Nasal Solution Research Articles

The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study

IntroductionNasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. ObjectiveThe aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. MethodsThe present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10cm visual analog scale. In addition, patients were examined to determine the crusting score. ResultsThere was no significant difference found in the preoperative and 7th and 15th postoperative days’ mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p<0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p<0.001). ConclusionHypertonic sea water is the recommended irrigation solution, as it is associated with less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency.

Development and evaluation of midazolam in situ nasal gel properties in presence of solubility enhancers at cilia-friendly pH

Midazolam (MDZ) is a short acting benzodiazepine not only used in treatment of pediatric status epilepticus but also is the most common preoperative sedative-agent in many surgical processes especially in children. According to MDZ hydrophobic characteristics at physiological-pH, its commercial parenteral aqueous solution is formulated in acidic pH that may cause pain and inflammation at administration-site. Alternatively, it is administered orally especially in children, however its bitter taste results low patient-compliance. Nasal route shows better acceptance than oral route. Considering fast clearance and frequent administration of nasal solutions, the mucoadhesive gels are considerable. According to MDZ poor aqueous solubility at physiologic pH (≈6) and nasal dose volume limitation, MDZ solubility enhancement techniques evaluation seems to be necessary in mucoadhesive gel formulation. Solubilized MDZ gel at physiologic pH -as a replacement of commercial acidic parenteral formulations- not only can improve MDZ residence-time in nasal-cavity but also reduces nasal administered volume. In this study, thermosensitive Poloxamer407 used as in situ gel-forming agent in various concentrations in presence of different solubility enhancers such as propylene glycol (P.G), polyethylene glycol400 (PEG400) and β-cyclodextrin (β-CD) in various amounts. MDZ solubility and gelation properties of different gel formulations were evaluated. Results showed Poloxamer gel containing P.G, enhanced MDZ solubility at nasal physiologic-pH up to 15.1 fold. Optimized nasal gel formulation indicated acceptable gelation-temperature (34±0.5 °C), gelation-capacity (1.5±0.10 min) with shearthinning pattern, which released MDZ within 1hour. Rat nasal histopathological showed no damage within 3 hours after nasal administration of MDZ nasal-gel. Stability tests of MDZ nasal-gel were acceptable over 90 days.

Stability of a novel corticosteroid nasal irrigation solution: betamethasone 17-valerate added to extemporaneously prepared nasal irrigation solutions.

There are no commercially available nasal irrigation solutions containing corticosteroids. Instead, such preparations are extemporaneously prepared by adding existing corticosteroid formulations to nasal irrigation solutions. The stability of the corticosteroid betamethasone 17-valerate (B17V), in nasal irrigation solutions of different compositions and pH and stored under different temperatures, was studied to determine the optimal choice of solution and storage conditions. Triplicate extemporaneous preparations made with B17V were prepared by adding a predetermined volume of B17V lotion to each nasal irrigation solution: normal saline (NS), sodium bicarbonate (NaHCO3 ) powder dissolved in tap water, and a commercially available powder mixture (FLO Sinus Care Powder), dissolved in tap water or pre-boiled tap water. Preparations were stored at 30°C and 4°C. Sampling was carried out at 0, 1, 2, 6, and 24 hours. The concentrations of B17V and its degradation compound, betamethasone 21-valerate (B21V), were determined by high-performance liquid chromatography. Preparations stored at 30°C contained a lower amount of B17V and higher amount of B21V than those stored at 4°C. B17V stability in nasal irrigation solutions decreased in the following order: NS, FLO in fresh tap water, FLO in pre-boiled tap water, and NaHCO3 . The degradation rate of B17V increased with higher storage temperature and higher pH. B17V is most stable when added to NS and least stable in NaHCO3 solution. FLO solution prepared with either cooled boiled water or tap water is an alternative if administered immediately. Storage at 4°C can better preserve stability of B17V, over a period of 24 hours.

Topical steroid-dependent face: Response to xylometazoline topical

Unsupervised and long-term use of fluorinated/potent topical steroids on the face can lead to side effects such as acne, skin thinning, photosensitivity, and a typical clinical presentation of a topical steroid-dependent face (TSDF) with rebound flushing, burning, dryness, and scaling on attempted withdrawal of the potent topical steroid cream. To evaluate the response of a commercially available nasal decongested solution of xylometazoline 0.05% in patients of long-term potent topical steroid abuse on the face. Two patients with a history of long-term, indiscriminate, and unsupervised topical steroid use on the face were asked to use a commercially available nasal decongestant solution, on face. Patients were asked to use the decongestant solution on face, once daily for 2 weeks. Follow-up after 2 weeks demonstrated excellent improvement in flushing and erythema. Side effects reported were transient tingling and stinging sensation. Xylometazoline, being an alpha-adrenergic agonist, presents an effective new option for treatment in patients of flushing and erythema, resulting from long-term topical steroid use on face.

A New Class of Polymeric Anti-Allergen Nasal Barrier Film Solution for the Treatment of Allergic Rhinitis

Objective: Allergic rhinitis (AR) is oversensitivity of nasal mucosa to allergen exposure leading to IgE-mediated nasal mucosal inflammation and cellular destruction. Applying any chemical drug over the nasal mucosa may provide symptomatic relief but at the same time the presence of chemicals, such as cortisones and antihistaminic, hampers mucosa repair and, in consequence, cellular defense functions. Therefore, cleaning, avoiding allergen exposure, and protecting nasal mucosa from contact with allergens with a cell-friendly mechanical device, could be an effective remedy to treat allergic rhinitis. Methods: A double blind, randomized, placebo controlled, multicenter clinical trial was conducted in patients suffering from severe AR. 15 patients were treated with saline as comparator product (CP) versus 31 treated with the test product (TP). The test product contained a natural gum-glycerol solution (VB-Gy) which was rendered filmogen using inert natural polymers (Allercyanidin-H) and termed as VB-Gy-Allercyanidin-H formula. The products (15 ml sprays) were applied topically over the nasal mucosa, 3-4 times a day over a period of 3 weeks. Total, reflective and instantaneous nasal symptom scores for rhinorrhea, nasal discharge, sneezing, and itching, as well as ocular scores (itching, tearing, redness) and rescue medicine use scores were evaluated daily during weeks -1 to +3 employing a 0 (no symptoms) to 3 (severe symptoms) scoring scale. Rhino-conjunctivitis quality of life (RQLQ) questionnaires were completed at the start and at the end of the study. Saline solution (CP) was used identically to the TP. Mean weekly results in CP and TP groups were compared with the scores at the start of treatment (baseline) and between the two groups. Results: CP was found to reduce only slightly the symptomatic manifestation of allergic rhinitis. The mean reduction compared to baseline at the end of weeks 1, 2, and 3 was respectively 11.7%, 13.6% and 15.1% for total nasal symptom scores (rTNSS); 9.9%, 14.5%, and 15.8% for total ocular symptom scores (rTOSS); and 4.97%, 8.45%, and 10.94% for pre-dose instantaneous total ocular symptom scores (am-iTOSS, p: Not Significant: NS). During the same period, compared to CP scores, the reduction in TP group was higher by 37.7%, 58.4%, and 73.5% for rTNSS; 38.3%, 54.6%, and 64.1% for rTOSS and 29.84%, 48.91%, and 59.77% for am-iTOSS (p<0.05 for all parameters vs. CP at the same time points). The rhinoconjunctivitis quality of life questionnaire (RQLQ), measured using standard established questionnaire, was improved by 50.28% in TP group compared to 22.85% in CP group. During the study period, at least one rescue medicine was used by 80% patients in CP group compared to only 29% in TP group. Both products were well tolerated and induced no undesired effects. Conclusion: In the absence of any cell-friendly, safe, and multi-target treatment for allergic rhinitis, using a mechanically acting, filmogen barrier solution capable of blocking new allergen contact and minimizing the concentration of immune cells on the nasal surface represents a simple but highly effective approach for the treatment of common allergic rhinitis.

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Evaluation of the effects on nasal mucociliary clearance of various nasal solutions applied topically in patients with sinusitis

Preclinical evaluation of Luffa operculata Cogn. and its main active principle in the treatment of bacterial rhinosinusitis

IntroductionThe prevalence of rhinosinusitis is quite high. Despite the widespread use of antibiotics for rhinosinusitis, there are other forms of treatment, including phytotherapy. One of the most widely used herbal medicines for treatment of rhinosinusitis is Luffa operculata. ObjectiveThis study aimed to evaluate the efficacy of topical nasal solution of the aqueous extract of L. operculata, determining the toxicity to its use and identifying the active principles presented in the aqueous extract. The secondary objective was to evaluate the action of active principles on bacteria commonly involved in acute rhino sinusitis. MethodsThe study was conducted in experimental model of sinusitis. Three different concentrations of L. operculata were used as local treatment of rhino sinusitis. The results were compared with those observed in control groups that received nasal saline solution. Histological examination of the liver, kidney, spleen, myocardium, brain and lungs of all animals evaluated the toxicity of L. operculata. The aqueous extract used was subjected to chromatographic analysis and an active principle was isolated and tested for in vitro inhibition of bacterial colonies usually found in rhino sinusitis. ResultsIntranasal treatment of sinusitis with L. operculata showed better clinical evolution than control group. Statistically significant difference (p>0.10) between the treated group and the control group was observed in the histologic evaluation for inflammatory pattern. The aqueous extract of L. operculata used presented a predominance of 2,3-dicafeoilglicaric acid, a substance not yet described in the literature. There was a significant difference in bacterial growth of Streptococcus pyogenes on blood-agar plates when under the influence of both the aqueous extract and the active substance. ConclusionTopical nasal solution of the aqueous extract of L. operculata is effective compared to the application of saline solution for the treatment of bacterial rhinosinusitis in an experimental model. L. operculata determined in vitro inhibition of growth of S. pyogenes.

Practice patterns in pediatric chronic rhinosinusitis: A survey of the American Rhinologic Society.

The management of pediatric chronic rhinosinusitis (PCRS) is evolving. To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%). For initial surgical therapy, 90% performed adenoidectomy; in addition, 31% also performed sinus lavage, 17% performed balloon catheter dilation (BCD), and 17% performed endoscopic sinus surgery (ESS). Sixty percent performed adenoidectomy before obtaining computed tomography imaging. When initial surgical treatment failed, 85% performed traditional ESS. In patients with pansinusitis, 50% of the respondents performed frontal sinusotomy and 70% performed sphenoidotomy. BCD was not frequently used; overall, 66% never or rarely used it, 20% sometimes used it, 12% usually used it, and 3% always or almost always used BCD. Most aspects of PCRS management among ARS members were aligned with published consensus statements. Adenoidectomy was almost always included as part of first-line surgical treatment but was also combined with adjunctive surgical procedures with moderate frequency. ESS was performed by a minority of rhinologists as a primary procedure for medically refractory PCRS but was favored when previous surgery failed. BCD was uncommonly used in PCRS.

Topical administration of hyaluronic acid in children with recurrent or chronic middle ear inflammations

Hyaluronic acid (HA) treatment has been successfully performed in patients with recurrent upper airway infections or rhinitis. The aim of this study was to assess the efficacy and safety of the topical nasal administration of an HA-based compound by investigating its effects in children with recurrent or chronic middle ear inflammations and chronic adenoiditis. A prospective, single-blind, 1:1 randomised controlled study was performed to compare otoscopy, tympanometry and pure-tone audiometry in children which received the daily topical administration of normal 0.9% sodium chloride saline solution (control group) or 9 mg of sodium hyaluronate in 3 mL of a 0.9% sodium saline solution. The final analysis was based on 116 children (49.1% boys; mean age, 62.9 ± 17.9 months): 58 in the control group and 58 in the study group. At the end of follow-up, the prevalence of patients with impaired otoscopy was significantly lower in the study group (P value = 0.024) compared to baseline but not in the control group. In comparison with baseline, the prevalence of patients with impaired tympanometry at the end of the follow-up period was significantly lower in the study group (P value = 0.047) but not in the control group. The reduction in the prevalence of patients with conductive hearing loss (CHL) (P value = 0.008) and those with moderate CHL (P value = 0.048) was significant in the study group, but not in the control group. The mean auditory threshold had also significantly improved by the end of treatment in the study group (P value = 0.004) but not in the control group. Our findings confirm the safety of intermittent treatment with a topical nasal sodium hyaluronate solution and are the first to document its beneficial effect on clinical and audiological outcomes in children with recurrent or chronic middle ear inflammations associated with chronic adenoiditis.

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline.

BackgroundThe regulation of mucociliary clearance is a key part of the defense mechanisms developed by the airway epithelium. If a high aggregate quality of evidence shows the clinical effectiveness of nasal irrigation, there is a lack of studies showing the intrinsic role of the different irrigation solutions allowing such results. This study investigated the impact of solutions with different pH and ionic compositions, eg, normal saline, non‐diluted seawater and diluted seawater, on nasal mucosa functional parameters.MethodsFor this randomized, controlled, blinded, in vitro study, we used airway epithelial cells obtained from 13 nasal polyps explants to measure ciliary beat frequency (CBF) and epithelial wound repair speed (WRS) in response to 3 isotonic nasal irrigation solutions: (1) normal saline 0.9%; (2) non‐diluted seawater (Physiomer®); and (3) 30% diluted seawater (Stérimar). The results were compared to control (cell culture medium).ResultsNon‐diluted seawater enhanced the CBF and the WRS when compared to diluted seawater and to normal saline. When compared to the control, it significantly enhanced CBF and slightly, though nonsignificantly, improved the WRS. Interestingly, normal saline markedly reduced the number of epithelial cells and ciliated cells when compared to the control condition.ConclusionOur results suggest that the physicochemical features of the nasal wash solution is important because it determines the optimal conditions to enhance CBF and epithelial WRS thus preserving the respiratory mucosa in pathological conditions. Non‐diluted seawater obtains the best results on CBF and WRS vs normal saline showing a deleterious effect on epithelial cell function.

Pharmacological, toxicological and neuronal localization assessment of galantamine/chitosan complex nanoparticles in rats: future potential contribution in Alzheimer’s disease management

Purpose: Nasal galantamine hydrobromide (GH)/chitosan complex nanoparticles (CX-NP2) could have an improved therapeutic potential for managing Alzheimer’s disease (AD). The current study aimed to investigate if the complexation reaction between GH and chitosan altered the pharmacological and toxicological profiles of the parent drug; GH.Methods: The nasal administration of CX-NP2 to male Wistar rats for 12 consecutive days was compared to negative control group, and oral and nasal GH solutions treated groups in 3 mg/kg daily GH dose. Brain acetylcholinesterase (AChE) protein level and activity were assessed. The in vivo toxicity of CX-NP2 was evaluated via monitoring the clinical signs throughout the study. Histopathological examination of brain sections was performed. The intracellular localization of CX-NP2 within brain neurons was investigated using transmission electron microscopy.Results: GH/chitosan complexation did not negatively alter the pharmacological efficiency of GH. Intriguingly, nasal CX-NP2 exhibited a significant decrease of AChE protein level and activity in rat brains compared to the oral and nasal GH solutions. No toxicity signs or histopathological manifestations were noticed. The nanoparticles were found intracellularly in the brain neurons.Conclusion: The pharmacological efficacy and in vivo safety of nasal CX-NP2 confirm their promising potential to contribute to the management of AD intranasally.

Cytofunctional changes in nasal ciliated cells in patients treated with hyaluronate after nasal surgery.

Hyaluronic acid (HA) plays a significant role in tissue repair of mucosal surfaces and, consequently, in surgical injury remodelling of nasal mucosa. To assess the effect of high-molecular-weight HA administered by aerosol on the morphofunctional recovery of ciliated cells damaged by surgical trauma. A single-blind, prospective, randomized trial was carried out with 94 patients who were randomly assigned, after endoscopic turbinoplasty, either to treatment with nasal saline solution irrigation (control group, n = 47) or to treatment with nasal douches based on high concentration (9 mg) and high-molecular-weight sodium hyaluronate (active treatment group, n = 47). All the patients were evaluated by using nasal fiberendoscopy, mucociliary transport time, nasal cytologic test, and a visual analog scale in terms of symptoms before and at 2 and 4 weeks after surgery. Visual analog scale values were significantly lower in the active treatment (AT) group at week 2 regarding each individual symptom. Mucociliary transport time was significantly reduced in patients in the AT group but only 1 month after surgery. Both the percentage of cellular impairments and the number of cells with hyperchromatic supranuclear stria showed significant improvements in the AT group in all postsurgery evaluations (p < 0.05). Intranasal use of sodium hyaluronate in patients who underwent functional nasal surgery improved both mucociliary clearance and nasal mucosa regeneration due to a faster recovery of the impaired ciliated cells.

Effect of salvianolic acid B on nasal absorption in rats in situ

This experiment focused on the effect of salvianolic acid B's nasal absorption characteristics in rats. In the study, HPLC determination of salvianolic acid B(SalB) in perfusion liquid was established to examine the SalB nasal irritation in different pH buffers and stability in nasal perfusion solution, and systematically study in vivo nasal absorption characteristics of SalB. Improved rats were adopted to establish the in situ nasal perfusion model to measure the release of total protein and lactate dehydrogenase in perfusion fluid, quantitatively evaluate the nasal irritation and the stability in perfusion liquid of pH 4.0, 5.0, 6.0 SalB phosphate buffer, compare the absorption of SalB in pH 5.0 buffer solution with low, medium and high concentrations (200, 400, 800 mg•L⁻¹). According to the results, nasal irritation: pH 4.0>pH 5.0>pH 6.0, RSD of pH 6.0 SalB buffer solution within 24 h was 3.1%, stability was poor. PH 5.0 SalB buffer solution had a smaller irritation and good stability. According to the nose perfusion test in rats, the nasal absorption of SalB fitted the first-order process and could be considered as passive absorption based on concentration gradient. SalB buffer solution of pH 5.0 had also a small nasal irritation and good stability, with a good absorption in rat nasal perfusion test, which therefore had a certain significance for the development of SalB nasal formulation.

Menthol inhibiting parasympathetic function of tracheal smooth muscle.

Menthol is used as a constituent of food and drink, tobacco and cosmetics nowadays. This cold receptor agonist has been used as a nasal inhalation solution in the daily life. The effect of menthol on nasal mucosa in vivo is well known; however, the effect of the drug on tracheal smooth muscle has been rarely explored. Therefore, during administration of the drug for nasal symptoms, it might also affect the trachea via oral intake or inhalation. We used our preparation to test the effectiveness of menthol on isolated rat tracheal smooth muscle. A 5 mm long portion of rat trachea was submersed in 30 ml Krebs solution in a muscle bath at 37ºC. Changes in tracheal contractility in response to the application of a parasympathetic mimetic agent were measured using a transducer connected to a Pentium III computer equipped with polygraph software. The following assessments of menthol were performed: (1) effect on tracheal smooth muscle resting tension; (2) effect on contraction caused by 10-6 M methacholine as a parasympathetic mimetic; (3) effect of the drug on electrically induced tracheal smooth muscle contractions. Results indicated that addition of a parasympathetic mimetic to the incubation medium caused the trachea to contract in a dose-dependent manner. Addition of menthol at doses of 10-5 M or above elicited a relaxation response to 10-6 M methacholine-induced contraction. Menthol could also inhibit electrical field stimulation (EFS) induced spike contraction. However, it alone had a minimal effect on the basal tension of trachea as the concentration increased. We concluded that the degree of drug-induced tracheal contraction or relaxation was dose-dependent. In addition, this study indicated that high concentrations of menthol might actually inhibit parasympathetic function of the trachea.

PLGA/DPPC/trimethylchitosan spray-dried microparticles for the nasal delivery of ropinirole hydrochloride: in vitro, ex vivo and cytocompatibility assessment

In the present study we investigated polymer-lipid microparticles loaded with ropinirole hydrochloride (RH) for nasal delivery. RH microparticles were further evaluated by means of scanning electron microscopy (SEM), ζ-potential measurements, Fourier-transform infrared spectroscopy (FT-IR), X-ray photoelectron spectroscopy (XPS) and x-ray diffraction (XRD). In vitro release studies were performed in simulated nasal electrolyte solution (SNES) pH5.5 at 35°C. Ex vivo permeation studies were conducted across sheep nasal mucosa. Cytocompatibility was tested in cultured human airway epithelial cells (Calu-3).SEM studies revealed spheroid microparticles in the range of 2.09μm to 2.41μm. The presence of trimethylchitosan (TMC) induced a slight shift towards less negative ζ-potential values. Surface chemistry (XPS) revealed the presence of dipalmitoylphospatidylcholine (DPPC) and poly(lactic-co-glycolic acid) (PLGA) onto microparticles' surface, further corroborating the FT-IR and XRD findings. In vitro release studies showed that the microparticle composition can partly modulate the release of RH. Ex vivo studies demonstrated a 2.35-folded enhancement of RH permeation when RH was co-formulated with TMC of low molecular weight, compared to the control. All formulations tested were found to be non-toxic to cells.The results suggest that polymer-lipid microparticles may be a promising carrier for the nasal delivery of RH.

Strategies for decreasing contamination of homemade nasal saline irrigation solutions.

Saline nasal irrigations (SNI) are an important adjunct in the treatment of rhinosinusitis, and many patients prepare and store these solutions in their homes without an awareness of the potential for contamination. The objectives of this study were to determine if such contamination occurs and the effect of preparation methods on contamination. Stock solutions of various tonicities and pHs were prepared using boiled, bottled, and distilled water (n = 57). The solutions were stored at ambient temperature or refrigerated for 1 week. Each day, 50 mL of the solutions were decanted to simulate transferring the stock solution into an irrigation vector. Cultures of the stock solutions were taken on days 1, 3, and 7. Overall contamination rate was 35.1%. The boiled water solutions were more likely to demonstrate bacterial growth (p < 0.001), as were those that were hypotonic (p = 0.046). pH had no significant effect (p = 0.127). Growth occurred as early as 24 hours after solution preparation. Pathogenic species isolated were Staphylococcus aureus, Moraxella sp, Sphingomonas paucimobilis, Acinetobacter junii, Methylobacterium sp, and Brevundimonas diminuta. No bacterial growth occurred in refrigerated solutions (p = 0.008). Pathogenic bacterial growth can occur in a short period of time in homemade SNI solutions with routine handling. Solutions should be refrigerated if possible. If solutions are to be stored at ambient temperature, they should be either isotonic or hypertonic and prepared from bottled or distilled water.

The effect of nasal irrigation formulation on the antimicrobial activity of nasal secretions.

Saline-based irrigation solutions are evidence-based rhinological treatments; however, the formulation of these solutions could theoretically alter the function of innate antimicrobial peptides. The aim of this study was to determine if the antimicrobial activity of normal human nasal secretions in vivo is altered by commercially available large volume irrigation solutions. Minimally manipulated sinonasal secretions were collected from patients with chronic rhinosinusitis (CRS; n = 10) and normal healthy volunteers (n = 20). In a subset of control patients (n = 10) secretions were collected prior to, and at 1 hour, 6 hours, and 24 hours after nasal irrigation with 4 commercial irrigation solutions. Lysozyme and lactoferrin levels were analyzed and the antimicrobial activity of secretions determined using a radial diffusion assay. The antimicrobial activity of nasal secretions was reduced in CRS patients compared to healthy volunteers (p < 0.01), but there was no significant difference in antimicrobial peptide concentrations. Isotonic nasal irrigation reduced lysozyme and lactoferrin levels, which returned to baseline levels by 6 hours; in addition to a sustained decrease in antimicrobial activity before returning to baseline at 24 hours. Low-salt solution stimulated peptide secretion by approximately 40% at 6 hours and 24 hours, but produced a transient decrease in antimicrobial activity, returning to baseline levels by 6 hours. Hypertonic solution initially decreased lysozyme and lactoferrin levels but maintained baseline levels of antimicrobial activity and increased peptide secretion by approximately 30% at 24 hours. The formulation of nasal irrigation solutions significantly affects the measured levels and functionality of sinonasal antimicrobial peptides.

Development of phenytoin intranasal microemulsion for treatment of epilepsy

The objective of the present investigation was to prepare phenytoin microemulsion for intranasal administration by application of experimental design. Phenytoin microemulsion was prepared by water titration method. The concentration of oil (X1), surfactant (X2) and cosurfactant (X3) were selected as independent variables, in a simplex centroid design, from microemulsion region obtained from pseuodoternary phase diagram while the globule size (Y1) and cumulative phenytoin diffused at 60 min (Y2) through sheep nasal mucosa were taken as dependent variables. Mathematical models were generated for the response variables. The validity of the generated equations was established using check point batches. Microemulsion that had a smaller globule size of dispersed phase and high level of % drug diffusion was desirable. The generated mathematical equations were used to identify the desirable zone where all the criteria for the responses were satisfied and an optimum batch was recognized. Ex-vivo study of optimum microemulsion on sheep nasal mucosa shows absence of nasal toxicity. It was found that faster recovery from seizures was obtained in rats treated with intra nasal phenytoin microemulsion in comparison to the rats treated with oral microemulsion and nasal solution. Higher concentration of phenytoin was found in rats treated with intranasal microemulsion in comparison to the rats treated with phenytoin solution administered intraperitoneally. Gamma scintigraphy results also suggested faster availability of drug into brain when microemulsion was administered intranasally.

THE CREATION OF NEWINTRANASALDRUGBASED ONRAW MATERIALSOF NATURAL ORIGINFORALLERGICRHINITISCOMBINED THERAPY

Allergic rhinitis is a disease of the nasal mucosa, which is based on allergic inflammation caused by the action of different natureallergens. Allergic rhinitis is quite common among the population, often occurs with frequent complications, resulting in decreased performance and quality of patients’life. Late or not effective therapy for this disease can lead to chronic disease and a combination of other pathologies, such as sinusitis, asthma and others.Primarily due to allergic inflammation in the lining of the nasal cavity,the allergen may persist for several weeks after exposure. Inflammation in the nasal cavitylining, triggered by allergens, leads to the accumulation of eosinophils, dendritic cells, T-lymphocytes and epithelial cells, which in its turn leads to activation and increased production of adhesion molecules by endothelial cells.Therapeutic help with allergic rhinitis may have the following areas:a) mechanical evacuation allergens;b) the use of pharmacological agents aimed at suppression of allergic process;c) the use of allergen-specific therapy;d) rational combination of the above directions for proper effect.Aim. Hold technological characteristics of salt dosage forms which are used as evacuation agents in the treatment of allergic rhinitis.Materials and methods. The material is known formulation, namely nasal saline solution. Information was taken from thesis, articles, patents and dissertation, etc.Results and discussion.Evacuation direction of curative care in allergic rhinitis caused by necessity of mechanical removal of allergens from the nasal cavity mucous areas. To do this, salt solutions of different compositionare used. According to the UkrainianState Register of medicines,salineis most common medicine in the domestic market amongpharmacotherapeutic group "means used for diseases of the nose". Range of nasal dosage forms is dominated by imported drugs, the share of domestic drugs is only 31.25%. As active ingredients, saline manufacturers mostly use sodium chloride, seawater and complex trace elements (magnesium, sodium, calcium) in different ratios. Such intranasal solutions by nature are mostly hypo or isotonic drugs. An exception is Aqua Maris® Strong (producer of "Jadran" Galenic Laboratory, Croatia), which is hypertonic solution of sterile seawater. As the solvent purified water or water for injectionare used. To ensure the stability of nasal dosage forms, some manufacturers of the tracks added preservatives, derivatives of quaternary ammonium compounds (benzalkonium chloride) and aromatic alcohols (benzyl alcohol). To normalize the pH substances of different chemical nature, such as sodium hydrogen phosphate dihydrate, sodium dihydrogen phosphate dihydrate, hydrochloric acidare used.Despite the existing range of drugs aimed at treatment and prevention of allergic rhinitis in patients,there is currentlyno safe and effectivetool that can fully provide therapeutic effect. When developing new means for intranasal pharmacotherapy of allergic rhinitis it is rational touse minerals of national origin, which will not only provide evacuation allergens, but also due to its high quality components will implement anti-inflammatory activity.Conclusions. As a result of research it was conducted that among intranasal medicines the natural salt is used for the treatment and prevention of allergic rhinitis. It is established that complex magnesium minerals from raw materials of natural originare perspective to be used.

Does atopy influence the effectiveness of treatment of adenoid hypertrophy with mometasone furoate?

The effect of topical mometasone for adenoid hypertrophy treatment is well established. Nevertheless, the influence of atopy on this treatment remains ill defined. This study aims to compare the effects of topical mometasone furoate treatment on the adenoid tissue between atopic and nonatopic children. Fifty-one children with obstructive respiratory complaints underwent a semistructured clinical questionnaire on nasal symptoms, prick test, and nasoendoscopy. Nasoendoscopic images were digitalized, and both adenoid and nasopharyngeal areas were measured in pixels; the relative adenoid/nasopharyngeal area was calculated. Patients were initially treated for 40 days with nasal saline solution. In a subsequent 40-day period, topical mometasone furoate (total dose, 100 μg/day) was used. Topical mometasone significantly improved nasal obstruction, snoring, and apnea and also significantly reduced the adenoid tissue area related to the nasopharynx (p < 0.0001). Treatment with this glucocorticoid was not influenced by atopy, neither for symptoms nor for adenoid area. Topical mometasone furoate significantly reduced the adenoid tissue area and led to a supplementary improvement of nasal symptoms. This improvement was similar for atopic and nonatopic patients.