Influence of topical phenypropanolamine on tachyphylaxis and mucociliary clearance in the human nose

AbstractTopical nasal phenylpropanolamine in a 2.5 per cent solution (PPA) was used in an evaluation of the possible development of tachyphylaxis and of possible effects on the mucociliary system after one week of treatment in healthy humans. The tendency of PPA to produce tachyphylaxis was evaluated by rhi-nomanometrie measurements of nasal airway resistance after repeated dose-response provocations. The mucociliary transport time was tested with the saccharine-dye test. No reduced dose-response effect or change in mucociliary transport time was found with PPA, thus indicating that one week of treatment does not contribute to such adverse effects.

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The prognostic value of mucociliary clearance in predicting success in tympanoplasty

The Journal of Laryngology & Otology ◽

10.1017/s0022215100124727 ◽

1993 ◽

Vol 107 (10) ◽

pp. 895-897 ◽

Cited By ~ 7

Author(s):

F. Giménez ◽

J. Marco-Algarra

Keyword(s):

Saccharin Solution ◽

Prognostic Value ◽

Mucociliary Clearance ◽

Mucociliary Transport ◽

Transport Time ◽

Failure Group ◽

Predicting Success ◽

Cent Sodium ◽

Success Group ◽

Normal Transport

AbstractMucociliary and equipressive eustachian tube functions have been studied, using saccharin solution (five per cent sodium saccharinate) and tubal manometry respectively, in 58 ears with chronic disease undergoing tympanoplasty. The position of the perforation site determines the results as the poorest results are obtained from the posterior ones, positive cases (47 per cent) and mean transport time (37.7 minutes), compared to the greater percentage of positive cases (86 per cent) and mean transport time (22.2 minutes) for anterior perforations.When both parameters are analysed together there is a direct relationship between normal equipressive function and normal mucociliary transport time and between negative transport time and tubal blocking. Significant differences in transport times have been found for the anterior and posterior perforations being shorter for the anterior ones.When surgical outcome is correlated with mucociliary transport, the normal transport time percentage is seen to be considerably higher in the success group (50 per cent) than in the failure group (22 per cent).

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Nebulized hypertonic saline in noncystic fibrosis bronchiectasis: a comprehensive review

Therapeutic Advances in Respiratory Disease ◽

10.1177/1753466619866102 ◽

2019 ◽

Vol 13 ◽

pp. 175346661986610 ◽

Cited By ~ 3

Author(s):

Luis Máiz Carro ◽

Miguel A. Martínez-García

Keyword(s):

Cystic Fibrosis ◽

Hypertonic Saline ◽

Mucociliary Clearance ◽

Mucociliary Transport ◽

Adherence To Treatment ◽

Comprehensive Review ◽

Mucociliary System ◽

Bronchial Inflammation ◽

Salty Taste ◽

Current Guidelines

Bronchiectasis occurs as a result of a vicious circle consisting of an impaired mucociliary transport system, inflammation, and infection and repair of the airways. Damage to the mucociliary system prevents secretion elimination and facilitates bacterial growth and bronchial inflammation. To facilitate mucociliary clearance, current guidelines recommend the use of hypertonic saline (HS) solutions in patients with bronchiectasis not secondary to cystic fibrosis (CF), although the evidence of efficacy in this pathology is sparse. A high percentage of patients with CF and bronchiectasis tolerate HS solutions, but often patients report cough, dyspnoea, throat irritation, or salty taste after inhalation. These adverse effects negatively impact adherence to treatment, which sometimes must be discontinued. Some studies have shown that the addition of hyaluronic acid increases the tolerability of HS solutions, both in patients with CF and in bronchiectasis of other etiologies. We aimed to review the benefits and safety of HS solutions in patients with bronchiectasis. The reviews of this paper are available via the supplemental material section.

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Nasal muco-ciliary transport time alteration: efficacy of 18B glycyrrhetinic acid

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2017.258 ◽

2017 ◽

Vol 12 ◽

Author(s):

Desiderio Passali ◽

Chiara Cappello ◽

Giulio Cesare Passali ◽

Cemal Cingi ◽

Codrut Sarafoleanu

Keyword(s):

Nasal Spray ◽

Nasal Mucosa ◽

Paranasal Sinuses ◽

Mucociliary Clearance ◽

Mucociliary Transport ◽

Clearance Time ◽

Vasomotor Rhinitis ◽

Transport Time ◽

Clearing System ◽

Objective Reduction

Background: Mucociliary clearance is the main self-clearing system of the nasal cavity and paranasal sinuses. This is a very important means of non specific defence against continuous organic and inorganic contamination conveyed by air. It works by trapping particles and microorganisms in the mucus and then by transporting the mucous film to the pharynx where it is eliminated with a cough or swallowed. Its congenital or acquired abnormalities are involved in the occurrence of widespread infectious and often severe nose and paranasal sinuses diseases; generally concerning the rhinopharyngealtubal district. Restoring mucociliary clearance of the nasal epithelium when altered thus represents a key therapeutic tool against rhinosinus chronic diseases. This study evaluates the clinical efficacy of the inhalation of a natural compound (Narivent® nasal spray) in chronic vasomotor rhinitis. Methods: The study involved 79 patients suffering from chronic vasomotor rhinitis presenting an increased mucociliary clearance time. Patients were randomized into 2 groups: a first group of 49 subjects and a second group of 30 subjects. The first group was treated with a nasal spray (Narivent® nasal spray) (2 sprays per nostril twice a day) for 30 days. The second group was treated with a nasal spray containing isotonic solution in the same way and for the same period of the first group. Nasal Mucociliary transport time was measured in the patients of both groups before treatment, after 15 days of treatment, and at the end of the 30 days treatment. Results: The study shows how one of the treatments carried out determines a major objective reduction of the mucociliary clearance time in the patients under examination, using the method which involves the use of an insoluble coloured tracer (vegetable carbon), bringing the values back within normal range. At the end of the study we objectivated an increase in the rate of mucociliary transport in 97.9% percentage of patients we enrolled. Conclusions: This study shows the effectiveness of treatment with natural extracts with nasal mucosa restoring function in the treatment of chronic vasomotor rhinitis, a nasal inflammatory disease characterized by morphological and functional alteration of the normal nasal mucosa.

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Is Speed of Onset of Anti-anxiety Efficacy with Pregabalin Influenced by Starting Dose?

European Psychiatry ◽

10.1016/s0924-9338(09)70762-x ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

B. Herman ◽

F. Mandel

Keyword(s):

Dose Response ◽

Change Score ◽

Early Improvement ◽

Response Effect ◽

Starting Dose ◽

Dsm Iv ◽

The Mean ◽

Dose Response Effect ◽

Titration Schedule ◽

Speed Of Onset

Objective:There appears to be no dose-response effect for pregabalin at doses of 300-600 mg, and a modest dose-response effect in the range of 150-300 mg. The goal of the current investigation was to determine the effect of the starting dose on the speed of onset of anxiolytic efficacy.Methods:Data were analyzed from 7 trials of outpatients with DSM-IV GAD and a HAM-A total score ≥18. Starting doses of pregabalin ranged from 100 mg (N=301) or 150 mg (N=104), to 200 mg (N=167) and 300 mg (N=388). Assessment of early improvement included the HAM-A total score and CGI-Severity and Improvement scores.Results:The mean Week 1 HAM-A change score was similar for a starting dose of 200 mg/d with no titration (-8.24) when compared to patients who started on 200 mg/d and then titrated up to 400 mg/d on Day 4 (-8.64). The mean Week 1 HAM-A change score was somewhat higher for patients started on 300 mg/d, and then titrated to 450 mg/d on Day 4/5 (-8.84) when compared to patients started on a lower (100/150 mg/d) dose and titrated on Day 5 to 400/450 mg/d (-7.32). Starting on a dose of 300 mg/d with no titration resulted in an intermediate Week 1 change score (-7.87). The interaction of starting dose and titration schedule with baseline anxiety severity will be summarized in detail.Conclusion:The initial dose of pregabalin appears to have only a weak effect on the speed of onset of anxiolytic improvement.

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