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and Topical Inhalation ·



  • and Topical Inhalation ·
  • Inhalation and topical steroid therapy and oral candidiasis: A brief overview
  • Training Objectives:
  • Methods: Inhalation and Topical Application of Essential Oils. By Shellie Enteen, RA, BA, LMBT. It's my hope that the information and guidelines presented in this. A route of administration in pharmacology and toxicology is the path by which a drug, fluid, Action may be topical (local), enteral (system-wide effect, but delivered . Inhalation by smoking a substance is likely the most rapid way to deliver. Z Erkr Atmungsorgane Folia Bronchol. Dec;(1) [Topical inhalation anesthesia]. [Article in German]. Pickroth G, Kandt D. PMID:

    and Topical Inhalation ·

    By Warburg assay, the dose response curve of econazole on resting Candida albicans, Saccharomyces cerevisiae, and Staphylococcus aureus was evaluated. The broad spectrum antimicrobial activity of econazole could be confirmed.

    In this comparison, econazole proved its broad spectrum and its high activity. A one-year trial of triamcinolone acetonide aerosol in severe steroid-dependent asthma.

    Twenty-three steroid-dependent severely asthmatic patients, ranging in age from 20 to 67 years, tolerated reduction in their oral dosage of steroids during a one-year trial of triamcinolone acetonide aerosol. Sixteen patients maintained their initial one-second forced expiratory volume without oral therapy with steroids, two required resumption of daily steroid dosage because of lethargy and arthralgia, and four required 2. Five-day oral courses of steroids were occasionally required because of episodes of asthma from a variety of external causes.

    One patient failed to benefit within two months and withdrew from the study. One patient had precipitins to Candida albicans prior to the study, and he developed transient oropharyngeal culture-positive thrush, which subsided with use of a gargle containing nystatin.

    None of the other patients had oral candidiasis, and laryngoscopic examination revealed no lesions attributed to the aerosol. The mean fasting cortisol level did not increase throughout the one-year trial. Thus, the use of triamcinolone acetonide aerosol 2, microgram or less daily can eliminate or greatly reduce oral requirements for steroids in patients with severe steroid-dependent asthma.

    Side effects are mild, but adrenal recovery may be exceedingly slow. Apr Int J Pediatr Otorhinolaryngol. The use of corticosteroids to reduce the morbidity associated with laryngotracheobronchitis croup has been a controversial issue for many years. Recent literature, however, does support a decreased morbidity and increased clinical response when short-term steroids are used. As a prophylactic measure against bacterial superinfection, antibiotics are commonly utilized in the treatment of croup.

    We present the case of an otherwise healthy infant with severe croup who was hospitalized and treated with both steroids and antibiotics. A relapse in her symptoms led to the diagnosis of candida laryngotracheitis. We recommend close monitoring of patients with croup treated aggressively with steroids and antibiotics. Steroid use should be limited to 24 h with antibiotics reserved for patients with signs of bacterial infection.

    Adverse effects of inhaled corticosteroids. Not serious if care is taken. Mar Br Med J. Effect of nystatin and Chlorhexidine digluconate on Candida albicans. Polyene antibiotics such as nystatin and amphotericin B are among the most widely recommended drugs for use against oral candidiasis. It is also generally accepted that chlorhexidine gluconate is an appropriate adjunct or an alternative to specific antimycotic drugs.

    The aim of the present study was to examine the effect of the combination of nystatin and chlorhexidine digluconate on Candida albicans in vitro. The minimum inhibitory concentration MIC value for the combination of the two drugs was found to be significantly higher than the values for each of the drugs alone, approximately 33 times the MIC value for the nystatin solution and 4 times the value for chlorhexidine digluconate.

    The results of the MIC study and the presence of a precipitate in all combinations of nystatin and chlorhexidine digluconate showed that the combination of the drugs is not effective in vitro against Candida albicans. The most likely reason is that a low solubility chlorhexidine-nystatin salt is formed, thus rendering the combined drug complex ineffective as an antibiotic agent.

    Assessment of oral candidiasis in patients with respiratory disease and efficacy of a new nystatin formulation. Jul Br Med J. Fifty consecutive patients with respiratory diseases who developed oropharyngeal candidiasis were assessed clinically and microbiologically before and after seven days' treatment with nystatin suspension or pastilles a new formulation. In 45 patients in whom microbiology yielded positive results there was frequent associated use of oral corticosteroids, antibiotics, sedatives, and inhaled corticosteroid, while in a few patients atropine analogues may have predisposed to infection.

    Dentures were worn by 32 of the infected patients. Concomitant treatment of dentures in chronically infected patients appeared to improve the therapeutic response. Pastilles and suspension were equally efficacious both clinically and microbiologically. The potential for enhanced drug delivery to the oropharynx suggests that nystatin pastilles may be useful in patients in whom poor compliance seems likely. Oral topical steroids and secondary oral candidiases. Oct J Oral Med. Cytological mechanisms of the development of mucosal candidiasis after exposure to a steroid aerosol preparation.

    Mucosal candidosis was induced in CBA mice by intraoral inoculation following treatment with corticosteroid-containing aerosol beclomethasone dipropionate. Histologically, in hormone treated mice the adherence of the pathogen to the mucosal surface was found during the first hours after inoculation.

    This is followed by the formation of the germ tubes and invasion in the epithelial layer. Pseudomycelial invasion in the malpighian layer is accompanied by the leukocyte response that limits the further spread of the fungal cells. In intact mice, the inoculation is not followed by the effective attachment of the fungal cells to the mucosal surface and induction of mycotic lesions. In vitro experiments have demonstrated the enhanced adherence of fungal blastospores to the epithelial cells of the hormone treated animals, that appears to be one of the mechanisms in the pathogenesis of candidosis in these animals.

    Incorporation of dexamethasone by Candida albicans. The incorporation of 3H-dexamethasone into Candida albicans has been studied. The results indicate that the steroid is incorporated unchanged and primarily into the cell wall and membrane of the organism. The incorporation appears to be of a noncovalent type. Growth of Candida albicans in dexamethasone-supplemented media. Candida albicans grown in dexamethasone DXM shows an apparent increase in dry weight.

    This increase, however, represents an artefact due to entrapment and incorporation of DXM by the yeast. Thus opportunistic infections by C. Effectiveness and complications of aerosol dexamethasone phosphate in severe asthma. Feb J Allergy. Effect of pre-treatment with dexamethasone on corneal pathogenicity of Candida albicans.

    Oct J Comm Dis. Nystatin-resistance of Candida albicans isolates from two cases of oral candidiasis. Jan Br J Oral Surg. Two cases of oral candidiasis are described which failed to respond to nystatin therapy when used in combination with triamcinolone acetonide. The isolates of C. Triamcinolone acetonide was detected in the saliva of both patients after treatment.

    Addition of this saliva to the isolates of C. Both patients were treated with miconazole nitrate and a mycological and clinical cure was obtained in one of the cases. Topical application of a corticosteroid destabilizes the host-parasite relationship in an experimental model of oral carrier state of Candida albicans.

    We have tested the impact of a predisposing factor to oral candidiasis in the form of a topical application of a corticosteroid Topsyn gel to the oral mucosa for 75 mice twice a day for a day period. Very rapidly after the treatment was initiated, i. A topical corticosteroid application also resulted in a massive depletion of T cells in the lymph nodes and in the transient abrogation of the DTH reaction to Candida antigens.

    These results suggest that resistance to superficial invasion by Candida is linked to the presence of an oral mucosal line of defense and that topical application of corticosteroids may dramatically shift the host-parasite relationship in favor of Candida.

    Elevated cortisol levels in whole saliva in HIV infected individuals. Free cortisol concentrations in unstimulated whole saliva samples, collected at Two HIV patients with pseudomembranous candidiasis had the highest saliva cortisol concentrations mean of Two other HIV patients one with Kaposi's sarcoma and the other with periodontitis had a mean cortisol value of The possibility of plasma contamination of whole saliva in the HIV patients with inflammatory oral mucosal lesions notwithstanding, our findings suggest an increased oral burden of cortisol in both the asymptomatic and symptomatic HIV-infected individuals.

    Glucocorticoids caused immunosuppression, provide selective growth advantage to various microorganisms including the fungi, and enhance replication or reactivation of latent viruses e. Our findings suggest a need to evaluate the relevance of endogenous glucocorticoid excess in blood and saliva to the causation of some major AIDS-associated oral lesions such as candidiasis, Kaposi's sarcoma, oral hairy leukoplakia and necrotizing gingivitis.

    Comparison of the antiasthmatic, oropharyngeal, and systemic glucocorticoid effects of budesonide administered through a pressurized aerosol plus spacer or the Turbuhaler dry powder inhaler. Adults with moderate to severe asthma inhaled budesonide 0. The ratio of the responses to the two inhalation devices approximated 1. Long-term effects of steroid therapy [in Polish]. Feb Wiad Lek. Asthma is a chronic inflammatory disease of the airways play. Anti-inflammatory drugs the fundamental role in the treatment of asthma and among them steroids are the most important.

    However, oral steroids may cause many serious side effects. A major breakthrough in the treatment of asthma was introducing inhaled steroids. Inhaled steroids have much less side effects than oral steroids, although they have the same anti-inflammatory activity. Long term effect of inhaled steroids can be divided into wanted and unwanted outcome. The desirable anti-inflammatory effect of steroids is reflected by lowering of bronchial hyperresponsiveness and a better control of asthma symptoms.

    Inhaled corticosteroid may have systemic side effects similar to those observed with oral steroids such as 1 adrenal suppression, 2 effect on bone metabolism, 3 growth suppression in children, 4 impaired skin collagen synthesis, 5 cataract, 6 metabolic disturbances, 7 effect on central nervous system. Summing up it is advisable to use inhaled corticosteroid in the lower effective dose. Inhaled steroids and oral candidiasis. Help your patient avoid this troubling symptom.

    Budesonide inhalation powder, available as Pulmicort Turbuhaler, is a corticosteroid with a high ratio of local to systemic effects that is administered to treat persistent asthma.

    The Turbuhaler achieves lung deposition approximately twice that of a metered-dose inhaler MDI with or without a spacer device. Budesonide inhalation powder has clinical efficacy equivalent to that of fluticasone and beclomethasone, but it has lower systemic bioavailability and fewer systemic side effects.

    As with other inhaled corticosteroids, dysphonia and oral candidiasis are the most frequent adverse effects, and systemic effects are infrequent. Patients prefer the Turbuhaler to the MDI, Diskhaler, and Rotahaler because it is easier to use and more convenient to carry. Safety of hydrofluoroalkanea beclomethasone dipropionate extrafine aerosol. Herein we assess the safety of an inhaled formulation of beclomethasone dipropionate BDP which uses the propellant hydrofluoroalkanea HFA for the treatment of asthma.

    Acute local tolerability as assessed by the incidence of cough and mean forced expiratory volume after 1 s inhalation was similar for both BDP and placebo formulated in either chlorofluorocarbon CFC or HFA propellants.

    Adrenal responsiveness to cosyntropin stimulation was normal in all but one patient. Equivalent efficacy at a lower dose and equivalent safety at the same dose imply that HFA-BDP may have a more favourable risk: Evaluation of the buccal component of systemic absorption with inhaled fluticasone propionate. Inhaled corticosteroids have dose related systemic effects determined by oral swallowed or oropharyngeal absorption and lung bioavailability. A study was undertaken to evaluate the significance of oropharyngeal absorption for fluticasone propionate.

    Sixteen healthy volunteers of mean age There were no significant differences between active treatments. Oropharyngeal absorption of fluticasone does not significantly contribute to its overall systemic bioactivity as assessed by sensitive measures of adrenal suppression.

    In view of almost complete hepatic first pass inactivation with fluticasone, there is no rationale to employ mouth rinsing to reduce its systemic effects although it may be of value for reducing oral candidiasis. The expression of secreted aspartyl proteinases Saps by clinical isolates of Candida albicans, C. Also, yeast growth, pH fluctuation and total protein concentration of the saliva cultures during incubation were measured.

    Sap expression was assessed by evaluating the enzyme activity as well as the antigen concentration. Saps were expressed well in human saliva supplemented with glucose by all three Candida species, although greater expressions was found in YCB-BSA medium.

    In general, for all three species, the rate of yeast growth, pH fluctuation and percentage reduction of total salivary protein concentration concurred with the degree of expression of Saps.

    These data strongly suggest that Saps of C. Comparative efficacy and safety of inhaled corticosteroids in asthma. Current guidelines emphasize the efficacy of inhaled corticosteroids for anti-inflammatory activity in asthma, and recommend higher doses and earlier initiation of therapy than previous guidelines.

    Concern over possible side effects with long term use has prompted an evaluation of the available literature to determine the optimal dose that may be administered without fear that significant side effects might occur e. Regular treatment with the following drugs in adults and children, respectively, is unlikely to result in any clinically significant effects on the above parameters: Systemic effects are influenced by potency and bioavailability.

    Inhaled corticosteroids owe their favourable safety profile to a high topical to systemic potency ratio compared with that of oral corticosteroids. In terms of relative topical potency, fluticasone propionate is more potent than budesonide, which is more potent than beclomethasone dipropionate, which is more potent than flunisolide and triamcinolone acetonide.

    The delivery device has an important influence on the amount of drug reaching the patient. A spacer device attached to a metered dose inhaler or a Turbuhaler reduces oropharyngeal deposition and increases lung deposition.

    As a result, a dosage reduction may be possible, and local side effects of dysphonia and oral candidiasis may be reduced. Patients requiring continued high doses by the inhaled route should be monitored for systemic effects and be considered for osteoporosis prevention therapy if appropriate.

    Experimental Oral Candidiasis in Animal Models. CBD oil can be infused into a wide variety of edibles and beverages, including coffee. The benefit of consuming CBD oil sublingually is that the absorption process bypasses the digestive system and liver metabolization, allowing the compounds to reach your bloodstream and interact with the endocannabinoid system more quickly. For those looking for quick effects, a sublingual CBD oil product is ideal.

    Pure CBD oil, as well as tinctures and concentrates, are CBD products that are designed for the sublingual method of application. They can easily be held in the mouth to give the active ingredients time to be absorbed by the capillaries in the mouth before being swallowed. Some CBD oil products are designed to be applied directly onto the skin. The active ingredients in these topical CBD products are absorbed through the skin so that they can interact with cells that are nearby the surface without ever entering the bloodstream.

    Topical CBD oil products are ideal for those looking for isolated pain relief or to address skin conditions because they can be applied directly to where they are needed most.

    The CBD oil topical products currently on the market primarily include lotions and salves. These products are more applicable for potentially addressing pain or serious skin issues.

    For daily skin health care, some companies also produce a collection of CBD oil bath and body care products, such as body wash, shampoo, conditioner, and moisturizing lotions. Finally, CBD can also be inhaled by vaporizing. A vaporizer heats CBD oil just enough to release its active compounds, avoiding the harmful byproducts that are created with combustion.

    During vaporization, CBD enters your lungs and diffuses directly into your bloodstream. Also, less CBD is lost during vaporizing compared to the ingestion method. Vaporizing CBD is typically a consumption option recommended for adults.

    Vaporizers range in size from tabletop, plug-in powered units to small, battery-powered portable pens.

    Inhalation and topical steroid therapy and oral candidiasis: A brief overview

    Science. May 9;() Administration of Micronized Therapeutic Agents by Inhalation or Topical Application. Taplin GV, Bryan FA. Essential oil applications include Inhalation and/or diffusion, which work best in the Applications of Essential Oils: Inhalation, diffusion and topical applications . Inhalation: How to Choose. Plant Therapy Topical Application vs Inhalation. We are often asked, “How do I know where to put these essential.

    Training Objectives:



    Science. May 9;() Administration of Micronized Therapeutic Agents by Inhalation or Topical Application. Taplin GV, Bryan FA.


    Essential oil applications include Inhalation and/or diffusion, which work best in the Applications of Essential Oils: Inhalation, diffusion and topical applications .


    Inhalation: How to Choose. Plant Therapy Topical Application vs Inhalation. We are often asked, “How do I know where to put these essential.


    The way by which illicit drugs can be administered or taken into the body are numerous. These routes include the oral route, transdermal.

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