mg/h). The patients in group II (n = 10) received etomidate (0.25 mg/kg) and fentanyl (0.005 mg/kg) for induction and isoflurane (0.6-1.2 vol%)/fentanyl (1.2 mg/h) for maintenance of general anaesthesia. Group III (n = 10) served as a control and patients were anaesthetized as in I or II. After sternotomy an audiotape that included an implicit memory task was presented to the patients in groups I and II. The story of Robinson Crusoe was told, and it was suggested to the patients that they remember Robinson Crusoe when asked what they associated with the word Friday 3-5 days postoperatively. Auditory evoked potentials were recorded awake and during general anaesthesia before and after the audiotape presentation on vertex (positive) and mastoids on both sides (negative). Auditory clicks were presented binaurally at 70 dBnHL at a rate of 9.3 Hz. Using the electrodiagnostic system Pathfinder I (Nicolet), 1000 successive stimulus responses were averaged over a 100 ms poststimulus interval and analyzed off-line. Latencies of the peak V, Na, Pa were measured. V belongs to the brainstem-generated potentials, which demonstrates that auditory stimuli were correctly transduced. Na, Pa are generated in the primary auditory cortex of the temporal lobe and are the electrophysiological correlate of the primary cortical processing of the auditory stimuli. RESULTS. None of the patients had an explicit memory

  10. Preparation and evaluation of buccal bioadhesive films containing clotrimazole.

    Science.gov (United States)

    Singh, S; Jain, S; Muthu, M S; Tiwari, S; Tilak, R

    2008-01-01

    Buccal bioadhesive films, releasing topical drugs in the oral cavity at a slow and predetermined rate, provide distinct advantages over traditional dosage forms. The aim of present study was to prepare and evaluate buccal bioadhesive films of clotrimazole for oral candidiasis. The film was designed to release the drug at a concentration above the minimum inhibitory concentration for a prolonged period of time so as to reduce the frequency of administration of the available conventional dosage forms. The different proportions of sodium carboxymethylcellulose and carbopol 974P (CP 974P) were used for the preparation of films. Carbopol was used to incorporate the desired bioadhesiveness in the films. The films were prepared by solvent casting method and evaluated for bioadhesion, in vitro drug release and effectiveness against Candida albicans. In vitro drug release from the film was determined using a modified Franz diffusion cell while bioadhesiveness was evaluated with a modified two-arm balance using rabbit intestinal mucosa as a model tissue. Films containing 5% CP 974P of the total polymer were found to be the best with moderate swelling along with favorable bioadhesion force, residence time and in vitro drug release. The microbiological studies revealed that drug released from the film could inhibit the growth of C. albicans for 6 h. The drug release mechanism was found to follow non-Fickian diffusion.

  11. FORMULATION AND EVALUATION OF BUCCAL FILMS OF SALBUTAMOL SULPHATE

    Directory of Open Access Journals (Sweden)

    VAMSHI KRISHNA

    2013-01-01

    Full Text Available For systemic drug delivery, the buccal region offers an attractive route of drug administration. The main objective of the study is to formulate buccal patches of salbutamol sulphate. Salbutamol sulfate is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It’s oral bioavailability is 40% due to extensive first pass metabolism. Salbutamol sulfate patches were prepared using HPMC, SCMC and Carbopol 934 in various proportions and combinations using Glycerol and tween-80 as plasticizers. Patches were laminated on one side with a water impermeable backing layer using ethyl cellulose for unidirectional drug release. The thickness of medicated patches were ranged between 0.402 and 0.431 mm and mass varied between 0.0312 and 0.0352 g. The surface-pH of patches ranged between 6 and 7. All formulations showed good folding endurance. Formulations F9 showed good drug content and Residence time of the tested patches ranged between 108 and 174 min. The maximum in vitro release was found to be 93.89% over a period of 150 min for formulation F9. Data of in vitro release from patches were fitted to different kinetic models such as Higuchi and Korsmeyer–Peppas models to explain the release profile. Formulations F9 were best fitted to the non-Fickian kinetics and zero order release was observed.

  12. Influence of buccal corridor dimension on smile esthetics

    Directory of Open Access Journals (Sweden)

    Diana Cunha Nascimento

    2012-10-01

    Full Text Available OBJECTIVE: To assess the influence of buccal corridor width on smile esthetics of male and female, Caucasian and Afro-descendant subjects by means of digitally manipulated photographs, as well as compare assessments of full-face view (FFV and close-up view of the mouth (CUVM images. METHODS: Facial photographs were taken of four adults' smile, two Caucasians and two Afro-descendants of both genders. The resulting images were digitally manipulated with the aim of rendering - from each original smile - three other smiles simulating three different buccal corridor widths, namely, narrow, medium width and wide. The rendered images, 12 of which portraying FFVs and 12 providing CUVMs, were assessed by 60 examiners who rated the attractiveness of each smile by means of a visual analog scale (VAS. The data were treated with ANOVA and Tukey's post test to compare the different buccal corridors, and Student's t test to compare the two image views (FFV and CUVM. RESULTS: Medium width buccal corridors were considered the most attractive in the four individuals investigated, both in the assessment of FFVs and CUVMs (p 0.05. Furthermore, no statistically significant difference was found between the analyses of FFVs and CUVMs (p > 0.05. CONCLUSION: The buccal corridor exercised a remarkable influence on smile esthetics, with the medium width group being rated as the most attractive. No influence was exerted by the individuals' face, ethnicity or gender.OBJETIVO: avaliar a influência do corredor bucal na estética de sorrisos femininos e masculinos, de leucodermas e melanodermas, por meio de fotografias manipuladas, bem como comparar essa avaliação numa vista facial completa e numa vista aproximada da boca. MÉTODOS: foram realizadas fotografias faciais do sorriso de quatro indivíduos adultos, sendo dois leucodermas e dois melanodermas, de ambos os sexos. As imagens geradas foram manipuladas a fim de produzir, a partir de cada sorriso original, três outros

  13. Ex vivo correlation of the permeability of metoprolol across human and porcine buccal mucosa.

    Science.gov (United States)

    Meng-Lund, Emil; Marxen, Eva; Pedersen, Anne Marie L; Müllertz, Anette; Hyrup, Birgitte; Holm, Rene; Jacobsen, Jette

    2014-07-01

    The pH partition theory proposes a correlation between fraction of unionized drug substance and permeability. The aim of this study was to compare the permeability of metoprolol and mannitol in ex vivo human and porcine buccal mucosa models at varying pH to validate whether the porcine permeability model is predictive for human buccal absorption. Human (n = 9-10) and porcine (n = 6-7) buccal mucosa were mounted in a modified Ussing chamber, and the kinetics of metoprolol and mannitol transport was assessed for a period of 5.5 h with the pH values of donor medium set at 7.4, 8.5, and 9.0. In addition, hematoxylin-eosin and Alcian blue-van Gieson were used as tissue stains to evaluate the histology and the presence of acidic polysaccharides (e.g., mucins), respectively. The permeability of metoprolol was decreased in human buccal mucosa by almost twofold when compared with porcine buccal mucosa with a positive correlation (r(2) = 0.96) between the permeability assessed in porcine and human buccal mucosa. There was no change in the degree of either epithelial swelling or desquamation when treating with the pH 9.0 donor medium for 5.5 h. These data suggest that buccal mucosa from pigs can be used to predict human buccal absorption.

  14. Ex Vivo Correlation of the Permeability of Metoprolol Across Human and Porcine Buccal Mucosa

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Marxen, Eva; Pedersen, Anne Marie Lynge;

    2014-01-01

    .0. In addition, hematoxylin-eosin and Alcian blue-van Gieson were used as tissue stains to evaluate the histology and the presence of acidic polysaccharides (e.g., mucins), respectively. The permeability of metoprolol was decreased in human buccal mucosa by almost twofold when compared with porcine buccal mucosa...

  15. Perineal urethrostomy stenosis repair with buccal mucosa: description of technique and report of four cases.

    Science.gov (United States)

    Kamat, Nagesh

    2008-11-01

    Perineal urethrostomy stenosis can be a difficult problem to treat, especially in patients with balanitis xerotica obliterans. We have devised a technique of using the buccal mucosa, with the idea of forming a composite stoma comprising skin and buccal mucosa. We describe the technique and short-term results in 4 patients.

  16. Development and evaluation of tamarind seed xyloglucan-based mucoadhesive buccal films of rizatriptan benzoate.

    Science.gov (United States)

    Avachat, Amelia M; Gujar, Kishore N; Wagh, Kishor V

    2013-01-16

    Mucoadhesive buccal films were developed using tamarind seed xyloglucan (TSX) as novel mucoadhesive polysaccharide polymer for systemic delivery of rizatriptan benzoate through buccal route. Formulations were prepared based on 3(2) factorial design with concentrations of TSX and carbopol 934P (CP) as independent variables. Three dependent variables considered were tensile strength, bioadhesion force and drug release. DSC analysis revealed no interaction between drug and polymers. Ex vivo diffusion studies were carried out using Franz diffusion cell, while bioadhesive properties were evaluated using texture analyzer with porcine buccal mucosa as model tissue. Results revealed that bilayer film containing 4% (w/v) TSX and 0.5% (w/v) CP in the drug layer and 1% (w/v) ethyl cellulose in backing layer demonstrated diffusion of 93.45% through the porcine buccal mucosa. Thus, this study suggests that tamarind seed polysaccharide can act as a potential mucoadhesive polymer for buccal delivery of a highly soluble drug like rizatriptan benzoate.

  17. TELOMERASE ACTIVITY DURING 7, 12-DIMETHYLBENZ [a] ANTHRACENE-INDUCED HAMSTER BUCCAL POUCH CARCINOGENESIS

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To investigate the roles of telomerase activity (TA) in relation to hamster buccal pouch tumor progression. Methods: male hamster were treated three times weekly with 0.5% of 7, 12-dimethyl- benzanthracene (DMBA) over a 15 weeks experimental period. Hamsters were sacrificed at 3, 6, 9, 12 and 15 weeks after treatment. Telomerase activity of hamster buccal pouch tissue were measured along with the analyses of the formation of DMBA-induced hamster buccal pouch tumors. Results: DMBA-induced squamous cell carcinomas were found at the 6th week after dosing. Telomerase activity elevation began at the 3rd week and was increasing to a plateau at the 12th week. Conclusion: Our results show that telomerase activity in the target tissue may be detected at the early stage of the DMBA-induced hamster buccal pouch tumor formation and suggests that telomerase activity may be used as a biomarker for an early clinical detection of buccal pouch cancer.

  18. Epidural fentanyl decreases the minimum local analgesic concentration of epidural lidocaine

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jian; ZHENG Yue-ying; FENG Zhi-ying; CHEN Chao-qin; ZHU Sheng-mei

    2012-01-01

    Background Epidural lidocaine can be used when regional anesthesia needs to be established quickly,but the effect of co-administering epidural fentanyl on the minimum local analgesic concentration(MLAC)of lidocaine is not known.We compared the MLAC of epidural lidocaine in combination with different doses of fentanyl for epidural anesthesia in adults.Methods One hundred and twenty patients requiring epidural analgesia were randomly allocated to receive 20 ml of one of four solutions:lidocaine,or lidocaine plus fentanyl 1 μg/ml,2 μg/ml,or 3 μg/ml.The first patient in each group was administered 1% lidocaine weight by volume;subsequent patients received a concentration determined by the response of the previous patient to a higher or lower concentration according to up and down sequential allocation in 0.1% increments.Efficacy was assessed using a visual analog pain scale,and accepted if this was ≤10 mm on a 100 mm scale within 30 minutes.The extent of motor block and of nausea and vomiting were recorded at 30 minutes after administration of the epidural solution and two hours after surgery,respectively.Results The MLAC of lidocaine in those receiving lidocaine alone was 0.785%(95%C/0.738-0.864).A significant dose-dependent reduction was observed with the addition of fentanyl:the MLAC of lidocaine with fentanyl at 2 μg/ml was 0.596%(95%Cl 0.537-0.660)and 0.387% with fentanyl at 3 μg/ml(95%Cl 0.329-0.446,P<0.001).Conclusion Epidural fentanyl significantly reduces the dose of lidocaine required for effective epidural analgesia in adults without causing adverse side effects.

  19. Correlation of ADRB1 rs1801253 Polymorphism with Analgesic Effect of Fentanyl After Cancer Surgeries.

    Science.gov (United States)

    Wei, Wei; Tian, Yanli; Zhao, Chunlei; Sui, Zhifu; Liu, Chang; Wang, Congmin; Yang, Rongya

    2015-01-01

    BACKGROUND Our study aimed to explore the association between β1-adrenoceptor (ADRB1) rs1801253 polymorphism and analgesic effect of fentanyl after cancer surgeries in Chinese Han populations. MATERIAL AND METHODS Postoperative fentanyl consumption of 120 patients for analgesia was recorded. Genotype distributions were detected by allele specific amplification-polymerase chain reaction (ASA-PCR) method. Postoperative pain was measured by visual analogue scale (VAS) method. Differences in postoperative VAS score and postoperative fentanyl consumption for analgesia in different genotype groups were compared by analysis of variance (ANOVA). Preoperative cold pressor-induced pain test was also performed to test the analgesic effect of fentanyl. RESULTS Frequencies of Gly/Gly, Gly/Arg, Arg/Arg genotypes were 45.0%, 38.3%, and 16.7%, respectively, and passed the Hardy-Weinberg Equilibrium (HWE) test. The mean arterial pressure (MAP) and the heart rate (HR) had no significant differences at different times. After surgery, the VAS score and fentanyl consumption in Arg/Arg group were significantly higher than in other groups at the postoperative 2nd hour, but the differences were not obvious at the 4th hour, 24th hour, and the 48th hour. The results suggest that the Arg/Arg homozygote increased susceptibility to postoperative pain. The preoperative cold pressor-induced pain test suggested that individuals with Arg/Arg genotype showed worse analgesic effect of fentanyl compared to other genotypes. CONCLUSIONS In Chinese Han populations, ADRB1 rs1801253 polymorphism might be associated with the analgesic effect of fentanyl after cancer surgery.

  20. A novel dosage form for buccal administration of bupropion

    Directory of Open Access Journals (Sweden)

    Nilsa Maria Galvão Almeida

    2015-03-01

    Full Text Available Bupropion is an antidepressant used in the treatment of smoking. The purpose of this study was to prepare controlled-release hydrogel films for buccal administration of bupropion and investigate its physicochemical and cytotoxic properties. The films were prepared from ultrapure sodium carboxymethylcellulose, hydroxypropylmethylcellulose K4M, and medium-viscosity chitosan. Evaluation of film physicochemical characteristics was based on scanning electron microscopy, bupropion content, mechanical strength (burst strength, relaxation, resilience, and traction, and cytotoxicity. Bupropion content in bilayer films was 121 mg per 9 cm2. The presence of bupropion modified film mechanical strength, but did not compromise the use of this pharmaceutical form. As shown by the cytotoxicity results, films containing bupropion did not cause cellular damage. Bupropion administration in the form of hydrogel films is a potentially useful alternative in the treatment of smoking.

  1. Myoepithelial carcinoma of buccal mucosa: A rare tumor

    Directory of Open Access Journals (Sweden)

    Jeevan Lata

    2014-01-01

    Full Text Available Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for < 1% of all salivary gland tumors. The most common sites of involvement are major salivary glands mainly parotid gland. Intraorally, it can arise from minor salivary glands; palate is the most common site of occurrence. It also occurs in nasopharynx, paranasal sinuses, nasal cavity and larynx in head and neck region. Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  2. Characterization of omega-3 tablets.

    Science.gov (United States)

    Vestland, Tina Lien; Jacobsen, Øyvind; Sande, Sverre Arne; Myrset, Astrid Hilde; Klaveness, Jo

    2016-04-15

    Omega-3 nutraceuticals are extensively used as health supplements worldwide. Various administration forms for delivery of omega-3 are available. However, the niche omega-3 tablets have so far remained unexplored. In this work tablets containing 25-40% (w/w) omega-3 oil as triglycerides or ethyl esters were prepared utilizing a direct compaction grade powder with β-cyclodextrin as encapsulating agent. It was found that powders with up to 35% (w/w) triglyceride oil and 30% (w/w) ethyl ester oil, respectively, can be directly compressed into tablets of excellent quality. Physical properties of omega-3 containing powders and tablets are described. The powder X-ray diffractograms of the powders and crushed tablets show evidence of the formation of new crystalline phases not present in β-cyclodextrin. In addition, (1)H NMR data suggest that the ethyl esters form inclusion complexes with β-cyclodextrin. Compaction of other, commercially available, omega-3 powders was performed as a comparison and deemed unsuccessful.

  3. Dissolution and permeation characteristics of artemether tablets ...

    African Journals Online (AJOL)

    and permeation characteristics of the formulations were studied using USP methods. Results: Tablets .... Table 2: Physical properties of the artemether tablets. Batch. Code. CS (kgf) ..... metformin using prosopis gum with antidiabetic potential.

  4. [Study on propofol and fentanyl administrated via common carotid artery in rabbits].

    Science.gov (United States)

    Li, Zhi-hua; Li, Fu-qiang; Xu, Guan-jie; Liu, Shun-suo

    2013-10-08

    To compare the pharmacodynamic differences of common carotid artery administration with ear vein administration of propofol and fentanyl in rabbits. Sixty New Zealand white rabbits were randomly divided into four groups(n = 15):PvFv, PvFa, PaFv and PaFa groups. Propofol 30 mg×kg(-1)×h(-1) and fentanyl 2 µg×kg(-1)×h(-1)were administrated via the ear vein or the common carotid artery. The outcomes were recorded, including the time of consciousness loss and recovery, to electrocerebral silence, dose of propofol and fentanyl, mean arterial pressure, heart rate, respiration rate and SpO2. (1) None of rabbits appeared breathing to be depressed seriously in group PaFa, while respiratory in the other groups were significantly depressed. (2) The dosage of propofol and fentanyl of group PaFa was significantly less than the other groups (P propol and fentanyl via the common carotid artery is more advantageous in some aspects, such as rapid anesthesia induction and recovery, smaller dose, and smaller impact on the hemodynamic and respiratory.

  5. Efficiency of propofol versus midazolam and fentanyl sedation at a pediatric teaching hospital: a prospective study.

    Science.gov (United States)

    Lightdale, Jenifer R; Valim, Clarissa; Newburg, Adrienne R; Mahoney, Lisa B; Zgleszewski, Steven; Fox, Victor L

    2008-06-01

    Many pediatric endoscopists are adopting propofol in their practices, with the expectation that propofol will increase their overall efficiency. To compare the efficiency of propofol versus midazolam and fentanyl by measuring elapsed times between initial intravenous administration and patient discharge at a pediatric teaching hospital. Endoscopy times were prospectively collected for consecutive patients who were undergoing either anesthesiologist-administered propofol or endoscopist-administered midazolam and fentanyl. The effect of the type of sedation on these times was assessed by using multiple linear regression by adjusting for other candidate predictors, including concomitant use of other sedatives, endotracheal intubation by anesthesiologists, and the presence of fellow trainees. Time to onset of sedation (time sedation started to scope in), procedure time (endoscope in to endoscope out), discharge time (endoscope out to hospital discharge), and total time (sedation started to hospital discharge). The times for 134 children (mean age 12 +/- 5 years) to receive propofol sedation were compared with those of 195 children (13 +/- 5 years) who received midazolam and fentanyl. Midazolam and fentanyl cases disproportionately included EGDs (P propofol had shorter times until sedated, similar procedure times, longer discharge times, and comparable total times. Multivariate analyses confirmed that fellow participation prolonged the procedure times (P propofol times (P propofol sedation in a pediatric teaching endoscopy unit may not lead to faster hospital times when compared with endoscopist-administered midazolam and fentanyl. These results are not explained by controlling for patient characteristics, the presence of a trainee, the sedative doses, or endotracheal intubation for airway management.

  6. Increase in Drug Overdose Deaths Involving Fentanyl-Rhode Island, January 2012-March 2014.

    Science.gov (United States)

    Mercado, Melissa C; Sumner, Steven A; Spelke, M Bridget; Bohm, Michele K; Sugerman, David E; Stanley, Christina

    2017-03-06

     This study identified sociodemographic, substance use, and multiple opioid prescriber and dispenser risk factors among drug overdose decedents in Rhode Island, in response to an increase in overdose deaths (ODs) involving fentanyl.  This cross-sectional investigation comprised all ODs reviewed by Rhode Island's Office of the State Medical Examiners (OSME) during January 2012 to March 2014. Data for 536 decedents were abstracted from OSME's charts, death certificates, toxicology reports, and Prescription Monitoring Program (PMP) databases. Decedents whose cause of death involved illicit fentanyl (N = 69) were compared with decedents whose causes of death did not involve fentanyl (other drug decedents; N = 467). Illicit-fentanyl decedents were younger than other drug decedents ( P  = 0.005). While more other-drug decedents than illicit fentanyl decedents had postmortem toxicological evidence of consuming heroin (31.9% vs 19.8%, P  cocaine, heroin). The proportion of all decedents acquiring greater than 100 MME/day prescription dosages written and/or filled by few prescribers and dispensers is concerning. To protect patients, prescribers and dispensers should review PMP records and substance abuse history prior to providing opioids.

  7. Identification of Chemical Attribution Signatures of Fentanyl Syntheses Using Multivariate Statistical Analysis of Orthogonal Analytical Data

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, B. P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Mew, D. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); DeHope, A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Spackman, P. E. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Williams, A. M. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2015-09-24

    Attribution of the origin of an illicit drug relies on identification of compounds indicative of its clandestine production and is a key component of many modern forensic investigations. The results of these studies can yield detailed information on method of manufacture, starting material source, and final product - all critical forensic evidence. In the present work, chemical attribution signatures (CAS) associated with the synthesis of the analgesic fentanyl, N-(1-phenylethylpiperidin-4-yl)-N-phenylpropanamide, were investigated. Six synthesis methods, all previously published fentanyl synthetic routes or hybrid versions thereof, were studied in an effort to identify and classify route-specific signatures. 160 distinct compounds and inorganic species were identified using gas and liquid chromatographies combined with mass spectrometric methods (GC-MS and LCMS/ MS-TOF) in conjunction with inductively coupled plasma mass spectrometry (ICPMS). The complexity of the resultant data matrix urged the use of multivariate statistical analysis. Using partial least squares discriminant analysis (PLS-DA), 87 route-specific CAS were classified and a statistical model capable of predicting the method of fentanyl synthesis was validated and tested against CAS profiles from crude fentanyl products deposited and later extracted from two operationally relevant surfaces: stainless steel and vinyl tile. This work provides the most detailed fentanyl CAS investigation to date by using orthogonal mass spectral data to identify CAS of forensic significance for illicit drug detection, profiling, and attribution.

  8. Advances in patient-controlled analgesia: the role of fentanyl ITS

    Directory of Open Access Journals (Sweden)

    Ian Power

    2009-01-01

    Full Text Available Ian Power, Jon G McCormackDepartment of Anaesthesia, Critical Care and Pain Medicine, The University of Edinburgh, Royal Infirmary, Edinburgh, UKAbstract: Effective pain relief is an essential component of a patient’s peri-operative care package. Good analgesia has been shown to reduce the incidence of cardiovascular, respiratory and thrombo-embolic complications following surgery. Satisfactory analgesia facilitates early patient ambulation following surgery, which may reduce in-patient stay. Patient-controlled analgesia (PCA systems are a well established standard therapy for acute post-operative pain; however some practical limitations limit their clinical utility. The fentanyl inotophoretic transdermal system (ITS is a novel self-contained needle-free PCA device, which delivers boluses of fentanyl transdermally. This system has been shown to provide analgesia equivalent to conventional PCA modalities, with unique design features that may confer advantages to patients and staff, including facilitating patient mobilization in the post-operative phase. This review will discuss the technology of iontophoretic systems, the pharmacology of transdermal fentanyl delivery, and some practical implications of the fentanyl ITS.Keywords: iontophoresis, transdermal, patient-controlled analgesia, fentanyl, post-operative pain

  9. [The hypnotic effect of fentanyl and sulfentanil. An electro-encephalographic comparison (author's transl)].

    Science.gov (United States)

    Kugler, J; Grote, B; Laub, M; Doenicke, A; Dick, E

    1977-07-01

    1. Electroencephalographic activity was registered in healthy subjects before, during and 90 minutes after intravenous injections of sufentanil and fentanyl. 2. With a dosage of ratio of 1:10, i.e., 0.025 mg/70 kg body weight sufentanil: 0.25 mg/70 kg body weight fentanyl as well as 0.015 mg/70 kg body weight sufentanil: 0.15 mg/70 kg body weight fentanyl, sufentanil was hypnotically more potent from fentanyl. 3. Sufentanil acts more powerfully on the respiratory regulation than does fentanyl. Periods of apnoea occur more frequently but can be interrupted by external psychophysiological stimulation. 4. The evaluation of indices of certain EEG-waves, characterizing well defined electroencephalographic stages corresponding to the waking-sleeping-behaviour confirmed the visual over-all analysis of the EEG-stages. 5. Physiological observations on heartrate, systemic blood pressure, rapid eye movements during wakefulness, and slow eye movements during sleepiness showed no reliable differences between sufentanil and fentanil. The systematically documented symptoms and vegetative signs of subjects also showed neither differences nor side-effects.

  10. Hyperglycolysis is exacerbated after traumatic brain injury with fentanyl vs. isoflurane anesthesia in rats.

    Science.gov (United States)

    Statler, Kimberly D; Janesko, Keri L; Melick, John A; Clark, Robert S B; Jenkins, Larry W; Kochanek, Patrick M

    2003-12-19

    Despite common use of narcotics in the clinical management of severe traumatic brain injury (TBI), in experimental models rats treated with fentanyl have exhibited worse functional outcome and more CA1 hippocampal death than rats treated with standard isoflurane anesthesia. We hypothesized that greater post-traumatic excitotoxicity, reflected by cerebral glucose utilization (CMRglu), may account for detrimental effects of fentanyl vs. isoflurane. Rats were anesthetized with either isoflurane (1% by inhalation) or fentanyl (10 mcg/kg iv bolus then 50 mcg/kg/h infusion). 14C-deoxyglucose autoradiography was performed 45 min after controlled cortical impact (CCI) to left parietal cortex (n=4 per anesthetic group) or in uninjured rats after 45 min of anesthesia (n=3 per anesthetic group). Uninjured rats treated with fentanyl vs. isoflurane showed 35-45% higher CMRglu in all brain structures (panesthesia. This post-traumatic hyperglycolysis suggests greater excitotoxicity and concurs with reports of worse functional outcome and more CA1 hippocampal death after TBI with fentanyl vs. isoflurane anesthesia.

  11. Comparison of paracetamol and fentanyl for pain relief during and after suction termination

    Science.gov (United States)

    Şahin, Ayça S.; Gülleroğlu, Aykan; Toker, Melike K.; Karabay, Ayşe G.; Adıyeke, Özal; Demiraran, Yavuz

    2016-01-01

    Objectives: To compare the combination of paracetamol (20 mg/kg) and propofol to fentanyl (1 µg/kg) and propofol in terms of providing adequate analgesia and a comparable recovery profile in suction termination procedures. Methods: This is a prospective, randomized clinical study in which we obtained informed consents from 146 women (fentanyl group: 76 [52.1%], paracetamol group: 70 [47.9%]) who were scheduled for suction curettage at the Istanbul Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey in January 2015. Patients were randomly allocated into a fentanyl group or a paracetamol group. Visual analogue scores, modified Aldrete scores, and hemodynamic parameters were recorded during and after the surgical procedure. A record was also maintained of any adverse events. Results: When the modified Aldrete scores at 60 minutes, systolic pressures at 0 minutes, oxygen saturation at 10, 15, 20 minutes, diastolic blood pressure at 10, 15, 20 minutes, heart rates, and visual analogue scores were compared, there was no significant difference between groups (p>0.05). In the fentanyl group, systolic blood pressures at 5, 10, 15, 20 minutes and diastolic blood pressure at 5 minutes and oxygen saturation at 5 minutes were significantly lower (p<0.05). Conclusion: Our study demonstrates that the analgesic properties and recovery profiles of intravenous paracetamol is as effective as fentanyl when used in suction termination procedures. Further larger studies are still required. PMID:27146615

  12. Effects of Parecoxib and Fentanyl on nociception-induced cortical activity

    Directory of Open Access Journals (Sweden)

    Wang Ying-Wei

    2010-01-01

    Full Text Available Abstract Background Analgesics, including opioids and non-steroid anti-inflammatory drugs reduce postoperative pain. However, little is known about the quantitative effects of these drugs on cortical activity induced by nociceptive stimulation. The aim of the present study was to determine the neural activity in response to a nociceptive stimulus and to investigate the effects of fentanyl (an opioid agonist and parecoxib (a selective cyclooxygenase-2 inhibitor on this nociception-induced cortical activity evoked by tail pinch. Extracellular recordings (electroencephalogram and multi-unit signals were performed in the area of the anterior cingulate cortex while intracellular recordings were made in the primary somatosensory cortex. The effects of parecoxib and fentanyl on induced cortical activity were compared. Results Peripheral nociceptive stimulation in anesthetized rats produced an immediate electroencephalogram (EEG desynchronization resembling the cortical arousal (low-amplitude, fast-wave activity, while the membrane potential switched into a persistent depolarization state. The induced cortical activity was abolished by fentanyl, and the fentanyl's effect was reversed by the opioid receptor antagonist, naloxone. Parecoxib, on the other hand, did not significantly affect the neural activity. Conclusion Cortical activity was modulated by nociceptive stimulation in anesthetized rats. Fentanyl showed a strong inhibitory effect on the nociceptive-stimulus induced cortical activity while parecoxib had no significant effect.

  13. Isoflurane compared with fentanyl-midazolam-based anesthesia in patients undergoing heart transplantation

    Science.gov (United States)

    Hsu, Che-Hao; Hsu, Yung-Chi; Huang, Go-Shine; Lu, Chih-Cherng; Ho, Shung-Tai; Liaw, Wen-Jinn; Tsai, Yi-Ting; Lin, Chih-Yuan; Tsai, Chien-Sung; Lin, Tso-Chou

    2016-01-01

    Abstract Inhalation anesthetics provide myocardial protection for cardiac surgery. This study was undertaken to compare the perioperative effects between isoflurane and fentanyl-midazolam-based anesthesia for heart transplantation. A retrospective cohort study was conducted by reviewing the medical records of heart transplantation in a single medical center from 1990 to 2013. Patients receiving isoflurane or fentanyl-midazolam-based anesthesia were included. Those with preoperative severe pulmonary, hepatic, or renal comorbidities were excluded. The perioperative variables and postoperative short-term outcomes were analyzed, including blood glucose levels, urine output, inotropic use, time to extubation, and length of stay in the intensive care units. After reviewing 112 heart transplantations, 18 recipients with fentanyl-midazolam-based anesthesia, and 29 receiving isoflurane anesthesia with minimal low-flow technique were analyzed. After cessation of cardiopulmonary bypass, recipients with isoflurane anesthesia had a significantly lower mean level and a less increase of blood glucose, as compared with those receiving fentanyl-based anesthesia. In addition, there was less use of dobutamine upon arriving the intensive care unit and a shorter time to extubation after isoflurane anesthesia. Compared with fentanyl-midazolam-based anesthesia, isoflurane minimal low-flow anesthesia maintained better perioperative homeostasis of blood glucose levels, less postoperative use of inotropics, and early extubation time among heart-transplant recipients without severe comorbidities. PMID:27583900

  14. Evaluation of quick disintegrating calcium carbonate tablets

    OpenAIRE

    Fausett, Hector; Gayser, Charles; Dash, Alekha K.

    2000-01-01

    The purpose of this investigation was to develop a rapidly disintegrating calcium carbonate (CC) tablet by direct compression and compare it with commercially available calcium tablets. CC tablets were formulated on a Carver press using 3 different forms of CC direct compressed granules (Cal-Carb 4450®, Cal-Carb 4457®, and Cal-Carb 4462®). The breaking strength was measured using a Stokes-Monsanto hardness tester. The disintegration and dissolution properties of the tablets were studied using...

  15. Evaluation of a mucoadhesive buccal patch for delivery of peptides: in vitro screening of bioadhesion.

    Science.gov (United States)

    Li, C; Bhatt, P P; Johnston, T P

    1998-10-01

    We have assessed the bioadhesive properties of several different mucoadhesive buccal patches. The patches consisted of custom coformulations of silicone polymers and Carbopol 974P. The contact angle of water was measured for each of the test formulations, using an ophthalmic shadow scope. The corresponding work of adhesion between the water and the patches (W1), and between the patches and freshly-excised rabbit buccal mucosa (W2) was then calculated, using a modification of Dupre's equation. The bioadhesive strength between the patches and excised rabbit buccal mucosa was also assessed. The results of the contact-angle measurements indicated that the contact angle decreased with an increase in the amount of Carbopol in the formulation. Additionally, the calculated values of both W1 and W2 increased with an increase in the amount of Carbopol in the buccal-patch formulations. A correlation (r not equal to 0.9808) was found between the measured contact angle and the calculated values for W2. The direct measurement of the force required to separate a buccal patch from excised rabbit buccal mucosa with the INSTRON demonstrated that the adhesive strength increased with an increase in the amount of Carbopol. This preliminary study has shown that the measurement of contact angles alone may provide a useful technique for estimating the work of adhesion, and may serve as a convenient and rapid screening procedure to identify potential mucoadhesive buccal-patch formulations.

  16. Quantitative criteria for improving performance of buccal DNA for high-throughput genetic analysis

    Directory of Open Access Journals (Sweden)

    Woo Jessica G

    2012-08-01

    Full Text Available Abstract Background DNA from buccal brush samples is being used for high-throughput analyses in a variety of applications, but the impact of sample type on genotyping success and downstream statistical analysis remains unclear. The objective of the current study was to determine laboratory predictors of genotyping failure among buccal DNA samples, and to evaluate the successfully genotyped results with respect to analytic quality control metrics. Sample and genotyping characteristics were compared between buccal and blood samples collected in the population-based Genetic and Environmental Risk Factors for Hemorrhagic Stroke (GERFHS study (https://gerfhs.phs.wfubmc.edu/public/index.cfm. Results Seven-hundred eight (708 buccal and 142 blood DNA samples were analyzed for laboratory-based and analysis metrics. Overall genotyping failure rates were not statistically different between buccal (11.3% and blood (7.0%, p = 0.18 samples; however, both the Contrast Quality Control (cQC rate and the dynamic model (DM call rates were lower among buccal DNA samples (p  Conclusions We identified a buccal sample characteristic, a ratio of ds/total DNA

  17. Overview and Future Potential of Buccal Mucoadhesive Films as Drug Delivery Systems for Biologics.

    Science.gov (United States)

    Montenegro-Nicolini, Miguel; Morales, Javier O

    2017-01-01

    The main route of administration for drug products is the oral route, yet biologics are initially developed as injectables due to their limited stability through the gastrointestinal tract and solubility issues. In order to avoid injections, a myriad of investigations on alternative administration routes that can bypass enzymatic degradation and the first-pass effect are found in the literature. As an alternative site for biologics absorption, the buccal route presents with a number of advantages. The buccal mucosa is a barrier, providing protection to underlying tissue, but is more permeable than other alternative routes such as the skin. Buccal films are polymeric matrices designed to be mucoadhesive properties and usually formulated with permeability enhancers to improve bioavailability. Conventionally, buccal films for biologics are manufactured by solvent casting, yet recent developments have shown the potential of hot melt extrusion, and most recently ink jet printing as promising strategies. This review aims at depicting the field of biologics-loaded mucoadhesive films as buccal drug delivery systems. In light of the literature available, the buccal epithelium is a promising route for biologics administration, which is reflected in clinical trials currently in progress, looking forward to register and commercialize the first biologic product formulated as a buccal film.

  18. In-vitro characterization of buccal iontophoresis: the case of sumatriptan succinate.

    Science.gov (United States)

    Telò, Isabella; Tratta, Elena; Guasconi, Barbara; Nicoli, Sara; Pescina, Silvia; Govoni, Paolo; Santi, Patrizia; Padula, Cristina

    2016-06-15

    Buccal administration of sumatriptan succinate might be an interesting alternative to the present administration routes, due to its non-invasiveness and rapid onset of action, but because of its low permeability, a permeation enhancement strategy is required. The aim of this work was then to study, in-vitro, buccal iontophoresis of sumatriptan succinate. Permeation experiments were performed in-vitro across pig esophageal epithelium, a recently proposed model of human buccal mucosa, using vertical diffusion cells. The iontophoretic behavior of the tissue was characterized by measuring its isoelectric point (Na(+) transport number and the electroosmotic flow of acetaminophen determination) and by evaluating tissue integrity after current application. The results obtained confirm the usefulness of pig esophageal epithelium as an in-vitro model membrane for buccal drug delivery. The application of iontophoresis increased sumatriptan transport, proportionally to the current density applied, without tissue damage: electrotransport was the predominant mechanism. Integrating the results of the present work with literature data on the transport of other molecules across the buccal mucosa and across the skin, we can draw a general conclusion: the difference in passive transport across buccal mucosa and across the skin is influenced by permeant lipophilicity and by the penetration pathway. Finally, buccal iontophoretic administration of sumatriptan allows to administer 6mg of the drug in 1h, representing a promising alternative to the current administration routes.

  19. ORALLY DISINTEGRATING TABLETS: A REVIEW

    Directory of Open Access Journals (Sweden)

    Mudgal Vinod Kumar

    2011-04-01

    Full Text Available Orally disintegrating tablets (ODTs are gaining prominence as new drug delivery systems and emerged as one of the popular and widely accepted dosage forms, especially for the pediatric and geriatric patients. To obviate the problem of dysphagia and to improve patient compliance, ODTs have gained considerable attention as preferred alternatives to conventional tablet and capsule formulations. Various scientific techniques including freeze drying, moulding, spray drying, sublimation, direct compression, cotton candy process, mass extrusion, melt granulation etc. have been employed for the development of ODTs. These techniques render the disintegration of tablet rapidly and dissolve in mouth without chewing or additional water intake. The current article is focused on ideal characteristics, significant features, patented technologies, formulation aspects including the use of superdisintegrants. Various marketed preparations along with numerous scientific advancements made so far in this avenue have also been discussed.

  20. Inhibitory effects of Zengshengping fractions on DMBA-induced buccal pouch carcinogenesis in hamsters

    Institute of Scientific and Technical Information of China (English)

    GUAN Xiao-bing; SUN Zheng; CHEN Xiao-xin; WU Hong-ru; ZHANG Xin-yan

    2012-01-01

    Background Zengshengping (ZSP) tablets had inhibitory effects on oral precancerous lesions by reducing the incidence of oral cancer.However,the severe liver toxicity caused by systemic administration of ZSP limits the long-term use of this anti-cancer drug.The purpose of this study was to evaluate the tumor inhibitory effects due to the topical application of extracts from ZSP,a Chinese herbal drug,on 7,12-dimethlbenz(a)anthracene (DMBA) induced oral tumors in hamsters.The study also investigated the anti-cancer mechanisms of the ZSP extracts on oral carcinogenesis.Methods DMBA (0.5%) was applied topically to the buccal pouches of Syrian golden hamsters (6-8 weeks old) three times per week for six weeks in order to induce the development of oral tumors.Different fractions of ZSP were either applied topically to the oral tumor lesions or fed orally at varying dosages to animals with oral tumors for 18 weeks.Tumor volume was measured by histopathological examination.Tumor cell proliferation was evaluated by counting BrdU labeled cells and by Western blotting for mitogen-activated protein kinase (MAPK) protein levels.The protein levels of apoptosis marker Caspase-3 and regulator Bcl-2 protein were also measured by Western blotting.Results Topical application of DMBA to the left pouch of hamsters induced oral tumor formation.Animals treated with DMBA showed a loss in body weight while animals treated with ZSP maintained normal body weights.Both the ZSP n-butanol fraction and water fraction significantly reduced tumor volume by 32.6% (P <0.01) and 22.9% (P <0.01)respectively.Topical application of ZSP also markedly decreased the BrdU-positive cell numbers in oral tumor lesions and reduced the expression level of MAPK.In addition,ZSP promoted tumor cell apoptosis by increasing Caspase-3 expression but decreasing Bcl-2 protein production.Conclusion The n-butanol and water fractions of ZSP are effective at inhibiting tumor cell proliferation and stimulating

  1. Automated visual inspection of imprinted pharmaceutical tablets

    Science.gov (United States)

    Bukovec, Marko; Špiclin, Žiga; Pernuš, Franjo; Likar, Boštjan

    2007-09-01

    This paper is on automated visual inspection of tablets that may, in contrast to manual tablet sorting, provide objective and reproducible tablet quality assurance. Visual inspection of the ever-increasing numbers of produced imprinted tablets, regulatory enforced for unambiguous identification of active ingredients and dosage strength of each tablet, is especially demanding. The problem becomes more tractable by incorporating some a priori knowledge of the imprint shape and/or appearance. For this purpose, we consider two alternative automated tablet defect detection methods. The geometrical method, incorporating geometrical a priori knowledge of the imprint shape, enables specific inspection of the imprinted and non-imprinted tablet surface, while the statistical method exploits statistical a priori knowledge of tablet surface appearance, derived from a training image database. The two methods were evaluated on a large tablet image database, consisting of 3445 images of four types of imprinted tablets, with and without typical production defects. A 'gold standard' for testing the performances of the two inspection methods was established by manually classifying the tablets into good and five defective classes. The results, obtained by ROC (receiver operating characteristics) analysis, indicate that the statistical method yields better defect detection sensitivity and specificity than the geometrical method. Both presented image analysis methods are quite general and promising tools for automated visual inspection of imprinted pharmaceutical tablets.

  2. Touch Screen Tablets and Emergent Literacy

    Science.gov (United States)

    Neumann, Michelle M.; Neumann, David L.

    2014-01-01

    The use of touch screen tablets by young children is increasing in the home and in early childhood settings. The simple tactile interface and finger-based operating features of tablets may facilitate preschoolers' use of tablet application software and support their educational development in domains such as literacy. This article reviews…

  3. 21 CFR 520.1310 - Marbofloxacin tablets.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Marbofloxacin tablets. 520.1310 Section 520.1310... DRUGS, FEEDS, AND RELATED PRODUCTS ORAL DOSAGE FORM NEW ANIMAL DRUGS § 520.1310 Marbofloxacin tablets. (a) Specifications. Each tablet contains 25, 50, 100, or 200 milligrams (mg) marbofloxacin....

  4. Enhanced delivery of ketobemidone through porcine buccal mucosa in vitro via more lipophilic ester prodrugs

    DEFF Research Database (Denmark)

    Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.

    1992-01-01

    The in vitro penetration of ketobemidone and various ester prodrugs through porcine buccal mucosa in a modified Ussing chamber was investigated in order to support the selection of a prodrug derivative with optimal buccal absorption. The nine esters studied included carboxylic acid and carbonate...... esters formed at the phenolic hydroxy group of ketobemidone. The esters were all rapidly hydrolyzed to the parent drug in a porcine buccal epithelial homogenate and only free ketobemidone was detected in the receptor compartment of the Ussing chamber. All the ester prodrugs showed enhanced rates...

  5. One-stage and two-stage penile buccal mucosa urethroplasty

    Directory of Open Access Journals (Sweden)

    G. Barbagli

    2016-03-01

    Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

  6. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, H M; Rassing, M R; Nielsen, Hanne Mørck

    2000-01-01

    and porcine buccal mucosa. Further, the permeability rates of ten beta-adrenoceptor antagonists (acebutolol, alprenolol, atenolol, labetalol, metoprolol, oxprenolol, pindolol, propranolol, timolol and tertatolol) across the TR146 cell culture model and porcine buccal mucosa were related to their lipophilicity...... x 10(-6) cm/s (metoprolol). For propranolol the cellular permeability value (P(c)) was lower than expected, probably due to accumulation in the TR146 cell layers. Limited correlation of permeability with k' was observed both for the TR146 cell culture model and the porcine buccal mucosa, although...

  7. COMPARATIVE STUDY OF EFFECT OF INTRAVENOUS MAGNESIUM SULPHATE AND INTRAVENOUS FENTANYL IN ATTENUATING THE HAEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND INTUBATION

    Directory of Open Access Journals (Sweden)

    Patta

    2016-07-01

    Full Text Available AIM To compare the haemodynamic response to laryngoscopy and intubation with intravenous MgSO4 and intravenous fentanyl. METHODS Fifty adult patients were divided into two groups randomly into group M and group F. Patients of group M received 30 mg/kg body weight of IV MgSO4 and group F received IV fentanyl 1.5 µg/kg 5 minutes before intubation. RESULTS IV Fentanyl showed greater degree of haemodynamic stability i.e. rise in heart rate, mean arterial pressure during laryngoscopy and intubation compared to IV MgSO4. IV fentanyl showed side effects like respiratory depression, nausea and vomiting. CONCLUSION IV fentanyl is a better drug in controlling haemodynamic response to laryngoscopy and intubation.

  8. Limited evidence for intranasal fentanyl in the emergency department and the prehospital setting--a systematic review

    DEFF Research Database (Denmark)

    Hansen, Morten Sejer; Dahl, Jørgen Berg

    2013-01-01

    The intranasal (IN) mode of application may be a valuable asset in non-invasive pain management. Fentanyl demonstrates pharmacokinetic and pharmacodynamic properties that are desirable in the management of acute pain, and IN fentanyl may be of value in the prehospital setting. The aim of this sys......The intranasal (IN) mode of application may be a valuable asset in non-invasive pain management. Fentanyl demonstrates pharmacokinetic and pharmacodynamic properties that are desirable in the management of acute pain, and IN fentanyl may be of value in the prehospital setting. The aim...... of this systematic review was to evaluate the current evidence for the use of IN fentanyl in the emergency department (ED) and prehospital setting....

  9. SOME CUNEIFORM TABLETS IN JERUSALEM

    Institute of Scientific and Technical Information of China (English)

    Wu; Yuhong

    2014-01-01

    <正>During the four and half months of my staying at the Albright Institute of Archaeological Research in Jerusalem and in the Hebrew University(01.12.2013–13.04.2014),I had the chance to read and study some unpublished cuneiform tablets.Here,I would like to make a small contribution to the work of publishing the precious information hidden in the cuneiform tablets from ancient Mesopotamia,and hope that some colleagues can give some improved reading to

  10. Comparing anesthesia with isoflurane and fentanyl/fluanisone/midazolam in a rat model of cardiac arrest

    DEFF Research Database (Denmark)

    Secher, Niels; Malte, Christian Lind; Tønnesen, Else

    2016-01-01

    CA model. We hypothesize that isoflurane anesthesia improves short-term outcome following resuscitation from CA compared with a subcutaneous fentanyl/fluanisone/midazolam anesthesia. METHODS: Male Sprague Dawley rats were randomized to anesthesia with isoflurane (n=11) or fentanyl...... samples for Endothelin-1 and cathecolamines were drawn before and after CA. KEY FINDINGS: Compared with fentanyl/fluanisone/midazolam anesthesia, isoflurane resulted in a shorter time to return of spontaneous circulation (ROSC), less use of epinephrine, increased coronary perfusion pressure during CPR......, higher mean arterial pressure post ROSC, increased plasma levels of Endothelin-1 and decreased levels of epinephrine. The choice of anesthesia did not affect ROSC rate or systemic O2 consumption. CONCLUSION: Isoflurane reduces time to ROSC, increases coronary perfusion pressure, and improves hemodynamic...

  11. Supply-side response to declining heroin purity: fentanyl overdose episode in New Jersey.

    Science.gov (United States)

    Hempstead, Katherine; Yildirim, Emel O

    2014-06-01

    The inelastic price demand observations characteristic of illegal drug markets have led to the conclusion that the burden of a negative supply shock would be completely reflected to consumers. This paper argues that the increasing availability of prescription opioids may threaten heroin sellers' profit margin and force them to find alternative methods to compensate buyers in the event of a supply shock. We investigate the 2006 fentanyl overdose episode in New Jersey and argue that the introduction of non-pharmaceutical fentanyl, its spatial distribution, and the timing of overdose deaths may have been related to trends in heroin purity. Using medical examiner data, as well as data from the Drug Enforcement Administration, Office of Diversion Control on retail sales of prescription opioids in a negative binomial specification, we show that month-to-month fluctuations in heroin purity have a significant effect on fentanyl-related overdoses, particularly in those areas where prescription opioids are highly available.

  12. Conversing Rate from Morphine to Continuous Infusion of Fentanyl in Patients Suffering Cancer Pain

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the proper conversing rate from morphine to continuous infusion of fentanyl in patients suffering cancer pain. Methods: A retrospective study was carried on in 20 patients with cancer pain in Shizuoka Cancer Center from Sep. 2002 to Nov. 2003. Pain intensity, adverse reactions, and satisfaction index of patients were evaluated. Results: The pain intensity was stable in 17 patients indicating good pain-control within 1 week after conversion and unstable in 3 patients after conversion suggesting poor pain-control. Fentanyl injection could alleviate side effects and increase the satisfaction index of patients. Conclusion: The equipotent ratio for ratio less than 72:1 was proposed to get stable pain-relieving effect. But the equipotent ratio for conversion of morphine to continuous infusion of fentanyl could not be determined. We must consider the morphine dose before the confirmation of the conversing rate.

  13. Chest wall rigidity in two infants after low-dose fentanyl administration.

    Science.gov (United States)

    Dewhirst, Elisabeth; Naguib, Aymen; Tobias, Joseph D

    2012-05-01

    Since its introduction into clinical practice, it has been known that fentanyl and other synthetic opioids may cause skeletal muscle rigidity. Involvement of the respiratory musculature, laryngeal structures, or the chest wall may impair ventilation, resulting in hypercarbia and hypoxemia. Although most common with the rapid administration of large doses, this rare adverse effect may occur with small doses especially in neonates and infants. We present 2 infants who developed chest wall rigidity, requiring the administration of neuromuscular blocking agents and controlled ventilation after analgesic doses of fentanyl. Previous reports regarding chest wall rigidity after the administration of low-dose fentanyl in infants and children are reviewed, the pathogenesis of the disorder is discussed, and treatment options offered.

  14. Fentanyl inhibits the invasion and migration of colorectal cancer cells via inhibiting the negative regulation of Ets-1 on BANCR.

    Science.gov (United States)

    Li, Ai-xiang; Xin, Wen-qi; Ma, Chuan-gen

    2015-09-25

    Recent studies have shown the potential anti-tumor effect of fentanyl on colorectal cancer (CRC). However, its underling mechanism is still unclear. Since studies indicates the abnormal expression of transcription factor Ets-1 and BRAF-activated lncRNA (BANCR) in CRC progress, the relationship between Ets-1 and BANCR was investigated here to illustrate the fentanyl-induced mechanism on CRC in vitro. The expression levels of Ets-1 and BANCR were first detected in fentanyl-treated CRC cells. The interaction between Ets-1 and BANCR promoter was verified with chromatin immunoprecipitation assays, as well as corresponding acetylation of histones. The regulation of Ets-1 on BANCR expression was confirmed through luciferase assays and RT-PCR analysis. And, cell clone formation, cell migration and invasion were observed to evaluate the anti-tumor effects of fentanyl. Ets-1 overexpression or co-overexpression with BANCR was further performed by plasmids transfection to show the regulatory role of Ets-1 in fentanyl-induced mechanism. Fentanyl induced BANCR upregulation and Ets-1 downregulation in CRC cells. Further studies showed that Ets-1 negatively regulated BANCR expression via the deacetylation of histones H3 within BANCR promoter. Moreover, fentanyl induced less cell clone formation, as well as inhibited cell migration and invasion in vitro, while Ets-1 overexpression inhibited fentanyl-induced effects that could be reversed by BANCR co-overexpression. Fentanyl showed anti-tumor like effects on CRC cells, including less cell clone formation and inhibited cell migration and invasion. Furthermore, the regulatory role of Ets-1 on BANCR influenced fentanyl-induced mechanism, indicating their potential application in the therapeutic treatment of CRC. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. A Comparison of the Effects of Fentanyl and Remifentanil on Nausea, Vomiting, and Pain after Cesarean Section

    Directory of Open Access Journals (Sweden)

    Fatemeh Gourtanian

    2011-09-01

    Full Text Available Background: The effects of different opioids on postoperative nausea and vomiting (PONV and pain have not been conclusively determined. The aim of this study was to compare the effects of fentanyl, remifentanil or fentanyl plus morphine on the incidence of PONV and pain in women subjected to cesarean section under general anesthesia. Methods: The study was a randomized clinical trial recruiting 96 parturients with American Society of Anesthesiologists (ASA physical status I and II. They scheduled for cesarean section under general anesthesia using sodium thiopental, succynylcholine, and isoflurane O2/N2O 50/50 mixture. After clamping the umbilical cord, the patients were given fentanyl (2 µg/kg/h, remifentanil (0.05 µg/kg/h, or fentanyl (2 µg/kg pulse morphine (0.1 mg/kg intravenously. Visual analog scale for pain and nausea, frequency of PONV, meperidine and metoclopramide consumption were evaluated at recovery, and 4, 8, 12 and 24 hours after the surgery. Results: There was no significant difference between the three groups in terms of frequency of nausea, vomiting, and mean nausea and pain scores at any time points. None of the patients required the administration of metoclopramide. However, the mean VAS for pain in remifentanil-treated group was insignificantly more than that in fentanyl- or fentanyl plus morphine-treated group at recovery or 4 hours after the surgery. The mean mepridine consumption in remifentanil-treated group was significantly (P=0.001 more than that in fentanyl- or fentanyl plus morphine-treated group in 24 hours after the surgery respectively. There was no significant difference in hemodynamic parameters of the three groups in all measurements after the surgery. Conclusion: The findings of this study showed that early postoperative analgesia was better with fentanyl, and postoperative meperidine consumption was significantly less with fentanyl than with remifentanil or combined fentayl and morphine. Trial

  16. A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE FOR INFRA - UMBILICAL SURGERIES

    Directory of Open Access Journals (Sweden)

    Ch. Srinivas

    2015-01-01

    Full Text Available BACKGROUND: Several adjuncts like adrenaline,opioids and alpha - 2 adrenergic agonists are being used with local anaesthetics intrathecally for prolongation of intra - operative and post - operative analgesia and to reduce the side - effects of high doses of local anaesthetics. [1] AIM: The present study was done to evaluate the onset and duration of sensory and motor block, hemodynamic effects, pos t - operative analgesia and adverse effects of Dexmedetomidine or Fentanyl given intrathecally with hyperbaric 0.5% Bupivacaine. MATERIALS AND METHODS: Ninety inpatients of ASA class I and II scheduled for various infra - umbilical surgeries under Sub - Arachnoi d Block were randomly divided into three groups of 30 each namely C (Control, D(Dexmedetomidine and F(Fentanyl. All received 12.5mg hyperbaric bupivacaine plus 0.5 ml Normal Saline in Group C (Control,5 μ g Dexmedetomidine (diluted in preservative free Normal saline of 0.5ml in Group D (Dexmedetomidine and 25 μ g Fentanyl (vol 0.5 ml in Group F (Fentanyl. The onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes and side - effects were not ed. RESULTS: The duration of sensory and motor block,rescue analgesia was significantly prolonged in Dexmedetomidine group when compared to that of the Fentanyl group which is longer than that of Control group. CONCLUSION: Dexmedetomidine 5 μg seems to be better than 25μg Fentanyl as a neuraxial adjuvant to hyperbaric Bupivacaine.

  17. A COMPARATIVE STUDY OF INTRATHECAL DEXMEDETOMIDINE AND FENTANYL AS ADJUVANTS TO BUPIVACAINE

    Directory of Open Access Journals (Sweden)

    Gollapalli Hanumanth

    2016-02-01

    Full Text Available INTRODUCTION Uncontrolled postoperative pain may produce a range of detrimental acute and chronic effects. Spinal anaesthesia provided by bupivacaine may be too short for providing postoperative analgesia. This study is conducted to evaluate the efficacy of intrathecal fentanyl and intrathecal dexmedetomidine as an adjuvant to hyperbaric bupivacaine with regards to the onset and duration of sensory and motor blockade, as well as postoperative analgesia and adverse effects. Hundred patients aged 18-55 years were randomly divided into two groups, each group consisting of 50 patients of either sex belonging to ASA class I and II posted for elective lower abdominal surgeries were given spinal anaesthesia using bupivacaine 0.5%, heavy 2.5 ml with either fentanyl 25µg (group F or 5µg of preservative free dexmedetomidine (group D. Assessment of the sensory and motor blockade were done at the end of each minute till the maximum level achieved. Measurement of blood pressure, pulse rate, respiratory rate and arterial oxygen saturation were obtained. Postoperatively the patients were observed for the duration of analgesia, time taken for complete regression of sensory blockade to S1 and time taken for complete recovery of motor power. RESULTS Our results showed a statistically highly significant prolongation of sensory and motor blockade, and postoperative analgesia in the dexmedetomidine group compared to the fentanyl group. In dexmedetomidine group four out of fifty patients, and in fentanyl group two out of fifty patients developed hypotension. In dexmedetomidine group five out of fifty patients, and in fentanyl group two out of fifty patients developed bradycardia. Incidence of pruritis is significantly high in fentanyl group.

  18. Lower-Dose Mepivacaine Plus Fentanyl May Improve Spinal Anesthesia for Knee Arthroscopy.

    Science.gov (United States)

    Kahn, Richard L; Cheng, Jennifer; Bae, James J; Fields, Kara; Muller, John G; MacGillivray, John D; Rose, Howard A; Williams, Riley J; YaDeau, Jacques T

    2015-10-01

    Previous work indicates that 30 mg isobaric mepivacaine 1.5% plus 10 μg fentanyl produces reliable anesthesia for knee arthroscopy with a more rapid recovery profile than 45 mg mepivacaine. This randomized controlled trial compared plain mepivacaine to three reduced doses of mepivacaine with 10 μg fentanyl for spinal anesthesia. Following written informed consent, subjects undergoing outpatient knee arthroscopy were prospectively randomized into one of four groups: mepivacaine 37.5 mg (M37.5); mepivacaine 30 mg plus fentanyl 10 μg (M30/F10); mepivacaine 27 mg plus fentanyl 10 μg (M27/F10); and mepivacaine 24 mg plus fentanyl 10 μg (M24/F10). The spinal was evaluated by the blinded anesthetist and surgeon. In the post-anesthesia care unit, sensory and motor block resolution was assessed. Subjects rated their satisfaction with the overall experience. Group M30/F10 (n = 6) had two "fair" anesthetics, and group M27/F10 (n = 10) had one "fair" and one "inadequate" anesthetic. Both groups were eliminated from further enrollment per study protocol. The recovery profiles showed little difference between groups M37.5 and M30/F10, except for motor block resolution (median (25th percentile, 75th percentile): 171 (135, 195) and 128 (120, 135), respectively). Groups M27/F10 and M24/F10 demonstrated recovery profiles that were faster than group M37.5. Patient satisfaction was 10/10 for all groups. Adding fentanyl 10 μg to a lower dose of mepivacaine 1.5% can lead to quicker recovery profiles. However, this advantage of a quicker recovery must be weighed against the likelihood of an incomplete anesthetic.

  19. Development and evaluation of controlled-release buccoadhesive verapamil hydrochloride tablets

    Directory of Open Access Journals (Sweden)

    Emami J.

    2008-05-01

    Full Text Available Background and purpose of the study: Verapamil hydrochloride is a calcium channel blocker which is used in the control of supraventricular arrhythmia, hypertension and myocardial infraction. There are considerable inter-individual variations in serum concencentration of verpamil due to variation in the extent of hepatic metabolism. In this study controlled-release buccoadhesive tablets of verapamil hydrochloride (VPH were prepared in order to achieve constant plasma concentrations, to improve the bioavailability by the avoidance of hepatic first-pass metabolism, and to prevent frequent administration. Materials and methods: Tablets containing fixed amount of VPH were prepared by direct compression method using polymers like carbomer (CP, hydroxypropylmethyl cellulose (HPMC and sodium carboxymethyl cellulose (NaCMC in various combination and ratios and evaluated for thickness, weight variation, hardness, drug content uniformity, swelling, mucoadhesive strength, drug release and possible interaction between ingredients. Results: All tablets were acceptable with regard to thickness, weight variation, hardness, and drug content. The maximum bioadhesive strength was observed in tablets formulated with a combination of CP-NaCMC followed by CP-HPMC and NaCMC-HPMC.  Decreasing the content of CP in CP-HPMC tablets or NaCMC in CP-NaCMC or NaCMC-HPMC systems resulted in decrease in detachment forces. Lower release rates were observed by lowering the content of CP in CP-HPMC containing formulations or NaCMC in tablets which contained CP-NaCMC or NaCMC-HPMC. The release behavior was non-Fickian controlled by a combination of diffusion and chain relaxation mechanisms and best fitted zero-order kinetics. Conclusion: The buccoadhesive VPH tablets containing 53% CP and 13.3% HPMC showed suitable release kinetics (n = 0.78, K0 zero order release = 4.11 mg/h, MDT = 5.66 h and adhesive properties and did not show any interaction between polymers and drug based on

  20. A STUDY OF SEX CHEROMATIN FORM BUCCAL SMEAR

    Directory of Open Access Journals (Sweden)

    Shankar

    2015-10-01

    Full Text Available The determination of sex of an individual is an important subject in Forensic Medicine and Criminology and in Civil Law. The determination of sex is necessary in both living and the dead bodies. The expert opinion of the medico legal specialist regarding positive identification of an individual will be required for the following reasons. For the identification of the sex of individual whether living or dead , For deciding cases relating to legitimacy, divorce, paternity, affiliation, marriage, education, im potence, right to disposal of property, and in intersex condition & in cases of concealed sex. Determination of sex will be done by presumptive, probable and certain signs of sex. Sex chromatin is a planoconvex mass of about 1 micron in diameter lying near nuclear membrane - Barr body. In the buccal smear the percentage of the nuclei containing chromatin body ranges from 0 to 4 in males & 20n to 80 in females . In females neutrophil leucocytes contain a small nuclear attachment of drum stick form - David son bo dy in up to 6% of cell . This is absent in males . Exact sex determination can be made by using a single specimen of buccal smear , saliva or hair follicle, by the combined treatment of quinacrinedi hydrochloride staining for Y chromosome which is seen as bright florescent body in the nuclei of male cell & florescent feulgen reaction using acriflavin Schiff reagent for X chromosomes , which is seen as bright yellow spot in the nuclei . The percentage of quanacrine positive bodies ranges from 45 to 80% in male s , and 0 to 4% in females . With feulgen reaction technique florescent bodies are found in 50 to 70 % of cell in females, and 0 to 2% in males. Determination of sex chromatin pattern was done by examination of oral smears technique on 50 males and 50 female s who have attended the Casualty of Government General Hospital, Ananthapuramu., A. P . , in the Dept . of forensic Medicine from 17 - 06 - 2012 to 30 - 12 - 2014. Slides were

  1. The potential of chitosan in enhancing peptide and protein absorption across the TR146 cell culture model-an in vitro model of the buccal epithelium

    DEFF Research Database (Denmark)

    Portero, Ana; Remuñán-López, Carmen; Nielsen, Hanne Mørck

    2002-01-01

    To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used.......To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used....

  2. Physiologically-based pharmacokinetic model for Fentanyl in support of the development of Provisional Advisory Levels

    Energy Technology Data Exchange (ETDEWEB)

    Shankaran, Harish, E-mail: harish.shankaran@pnnl.gov [Computational Biology and Bioinformatics Group, Pacific Northwest National Laboratory, Richland, WA 99352 (United States); Adeshina, Femi [National Homeland Security Research Center, United States Environmental Protection Agency, Washington, DC 20460 (United States); Teeguarden, Justin G. [Systems Toxicology Group, Pacific Northwest National Laboratory, Richland, WA 99352 (United States)

    2013-12-15

    Provisional Advisory Levels (PALs) are tiered exposure limits for toxic chemicals in air and drinking water that are developed to assist in emergency responses. Physiologically-based pharmacokinetic (PBPK) modeling can support this process by enabling extrapolations across doses, and exposure routes, thereby addressing gaps in the available toxicity data. Here, we describe the development of a PBPK model for Fentanyl – a synthetic opioid used clinically for pain management – to support the establishment of PALs. Starting from an existing model for intravenous Fentanyl, we first optimized distribution and clearance parameters using several additional IV datasets. We then calibrated the model using pharmacokinetic data for various formulations, and determined the absorbed fraction, F, and time taken for the absorbed amount to reach 90% of its final value, t90. For aerosolized pulmonary Fentanyl, F = 1 and t90 < 1 min indicating complete and rapid absorption. The F value ranged from 0.35 to 0.74 for oral and various transmucosal routes. Oral Fentanyl was absorbed the slowest (t90 ∼ 300 min); the absorption of intranasal Fentanyl was relatively rapid (t90 ∼ 20–40 min); and the various oral transmucosal routes had intermediate absorption rates (t90 ∼ 160–300 min). Based on these results, for inhalation exposures, we assumed that all of the Fentanyl inhaled from the air during each breath directly, and instantaneously enters the arterial circulation. We present model predictions of Fentanyl blood concentrations in oral and inhalation scenarios relevant for PAL development, and provide an analytical expression that can be used to extrapolate between oral and inhalation routes for the derivation of PALs. - Highlights: • We develop a Fentanyl PBPK model for relating external dose to internal levels. • We calibrate the model to oral and inhalation exposures using > 50 human datasets. • Model predictions are in good agreement with the available

  3. [Analgosedation with fentanyl/midazolam after correction of congenital heart defects].

    Science.gov (United States)

    Michel-Behnke, I; Rothes, A; Hund, F; Huth, R; Wippermann, C F; Schmidt, F X; Oelert, H; Schranz, D

    1995-01-01

    There is no standard therapy in the management of postoperative pain control following corrective cardiac surgery of congenital heart disease. Assessment in the preverbal age is difficult. In a randomized study we compared a combined treatment of fentanyl and midazolam, given as continuous infusion versus single dose application. A pain assessment score was used to measure the effectiveness of analgosedation in addition to recording nurseries observations. Fentanyl and midazolam are an appropriate combination for postoperative pain treatment. Continuous application is considered to be more effective concerning basic anxiety, cumulative dosage and to avoid volume overload in infants and young children, following cardiac surgery; overdosage was not observed.

  4. [Splitting of tablets: small pieces a risk].

    Science.gov (United States)

    Picksak, Gesine; Stichtenoth, Dirk O

    2007-09-01

    For economic reasons physicians prescribe more and more multiunit tablets. Splitting of multiunit tablets depends on the physical-chemical properties of the agents, the galenic of the dosage form, the size and contour of the tablet and the shape of the score. Tablets with one or more scores are prepared to be divided for a single/multiple dose. How easily and exact a tablet can be divided depends heavily on the physical shape, its size and the outfit of the score. The fragments have to fulfil the requirements according to the European Pharmacopoeia: Uniformity of multiunit tablets. Since exact dosing is guaranteed only if tablets are divided properly, information and guidance of the patients by the physician and pharmacist is of critical importance.

  5. Quantitative Appearance Inspection for Film Coated Tablets.

    Science.gov (United States)

    Yoshino, Hiroyuki; Yamashita, Kazunari; Iwao, Yasunori; Noguchi, Shuji; Itai, Shigeru

    2016-01-01

    The decision criteria for the physical appearance of pharmaceutical products are subjective and qualitative means of evaluation that are based entirely on human interpretation. In this study, we have developed a comprehensive method for the quantitative analysis of the physical appearance of film coated tablets. Three different kinds of film coated tablets with considerable differences in their physical appearances were manufactured as models, and their surface roughness, contact angle, color measurements and physicochemical properties were investigated as potential characteristics for the quantitative analysis of their physical appearance. All of these characteristics were useful for the quantitative evaluation of the physical appearances of the tablets, and could potentially be used to establish decision criteria to assess the quality of tablets. In particular, the analysis of the surface roughness and film coating properties of the tablets by terahertz spectroscopy allowed for an effective evaluation of the tablets' properties. These results indicated the possibility of inspecting the appearance of tablets during the film coating process.

  6. Evaluation of resorbable membrane in treatment of human gingival isolated buccal recession

    Directory of Open Access Journals (Sweden)

    Sumit Narang

    2011-01-01

    Conclusion: Resorbable membrane is a versatile treatment modality for coverage of isolated buccal gingival recession. Although membrane exposure occurred in four patients, it did not interfere with post operative healing.

  7. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Verhoef, J C; Ponec, M

    1999-01-01

    The aim of the present study was to characterize the TR146 cell culture model as an in vitro model of human buccal epithelium with respect to the permeability of test substances with different molecular weights (M(w)). For this purpose, the apparent permeability (P(app)) values for mannitol...... and for fluorescein isothiocyanate (FITC)-labelled dextrans (FD) with various M(w) (4000-40000) were compared to the P(app) values obtained using porcine buccal mucosa as an in vitro model of the human buccal epithelium. The effect of 10 mM sodium glycocholate (GC) on the P(app) values was examined. To identify...... cell culture model is a suitable in vitro model for mechanistic permeability studies of human buccal drug permeability....

  8. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Mørck Nielsen, H; Rømer Rassing, M; Nielsen, Hanne Mørck

    2000-01-01

    The objective of the present study was to characterise the TR146 cell culture model as an in vitro model of human buccal mucosa with respect to the enzyme activity in the tissues. For this purpose, the contents of aminopeptidase, carboxypeptidase and esterase in homogenate supernatants of the TR146...... cell culture model, and human and porcine buccal epithelium were compared. The esterase activity in the intact cell culture model and in the porcine buccal mucosa was compared. Further, the TR146 cell culture model was used to study the permeability rate and metabolism of leu-enkephalin. The activity...... of the three enzymes in the TR146 homogenate supernatants was in the same range as the activity in homogenate supernatants of human buccal epithelium. In the TR146 cell culture model, the activity of aminopeptidase (13.70+/-2.10 nmol/min per mg protein) was approx. four times the activity of carboxypeptidase...

  9. Metastasis of Renal Cell Carcinoma to the Buccal Mucosa 19 Years after Radical Nephrectomy

    Directory of Open Access Journals (Sweden)

    Hernani Gil-Julio

    2012-01-01

    Full Text Available Renal cell carcinoma (RCC has high metastatic potential, which requires early diagnosis to optimize the chance of cure. Metastasis of RCC to the head and neck region is less common and metastasis to the buccal mucosa is extremely rare. This phenomenon occurs mostly in patients with generalized dissemination, especially with lung metastases. In this article we report a case of buccal mucosa metastasis from RCC in a 65-year-old man who presented 19 years after undergoing a left radical nephrectomy for clear cell RCC. Surgical excision of the buccal lesion was performed without evidence of recurrence or new metastatic lesions after 6 years of followup. To our knowledge, this is the first case of metastasis to the buccal mucosa from a RCC reported in the literature.

  10. Buccal absorption of ketobemidone and various ester prodrugs in the rat

    DEFF Research Database (Denmark)

    Hansen, L.B.; Jorgensen, A.; Rasmussen, S.N.

    1992-01-01

    The buccal absorption of ketobemidone, a strong narcotic analgesic, and various carboxylate and carbonate ester prodrugs was studied in rats. The compounds were administered in the form of aqueous solutions of pH 7.4. The absolute bioavailability of ketobemidone following buccal dosing was 26......% whereas the bioavailability of ketobemidone following buccal administration of the prodrugs ranged from 37 to 98%. The highest bioavailability was obtained with the ethyl carbonate ester. An apparent parabolic correlation between bioavailability and lipophilicity of the compounds was seen. All esters were...... rapidly hydrolyzed to ketobemidone after both buccal and intravenous administration. The acute toxicity of the esters after i.v. administration to mice and rats was similar to that of the parent drug. It is concluded that esterification of the phenolic hydroxyl group in ketobemidone to give a more...

  11. Assessment of buccal bone thickness of aesthetic maxillary region: a cone-beam computed tomography study

    National Research Council Canada - National Science Library

    Fuentes, Ramón; Flores, Tania; Navarro, Pablo; Salamanca, Carlos; Beltrán, Víctor; Borie, Eduardo

    2015-01-01

    The aim of this study was to analyze the anatomical dimensions of the buccal bone walls of the aesthetic maxillary region for immediate implant placement, based upon cone-beam computed tomography (CBCT...

  12. Buccal midazolam spray as an alternative to intranasal route for conscious sedation in pediatric dentistry.

    Science.gov (United States)

    Chopra, Radhika; Mittal, Meenu; Bansal, Kalpana; Chaudhuri, Payal

    2013-01-01

    To evaluate the acceptance of midazolam spray through buccal route as compared to intranasal route and compare the efficacy of the drug through both the routes. 30 patients aged 2-8 years with Grade I or II Frankl's Behaviour Rating Scale were selected who required similar treatment under local anesthesia on two teeth. Midazolam spray was administered randomly through buccal or intranasal routes for the two appointments. Scoring was done for the acceptance of drug and Houpt's score was recorded for the behaviour of patients during the treatment. Acceptance of drug through buccal route was significantly better than the intranasal route (p 0.05). Midazolam spray can be effectively used through the buccal mucosa in children who give poor compliance with the intranasal administration.

  13. Buccal vs. nasogastric tube administration of tacrolimus after pediatric liver transplantation

    NARCIS (Netherlands)

    Goorhuis, JF; Scheenstra, R; Peeters, PMJG; Albers, MJIJ

    2006-01-01

    Tacrolimus is an important drug for immunosuppression after liver transplantation. Bioavailability of enterally administered tacrolimus is poor, and further reduced by gastric residuals or by enteral nutrition. Buccal administration might be an alternative route especially in children. Tacrolimus tr

  14. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, M R

    1999-01-01

    The aim of the present study was to evaluate the TR146 cell culture model as an in vitro model of human buccal epithelium with respect to the permeability enhancement by different pH values, different osmolality values or bile salts. For this purpose, the increase in the apparent permeability (P...... for efficacy studies and mechanistic studies of enhancers with potential use in human buccal drug delivery....

  15. Histopathological changes of free buccal mucosa and colonic mucosa grafts after translation to dog bladder

    Institute of Scientific and Technical Information of China (English)

    XU Yue-min; LI Tai; SA Ying-long; QIAO Yong; ZHANG Hui-zhen; ZHANG Xin-ru; ZHANG Jiong; CHEN Zhong; XIE Hong; SI Jie-min

    2005-01-01

    @@ Over the past years, more cases using buccal mucosa for urethral reconstruction have been reported.1-4 The excellent early results with this tissue led some authors to extend their indications for its use. However, patients with complex, long-segment urethral strictures and significant scar tissue formation after the failure of previous urethroplasty, still present an operative challenge. The buccal mucosa may not be useful for the treatment of the complicated lengthy urethral strictures because of limited material.

  16. Relative Telomere Repeat Mass in Buccal and Leukocyte-Derived DNA

    Science.gov (United States)

    Finnicum, Casey T.; Dolan, Conor V.; Willemsen, Gonneke; Weber, Zachary M.; Petersen, Jason L.; Beck, Jeffrey J.; Codd, Veryan; Boomsma, Dorret I.; Davies, Gareth E.; Ehli, Erik A.

    2017-01-01

    Telomere length has garnered interest due to the potential role it may play as a biomarker for the cellular aging process. Telomere measurements obtained from blood-derived DNA are often used in epidemiological studies. However, the invasive nature of blood draws severely limits sample collection, particularly with children. Buccal cells are commonly sampled for DNA isolation and thus may present a non-invasive alternative for telomere measurement. Buccal and leukocyte derived DNA obtained from samples collected at the same time period were analyzed for telomere repeat mass (TRM). TRM was measured in buccal-derived DNA samples from individuals for whom previous TRM data from blood samples existed. TRM measurement was performed by qPCR and was normalized to the single copy 36B4 gene relative to a reference DNA sample (K562). Correlations between TRM from blood and buccal DNA were obtained and also between the same blood DNA samples measured in separate laboratories. Using the classical twin design, TRM heritability was estimated (N = 1892, MZ = 1044, DZ = 775). Buccal samples measured for TRM showed a significant correlation with the blood-1 (R = 0.39, p < 0.01) and blood-2 (R = 0.36, p < 0.01) samples. Sex and age effects were observed within the buccal samples as is the norm within blood-derived DNA. The buccal, blood-1, and blood-2 measurements generated heritability estimates of 23.3%, 47.6% and 22.2%, respectively. Buccal derived DNA provides a valid source for the determination of TRM, paving the way for non-invasive projects, such as longitudinal studies in children. PMID:28125671

  17. Raman mapping of oral buccal mucosa: a spectral histopathology approach

    Science.gov (United States)

    Behl, Isha; Kukreja, Lekha; Deshmukh, Atul; Singh, S. P.; Mamgain, Hitesh; Hole, Arti R.; Krishna, C. Murali

    2014-12-01

    Oral cancer is one of the most common cancers worldwide. One-fifth of the world's oral cancer subjects are from India and other South Asian countries. The present Raman mapping study was carried out to understand biochemical variations in normal and malignant oral buccal mucosa. Data were acquired using WITec alpha 300R instrument from 10 normal and 10 tumors unstained tissue sections. Raman maps of normal sections could resolve the layers of epithelium, i.e. basal, intermediate, and superficial. Inflammatory, tumor, and stromal regions are distinctly depicted on Raman maps of tumor sections. Mean and difference spectra of basal and inflammatory cells suggest abundance of DNA and carotenoids features. Strong cytochrome bands are observed in intermediate layers of normal and stromal regions of tumor. Epithelium and stromal regions of normal cells are classified by principal component analysis. Classification among cellular components of normal and tumor sections is also observed. Thus, the findings of the study further support the applicability of Raman mapping for providing molecular level insights in normal and malignant conditions.

  18. Small Buccal Fat Pad Cells Have High Osteogenic Differentiation Potential.

    Science.gov (United States)

    Tsurumachi, Niina; Akita, Daisuke; Kano, Koichiro; Matsumoto, Taro; Toriumi, Taku; Kazama, Tomohiko; Oki, Yoshinao; Tamura, Yoko; Tonogi, Morio; Isokawa, Keitaro; Shimizu, Noriyoshi; Honda, Masaki

    2016-03-01

    Dedifferentiated fat (DFAT) cells derived from mature adipocytes have mesenchymal stem cells' (MSCs) characteristics. Generally, mature adipocytes are 60-110 μm in diameter; however, association between adipocyte size and dedifferentiation efficiency is still unknown. This study, therefore, investigated the dedifferentiation efficiency of adipocytes based on cell diameter. Buccal fat pad was harvested from five human donors and dissociated by collagenase digestion. After exclusion of unwanted stromal cells by centrifugation, floating adipocytes were collected and their size distribution was analyzed. The floating adipocytes were then separated into two groups depending on cell size using 40- and 100-μm nylon mesh filters: cell diameters less than 40 μm (small adipocytes: S-adipocytes) and cell diameters of 40-100 μm (large adipocytes: L-adipocytes). Finally, we evaluated the efficiency of adipocyte dedifferentiation and then characterized the resultant DFAT cells. The S-adipocytes showed a higher capacity to dedifferentiate into DFAT cells (S-DFAT cells) compared to the L-adipocytes (L-DFAT cells). The S-DFAT cells also showed a relatively higher proportion of CD146-positive cells than L-DFAT cells, and exhibited more osteogenic differentiation ability based on the alkaline phosphatase activity and amount of calcium deposition. These results suggested that the S- and L-DFAT cells had distinct characteristics, and that the higher dedifferentiation potential of S-adipocytes compared to L-adipocytes gives the former group an advantage in yielding DFAT cells.

  19. Treatment of inadequate lactation with oral sulpiride and buccal oxytocin.

    Science.gov (United States)

    Ylikorkala, O; Kauppila, A; Kivinen, S; Viinikka, L

    1984-01-01

    Thirty-six puerperal women with inadequate lactation were treated with 50 mg sulpiride (N = 24) or placebo (N = 12) three times a day for two weeks. These treatments were supplemented with buccal oxytocin (100 IU, 300 IU, or 400 IU) or placebo preceding each breast-feeding on the sixth and 14th and on the seventh and 13th days of oral treatment, respectively. One woman treated with sulpiride and three women treated with placebo discontinued the trial because of the lack of the effect of treatment. The concentration of prolactin in maternal serum was higher (P less than .001) during sulpiride than placebo treatment at one week (380 +/- 43 ng/ml vs 23 +/- 7 ng/ml, mean +/- SE) and two weeks of treatment (381 +/- 38 ng/ml vs 34 +/- 10 ng/ml). Also, the daily breast milk yield, as measured objectively, was greater (P less than .05) during sulpiride than placebo treatment both at one week (628 +/- 51 ml vs 440 +/- 68 ml) and two weeks of treatment (684 +/- 67 ml vs 423 +/- 60 ml). Various doses of oxytocin failed to stimulate the milk secretion in the presence or absence of sulpiride-induced hyperprolactinemia. Thus, sulpiride improved inadequate lactation, whereas exogenous oxytocin alone or together with sulpiride had no effect on lactation in these mothers whose infants were able to suckle normally.

  20. Photodynamic therapy for the treatment of buccal candidiasis in rats.

    Science.gov (United States)

    Junqueira, Juliana Campos; Martins, Joyce da Silva; Faria, Raquel Lourdes; Colombo, Carlos Eduardo Dias; Jorge, Antonio Olavo Cardoso

    2009-11-01

    The study objective was to evaluate the effects of photodynamic therapy on buccal candidiasis in rats. After experimental candidiasis had been induced on the tongue dorsum, 72 rats were distributed into four groups according to treatment: treated with laser and methylene blue photosensitizer (L+P+); treated only with laser (L+P-); treated only with photosensitizer (L--P+); not treated with laser or photosensitizer (L-P-). The rats were killed immediately, 1 day, or 5 days after treatment, for microscopic analysis of the tongue dorsum. Observation verified that the photodynamic therapy group (L+P+) exhibited fewer epithelial alterations and a lower chronic inflammatory response than the L-P- group. The group L+P- presented more intense epithelial alterations and chronic inflammatory response than the remaining groups. The L-P+ group showed tissue lesions similar to those of the L-P- group. In conclusion, rats treated with photodynamic therapy developed more discrete candidiasis lesions than did the remaining groups.

  1. Cytokeratin expression in human fetal tongue and buccal mucosa

    Indian Academy of Sciences (India)

    M M Vaidya; Sharda S Sawant; Anita M Borges; N K Naresh; Manda C Purandare; A N Bhisey

    2000-09-01

    Expression of cytokeratins (CK), a subset of intermediate filament (IF) proteins in epithelia, is developmentally regulated. CK expression may also change after malignant transformation. Our earlier studies on CK expression in human oral tumours and pre-cancerous lesions have shown specific changes in CK expression. We analysed CK expression in human tongue and buccal mucosa (BM) in fetuses in the embryonic age group of 16 to 27 weeks using biochemical and immunohistochemical techniques to find out whether there is any similarity in CK expression in human oral squamous cell carcinomas (SCC) and fetal oral tissues. CK 1, 8 and 18 were detected in a majority of samples using both techniques. Our earlier studies had shown aberrant expression of CK 1 and 18 in many of the oral SCC and leukoplakias. Studies by immunohistochemistry showed that these different CK antigens were expressed in different cell layers. CK 1(2) were present in the stratified epithelial layers whereas CK 8 and 18 were restricted to glandular epithelium. Till 27 weeks of gestation, both tongue and BM expressed CK 1, 8 and 18 along with CK 6 and 16. Thus, fetal tissues showed some similarities in CK pattern with their respective SCC.

  2. Dental prosthesis and buccal lesions in the elderly

    Directory of Open Access Journals (Sweden)

    Beatriz García Alpizar

    2010-02-01

    Full Text Available Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship with the lesions of the oral mucosa. The square chi tests and the analysis of relative risk were use to determine the association between the variables, also we used a logistical regression model to determine the independent relationship of each factor with the presence of the lesions. Results: We was a 12% of the people with stomatitis sub prosthesis, 8% presented lesions growth hyperplasic and 5,6% they were have angular queilitis. The lesions in the oral mucosa increased in people with prosthesis in not well state, bad hygiene this and in the female sex. Conclusion: the chronic lesions were the more prevalence in this study and they were very related with factors like: state of the conservation the prosthesis, time use, hygiene this and sex of the individual; but when determining the independent influence from each factor with the presence lesions, we established that only the state of conservation of the prosthesis and their hygiene affected of the important way to the old men of this study.

  3. Micronucleus frequency in buccal mucosa cells of mobile phone users.

    Science.gov (United States)

    Hintzsche, Henning; Stopper, Helga

    2010-03-01

    Mobile phones are being used extensively throughout the world, with more than four billion accounts existing in 2009. This technology applies electromagnetic radiation in the microwave range. Health effects of this radiation have been subject of debate for a long time, both within the scientific community and within the general public. This study investigated the effect of mobile phone use on genomic instability of the human oral cavity's mucosa cells. 131 Individuals donated buccal mucosa cells extracted by slightly scraping the oral cavity with a cotton swab. Every participant filled out a questionnaire about mobile phone use including duration of weekly use, overall period of exposure and headset usage. 13 Individuals did not use mobile phones at all, 85 reported using the mobile phone for three hours per week or less, and 33 reported use of more than three hours per week. Additionally, information on age, gender, body weight, smoking status, medication and nutrition was retrieved. For staining of the cells a procedure using alpha-tubulin-antibody and chromomycin A(3) was applied. Micronuclei and other markers were evaluated in 1000 cells per individual at the microscope. A second scorer counted another 1000 cells, resulting in 2000 analyzed cells per individual. Mobile phone use did not lead to a significantly increased frequency of micronuclei.

  4. Onset of buccal pumping in catshark embryos: how breathing develops in the egg capsule.

    Directory of Open Access Journals (Sweden)

    Taketeru Tomita

    Full Text Available Respiration in fishes involves buccal pumping, which is characterized by the generation of nearly continuous water flow over the gills because of the rhythmic expansion/compression of the pharyngeal cavity. This mechanism is achieved by the functions of the vascular, skeletal, and muscular systems. However, the process by which the embryo establishes the mechanism remains a mystery. Morphological and kinematical observations on captive cloudy catsharks, Scyliorhinus torazame, have suggested that the embryo starts buccal pumping just before the respiratory slits open on the egg capsule. During the pre-opening period, the embryo acquires oxygen mainly via the external gill filaments. After slit opening, respiration of the embryo involves buccal pumping to pass water over the "internal gills." The onset of buccal pumping accompanies four morphological changes: (1 regression of the external gill filaments, (2 development of blood vessels within the "internal gills," (3 completion of the development of hyoid skeletal and muscular elements, and (4 development of the oral valve. A previous study showed that buccal pumping allows the embryo to actively regulate oxygen intake by changing the pumping frequency. Thus, establishment of buccal pumping in the egg capsule is probably important for embryo survival in the unstable oxygen environment of the egg capsule after slit opening.

  5. Educative intervention for knowledge development on buccal health in elementary school.

    Directory of Open Access Journals (Sweden)

    Olga Lidia García Álvarez

    2008-08-01

    Full Text Available Background: There is high prevalence of buccal diseases which could be avoided with appropriate hygienic and alimentary habits that are supposed to be learned since the first stages of life. Objective: To verify the efficacy of an educative strategy on buccal health to develop buccal self-care through its application in girls and boys. Methods: An intervention study was developed with before and after design in 80 children of 5th grade and teachers of the primary school “Armando Mestre Martínez” in Cienfuegos, from September 2005 to March 2006. Initially, learning necessities and buccal hygiene were determined in both groups and later we verified the strategy efficiency. Initial information was obtained through surveys, focal groups, experts’ opinions and observation. Wilcoxon rank test was used for matched samples and Mc Nemar test for variables verification. Findings: Significant differences were obtained between the initial and final knowledge on buccal health and buccal hygiene coefficient. Qualitative methods showed audience approval of this strategy. Conclusions: Educative strategy applications allowed children learning actions of self-care as correct teeth brushing, use of dental floss, appropriate dietary selection and identification of prejudicial habits.

  6. Factors affecting buccal corridor space in Angle′s Class II Division 1 malocclusion

    Directory of Open Access Journals (Sweden)

    Rashmi Bhat

    2014-01-01

    Full Text Available Background and Objectives: Buccal corridor space has been thought of primarily in terms of maxillary width, but there is also evidence that they are heavily influenced by the antero-posterior position of maxilla. The present study was undertaken with an aim of evaluating and comparing the dental and skeletal factors related to buccal corridor space in individuals having Class I and Class II Division 1 malocclusions. Materials and Methods: A total of 80 subjects of which 40 were males and 40 were females in the age group of 20-30 years were selected as per inclusion criteria and were grouped as Group I having Class I malocclusion and as Group II having Class II malocclusions based on angle ANB. 12 linear and 2 angular cephalometric measurements and 4 study cast measurements were used to correlate with the buccal corridor linear ratio (BCLR, calculated on smile photograph using the Adobe Photoshop 7.0 software (Adobe Systems Inc., San Jose, California, USA. The data obtained was statistically evaluated using independent t-test and multiple linear regression analysis. Result: Buccal corridor space is larger in individuals with Class II Division 1 malocclusion when compared with individuals with Class I malocclusions. There exists a significant difference in buccal corridor space between males and females. Conclusion: The present study helps in establishing the correlation between certain factors and the amount of buccal corridor space in individuals having skeletal Class II pattern.

  7. Conscious sedation for middle ear surgeries: A comparison between fentanyl-propofol and fentanyl-midazolam infusion

    Directory of Open Access Journals (Sweden)

    Raghu S Thota

    2015-01-01

    Full Text Available Introduction and Aim: Middle ear surgeries can be performed under local anesthesia and sedation and can be well tolerated by the patient with minimal discomfort. This study was undertaken to compare two techniques of conscious sedation, intravenous midazolam, and propofol infusion for tympanoplasty. Materials and Methods: Forty patients scheduled for right or left tympanoplasty. American Society of Anesthesiologists I or II in age group 18-75 years were included in the study. The patients were randomly allocated into one of the two groups to receive either propofol (group I or midazolam (group II. Results: The mean duration of anesthesia was 116.00 ± 33.94 min in group I, while 97.50 ± 30.76 min in group II (P = 0.07. The modified Ramsay sedation scale was not statistically significant in both the groups. In group I, 70% of the patients and 95% of the patients in group II had amnesia during the surgery (P = 0.091. The mean visual analog scale (VAS score for surgeons and patients was not statistically significant in both the groups. In group I there was a positive correlation between the total dose of fentanyl and VAS score for surgeons (P = 0.02. There was also a positive correlation between the total dose of propofol and VAS score for surgeons (P = 0.034 and patients (P = 0.039 in group I. Conclusion: Though propofol had shown a faster recovery and less nausea vomiting, we need a larger sample size to conclude, which of the technique is better. Both the techniques are safe, simple and versatile and provide excellent sedation with rapid trouble free recovery.

  8. Increases in self-reported fentanyl use among a population entering drug treatment: The need for systematic surveillance of illicitly manufactured opioids.

    Science.gov (United States)

    Cicero, Theodore J; Ellis, Matthew S; Kasper, Zachary A

    2017-08-01

    Recent reports indicate a sharp increase in fentanyl-related overdose deaths across the United States, much of which is likely related to the introduction of cheap, illicitly manufactured fentanyl derivatives. In this study, we sought to estimate the magnitude of illicit fentanyl use from 2012 to 2016 using a national opioid abuse surveillance system. The study program surveyed 10,900 individuals entering substance abuse treatment for opioid use disorder, with participants asked to endorse past month 'use to get high' of fentanyl drugs, stratified by identifiable (i.e., branded) fentanyl formulations or a 'type unknown' drug alleged to contain fentanyl. Total past-month fentanyl-use rose modestly from 2012 to 2016. While use of known fentanyl products remained relatively stable (mean=10.9%; P=0.25), endorsements of 'unknown' fentanyl products nearly doubled from 9% in 2013 to 15.1% by 2016 (P<0.001). Data show no discernable indication that this increase is diminishing or stabilizing. This first attempt to assess the prevalence of illicit fentanyl use shows that recent increases in fentanyl use seem to be due almost entirely to 'unknown' fentanyl presumed to be illicitly manufactured. Given that it is difficult to assess the extent to which fentanyl may have been substituted for another drug (i.e., oxycodone, alprazolam, etc.) or was used as a heroin admixture, our data likely represent an underestimation of the full magnitude of illicit fentanyl abuse. As such, this growing public health problem requires immediate attention and more systematic efforts to identify and track its abuse. Copyright © 2017. Published by Elsevier B.V.

  9. Quantitative determination of fentanyl in newborn pig plasma and cerebrospinal fluid samples by HPLC-MS/MS.

    Science.gov (United States)

    Blanco, M E; Encinas, E; González, O; Rico, E; Vozmediano, V; Suárez, E; Alonso, R M

    2015-09-01

    In this study, a selective and sensitive high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method requiring low sample volume (≤100 μL) was developed and validated for the quantitative determination of the opioid drug fentanyl in plasma and cerebrospinal fluid (CSF). A protein precipitation extraction with acetonitrile was used for plasma samples whereas CSF samples were injected directly on the HPLC column. Fentanyl and (13) C6 -fentanyl (Internal Standard) were analyzed in an electrospray ionization source in positive mode, with multiple reaction monitoring (MRM) of the transitions m/z 337.0/188.0 and m/z 337.0/105.0 for quantification and confirmation of fentanyl, and m/z 343.0/188.0 for (13) C6 -fentanyl. The respective lowest limits of quantification for plasma and CSF were 0.2 and 0.25 ng/mL. Intra- and inter-assay precision and accuracy did not exceed 15%, in accordance with bioanalytical validation guidelines. The described analytical method was proven to be robust and was successfully applied to the determination of fentanyl in plasma and CSF samples from a pharmacokinetic and pharmacodynamic study in newborn piglets receiving intravenous fentanyl (5 µg/kg bolus immediately followed by a 90-min infusion of 3 µg/kg/h).

  10. Safety and efficiency of prehospital pain management with fentanyl administered by emergency medical technicians

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Brogaard, Kjeld; Dahl, Michael

    2007-01-01

    minor, and were not treated with naloxone.   Conclusions: Our results suggest that non-medical personnel safely can administer IV fentanyl to selected groups of patients with a satisfactory result in terms of a considerable reduction in pain score and an acceptable rate of negative coincident events....

  11. Intrathecal fentanyl abolishes the exaggerated blood pressure response to cycling in hypertensive men

    DEFF Research Database (Denmark)

    Barbosa, Thales C; Vianna, Lauro C; Fernandes, Igor A;

    2016-01-01

    of fentanyl, a μ-opioid receptor agonist, aiming to attenuate the central projection of opioid-sensitive group III and IV muscle afferent nerves. The cardiovascular response to exercise of these subjects was compared with that of six normotensive men. During cycling, the hypertensive group demonstrated...

  12. Patient considerations in the use of transdermal iontophoretic fentanyl for acute postoperative pain

    Directory of Open Access Journals (Sweden)

    Hartrick CT

    2016-04-01

    Full Text Available Craig T Hartrick,1 Cecile R Pestano,1 Li Ding,2 Hassan Danesi,2 James B Jones,2 1Beaumont Health System, Troy, MI, 2The Medicines Company, Parsippany, NJ, USA Abstract: Opioids are commonly used in the management of moderate-to-severe postoperative pain. Patient-controlled analgesic techniques are recognized as preferred administration methods. Previously, research has focused on intravenously administered opioids via a programmable pump. More recently, an iontophoretic transdermal system (ITS, which is patient controlled, has been developed. The focus of this review is on pain management using the fentanyl ITS during the 24–72-hour time period immediately following surgery. Fentanyl ITS offers a needle-free alternative to traditional intravenous (IV patient-controlled analgesia (PCA system that is as effective and safe as IV PCA. This system is easy to use for both patients and nurses. The use of fentanyl ITS is generally associated with a better ease-of-care profile, including a greater ease of mobility, from a patients' perspective when compared with morphine IV PCA. Keywords: patient-controlled analgesia, fentanyl iontophoretic transdermal system, ease of care, mobility, patient perspective, review

  13. Fatal Overdose due to Confusion of an Transdermal Fentanyl Delivery System

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    Ingo Voigt

    2013-01-01

    Full Text Available Background. The use of transdermal fentanyl systems has increased over recent years, especially in patients with chronic pain. Large misuse potential and fatal outcomes have been described. Case Presentation. A 58-year-old patient presenting with clinical signs of opioid poisoning (hypoventilation, bradycardia, hypotension, and miosis was admitted to our ICU. The first body check revealed a 75 mcg per hour fentanyl patch at the patient's right scapula. Some months ago, patient's aunt died after suffering from an oncological disease. During breaking up of her household, the patches were saved by the patient. Not knowing the risk of this drug, he mistook it as a heat plaster. Investigations. Laboratory test showed an impaired renal function and metabolic acidosis. Urine drug test was negative at admittance and 12 h later. CCT scan presented a global hypoxic brain disease. Treatment and Outcome. The patient was discharged 30 days after admittance in a hemodynamic stable condition but a vegetative state and transferred to a rehabilitation center. Learning Points. With the ongoing increase in fentanyl patch prescriptions for therapeutic reasons, it is likely that misuse cases will become more relevant. Conventional urine drug screening tests are not able to exclude the diagnosis fentanyl intoxication. History taking should include family member's drug prescriptions.

  14. The use of rotation to fentanyl in cancer-related pain

    Science.gov (United States)

    Dima, Delia; Tomuleasa, Ciprian; Frinc, Ioana; Pasca, Sergiu; Magdo, Lorand; Berindan-Neagoe, Ioana; Muresan, Mihai; Lisencu, Cosmin; Irimie, Alexandru; Zdrenghea, Mihnea

    2017-01-01

    Pain is commonly diagnosed with respect to cancer and heart diseases, being a major symptom in most neoplastic diseases. Uncontrolled pain leads to a decrease in the quality of life and an increase in the morbidity of the patient. Opioids represent the best analgetic supportive therapy and are frequently used in patients suffering from cancer and experiencing a high level of pain. Opioid treatment starts with a gradual titration of the dose until the minimum effective dose and the maximum tolerated dose are determined. Opioid rotation refers to the switch from one opioid to another in order to get a better response to analgetic therapy and reduce side effects. Fentanyl therapy is recommended to be continued during chemotherapy, radiotherapy, or in the case of surgical intervention. Rotation to fentanyl patches is an efficient and elegant solution for cancer patients, with reduced side effects. Opioid rotation, especially to fentanyl, was shown to increase the quality of life in patients with malignant disease. Finally, rotation to fentanyl is also advantageous from an economic point of view. PMID:28223843

  15. Safety of Intranasal Fentanyl in the Out-of-Hospital Setting

    DEFF Research Database (Denmark)

    Karlsen, Anders P H; Pedersen, Danny M B; Trautner, Sven

    2014-01-01

    : In this prospective observational study, we administered intranasal fentanyl in the out-of-hospital setting to adults and children older than 8 years with severe pain resulting from orthopedic conditions, abdominal pain, or acute coronary syndrome refractory to nitroglycerin spray. Patients received 1 to 3 doses...

  16. Remifentanil versus Fentanyl/Midazolam in Painless Reduction of Anterior Shoulder Dislocation; a Randomized Clinical Trial

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    Mohammad Gharavifard

    2016-04-01

    Full Text Available Introduction: Performance of painful diagnostic and therapeutic procedures is common in emergency department(ED, and procedural sedation and analgesia (PSA is a fundamental skill for every emergency physician.This studywas aim to compare the efficacy of remifentanil with fentanyl/midazolam in painless reduction of anteriorshoulder dislocation. Methods: In this randomized, double blind, clinical trial the procedural characteristics,patients satisfaction as well as adverse events were compared between fentanyl/midazolamand remifentanilfor PSA of 18–64 years old patients, which were presented to ED following anterior shoulder dislocation.Results: 96 cases were randomly allocated to two groups (86.5% male. There were no significant difference betweengroups regarding baseline characteristics. Remifentanil group had lower duration of procedure (2.5§1.6versus 4.6§1.8 minutes, p Ç 0.001, higher pain reduction (53.7§13.3 versus 33.5§19.6, p Ç 0.001, lower failurerate (1 (2.1% versus 15 (31.3%, p Ç 0.001, higher satisfaction (p Æ 0.005. Adverse events were seen in 12 (25%patients in midazolam/fentanyl and 8 (16.7% cases in remifentanil group (p Æ 0.122. Conclusion: It seemsthat use of remifentanil resulted in lower procedural time, lower failure rate, and lower pain during procedureas well as higher patient satisfaction in comparison with midazolam/fentanyl combination in anterior shoulderdislocation.

  17. Disaster after the plaster. Fentanyl withdrawal symptoms in a curable hospice patient.

    NARCIS (Netherlands)

    Maathuis, M.H.; Dijkstra, D.D.

    2011-01-01

    Opioids have been used for thousands of years for pain relief. Transdermal fentanyl (TDF) is a synthetic opioid that is prescribed for the treatment of chronic pain. This clinical lesson demonstrates that TDF may be easy to start but sometimes difficult to stop. Like any other opioid there is a subs

  18. Safety and efficiency of prehospital pain management with fentanyl administered by emergency medical technicians

    DEFF Research Database (Denmark)

    Nielsen, Niels Dalsgaard; Brogaard, Kjeld; Dahl, Michael

    2007-01-01

    minor, and were not treated with naloxone.   Conclusions: Our results suggest that non-medical personnel safely can administer IV fentanyl to selected groups of patients with a satisfactory result in terms of a considerable reduction in pain score and an acceptable rate of negative coincident events....

  19. EFFECTS OF INTRAVENOUS FENTANYL ON SPONTANEOUS RENAL SYMPATHETIC NERVE ACTIVITY IN NORMAL AND VAGOTOMIZED RABBITS

    Institute of Scientific and Technical Information of China (English)

    Chen Wang; James G.Whitwam

    2004-01-01

    Objective To investigate the roles of sympathetic and vagus nerves in hypotension and bradycardia induced by fentanyl.Methods Fourteen rabbits were divided into 2 groups: normal and vagotomized rabbits. Rabbits were anesthetized,paralyzed, and artificial ventilated. Right renal sympathetic nerve was exposed and prepared for recording electrical activity.Fentanyl was injected intravenously in incremental doses of 1, 4, 15, 30, and 50 μg/kg at 10 minutes intervals.Results Fentanyl significantly reduced the spontaneous activity of renal sympathetic nerve, mean arterial pressure, and heart rate above a total dose of 20 μg/kg in both normal and vagotomized rabbits. However, normal rabbits spontaneous sympathetic nerve activity and mean arterial pressure were more depressed than vagotomized rabbits at total doses of 50 and 100 μg/kg. There were no significant difference in the reduction of heart rate between normal and vagotomized rabbits.Conclusion Fentanyl induction of bradycardia and hypotension in rabbits is mainly due to depression of sympathetic nerve activity.

  20. Frontal lobe oxygenation is maintained during hypotension following propofol-fentanyl anesthesia

    NARCIS (Netherlands)

    P. Nissen; J.J. van Lieshout; H.B. Nielsen; N.H. Secher

    2009-01-01

    Near-infrared spectroscopy (NIRS) assesses cerebral oxygen saturation (Sco2) as a balance between cerebral oxygen delivery and consumption. In 71 patients, we evaluated whether marked reduction in mean arterial pressure (MAP) during propofol-fentanyl anesthesia induction affects frontal lobe Sco2. T

  1. Epidural ropivacaine combined with fentanyl or in combination with clonidine in infraumblical surgeries: a comparative study

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    Rakesh Bahadur Singh

    2015-10-01

    Conclusions: So this study re-established the fact, that the fentanyl and clonidine when added as adjuvant to epidural ropivacaine, significantly prolongs the analgesic duration without causing significant hemodynamic and respiratory changes. [Int J Res Med Sci 2015; 3(10.000: 2740-2744

  2. Safety and Efficacy of Oral Transmucosal Fentanyl Citrate for Prehospital Pain Control on the Battlefield

    Science.gov (United States)

    2012-01-01

    parenterally since the early 1960s. Because fentanyl quickly crosses the blood- brain barrier, allowing for rapid onset of pain relief, it is often used...O’Connor KC, Johnson TR, Mosely DS, Meyer DE, Holcomb JB. A novel pain management strategy for combat casualty care. Ann Emerg Med. 2004;44:121 127. 7

  3. Epidural labor analgesia: A comparison of ropivacaine 0.125% versus 0.2% with fentanyl

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    Yogesh Kumar Chhetty

    2013-01-01

    Conclusion: We conclude that both the concentrations of ropivacaine (0.2% and 0.125% with fentanyl are effective in producing epidural labor analgesia. However, 0.2% concentration was found superior in terms of faster onset, prolonged duration, lesser breakthrough pain requiring lesser top-ups, and hence a lesser consumption of opioids.

  4. Colonoscopy sedation: clinical trial comparing propofol and fentanyl with or without midazolam.

    Science.gov (United States)

    das Neves, Jose Francisco Nunes Pereira; das Neves Araújo, Mariana Moraes Pereira; de Paiva Araújo, Fernando; Ferreira, Clarice Martins; Duarte, Fabiana Baeta Neves; Pace, Fabio Heleno; Ornellas, Laura Cotta; Baron, Todd H; Ferreira, Lincoln Eduardo Villela Vieira de Castro

    2016-01-01

    Colonoscopy is one of the most common procedures. Sedation and analgesia decrease anxiety and discomfort and minimize risks. Therefore, patients prefer to be sedated when undergoing examination, although the best combination of drugs has not been determined. The combination of opioids and benzodiazepines is used to relieve the patient's pain and discomfort. More recently, propofol has assumed a prominent position. This randomized prospective study is unique in medical literature that specifically compared the use of propofol and fentanyl with or without midazolam for colonoscopy sedation performed by anesthesiologists. The aim of this study was to evaluate the side effects of sedation, discharge conditions, quality of sedation, and propofol consumption during colonoscopy, with or without midazolam as preanesthetic. The study involved 140 patients who underwent colonoscopy at the University Hospital of the Federal University of Juiz de Fora. Patients were divided into two groups: Group I received intravenous midazolam as preanesthetic 5min before sedation, followed by fentanyl and propofol; Group II received intravenous anesthesia with fentanyl and propofol. Patients in Group II had a higher incidence of reaction (motor or verbal) to the colonoscope introduction, bradycardia, hypotension, and increased propofol consumption. Patient satisfaction was higher in Group I. According to the methodology used, the combination of midazolam, fentanyl, and propofol for colonoscopy sedation reduces propofol consumption and provides greater patient satisfaction. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  5. Use of fentanyl and midazolam in mechanically ventilated children--Does the method of infusion matter?

    Science.gov (United States)

    da Silva, Paulo Sérgio Lucas; Reis, Maria Eunice; de Aguiar, Vânia Euzébio; Fonseca, Marcelo Cunio Machado

    2016-04-01

    Benzodiazepines and opioids are commonly used in pediatric intensive care unit. However, there is no previous study assessing the use of administering these drugs combined (single solution) or separately. We sought to evaluate the impact of these 2 different methods of providing sedation/analgesia in pediatric intensive care unit. One hundred twelve patients mechanically ventilated for more than 48 hours were randomized to receive a protocolized sedation regime comprising midazolam and fentanyl either separately (group 1, 57 patients) or combined as a single solution (group 2, 55 patients). Primary end point variable was the cumulated dose of midazolam and fentanyl. The median cumulated doses of both fentanyl (0.19 vs 0.37 mg/kg, P midazolam (28.8 vs 45.6 mg/kg, P midazolam and fentanyl had a higher cumulated dose of compared with those patients who did not. The potential risk for long-term neurologic effects on developing brains associated with this finding should be considered. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A Comparative study of intrathecal dexmedetomidine and fentanyl as adjuvants to Bupivacaine

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    Rajni Gupta

    2011-01-01

    Full Text Available Background: Various adjuvants have been used with local anesthetics in spinal anesthesia to avoid intraoperative visceral and somatic pain and to provide prolonged postoperative analgesia. Dexmedetomidine, the new highly selective α2-agonist drug, is now being used as a neuraxial adjuvant. The aim of this study was to evaluate the onset and duration of sensory and motor block, hemodynamic effect, postoperative analgesia, and adverse effects of dexmedetomidine or fentanyl given intrathecally with hyperbaric 0.5% bupivacaine. Materials and Methods: Sixty patients classified in American Society of Anesthesiologists classes I and II scheduled for lower abdominal surgeries were studied. Patients were randomly allocated to receive either 12.5 mg hyperbaric bupivacaine plus 5 μg dexmedetomidine (group D, n=30 or 12.5 mg hyperbaric bupivacaine plus 25 μg fentanyl (group F, n=30 intrathecal. Results: Patients in dexmedetomidine group (D had a significantly longer sensory and motor block time than patients in fentanyl group (F. The mean time of sensory regression to S1 was 476±23 min in group D and 187±12 min in group F (P<0.001. The regression time of motor block to reach modified Bromage 0 was 421±21 min in group D and 149±18 min in group F (P<0.001. Conclusions: Intrathecal dexmedetomidine is associated with prolonged motor and sensory block, hemodynamic stability, and reduced demand for rescue analgesics in 24 h as compared to fentanyl.

  7. Examining smoking-induced differential gene expression changes in buccal mucosa

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    Jenkins Marita C

    2010-06-01

    Full Text Available Abstract Background Gene expression changes resulting from conditions such as disease, environmental stimuli, and drug use, can be monitored in the blood. However, a less invasive method of sample collection is of interest because of the discomfort and specialized personnel necessary for blood sampling especially if multiple samples are being collected. Buccal mucosa cells are easily collected and may be an alternative sample material for biomarker testing. A limited number of studies, primarily in the smoker/oral cancer literature, address this tissue's efficacy as an RNA source for expression analysis. The current study was undertaken to determine if total RNA isolated from buccal mucosa could be used as an alternative tissue source to assay relative gene expression. Methods Total RNA was isolated from swabs, reverse transcribed and amplified. The amplified cDNA was used in RT-qPCR and microarray analyses to evaluate gene expression in buccal cells. Initially, RT-qPCR was used to assess relative transcript levels of four genes from whole blood and buccal cells collected from the same seven individuals, concurrently. Second, buccal cell RNA was used for microarray-based differential gene expression studies by comparing gene expression between a group of female smokers and nonsmokers. Results An amplification protocol allowed use of less buccal cell total RNA (50 ng than had been reported previously with human microarrays. Total RNA isolated from buccal cells was degraded but was of sufficient quality to be used with RT-qPCR to detect expression of specific genes. We report here the finding of a small number of statistically significant differentially expressed genes between smokers and nonsmokers, using buccal cells as starting material. Gene Set Enrichment Analysis confirmed that these genes had a similar expression pattern to results from another study. Conclusions Our results suggest that despite a high degree of degradation, RNA from buccal

  8. Fentanyl and Midazolam Are Ineffective in Reducing Episodic Intracranial Hypertension in Severe Pediatric Traumatic Brain Injury.

    Science.gov (United States)

    Welch, Timothy P; Wallendorf, Michael J; Kharasch, Evan D; Leonard, Jeffrey R; Doctor, Allan; Pineda, Jose A

    2016-04-01

    To evaluate the clinical effectiveness of bolus-dose fentanyl and midazolam to treat episodic intracranial hypertension in children with severe traumatic brain injury. Retrospective cohort. PICU in a university-affiliated children's hospital level I trauma center. Thirty-one children 0-18 years of age with severe traumatic brain injury (Glasgow Coma Scale score of ≤ 8) who received bolus doses of fentanyl and/or midazolam for treatment of episodic intracranial hypertension. None. The area under the curve from high-resolution intracranial pressure-time plots was calculated to represent cumulative intracranial hypertension exposure: area under the curve for intracranial pressure above 20 mm Hg (area under the curve-intracranial hypertension) was calculated in 15-minute epochs before and after administration of fentanyl and/or midazolam for the treatment of episodic intracranial hypertension. Our primary outcome measure, the difference between predrug and postdrug administration epochs (Δarea under the curve-intracranial hypertension), was calculated for all occurrences. We examined potential covariates including age, injury severity, mechanism, and time after injury; time after injury correlated with Δarea under the curve-intracranial hypertension. In a mixed-effects model, with patient as a random effect, drug/dose combination as a fixed effect, and time after injury as a covariate, intracranial hypertension increased after administration of fentanyl and/or midazolam (overall aggregate mean Δarea under the curve-intracranial hypertension = +17 mm Hg × min, 95% CI, 0-34 mm Hg × min; p = 0.04). The mean Δarea under the curve-intracranial hypertension increased significantly after administration of high-dose fentanyl (p = 0.02), low-dose midazolam (p = 0.006), and high-dose fentanyl plus low-dose midazolam (0.007). Secondary analysis using age-dependent thresholds showed no significant impact on cerebral perfusion pressure deficit (mean Δarea under the curve

  9. Investigating the Effects of Adding Fentanyl to Bupivacaine in Spinal Anesthesia of Opium-addicted Patients

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    H Satari

    2014-10-01

    Full Text Available Introduction: Spinal anesthesia in opium-addicted patients can be associated with many complications. Hence, this study aimed to investigate sensory and motor block characteristics, duration of postoperative analgesia, hemodynamic and side effects by adding Fentanyl to bupivacaine in spinal Anesthesia of opium-addicted patients. Methods: In a double-blind randomized clinical trial, 60 American society of Anesthesiology (ASA class I and II opium-addicted patients under spinal anesthesia in lower abdominal and lower limb operations were randomly classified into two groups of spinal anesthesia with bupivacaine and bupivacaine-fentanyl. Clinical symptoms, side effects, the duration of sensory and motor block, initiation of analgesia requirement and sensory block were assessed. Results: The study results indicated no significant difference between bupivacaine and bupivacaine-fentanyl groups in regard with demographic, side effects, blood pressure and heart rate, though a significant difference was observed in respiratory rate 5min, 10min, 45min, 75min and 90 min after block. Duration of sensory (100.33 to 138.83 and motor block (93.43 to 107.66 and , initiation of analgesia requirement (165.33 to 187.76 was significantly longer in bupivacaine-fentanyl, though initiation of sensory block (8.83 to 4.93 was significantly longer in bupivacaine. Conclusion: Addition of fentanyl to bupivacaine in spinal anesthesia increases the duration of sensory and motor block and initiation of analgesia requirement in opium-addicted patients and also decreases initiation of sensory block in these patients.

  10. Comparison of efficacy of bupivacaine and fentanyl with bupivacaine and sufentanil for epidural labor analgesia

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    Kalra Sumit

    2010-01-01

    Full Text Available Objectives: A study to compare the efficacy between fentanyl and sufentanil combined with low concentration (0.0625% of bupivacaine for epidural labor analgesia in laboring women. Materials and Methods: Fifty full term parturients received an initial bolus dose of a 10 ml solution containing 0.125% bupivacaine. The patients were randomly divided into two: group F received 0.0625% bupivacaine with 2.5 mcg/ml fentanyl and group S received 0.0625% bupivacaine with 0.25 mcg/ml sufentanil. Verbal analogue pain scores, need of supplementary/rescue boluses dose of bupivacaine consumed, mode of delivery, maternal satisfaction, and neonatal Apgar scores were recorded. No significant difference was observed between both groups. Results: Both the groups provided equivalent labor analgesia and maternal satisfaction. The chances of cesarean delivery were also not increased in any group. No difference in the cephalad extent of sensory analgesia, motor block or neonatal Apgar score were observed. Although mean pain scores throughout the labor and delivery were similar in both groups, more patients in fentanyl group required supplementary boluses though not statistically significant. Conclusion: We conclude that both 0.0625% bupivacaine-fentanyl (2.5 μg/ml and 0.0625% bupivacaine-sufentanil (0.25 μg/ml were equally effective by continuous epidural infusion in providing labor analgesia with hemodynamic stability achieving equivalent maternal satisfaction without serious maternal or fetal side effects. We found that sufentanil was 10 times more potent than fentanyl as an analgesic for continuous epidural labor analgesia.

  11. Fentanyl versus tramadol with levobupivacaine for combined spinal-epidural analgesia in labor

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    Veena Chatrath

    2015-01-01

    Full Text Available Background: Neuraxial labor analgesia using new local anesthetics such as levobupivacaine has become very popular by virtue of the safety and lesser motor blockade caused by these agents. Combined spinal-epidural analgesia (CSEA has become the preferred method for labor analgesia as it combines benefits of both spinal analgesia and flexibility of the epidural catheter. Adding opioids to local anesthetic drugs provide rapid onset and prolonged analgesia but may be associated with several maternal and fetal adverse effects. The purpose of this study is to compare fentanyl and tramadol used in CSEA in terms of duration of analgesia and frequency of the adverse fetomaternal outcome. Materials and Methods: A total of 60 primiparas with a singleton pregnancy in active labor were given CSEA after randomly allocating them in two groups of 30 each. Group I received intrathecal 2.5 mg levobupivacaine + 25 μg fentanyl followed by epidural top ups of 20 ml 0.125% solution of the same combination. Group II received 25 mg tramadol instead of fentanyl. Epidural top ups were given when parturient complained of two painful contractions (visual analogue scale ≥ 4. Data collected were demographic profile of the patients, analgesic qualities, side- effects and the fetomaternal outcome. Results: Patients in Group II had significantly prolonged analgesia (145 ± 9 minutes than in Group I (95 ± 7 minutes. Patients receiving fentanyl showed rapid onset of analgesia, but there were more incidence of side-effects like shivering, pruritus, transient fetal bradycardia, hypotension, nausea and vomiting. Only side-effect in the tramadol group was nausea and vomiting. During labor, maternal satisfaction was excellent. Conclusions: Adding tramadol to local anesthetic provides prolonged analgesia with minimal side effects. Fentanyl, when used as adjuvant to local anesthetic, has a rapid onset of analgesia but has certain fetomaternal side-effects.

  12. COMPARATIVE EVALUATION OF PROPOFOL KETAMINE AND PROPOFOL FENTANYL IN DAY CARE SURGERIES

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    Brajesh

    2014-09-01

    Full Text Available To find the ideal drug combinations which can be used during day care surgeries and procedures. AIMS: This study was conducted. To evaluate and compare the efficacy, and haemodynamic stability of ketamine and fentanyl combination with propofol. To compare the incidence of side effects. To compare the time of awakening and recovery time. To compare the discharge criteria in both groups. METHODS: The study was conducted in 50 patients of age group 18-50 years of either gender belonging to ASA grade I and II, were divided into two groups of 25 each. They underwent elective surgery of approximately 1 hour duration. Group I received Propofol-ketamine while group II received Propofol-fentanyl for induction and maintenance of anaesthesia. Postoperatively, time for awakening, recovery time ‘(by modified Aldrete scoring system and discharge status (by modified post anaesthetic discharge scoring system were recorded and compared in two groups. RESULTS: Profol-fentanyl combination produced a significantly greater fall in pulse rate and in both systolic and diastolic blood pressure as compared to Propofol-ketamine during induction and maintenance of anaesthesia. Fall in respiratory rate was greater in Propofol-fentanyl group as compared to Propofol-ketamine group. The recovery time in group I was longer than group II. Discharge criteria is significantly earlier in group II. CONCLUSION: Both Profol-ketamine and Propofol-fentanyl combination reduce rapid, pleasant and safe anesthesia with only a few untoward side effects and propofol-ketamine produces better haemodynamic statistic, during anaesthesia.

  13. A comparative evaluation of thoracic and lumbar epidural fentanyl for post thoracotomy pain.

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    Swaroop N

    2002-01-01

    Full Text Available Thirty patients undergoing closed mitral valvotomy were prospectively randomised to receive either thoracic or lumbar epidural catheter. General anaesthesia consisted of morphine sulphate 0.15 mg/kg (single dose given before skin incision, thiopentone sodium 4-6 mg/kg, vecuronium and halothane titrated to stable haemodynamics. In the immediate postoperative period, pain was assessed by VAS (visual analogue scale and VRS (verbal ranking score and an epidural fentanyl bolus of 1.5 microg/kg was given followed by an infusion of 0.4 microg/kg/hr. Pain was assessed after 30 min and if pain relief was still inadequate, another fentanyl bolus of 1 microg/kg was administered, followed by an increase in infusion rate to 0.6 microg/kg/hr. If two consecutive pain scores were satisfactory (VAS <4, VRS <1 maintenance dose of fentanyl was decreased by 0.2 microg/kg/hr. Thoracic group received significantly less total dose of fentanyl in 24 hrs period (446.7 +/- 101.70microg compared with the lumbar group (705.33 +/- 181.03microg (p<0.01. The mean infusion rate was also significantly less in the thoracic group as compared with the lumbar group (0.44 +/- 0.08microg/kg/hr vs 0.61 +/- 11microg/kg/hr, p<0.001. The side effects were comparable between both the groups and none of the patients had significant respiratory depression. The data suggest that thoracic epidural fentanyl infusion is superior to lumbar infusion for post thoracotomy pain relief because of smaller dose requirement.

  14. Death by band-aid: fatal misuse of transdermal fentanyl patch.

    Science.gov (United States)

    Bakovic, Marija; Nestic, Marina; Mayer, Davor

    2015-11-01

    We present a case of fatal intoxication by the application of a transdermal fentanyl patch upon a superficial bleeding abrasion of a 2-year-old girl. The grandmother discovered the body of the child in bed at approximately 7 a.m. External examination revealed a properly developed, nourished, and hydrated child, with some vomit in the nostrils and inside the mouth. There was no evidence of trauma besides small contusions and abrasions on the knees, with a patch placed over the largest abrasion. Closer inspection revealed that this was transdermal fentanyl patch. Internal examination and microscopic analysis revealed regurgitation of stomach content, cerebral and pulmonary edema, and liver congestion. Toxicology analysis revealed trace levels of fentanyl in the blood just above the limit of detection (2 ng/mL), while concentrations in the urine, liver, and kidney were approximately 102, 28, and 10 ng/mL, respectively. Investigation discovered that the child injured her knee while playing the evening before. The grandmother applied the patch to cover the injury, unaware that she had used a fentanyl transdermal patch instead of simple band-aid. Although fatal intoxications are uncommon among young children in high-income countries, it is of major interest to raise awareness of such events especially since a great majority of these are preventable. The presented case points at the need for more thorough education of users and more strict rules in prescribing and handling of this potent medicine. As well, we find this case to be a useful contribution to the evaluation of postmortem fentanyl concentrations in fatal intoxication in a small child.

  15. A better dissolution method for ranitidine tablets USP.

    Science.gov (United States)

    Cappola, M L

    2001-01-01

    Ranitidine tablets USP showed variable intra- and inter-lab dissolution results. In order to ascertain the reason for this behavior, ranitidine tablets USP produced by (BIPI) Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, and Zantac Tablets (brand of ranitidine USP), Glaxo Inc., Research Triangle, NC, were subjected to the compendia (USP) dissolution testing using paddle and basket apparatus. Two potencies of tablets 150 mg and 300 mg were tested. Comparison of BIPI tablets and matching Zantac tablets indicated that both brands of ranitidine tablets USP had similar dissolution behavior. When the basket apparatus was substituted for the paddle apparatus the overall rate and extent of tablet dissolution increased, while the individual tablet variability decreased. BIPI 150 mg tablets using the basket apparatus, but at reduced rotational speed of 30 rpm, showed increase in rate and extent of drug dissolved, with less individual tablet variability compared to the paddle apparatus at 50 rpm. The 300 mg tablet (30 rpm/basket apparatus) had an initial slower rate, but then rapidly equaled the paddle apparatus dissolution results, and had less individual tablet variability. Paddle apparatus tablet sinkers were used to prevent tablets from sticking to the bottom of the dissolution vessel. Overall dissolution for all tablets with sinkers showed a trend which was more rapid and complete than tablets without sinkers. Results showed that dissolution artifacts for ranitidine tablets could be reduced by the use of baskets or tablet sinkers.

  16. Correlation analysis of alveolar bone loss in buccal/palatal and proximal surfaces in rats

    Directory of Open Access Journals (Sweden)

    Carolina Barrera de Azambuja

    2012-12-01

    Full Text Available The aim was to correlate alveolar bone loss in the buccal/palatal and the mesial/distal surfaces of upper molars in rats. Thirty-three, 60-day-old, male Wistar rats were divided in two groups, one treated with alcohol and the other not treated with alcohol. All rats received silk ligatures on the right upper second molars for 4 weeks. The rats were then euthanized and their maxillae were split and defleshed with sodium hypochlorite (9%. The cemento-enamel junction (CEJ was stained with 1% methylene blue and the alveolar bone loss in the buccal/palatal surfaces was measured linearly in 5 points on standardized digital photographs. Measurement of the proximal sites was performed by sectioning the hemimaxillae, restaining the CEJ and measuring the alveolar bone loss linearly in 3 points. A calibrated and blinded examiner performed all the measurements. Intraclass Correlation Coefficient revealed values of 0.96 and 0.89 for buccal/lingual and proximal surfaces, respectively. The Pearson Correlation Coefficient (r between measurements in buccal/palatal and proximal surfaces was 0.35 and 0.05 for the group treated with alcohol, with and without ligatures, respectively. The best correlations between buccal/palatal and proximal surfaces were observed in animals not treated with alcohol, in sites both with and without ligatures (r = 0.59 and 0.65, respectively. A positive correlation was found between alveolar bone loss in buccal/palatal and proximal surfaces. The correlation is stronger in animals that were not treated with alcohol, in sites without ligatures. Areas with and without ligature-induced periodontal destruction allow detection of alveolar bone loss in buccal/palatal and proximal surfaces.

  17. Bone response to buccal tooth movements-with and without flapless alveolar decortication.

    Science.gov (United States)

    Ruso, Stephen; Campbell, Phillip M; Rossmann, Jeffrey; Opperman, Lynne A; Taylor, Reginald W; Buschang, Peter H

    2014-12-01

    To evaluate the biological response of alveolar bone surrounding maxillary second premolars to flapless alveolar decortication and moderate, continuous forces in a buccal direction. Using a randomized split-mouth experimental design, unilateral alveolar decortication was performed with a piezosurgery unit around the maxillary second premolars of six female dogs. The contralateral side received a sham surgery. The maxillary second premolars were moved buccally with archwires (initial 163.9 cN expansive force) for 9 weeks, followed by 2 weeks of consolidation. Intraoral, radiographic, and model measurements were performed to evaluate tooth movements; the amount and quality of surrounding bone were quantified using micro-CT; bone formation was evaluated histologically. The experimental premolars were expanded and tipped significantly (P < 0.05) more than the control premolars (1.35 times and 2.05 times as much, respectively). Peak rates of tooth movement occurred around 5 weeks. Dehiscenses were observed on both the experimental and control sides, with no statistically significant side differences in buccal bone height (BBH). Micro-CT analyses showed less mature bone in the apico-buccal and cervico-lingual regions around the experimental teeth. Hematoxylin and eosin sections demonstrated fenestrations on the cervico-buccal bone on both sides. The experimental side showed substantially more new bone formation and modeling of apico-buccal, cervico-lingual, and buccal bone than the control side. Archwire expansion resulted in reductions in BBH. Piezosurgical flapless alveolar decortication, in combination with archwire expansion, increased tooth movements and tipping and produced less bone, less dense bone, and less mature bone. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  18. Estimating Fatty Acid Composition of Infant Buccal Mucosal Cells by Capillary Gas Chromatography

    Institute of Scientific and Technical Information of China (English)

    CHEN Fei; ZHANG Wei-li; LI Fang; ZHU Xiao-dong; ZHU Jian-xing

    2008-01-01

    Long chain polyunsaturated fatty adds, i. e., docosahexaenoic acid (DHA or C22 : 6n -3), arachidonic acid (AA or C20 : 4n - 6) have been identified as essential fatty acids and play an important role in growth and development of infants. Mensurement of fatty acid composition is usually by collection of blood, but to obtain blood in infants is difficult. Nowadays, the fatty acid composition can be estimated by collecting buccal mucosal cells, which can avoid repeated blood sampling. The purpose of this paper is to compare the fatty acid composition of cheek calls with that of plasma and red blood cells (RBCs). In this study, twenty-seven infants were enrolled, and buccal mucosal cells and blood samples were obtained from these infants of the same time. Fatty acid composition of buccal mucesal cells, plasma and RBCs were measured by capillary gas chromatography. The results show that the contents of AA and DHA in the buccal mucosal cells are correlated well with that in the plasma [r=0.36 (P=0.042) and r=0.38 (P=0.033), respectively]. The ratio of AA to DHA is 1.32% in buccal mucosal cells, 1.60% in plasma and 1.55% in RBCs and there are no significant differences among groups (P = 0.134). It shows that the fatty acid composition in buccal mucosal cells can reflect the fat nutrition status in infants and can be detected by capillary gas chromatography. Estimating fatty acid composition of buccal mucosal cells in infants by capillary gas chromatography is feasible, and because of its noninvasiveness, it can be suitable for nutrition research in infants.

  19. Can Tablet Computers Enhance Faculty Teaching?

    Science.gov (United States)

    Narayan, Aditee P; Whicker, Shari A; Benjamin, Robert W; Hawley, Jeffrey; McGann, Kathleen A

    2015-06-01

    Learner benefits of tablet computer use have been demonstrated, yet there is little evidence regarding faculty tablet use for teaching. Our study sought to determine if supplying faculty with tablet computers and peer mentoring provided benefits to learners and faculty beyond that of non-tablet-based teaching modalities. We provided faculty with tablet computers and three 2-hour peer-mentoring workshops on tablet-based teaching. Faculty used tablets to teach, in addition to their current, non-tablet-based methods. Presurveys, postsurveys, and monthly faculty surveys assessed feasibility, utilization, and comparisons to current modalities. Learner surveys assessed perceived effectiveness and comparisons to current modalities. All feedback received from open-ended questions was reviewed by the authors and organized into categories. Of 15 eligible faculty, 14 participated. Each participant attended at least 2 of the 3 workshops, with 10 to 12 participants at each workshop. All participants found the workshops useful, and reported that the new tablet-based teaching modality added value beyond that of current teaching methods. Respondents developed the following tablet-based outputs: presentations, photo galleries, evaluation tools, and online modules. Of the outputs, 60% were used in the ambulatory clinics, 33% in intensive care unit bedside teaching rounds, and 7% in inpatient medical unit bedside teaching rounds. Learners reported that common benefits of tablet computers were: improved access/convenience (41%), improved interactive learning (38%), and improved bedside teaching and patient care (13%). A common barrier faculty identified was inconsistent wireless access (14%), while no barriers were identified by the majority of learners. Providing faculty with tablet computers and having peer-mentoring workshops to discuss their use was feasible and added value.

  20. Variable efficacy of calcium carbonate tablets.

    Science.gov (United States)

    Kobrin, S M; Goldstein, S J; Shangraw, R F; Raja, R M

    1989-12-01

    Orally administered calcium carbonate tablets are commonly prescribed as a calcium supplement and for their phosphate-binding effects in renal failure patients. Two cases are reported in which a commercially available brand of calcium carbonate tablets appeared to be ineffective. Formal investigation of the bioavailability of this product revealed it to have impaired disintegration and dissolution and a lack of clinical efficacy. Recommendations that will enable physicians to avoid prescribing and pharmacists to avoid dispensing ineffective calcium carbonate tablets are proposed.

  1. TABLET COATING TECHNIQUES: CONCEPTS AND RECENT TRENDS

    OpenAIRE

    Gupta Ankit; Bilandi Ajay; Kataria Mahesh Kumar; Khatri Neetu

    2012-01-01

    Tablet coating is a common pharmaceutical technique of applying a thin polymer-based film to a tablet or a granule containing active pharmaceutical ingredients (APIs). Solid dosage forms are coated for a number of reasons, the most important of which is controlling the release profiles. The amount of coating on the surface of a tablet is critical to the effectiveness of the oral dosage form. Tablets are usually coated in horizontal rotating pans with the coating solution sprayed onto the free ...

  2. VALIDATION OF FILM COATED MULTIVITAMIN TABLETS

    Directory of Open Access Journals (Sweden)

    Vipin Kumar

    2013-06-01

    Full Text Available The validation is fundamental segment that supports to a commitment of company towards quality assurance. It also assures that product meets its predetermined quality specification and quality. Validation of each steps of manufacturing during multivitamin tablet formulation is called process validation of multivitamin tablets. During past film coating is not much favorable but now for multivitamin tablets film coating is used. The objective is to present a review and to discuss aspects of validation of film coated multivitamin tablets in terms of unit operations; that is, those individual technical operations that comprise the various steps involved in product design and evaluation.

  3. Evaluation of quick disintegrating calcium carbonate tablets.

    Science.gov (United States)

    Fausett, H; Gayser, C; Dash, A K

    2000-07-02

    The purpose of this investigation was to develop a rapidly disintegrating calcium carbonate (CC) tablet by direct compression and compare it with commercially available calcium tablets. CC tablets were formulated on a Carver press using 3 different forms of CC direct compressed granules (Cal-Carb 4450, Cal-Carb 4457, and Cal-Carb 4462). The breaking strength was measured using a Stokes-Monsanto hardness tester. The disintegration and dissolution properties of the tablets were studied using USP methodology. The calcium concentration was determined by an atomic absorption spectrophotometer. Scanning electron microscopy was used to evaluate the surface topography of the granules and tablets. Breaking strength of Cal-Carb 4450, Cal-Carb 4457, and Cal-Carb 4462 tablets was in the range of 7.2 to 7.7 kg, as compared with a hardness of 6.2 kg and 10 kg for the commercially available calcium tablets Citracal and Tums, respectively. The disintegration time for the tablets presented in the order earlier was 4.1, 2.1, 1.9, 2.9, and 9.7 minutes, respectively. The dissolution studies showed that all formulations released 100% of the elemental calcium in simulated gastric fluid in less than 20 minutes. In summary, this study clearly demonstrated that quick disintegrating CC tablets can be formulated without expensive effervescence technology.

  4. A comparison of intrathecal dexmedetomidine verses intrathecal fentanyl with epidural bupivacaine for combined spinal epidural labor analgesia

    Directory of Open Access Journals (Sweden)

    P K Dilesh

    2014-01-01

    Conclusion: 10 μg dexmedetomidine intrathecally provides a longer duration of analgesia with lesser incidence of pruritus compared to 20 μg fentanyl intrathecally for CSE labor analgesia with comparable neonatal side-effects.

  5. A comparison between post-operative analgesia after intrathecal nalbuphine with bupivacaine and intrathecal fentanyl with bupivacaine after cesarean section

    Directory of Open Access Journals (Sweden)

    Hala Mostafa Gomaa

    2014-10-01

    Conclusion: Either intrathecal nalbuphine 0.8 mg or intrathecal fentanyl 25 μg combined with 10 mg bupivacaine provides good intra-operative and early post-operative analgesia in cesarean section.

  6. Development of the fentanyl iontophoretic transdermal system (ITS) for patient-controlled analgesia of postoperative pain management.

    Science.gov (United States)

    Minkowitz, Harold S; Danesi, Hassan; Ding, Li; Jones, James B

    2015-09-01

    The fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-activated drug delivery system used for patient-controlled analgesia in adult hospitalized patients with postoperative pain. The system design has been updated to a separated system consisting of a Controller and a Drug Unit, and has had regulatory submissions in USA and Europe in 2014. Fentanyl ITS has been shown to be therapeutically equivalent to morphine intravenous (iv.) patient-controlled analgesia. One of the advantages of fentanyl ITS is that patients have better mobility as there is no need for an iv. pump, iv. lines and pole. The introduction of the updated fentanyl ITS will add a versatile tool to the postoperative pain management armamentarium.

  7. Morphology of the Lingual and Buccal Papillae in Alpaca (Vicugna pacos) - Light and Scanning Electron Microscopy.

    Science.gov (United States)

    Goździewska-Harłajczuk, K; Klećkowska-Nawrot, J; Janeczek, M; Zawadzki, M

    2015-10-01

    The aim of this study was the description of the lingual and buccal papillae in adult alpaca (Vicugna pacos) by light and scanning electron microscopy (SEM). The tongue consisted of apex, body and root. Four types of lingual papillae (filiform, fungiform, conical and circumvallate) in addition to two types of buccal papillae were observed. The filiform papillae, some with secondary papillae, were distributed on both the corpus and apex of the tongue, with stratified epithelium, and layer of keratin coat were recognized. The short (small) cone papillae had pointed top, while bunoform papillae were wide with smooth apex. The much less numerous circumvallate papillae with pseudopapillae on the each rim of the caudal lingual body were present with weak layer of keratin and intra-epithelial taste buds. The small fungiform papillae were found on the dorsal lingual surface, while the large fungiform papillae were situated on the ventral surface of the tongue, especially, in rostral part and were round in shape with numerous gustatory pores and very thin keratin coat. Pseudopapillae were present on the buccal conical 'bunoform' papillae surface, while 'elongate' buccal papillae surface was rather softly folded with thin coat of keratin. Microridges were observed in the less keratinized parts of each type of papillae. The orientation of either lingual or buccal papillae into the throat side facilitates the emptying of oral cavity from nutrient and swallowing of food. In conclusion, the anatomical features of the alpaca tongue are an adaptation to the feeding habits.

  8. A comparative ex vivo drug permeation study of beta-blockers through porcine buccal mucosa.

    Science.gov (United States)

    Amores, Sonia; Lauroba, Jacinto; Calpena, Ana; Colom, Helena; Gimeno, Alvaro; Domenech, José

    2014-07-01

    Apparent permeability coefficients (kp) of a series of beta-blockers: acebutolol, atenolol, labetalol, metoprolol, oxprenolol and propranolol, through porcine buccal mucosa were determined. The aim of the study was to determine the permeation parameters (apparent permeability coefficient, kp; flux, J; and lag time, TL) as a measure of the intrinsic permeability of porcine buccal mucosa to these drugs, in order to predict the efficacy of their possible administration through human buccal mucosa. A positive linear correlation was observed between the apparent permeability coefficient, kpand the partition coefficient, P. Oxprenolol and propranolol are the drugs that presented the highest values of kp: 0.3231×10(2) cm/h and 0.5666×10(2) cm/h, respectively. Multiple linear regression (MLR) using least square estimation was performed on the data set with logkpas dependent variable and the descriptors as predictor variables. The potential systemic capacity after a buccal administration was predicted by estimating the plasma concentrations at steady-stated (Css). Considering the entire process of permeation ex vivo, propranolol and oxprenolol would seem to be the best candidates for administration through the buccal mucosa.

  9. In vitro and in vivo evaluation of buccal bioadhesive films containing salbutamol sulphate.

    Science.gov (United States)

    Singh, Sanjay; Soni, Rajeev; Rawat, Manoj Kumar; Jain, Achint; Deshpande, Shripad Bhimarao; Deshpande, Shripad Bheemrao; Singh, Sanjeev Kumar; Muthu, Madaswamy Sona

    2010-03-01

    The aim of present study was to prepare and evaluate buccal bioadhesive films of salbutamol sulphate (SS) for the treatment of asthma. The films were designed to release the drug for a prolonged period of time so as to reduce the frequency of administration of the available conventional dosage forms of SS. The different proportions of sodium carboxymethylcellulose (SCMC) and Carbopol 940P (CP 940P) were used for the preparation of films. Carbopol was used to incorporate the desired bioadhesiveness in the films. The films were prepared by solvent casting method and evaluated for bioadhesion, in vitro drug release and anti asthmatic effect (bronchoprotection) in histamine induced bronchospasm of guinea pigs. In vitro drug release from the film was determined using a modified Franz diffusion cell while bioadhesiveness was evaluated with a modified two-arm balance using guinea pig buccal mucosa as a model tissue. Films containing SCMC : CP 940P ratio of 76 : 24 was found to be the best with moderate swelling along with favorable bioadhesion force and in vitro drug release. The drug release mechanism was found to follow non-Fickian diffusion as release mechanism. The prolonged in vivo effect (bronchoprotection) obtained from the buccal bioadhesive film of SS administered via buccal route may improve the treatment of asthmatic disorders by reducing the frequency of administration which is associated with the tolerance effect of SS. Additionally for the clinical benefit, it is also expected to reduce the major adverse effects of SS such as tachycardia and arrhythmias via buccal absorption.

  10. Buccal space lesions: a new classification based on CT and MR imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyo Cheol; Han, Moon Hee; Moon, Min Hoan [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

    2004-02-01

    To present a new classification based on the CT and MR imaging findings of buccal space lesions, and to propose guidelines for their radiologic differentiation. Sixty-two histopathologically confirmed or clinically diagnosed buccal space lesions were classified on the basis of their morphologic appearance and extension to adjacent space as either (1) a mass with a distinct margin, confined to the buccal space; (2) a mass with surrounding infiltration, confined to the buccal space; or (3) a multi-space occupying mass. Type 1 included pleomorphic adenoma, ex-pleomorphic adenoma, carcinoma, B-cell lymphoma, acinic cell carcinoma, rhabdomyosarcoma, glomus tumor and ameloblastoma, and differentiation between malignant and benign neoplasms was not possible. Type 2 included adenoid cystic carcinoma, abscess, complicated dermoid cyst, and Kimura disease. T-cell lymphoma, neurofibroma, vascular malformation, inflammation, and foreign body granuloma pertained to type 3, and each type-3 entity showed different imaging characteristics. This new classification based on CT and MR imaging characteristics may provide useful guide-lines for predicting the differential diagnosis of buccal space lesions.

  11. Influence of anatomic reference on the buccal contour of prosthetic crowns

    Directory of Open Access Journals (Sweden)

    Flávia Sabrina Queirós Vasconcelos

    2009-09-01

    Full Text Available During clinical practice, when performing prosthetic rehabilitation with single crowns, improper reproduction of the dental contour by the dental laboratory is a common occurrence. Therefore, the present study evaluated the fidelity of the reproduction of the buccal contour in an upper left canine performed by three Dental Prosthesis Technicians (DPT using the indirect laminate veneer technique. First, the DPTs confected the veneers based on a model obtained from the upper arch of a dental dummy, containing a replica of an upper left canine with a prosthetic preparation for a laminate veneer. Then, the same DPTs received other identical models, now with the replica of the upper left canine with no preparation, to be used as an anatomical reference for confecting the laminate veneers. The laminate veneers were then bonded to the plaster models and had their buccal contour individually measured. Measurements were also made of the buccal contour of the reference canine. The data were analyzed by ANOVA and the t-test (p = 0.05. Results showed 100% of buccal overcontour when the laminate veneers were compared to the reference canine, regardless of which DPT confected the veneer and regardless of using or not the anatomical reference. The DPTs who participated in the present study were unable to acomplish a faithful anatomical reproduction of the buccal contour, creating an overcontour in all samples. This situation may be responsible for increasing the probability of periodontal and esthetic harm in clinical practice.

  12. Efficacy and usability of buccal midazolam in controlling acute prolonged convulsive seizures in children.

    Science.gov (United States)

    Ashrafi, Mahmoud Reza; Khosroshahi, Nahid; Karimi, Parviz; Malamiri, Reza Azizi; Bavarian, Behrouz; Zarch, Anoushiravan Vakili; Mirzaei, Mehdi; Kompani, Farshid

    2010-09-01

    A Prolonged convulsive seizure is the most common neurological medical emergency with poor outcome. An ideal anticonvulsant should be easy-to-use, effective, and safe, and it should also have a long-lasting effect. Benzodiazepines, give via the intravenous or rectal route have generally been used as first-line drugs. In small children, IV access can be difficult and time consuming. Midazolam is a potent anticonvulsant and is rapidly absorbed from the rectal, nasal, and buccal mucosa. Our aim was to evaluate the efficacy and usability of buccal midazolam in controlling seizures in children with acute prolonged seizures, by comparing it with rectal diazepam. Ninety-eight patients were enrolled, with 49 patients in each treatment group. In the buccal midazolam group, 42 (88%) patients were controlled in less than 4 min of drug administration, and all of the patients were controlled within 5 min of drug administration. In the rectal diazepam group, 24 (49%) patients were controlled in less than 4 min and 40 (82%) patients were controlled within 5 min of drug administration. The time for drug administration and drug effect was significantly less with buccal midazolam than with rectal diazepam (p valuediazepam group, 7 (14%) parents were satisfied. Buccal midazolam was significantly more acceptable than rectal diazepam (p valuediazepam but more convenient to use in the controlling acute prolonged seizures in children, especially in situations in which there is a difficulty in gaining IV access, for example, in infants.

  13. Genotoxic effects of panoramic radiation by assessing the frequency of micronuclei formation in exfoliated buccal epithelium

    Directory of Open Access Journals (Sweden)

    Vidya KB

    2014-04-01

    Full Text Available Background: Panoramic radiography is one of the most commonly used radiographic methods to complement clinical examination. Ionizing radiation is a well-known mutagen and carcinogen in the human population. So this study was undertaken to evaluate the possible genotoxic effects of panoramic radiation by assessing the frequency of micronuclei formation in the exfoliated buccal epithelium. Methods: 50 patients of either sex in the age range of 15 to 75 years with apparently normal oral mucosa with no adverse habits and without any oral lesions were included in the present study after their consent. Buccal epithelial cells were obtained from the buccal mucosa by scraping with the toothbrush immediately before and after 10 +/- 2 days of exposure to panoramic radiography. Cytological preparations were stained and observed under microscope. Student's paired and lsquo;t' test was used for the comparison between mean frequency of micronuclei in buccal epithelial cells in patients before and after panoramic radiography. Results: Significant increase (P <0.0001 in the frequency of cells with micronuclei and total number of micronuclei after panoramic radiography was detected. Conclusion: The X-radiation emitted during panoramic radiography does induce some genotoxic changes in the form of increased frequency of micronuclei in target buccal epithelial cells. [Int J Res Med Sci 2014; 2(2.000: 541-544

  14. Anatomical relationship of maxillary posterior teeth with the sinus floor and buccal cortex.

    Science.gov (United States)

    Jang, J K; Kwak, S W; Ha, J H; Kim, H C

    2017-08-01

    This study aimed to evaluate the possibility of root fenestration or oroantral communication by evaluating the distance from root apex to the sinus floor and buccal cortex in maxillary posterior teeth using cone-beam computed tomography (CBCT) images. The study included 2182 roots of the maxillary posterior teeth from 219 patients after reviewing CBCT images of 462 patients according to the location of roots by two endodontists. The distances from each root apex to the maxillary sinus floor and buccal and palatal cortices were evaluated according to sex and age, and the mean values were compared by one-way analysis of variance and Mann-Whitney U-test. The distance between root apex and maxillary sinus floor was the greatest in maxillary first premolars and shortest in the mesio-buccal roots of maxillary second molars. The distances from root apex to the buccal and palatal cortical bones were significantly greater in male patients than those in female patients (P maxillary first molars exhibited the highest incidence as well as the greatest mean length (1·96 mm) of protrusion into the maxillary sinus. The distance from root apex to the sinus floor was found to increase with age, except in case of maxillary second premolars. Understanding the relationship of maxillary posterior teeth with the sinus floor and buccal cortex could provide clinicians valuable information to help reduce iatrogenic damage. © 2017 John Wiley & Sons Ltd.

  15. Influence of Smile Arc and Buccal Corridors on Facial Attractiveness: A Cross-sectional Study

    Science.gov (United States)

    Gaikwad, Shashank; Vaz, Anna C; Singh, Baldeep; Taneja, Lavina; Vinod, KS; Verma, Prateek

    2016-01-01

    Introduction Two aspects of the smile: the Smile Arc (SA) and Buccal Corridors (BC) have been the interest of the orthodontist in recent years. Aim The present study was undertaken to evaluate the influence of the smile arc and buccal corridors on facial attractiveness as evaluated by orthodontists, general dentists and laymen. Materials and Methods Two subjects (one male & one female) were selected from the regional population fulfilling the criteria of an ideal smile arc and ideal buccal corridors. Frontal smile view photographs of these subjects were taken and modified by using adobe photoshop 7.0 to create combination of three smile arc variance and three buccal corridors variations respectively which were shown to 25 orthodontists, 25 general dentists & 25 laymen, to rate the facial attractiveness of each image on a rating scale. Results All the three groups (laypersons, dentists and orthodontists) showed significant difference in ratings, indicating that they had different perceptions on the facial attractiveness. Conclusion Orthodontists were more precise in discerning the smile arc and buccal corridors compared to dentists and laypersons. PMID:27790573

  16. Effect of soybean-lecithin as an enhancer of buccal mucosa absorption of insulin.

    Science.gov (United States)

    Tian, Weiqun; Hu, Qiaolin; Xu, Ying; Xu, Yi

    2012-01-01

    Transmucosal delivery is a suitable route for insulin non-injection administration. In order to understand how insulin passes through mucosa with soybean-lecithin as an enhancing absorption. The penetration rate of insulin molecular through porcine buccal mucosa was investigated by measuring transbuccal fluxes in the Ussing Chambers. The imaging morphology of rabbits buccal mucosa was analyzed by using non-contact mode atomic force microscopy. The permeation rate can be increased by co-administration of soybean-lecithin. Untreated buccal mucosa showed relatively smooth surface characteristics, with many small crater-like pits and indentations spread over mucosa surfaces. Buccal mucosa that had been treated with 1.0% (w/v) sodium deoxycholic acid (pH 7.4) appeared to much more indentations characteristic, which treated with 2.5% (w/v) soybean-lecithin (pH 7.4) and 2.5% (w/v) Azone or laurocapram (pH 7.4) appeared rather different, the surface mucosa treated with soybean-lecithin emulsion showed a fine, rippling effect whereas those exposed to Azone display a more coarse, undulating surface feature. As a result of that Azone could damage the surface of the buccal mucosa, but soybean-lecithin could not. This study demonstrated that soybean-lecithin is a better and safer enhancer for insulin transmucosal delivery.

  17. Use of buccal myomucosal flap for palatal lengthening in cleft palate patient: Experience of 20 cases

    Directory of Open Access Journals (Sweden)

    Don Varghese

    2015-01-01

    Full Text Available Background: The purpose of this review was to assess the effectiveness of the buccal myomucosal flap in secondary repairs of cleft palate in 20 patients. Patients and Methods: Totally, 20 patients, who underwent secondary palatoplasty between 5 years and 8 years in which a buccal myomucosal flap was used, were reviewed retrospectively. All patients had undergone at least one previous attempted repair at other institutions. Indications for the secondary repair included velopharyngeal incompetence and/or oronasal fistula. Patients were evaluated preoperatively for oronasal fistula status, velopharyngeal competence, nasal resonance, speech quality, and nasal escape. Results: The buccal myomucosal flap was used in all 20 patients, and there was marked increase in the quality of speech as well as nasal regurgitation decreased. In patients with levator dysfunction due to poor primary surgery and glottal speech the results were inconclusive Conclusion: Palate re-repair combined with a buccal myomucosal flap, occasionally in conjunction with other techniques, is an effective method for correcting failed cleft palate repairs. Minimum donor site morbidity and complication makes the buccal flap a useful armamentarium of a cleft surgeon.

  18. Fentanyl supplement expedites the onset time of sensory and motor blocking in interscalene lidocaine anesthesia

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    RS Moharari

    2010-12-01

    Full Text Available Background and the purpose of the study: Opioids are usually used in regional anesthesia, with or without local anesthetics to improve the regional block or postoperative pain control. Since no data are available on fentanyl's effect on the onset time of lidocaine interscalene anesthesia, the purpose of this study was to examine its effect on the onset time of sensory and motor blockade during interscalene anesthesia.  Methods: In a prospective, randomized, double-blind study, ninety patients scheduled for elective shoulder, arm and forearm surgeries under an  interscalene brachial plexus block .They were randomly allocated to receive either 30 ml of  1.5 % lidocaine with 1.5 ml of isotonic saline  (control group, n = 39 or 30 ml of 1.5%  lidocaine with 1.5 ml (75µg of  fentanyl (fentanyl group,n=41. Then the onset time of sensory and motor blockades of the shoulder, arm and forearm were evaluated every 60 sec. The onset time of the sensory and motor blockades was defined as the time between the last injection and the total abolition of the pinprick response and complete paralysis. The duration of sensory blocks were considered as the time interval between the administration of the local anesthetic and the first postoperative pain sensation. Results: Ten patients were excluded because of unsuccessful blockade or unbearable pain during the surgery. The onset time of the sensory block was significantly faster in the fentanyl group (186.54± 62.71sec compared with the control group (289.51± 81.22, P < 0.01. The onset times of the motor block up to complete paralysis in forearm flexion was significantly faster in the fentanyl group (260.61± 119.91sec than the control group (367.08± 162.43sec, P < 0.01 There was no difference in the duration of the sensory block between two groups. Conclusion: Results of the study showed that the combination of 75 µg fentanyl and 1.5% lidocaine solution accelerated the onset of sensory and motor

  19. Synthesis and evaluation of fluorinated derivatives of fentanyl as candidates for opiate receptor studies using positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Dahren Hwang; Feliu, A.L.; Wolf, A.P.; MacGregor, R.R.; Fowler, J.S.; Arnett, C.D.

    1986-03-01

    Three fluorinated derivatives of fentanyl, fluorofentanyl (3), keto-fluorofentanyl (5), and fluorofentanol (6), were synthesized and their abilities to compete with /sup 3/diprenorphine for binding sites in guinea pig brain membranes were determined. The relative potencies were fentanyl > 3 approx.= 6 >> 5. On the basis of its apparent affinity for opiate receptors and its relative ease of synthesis, 6 was selected for further study. Fentanyl was slightly better than 6 in its ability to compete with (/sup 3/H)naltrexone for binding sites in rat brain membranes. Both fentayl and 6 exhibited a similar high ''sodium ratio'' (quotient of the IC/sub 50/'s against (/sup 3/H)naltrexone in the presence and absence of sodium chloride) generally characteristic of opiate agonists. The analgesic potencies of fentanyl and 6 were determined in rats by measuring suppression of locomotion and vocalization responses to footshock. 6 appeared slightly less potent than fentanyl, but produced a similar analgesia and catalepsy which was entirely blocked by pretreatment of rats with naloxone, an opiate antagonist. A rapid synthesis of (/sup 18/F)-6 was developed and the tissue distribution of (/sup 18/F)-6 in mice was determined 5, 60, and 120 minutes after intravenous injection. The use of this general route to /sup 18/F-labeled derivatives of fentanyl for studies of the opiate receptor using positron emission tomography is planned.

  20. DNA breakage detection-fluorescence in situ hybridization (DBD-FISH in buccal cells

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    E. I. Cortés-Gutiérrez

    2012-12-01

    Full Text Available DNA breakage detection-fluorescence in situ hybridization (DBD-FISH is a recently developed technique that allows cell-by-cell detection and quantification of DNA breakage in the whole genome or within specific DNA sequences. The present investigation was conducted to adapt the methodology of DBD-FISH to the visualization and evaluation of DNA damage in buccal epithelial cells. DBD-FISH revealed that DNA damage increased significantly according to H2O2 concentration (r2=0.91. In conclusion, the DBD-FISH technique is easy to apply in buccal cells and provides prompt results that are easy to interpret. Future studies are needed to investigate the potential applicability of a buccal cell DBD-FISH model to human biomonitoring and nutritional work.

  1. DNA breakage detection-fluorescence in situ hybridization (DBD-FISH) in buccal cells.

    Science.gov (United States)

    Cortés-Gutiérrez, E I; Dávila-Rodríguez, M I; Fernández, J L; López-Fernández, C; Gosálvez, J

    2012-12-28

    DNA breakage detection-fluorescence in situ hybridization (DBD-FISH) is a recently developed technique that allows cell-by-cell detection and quantification of DNA breakage in the whole genome or within specific DNA sequences. The present investigation was conducted to adapt the methodology of DBD-FISH to the visualization and evaluation of DNA damage in buccal epithelial cells. DBD-FISH revealed that DNA damage increased significantly according to H2O2 concentration (r2=0.91). In conclusion, the DBD-FISH technique is easy to apply in buccal cells and provides prompt results that are easy to interpret. Future studies are needed to investigate the potential applicability of a buccal cell DBD-FISH model to human biomonitoring and nutritional work.

  2. Prosthetic improvement of pronounced buccally positioned zygomatic implants: a clinical report.

    Science.gov (United States)

    Bacchi, Ataís; Santos, Mateus Bertolini Fernandes dos; Pimentel, Marcele Jardim; Nóbilo, Mauro Antonio de Arruda; Consani, Rafael Leonardo Xediek

    2014-08-01

    This report presents a prosthetic technique for the improvement of surgically positioned, buccally placed zygomatic implants with the use of custom abutments for improved retention screw position and an esthetic implant reconstruction. The patient presented four zygomatic implants with pronounced buccal inclination. The anterior implants were inclined toward the location where the anterior artificial teeth should be placed during rehabilitation. As the manufacturer does not provide angulated abutments, we attempted the waxing and overcasting of a prosthetic abutment, repositioning the access holes of the prosthetic screws to a more palatal position. This clinical report demonstrates that abutment customization could be an interesting way to relocate the access holes of the prosthetic screws in cases of zygomatic implants with pronounced buccal inclination.

  3. Regulation of protease-activated receptor-1 expression in human buccal fibroblasts stimulated with arecoline.

    Science.gov (United States)

    Tsai, Chung-Hung; Lee, Shiuan-Shinn; Huang, Fu-Mei; Chang, Yu-Chao

    2013-09-01

    The purpose of this study was to compare the major thrombin receptor protease-activated receptor-1 (PAR-1) expression in normal human buccal mucosa and oral submucous fibrosis (OSF) specimens and further explore the potential mechanisms that may lead to induce PAR-1 expression. Thirty OSF and 10 normal buccal mucosa specimens were examined by immunohistochemistry. Buccal mucosal fibroblasts (BMFs) were challenged with arecoline by using Western blot analysis. N-acetyl-L-cysteine (NAC), LY294002, herbimycin A, NS-398, and PD98059 were added to find the possible regulatory mechanisms. PAR-1 expression was significantly higher in OSF specimens (p Arecoline was found to elevate PAR-1 expression in a dose-dependent and time-dependent manner (p arecoline-induced PAR-1 expression (p Arecoline-induced PAR-1 expression was downregulated by NAC, LY294002, herbimycin A, NS398, and PD98059. Copyright © 2012 Wiley Periodicals, Inc.

  4. HIV infection induces morphometrical changes on the oral (buccal mucosa and tongue) epithelial cells.

    Science.gov (United States)

    Pompermayer, Adriane Bastos; Gil, Francisca Berenice Dias; França, Beatriz Helena Sottile; Machado, Maria Ângela Naval; Trevilatto, Paula Cristina; Fernandes, Angela; de Lima, Antônio Adilson Soares

    2011-01-01

    The aim of this study was to assess morphological and morphometrical alterations of oral squamous epithelial cells in type 1 HIV infected individuals. Oral smears were collected from tongue and buccal mucosa of 30 HIV infected (experimental) and 30 non-infected (control) individuals by liquid-based exfoliative cytology. The cells were morphologically analyzed and the nuclear area (NA), the cytoplasmic area (CA) and the nucleus-to-cytoplasm area ratio (NA/CA) were calculated. No morphological differences were found between the groups. The mean values of CA were decreased in tongue (P=.00006) and buccal mucosa (P=.00242) in HIV infected individual, while mean values of NA were increased (P=.00308 and .00095, respectively) in the same group. NA/CA ratio for experimental group was increased in both collected places, with P=.00001 (tongue) and P=.00000 (buccal mucosa). This study revealed that HIV infection was able to induce morphometrical changes on the oral epithelial cells.

  5. Breaking of scored tablets : a review

    NARCIS (Netherlands)

    van Santen, E; Barends, D M; Frijlink, H W

    2002-01-01

    The literature was reviewed regarding advantages, problems and performance indicators of score lines. Scored tablets provide dose flexibility, ease of swallowing and may reduce the costs of medication. However, many patients are confronted with scored tablets that are broken unequally and with diffi

  6. Transforming the Classroom With Tablet Technology.

    Science.gov (United States)

    Sargent, Lana; Miles, Elizabeth

    Identifying the most effective models for integrating new technology into the classroom and understanding its effects on educational outcomes are essential for nurse educators. This article describes an educational intervention with tablet technology (iPads) using an innovative case-based learning model in a nursing program. Students reported positive learning outcomes when using the tablet technology for learning course content.

  7. Tablet PCs: A Physical Educator's New Clipboard

    Science.gov (United States)

    Nye, Susan B.

    2010-01-01

    Computers in education have come a long way from the abacus of 5,000 years ago to the desktop and laptop computers of today. Computers have transformed the educational environment, and with each new iteration of smaller and more powerful machines come additional advantages for teaching practices. The Tablet PC is one. Tablet PCs are fully…

  8. 21 CFR 520.1510 - Nitenpyram tablets.

    Science.gov (United States)

    2010-04-01

    ... and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... order of a licensed veterinarian. (d) Conditions of use—(1) Dogs—(i) Amount—(A) One 11.4-mg tablet for dogs weighing less than 25 pounds (lb) or one 57-mg tablet for dogs weighing more than 25 lb, as...

  9. Buccal bone loss after immediate implantation can be reduced by the flapless approach

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    ARTHUR BELÉM NOVAES JR

    2011-10-01

    Full Text Available Aim: The aim of this study was to evaluate the buccal bone remodeling after immediate implantation with flap or flapless approach. Material and Methods: The mandibular bilateral premolars of 3 dogs were extracted and immediately three implants were placed in both hemi-arches of each dog. Randomly, one hemi-arch was treated with the flapless approach, while in the contra lateral hemi-arch tooth extractions and implant placement were done after mucoperiosteal flap elevation. Non-submerged healing of 12 weeks was provided for both groups. Histomorphometric analysis was done to compare buccal and lingual bone height loss, bone density and bone-to-implant contact in the groups. Fluorescence analysis was performed to investigate the dynamic of bone remodeling in the different groups. Results: There was a significant association between the surgical flap and the extent of bone resorption around immediate implants. The loss of buccal bone height was significantly lower in the flapless group when compared to the flap group (0.98 mm x 2.14 mm, respectively, p<0.05. The coronal and apical buccal bone densities of the flap group were significantly higher when compared to the lingual components, showing anatomical differences between the bone plates. Fluorescence analysis showed no major differences in bone healing between the flap and flapless groups, supporting that the higher loss of buccal bone height is linked to the anatomic characteristics of this plate and to the negative influence of the detachment of the periosteum in immediate implant therapy. Conclusion: The flapless approach for immediate post-extraction implants reduces the buccal bone height loss.

  10. Pharmacokinetics of buprenorphine following intravenous and buccal administration in cats, and effects on thermal threshold.

    Science.gov (United States)

    Hedges, A R; Pypendop, B H; Shilo-Benjamini, Y; Stanley, S D; Ilkiw, J E

    2014-06-01

    This study reports the pharmacokinetics of buprenorphine, following i.v. and buccal administration, and the relationship between buprenorphine concentration and its effect on thermal threshold. Buprenorphine (20 μg/kg) was administered intravenously or buccally to six cats. Thermal threshold was determined, and arterial blood sampled prior to, and at various times up to 24 h following drug administration. Plasma buprenorphine concentration was determined using liquid chromatography/mass spectrometry. Compartment models were fitted to the time-concentration data. Pharmacokinetic/pharmacodynamic models were fitted to the concentration-thermal threshold data. Thermal threshold was significantly higher than baseline 44 min after buccal administration, and 7, 24, and 104 min after i.v. administration. A two- and three-compartment model best fitted the data following buccal and i.v. administration, respectively. Following i.v. administration, mean ± SD volume of distribution at steady-state (L/kg), clearance (mL·min/kg), and terminal half-life (h) were 11.6 ± 8.5, 23.8 ± 3.5, and 9.8 ± 3.5. Following buccal administration, absorption half-life was 23.7 ± 9.1 min, and terminal half-life was 8.9 ± 4.9 h. An effect-compartment model with a simple effect maximum model best predicted the time-course of the effect of buprenorphine on thermal threshold. Median (range) ke0 and EC50 were 0.003 (0.002-0.018)/min and 0.599 (0.073-1.628) ng/mL (i.v.), and 0.017 (0.002-0.023)/min and 0.429 (0.144-0.556) ng/mL (buccal).

  11. A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion

    Energy Technology Data Exchange (ETDEWEB)

    Akyalcin, Sercan; Englih, Jeryl D.; Stephens, Claude R.; Winkelmann, Sam [Dept. of Orthodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Schaefer, Jeffrey S. [Todd Hughes Orthodontics, Houston (United States)

    2013-06-15

    This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.

  12. Product development of pumpkin tablet

    Directory of Open Access Journals (Sweden)

    Kamgoed, T.

    2007-05-01

    Full Text Available The development of pumpkin tablet was studied and the drying conditions of pumpkin using a double drum dryer were optimized. The study factors were drying agents (maltodextrin D.E.13-16 andtapioca flour at different levels (3 and 5%, drying temperatures (130 and 140oC and drum dryer speeds (4 and 5 rpm. The results showed that the optimal conditions were using 3% maltodextrin D.E.13-16, dryingtemperature of 130oC and drum dryer speed of 4 rpm. The moisture, fat, bulk density, reducing sugars and granulometric retention of the obtained pumpkin powder were 3.39%, 1.42%, 1.004 g/ml, 12.63% and 0.67%, respectively and L*, a* and b* values were 73.85, -0.60 and 35.23, respectively. A study of suitable amount of icing sugar using different contents for tablet production (0, 10, 20, 30 and 40% was performedand showed that using 20% icing sugar was the most acceptable. The obtained pumpkin tablet was subjected to chemical, physical and microbiological analysis. The ash, moisture, protein, fat, fiber and carbohydratecontents were 1.87, 3.60, 3.34, 1.00, 2.26 and 87.99%, respectively. The reducing sugars and β-carotene contents were 5.44±0.61% and 3.79±0.57 mg/100g, respectively. The Aw, hardness and solubility were 0.56,3.25 kgf and 25.00 %, respectively. The L*, a* and b* values were 79.85, 0.28 and 23.64, respectively. The total microbial count and the yeast and mould count were <10 CFU/g. The shelf life of the pumpkin tabletwas at least 4 months at room temperature (35±2oC.

  13. Orodispersible tablets of Lamotrigine: preparation and evaluation

    Directory of Open Access Journals (Sweden)

    Anand Patel

    2014-08-01

    Full Text Available The aim of the present research was to prepare orodispersible tablets of Lamotrigine for applications in epilepsy and convulsion related problems. Fast action onset is highly desirable in the control of this type of disease condition. All tablets were prepared by solid dispersion method using mannitol and synthetic superdisintegrants like Explotab, Cross Povidone and Micro Crystalline Cellulose. The different powder blends were evaluated for pre-formulation parameters. Effect of superdisintegrants on wetting, disintegration and dissolution parameters was studied. The tablets were evaluated for various parameters like wetting time, hardness, friability, drug content, disintegration and in vitro dissolution. Tablets with Explotab have shown good disintegrating features, also the dispersion not showing any bitter taste; indicate the capability of Vanilla used, as taste masking agents. Almost more than 99% of drug was released from the formulation(F4 within 27 min. Tablets have shown no appreciable changes with respect to physical appearance, drug content, disintegration time, and dissolution profiles.

  14. High-throughput sequencing of forensic genetic samples using punches of FTA cards with buccal swabs

    DEFF Research Database (Denmark)

    Kampmann, Marie-Louise; Buchard, Anders; Børsting, Claus;

    2016-01-01

    with buccal swabs and compared the results with those obtained with DNA extracted using the EZ1 DNA Investigator Kit. Concordant profiles were obtained for all samples. Our protocol includes simple punch, wash, and PCR steps, reducing cost and hands-on time in the laboratory. Furthermore, it facilitates......Here, we demonstrate that punches from buccal swab samples preserved on FTA cards can be used for high-throughput DNA sequencing, also known as massively parallel sequencing (MPS). We typed 44 reference samples with the HID-Ion AmpliSeq Identity Panel using washed 1.2 mm punches from FTA cards...

  15. Differences in motility pattern between human buccal fibroblasts and periodontal and skin fibroblasts

    DEFF Research Database (Denmark)

    Lepekhin, Eugene; Grøn, Birgitte; Berezin, Vladimir

    2002-01-01

    at these sites can be explained by differences in the motile behavior of their respective fibroblast populations. The migratory characteristics were studied in a two-dimensional culture system. The migration of single cells was time-lapse video recorded at intervals of 15 min for a period of 6 h using a computer...... displacement of periodontal and skin fibroblasts. The decreased cellular displacement of the buccal fibroblasts was found to be due to both lower cellular speed and less persistence in direction. The buccal fibroblasts also displayed smaller areas and longer processes. The differences in cellular morphology...

  16. Effect of cryoprotectants for maintaining drug permeability barriers in porcine buccal mucosa

    DEFF Research Database (Denmark)

    Marxen, Eva; Axelsen, Mary Carlos; Pedersen, Anne Marie Lynge;

    2016-01-01

    if permeability barriers for small molecules (nicotine and diazepam) were maintained after freezing porcine buccal mucosa with cryoprotectants to -80°C. Combinations of dimethyl sulfoxide, bovine serum albumin, glycerol and sucrose were used as cryoprotectants. The permeability of nicotine and diazepam across...... tissue. Freezing with or without cryoprotectants did not significantly affect the flux of diazepam compared to fresh tissue. Only minor histological changes were seen in frozen/thawed porcine buccal mucosa compared to fresh tissue. In conclusion, permeability barriers for nicotine and diazepam were...

  17. Frontal lobe oxygenation is maintained during hypotension following propofol-fentanyl anesthesia

    DEFF Research Database (Denmark)

    Nissen, P.; Lieshout, J.J. van; Nielsen, H.B.

    2009-01-01

    Near-infrared spectroscopy (NIRS) assesses cerebral oxygen saturation (Sco2) as a balance between cerebral oxygen delivery and consumption. In 71 patients, we evaluated whether marked reduction in mean arterial pressure (MAP) during propofol-fentanyl anesthesia induction affects frontal lobe Sco2....../min (50-96 beats/min), and 5.3 L/min (2.4-9.0 L/min), respectively, but immediately following intravenous administration of fentanyl and propofol, MAP decreased to 63 mm Hg (37-109 mm Hg), HR to 63 beats/min (40-103 beats/min), and CO to 4.1 L/min (7.9-70 L/min) (P

  18. CLINICAL EVALUATION OF EPIDURAL ADMINISTRATION OF MORPHINE, FENTANYL, METHADONE, LIDOCAINE AND LIDOCAINE WITH EPINEPHRINE IN CATTLE

    Directory of Open Access Journals (Sweden)

    A. Tabatabaei Naeine, A. Rezakhani and J. Fazlinia

    2004-01-01

    Full Text Available The purpose of this study was to determine the analgesic efficacy and clinical effects of morphine, fentanyl, methadone, lidocaine, lidocaine with epinephrine and saline (control when injected epidurally into the caudal epidural space in cattle. Epidural analgesia was achieved in five cattle on five successive occasions at weekly intervals. Analgesia was defined as a lack of response to hemostat pressure and pinprick in the skin of the perineal area and ventral aspect of the tail. The results demonstrated that while epidural lidocaine and lidocaine with epinephrine decreased the response to hemostat and pinprick compared to control, there was no reduction in response after the administration of morphine, methadone or fentanyl. Heart rate, pulse and respiratory rates were not significantly altered by any of the drugs. Neither did the drugs produce any change in the electrocardiogram (ECG of the animals.

  19. Formulation of nicotine mucoadhesive tablet for smoking cessation and evaluation of its pharmaceuticals properties

    Directory of Open Access Journals (Sweden)

    Rahim Bahri-Najafi

    2013-01-01

    Full Text Available Background: Nicotine replacement therapy (NRT with gradual decreasing of nicotine is one of the smoking cessation methods. Muccoadhesive formulations are among the novel drug delivery systems that are available in the form of tablets and films, and can be used for NRT. Muccoadhesive nicotine tablets when placed in the upper gum will attach to the buccal mucosa and release nicotine content in a controlled manner. This will meet the immediate and long-term need of the individual to the nicotine, such that the person can decrease his/her dependency on smoking. [1] Materials and Methods: In this study, the tablets were prepared using different conventional bioadhesive polymers such as Hydroxypropyl Methycellulose (HPMC 50cps, sodium carboxy methyl cellulose (NaCMC, and carbapol 934 (CP934 in singular or mixture form. Magnesium hydroxide were used as the pH increasing agent; magnesium stearate as the lubricant; and lactose as the excipiente. Nicotine hydrogen bitartrate, more stable than the liquid, was used in different formulations. Pharmaceutics characteristics such as adhesion degree and drug release rate were evaluated. Results: Increasing of HPMC 50cps in the formulations decrease speed release of nicotine. The carbapol in formulations beget slow releasing of nicotine. With increasing the percent of lactose, the rate of release in formulations was increased. Formulations, which have HPMC 50cps has best adhesiveness and the formulations contains carbapol had not suitable adhesiveness. Formulations contains NaCMC were very fast release and had not suitable adhesiveness. Conclusion: The formulation contains mixture of HPMC50cps and CP934 was the best because of suitable adhesiveness and minimum swing in release.

  20. A comparison of fentanyl with tramadol during propofol-based deep sedation for pediatric upper endoscopy.

    Science.gov (United States)

    Bedirli, Nurdan; Egritas, Odul; Cosarcan, Kaan; Bozkirli, Fusun

    2012-02-01

    This study was conducted to compare the efficacy and safety of tramadol with those of fentanyl and to evaluate the impact of age in pediatric patients undergoing upper gastrointestinal endoscopy (UGIE). Eighty patients with ASA I-II, aged 1-16 years, undergoing UGIE were included in this study. Baseline anesthesia was maintained with 1 mg·kg(-1) propofol, and then, the patients were randomly assigned to receive 2 μg·kg(-1) fentanyl (group F, n = 40) or 2 mg·kg(-1) tramadol (group T, n = 40). Additional propofol, 0.5-1 mg·kg(-1), was administered when needed. Heart rate, mean arterial pressure, oxygen saturation (SpO(2)), and sedation scores were recorded at baseline, induction, and every 5 min. Endoscopy duration, recovery time, and adverse effects were recorded. The data were separated for subgroup analyses based on the age of 0-2, 2-12, and over 12 years. Fentanyl significantly decreased the saturation at induction, 5th min and 10th min in patients of 0-2 years; at 5th and 10th min in 2-12 years; and at 5th min in >12 years. In all age subgroups, sedation scores at 10th, 15th, and 20th min, the overall frequency of adverse effects, and the recovery time were significantly lower in group T compared with group F. Tramadol in pediatric patients undergoing UGIE provided sedation as efficient as fentanyl with a better hemodynamic and respiratory stability and provided a superior safety and tolerance in younger children. © 2011 Blackwell Publishing Ltd.

  1. COMPARISON OF THE EFFECTS OF FENTANYL AND DEXMEDETOMIDINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK ACHIEVED WITH ROPIVACAINE

    Directory of Open Access Journals (Sweden)

    Soma C.

    2015-07-01

    Full Text Available BACKGROUND & OBJECTIVES: Supraclavicular block of brachial plexus provides complete and reliable anaesthesia for upper limb surgeries. Ropivacaine, is an affective local anaesthetic in for brachial plexus anaesthesia. It is a potent blocker of Aδ and C fibres, rendering good sensory effect but le ss motor blockade. We evaluated the anaesthetic quality and length of analgesia with the addition of either fentanyl or dexmedetomidine to ropivacaine for Supraclavicular brachial plexus block. METHODS: In a prospective clinical trial, 90 patients were ran domly allocated to either receive 30 ml ropivacaine 0.5% (Group R, 30 ml ropivacaine 0.5% with fentanyl 50 mcg (Group RF or 30 ml ropivacaine 0.5% with dexmedetomedine 50 mcg (Group RD in Supraclavicular brachial plexus. The characteristics for anaesthe sia and analgesia were assessed for the three groups. OBSERVATIONS: Demographic profile was comparable in the groups. The onset of analgesia and time to complete analgesia was enhanced in Group RD and Group RF compared to Group R. Prolongation of sensory b lockade and motor blockade with extended duration of postoperative analgesia was observed in Group RD and Group RF compared to Group R. There were minimum haemodynamic disturbances and side - effects in any group except f or Grade 3 sedation score which was f requently noted in patients receiving dexmedetomidine as adjunct. RESULTS: Compared to the use of ropivacaine 0.5%, 30 ml alone for supraclavicular brachial plexus block, the addition of 50 mcg fentanyl or 50 mcg dexmedetomidine to ropivacaine enhanced onset of block and also increased duration of surgical anaesthesia with prolongation of post - operative analgesia. Furthermore blockade characteristics improved better with addition of dexmedetomodine than fentanyl without increasing incidence of unwanted s ide - effects.

  2. COMPARATIVE EVALUATION OF INTRATHECAL BUPIVACAINE-FENTANYL AND BUPIVACAINE-SUFENTANIL FOR CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Pooja

    2014-06-01

    Full Text Available BACKGROUND: Addition of lipophilic opioids like Fentanyl and Sufentanil to local anaesthetic for spinal anaesthesia has shown to prolong the duration of analgesia. This study was carried out to study (a Comparison of effect of Fentanyl and Sufentanil added to Bupivacaine on onset and duration of anaesthesia in Cesarean Section. (b To compare the quality and duration of analgesia between the two opioids and (c To compare the effect on neonatal outcome. METHODS: 50 parturients of ASA grade 1 and 2 undergoing Cesarean Section were randomized into two groups of 25 each. Group F received 2.5 ml 0.5% Bupivacaine heavy + inj. Fentanyl 0.25 ml (12.5 mcg and Group S received 2.5 ml 0.5% Bupivacaine heavy + inj. Sufentanil 0.1 ml (5 mcg intrathecally. Onset of sensory and motor blockade was noted in all the patients. Haemodynamic parameters were recorded every 5 minutes for first 30 minutes and then every 15 minutes till the completion of surgery. Duration of sensory and motor sensory blockade was observed post operatively. RESULT: Both the groups were stable haemodynamically. Both the groups were comparable regarding the duration of sensory and motor block, but the total duration of effective analgesia was significantly longer in Sufentanil group. Pruritus was significant side effect in Sufentanil group. Neither the mother nor the neonate had respiratory depression. CONCLUSION: Addition of Sufentanyl to intrathecal bupivacaine provides longer duration of analgesia as compared to intrathecal fentanyl-bupivacaine. However, the incidence of pruritus was greater in Sufentanyl group.

  3. COMPARISON OF EFFICACY OF BUTORPHANOL AND FENTANYL AS INTRATHECAL ADJUVANT TO BUPIVACAINE

    Directory of Open Access Journals (Sweden)

    Gopal Reddy

    2015-04-01

    Full Text Available OBJECTIVE: The objective of the study was to compare the efficacy of butorphanol and Fentanyl as an adjuvant to local anaesthetics in relation to onset, degree and recovery time of sensory and motor blockade in orthopaedi c procedures done under spinal anaesthesia. METHODS: In a Randomized double blind study, 90 cases of ASA grade 1 & 2 between the ages of 18 - 60yrs of either sex undergoing elective lower limb orthopaedic procedures were allocated into three groups of 30 each. Group A received intrathecal 0.5% hyperbaric bupivacaine 3ml with 0.2 ml of normal saline (n=30. Group B received intrathecal 0.5% hyperbaric bupivacaine 3ml with Butorphanol 200microgram. (n=30 Group C received intrathecal 0.5% hyperbaric bupivaca ine 3ml with fentanyl 20microgram. (n=30.Vital parameters, onset, level, duration and regression of sensory & motor block, duration of effective analgesia were recorded and compared. Analysis was done by of variance (ANOVA test. RESULTS: Intrathecal admi nistration of Bupivacaine + Butorphanol (141.6±7.2 min Bupivacaine + Fentanyl (124.5±7.1min prolongs 2 segment regression times compared to Bupivacaine with Normal saline (118.3±12.5min without altering the duration of motor blockade. Duration of effect ive analgesia was 191.8±19,272.8±17.2 min and 270.0±27.4 min in Group A, Group B and Group C respectively. Post - operative side effects were comparable in all the three groups. CONCLUSION: Both fentanyl and butorphanol given intrathecally along with hyperba ric Bupivacaine prolong the d uration of effective analgesia.

  4. Comparative pharmacokinetics of intravenous fentanyl and buprenorphine in healthy Greyhound dogs

    OpenAIRE

    2014-01-01

    The purpose of this study was to compare the pharmacokinetics of two highly protein bound, lipophilic opioid drugs. Fentanyl (10 μg/kg) and buprenorphine (20 μg/kg) were administered intravenously (IV) to six healthy Greyhound dogs (3 males and 3 females). The doses were based on clinically administered doses for dogs. Plasma drug concentrations were determined using liquid chromatography with mass spectrometry and noncompartmental pharmacokinetics were estimated with computer software. The v...

  5. Comparison of Preanesthetic Sedation after Intranasal Administration of Fentanyle, Ketamin and Midazolam

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    F Javaherforoosh

    2006-07-01

    Full Text Available Introduction & Objective: Induction of anesthesia in children can be a challenge for anesthetist. A stormy induction may increase the personality & behavioral changes. Therefore, it is desirable that they enter the operating room sedated. Many drugs are used for preanesthetic medication and there are many routes for administration. One route of administration is nasal mucous. In this study we compared the effect and side effect of three drugs (midazolam, ketamin and fentanyle after intra nasal administration. Materials & Methods: This is a double blind clinical trial. In this study we selected 60 patients (20 patients for every group A, B or C. We used 3 mg/kg ketamin or 3µg/kg fentanyle or 0.3 mg/kg midazolam by intranasal spray. After administration and in 5, 10 and 15 minutes, we observed the SPO2, PR and RR. After 15 min’s we separated children from parents and brought them to the operating room and controlled the acceptance of separation, depth of sedation with Ramsay score, acceptance of mask and tolerance of IV canulation. The data were then analyzed using K2 and kruskal-wallis test. Results: In our study we found that in SPO2 fentanyle had the highest rate of reduction even though none of the children had SPO2 lower than 90%. There were no differences between drugs in RR. In fentanyle group, we had the lowest rate and in ketamin group the highest rate. Midazolam had the medium rate. The rate of sedation for acceptance of separation from parents had no difference between the groups and all drugs with this dosage were effective for this aim. However, in Ramsay score, acceptance of mask and tolerance of IV canulation, the midazolam was more effective than the others. Conclusion: Intranasal administration of midazolam is a safe route for sedation in children in the pre-anesthetic time.

  6. Evaluation of the effect of added fentanyl to hyperbaric bupivacaine for spinal anesthesia

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    Mina Jafari-Javid

    2011-01-01

    Full Text Available Background: Potentiating the effect of the intrathecal local anesthetics by intrathecal injection of opiods for intra-abdominal surgeries is known. The objective of this study is to investigate the pain-relieving effects of intrathecal fentanyl to bupivacaine in elective caesarean surgery.Materials and Method: In a double blind clinical trial 60 patients candidate for elective cesarean section. They were studied in two groups. Cases in the control group received 12.5 mg of bupivacaine and in the study group received 8 mg of bupivacaine and 20 µg fentanyl. The parameters taken into consideration were hemodynamic stability, visceral pain, nausea and vomiting, intraoperative shivering, the amount of intraoperative administered dose of fentanyl and ephedrine and postoperative pain. Results: The average blood pressure changes after 5, 10, 20, 60 minutes were lower in the study group. Shivering and ephedrine dose during operation were lower in study group and statistically significant respectively (p=0.01, p=0.001, respectively. Duration of analgesia after operation increased from (115.5±7.5 min in control group to (138.5±9.9 min in study group, but the quality of analgesia during peritoneal manipulation did not change. Pulse rate and vomiting during operation were not statistically different between two groups.Conclusion: Reduction of local anesthetic dose with adding fentanyl may cause hemodynamic stability, increasing the postoperative pain-free time, decrease shivering and vasopressor consumption in spinal anesthesia and reduction of the amount of blood pressure drop during elective cesarean surgery

  7. COMPARISON OF DEXMEDETOMIDINE WITH FENTANYL FOR SEDATION IN TYMPANOPLASTY (ENT SURGERIES DONE UNDER MONITORED ANAESTHESIA CARE

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    Illendula

    2016-02-01

    Full Text Available INTRODUCTION Monitored anaesthesia care involves administering a combination of drugs for anxiolytic, hypnotic, amnestic and analgesic effect. Ideally it should result in less physiological disturbance and allow for more rapid recovery than general anaesthesia. It typically involves administration of local anaesthesia in combination with IV sedatives, anxiolytic and analgesic drugs which is a common practice during various ENT surgical procedures. AIM OF STUDY Is to “Compare Dexmedetomidine with Fentanyl for sedation in tympanoplasty (ENT Surgeries”. The objective of the study is to evaluate the efficacy of dexmedetomidine and fentanyl as an appropriate sedative drug for Monitored Anaesthesia Care in Tympanoplasty (ENT surgeries METHODS & MATERIALS A total of 60 patients are being recruited into this study with regards to assess, Pain, Discomfort, Sedation, Peripheral Oxygen Saturation (SPO2 & Systolic Blood Pressure (SBP, Diastolic blood pressure (DBP, Mean arterial blood pressure(MAP & Heart rate This study was undertaken at Govt. ENT Hospital Hyderabad. Sixty (60 patients undergoing Tympanoplasty surgery were taken for study. Thus the study contains 30 patients in Dexmedetomidine group-(Group D and 30 patients in Fentanyl group (Group F RESULT Dexmedetomidine provides less discomfort, better sedation, and analgesia when compared with fentanyl under monitored anaesthesia care (Conscious sedation. However, the risk of adverse effects requires monitoring for ready intervention. It provides a unique type of sedation, “conscious sedation” in which patients appear to be sleepy but are easily arousable, cooperative and communicative when stimulated. It is sedative and analgesic agent, with opioid-sparing properties and minimal respiratory depression.

  8. A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy

    OpenAIRE

    Lightdale, Jenifer R; Mitchell, Paul D; Fredette, Meghan E.; Mahoney, Lisa B.; Zgleszewski, Steven E.; Lisa Scharff; Fox, Victor L

    2011-01-01

    Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ...

  9. The Effects of Intrathecal Fentanyl on Sedation Depth and Postoperative Recovery Room Delirium

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    Ozgur Bulent Tuzun

    2015-01-01

    Full Text Available Background/Aim. Intrathecal anaesthesia has been shown to increase sedation level. This study aimed to evaluate the effects of intrathecal applied fentanyl with levobupivacaine on intraoperative sedation and recovery room delirium. Materials and Methods. The study included 68 patients, ASA I–III, 55–85 years. One day preoperatively, the Confusion Assessment Method (CAM and the Mini Mental Status Test (MMST were applied and patients were separated into two groups. In Group L 2.5 mL levobupivacaine and in Group LF 2 mL levobupivacaine and 0.5 mL fentanyl were applied intrathecally. In a supine position, following a propofol IV 1 mg kg−1 bolus to obtain Bispectral Index (BIS of 70–85, propofol infusion was started (1 mg kg−1 st−1. With observation of SpO2, BIS, and the Observer Assessment and Alertness/Sedation Scale (OAA/SS with the haemodynamic values, the total propofol amount was calculated. Evaluations were made of pain severity (VAS, analgesic use, transfusion requirement, and recovery room delirium. Results. In the comparison within the groups, a significant decrease was determined in HR and MAP compared to the initial values (p<0.05. A positive correlation was found between the BIS and OAA/SS values. The amounts of propofol used were similar between the groups. Conclusions. Intrathecal fentanyl and levobupivacaine had the same effect on sedation or BIS and fentanyl did not cause delirium.

  10. Intranasal fentanyl for the management of acute pain in children.

    Science.gov (United States)

    Murphy, Adrian; O'Sullivan, Ronan; Wakai, Abel; Grant, Timothy S; Barrett, Michael J; Cronin, John; McCoy, Siobhan C; Hom, Jeffrey; Kandamany, Nandini

    2014-10-10

    Pain is the most common symptom in the emergency setting; however, timely management of acute pain in children continues to be suboptimal. Intranasal drug delivery has emerged as an alternative method of achieving quicker drug delivery without adding to the distress of a child by inserting an intravenous cannula. We identified and evaluated all randomized controlled trials (RCTs) and quasi-randomized trials to assess the effects of intranasal fentanyl (INF) versus alternative analgesic interventions in children with acute pain, with respect to reduction in pain score, occurrence of adverse events, patient tolerability, use of "rescue analgesia," patient/parental satisfaction and patient mortality. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 1); MEDLINE (Ovid SP, from 1995 to January 2014); EMBASE (Ovid SP, from 1995 to January 2014); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO Host, from 1995 to January 2014); the Latin American and Caribbean Health Science Information Database (LILACS) (BIREME, from 1995 to January 2014); Commonwealth Agricultural Bureaux (CAB) Abstracts (from 1995 to January 2014); the Institute for Scientific Information (ISI) Web of Science (from 1995 to January 2014); BIOSIS Previews (from 1995 to January 2014); the China National Knowledge Infrastructure (CNKI) (from 1995 to January 2014); International Standard Randomized Controlled Trial Number (ISRCTN) (from 1995 to January 2014); ClinicalTrials.gov (from 1995 to January 2014); and the International Clinical Trials Registry Platform (ICTRP) (to January 2014). We included RCTs comparing INF versus any other pharmacological/non-pharmacological intervention for the treatment of children in acute pain (aged < 18 years). Two independent review authors assessed each title and abstract for relevance. Full copies of all studies that met the inclusion criteria were retrieved for further assessment. Mean difference (MD), odds

  11. Postoperative analgesia in children when using clonidine in addition to fentanyl with bupivacaine given caudally.

    Science.gov (United States)

    Jarraya, Anouar; Elleuch, Sahar; Zouari, Jawhar; Smaoui, Mohamed; Laabidi, Sofiene; Kolsi, Kamel

    2016-01-01

    The aim of the study was to evaluate the efficacy of clonidine in association with fentanyl as an additive to bupivacaine 0.25% given via single shot caudal epidural in pediatric patients for postoperative pain relief. In the present prospective randomized double blind study, 40 children of ASA-I-II aged 1-5 years scheduled for infraumblical surgical procedures were randomly allocated to two groups to receive either bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg and clonidine 1μg/kg (group I) or bupivacaine 0.25% (1 ml/kg) with fentanyl 1 μg/kg (group II). Caudal block was performed after the induction of general anesthesia. Postoperatively patients were observed for analgesia, sedation, hemodynamic parameters, and side effects or complications. Both the groups were similar with respect to patient and various block characteristics. Heart rate and blood pressure were not different in 2 groups. Significantly prolonged duration of post-operative analgesia was observed in group I (Pbupivacaine in single shot caudal epidural in children may provide better and longer analgesia after infraumblical surgical procedures.

  12. Propofol Versus Midazolam/Fentanyl Sedation for Colonoscopy in the Elderly Patient Population.

    Science.gov (United States)

    Lovett, Pamela; Gómez, Victoria; Hodge, David O; Ladlie, Beth

    2017-06-01

    Despite current literature, data on the most effective sedation and best patient outcomes are insufficient for providing recovery time recommendations for elderly patients undergoing colonoscopy with sedation. We sought to identify the best sedation practice for shorter recovery times. Therefore, a study was conducted to examine recovery times among patients older than 65 years undergoing elective colonoscopy with intravenous sedation with either propofol or the combination of midazolam/fentanyl. A retrospective descriptive, exploratory design was used. We retrospectively reviewed data from patients older than 65 years undergoing outpatient elective colonoscopy at our institution between January and December 2013. Recovery times were evaluated for those administered intravenous propofol or a combination of midazolam/fentanyl. Patient demographics and sedation medications were obtained from patient records. A modified Aldrete score greater than 8 was required for discharge. Recovery time was defined as the time from procedure completion to a modified Aldrete score greater than 8. Propofol sedation was associated with longer recovery times compared with sedation with a combination of midazolam and fentanyl (mean: 50 minutes versus 31 minutes, P < .001). Propofol sedation was not associated with shorter recovery times. Further studies are needed to validate these findings. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  13. Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change

    Directory of Open Access Journals (Sweden)

    Arthur Halley Barbosa do Vale

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Thermal injuries and injured areas management are important causes of pain in burned patients, requiring that these patients are constantly undergoing general anesthesia for dressing change. Nitrous oxide (N2O has analgesic and sedative properties; it is easy to use and widely available. Thus, the aim of this study was to evaluate the analgesic effect of N2O combined with fentanyl in burned patients during dressing change. METHOD: After approval by the institutional Ethics Committee, 15 adult burned patients requiring daily dressing change were evaluated. Patient analgesia was controlled with fentanyl 0.0005% administered by intravenous pump infusion on-demand. Randomly, in one of the days a mixture of 65% N2O in oxygen (O2 was associated via mask, with a flow of 10 L/min (N2O group and on the other day only O2 under the same flow (control group. RESULTS: No significant pain reduction was seen in N2O group compared to control group. VAS score before dressing change was 4.07 and 3.4, respectively, in N2O and control groups. Regarding pain at the end of the dressing, patients in N2O group reported pain severity of 2.8; while the control group reported 2.87. There was no significant difference in fentanyl consumption in both groups. CONCLUSIONS: The association of N2O was not effective in reducing opioid consumption during dressing changes.

  14. Comparison of midazolam sedation with or without fentanyl in cataract surgery.

    Science.gov (United States)

    Cok, O Yalcin; Ertan, A; Bahadir, M

    2008-01-01

    We compared the effect of midazolam sedation with or without fentanyl on the hemodynamic parameters, sedation, and pain and satisfaction profile in cataract surgery. Two hundred and ten patients were randomly allocated to receive either midazolam 1 mg i.v. (Group M, n = 101) alone or with fentanyl 25 microg (Group MF, n = 100) before retrobulbar injection. Hemodynamic parameters, observer's assessment of alertness/sedation (OAA/S) scores, pain during block and surgery, satisfaction of patient and surgeons were assessed. Heart rate and diastolic arterial pressure decreased after retrobulbar injection in comparison to baseline whereas systolic arterial pressure values increased in both groups. The majority of patients in both groups experienced mild pain during retrobulbar injection but no pain during surgery. There was a significant decrease in OAA/S scores in both groups (p = 0.001) and this decline was more significant in Group MF (p = 0.038). We suggest that midazolam alone may produce optimal block conditions for the patient and it is satisfactory during the procedure while the addition of fentanyl has not improved the effect on the examined parameters.

  15. Determination of buprenorphine, fentanyl and LSD in whole blood by UPLC-MS-MS.

    Science.gov (United States)

    Berg, Thomas; Jørgenrud, Benedicte; Strand, Dag Helge

    2013-04-01

    A sensitive ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS-MS) method has been developed and validated for the quantification of buprenorphine, fentanyl and lysergic acid diethylamide (LSD) in whole blood. Sample preparation was performed by liquid-liquid extraction (LLE) with methyl tert-butyl ether. UPLC-MS-MS analysis was performed with a mobile phase consisting of ammonium formate (pH 10.2) and methanol. Positive electrospray ionization MS-MS detection was performed with two multiple reaction monitoring transitions for each of the analytes and the deuterium labeled internal standards. Limit of detection values of buprenorphine, fentanyl and LSD were 0.28, 0.044 and 0.0097 ng/mL and limit of quantification values were 0.94, 0.14 and 0.036 ng/mL, respectively. Most phospholipids were removed during LLE. No or only minor matrix effects were observed. The method has been routinely used at the Norwegian Institute of Public Health since September 2011 for qualitative and quantitative detections of buprenorphine, fentanyl and/or LSD in more than 400 whole blood samples with two replicates per sample.

  16. A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy

    Science.gov (United States)

    Lightdale, Jenifer R.; Mitchell, Paul D.; Fredette, Meghan E.; Mahoney, Lisa B.; Zgleszewski, Steven E.; Scharff, Lisa; Fox, Victor L.

    2011-01-01

    Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ketamine (n = 17) moved more (median 25% of procedure time versus 8%, P = .03) and required similar low levels of restraint (0.83% versus 0.25%, P = .4) as patients sedated with midazolam/fentanyl (n = 20). Age-adjusted analyses suggested that patients sedated with ketamine were comparably more quiet (P = .002). Conclusions. A pilot trial of ketamine at our institution was associated with episodes of laryngospasm. In addition, children sedated with ketamine moved and required restraint similarly to patients sedated with midazolam/fentanyl. Physician perceptions may be affected by the fact that children who received ketamine were less likely to vocalize distress. PMID:21760813

  17. A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy

    Directory of Open Access Journals (Sweden)

    Jenifer R. Lightdale

    2011-01-01

    Full Text Available Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ketamine (=17 moved more (median 25% of procedure time versus 8%, =.03 and required similar low levels of restraint (0.83% versus 0.25%, =.4 as patients sedated with midazolam/fentanyl (=20. Age-adjusted analyses suggested that patients sedated with ketamine were comparably more quiet (=.002. Conclusions. A pilot trial of ketamine at our institution was associated with episodes of laryngospasm. In addition, children sedated with ketamine moved and required restraint similarly to patients sedated with midazolam/fentanyl. Physician perceptions may be affected by the fact that children who received ketamine were less likely to vocalize distress.

  18. Serotonin syndrome caused by fentanyl and methadone in a burn injury.

    Science.gov (United States)

    Hillman, Ashley D; Witenko, Corey J; Sultan, Said M; Gala, Gary

    2015-01-01

    Serotonin syndrome is a syndrome identified by a triad of altered mental status, neuromuscular overactivity, and autonomic instability caused by the overstimulation of serotonin in the central nervous system and periphery. Serotonin syndrome may be provoked with the addition or increase in serotonergic agents such as selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors as well as other agents with serotonergic properties. Some narcotics, including fentanyl and methadone, have these properties and may be associated with the development of serotonin syndrome when used in conjunction with other agents. Currently, there are no identified case reports of narcotics as the sole agent causing serotonin syndrome. This report provides a brief overview of serotonin syndrome, particularly with cases involving administration of narcotics such as fentanyl and methadone. The case described is the first report associated with fentanyl and methadone without the coadministration of other serotonergic agents, and a possible drug interaction with voriconazole is discussed. This raises awareness of using multiple serotonergic narcotics and the potential precipitation of serotonin syndrome.

  19. Effect of chronic pain on fentanyl self-administration in mice.

    Directory of Open Access Journals (Sweden)

    Carrie L Wade

    Full Text Available The development of opioid addiction in subjects with established chronic pain is an area that is poorly understood. It is critically important to clearly understand the neurobiology associated with propensity toward conversion to addiction under conditions of chronic pain. To pose the question whether the presence of chronic pain influences motivation to self-administer opioids for reward, we applied a combination of rodent models of chronic mechanical hyperalgesia and opioid self-administration. We studied fentanyl self-administration in mice under three conditions that induce chronic mechanical hyperalgesia: inflammation, peripheral nerve injury, and repeated chemotherapeutic injections. Responding for fentanyl was compared among these conditions and their respective standard controls (naïve condition, vehicle injection or sham surgery. Acquisition of fentanyl self-administration behavior was reduced or absent in all three conditions of chronic hyperalgesia relative to control mice with normal sensory thresholds. To control for potential impairment in ability to learn the lever-pressing behavior or perform the associated motor tasks, all three groups were evaluated for acquisition of food-maintained responding. In contrast to the opioid, chronic hyperalgesia did not interfere with the reinforcing effect of food. These studies indicate that the establishment of chronic hyperalgesia is associated with reduced or ablated motivation to seek opioid reward in mice.

  20. Mathematical tablets from Tell Harmal

    CERN Document Server

    Gonçalves, Carlos

    2015-01-01

    This work offers a re-edition of twelve mathematical tablets from the site of Tell Harmal, in the borders of present-day Baghdad. In ancient times, Tell Harmal was Šaduppûm, a city representative of the region of the Diyala river and of the kingdom of Ešnunna, to which it belonged for a time. These twelve tablets were originally published in separate articles in the beginning of the 1950s and mostly contain solved problem texts. Some of the problems deal with abstract matters such as triangles and rectangles with no reference to daily life, while others are stated in explicitly empirical contexts, such as the transportation of a load of bricks, the size of a vessel, the number of men needed to build a wall and the acquisition of oil and lard. This new edition of the texts is the first to group them, and takes into account all the recent developments of the research in the history of Mesopotamian mathematics. Its introductory chapters are directed to readers interested in an overview of the mathematical con...

  1. Fentanyl added to propofol anesthesia elongates sinus node recovery time in pediatric patients with paroxysmal supraventricular tachycardia.

    Science.gov (United States)

    Fujii, Keisuke; Iranami, Hiroshi; Nakamura, Yoshihide; Hatano, Yoshio

    2009-02-01

    In some types of pediatric supraventricular tachycardia, reentrant mechanisms are sensitive to enhanced vagal tone. Propofol is a feasible anesthetic for pediatric electrophysiological study and radiofrequency catheter ablation. Although fentanyl and propofol infusions both enhance cardiac vagal tone, it is unclear whether the combination of propofol and fentanyl has a potential to enhance it. In this study, we evaluated the hypothesis that fentanyl combined with propofol could alter cardiac electrophysiological activities in pediatric patients undergoing electrophysiological study and radiofrequency catheter ablation. Twenty-seven pediatric patients (9 Wolff-Parkinson-White syndrome, 7 concealed accessory pathway and 11 atrioventricular nodal reentry tachycardia) were enrolled in this study. Anesthesia was induced with propofol 2.0 mg/kg and was maintained with a continuous infusion of propofol at a rate of 100-167 microg x kg(-1) x min(-1). During a stable anesthetic state, the calculated sinoatrial conduction time and corrected sinus node recovery time (CSNRT) were measured before and after fentanyl administration. The fentanyl dose consisted of an initial 2.0 microg/kg IV bolus and subsequent continuous infusion of 0.075 microg x kg(-1) x min(-1). Bispectral Index scores and systemic blood pressure remained unchanged throughout the examinations. Fentanyl administration significantly prolonged CSNRT (P = 0.005) but not calculated sinoatrial conduction time (P = 0.35). Since an enhanced cardiac vagal tone is one of the causative factors for prolonged CSNRT, our findings greatly support the hypothesis that fentanyl combined with propofol has a potential to enhance cardiac vagal tone.

  2. Bioavailability of hydrochlorothiazide from isomalt-based moulded tablets.

    Science.gov (United States)

    Ndindayino, F; Vervaet, C; Van den Mooter, G; Remon, J P

    2002-10-10

    The bioavailability of hydrochlorothiazide (HCT) from moulded isomalt-based tablets was evaluated after oral administration of 50 mg HCT to healthy volunteers as an oral moulded tablet and as a lozenge, in comparison with a conventional tablet formulation (Dichlotride 50 mg). Moulded tablets had a high relative bioavailability (F(rel)) as the pharmacokinetic parameters (C(max), t(max), t(1/2), AUC(0-->24 h)) determined from HCT plasma concentration versus time profiles were not significantly different (P>0.05; two-way ANOVA) in comparison with the conventional tablet. The relative bioavailability of the moulded tablet administered as a lozenge and as an oral tablet was 106.2+/-30.9% and 89.4+/-25.9%, respectively, in relation to the conventional tablet formulation. Direct moulding of isomalt tablets proved to be a suitable technique to administer a poorly soluble drug either as a conventional tablet or as a lozenge.

  3. The Effects of RuiFentanyl and Fentanyl on Cognitive Functions for Elderly Patients after Surgery%瑞芬太尼与芬太尼对老年患者术后认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    庆晓峰

    2015-01-01

    目的:对比瑞芬太尼与芬太尼对老年患者全麻术后认知功能的影响。方法筛选我院2013年1月至2014年10月进行非心脏择期手术患者84例作为研究对象。所有患者均在全麻下进行手术,随机将其分为瑞芬太尼组与芬太尼组,其中瑞芬太尼组采用瑞芬太尼联合丙泊酚靶控输注,芬太尼组采用芬太尼联合丙泊酚靶控输注,比较两组患者术后睁眼时间、拔管时间及语言唤醒应答时间,并采用简易智力状态调查量表( MMSE)评估两组患者术前6h,术后2、4、6h认知情况。结果瑞芬太尼组术后睁眼时间、拔管时间及语言唤醒应答时间明显短于芬太尼组(P<0.05);两组患者术后2 h均较术前MMSE评分显著降低( P<0.05),但瑞芬太尼术后2、4、6 h MMSE评分明显高于芬太尼组( P<0.05)。结论瑞芬太尼与芬太尼均可引起老年患者全麻术后短暂认知功能障碍,但瑞芬太尼对认知障碍影响效果弱于芬太尼,并且睁眼时间、术后苏醒时间较短。%Objective To compare the effects of RuiFentanyl and Fentanyl on cognitive functions-for elderly patients after surgery.Methods 84 cases undergoing non-cardiac selective operation between January,2013 and October, 2014 in our hospital were selected as the research object. The patients received surgery under general anesthesia and were randomly divided into RuiFen-tanyl group and Fentanyl group.The RuiFentanyl group adopted the target controlled injection with Rui Fentanyl with propofol and the Fentanyl group was for Fentanyl with propofol.The postoperative eye-open time, extubation time and language awakening and response time were compared in the two groups.The simple mental state survey scale ( MMSE) was used to evaluate cognitive situation of the two groups at 6 h before operation and 2 h,4 h and 6 h after operation.Results The eye-open time, extubation time and language awakening and response

  4. Newer generation fentanyl transmucosal products for breakthrough pain in opioid-tolerant cancer patients.

    Science.gov (United States)

    Elsner, Frank; Zeppetella, Giovambattista; Porta-Sales, Josep; Tagarro, Ignacio

    2011-01-01

    Oral normal-release morphine has long been considered the gold-standard treatment for cancer breakthrough pain. However, its relatively long time to analgesic onset, delay in maximal analgesic effect and prolonged duration of action make it unsuitable for the management of breakthrough pain episodes. These limitations led to the development of an oral transmucosal formulation of the fast-acting opioid fentanyl (oral transmucosal fentanyl citrate [OTFC] lozenge on a plastic handle; Actiq®), which has been shown to produce more rapid and effective pain relief than oral morphine. However, the formulation itself has some limitations. Consequently, investigators have continued to develop other, newer generation, transmucosal formulations of fentanyl to further improve the management of breakthrough pain. Recently, five such compounds (Effentora®/Fentora®, Abstral®, Instanyl®, Breakyl®/OnsolisTM and PecFent®) have been concurrently approved in Europe and/or the US, and have documented efficacy in quickly relieving breakthrough pain episodes. All of the available pivotal efficacy trials of these agents are randomized, double-blind comparisons with placebo. There are no head-to-head trials comparing any of the newer transmucosal formulations with each other. Only one non-pivotal study of intranasal fentanyl spray used a transmucosal preparation as an active comparator. However, that comparator was OTFC, not one of the newer transmucosal products. Close examination of the existing trials assessing these newer transmucosal preparations reveals significant variation in many study parameters, such as patient selection criteria, severity of breakthrough pain episodes, proportions of patients with a neuropathic pain component, titration protocols, choice of the primary endpoints, protocols for repeat dosing and rescue medication, the separation of treated episodes and the extent of the placebo response, all of which may have affected efficacy results. It is therefore

  5. Metabolic Patterns of Fentanyl, Meperidine, Methylphenidate, Tapentadol and Tramadol Observed in Urine, Serum or Plasma.

    Science.gov (United States)

    Wu, Fang; Slawson, Matthew H; Johnson-Davis, Kamisha L

    2017-05-01

    Drug testing is a useful tool to identify drug use or monitor adherence to prescription drugs. The interpretation of drug results can be complicated based on the pattern and proportional concentrations of drugs and/or drug metabolite(s). The purpose of this retrospective study was to detect the positivity rates and metabolic patterns of five prescription drugs, including fentanyl, meperidine, methylphenidate, tapentadol and tramadol. Retrospective data were retrieved from the laboratory information system in a national reference laboratory. Drug testing was performed using four mass spectrometry methods that were validated for clinical use. For urine specimens, the positivity rate was the highest for methylphenidate (62.3%, n = 2,489), followed by tramadol (43.7%, n = 3,483), fentanyl (41.9%, n = 4,657), tapentadol (37.9%, n = 736) and meperidine (8.3%, n = 138). Among positive samples, both parent drug and metabolite(s) was detectable in 94.9% of meperidine samples, 94.5% of tramadol samples, 93.8% of fentanyl samples, 89.9% of methylphenidate and 86.6% of tapentadol samples. For serum or plasma specimens, the positivity rate was the highest for tapentadol (75.0%, n = 39), followed by methylphenidate (74.2%, n = 569), fentanyl (53.6%, n = 113), meperidine (41.9%, n = 18) and tramadol (28.9%, n = 213). Similar metabolic patterns were found in serum or plasma. Of positive results, both parent drug and metabolite(s) were found in 94.7% of fentanyl samples, 83.3% of meperidine samples, 79.6% of methylphenidate samples, 53.8% of tapentadol samples and 44.1% of tramadol samples. Our data demonstrates the metabolic patterns of five drugs from a random urine or serum/plasma collection in patients that have been prescribed these medications. The data presented can be used to guide clinicians in determining drug adherence by assessing the positivity rates of the parent drug and corresponding metabolite(s). © The Author 2017. Published by Oxford University Press. All rights

  6. Postoperative pain management with transdermal fentanyl after forefoot surgery: a randomized, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Merivirta R

    2015-01-01

    Full Text Available Riika Merivirta,1 Mikko Pitkänen,2 Jouko Alanen,3 Elina Haapoja,1 Mari Koivisto,4 Kristiina Kuusniemi11Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine of Turku University Hospital and University of Turku, Turku, 2Department of Anaesthesia, Hospital Orton, Invalid Foundation, Helsinki, 3Terveystalo Clinic Hospital, Helsinki, 4Department of Biostatistics, University of Turku, Turku, FinlandBackground: Quality of life is decreased in patients with hallux valgus deformity, mainly because of pain. Significant improvement is usually achieved by surgery. However, postoperative pain can be moderate to severe for 2–3 days. The aim of the present study was to evaluate the use of transdermal fentanyl for postoperative pain management after forefoot surgery.Methods: Sixty patients undergoing hallux valgus or hallux rigidus surgery were allocated to receive a patch delivering either fentanyl 12 µg/hour or placebo for postoperative pain. The consumption of rescue opioid oxycodone, the primary outcome measure, was evaluated daily until the fourth postoperative day. Total consumption of oxycodone during the study period was also assessed. Pain scores and possible adverse effects were evaluated every 6 hours during the first 24 hours and on the fourth postoperative day.Results: The use of rescue opioid was low in both groups, the median (range consumption of oxycodone being 10 (0–50 mg on the day of surgery (no difference between the groups, P=0.31 and 0 (0–35 mg thereafter. The total combined consumption was 10 (0–105 mg in the fentanyl group and 20 (0–70 mg in the placebo group (P=0.23. There were no statistically significant differences in pain scores or adverse effects between the groups.Conclusion: As a part of multimodal analgesia with ibuprofen and acetaminophen, a patch delivering fentanyl 12 µg/hour did not significantly decrease the consumption of rescue opioid or pain scores after forefoot surgery

  7. Chemokine production by buccal epithelium as a distinctive feature of pediatric Crohn disease

    NARCIS (Netherlands)

    Damen, GM; Hol, J; de Ruiter, L.; Bouquet, J; Sinaasappel, M; van der Woude, J; Laman, JD; Hop, WCJ; Buller, HA; Escher, JC; Nieuwenhuis, EES

    Objectives: Inflammatory bowel diseases (IBD) represent an aberrant immune response by the mucosal immune system to luminal bacteria. Because the oral mucosa harbors the first epithelial cells that interact with microorganisms, we assessed the immunologic activity of buccal epithelium in children

  8. Cytomorphometric analysis of gingival epithelium and buccal mucosa cells in type 2 diabetes mellitus patients

    Directory of Open Access Journals (Sweden)

    Manisha Sahu

    2017-01-01

    Conclusion: This study contributes to the general understanding of the alterations in the cellular pattern of buccal and gingival mucosa cells in diabetic patients and can be used as an additional tool to aid in the evaluation of oral mucosal alterations in diabetes mellitus.

  9. Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium

    Science.gov (United States)

    Al Shammari, Abdullah Faraj; Ibrahim, Ibrahim Khalil AL; Alaauldeen, Amjad Ibrahim; Merza, Randa Fouad; Ahmed, Hussain Gadelkarim

    2016-01-01

    Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer. PMID:27893201

  10. Chemokine production by buccal epithelium as a distinctive feature of pediatric Crohn disease

    NARCIS (Netherlands)

    Damen, GM; Hol, J; de Ruiter, L.; Bouquet, J; Sinaasappel, M; van der Woude, J; Laman, JD; Hop, WCJ; Buller, HA; Escher, JC; Nieuwenhuis, EES

    2006-01-01

    Objectives: Inflammatory bowel diseases (IBD) represent an aberrant immune response by the mucosal immune system to luminal bacteria. Because the oral mucosa harbors the first epithelial cells that interact with microorganisms, we assessed the immunologic activity of buccal epithelium in children wi

  11. Characterization of chitosan-magnesium aluminum silicate nanocomposite films for buccal delivery of nicotine

    DEFF Research Database (Denmark)

    Pongjanyakul, Thaned; Khunawattanakul, Wanwisa; Strachan, Clare J

    2013-01-01

    The objective of this study was to prepare and characterize chitosan-magnesium aluminum silicate (CS-MAS) nanocomposite films as a buccal delivery system for nicotine (NCT). The effects of the CS-MAS ratio on the physicochemical properties, release and permeation, as well as on the mucoadhesive...

  12. Formulation and evaluation of a bioadhesive patch for buccal delivery of tizanidine

    Directory of Open Access Journals (Sweden)

    Mohamed S. Pendekal

    2012-06-01

    Full Text Available Tizanidine hydrochloride (THCl is an antispasmodic agent which undergoes extensive first pass metabolism making it a possible candidate for buccal delivery. The aim of this study was to prepare a monolayered buccal patch containing THCl using the emulsification solvent evaporation method. Fourteen formulations were prepared using the polymers Eudragit® RS 100 or Eudragit® RL 100 and chitosan. Polymer solutions in acetone were combined with a THCl aqueous solution (in some cases containing chitosan by homogenization at 9000 rpm for 2 min in the presence of triethyl citrate as plasticizer and cast in novel Teflon molds. Physicochemical properties such as film thickness, in vitro drug release and in vitro mucoadhesion were evaluated after which permeation across sheep buccal mucosa was examined in terms of flux and lag time. Formulations prepared using a Eudragit® polymer alone exhibited satisfactory physicomechanical properties but lacked a gradual in vitro drug release pattern. Incorporation of chitosan into formulations resulted in the formation of a porous structure which did exhibit gradual release of drug. In conclusion, THCl can be delivered by a buccal patch formulated as a blend of Eudragit® and chitosan, the latter being necessary to achieve gradual drug release.

  13. Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits

    Directory of Open Access Journals (Sweden)

    Geovanne F. Souza

    2008-06-01

    Full Text Available PURPOSE: Buccal mucosa is a widely accepted tissue for urethroplasty. The exact healing and tissue integration process, mainly the histological characteristics of dorsal buccal mucosa graft urethroplasty when used dorsally to reconstruct the urethral plate has not previously been assessed, and thus we developed an experimental model to address this question. MATERIALS AND METHODS: In 12 New Zealand rabbits (weight 2.5 kg we surgically created a dorsal penile urethral defect. A buccal mucosa graft was sutured to the corpora and tunica albuginea, and the ventral urethra anastomosed to this new urethral plate. The animals were divided in three groups and sacrificed 1, 3 and 6 weeks after surgery (groups 1, 2 and 3. A retrograde urethrogram was obtained at autopsy in the last group and the penis analyzed histologically with hematoxylin-eosin and Masson's staining. RESULTS: The urethrograms showed no evidence of fistula or stricture. In group 1 the histopathological analysis showed submucosal lymph-mononuclear inflammatory edema, numerous eosinophils and squamous epithelium integrated into the adjacent urothelium. In group 2 there was no evidence of an inflammatory response but rather complete subepithelial hyaline healing, which was more marked in group 3. CONCLUSION: Healing of buccal mucosa grafts to reconstruct the urethral plate can be achieved by total integration of the squamous epithelium with the urothelium, maintaining the original histological properties of the graft with no fibrosis or retraction.

  14. Testing Dietary Hypotheses of East African Hominines Using Buccal Dental Microwear Data

    Science.gov (United States)

    Martínez, Laura Mónica; Estebaranz-Sánchez, Ferran; Galbany, Jordi

    2016-01-01

    There is much debate on the dietary adaptations of the robust hominin lineages during the Pliocene-Pleistocene transition. It has been argued that the shift from C3 to C4 ecosystems in Africa was the main factor responsible for the robust dental and facial anatomical adaptations of Paranthropus taxa, which might be indicative of the consumption of fibrous, abrasive plant foods in open environments. However, occlusal dental microwear data fail to provide evidence of such dietary adaptations and are not consistent with isotopic evidence that supports greater C4 food intake for the robust clades than for the gracile australopithecines. We provide evidence from buccal dental microwear data that supports softer dietary habits than expected for P. aethiopicus and P. boisei based both on masticatory apomorphies and isotopic analyses. On one hand, striation densities on the buccal enamel surfaces of paranthropines teeth are low, resembling those of H. habilis and clearly differing from those observed on H. ergaster, which display higher scratch densities indicative of the consumption of a wide assortment of highly abrasive foodstuffs. Buccal dental microwear patterns are consistent with those previously described for occlusal enamel surfaces, suggesting that Paranthropus consumed much softer diets than previously presumed and thus calling into question a strict interpretation of isotopic evidence. On the other hand, the significantly high buccal scratch densities observed in the H. ergaster specimens are not consistent with a highly specialized, mostly carnivorous diet; instead, they support the consumption of a wide range of highly abrasive food items. PMID:27851745

  15. Rapidly-growing buccal mass in a 6-month-old infant.

    Science.gov (United States)

    Kumar, A; Brierley, D; Hunter, K D; Lee, N

    2015-11-01

    Lipoblastoma and lipoblastomatosis are rare benign tumours of fetal-embryonal adipocytes that usually present in young children, which is why they are not often included in the differential diagnosis of soft tissue lesions in infants. We describe a case of a 6-month-old infant with an intraoral buccal lipoblastoma.

  16. Reactivation of inactive X chromosome in buccal smear of carcinoma of breast

    Directory of Open Access Journals (Sweden)

    Natekar Prashant

    2008-01-01

    Full Text Available Buccal mucosal smears of 100 female patients of carcinoma of breast were compared with 100 controls matched accordingly. The frequency of Barr bodies was significantly lower in carcinoma of breast patients (menstruating and menopausal women P < 0.001 when compared with controls indicating reactivation of the inactive X chromosome.

  17. Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium

    Science.gov (United States)

    Al Shammari, Abdullah Faraj; AL Ibrahim, Ibrahim Khalil; Alaauldeen, Amjad Ibrahim; Merza, Randa Fouad; Ahmed, Hussain Gadelkarim

    2016-10-01

    Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P < 0.016)) and 4.3 (0.93- 20.2), P <0.06)), respectively, in the two sites. Conclusion: Tobacco smoking is a major risk factor for occurrence of cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer.

  18. A Non-Invasive Strategy for Neonatal Alloimmune Thrombocytopenia Diagnosis: Newborn Platelet Genotyping with Buccal Swabs

    Directory of Open Access Journals (Sweden)

    Gérald Bertrand

    2016-07-01

    Full Text Available Neonatal alloimmune thrombocytopenia results from the maternal immune response against fetal-specific antigens inherited from the father. The diagnosis is ascertained only when the maternal alloantibody and the offending antigen present in the newborn are identified. Up until now most laboratories perform DNA extraction for neonatal genotyping from newborn blood samplings. In order to avoid such an invasive procedure, two protocols of DNA extraction from buccal swabs were developed: a manual protocol using the QIAamp mini blood kit (Qiagen, and an automated procedure with the MagNA Pure Compact instrument (Roche. Both EDTA-blood and buccal swabs from thrombocytopenic newborns were genotyped manually (14 samples, automatically (15 samples or both manually and automatically (two samples. Human Platelet Antigen (HPA genotyping was performed using the BeadChip assay (BioArray, Immucor. Concordant genotypings were obtained for all samples except for one swab with the manual method. The automated DNA extraction from newborn buccal swabs with the MagNA Pure Compact instrument was chosen as the first-line strategy, with a significant gain of time in processing buccal swabs.

  19. Statistical optimization of insulin-loaded Pluronic F-127 gels for buccal delivery of basal insulin.

    Science.gov (United States)

    Das, Nilanjana; Madan, Parshotam; Lin, Senshang

    2012-01-01

    The principle of statistical optimization was employed to fabricate insulin-loaded Pluronic F-127 (PF-127) gel formulations having the potential for buccal delivery of basal insulin. A two-level resolution III fractional factorial design was applied to simultaneously evaluate five independent formulation variables: PF-127 concentration, insulin concentration, sodium sulfate concentration, hydroxypropylmethyl cellulose (HPMC) concentration, and presence of sodium glycocholate. The amount of insulin released and permeated from gels as well as gelation time and mucoadhesion force of gels were measured and used as dependent response variables for formulation optimization. Optimization of a gel formulation was achieved by applying constrained optimization via regression analysis. In vitro permeation flux of insulin from the optimized formulation through procine buccal mucosa was 93.17 (±0.058, n = 3) μg/cm(2). Plasma insulin levels following buccal administration of the optimized formulation at 10, 25 and 50 IU/kg to healthy rats were found to be dose dependent and basal insulin levels were maintained at least for 8 h. Furthermore, continuous hypoglycemia for at least 8 h was observed with 89%, 51% and 25% of blood glucose reduction, respectively, for these three doses. The results of this investigation conclude the feasibility of development of optimized buccal insulin-loaded Pluronic F-127 gels for basal insulin delivery.

  20. A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

    Directory of Open Access Journals (Sweden)

    Mohammad Ghofrani

    2012-09-01

    Full Text Available Objective: The purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in Iranian children.Methods: This is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases or intravenous diazepam (60 cases at the emergency department of a children's hospital. The primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. The second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one.Findings: In the midazolam group, 22 (68.8% patients were relieved from seizures in 10 minutes.Meanwhile, diazepam controlled the episodes of 42 (70% patients within 10 minutes. The difference was,however, not statistically significant (P=0.9. The mean time required to control the convulsive episodes after administration of medications was not statistically significant (P=0.09. No significant side effects were observed in either group. Nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam.Conclusion: Buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.

  1. Formulation and evaluation of anti-asthmatic drug montelukast in mucoadhesive buccal patches

    Institute of Scientific and Technical Information of China (English)

    Magdy Ibrahim Mohamed; Mary Kamal Gad Mekhael

    2014-01-01

    Objective: To formulate and evaluate anti-asthmatic drug montelukast in mucoadhesive buccal patches. Methods:Buccal patches were formulated by using different hydrophilic polymers by solvent casting technique. Buccal patches were evaluated by seven physical appearances, in addition toin vitro drug release study. Results: All patches were uniform and translucent, and had smooth surface. In vitro release studies were conducted for montelukast buccal patches proved that release in the range of 75.26%-92.30% in 8 h. Emission of montelukast from all patches simulated zero order and diffusion mechanism. Finally it can be concluded that F3, F15 and F16 are the best formulation. Conclusions: The investigation concluded that patch of 5 mg of montelukast sodium were formulated by using sodium alginate with sodium carboxy methyl cellulose, hydroxy propyl methyl cellulose K100M with sodium carboxy methyl cellulose, and hydroxy propyl methyl cellulose K100M with sodium alginate (F3, F15 and F16 formulations) were the best formulations.

  2. Periodontal Responses to Augmented Corticotomy with Collagen Membrane Application during Orthodontic Buccal Tipping in Dogs

    Directory of Open Access Journals (Sweden)

    Dong-Yeol Lee

    2014-01-01

    Full Text Available This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM application in augmented corticotomy using deproteinized bovine bone mineral (DBBM, during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19±14.60° and 28.12±11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9±19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.

  3. Teach yourself visually Windows 8 tablets

    CERN Document Server

    McFedries, Paul

    2012-01-01

    A visual guide to all the features of the new Windows 8 Tablet This must-have resource features visually rich, step-by-step instructions that show you how to get the most enjoyment from your Windows 8 tablet. Learn about the exciting new Metro UI, optimized specifically for touch devices. The most popular and commonly used apps and functions are covered too, along with the basics of syncing with a network, setting up e-mail, watching videos, listening to music, and common productivity tasks. This book provides all the guidance needed to enjoy all the best the new Windows 8 tablets have to offe

  4. Portable Tablets in Science Museum Learning

    DEFF Research Database (Denmark)

    Gronemann, Sigurd Trolle

    2016-01-01

    Despite the increasing use of portable tablets in learning, their impact has received little attention in research. In five different projects, this media-ethnographic and design-based analysis of the use of portable tablets as a learning resource in science museums investigates how young people......’s learning with portable tablets matches the intentions of the museums. By applying media and information literacy (MIL) components as analytical dimensions, a pattern of discrepancies between young people’s expectations, their actual learning and the museums’ approaches to framing such learning...

  5. Comparative investigations of tablet crushing force testers

    DEFF Research Database (Denmark)

    Sonnergaard, Jørn; Jensen, C.G.; Poulsen, L.

    2005-01-01

    The performance of 16 tablet breaking force testers was evaluated in terms of accuracy, reproducibility and repeatability. Three tablet formulations with different plastic or brittle deformation mechanisms and with target breaking forces of 50, 100 and 150 N were tested. Statistically significant...... by the concept of components of variance was 5-7 % depending on the model tablet excipient. The standard deviation within testers (repeatability) was affected by the type of model formulation showing increasing variability with increasing brittleness of the compressed material. No specific effect of altering...

  6. A new formulation of fenofibrate: suprabioavailable tablets.

    Science.gov (United States)

    Guichard, J P; Blouquin, P; Qing, Y

    2000-01-01

    The rationale for, and development of, a new suprabioavailable fenofibrate tablet formulation is described. The new suprabioavailable tablet formulation combines well-established micronisation technology with a new micro-coating process. The new formulation provides more predictable and reliable drug absorption. Owing to the strong relationship between the fenofibrate dissolution performance and its oral bioavailability, equivalent plasma levels of active principal are achieved at a lower dose, with less inter-subject variability and a reduced food effect. The new suprabioavailable tablet may, therefore, be a more efficient and better tolerated formulation.

  7. Android Tablet Application Development For Dummies

    CERN Document Server

    Felker, Donn

    2011-01-01

    Get up to speed on the hottest opportunity in the application development arena App development for tablets is a booming business. Android tablets, including the popular Motorola Xoom, are gaining market share at breakneck speed, and this book can have even novice programmers creating great Android apps specifically for tablets quickly and easily. A little Java knowledge is helpful but not essential to get started creating apps. Android expert Donn Felker helps you get the Android environment up and running, use XML to create application menus, create an icon for your app, and submit your app

  8. In vitro release and permeation of oxytocin from a mucoadhesive buccal patch.

    Science.gov (United States)

    Li, C; Bhatt, P P; Johnston, T P

    1996-12-01

    A biocompatible, mucoadhesive patch was evaluated for potential use in the delivery of peptides. The model peptide oxytocin was incorporated into the polymeric patch matrix and the diffusion of oxytocin across excised rabbit buccal epithelium was studied following patch application. Penetration of oxytocin across excised mucosa from an applied patch did not exhibit a characteristic lag time for diffusion, with the steady-state flux of oxytocin being 0.062 +/- 0.019 microgram/cm2/hr. However, when finite-dose diffusion studies were conducted to quantitate transport of oxytocin across rabbit buccal mucosa, the mean apparent permeability coefficient (P), diffusion coefficient (D), partition coefficient (K), and lag time (tlag) were (1.94 +/- 0.74) x 10(-7) cm/sec, (9.20 +/- 1.65) x 10(-8) cm2/sec, 0.13 +/- 0.05 and 1.86 +/- 0.31 hr, respectively. The release of oxytocin from the mucoadhesive buccal patches in vitro proceeded very rapidly during the first 2 hr, with 72% of the amount initially incorporated into the patches released at 24 hr. The disappearance rate of intact, parent oxytocin when an oxytocin solution was placed in direct contact with the serosal and mucosal sides of freshly excised rabbit buccal mucosa was 0.74 +/- 0.34 microgram/cm2/hr and 3.38 +/- 1.07 micrograms/cm2/hr, respectively. Thus, the buccal patch evaluated in these studies appears to be suitable for transmucosal delivery of peptides.

  9. Buccal Corridors: A Fact or a Myth in the Eyes of Laymen?

    Science.gov (United States)

    Elhiny, Omnia A.; Harhash, Asmaa Y.

    2016-01-01

    AIM: This study aimed to investigate laymen knowledge of the existence of the buccal corridor and whether it was an important factor for them in judging smile attractiveness and the effect of introducing the knowledge to them on their further judgment. MATERIALS AND METHODS: Nine subjects were randomly selected with variable buccal corridor percentages. They were coached to smile in a posed fashion and full face smile photographs were taken from a standardised distance. The photographs were randomly arranged in a power point presentation and displayed to a panel of thirty-nine randomly selected laymen judges. The judges made their beauty judgment on a visual analogue scale (VAS) and filled a questionnaire. After their education about the buccal corridor, they were asked to make a second judgment on a second sheet with VAS and with a different random sequence of the photographs. RESULTS: Intra-class correlation agreement for all the judges between the first and second scores was 0.713. The Spearman’s rho Correlation coefficient indicated a positive correlation for all the photos. For the male judges, the agreement between the ratings was 0.839, and the correlation was positive for all the photos. For the female judges, the agreement between the ratings was 0.510, and the correlation was positive for all the photographs. Hundred percent of the judges were not familiar with the buccal corridor. Eighty percent of the female judges and 44.4% of the male judges mentioned that it would affect their further judgment. CONCLUSION: Laymen build their esthetic judgments on what we teach them, and modifying treatment plans to include corrections of buccal corridors for esthetic reasons only is a myth. PMID:28028418

  10. Genotoxic Effects of Tobacco on Buccal Epithelium: Cell Nuclear Anomalies as Biomarker

    Directory of Open Access Journals (Sweden)

    Sohini Das Biswas

    2014-12-01

    Full Text Available Background: Tobacco use has toxic effects on different organs. This study was carried out to assess the effect of indigenous tobacco both in smoking (bidi and smokeless (gutkha, zarda and khaini forms on buccal cells at chromosomal level, through assessment of different nuclear anomalies as biomarker. Methods:This study was done on people living in Durgapur and its adjacent areas, West Bengal, India during January to July 2011. The samples were collected from 50 smokers (case group, 50 smokeless tobacco consumers or chewers (case group and 50 non-tobacco consumers (control group. Micronucleus assay was used to assess buccal cell nuclear changes. Buccal smears collected from study subjects were prepared on a grease free slide. Prepared slides were observed under light microscope and 2 to 5 fields were observed randomly for counting the different anomalies. In each field, the frequency of each anomaly was assessed in 100 cells and reported with percentage. Results:Chewers had significantly the highest frequency of all nuclear anomalies compared to smokers and healthy controls (HCs. Smokers also had significantly more anomalies compared to HCs. Condensed chromatin (CC, karyolysis (KL and bi-nucleation (BN in chewers and CC, pyknosis and BN in smokers were the most frequent anomalies. KL was significantly more frequent in chewers compared to smokers (59.8 ± 6.4 vs. 24.2 ± 12.4%, P < 0.001, however, the frequency of other nuclear anomalies were not significantly different in these two study groups. Presence of each nuclear anomaly was significantly greater in older ages in all study groups. Conclusion:Tobacco can cause and increase the rate of nuclear anomalies in both smoking and smokeless forms compared to HCs. The genotoxic effects of tobacco on buccal cells are partly age-related. Cell nuclear anomalies in buccal tissue can be used as biomarker indicating the detrimental effects of tobacco.

  11. Single stage dorsal inlay buccal mucosal graft with tubularized incised urethral plate technique for hypospadias reoperations

    Institute of Scientific and Technical Information of China (English)

    Wei-Jing Ye; Ping Ping; Yi-Dong Liu; Zheng Li; Yi-Ran Huang

    2008-01-01

    Aim: To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods: From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old(average 11.62 ± 7.18 years) with failed previous hypospadias surgery were included in the present study. Indica- tions included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corporacavemosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results: The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion: Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations. (Asain J Androl 2008 Jul; 10: 682- 686)

  12. Microstructure of Tablet-Pharmaceutical Significance, Assessment, and Engineering.

    Science.gov (United States)

    Sun, Changquan Calvin

    2017-05-01

    To summarize the microstructure - property relationship of pharmaceutical tablets and approaches to improve tablet properties through tablet microstructure engineering. The main topics reviewed here include: 1) influence of material properties and manufacturing process parameters on the evolution of tablet microstructure; 2) impact of tablet structure on tablet properties; 3) assessment of tablet microstructure; 4) development and engineering of tablet microstructure. Microstructure plays a decisive role on important pharmaceutical properties of a tablet, such as disintegration, drug release, and mechanical strength. Useful information on mechanical properties of a powder can be obtained from analyzing tablet porosity-pressure data. When helium pycnometry fails to accurately measure true density of a water-containing powder, non-linear regression of tablet density-pressure data is a useful alternative method. A component that is more uniformly distributed in a tablet generally exerts more influence on the overall tablet properties. During formulation development, it is highly recommended to examine the relationship between any property of interest and tablet porosity when possible. Tablet microstructure can be engineered by judicious selection of formulation composition, including the use of the optimum solid form of the drug and appropriate type and amount of excipients, and controlling manufacturing process.

  13. Dissolution development of valdecoxib tablets

    Directory of Open Access Journals (Sweden)

    Subramanian G

    2006-01-01

    Full Text Available Valdecoxib is a nonsteroidal antiinflammatory drug, and it is listed in class 2 of biopharmaceutic classification of drugs. Valdecoxib is a poorly water-soluble and highly permeable drug. In the present study a new dissolution medium was developed, as there is no official dissolution medium available in the literature. The composition of the dissolution medium was selected on the basis of solubility data at 37°. Solubility data revealed that addition of surfactant may be suitable as dissolution medium. The concentration of 0.6% w/v sodium lauryl sulphate in water could be a suitable dissolution medium. The discriminating power of the selected dissolution medium (0.6% sodium lauryl sulphate in water relative to the other dissolution mediums was evaluated. The selected dissolution medium was used for the evaluation of valdecoxib tablets.

  14. Comparative population pharmacokinetics of fentanyl using non-linear mixed effect modeling: burns vs. non-burns.

    Science.gov (United States)

    Kaneda, Kotaro; Han, Tae-Hyung

    2009-09-01

    Fentanyl is a commonly used analgesic and sedative for the burned in the operating theater as well as the burn care units. The aim of this study was to characterize fentanyl population pharmacokinetics in burns and to identify clinically significant covariates. Twenty adults, aged 37+/-3 years, with 49+/-4% (mean+/-S.E.) total body surface area burn, were enrolled at 17+/-3 days after the injury. Twenty non-burn adults served as controls. After an intravenous bolus of 200 mcg fentanyl, the plasma concentrations were sequentially determined up to 4.5 h. Concentration-time profiles were subjected to non-linear mixed effect modeling. Cardiac indices were estimated with esophageal Doppler monitor. Burned patients have higher cardiac index than the non-burned. Three-compartment model was the best fit. The volumes of distribution were considerably expanded in all three compartments (27.9 L vs. 63.4 L, 64.7 L vs. 92.9 L, 153 L vs. 301 L, respectively) compared to the non-burned. BURN was the single most important covariate significantly improving the model. The primary effect of burn trauma on fentanyl pharmacokinetics is substantially expanded volumes of distribution, i.e., dilutional. Difference in simulation, however, was insufficient to explain the augmented resistance to fentanyl, implying the importance of titrating analgesics to the clinical effect.

  15. An improved cryopreservation method for porcine buccal mucosa in ex vivo drug permeation studies using Franz diffusion cells.

    Science.gov (United States)

    Amores, Sonia; Domenech, José; Colom, Helena; Calpena, Ana C; Clares, Beatriz; Gimeno, Álvaro; Lauroba, Jacinto

    2014-08-18

    The use of isolated animal models to assess percutaneous absorption of molecules is frequently reported. The porcine buccal mucosa has been proposed as a substitute for the buccal mucosa barrier on ex vivo permeability studies avoiding unnecessary sacrifice of animals. But it is not always easy to obtain fresh buccal mucosa. Consequently, human and porcine buccal mucosa is sometimes frozen and stored in liquid nitrogen, but this procedure is not always feasible. One cheaper and simpler alternative is to freeze the buccal mucosa of freshly slaughtered pigs in a mechanical freezer, using DMSO and albumin as cryoprotective agents. This study compared the ex vivo permeability parameters of propranolol hydrochloride through porcine buccal mucosa using a Franz diffusion cell system and HPLC as detection method. The freezing effects on drug permeability parameters were evaluated. Equally histological studies were performed. Furthermore, the use of the parameter transmucosal water loss (TMWL) as an indicator of the buccal mucosa integrity was evaluated just as transepidermal water loss (TEWL) is utilized for skin integrity. The results showed no difference between fresh and frozen mucosal flux, permeability coefficient or lag time of propranolol. However, statistical significant difference in TMWL between fresh and frozen mucosa was observed.

  16. Perceptions of brachyfacial, mesofacial and dolichofacial individuals with regard to the buccal corridor in different facial types

    Directory of Open Access Journals (Sweden)

    Matheus Melo PITHON

    2014-10-01

    Full Text Available Objective: Evaluate the esthetic perception and attractiveness of the smile with regard to the buccal corridor in different facial types by brachyfacial, mesofacial and dolichofacial individuals. Material and Methods: The image of a smiling individual with a mesofacial type of face was changed to create three different facial types with five different buccal corridors (2%, 10%, 15%, 22% and 28%. To achieve this effect, a photo editing software was used (Adobe Photoshop, Adobe Systems Inc, San Francisco, CA, EUA. The images were submitted to evaluators with brachyfacial, mesofacial and dolichofacial types of faces, who evaluated the degree of esthetic perception and attractiveness by means of a visual analog scale measuring 70 mm. The differences between evaluators were verified by the Mann-Whitney test. All statistics were performed with a confidence level of 95%. Results: Brachyfacial individuals perceived mesofacial and dolichofacial types of faces with buccal corridor of 2% as more attractive. Mesofacial individuals perceived mesofacial and dolichofacial types of faces with buccal corridor of 2%, 10% and 15% as more attractive. Dolichofacial individuals perceived the mesofacial type of face with buccal corridor of 2% as more attractive. Evaluators of the female sex generally attributed higher scores than the male evaluators. Conclusion: To achieve an enhanced esthetic smile it is necessary to observe the patient’s facial type. The preference for narrow buccal corridors is an esthetic characteristic preferred by men and women, and wide buccal corridors are less attractive.

  17. Tablets for Learning in Higher Education

    DEFF Research Database (Denmark)

    Godsk, Mikkel

    Based on a small-scale literature review this paper identifies the top 10 affordances of post PC tablets (sometimes referred to as ‘tablet computers’) for higher education in settings where the technology is used for learning. The review shows that the predominant affordances of the technology......, the concepts of tabletcasts and tabletcasting are introduced as one possible framing for future research on tablets as an educational technology....... are related to its ability to support engaging, inclusive, and/or collaborative learning, to provide flexibility in place, and to include multimedia and interactive content in teaching practice. However, performing the review also revealed that the notion of tablets for learning is equivocal. As a consequence...

  18. An animal model of buccal mucosa cancer and cervical lymph node metastasis induced by U14 squamous cell carcinoma cells.

    Science.gov (United States)

    Zhao, Xin; Pang, Liang; Qian, Yu; Wang, Qiang; Li, Yong; Wu, Mingyi; Ouyang, Zilan; Gao, Zhi; Qiu, Lihua

    2013-04-01

    The buccal mucosa is the site with the highest risk of contracting a malignancy in habitual betel quid chewers who expose the buccal mucosa to high doses of carcinogens. Of all oral cancers, those of the buccal mucosa are associated with the poorest prognoses. Therefore, it would be helpful to have an animal model to evaluate new treatment modalities for buccal mucosa cancer. In the present study, we evaluated whether the imprinting control region (ICR) mouse animal model could be employed as a cancer model for buccal mucosa cancer. Sixty male ICR mice were randomly divided into two groups, a normal group (n=10) and a cancer-induced group (n=50). Each mouse in the cancer group was inoculated with 0.05 ml U14 cancer cell suspension (1×10(7)/ml) on the buccal mucosa. Histological staining and gene expression assays revealed that neck lymph node metastasis animal models were established. After 20 days, the cheek tumor formation rate of the ICR mice reached 100%. Furthermore, the neck lymph node metastasis rate was 53%. We identified that U14 cells produce strong metastasis in ICR mice. Metastasis of the tumor to the lymph node began with carcinoma metastasis encroaching on the marginal sinus. Then it infiltrated to the cortex and medulla and the infiltration continued until the normal lymph node structure was completely damaged. This animal model may be employed in medical research on buccal mucosa cancer and cervical lymph node metastasis. In conclusion, our findings indicate that U14 cell-induced mouse buccal mucosa cancer may be a potential cancer model for human buccal mucosa squamous cell carcinoma.

  19. Electronic acquisition of OSCE performance using tablets

    Directory of Open Access Journals (Sweden)

    Hochlehnert, Achim

    2015-10-01

    Full Text Available Background: Objective Structured Clinical Examinations (OSCEs often involve a considerable amount of resources in terms of materials and organization since the scores are often recorded on paper. Computer-assisted administration is an alternative with which the need for material resources can be reduced. In particular, the use of tablets seems sensible because these are easy to transport and flexible to use.Aim: User acceptance concerning the use of tablets during OSCEs has not yet been extensively investigated. The aim of this study was to evaluate tablet-based OSCEs from the perspective of the user (examiner and the student examinee.Method: For two OSCEs in Internal Medicine at the University of Heidelberg, user acceptance was analyzed regarding tablet-based administration (satisfaction with functionality and the subjective amount of effort as perceived by the examiners. Standardized questionnaires and semi-standardized interviews were conducted (complete survey of all participating examiners. In addition, for one OSCE, the subjective evaluation of this mode of assessment was gathered from a random sample of participating students in semi-standardized interviews.Results: Overall, the examiners were very satisfied with using tablets during the assessment. The subjective amount of effort to use the tablet was found on average to be “hardly difficult”. The examiners identified the advantages of this mode of administration as being in particular the ease of use and low rate of error. During the interviews of the examinees, acceptance for the use of tablets during the assessment was also detected.Discussion: Overall, it was found that the use of tablets during OSCEs was well accepted by both examiners and examinees. We expect that this mode of assessment also offers advantages regarding assessment documentation, use of resources, and rate of error in comparison with paper-based assessments; all of these aspects should be followed up on in

  20. Tablets with thyme (Thymus Vulgaris L extracts

    Directory of Open Access Journals (Sweden)

    Zeković Zoran P.

    2002-01-01

    Full Text Available The strongly antiseptic and antifungal activities of thyme is mainly due to the presence of phenolic compounds, thymol and carvacrol. Thyme extracts essential oil, extract obtained using 70% ethanol and extract obtained by supercritical fluid extraction (SFE using carbon dioxide, were incorporated in the most useful form of pharmaceutical products - tablets. The work is concerned with the characterisation of the obtained tablets containing thyme extracts.

  1. MOUTH DISSOLVING TABLETS: A FUTURE COMPACTION

    Directory of Open Access Journals (Sweden)

    Srivastava Saurabh

    2012-08-01

    Full Text Available An orally disintegrating tablet or mouth dissolving tablet (MDT is a drug dosage form available for a limited amount of over-the-counter (OTC and prescription medications. MDTs differ from traditional tablets in that they are designed to be dissolved on the tongue rather than swallowed whole. A variety of pharmaceutical research has been conducted to develop new dosage forms. Among the dosage forms developed to facilitate ease of medication, the mouth dissolving tablet (MDT is one of the most widely employed commercial products. As our society is becoming increasingly aged, the development of mouth dissolving tablets have been formulated for pediatric, geriatric, and bedridden patients and for active patients who are busy and travelling and may not have access to water. Such formulations provide an opportunity for product line extension in the many elderly persons will have difficulties in taking conventional oral dosage forms (viz., solutions, suspensions, tablets, and capsules because of hand tremors and dysphagia. Oral delivery is currently the gold standard in the pharmaceutical industry where it is regarded as the safest, most convenient and most economical method of drug delivery having the highest patient compliance. Recent development in fast disintegrating technology mainly works to improve the disintegration quality of these delicate dosage forms without affecting their integrity. This article focuses on the patented technologies available and the advances made so far in the field of fabrication of mouth dissolving tablets. Apart from the conventional methods of fabrication, this review also provides the detailed concept of some unique technologies like freeze drying, direct compression, spray drying, tablet molding, sublimation, fast dissolving films cotton candy process, along with their advantages and limitations.

  2. Tablets Helping Elderly and Disabled People

    OpenAIRE

    Castro, Mercedes; Ruiz-Mezcua, Belén; Sánchez-Pena, José Manuel; García-Crespo, Ángel; Iglesias, Ana; Pajares, José Luis

    2012-01-01

    Proceedings of: Ambient Assisted Living Joint Programme Forum 2011 (AAL JP Forum 2011), Lecce (Italy), September 26-28, 2011 The article introduces the basics by which tablets are considered as appropriate tools for integration and promotion of the elderly in the digital world. To prove this, the paper presents three research projects carried out by CESyA that integrate Automatic Speech Recognition (ASR), Voice Synthesis, subtitling, audiodescription or audio navigation tools into tablets ...

  3. Formulation and optimization of potassium iodide tablets.

    Science.gov (United States)

    Al-Achi, Antoine; Patel, Binit

    2015-01-01

    The use of potassium iodide (KI) as a protective agent against accidental radioactive exposure is well established. In this study, we aimed to prepare a KI tablet formulation using a direct compression method. We utilized Design of Experiment (DoE)/mixture design to define the best formulation with predetermined physical qualities as to its dissolution, hardness, assay, disintegration, and angle of repose. Based on the results from the DoE, the formulation had the following components (%w/w): Avicel 48.70%, silicon dioxide 0.27%, stearic acid (1.00%), magnesium stearate 2.45%, and dicalcium phosphate 18.69%, in addition to potassium iodide 28.89% (130 mg/tablet). This formulation was scaled-up using two tablet presses, a single-punch press and a rotary mini tablet press. The final scaled-up formulation was subjected to a variety of quality control tests, including photo-stability testing. The results indicate that potassium iodide tablets prepared by a rotary mini tablet press had good pharmaceutical characteristics and a shelf-life of 25 days when stored at room temperature protected from light.

  4. [Overview of regulatory aspects guiding tablet scoring].

    Science.gov (United States)

    Teixeira, Maíra Teles; Sá-Barreto, Lívia Cristina Lira; Silva, Dayde Lane Mendonça; Cunha-Filho, Marcílio Sergio Soares

    2016-06-01

    Tablet scoring is a controversial but common practice used to adjust doses, facilitate drug intake, or lower the cost of drug treatment, especially in children and the elderly. The risks of tablet scoring are mainly related to inaccuracies in the resulting dose and stability problems. The aim of this article is to provide an overview of worldwide guidelines regarding tablet scoring. We found that regulatory health agencies in Mercosur countries as well as other South American countries do not have published standards addressing tablet splitting. Among the surveyed health agencies, the Food and Drug Administration (FDA) in the United States is the only one to present standards, ranging from splitting instructions to regulation of the manufacturing process. The concept of functional scoring implemented by the FDA has introduced some level of guarantee as to the ability of tablets to be split. In conclusion, technical and scientific bases are still insufficient to guide health rules on this subject, making the decision on scoring, in certain situations, random and highly risky to public health. The need for more detailed regulation is vital to ensure the safety of tablet medications.

  5. Formulation and evaluation of antihelminthic polyherbal tablets

    Directory of Open Access Journals (Sweden)

    Dinesh Puri

    2011-01-01

    Full Text Available From time immemorial, man has been depending on plants as medicine. Helminthes infections are among the most common infections in man, affecting a large proportion of the world′s population. These helminthic diseases can be treated by various herbal drugs. The purpose of the present work was to formulate antihelminthic tablets. In this work, a spray dried-powder was used, which was obtained from the extract of different part of seven plants that were used in helminthic disease. The different tablets were prepared by using different types of disintegrating agents and various excipients. All parameters related to physicochemical property, trace metal and microbial examination of the spray-dried powder showed that these were within limits and could be used for the tablet formulation. The granules of the spray-dried powder were prepared by a wet granulation technique using isopropyl alcohol. The blends were evaluated for flow properties and for compressibility, which were found to be good. The tablets were prepared using a single rotatory punching machine, in which the punch size was 11 mm×8 mm, and formulated caplet-type tablets. These tablets were evaluated for the colour, odor, thickness and diameter, with visual inspection for any defects, weight variation, hardness, friability and in vitro disintegration time.

  6. Evaluation of Certain Pharmaceutical Quality Attributes of Lisinopril Split Tablets

    Directory of Open Access Journals (Sweden)

    Khairi M. S. Fahelelbom

    2016-10-01

    Full Text Available Tablet splitting is an accepted practice for the administration of drugs for a variety of reasons, including dose adjustment, ease of swallowing and cost savings. The purpose of this study was to evaluate the physical properties of lisinopril tablets as a result of splitting the tablets either by hand or with a splitting device. The impact of the splitting technique of lisinopril (Zestril® tablets, 20 mg on certain physical parameters such as weight variation, friability, disintegration, dissolution and drug content were studied. Splitting the tablets either by hand or with a splitter resulted in a minute but statistically significant average weight loss of <0.25% of the tablet to the surrounding environment. The variability in the weight of the hand-split tablet halves was more pronounced (37 out of 40 tablet halves varied by more than 10% from the mean weight than when using the tablet splitter (3 out of 40 tablet halves. The dissolution and drug content of the hand-split tablets were therefore affected because of weight differences. However, the pharmacopoeia requirements for friability and disintegration time were met. Hand splitting of tablets can result in an inaccurate dose and may present clinical safety issues, especially for drugs with a narrow therapeutic window in which large fluctuations in drug concentrations are undesirable. It is recommended to use tablets with the exact desired dose, but if this is not an option, then a tablet splitter could be used.

  7. Influence of endotoxin-induced sepsis on the requirements of propofol-fentanyl infusion rate in pigs

    DEFF Research Database (Denmark)

    Bollen, Peter; Nielsen, Bjørn J; Toft, Palle

    2007-01-01

    Endotoxin-induced sepsis in pigs is a recognized experimental model for the study of human septic shock. Generally, pigs are brought into general anaesthesia before sepsis is induced. It is our experience that drug dosages of propofol and fentanyl need to be reduced during endotoxin-induced sepsis......, in order to prevent respiratory and cardiovascular depression, but the scientific evidence for this observation is lacking. Therefore, we measured the consumption of propofol and fentanyl at equal level of anaesthesia in pigs with (n = 5) and without (n = 5) endotoxin-induced sepsis, using the cerebral...... state index (CSI) as measure of anaesthetic depth. Infusion rates of propofol (P propofol and 12 microg/kg/hr (S.D. 2) for fentanyl, whereas...

  8. PROSPECTIVE RANDOMISED CONTROL STUDY OF POST OP EPIDURAL ANALGESIA WITH BUPIVACAINE AND FENTANYL VS. BUPIVACAINE AND CLONIDINE

    Directory of Open Access Journals (Sweden)

    Rachana

    2014-07-01

    Full Text Available The aim of the study was to compare the relative potencies and clinical characteristics of epidural Clonidine and Fentanyl with Bupivacaine in lower limb and lower abdominal surgeries using patient-controlled analgesia. In a randomised double-blinded study, 60 ASA I or II patients requiring epidural analgesia for post- operative pain relief were allocated to receive either 0.125% Bupivacaine with Clonidine 1µg/kg or 0.125% Bupivacaine with Fentanyl 1µg/kg via a sterile syringe by trained anaesthesiologists. Analgesia was established with 10-15 ml bolus of study solution. There were significant differences in onset time, duration and quality of analgesia, local anaesthetic consumption, between the two groups. We conclude that 0.125% Bupivacaine with Clonidine 1µg/kg group of patients clinically had better quality of analgesia and for a longer duration in comparison with patients receiving 0.125% Bupivacaine with Fentanyl 1µg/kg.

  9. Pharmacological and clinical differences among transmucosal fentanyl formulations for the treatment of breakthrough cancer pain: a review article.

    Science.gov (United States)

    Corli, O; Roberto, A

    2014-10-01

    Breakthrough pain (BTP) is highly prevalent (59.2%) in chronic cancer patients and normally needs rescue treatments' with opioids when pain flares up. Transmucosal oral/nasal fentanyl formulations are commonly used in clinical practice. The different methods of release influence the pharmacokinetics and clinical properties of these formulations. The aim of this review was to assess and weigh these differences. Clinical trials comparing one transmucosal fentanyl with placebo or another active drug were included. We searched Medline for the last ten years and analyzed 13 studies, totaling 1447 patients. Clinical data on efficacy and safety were compared. In parallel, we report the differences in delivery systems, bioavailability, maximum plasma concentration (Cmax), plasma half-life, and time to reach Cmax (tmax). Considerable variability emerged between formulations. This suggests some considerations on the choice of the fentanyl formulation in the light of the BTP features in each clinical case.

  10. Exposure to time varying magnetic fields associated with magnetic resonance imaging reduces fentanyl-induced analgesia in mice

    Energy Technology Data Exchange (ETDEWEB)

    Teskey, G.C.; Prato, F.S.; Ossenkopp, K.P.; Kavaliers, M.

    1988-01-01

    The effects of exposure to clinical magnetic resonance imaging (MRI) on analgesia induced by the mu opiate agonist, fentanyl, was examined in mice. During the dark period, adult male mice were exposed for 23.2 min to the time-varying (0.6 T/sec) magnetic field (TVMF) component of the MRI procedure. Following this exposure, the analgesic potency of fentanyl citrate (0.1 mg/kg) was determined at 5, 10, 15, and 30 min post-injection, using a thermal test stimulus (hot-plate 50 degrees C). Exposure to the magnetic-field gradients attenuated the fentanyl-induced analgesia in a manner comparable to that previously observed with morphine. These results indicate that the time-varying magnetic fields associated with MRI have significant inhibitory effects on the analgesic effects of specific mu-opiate-directed ligands.

  11. Stability of Fentanyl Citrate, Hydromorphone Hydrochloride, Ketamine Hydrochloride, Midazolam, Morphine Sulfate, and Pentobarbital Sodium in Polypropylene Syringes

    OpenAIRE

    Collin Anderson; Mark MacKay

    2015-01-01

    Purpose: Determine the stability of fentanyl 10 mcg/mL in 0.9% sodium chloride, fentanyl 10 mcg/mL in 5% dextrose, fentanyl 50 mcg/mL, hydromorphone 100 mcg/mL in 0.9% sodium chloride, ketamine 10 mg/mL, midazolam 0.4 mg/mL in 5% dextrose, midazolam 5 mg/mL, morphine 1 mg/mL in 0.9% sodium chloride, morphine 1 mg/mL in 5% dextrose, and pentobarbital 50 mg/mL when stored as single drug entities at room temperature in polypropylene syringes. Methods: Four 5 mL samples of each drug and concentra...

  12. PHARMACOKINETIC EVALUATION OF A LONG-ACTING FENTANYL SOLUTION AFTER TRANSDERMAL ADMINISTRATION IN HELMETED GUINEAFOWL (NUMIDA MELEAGRIS).

    Science.gov (United States)

    Waugh, Lynnette; Knych, Heather; Cole, Gretchen; D'Agostino, Jennifer

    2016-06-01

    The objective of this study was to investigate the pharmacokinetics of a long-acting fentanyl solution in helmeted guineafowl ( Numida meleagris ) after transdermal administration. Twenty-one guineafowl received a single administration of 5 mg/kg of fentanyl transdermal solution. No adverse effects on behavior were appreciated. Plasma fentanyl concentrations were determined by liquid chromatography-mass spectrometry analysis of protein-precipitated samples. Mean maximum plasma concentration was 228.8 ng/ml at 4 hr. The mean plasma terminal half-life was 33.2 hr. At 168 hr the mean plasma concentration was 1.3 ng/ml. A single topical dose of 5 mg/kg appears to be safe for use in this species and maintained plasma concentrations above those reported to be analgesic in dogs for at least 7 days.

  13. Pharmacokinetics and pharmacodynamics of propofol and fentanyl in patients undergoing abdominal aortic surgery - a study of pharmacodynamic drug-drug interactions.

    Science.gov (United States)

    Wiczling, Paweł; Bieda, Krzysztof; Przybyłowski, Krzysztof; Hartmann-Sobczyńska, Roma; Borsuk, Agnieszka; Matysiak, Jan; Kokot, Zenon J; Sobczyński, Paweł; Grześkowiak, Edmund; Bienert, Agnieszka

    2016-07-01

    Propofol is routinely combined with opioid analgesics to ensure adequate anesthesia during surgery. The aim of the study was to assess the effect of fentanyl on the hypnotic effect of propofol and the possible clinical implications of this interaction. The pharmacokinetic/pharmacodynamic (PK/PD) data were obtained from 11 patients undergoing abdominal aortic surgery, classified as ASA III. Propofol was administered by a target-controlled infusion system. Fentanyl 2-3 µg/kg was given whenever insufficient analgesia occurred. The bispectral index (BIS) was used to monitor the depth of anesthesia. A population PK/PD analysis with a non-linear mixed-effect model (NONMEM 7.2 software) was conducted. Two-compartment models satisfactorily described the PK of propofol and fentanyl. The delay of the anesthetic effect in relation to PK was described by the effect compartment. The BIS was linked to propofol and fentanyl effect-site concentrations through an additive Emax model. Context-sensitive decrement times (CSDT) determined from the final model were used to assess the influence of fentanyl on the recovery after anesthesia. The population PK/PD model was successfully developed to describe simultaneously the time course and variability of propofol and fentanyl concentrations and BIS. Additive propofol-fentanyl interactions were observed and quantitated. The duration of the fentanyl infusion had minimal effect on CSDT when it was shorter than the duration of the propofol infusion. If the fentanyl infusion was longer than the propofol infusion, an almost two-fold increase in CSDT occurred. Additional doses of fentanyl administered after the cessation of the propofol infusion result in lower BIS values, and can prolong the time of recovery from anesthesia. Copyright © 2016 John Wiley & Sons, Ltd.

  14. Effects of intravenous administration of perzinfotel, fentanyl, and a combination of both drugs on the minimum alveolar concentration of isoflurane in dogs.

    Science.gov (United States)

    Ueyama, Yukie; Lerche, Phillip; Eppler, C Mark; Muir, William W

    2009-12-01

    OBJECTIVE-To determine the effects of IV administration of perzinfotel and a perzinfotel-fentanyl combination on the minimum alveolar concentration (MAC) of isoflurane in dogs. ANIMALS-6 healthy sexually intact Beagles (3 males and 3 females). PROCEDURES-All dogs were instrumented with a telemetry device for continuous monitoring of heart rate, arterial blood pressure, and core body temperature (at a femoral artery). Dogs were anesthetized with propofol (6 mg/kg, IV) and isoflurane. Isoflurane MAC values were determined in 3 experiments in each dog, separated by at least 7 days, before (baseline) and after the following treatments: no treatment (anesthetic only), perzinfotel (20 mg/kg, IV), fentanyl (5 microg/kg bolus, IV, followed by a continuous IV infusion at 0.15 microg/kg/min), and a fentanyl-perzinfotel combination (20 mg of perzinfotel/kg, IV, plus the fentanyl infusion). Bispectral index and oxygen saturation as measured by pulse oximetry were also monitored throughout anesthesia. RESULTS-Without treatment, the mean +/- SD isoflurane MAC for all 6 dogs was 1.41 +/- 0.10%. Baseline MAC was 1.42 +/- 0.08%. Intravenous administration of perzinfotel, fentanyl, and the perzinfotel-fentanyl combination significantly decreased the MAC by 39%, 35%, and 66%, respectively. Perzinfotel and perzinfotel-fentanyl administration yielded significant increases in the bispectral index. Mean, systolic, and diastolic arterial blood pressures significantly increased from baseline values when perzinfotel was administered. Systolic arterial blood pressure significantly increased from the baseline value when perzinfotel-fentanyl was administered. No adverse effects were detected. CONCLUSIONS AND CLINICAL RELEVANCE-IV administration of perzinfotel, fentanyl, or a perzinfotel-fentanyl combination reduced isoflurane MAC in dogs and increased arterial blood pressure.

  15. Rapid and reliable smooth extubation – Comparison of fentanyl with dexmedetomidine: A randomized, double-blind clinical trial

    Science.gov (United States)

    Rani, P.; Hemanth Kumar, V. R.; Ravishankar, M.; Sivashanmugam, T.; Sripriya, R.; Trilogasundary, M.

    2016-01-01

    Background: Fentanyl and dexmedetomidine have been tried to attenuate airway and circulatory reflexes during emergence and extubation individually but have not been compared with respect to the level of sedation to evolve a reliable technique for rapid and smooth extubation. Aim: To compare the effects of fentanyl and dexmedetomidine in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. Setting and Design: This double-blind, randomized, controlled study was done in patients undergoing surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status 1 or 2. Methodology: All patients received a standardized anesthetic protocol. Patients were randomized to receive either fentanyl 1 μg/kg or dexmedetomidine 0.75 μg/kg. Fifteen minutes before expected last surgical suture, isoflurane was cutoff and equal amount of test solution was given when train-of-four ratio was 0.3. The degree of sedation, airway, and circulatory responses at the time of suction and extubation were analyzed. Statistical Analysis Used: Chi-square test for nonparametric data and t-test for parametric data. Results: Heart rate (HR) was comparable in both the groups until endotracheal extubation. Later, there was rise in HR in fentanyl group. There was stastisticaly significant drop in blood pressure at 5 min after test drug administration in both the groups. Airway response for suctioning and extubation was better in dexmedetomidine group and it was associated with better sedation score than fentanyl group. Conclusion: Single dose of 0.75 μg/kg dexmedetomidine given 15 min before extubation provides smooth extubation when compared to fentanyl. PMID:27746558

  16. Low-dose bupivacaine spinal anaesthesia for percutaneous nephrolithotomy: the suitability and impact of adding intrathecal fentanyl.

    Science.gov (United States)

    Atallah, M M; Shorrab, A A; Abdel Mageed, Y M; Demian, A D

    2006-08-01

    Unilateral spinal anaesthesia has been used for lower limb surgery with a stable cardiovascular state and a short recovery unit stay. We sought to test the suitability of low-dose bupivacaine spinal anaesthesia for percutaneous nephrolithotomy, a procedure hitherto performed under general anaesthesia. Furthermore, we hypothesized that adding intrathecal fentanyl to bupivacaine may improve the quality of anaesthesia. We randomly allocated, through computer-generated randomization, 108 patients subjected to percutaneous nephrolithotomy to receive either 7.5 mg of hyperbaric bupivacaine 5 mg/ml alone or with the addition of 10 microg of fentanyl. Drugs were given at the L(2)-L(3) interspace with the patient in the lateral decubitus position. The patients remained in this position for 10 min, after which the sensory and motor blocks were assessed. Intra-operative analgesic supplementation, when deemed necessary, was achieved with intravenous fentanyl boluses (25 microg). The sensory and motor blocks after intrathecal bupivacaine and bupivacaine-fentanyl were similar. Sensory block, in both groups, reached the fifth and eighth thoracic dermatomes on the operative and non-operative sides, respectively. Deep motor block occurred on the operative side in all patients and in nearly 50% of patients on the non-operative side. The patients in the bupivacaine-fentanyl group required less intra-operative and post-operative analgesics, and both patients and endoscopists were better satisfied. This study demonstrated, for the first time, that intrathecal low-dose bupivacaine and fentanyl offers a reliable neuraxial block for patients subjected to percutaneous nephrolithotomy, with stable haemodynamics, good post-operative analgesia and acceptable patient and endoscopist satisfaction.

  17. Influence of tablet splitting on content uniformity of lisinopril/hydrochlorthiazide tablets.

    Science.gov (United States)

    Vranić, Edina; Uzunović, Alija

    2007-11-01

    Dose-related adverse effects of medications are a major problem in modern medical practice. The "correct" dose, based on drug company guidelines in package inserts, may not be correct for many patients. Tablet splitting or dividing has been an accepted practice for many years as a means of obtaining the prescribed dose of medication. As model tablets for this investigation, two batches of lisinopril- hydrochlorothiazide scored tablets labeled to contain 20/12.5 mg were used. The aim of this study was to establish possible influence of tablet splitting on content uniformity of lisinopril/hydrochlorthiazide tablets. Determination of the content uniformity of lisinopril and hydrochlorthiazide in our batches, was carried out by HPLC method. The results of content uniformity studies for halves of tablets containing combination of lisinopril-hydrochlorthiazide (supposed to contain 50% of stated 20/12.5 mg in the whole tablet) were: 49.60 +/-3.29% and 49.29+/-0.60 % (lisinopril); 50.33+/-3.50% and 50.69+/-1.95% (hydrochlorthiazide) for batch I and II, respectively. We can conclude that the results obtained in this study support an option of tablet splitting, which is very important for obtaining the required dosage when a dosage form of the required strength is unavailable, and for better individualization of the therapy.

  18. Tablet splitting: Product quality assessment of metoprolol succinate extended release tablets.

    Science.gov (United States)

    Zhao, Na; Zidan, Ahmed; Tawakkul, Mobin; Sayeed, Vilayat A; Khan, Mansoor

    2010-11-30

    Metoprolol succinate extended release tablets comprise a multiple unit system containing metoprolol succinate in a multitude of controlled release pellets. Each pellet acts as a separate drug delivery unit and is designed to deliver metoprolol continuously over the dosage interval. Despite the flexibility that controlled release pellets may offer, segregation is one of the challenges that commonly occur during tableting for such drug delivery system. Since all commercial metoprolol succinate extended release tablets are scored, they are deemed suitable for splitting. The present study was aimed at utilizing an innovative technology to determine the dose uniformity for split tablets. Four marketed drug products consisting of innovator and generics were evaluated for effect of splitting on weight, assay and content uniformity. Novel analytical tool such as near infrared (NIR) chemical imaging was used to visualize the distribution of metoprolol succinate and functional excipients on the surfaces of the marketed tablets. The non-homogeneous distribution of directly compressed metoprolol succinate beads on the surface of the tablets as well as the split intersection explained the large variation in the split tablets' weight and content uniformity results. The obtained results indicated the usefulness of NIR chemical imaging to determine the need for content uniformity studies for certain split tablets.

  19. Comparison of dipyrone/propofol versus fentanyl/propofol anaesthesia during surgery in rabbits.

    Science.gov (United States)

    Baumgartner, C; Koenighaus, H; Ebner, J; Henke, J; Schuster, T; Erhardt, W

    2011-01-01

    In this study, the investigation of the intraoperative effects of dipyrone (metamizol) on heart rate (HR), mean arterial pressure (MAP) and analgesic efficacy in rabbits is described for the first time. This was carried out to evaluate the cardiovascular stability achieved using dipyrone compared with fentanyl. In this prospective study, 17 female New Zealand White rabbits were randomly allocated to either one of two groups: dipyrone/propofol (DP) or fentanyl/propofol (FP). Anaesthesia was induced in both groups using propofol to effect (4.0-8.0 mg/kg intravenously) until the swallowing reflex was lost for intubation. After induction, anaesthesia was maintained with continuous infusion of propofol 1.5-1.7 mg/kg/min intravenously. Analgesics were then injected in defined boluses of either dipyrone 65 mg/kg or fentanyl 0.0053 mg/kg. After surgical tolerance, defined as loss of the ear pinch reflex and loss of the anterior and posterior pedal withdrawal reflex, was achieved, two surgical procedures were performed. The surgical procedures (implantation of either a pacemaker or an electrocardiogram transmitter), both require a comparable level of analgesic depth. During and after surgery, clinical variables, such as MAP, HR, peripheral arterial oxygen saturation (SpO₂) and end-tidal CO₂ (P(E')CO₂) were recorded simultaneously every 2 min. Eight time points were chosen for comparison: baseline, surgical tolerance (ST), values at 10, 20 and 30 min after reaching ST, values at the end of propofol infusion (EI) and data at 10 and 20 min after EI. Both FP and DP combinations provided effective anaesthesia and analgesia in rabbits. In both groups a significant decrease of HR and MAP was measured. The results of this study indicate that the non-opioid drug dipyrone produces similar analgesic and even better cardiovascular effects by trend in rabbits. Therefore we conclude that dipyrone in combination with propofol can be used as an alternative to FP for intraoperative

  20. Oxycodone versus fentanyl for intravenous patient-controlled analgesia after laparoscopic supracervical hysterectomy

    Science.gov (United States)

    Kim, Nan Seol; Lee, Jeong Seok; Park, Su Yeon; Ryu, Aeli; Chun, Hea Rim; Chung, Ho Soon; Kang, Kyou Sik; Chung, Jin Hun; Jung, Kyung Taek; Mun, Seong Taek

    2017-01-01

    Abstract Background: Oxycodone, a semisynthetic thebaine derivative opioid, is widely used for the relief of moderate to severe pain. The aim of this study was to compare the efficacy and side effects of oxycodone and fentanyl in the management of postoperative pain by intravenous patient-controlled analgesia (IV-PCA) in patients who underwent laparoscopic supracervical hysterectomy (LSH). Methods: The 127 patients were randomized to postoperative pain treatment with either oxycodone (n = 64, group O) or fentanyl group (n = 63, group F). Patients received 7.5 mg oxycodone or 100 μg fentanyl with 30-mg ketorolac at the end of anesthesia followed by IV-PCA (potency ratio 75:1) for 48 hours postoperatively. A blinded observer assessed postoperative pain based on the numerical rating scale (NRS), infused PCA dose, patient satisfaction, sedation level, and side effects. Results: Accumulated IV-PCA consumption in group O was less (63.5 ± 23.9 mL) than in group F (85.3 ± 2.41 mL) during the first 48 hours postoperatively (P = 0.012). The NRS score of group O was significantly lower than that of group F at 4 and 8 hours postoperatively (P dizziness, and drowsiness was significantly higher in group O than in group F. Patient satisfaction was lower in group O than in group F during the 48 hours after surgery (P dizziness, and drowsiness, suggests that the doses used in this study were not equipotent. PMID:28272250

  1. COMPARISON OF DEXMEDETOMIDINE, BUPRENORPHINE AND FENTANYL AS AN ADJUVANT TO BUPIVACAINE DURING SPINAL ANAESTHESIA FOR HEMIARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    Pradeep R

    2016-10-01

    Full Text Available BACKGROUND Opioids such as fentanyl or buprenorphine are being added as adjuvant to local anaesthetic for spinal anaesthesia. Dexmedetomidine, a new α2 agonist is being tried as an adjuvant in the recent times. MATERIALS AND METHODS The patients were randomised into three Groups (n=30 each by closed envelope technique. Patients in Group 1 received 10 µg fentanyl with 15 mg of 0.5% hyperbaric bupivacaine, Group 2 received 15 mg of 0.5% hyperbaric bupivacaine supplemented with 30 µg of buprenorphine and Group 3 received 15 mg of 0.5% hyperbaric bupivacaine plus 5 µg dexmedetomidine intrathecally. The time to reach maximum sensory and motor level, the regression time of the same, any adverse effects were recorded. Data were analysed using chi-square test or Fisher’s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was accepted as statistically significant. Settings and Design- The study was conducted in a prospective, randomised and double-blind manner. It included ninety American Society of Anaesthesiologists class I and II patients undergoing hemiarthroplasty under spinal anaesthesia. RESULTS In this study, the patients in dexmedetomidine group showed significantly longer duration of motor block (240±20 mins. and sensory blockade (180±22.2 mins. compared to other groups, which is statistically significant (P=0.0001 and P=0.006, respectively. The time to first request of analgesic postoperatively was also longer (260±30.2 in dexmedetomidine group when compared with other groups (P=0.0001. Haemodynamic parameters were stable and there were no complications in any group. CONCLUSIONS We concluded that intrathecal dexmedetomidine (5 µg with bupivacaine provides significantly longer duration of sensory and motor blockade and longer duration for first request of analgesia in the recovery than intrathecal buprenorphine (30 µg or fentanyl (10 µg with bupivacaine for spinal anaesthesia for

  2. Sufentanil reduces emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl

    Institute of Scientific and Technical Information of China (English)

    LI Jun; HUANG Zhi-lian; ZHANG Xu-tong; LUO Ke; ZHANG Zhan-qin; MAO Yi; ZHUANG Xiao-biao; LIAN Qing-quan; CAO Hong

    2011-01-01

    Background Emergence agitation is a common problem in pediatric anesthesia,especially after sevoflurane induction and maintenance anesthesia.The purpose of this study was to investigate the effect of sufentanil to reduce emergence agitation after sevoflurane anesthesia in children undergoing adenotonsillectomy compared with fentanyl.Methods One hundred and five children,aged 3-11 years,were randomly allocated to receive normal saline (control group),sufentanil 0.2 μg/kg (S2) or fentanyl 2 μg/kg (F2) 1 minute after loss of the eyelash reflex.Anesthesia was induced and maintained with sevoflurane.Time to tracheal extubation,recovery time,Paediatric Anesthesia Emergence Delirium (PAED) scale,and emergence behavior were assessed.Results The incidence of severe agitation was significantly lower in S2 and F2 groups vs.the control group,4/32 and 15/34 vs.24/34 respectively,(P=0.002,0.009,respectively).PAED scales were significantly different among three groups (P=0.007),and lower in the S2 and F2 groups than in the control group (P=0.007 and P=0.025,respectively).And the incidence of severe agitation and the PAED scale score was significantly different between the S2 and F2 groups (P=0.007,P=0.019,respectively).Time to tracheal extubation and recovery time were similar in all three groups.Conclusions Administration of sufentanil at 0.2 μg/kg after induction of anesthesia reduced emergence agitation in children receiving sevoflurane anesthesia for adenotonsillectomy compared with fentanyl.This was without delaying the recovery time or causing significant hypotension.

  3. Patient-controlled intravenous fentanyl for cystospasm after transurethral resection of the prostate

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective: To evaluate the clinical efficacy and safety of patient-controlled intravenous analgesia (PCIA) with fentanyl for cystospasm after transurethral resection of the prostate. Methods: Sixty benign prostatic hyperplasia (BPH) patients scheduled for transurethral resection of the prostate (TURP) under general anesthesia with laryngeal mask airway (LMA) were randomly divided into groups F and S. Group F (n=30) received PCIA device with fentanyl 10 μg/kg+8 mg ondansetron, and Group S (n=30) received placebo (PCIA device with 8 mg ondansetron). The visual analog scale (VAS) scores for pain were evaluated at 0, 2, 4, 8, 16, 24, and 48 h by the same staff. And recorded were incidence of cystospasm, side effects, application of hemostatic, duration of drawing Foley catheter and continuous bladder irrigation, time of exhaust after operation, time of post-operative stay and cost of hospitalization. Results: The incidence of cystospasm in Group F was significantly lower than that in Group S in the 48 h after operation (P<0.05), the VAS scores for pain in Group F was significantly lower than that in Group S within the 48 h after operation (P<0.01). The time of exhaust after operation in Group F was significantly later than in Group S (P<0.05). No significant difference was observed in applications of hemostatic, duration of drawing Foley catheter, duration of continuous bladder irrigation, time of post-operative stay and cost of hospitalization between the 2 groups. Conclusion: PCIA with fentanyl (10 μg/kg) relieves pain with little side effect and reduces cystospasm satisfactorily.

  4. Comparison of Postoperative Analgesic Effects of Thoracic Epidural Morphine and Fentanyl

    Directory of Open Access Journals (Sweden)

    Gönül Sağıroğlu

    2011-11-01

    Full Text Available Objective: In our study, we aimed to compare epidural morphine and fentanyl analgesia and the side effects in post-thoracotomy pain management. Material and Methods: Forty patients, planned for elective thoracotomy were included. Bupivacain- morphine was administered through an epidural catheter to the patients in Group-M while bupivacain-fentanyl was given in Group-F. Pain assessment was carried out with the Visual Analogue Scale (VAS and VAS-I and VAS-II were assessed in 0, 4, 16 and 24th hour in the postoperative unit. Adverse effects were recorded after the 24th hour. Statistical analyses were performed by using Two-sample independent-t test, Mann Whitney-U test, Wilcoxon-signed ranks test and Pearson chi-squared tests. Results: Although, the VAS-I and VAS-II scores were lower in Group-M than Group-F, the difference was not significant statistically (p>0.05. When other hours were compared with initial states, beginning from the 4th hour, in both groups there was a statistically significant drop in VAS-I and VAS-II scores at all times (p<0.001. Comparing the complications between the groups, in Group-M nausea-vomiting (p<0.015 and bradycardia (p<0.012 were found significantly more frequently than in Group-F. Conclusion: We concluded that, in pain management after thoracic surgery, either morphine or fentanyl may be chosen in thoracal epidural analgesia but, especially in the early postoperative hours, close follow-up is necessary due to the risk of bradycardia development.

  5. Spinal mepivacaine with fentanyl for outpatient knee arthroscopy surgery: a randomized controlled trial.

    Science.gov (United States)

    O'Donnell, Dermot; Manickam, Baskar; Perlas, Anahi; Karkhanis, Reena; Chan, Vincent W S; Syed, Khalid; Brull, Richard

    2010-01-01

    The foremost limitation of local anesthetic solutions for spinal anesthesia in the outpatient setting is prolonged motor blockade and delayed ambulation. The purpose of this study was to determine if the addition of intrathecal fentanyl to low-dose spinal mepivacaine provides adequate anesthesia with shorter duration of functional motor blockade for ambulatory knee surgery compared with spinal mepivacaine alone. Following institutional review board approval and informed consent, 34 patients undergoing unilateral knee arthroscopy were enrolled in this study. The patients were randomly assigned to receive either 30 mg of isobaric mepivacaine 1.5% plus fentanyl 10 microg (M + F group) or 45 mg of isobaric mepivacaine 1.5% alone (M group) intrathecally. Postoperatively, the times to achieve sensory block regression to the S1 dermatome and to attain functional motor block recovery enabling ambulation were recorded. All assessments were blinded. The time to completion of Phase I recovery was shorter in the M + F group (104.6 +/- 28.4 min) than in the M group (129.1 +/- 30.4 min; P = 0.023). Regression of sensory blockade to S1 was earlier in the M + F group (118.4 +/- 53.5 min) than in the M group (169.7 +/- 38.9 min; P = 0.003). Patients in the M + F group (176.4 +/- 40.3 min) were able to ambulate significantly earlier than those in the M group (205.6 +/- 31.4 min; P = 0.025). No cases of transient or persistent neurological dysfunction were noted. When compared with 45 mg isobaric mepivacaine 1.5%, an intrathecal dose of 30 mg isobaric mepivacaine 1.5% plus 10 microg fentanyl produces reliable anesthesia, hastens block regression, shortens stay in Phase I recovery, and enables earlier ambulation for patients undergoing unilateral knee arthroscopy (Registration no. NCT00803725).

  6. The Effect of Intravenous Fentanyl on Pain and Duration of the Active Phase of First Stage Labor

    OpenAIRE

    Nahid Jahani Shoorab; Samira Ebrahimzadeh Zagami; Kobra Mirzakhani; Seyed Reza Mazlom

    2013-01-01

    Objectives: Opioids are most widely used for pain relief during childbirth. An alternative opioid, fentanyl, has been shown to be a good option for pain management and has fewer side-effects on both mother and fetus. Therefore, the purpose of this study is to determine the effect of fentanyl on pain as well as the duration of the active phase of labor.Methods: This clinical trial was conducted on 70 multiparous parturients having labor from May to July 2006 at Tamin Ejtemai Hospital. They wer...

  7. Fentanyl Enhances Hepatotoxicity of Paclitaxel via Inhibition of CYP3A4 and ABCB1 Transport Activity in Mice.

    Directory of Open Access Journals (Sweden)

    Jing-Dun Xie

    Full Text Available Fentanyl, a potent opioid analgesic that is used to treat cancer pain, is commonly administered with paclitaxel in advanced tumors. However, the effect of fentanyl on the hepatotoxicity of paclitaxel and its potential mechanism of action is not well studied. The purpose of this study was to investigate the effect of fentanyl on the hepatotoxicity of paclitaxel and its potential mechanisms of action. Pharmacokinetic parameters of paclitaxel were tested using reversed phase high-performance liquid chromatography (RP-HPLC. Aspartate transaminase (AST, alanine aminotransferase (ALT, and mouse liver histopathology were examined. Moreover, the cytotoxicity of anti-carcinogens was examined using 1-(4, 5-dimethylthiazol-2-yl-3,5-diphenylformazan (MTT, and the intracellular accumulation of doxorubicin and rhodamine 123 was detected by flow cytometry. Furthermore, the expression of ABCB1 and the activity of ABCB1 ATPase and CYP3A4 were also examined. In this study, the co-administration of fentanyl and paclitaxel prolonged the half-life (t1/2 of paclitaxel from 1.455 hours to 2.344 hours and decreased the clearance (CL from 10.997 ml/h to 7.014 ml/h in mice. Fentanyl significantly increased the levels of ALT in mice to 88.2 U/L, which is more than 2-fold higher than the level detected in the control group, and it increased the histological damage in mouse livers. Furthermore, fentanyl enhanced the cytotoxicity of anti-carcinogens that are ABCB1 substrates and increased the accumulation of doxorubicin and rhodamine 123. Additionally, fentanyl stimulated ABCB1 ATPase activity and inhibited CYP3A4 activity in the liver microsomes of mice. Our study indicates that the obvious hepatotoxicity during this co-administration was due to the inhibition of CYP3A4 activity and ABCB1 transport activity. These findings suggested that the accumulation-induced hepatotoxicity of paclitaxel when it is combined with fentanyl should be avoided.

  8. [Experimental investigations of the analgesic activity of fentanyl and the non-opiodal agents -clonidine and isradipine, and protease inhibitors].

    Science.gov (United States)

    Pyregov, A V; Aliautdin, R N; Petrov, V E; Pivovarova, G M; Siluianova, E V; Gur'ianov, V A

    2007-01-01

    The analgesic activity of clonidine, isradipine, antagosane (aprotinine), transamine, and their combinations with fentanyl in subanalgesic doses was experimentally studied on mice, by using the tail-flick test. Analgesic activity was found in clonidine, antagosane, and transamine. A combination of fentanyl used in subanalgesic doses and clonidine, isradipine, antagosane, or transamine had supertotal analgesic activity. The findings serve as a basis for effectively making up a component of analgesia during anesthetic support at surgery made in patients with baseline sympathicotonia, ischemia/reperfusion syndrome, and a systemic inflammatory reaction.

  9. Pain management in the elderly: transdermal fentanyl for the treatment of pain caused by osteoarthritis of the knee and hip.

    Science.gov (United States)

    Mordarski, Sylwester

    2014-01-01

    This study was designed to evaluate the utility of transdermal fentanyl (transdermal fentanyl, TDF) for the treatment of pain due to osteoarthritis (osteoarthritis, OA) of the knee and hip, which was not adequately controlled by nonopioid analgesics or weak opioids. WOMAC is a reliable, valid, and responsive multidimensional, self-administrated outcome measure designed specifically to evaluate patients with OA of the knee or hip. TDF significantly increased pain control and improved functioning and quality of life. Metoclopramide appeared to be of limited value in preventing nausea and vomiting.

  10. Abuse and rational use of fentanyl%芬太尼的滥用及监测管理

    Institute of Scientific and Technical Information of China (English)

    马军丽; 逄立艳; 钟蕾; 张黎明

    2012-01-01

      Object: To provide information in the clinical rational use and for scientific supervision, by understanding of the pharmacological characteristics and the risk of abuse of fentanyl, and analysis of their abuse at home and abroad. Method: We retrievaled fentanyl abuse reports at home and abroad, summarizing and analyzing drug abuse data related to fentanyl in recent years. Reslut: Fentanyl has the potential for abuse due to its unique pharmacological properties, literature and monitoring data show that fentanyl abuse occurred in Europe and the United States since the fentanyl listed, the report of fentanyl abuse also occurred in Beijing. Conclusion:The irrational use of the fentanyl class wil lead to serious risks. Clinicians, patients, drug administration departments should enhance the understanding of its risk of abuse, and actively avoid the occurrence of irrational use, and put an end to the abuse incident.%  目的:了解芬太尼的药理特性及滥用风险,分析其国内外的滥用情况,为该药在临床的合理使用及科学监管提供参考。方法:检索国内外芬太尼滥用的文献报道,汇总近年来国内外药物滥用数据中有关芬太尼的数据并进行分析。结果:芬太尼由于其独特的药理特性存在被滥用的可能,文献报告和监测数据表明,自芬太尼上市以来欧美国家相继发生芬太尼滥用现象,北京市也存在芬太尼滥用的监测报告。结论:芬太尼类化合物的不合理使用会带来严重的安全隐患,临床医生、患者、药品监管部门都应当增强对其滥用风险的认识,积极避免不合理用药情况的出现。

  11. In vitro, ex vivo and in vivo examination of buccal absorption of metoprolol with varying pH in TR146 cell culture, porcine buccal mucosa and Göttingen minipigs

    DEFF Research Database (Denmark)

    Holm, René; Meng-Lund, Emil; Andersen, Morten B.;

    2013-01-01

    This work studied the buccal absorption of metoprolol in vitro, ex vivo and in vivo as a function of buffered pH at 7.4, 8.5, 9.0 and 9.5. Permeability studies showed a correlation (r(2)=0.92) between in vitro TR146 cell culture and ex vivo porcine buccal mucosa in a modified Ussing chamber...

  12. Comparison of Effect of Intrathecal Sufentanil-Bupivacaine and Fentanyl-Bupivacaine Combination on Postoperative Analgesia

    Directory of Open Access Journals (Sweden)

    Ishwar Singh

    2008-01-01

    Full Text Available Fifty ASA grade I/II patients scheduled for elective lower abdominal, lower limb and urological procedures were divided into two groups of 25 each .The first group (Group S received 2.5 ml of heavy bupivacaine with 0.2. ml sufentanil made up to 3 ml with saline. The second group (Group F received 2.5 ml of heavy bupivacaine with 0.5 ml of fentanyl. From our study it can be concluded that bupivacaine sufentanil combination although had shorter onset of action, but had more side effects especially nausea, vomiting and headache. The time for rescue analgesia in both groups was however similar.

  13. Use of intranasal fentanyl for the relief of pediatric orthopedic trauma pain.

    Science.gov (United States)

    Saunders, Mary; Adelgais, Kathleen; Nelson, Douglas

    2010-11-01

    The objective was to evaluate the use of a single 2 μg/kg dose of intranasal fentanyl as analgesia for painful orthopedic injuries in children presenting to a pediatric emergency department (ED). This was a prospective, nonblinded interventional trial, in a convenience sample of patients 3 to 18 years of age seen in a tertiary care pediatric ED. All had clinically suspected fractures and were treated between July and November 2006. Eligible patients had moderate to severe pain based on initial pain scores using the Wong Baker Faces Scale (WBS) for patients aged 3-8 years or the Visual Analog Scale (VAS) for patients aged 9-18 years. All enrolled patients received fentanyl via intranasal atomization. Pain scores were obtained at baseline and at 10, 20, and 30 minutes after intranasal fentanyl administration. Satisfaction scores were obtained using a 100-mm VAS. Vital signs and adverse events were recorded. Eighty-one patients were enrolled, 28 in the VAS group and 53 in the WBS group. The mean patient age was 8 years. Fracture locations included forearm, 38 (47%); supracondylar, 16 (20%); clavicle, 7 (9%); tibia/fibula, 5 (6%); and other, 15 (18%). In the WBS group, the median pain scores decreased from five faces (interquartile range [IQR] = 4-6) at baseline to three faces (IQR = 2-5) at 10 minutes, two faces (IQR = 1-4) at 20 minutes, and two faces (IQR = 1-3) at 30 minutes. The mean pain score in the VAS group at baseline was 70 mm (95% confidence interval [CI] = 63 to 77 mm). In this group, the pain scores decreased by a mean of 21 mm (95% CI = 14 to 28 mm) at 10 minutes, 25 mm (95% CI = 15 to 34 mm) at 20 minutes, and 27 mm (95% CI = 16 to 37 mm) at 30 minutes. Mean satisfaction scores were 79 mm for providers, 74 mm for parents, and 62 mm for patients. No adverse events were recorded.   Intranasal fentanyl at a dose of 2 μg/kg provides effective analgesia for pediatric ED patients with painful orthopedic trauma within 10 minutes of administration. © 2010

  14. Infusion of Pentobarbital and Fentanyl Combination for Long-Term Anaesthesia in Pigs

    OpenAIRE

    KILIÇ, Nuh

    2004-01-01

    The cardiopulmonary and clinical effects of the infusion of pentobarbital sodium in combination with fentanyl for long-term anaesthesia in 9 pigs were investigated. Pigs were premedicated with i.m. atropine at a dose of 0.05 mg/kg and azaperon at a dose of 2 mg/kg. General anaesthesia was induced with i.v. thiopental sodium at a dose of 3.3 mg/kg. After induction of anaesthesia, the pigs were intubated and supplied with oxygen during anaesthesia. Anaesthesia was maintained with an i.v. infusi...

  15. Comparative evaluation of dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2011-01-01

    Full Text Available Background and Aims: Opioids as epidural adjunct to local anesthetics (LA have been in use since long and α-2 agonists are being increasingly used for similar purpose. The present study aims at comparing the hemodynamic, sedative, and analgesia potentiating effects of epidurally administered fentanyl and dexmedetomidine when combined with ropivacaine. Methods: A total of one hundred patients of both gender aged 21-56 years, American Society of Anaesthesiologist (ASA physical status I and II who underwent lower limb orthopedic surgery were enrolled into the present study. Patients were randomly divided into two groups: Ropivacaine + Dexmedetomidine (RD and Ropivacaine + Fentanyl (RF, comprising 50 patie nts each. Inj. Ropivacaine, 15 ml of 0.75%, was administered epidurally in both the groups with addition of 1 μg/kg of dexmedetomidine in RD group and 1 μg/kg of fentanyl in RF group. Besides cardio-respiratory parameters and sedation scores, various block characteristics were also observed which included time to onset of analgesia at T10, maximum sensory analgesic level, time to complete motor blockade, time to two segmental dermatomal regressions, and time to first rescue analgesic. At the end of study, data was compiled systematically and analyzed using ANOVA with post-hoc significance, Chi-square test and Fisher′s exact test. Value of P<0.05 is considered significant and P<0.001 as highly significant. Results: The demographic profile of patients was comparable in both the groups. Onset of sensory analgesia at T10 (7.12±2.44 vs 9.14±2.94 and establishment of complete motor blockade (18.16±4.52 vs 22.98±4.78 was significantly earlier in the RD group. Postoperative analgesia was prolonged significantly in the RD group (366.62±24.42 and consequently low dose consumption of local anaesthetic LA (76.82±14.28 vs 104.35±18.96 during epidural top-ups postoperatively. Sedation scores were much better in the RD group and highly significant on

  16. Factors affecting the possibility to detect buccal bone condition around dental implants using cone beam computed tomography

    DEFF Research Database (Denmark)

    Liedke, Gabriela S; Spin-Neto, Rubens; da Silveira, Heloisa E D

    2017-01-01

    OBJECTIVES: To evaluate factors with impact on the conspicuity (possibility to detect) of the buccal bone condition around dental implants in cone beam computed tomography (CBCT) imaging. MATERIAL AND METHODS: Titanium (Ti) or zirconia (Zr) implants and abutments were inserted into 40 bone blocks...... in a way to obtain variable buccal bone thicknesses. Three combinations regarding the implant-abutment metal (TiTi, TiZr, or ZrZr) and the number of implants (one, two, or three) were assessed. Two CBCT units (Scanora 3D - Sc and Cranex 3D - Cr) and two voxel resolutions (0.2 and 0.13 mm) were used....... Reconstructed sagittal images (2.0 and 5.0 mm thickness) were evaluated by three examiners, using a dichotomous scale when assessing the condition of the buccal bone around the implants. A multivariate logistic regression was performed using examiners' detection of the buccal bone condition as the dependent...

  17. The role of tobacco as an etiological agent for oral cancer: Cytomorphometrical analysis of the buccal mucosa in tobacco users

    Directory of Open Access Journals (Sweden)

    Megha Singh

    2014-01-01

    Conclusion: The results confirmed that tobacco chewing and smoking influenced the cytomorphology of normal appearing buccal mucosa and the degree of these changes were found to be greater in chewers as compared to smokers.

  18. Radiation risk assessment in professionals working in dental radiology area using buccal micronucleus cytome assay.

    Science.gov (United States)

    Sadatullah, Syed; Dawasaz, Ali Azhar; Luqman, Master; Assiry, Ali A; Almeshari, Ahmed A; Togoo, Rafi Ahmad

    2013-11-01

    The aim of this study was to assess the incidence of micronuclei (MN) in buccal mucosal cells of professionals working in radiology area to determine the risk of stochastic effects of radiation. All the professionals and students working in King Khalid University - College of Dentistry radiology area were included in the Risk Group (RG = 27). The Control Group (CG = 27) comprised of healthy individual matching the gender and age of the RG. Buccal mucosal scraping from all the 54 subjects of RG and CG were stained with Papanicolaou stain and observed under oil immersion lens (×100) for the presence of micronuclei (MN) in the exfoliated epithelial cells. There was no significant difference between the incidence of MN in RG and CG (p = >0.05) using t-test. Routine radiation protection protocol does minimize the risk of radiation induced cytotoxicity, however, screening of professionals should be carried out at regular intervals.

  19. A buccal cell model comet assay: Development and evaluation for human biomonitoring and nutritional studies

    Energy Technology Data Exchange (ETDEWEB)

    Szeto, Y.T. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); School of Health Sciences, Macao Polytechnic Institute, Macao (China); Benzie, I.F.F. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China)]. E-mail: iris.benzie@inet.polyu.edu.hk; Collins, A.R. [Department of Nutrition, University of Oslo, Oslo (Norway); Choi, S.W. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Cheng, C.Y. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Yow, C.M.N. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Tse, M.M.Y. [School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong (China)

    2005-10-15

    The comet assay is a widely used biomonitoring tool for DNA damage. The most commonly used cells in human studies are lymphocytes. There is an urgent need to find an alternative target human cell that can be collected from normal subjects with minimal invasion. There are some reports of buccal cells, collected easily from the inside of the mouth, being used in studies of DNA damage and repair, and these were of interest. However, our preliminary studies following the published protocol showed that buccal cells sustained massive damage and disintegrated at the high pH [O. Ostling, K.J. Johanson. Microelectrophoretic study of radiation-induced DNA damages in individual mammalian cells. Biochem. Biophys. Res. Commun. 123 (1984) 291-298] used, but that at lower pH were extremely resistant to lysis, an essential step in the comet assay. Therefore, the aims of this study were to develop a protocol than enabled buccal cell lysis and DNA damage testing in the comet assay, and to use the model to evaluate the potential use of the buccal cell model in human biomonitoring and nutritional study. Specifically, we aimed to investigate intra- and inter-individual differences in buccal cell DNA damage (as strand breaks), the effect of in vitro exposure to both a standard oxidant challenge and antioxidant treatment, as well as in situ exposure to an antioxidant-rich beverage and supplementation-related effects using a carotenoid-rich food. Successful lysis was achieved using 0.25% trypsin for 30 min followed by proteinase K (1 mg/ml) treatment for 60 min. When this procedure was performed on cells pre-embedded in agarose on a microscope slide, followed by electrophoresis (in 0.01 M NaOH, 1 mM EDTA, pH 9.1, 18 min at 12 V), a satisfactory comet image was obtained, though inter-individual variation was quite wide. Pre-lysis exposure of cells to a standard oxidant challenge (induced by H{sub 2}O{sub 2}) increased DNA strand breaks in a dose related manner, and incubation of cells in

  20. [Relation between natural bacterial colonization and adhesion to human buccal epithelium].

    Science.gov (United States)

    Maianskiĭ, A N; Vorob'eva, O N; Malysheva, E F; Malyshev, Iu V

    1987-02-01

    As the results of the quantitative study of Streptococcus salivarius adhering to buccal epithelial cells, three levels of their natural colonization were established: low (less than 20 bacteria per epithelial cell), medium (20-50 bacteria), and high (more than 50 bacteria). The characteristics of natural colonization by S. salivarius inversely correlated with the resistance of epithelial cells to the adhesion of Pseudomonas aeruginosa. In the process of interaction with P. aeruginosa highly adhesive strain, S. salivarius, naturally colonizing the cells of the buccal epithelium, decreased in number 2-10 times up to complete desorption. These results may be regarded as the manifestation of one of the mechanisms regulating the microecological balance in the system of mucous membranes.

  1. Rare carcinoma ex pleomorphic adenoma of the buccal minor salivary gland causing a therapeutic dilemma

    Directory of Open Access Journals (Sweden)

    Yogesh Kini

    2012-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA, as a group, constitutes 12% of malignant salivary gland tumors. We present a case of CXPA of the buccal mucosa in a 17-year-old patient. The buccal mass was of a size of 3.0 cm located in the right cheek. Pleomorphic adenoma was the provisional diagnosis. The tumor was excised under local anesthesia. Histopathological evaluation revealed a pre-existing pleomorphic adenoma. However, on magnification, certain areas showed islands of dysplastic epithelial cells′ invading the fibrous capsule and CXPA was diagnosed. The patient was recalled and secondary surgery of the site performed. No tumor tissue could be detected in the secondary resection specimen. There is no sign of recurrence since 2 years.

  2. Three-dimensional canine loop for management of buccally erupted canines

    Directory of Open Access Journals (Sweden)

    Praveen Mehrotra

    2015-01-01

    Full Text Available Maxillary canines are known as the cornerstones of mouth. They are considered to be important for esthetics and for functional occlusion. Any disturbance in the eruption process leading to an aberrant position will hamper esthetics as well as function. Orthodontic tooth movement of total buccally blocked-out canine is usually difficult as it is related with the problems of severe crowding, midline deviation, involvement of long root movement and risk of gingival recession. Such conditions can be treated orthodontically in various ways, but this clinical innovation helps to correct the buccally placed canines into the arch with a precise control of the canine in all the Three-dimensions (3D of space as well as providing maximum comfort to the patient by placing the canine loop on the palatal surface of the tooth, reducing soreness on the labial mucosa. It can be easily fabricated and activated at chairside for either simultaneous or sequential control in 3D.

  3. Effect of zinc deficiency on keratins in buccal epithelium of rats.

    Science.gov (United States)

    Hsu, D J; Daniel, J C; Gerson, S J

    1991-01-01

    Weanling rats fed a zinc-deficient diet (less than 1 part/10(6)) for 4 weeks develop parakeratotic and hyperplastic buccal epithelium with increased mitotic activity. Normal buccal epithelium contains major keratin polypeptides of 56, 46 and 43 kDa. Four-week zinc-deficient rats lacked the 43 kDa keratin. It appears that the 46 and 43 kDa keratins are related, differing as a result of some post-translation modification. A proteolytic cleavage of the 46 kDa keratin to the 43 kDa species is the most likely mechanism. The findings point to a decrease of keratinolytic enzyme activity in the zinc-deficient rats.

  4. The cytological status of the nasal mucosa and the buccal epithelium in coal miners

    Energy Technology Data Exchange (ETDEWEB)

    L.T. Bazeliuk; B.M. Salimbaeva

    2006-11-15

    Sixty-four persons were examined. The examination was undertaken to study the cytomophological parameters of the cells of the nasal mucosa and the buccal epithelium in coal miners. Group 1 consisted of 18 donors without contact with industrial dust; Group 2 comprised 24 apparently healthy miners; Group 3 included 22 workers (drift miners) with Stage 1 anthracosilicosis, grade 1 respiratory failure. The patients with Stage 1 anthracosilicosis had noticeably worse morphofunctional characteristics of the epithelium that displayed extensive fields with pronounced structural changes, such as destruction and desquamation of the integumentary epithelium of the nasal mucosa. Nasal mucosal atrophic changes were observed in 50% of the examined miners. Examination of the buccal epithelium in apparently healthy miners (code 0) and in workers with Stage I anthracosilicosis revealed the increased proportion of microfloral (Streptococcus) contamination by 79% and 3.7 times, respectively.

  5. Effect of repeated compaction of tablets on tablet properties and work of compaction using an instrumented laboratory tablet press.

    Science.gov (United States)

    Gamlen, Michael John Desmond; Martini, Luigi G; Al Obaidy, Kais G

    2015-01-01

    The repeated compaction of Avicel PH101, dicalcium phosphate dihydrate (DCP) powder, 50:50 DCP/Avicel PH101 and Starch 1500 was studied using an instrumented laboratory tablet press which measures upper punch force, punch displacement and ejection force and operates using a V-shaped compression profile. The measurement of work compaction was demonstrated, and the test materials were ranked in order of compaction behaviour Avicel PH101 > DCP/Avicel PH101 > Starch > DCP. The behaviour of the DCP/Avicel PH101 mixture was distinctly non-linear compared with the pure components. Repeated compaction and precompression had no effect on the tensile fracture strength of Avicel PH101 tablets, although small effects on friability and disintegration time were seen. Repeated compaction and precompression reduced the tensile strength and the increased disintegration time of the DCP tablets, but improved the strength and friability of Starch 1500 tablets. Based on the data reported, routine laboratory measurement of tablet work of compaction may have potential as a critical quality attribute of a powder blend for compression. The instrumented press was suitable for student use with minimal supervisor input.

  6. Astronomy Learning Activities for Tablets

    Science.gov (United States)

    Pilachowski, Catherine A.; Morris, Frank

    2015-08-01

    Four web-based tools allow students to manipulate astronomical data to learn concepts in astronomy. The tools are HTML5, CSS3, Javascript-based applications that provide access to the content on iPad and Android tablets. The first tool “Three Color” allows students to combine monochrome astronomical images taken through different color filters or in different wavelength regions into a single color image. The second tool “Star Clusters” allows students to compare images of stars in clusters with a pre-defined template of colors and sizes in order to produce color-magnitude diagrams to determine cluster ages. The third tool adapts Travis Rector’s “NovaSearch” to allow students to examine images of the central regions of the Andromeda Galaxy to find novae. After students find a nova, they are able to measure the time over which the nova fades away. A fourth tool, Proper Pair, allows students to interact with Hipparcos data to evaluate close double stars are physical binaries or chance superpositions. Further information and access to these web-based tools are available at www.astro.indiana.edu/ala/.

  7. Procedures for risk-stratification of lung cancer using buccal nanocytology

    OpenAIRE

    Subramanian, H; P. Viswanathan; Cherkezyan, L.; Iyengar, R; Rozhok, S.; Verleye, M.; Derbas, J.; Czarnecki, J.; Roy, H K; Backman, V

    2016-01-01

    Lung cancer is the leading cause of cancer deaths in the U.S. with survival dramatically depending on stage at diagnosis. We had earlier reported that nanocytology of buccal cells can accurately risk-stratify smokers for the presence of early and late-stage lung cancer. To translate the technique into clinical practice, standardization of operating procedures is necessary to consistently yield precise and repeatable results. Here, we develop and validate simple, robust, and easily implementab...

  8. Transmucosal delivery of oxytocin to rabbits using a mucoadhesive buccal patch.

    Science.gov (United States)

    Li, C; Bhatt, P P; Johnston, T P

    1997-08-01

    A biocompatible, mucoadhesive buccal patch was evaluated in rabbits for transmucosal delivery of peptides. Oxytocin (OT) was incorporated into custom coformulations of Carbopol 974P and silicone polymer and the resulting plasma OT concentration versus time profiles determined following patch application. For comparative purposes, the mean values determined for the elimination half-life (t1/2), volume of distribution (Vd), and the total body clearance (CL) following intravenous injection of OT were 2.9 +/- 0.2 min, 85.3 +/- 6.7 ml, and 20.4 +/- 2.03 ml/min, respectively. Following application of oxytocin-loaded mucoadhesive patches, plasma OT concentrations remained 20- to 28-fold greater from 0.5 to 3.0 hr than control animals administered placebo patches. The steady-state plasma OT concentration (Css) following application of the buccal patches was 80.6 +/- 15.9 pg/ml. The lag-time associated with attainment of the Css was 0.45 +/- 0.18 hr. Steady-state flux (Jss) of oxytocin in vivo was 139 +/- 36.8 ng/hr/cm2. Based on the amount of OT remaining in the patches following removal, the average dose of OT released in vivo was 0.27 +/- 0.024 mg with a bioavailability of 0.1%. No significant alterations in mucosal histology were observed when underlying mucosa to which OT patches had been applied were compared to either control (no patch) mucosa or mucosa underneath placebo patches. The mucoadhesive buccal patches were easy to apply and remove, nonirritating to tissue, and able to continuously deliver a nonapeptide over 3 hr. Based on these preliminary studies, the mucoadhesive buccal patches evaluated may represent an improved transmucosal drug delivery system for peptides and conventional drug substances.

  9. Direct PCR amplification of the HVSI region in mitochondrial DNA from buccal cell swabs

    Directory of Open Access Journals (Sweden)

    Kovačević-Grujičić Nataša

    2012-01-01

    Full Text Available Amplification of human mitochondrial DNA (mtDNA has been widely used in population genetics, human evolutionary and molecular anthropology studies. mtDNA hypervariable segments I and II (HVSI and HVSII were shown to be a suitable tool in genetic analyses due to the unique properties of mtDNA, such as the lack of recombination, maternal mode of inheritance, rapid evolutionary rate and high population-specific polymorphisms. Here we present a rapid and low-cost method for direct PCR amplification of a 330 bp fragment of HVSI from buccal cell samples. Avoiding the DNA isolation step makes this method appropriate for the analysis of a large number of samples in a short period of time. Since the transportation of samples and fieldwork conditions can affect the quality of samples and subsequent DNA analysis, we tested the effects of long-term storage of buccal cell swabs on the suitability of such samples for direct PCR amplification. We efficiently amplified a 330 bp fragment of HVSI even after the long-term storage of buccal cells at room temperature, +4°C or at -20°C, for up to eight months. All examined PCR products were successfully sequenced, regardless of sample storage time and conditions. Our results suggest that the direct PCR amplification of the HVSI region from buccal cells is a method well suited for large-scale mtDNA population studies.[Acknowledgments. This work was supported by the Ministry of Education and Science of the Republic of Serbia (Grant no. III 47025.

  10. Evaluation of the scatter doses in the direction of the buccal mucosa from dental metals.

    Science.gov (United States)

    Shimamoto, Hiroaki; Sumida, Iori; Kakimoto, Naoya; Marutani, Keisuke; Okahata, Ryoko; Usami, Ai; Tsujimoto, Tomomi; Murakami, Shumei; Furukawa, Souhei; Tetradis, Sotirios

    2015-05-08

    The presence of dental metals creates radiation dose perturbation due to scattered radiation during radiation therapy for the head and neck region. The purpose of our study was to compare the scatter doses resulting from various dental metals in the direction of the buccal mucosa among a single-field technique, three-dimensional conformal radiation therapy (3D CRT), and intensity-modulated radiation therapy (IMRT) during radiation therapy for the head and neck region. We used nine metal cubes with 10 mm sides, which were placed inside a water phantom. The scatter doses from the cubes in the direction of the buccal mucosa were measured using radiochromic films. The films were placed perpendicularly to the surface of the cubes. The phantom was irradiated with a 4 MV photon energy by a linear accelerator for all techniques. In the single-field technique, the scatter doses from dental metals showed 3.7%-19.3% dose increases, and gold showed the largest dose increase. In 3D CRT, the scatter doses from dental metals showed 1.4%-6.9% dose increases, which were within the measurement uncertainty (except for gold). In IMRT, the scatter doses from dental metals showed only 1.4%-4.3% dose increases, which were all within the measurement uncertainty. During radiation therapy for the head and neck region, the scatter doses from the tested dental metals in the direction of the buccal mucosa in 3D CRT or IMRT were lower than those using the single-field technique. However, there were no differences between the scatter doses resulting from particular dental metals in the direction of the buccal mucosa in 3D CRT and those in IMRT, except for gold.

  11. BUCCAL ADVANCEMENT FLAP DAN ANTROSTOMI: UNTUK TERAPI ORO ANTRAL FISTULA (Laporan Kasus

    Directory of Open Access Journals (Sweden)

    Rizal Rivandi

    2015-08-01

    Full Text Available Buccal advancement flap is one of the many ways of treating oro antral fistula. This technique is frequently used by dentists because it is easier to do and has several advantages compared to other techniques. This paper reports a case of oro antral fistula caused by complication of a tooth extraction, with discussions about definition, ethics and other therapies of oro antral fistula.

  12. In vitro Fluoride Release and Tensile Bond Strength of a Polymeric Intra-Buccal Bioadhesive

    OpenAIRE

    Vinicius PEDRAZZI; LARA, Elza Helena Guimaraes; PANZERI, Heitor; John H Collett; ISSA, Joao Paulo Mardegan

    2009-01-01

    The intra-buccal polymeric bioadhesive systems that can stay adhered to the oral soft tissues for drug programmed release, with the preventive and/or therapeutic purpose has been employed for large clinical situations. A system based on hydroxypropyl methyl cellulose/Carbopol 934`/magnesium stearate (HPMC/Cp/StMg) was developed having the sodium fluoride as active principle. This kind of system was evaluated according to its resistance to the removal by means of physical test of tensile stren...

  13. Development and in vitro evaluation of a buccal drug delivery system based on preactivated thiolated pectin.

    Science.gov (United States)

    Hauptstein, Sabine; Hintzen, Fabian; Müller, Christiane; Ohm, Moritz; Bernkop-Schnürch, Andreas

    2014-11-01

    The aim of this study was to evaluate the potential of preactivated thiolated pectin (Pec-Cys-MNA) for buccal drug delivery. Therefore, a gel formulation containing this novel polymer and the model drug lidocaine was prepared and investigated in vitro in terms of rheology, mucoadhesion, swelling behavior and drug release in comparison to formulations based on pectin (Pec) and thiolated pectin (Pec-Cys). Both pectin derivatives showed gel formation without addition of any other excipient due to self-crosslinking thiol groups. Under same conditions, pectin did not show gel formation. Viscosity of Pec-Cys-based formulation increased 92-fold and viscosity of Pec-Cys-MNA-based formulations by 4958-fold compared to pectin-based formulation. Gels did not dissolve in aqueous environment during several hours and were able to take up water. Mucoadhesion of pectin on buccal tissue could be improved significantly, value of total work of adhesion increased in the following rank order: Pec-Cys-MNA > Pec-Cys > Pec. The retention time of a model drug incorporated in gel formulations on buccal mucosa under continuous rinsing with phosphate-buffered saline was prolonged, after 1.5 h 3-fold higher amount of a model drug was to be found on tissue after application of Pec-Cys-MNA-based formulation compared to pectin-based and 2-fold compared to Pec-Cys-based formulation. The Pec-Cys-MNA-based gel showed a more sustained release of lidocaine than Pec-Cys-based gel, whereas pectin solution revealed an immediate release. According to these results, the self-crosslinking pectin-derivative is a promising tool for buccal application.

  14. Hypoxic regulation of plasminogen activator inhibitor-1 expression in human buccal mucosa fibroblasts stimulated with arecoline.

    Science.gov (United States)

    Tsai, Chung-Hung; Lee, Shiuan-Shinn; Chang, Yu-Chao

    2015-10-01

    Oral submucous fibrosis (OSF) is regarded as a pre-cancerous condition with fibrosis in oral subepithelial connective tissue. Hypoxia-inducible factor (HIF)-1α regulates a wide variety of profibrogenic genes, which are closely associated with tissue fibrosis. The aim of this study was to compare HIF-1α expression in normal buccal mucosa tissues and OSF specimens and further explore the potential mechanisms that may lead to the induction of HIF-1α expression. Twenty-five OSF specimens and six normal buccal mucosa were examined by immunohistochemistry. The expression of HIF-1α from fibroblasts cultured from OSF and normal buccal mucosa was measured by Western blot. Arecoline, a major areca nut alkaloid, was challenged to normal buccal mucosa fibroblasts (BMFs) to elucidate whether HIF-1α expression could affect by arecoline. In addition, the effects of arecoline on plasminogen activator inhibitor (PAI)-1 expression were evaluated in environmental hypoxia. HIF-1α expression was significantly higher in OSF specimens and expressed mainly by fibroblasts, epithelial cells, and inflammatory cells. Fibroblasts derived from OSF were found to exhibit higher HIF-1α protein expression than BMFs (P Arecoline was found to upregulate HIF-1α protein in a dose-dependent manner (P arecoline-induced PAI-1 protein expression than normoxic conditions (P < 0.05). These results suggest that HIF-1α expression is significantly upregulated in OSF tissues from areca quid chewers, implying a potential role as a biomarker for local tissue hypoxia. The activation of HIF-1α may promote fibrogenesis by an increase of PAI-1 expression and a subsequent elevation of extracellular matrix production in oral submucosa leading to fibrosis. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Texture analysis of CT images in the characterization of oral cancers involving buccal mucosa

    Science.gov (United States)

    Raja, JV; Khan, M; Ramachandra, VK; Al-Kadi, O

    2012-01-01

    Objective The aim of this study was to investigate the usefulness of texture analysis in the characterization of oral cancers involving the buccal mucosa and to assess its effectiveness in differentiating between the various grades of the tumour. Methods Contrast enhanced CT examination was carried out in 21 patients with carcinoma of the buccal mucosa who had consented to retrospective analysis during a research study that was approved by the institutional review board. Two regions of interest (ROIs) were created, one at the site of the lesion and the other at the contralateral normal side. Texture analysis measures of fractal dimension (FD), lacunarity and grey level co-occurrence matrix (GLCM) were computed for each ROI. The numeric data from the two ROIs were compared and were correlated with the tumour grade as confirmed by biopsy. Results The difference between the mean FD and GLCM parameters of the lesion vs the normal ROI were statistically significant (p 0.05). Conclusion Texture analysis on CT images is a potential method in the characterization of oral cancers involving the buccal mucosa and deserves further investigation as a predictor of tumour aggression. PMID:22241875

  16. Cytomorphometric Characteristics of Buccal Mucosal Cells in Behçet’s Disease Patients

    Directory of Open Access Journals (Sweden)

    Erol Aktunc

    2016-01-01

    Full Text Available Background. The aim of this study was to compare the cytomorphometric characteristics of the buccal cells of Behçet’s disease patients with those of healthy controls. Methods. This case-control study compared a group of 30 patients with Behçet’s disease with an age- and gender-matched control group of 30 healthy individuals. The buccal mucosal smears were stained using the Papanicolaou technique for cytomorphometric analyses. The nuclear and cytoplasmic areas were evaluated using digital image analysis; the ratio of nuclear to cytoplasmic areas and nuclear roundness are presented. Results. The nuclear and cytoplasmic areas of the BD patients’ cells were significantly smaller than those of the healthy controls’ cells, while the nucleus-to-cytoplasm ratio and neutrophil infiltration rate did not differ significantly between the groups. However, the nuclear area, cytoplasmic area, nucleus-to-cytoplasm ratio, and nuclear roundness factor were significantly higher in patients without aphthae. The neutrophil infiltration rate did not differ significantly in patients with or without aphthae. Conclusion. Behçet’s disease can produce cytomorphometric changes in buccal cells that are detectable by exfoliative cytology and cytomorphometric analysis techniques.

  17. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation.

    Science.gov (United States)

    Araújo, Mauricio G; Wennström, Jan L; Lindhe, Jan

    2006-12-01

    To determine whether the reduction of the alveolar ridge that occurs following tooth extraction and implant placement is influenced by the size of the hard tissue walls of the socket. Six beagle dogs were used. The third premolar and first molar in both quadrants of the mandible were used. Mucoperiostal flaps were elevated and the distal roots were removed. Implants were installed in the fresh extraction socket in one side of the mandible. The flaps were replaced to allow a semi-submerged healing. The procedure was repeated in the contra later side of the mandible after 2 months. The animals were sacrificed 1 month after the final implant installation. The mandibles were dissected, and each implant site was removed and processed for ground sectioning. Marked hard tissue alterations occurred during healing following tooth extraction and implant installation in the socket. The marginal gap that was present between the implant and the walls of the socket at implantation disappeared as a result of bone fill and resorption of the bone crest. The modeling in the marginal defect region was accompanied by marked attenuation of the dimensions of both the delicate buccal and the wider lingual bone wall. Bone loss at molar sites was more pronounced than at the premolar locations. Implant placement failed to preserve the hard tissue dimension of the ridge following tooth extraction. The buccal as well as the lingual bone walls were resorbed. At the buccal aspect, this resulted in some marginal loss of osseointegration.

  18. A randomized controlled trial of different buccal misoprostol doses in mifepristone medical abortion.

    Science.gov (United States)

    Chong, Erica; Tsereteli, Tamar; Nguyen, Nhu Ngoc Thi; Winikoff, Beverly

    2012-09-01

    An 800-mcg dose of buccal misoprostol following mifepristone has been shown to be highly effective in terminating pregnancies through 63 days since the last menstrual period (LMP) (B. Winikoff, I.G. Dzuba, M.D. Creinin, et al., Two distinct oral routes of misoprostol in mifepristone medical abortion: a randomized controlled trial. Obstet Gynecol 2008; 112: 1303-1310). However, a two 200-mcg misoprostol pill option would simplify administration, and potentially reduce costs and increase women's satisfaction. This study compares a 400-mcg dose (Group I) to an 800-mcg dose (Group II) of buccal misoprostol. Eligible and consenting women requesting medical termination of early pregnancy (n=1122) were randomized and instructed to take misoprostol 36 to 48 h after taking 200 mg mifepristone. Follow-up visits occurred 12 to 15 days after mifepristone administration. Ninety-six percent of women in both groups had successful abortions. Women in Group I experienced significantly less vomiting and fever/chills than women in Group II. Ninety-six percent of women in both groups found the procedure very satisfactory or satisfactory. Four hundred micrograms of buccal misoprostol is as effective as the standard 800-mcg dose in terminating pregnancies up to 63 days LMP and reduces side effects. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Evaluation of analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease.

    Science.gov (United States)

    Stathopoulou, Thaleia-Rengina; Kouki, Maria; Pypendop, Bruno H; Johnston, Atholl; Papadimitriou, Serafeim; Pelligand, Ludovic

    2017-09-01

    Objectives The objective of this study was to evaluate the analgesic effect and absorption of buprenorphine after buccal administration in cats with oral disease. Methods Six adult client-owned cats with chronic gingivostomatitis (weighing 5.1 ± 1.1 kg) were recruited for a randomised, prospective, blinded, saline-controlled, crossover study. Pain scores, dental examination, stomatitis score and buccal pH measurement were conducted on day 1 under sedation in all cats. On day 2, animals were randomised into two groups and administered one of the two treatments buccally (group A received buprenorphine 0.02 mg/kg and group B received 0.9% saline) and vice versa on day 3. Pain scores and food consumption were measured at 30, 90 and 360 mins after the administration of buprenorphine. Blood samples were taken at the same time and plasma buprenorphine concentration was measured by liquid chromatography-mass spectrometry. Data were statistically analysed as non-parametric and the level of significance was set as P gingivostomatitis produces an analgesic effect and low inter-individual variability in plasma concentration, and it can be incorporated in their multimodal analgesia plan.

  20. Micronucleus frequency in exfoliated buccal cells from hairdresser who expose to hair products

    Directory of Open Access Journals (Sweden)

    Koh Hui Yee

    2015-06-01

    Full Text Available Background: Hairdresser is one of the fastest growing occupations in today’s society. Hairdresser help styling, cutting, colouring, perming, curling, straightening hair and various treatment to customer. Somehow, hairdresser are constantly exposed to chemical substances such as aromatic amines, hydrogen peroxide, thioglycolic acid, formaldehyde in hair products which can cause damage to human’s genome. Micronucleus is one of the effective biomarker for processes associated with the induction of DNA damage. Purpose: The aim of this study was to determine the micronucleus frequencies in buccal mucosa epithelial cells of hairdresser who were exposed to chemical of hair products. Method: This study was conducted on twenty female subjects, who were divided into 2 groups: exposed and non-exposed (control group. All subjects recruited were working in the same beauty salon. Buccal cells were obtained from each individual by using cytobrush. The cells were stained with modified Feulgen-Ronssenback method and counting of micronucleus per 1000 cell was done under light microscope. The data were analyzed using independent t-test and one-way Anova (p<0.05. Result: The result showed a significant difference in micronucleus frequency between 2 groups. There were a significantly increase of micronucleus frequency in hairdressers and increase of  micronucleus frequency with the longer duration of exposure. Conclusion: It concluded that the chemical substances of hair products had affected the micronucleus frequency ofthe epithelial cells in buccal mucosa of hairdressers.