Repurposed benzydamine targeting CDK2 suppresses the growth of esophageal squamous cell carcinoma / 医学前沿

Esophageal squamous cell carcinoma (ESCC) is one of the leading causes of cancer death worldwide. It is urgent to develop new drugs to improve the prognosis of ESCC patients. Here, we found benzydamine, a locally acting non-steroidal anti-inflammatory drug, had potent cytotoxic effect on ESCC cells. Benzydamine could suppress ESCC proliferation in vivo and in vitro. In terms of mechanism, CDK2 was identified as a target of benzydamine by molecular docking, pull-down assay and in vitro kinase assay. Specifically, benzydamine inhibited the growth of ESCC cells by inhibiting CDK2 activity and affecting downstream phosphorylation of MCM2, c-Myc and Rb, resulting in cell cycle arrest. Our study illustrates that benzydamine inhibits the growth of ESCC cells by downregulating the CDK2 pathway.

Low level laser therapy versus benzydamin in prevention and treatment of oral mucositis induced by anticancer treatments (clinical and biochemical study) / Terapia a laser de baixa intensidade versus benzidamina na prevenção e tratamento da mucosite oral induzida por terapia oncológica

Objective: In this study, patients undergoing neck and head radiotherapy (RT) with or with no chemotherapy were contrasted to the low-level laser therapy (LLLT) efficacy against benzydamine hydrochloride in treating and preventing oral mucositis (OM) (CHT). Material and Methods: This study included 90 individuals with neck and head cancer who were undergoing radiotherapy (RT) individually or in mixture with chemotherapy (CHT), varying in age from 18 to 80 years. Three equal groups were randomly formulated: Group, I patients were using oral care only, Group II patients were using benzydamine hydrochloride mouth rinse, and Group III patients were medicated by using low-level laser therapy. The National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) and the World Health Organization (WHO) were used to rate the severity of OM, and the pain was validated utilizing a visual analog scale (VAS). The salivary level of tumor necrotic factor-α (TNF- α) was assayed. Results: As per WHO and NIC, the grade of oral mucositis at the end of cancer treatment was less in the LLLT group than in the other two groups. The alteration in TNF- α level was not significant. The laser group is more liable to have less salivary levels of the pro-inflammatory cytokines TNF- α . Conclusion: The incidence of oral mucositis severity has seemed to be reduced due to the prophylactic use of benzydamine hydrochloride and laser therapy protocols. However, laser therapy was more efficient in controlling the shape and progression of OM (AU)

Objetivo: Neste estudo, pacientes submetidos à radioterapia (RT) da cabeça e pescoço com ou sem quimioterapia foram avaliados quanto à eficácia da terapia com laser de baixa potência (LLLT) versus o cloridrato de benzidamina no tratamento e prevenção da mucosite oral (MO) (CHT). Material e Métodos: Este estudo incluiu 90 indivíduos com câncer de cabeça e pescoço submetidos à radioterapia (RT) individualmente ou em combinação com quimioterapia (QT), com idade variando de 18 a 80 anos. Três grupos iguais foram aleatoriamente formulados: os pacientes do Grupo I usaram apenas higiene bucal, os pacientes do Grupo II usaram bochechos com cloridrato de benzidamina e os pacientes do Grupo III foram medicados com terapia a laser de baixa intensidade. Foram utilizados os critérios do National Institute of Cancer-Common Toxicity Criteria (NIC-CTC) e da Organização Mundial da Saúde (OMS) para classificar a gravidade da OM, e a dor foi validada utilizando uma escala visual analógica (VAS). O nível salivar de fator necrótico tumoral-α (TNF-α) foi ensaiado. Resultados: De acordo com a OMS e NIC, o grau de mucosite oral ao final do tratamento do câncer foi menor no grupo LLLT do que nos outros dois grupos. A alteração no nível de TNF-α não foi significativa. O grupo com tratamento a laser apresentou menores níveis de citocinas pró-inflamatórias TNF-α na saliva. Conclusão: A gravidade da mucosite oral parece ser reduzida devido ao uso profilático de cloridrato de benzidamina e protocolos de laserterapia. No entanto, a laserterapia foi mais eficiente em controlar a forma e a progressão da MO. (AU)

Effects of benzydamine hydrochloride spray on postoperative sore throat associated with double-lumen endobronchial intubation: a double-blind, randomized controlled clinical trial

BACKGROUND: Postoperative sore throat is a common complication of endotracheal intubation; the thicker the endotracheal tube, the higher the frequency of postoperative sore throat. So, we evaluated the effect of benzydamine hydrochloride spray on postoperative sore throat, associated with double-lumen endobronchial intubation. METHODS: Sixty patients undergoing thoracic surgery were scheduled and enrolled for intubation, with a double-lumen endobronchial tube. Of these patients, 30 were sprayed with benzydamine hydrochloride (group B), and 30 with normal saline (group N), 10 minutes before intubation was performed. Patients were randomly assigned to the two groups. Blood pressure and heart rate were recorded before, and after endotracheal intubation. Symptoms of sore throat, hoarseness, and dysphagia were examined one hour, as well as 24 hours, after surgery. RESULTS: Incidence of sore throat was 73.3% and 23.3% (P < 0.001) in groups N and B, respectively, at one hour after surgery. In addition, incidence of sore throat at 24 hours after the operation, was also statistically significant (66.6% and 20.0%, P = 0.001). Frequency of dysphagia at one hour, and 24 hours after surgery, was lower in group B. There were no significant differences in heart rate, blood pressure, and hoarseness at 24 hours after surgery between the two groups. CONCLUSIONS: In cases wherein a double-lumen endobronchial tube was used, an oropharyngeal spray of benzydamine hydrochloride before tracheal intubation, reduced incidence of postoperative sore throat.

Randomized controlled trial to compare oral analgesic requirements and patient satisfaction in using oral non-steroidal anti-inflammatory drugs versus benzydamine hydrochloride oral rinses after mandibular third molar extraction: a pilot study

BACKGROUND: Third molar extraction is associated with considerable pain and discomfort, which is mostly managed with oral analgesic medication. We assessed the analgesic effect of benzydamine hydrochloride, a topical analgesic oral rinse, for controlling postoperative pain following third molar extraction. METHODS: A randomized controlled trial was conducted in 40 patients divided into two groups, for extraction of fully erupted third molar. Groups A received benzydamine hydrochloride mouthwash and group B received normal saline gargle with oral ibuprofen and paracetamol. Oral ibuprofen and paracetamol was the rescue analgesic drug in group A. Patients were evaluated on the 3(rd) and 7(th) post-operative days (POD) for pain using the visual analogue score (VAS), trismus, total number of analgesics consumed, and satisfaction level of patients. RESULTS: The VAS in groups A and B on POD3 and POD7 was 4.55 ± 2.54 and 3.95 ± 1.8, and 1.2 ± 1.64 and 0.95 ± 1.14, respectively and was statistically insignificant. The number of analgesics consumed in groups A and B on POD3 (5.25 ± 2.22 and 6.05 ± 2.43) was not statistically different from that consumed on POD7 (9.15 ± 5.93 and 10.65 ± 6.46). The p values for trismus on POD3 and POD7 were 0.609 and 0.490, respectively and those for patient satisfaction level on POD3 and POD7 were 0.283 and 0.217, respectively. CONCLUSIONS: Benzydamine hydrochloride oral rinses do not significantly reduce intake of oral analgesics and are inadequate for pain relief following mandibular third molar extraction.

Anafilaxia a cloridrato de benzidamina: relato de caso / Anaphylaxis to benzydamine hydrochloride: a case report

Reações de hipersensibilidade a medicamentos (RHM) podem induzir manifestações clínicas heterogêneas, desde leves até graves. São classificadas em imunológicas ou alérgicas quando mediadas por anticorpos ou linfócitos T, e não imunológicas quando decorrentes de efeitos farmacológicos da droga, incluindo inibição da enzima cicloxigenase (Cox). Os dois grupos mais frequentemente implicados nas RHM são os anti-inflamatórios não esteroidais (AINEs), e os antibióticos betalactâmicos. O manejo adequado das reações aos AINEs depende da identificação do mecanismo fisiopatológico envolvido, que permitirá classificar em reator seletivo (indivíduo que reage a um único fármaco e a outros com estrutura química similar), ou reator múltiplo ou intolerante cruzado (aquele que reage a múltiplos fármacos de estrutura química não relacionada). O cloridrato de benzidamina (CBZ) é um AINE de uso frequente e relativamente seguro, sem descrições de reações graves associadas ao seu uso. Atua inibindo as enzimas Prostaglandina Endoperoxidase H Sintase 1 e/ou 2, e a Fosfolipase A2. Em pacientes com história de reações aos AINEs, o teste de provocação é a ferramenta diagnóstica padrão ouro para confirmar ou excluir a reatividade cruzada a outros AINEs e definir um fármaco alternativo seguro. Descreveremos um caso raro de anafilaxia ao CBZ durante teste de provocação oral.

Hypersensitivity drug reactions (HDRs) may induce mild to severe heterogeneous clinical manifestations. They are classified as immunological or allergic when mediated by antibodies or T lymphocytes, and non-immunological when resulting from pharmacological effects of the drug, including inhibition of the cyclooxygenase (Cox) enzyme. The two groups of drugs most frequently implicated in HDRs are non-steroidal anti-inflammatory drugs (NSAIDs) and beta-lactam antibiotics. Appropriate management of NSAID reactions depends on identification of the pathophysiological mechanism involved, which will allow to classify the patient as selective reactor (patient reacting to a single drug and others with similar chemical structure) or multiple or cross-intolerant reactor (patient reacting to multiple drugs with unrelated chemical structure). Benzydamine hydrochloride (BZH) is a frequently used, relatively safe NSAID for which descriptions of severe reactions are not available. BZH acts inhibiting the enzymes prostaglandin endoperoxide H synthase (PGHS) 1 and/ or 2 and phospholipase A2. In patients with a history of NSAID reactions, the challenge test is the gold standard diagnostic tool to confirm or exclude cross-reactivity to other NSAIDs, and to define a safe alternative drug. In this paper, we describe a rare case of anaphylaxis to BZH during an oral drug provocation test.

Investigations on the effects of mouthrinses on the colour stability and surface roughness of different dental bioceramics

PURPOSE: In this study, three bioceramic materials, [IPS Empress CAD (Ivoclar), IPS e.max CAD (Ivoclar), and Lava Ultimate CAD (3M ESPE)] were treated with three commercial mouthrinses [Listerine, Tantum Verde, and Klorhex]; and changes in colour reflectance and surface roughness values were then quantitatively assessed. MATERIALS AND METHODS: One hundred and twenty ceramic samples, with dimensions of 2 × 12 × 14 mm, were prepared and divided into nine sample groups, except three control samples. The samples were immersed in the mouthrinse solutions for 120 hrs, and changes in colour reflectance and surface roughness values were measured by UV light spectrophotometry (Vita Easyshade; VITA Zahnfabrik) and by profilometer device (MitutoyoSurftest SJ-301), respectively. The change of surface roughness was inspected by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: There was a positive correlation between the ΔE and increase in the surface roughness. Two of the ceramic materials, IPS Empress and Lava Ultimate, were affected significantly by the treatment of the mouthrinse solutions (P<.05). The most affecting solution was Tantum Verde and the most affected material was Lava Ultimate. As expected, the most resistant material to ΔE and chemical corrosion was IPS e max CAD among the materials used. CONCLUSION: This work implied that mouthrinse with lower alcohol content had less deteriorating effect on colour and on the surface morphology of the bioceramic materials.

Comparative study between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on endotracheal tube cuff as regards postoperative sore throat / Estudo comparativo entre cloridrato de benzidamina em gel, lidocaína a 5% em gel e lidocaína a 10% em spray no balonete do tubo endotraqueal em relação à dor de garganta pós-operatória

ABSTRACT Postoperative sore throat is a common complication after endotracheal intubation. After tracheal intubation, the incidence of sore throat varies from 14.4% to 50%. The aim of the study was to compare between benzydamine hydrochloride gel, lidocaine 5% gel and lidocaine 10% spray on the endotracheal tube cuff as regards postoperative sore throat. The present study was carried out on 124 patients admitted to Alexandria university hospitals for lumbar fixation surgery requiring general anesthesia. Patients were randomly allocated into 4 groups. Benzydamine hydrochloride gel, 5% lidocaine hydrochloride gel, 10% lidocaine hydrochloride spray, or normal saline were applied on endotracheal tube cuffs before endotracheal intubation. The patients were examined for sore throat (none, mild, moderate, or severe) at 0, 1, 6, 12, and 24 h after extubation. The results were collected, analyzed and presented in table and figure. The highest incidence of postoperative sore throat occurred at 6 h after extubation in all groups. There was a significantly lower incidence of postoperative sore throat in the benzydamine group than 5% lidocaine gel, 10% lidocaine spray, and normal saline groups. The benzydamine group had significantly decreased severity of postoperative sore throat compared with the 10% lidocaine, 5% lidocaine, and normal saline groups at observation time point. Compared with the 5% lidocaine the 10% lidocaine group had significantly increased incidence and severity of postoperative sore throat after extubation. Compared with normal saline the 10% lidocaine group had increased incidence of postoperative sore throat. There were no significant differences among groups in local or systemic side effects. So in conclusion, benzydamine hydrochloride gel on the endotracheal tube cuff is a simple and effective method to reduce the incidence and severity of postoperative sore throat. Application of 10% lidocaine spray should be avoided because of worsening of postoperative sore throat where incidence increased but not the severity in relation to 5% lidocaine gel. Applying 5% lidocaine on the endotracheal tube cuff does not prevent postoperative sore throat but its application is better than lidocaine 10% spray or saline.

RESUMO A dor de garganta pós-operatória (DGPO) é uma complicação comum após a intubação traqueal. Em seguida a esse procedimento, a incidência de dor de garganta varia de 14,4 a 50%. O objetivo do estudo foi comparar os efeitos da aplicação de cloridrato de benzidamina em gel, lidocaína a 5% em gel e lidocaína a 10% em spray no balonete do tubo endotraqueal, no que diz respeito à dor de garganta pós-operatória. O presente estudo foi feito com 124 pacientes internados em hospitais universitários de Alexandria para cirurgia de fixação lombar que necessitavam de anestesia geral. Os pacientes foram aleatoriamente alocados em quatro grupos. Procedeu-se à aplicação de cloridrato de benzidamina em gel, cloridrato de lidocaína a 5% em gel, cloridrato de lidocaína a 10% em spray ou salina normal nos balonetes do TET antes da intubação endotraqueal. Os pacientes foram examinados para dor de garganta (nenhuma, leve, moderada ou intensa) a 0, uma, seis, 12 e 24 horas após a extubação. Os resultados foram coletados, analisados e apresentados em tabelas e figuras. A maior incidência de DGPO ocorreu seis horas após a extubação em todos os grupos. Houve incidência significativamente menor de DGPO no grupo de benzidamina versus grupos de lidocaína a 5% em gel, lidocaína a 10% em spray e salina normal. O grupo tratado com benzidamina exibiu redução significativa na intensidade da DGPO, em comparação com os grupos de lidocaína a 10%, lidocaína a 5% e salina normal no ponto no tempo de observação. Em comparação com lidocaína a 5%, o grupo tratado com lidocaína a 10% exibiu incidência e intensidade significativamente aumentadas na DGPO após a extubação. Em comparação com salina normal, o grupo tratado com lidocaína a 10% exibiu maior incidência de DGPO. Não foram observadas diferenças significativas entre grupos quanto a efeitos colaterais locais ou sistêmicos. Assim, em conclusão, o uso de cloridrato de benzidamina em gel no balonete do TET é um método simples e eficaz para reduzir a incidência e a gravidade da DGPO. Deve-se evitar a aplicação de lidocaína a 10% em spray, devido ao agravamento da DGPO, visto ter ocorrido aumento na incidência, mas não na severidade, em relação à lidocaína a 5% em gel. A aplicação de lidocaína a 5% no balonete do TET não impede a ocorrência da DGPO, mas a sua aplicação oferece melhores resultados do que lidocaína a 10% em spray, ou solução salina.

Hallucinations after Ingesting a High Dose of Benzydamine Hydrochloride

No abstract available.

Gel de própolis mucoadesivo versus solução de cloridrato de benzidamina na prevenção da mucosite oral em pacientes irradiados em região de cabeça e pescoço. Ensaio clinico, cego, randomizado: fase II / Propolis mucoadhesive gel versus Benzydamine Hydrochloride Solution to Prevention of Oral Mucositis in Patients Irradiated in Head and Neck Region. A phase II study randomized and blind

Os efeitos colaterais mais conhecidos em cavidade bucal, durante a radioterapia para o tratamento de câncer em região da cabeça e pescoço, são a mucosite e a candidose. Essas alterações são potencializadas pela hipossalivação em decorrência de alterações nas glândulas salivares. Existem diversos protocolos para o controle da mucosite, hipossalivação e candidose bucais nesses pacientes, entretanto, nenhum deles é totalmente eficaz. A Própolis possui atividade analgésica, anti-inflamatória, antifúngica e cicatrizante. Essas características farmacológicas conferem à Própolis um grande potencial para prevenir as alterações na cavidade bucal dos pacientes que serão submetidos à radioterapia. O objetivo deste trabalho foi avaliar a efetividade do Gel contendo Própolis na prevenção da mucosite e candidose em comparação com o cloridrato de benzidamina. Vinte e seis pacientes foram incluídos no estudo. Os pacientes foram aleatorizados em dois grupos, sendo que o grupo 1 usou o cloridrato de benzidamina e o grupo 2 o gel de Própolis. Tanto os pacientes do grupo 1 , como os pacientes do grupo 2 usaram os produtos 3 (três) vezes ao dia, durante todo o período da radioterapia e duas semanas após o término do tratamento e todos foram avaliados semanalmente. Os resultados obtidos mostraram que 84,6% dos pacientes eram do sexomasculino e que 19,2% dos pacientes mantinham o hábito de fumar e consumir bebidas alcoólicas. A dose média de radioterapia foi 6466,1 Gys. Após a análise final dos dados, observou-se que o Gel de Própolis apresentou melhor efetividade na prevenção da mucosite, a partir da 17a sessão de radioterapia, quando comparado ao grupo cloridrato de benzidamina. Setenta e oito por cento (78,6%) dos pacientes avaliaram o produto como bom, enquanto 85,7% o indicariam para pacientes com a mesma condição. O estudo mostrou que o controle da inflamação na mucosa bucal pelo Gel contendo Própolis foi melhor...

The best known side effects in the oral cavity during radiotherapy for the treatment of cancer in the head and neck, are mucositis and candidiasis. These changes are enhanced by hyposalivation due to changes in the salivary glands. There are many protocols for the control of mucositis, hyposalivation, and oral candidiasis in these patients however, none iscompletely effective. Propolis has analgesic, anti-inflammatory, antifungal and healing activity. These pharmacological characteristics give propolis great potential to prevent changes in the oral cavity of patients undergoing radiotherapy. The aim of this study was to evaluate the effectiveness of the gel containing propolis in preventing mucositis and candidiasis compared with benzydamine hydrochloride. Twenty-six patients were included in this study. Patients were divided into two groups with group 1 used the benzydamine hydrochloride and group 2 gel propolis. Both group used the products three times a day during the whole period of radiotherapy and two weeks after the end of treatment and all patients were evaluated weekly...

Benzydamine Oral Spray Inhibiting Parasympathetic Function of Tracheal Smooth Muscle

OBJECTIVES: Benzydamine is a nonsteroidal anti-inflammatory agents agent with anti-inflammatory and local anesthesia properties that is available in the entire world as an oral spray for oral mucositis patients who are suffering from radiation effects. The effect of benzydamine on oral mucositis in vivo is well known; however, the effect of the drug on tracheal smooth muscle has rarely been explored. During administration of the benzydamine for oral symptoms, it might affect the trachea via oral intake or inhalation. METHODS: We examined the effectiveness of benzydamine on isolated rat tracheal smooth muscle. The following assessments of benzydamine were performed: effect on tracheal smooth muscle resting tension; effect on contraction caused by 10(-6)M methacholine as a parasympathetic mimetic; and effect of the drug on electrically induced tracheal smooth muscle contractions. RESULTS: Addition of methacholine to the incubation medium caused the trachea to contract in a dose-dependent manner. Addition of benzydamine at doses of 10(-5)M or above elicited a significant relaxation response to 10(-6)M methacholine-induced contraction. Benzydamine could inhibit electrical field stimulation-induced spike contraction. It alone had a minimal effect on the basal tension of trachea as the concentration increased. CONCLUSION: This study indicated that high concentrations of benzydamine might actually inhibit parasympathetic function of the trachea. Benzydamine might reduce asthma attacks in oral mucositis patients because it could inhibit parasympathetic function and reduce methacholine-induced contraction of tracheal smooth muscle.

effect of olive leaf extract in decreasing the expression of two pro-inflammatory cytokines in patients receiving chemotherapy for cancer. A randomized clinical trial

Oral mucositis is the most common side effects of chemotherapy of all cancer with intensive treatments regimen, and is the most common side effects of head and neck radiation therapy. For steam cell transplantation, its also regarded as the most debilitating side effects. The objectives of this study were to assess the effect of a mouth rinse containing olive leaf extract [OLE] in preventing severe oral mucositis in patients receiving chemotherapy, and to estimate its effect in decreasing pro-inflammatory cytokine production after chemotherapy. This study utilized a placebo-controlled, randomized, double-blind, and cross-over design. Twenty-five patients undergoing intensive chemotherapy were randomly assigned to receive a mouth wash containing OLE, benzydamine hydrochloride, or placebo in 3 different cycles of chemotherapy. Oral mucositis severity was assessed using the World Health Organization criteria and Oral Mycositis Assessment Scale. Patients were evaluated weekly until 15 days after chemotherapy for each cycle. Salivary levels of interleukin-1 beta [IL-1[beta] and tumor necrosis factor-alpha [TNF-alpha] were evaluated by enzyme-linked immunosorbant assay. Oral mucositis rates and severity after 2 weeks were significantly lower in the OLE and benzydamine groups compared to the placebo group. The IL-1beta and TNF-alpha levels were significantly decreased in the OLE group compared to the other groups. Preliminary findings indicate that OLE is effective in reducing IL-1 beta and TNF-alpha levels after chemotherapy and exert a therapeutic effect and prevent development of severe oral mucositis

Uso abusivo de benzidamina no Brasil: uma abordagem em farmacovigilância / Use abusive of benzydamine in Brazil: an overview in pharmacovigilance

O uso abusivo de medicamentos tem sido objeto de crescente interesse em saúde pública e geralmente veiculado na imprensa brasileira. Dentre os medicamentos, objeto de abuso e que causam dependência física e/ou psíquica, incluemse os barbitúricos, benzodiazepínicos, analgésicos opióides e anfetaminas. Os analgésicos, antitérmicos e antiinflamatórios não esteroidais, apesar de não fazerem parte dessa relação de fármacos, estão, geralmente, associados ao uso recreativo ou fins não terapêuticos. O objetivo deste ensaio é apresentar informações sobre o uso abusivo de benzidamina no Brasil. Trata-se de um estudo descritivo do tipo exploratório, em que foram utilizadas diferentes estratégias metodológicas adotadas na prática de regulação em farmacovigilância. O uso abusivo desse fármaco foi constatado na literatura científica, imprensa e internet. Em função da facilidade na compra de medicamentos sujeitos à prescrição médica, entre outros fatores, devem-se exigir meios e formas para monitorar a comercialização e utilização de medicamentos, assegurando seu uso seguro e racional, incluindo o fortalecimento da farmacovigilância no Brasil.

The abusive drug use has been object of increasing concern in public health and is commonly issued in the Brazilian press. Amongst medicines, those that are abuse substances and cause physical and/or psychic dependence, barbiturates, benzodiazepines, opioid analgesics and amphetamines are included. Analgesics, antipyretics and non-steroidal anti-inflammatory drugs, even not making part of this list, are generally associated with recreational use or non therapeutical purpose. The objective of this essay is to present information on the abusive use of benzydamine in Brazil. The present study is an exploratory essay in which different methodological strategies adopted in the regulatory practice of pharmacovigilance have been used. The abusive use of this drug was evidenced in scientific literature, press releases and on the internet. Considering the facility of purchasing drugs under medical prescription, among other factors, it must be demanded ways to assess the marketing and use of medicines, and assure its safe and rational use, including the strengthening of pharmacovigilance in Brazil.

Uso a longo prazo de alternativas terapêuticas aos anti-inflamatórios não-esteroidais / Long term use of therapeutic alternatives for non-steroidal anti-inflammatory drugs

A benzidamina e o etoricoxibe são drogas que podem ser utilizadas como alternativa terapêutica em pacientes com hipersensibilidade aos anti-inflamatórios não-esteroidais (AINEs). O objetivo do estudo foi avaliar a utilização destas medicações a longo prazo em pacientes com teste de provocação negativo. Métodos: Pacientes com hipersensibilidade aos AINEs que apresentaram teste de provocação negativo foram contactados por telefone e questionados sobre a utilização posterior da drogatestada. Os pacientes que responderam que não voltaram a utilizar a droga foram questionados sobre os motivos pelo qualnão usaram. Resultados: Dos 53 pacientes testados, 50 apresentaram teste de provocação negativo. Destes, 36 foram contactados por telefone e 18 haviam utilizado novamente a droga sem qualquer reação. Dentre os que não foram expostos novamente aos medicamentos, metade não o fez porque não julgou necessário, e a outra metade por receio de uma nova reação. Conclusões: O teste de provocação oral é seguro para a determinação de alternativas terapêuticas, mas a eficácia do mesmo está diretamente relacionada ao entendimento do paciente quanto a possibilidade de novas reações. Além disso, as indicações para o teste também devem ser revistas.

Benzydamine and etoricoxib are drugs that can be used as an alternative therapy in patients with hypersensitivity to thenon-steroidal anti-inflammatory drugs (NSAIDs). The aim of the study was to evaluate the long-term use of these drugs inpatients with a negative drug provocation test. Methods: Patients with NSAIDs hypersensitivity that presented a negative drug provocation test were contacted by telephone and questioned about the subsequent use of the tested drug. The patients who answered that they had not used the drug again were questioned on the reasons for not using it. Results: Of the 53 patients tested, 50 presented a negative drug provocation test. Of these, 36 were contacted by telephone and 18 had used the drug again without any reaction. Among the ones that were not exposed again to the drugs, halfof them had not used because they didn't judge necessary, andt he other half were afraid of a new reaction. Conclusions: The drug provocation test is safe for the determination of an alternative therapy, but the effectiveness oft he test is directly related to the patient's understanding about the possibility of new reactions. Besides, the indications for the test should also be reviewed.

Recreational use of benzydamine as a hallucinogen among street youth in Brazil / Uso recreacional de benzidamina como alucinógeno entre adolescentes em situação de rua no Brasil

OBJECTIVE: To describe the recreational use of benzydamine, an anti-inflammatory drug, among street youth in Brazil. METHOD: Design: a descriptive, cross sectional survey. Setting: 93 welfare services for the street youth in 27 Brazilian capitals. Participants: 2807 street youth, 10 to 18 years old. Main outcome measures: demographic characteristics, drug use pattern (lifetime use, use in the past 30 days, frequency, and characteristics of use in the past month) and effects of benzydamine through the use of a questionnaire. RESULTS: 78 reported lifetime recreational benzydamine use (67 cases identified only in three capitals). Among the 30 respondents reporting drug use in the last month (the month preceding the survey), 66.7 percent (n = 20) used the drug on 4 or more days (in the month preceding the survey). The most frequently (50 percent) pleasure effects reported were hallucination and nonspecific sensory changes described as "trips". Unwanted effects were reported by 75 percent of respondents, they were especially nausea and vomiting (21.4 percent). In the majority of the cases, drug was obtained from drugstores without a medical prescription. CONCLUSION: This study identifies the recreational use of benzydamine among street youth, mainly in the Northeast of Brazil, and also indicates the need for special controls on the dispensation of this substance.

OBJETIVO: Descrever o uso recreacional de benzidamina, um medicamento antiinflamatório, entre adolescentes em situação de rua no Brasil. MÉTODO: Desenho: descritivo, transversal. Local: 93 instituições assistenciais para crianças e adolescentes em situação de rua nas 27 capitais do Brasil. Participantes: 2.807 crianças e adolescentes em situação de rua, com idade entre 10 e 18 anos. Principais medidas de interesse: características demográficas, padrão de uso (uso na vida, uso nos últimos 30 dias, frequência e características de uso no mês anterior à pesquisa) e efeitos da benzidamina usando um questionário. RESULTADOS: 78 relataram uso recreacional na vida de benzidamina (67 casos identificados somente em três capitais). Entre os 30 entrevistados que relataram uso recente da substância (no mês que precedia a investigação), 66,7 por cento (n = 20) tomaram o medicamento em quatro dias ou mais no mês. Os efeitos desejados mais frequentemente reportados foram alucinações e alterações sensoriais inespecíficas como "viagem" (50 por cento). Efeitos indesejados foram citados por 75 por cento dos entrevistados, principalmente náuseas e vômitos (21,4 por cento). Na maioria dos casos, o medicamento foi obtido de drogarias sem apresentação de prescrição médica. CONCLUSÃO: Os resultados observados neste estudo identificam o uso recreacional de benzidamina entre crianças e adolescentes em situação de rua, especialmente no Nordeste do Brasil, e indicam a necessidade de controle especial sobre a dispensação desta substância.

Consumo de medicamentos e internet: análise crítica de uma comunidade virtual / Medicine consumption and the internet: critical evaluation of a virtual community

OBJETIVO: Discute-se a promoção do uso de medicamentos na mídia a partir da análise dos diálogos de uma comunidade virtual, cujos participantes utilizam a substância benzidamina em altas dosagens, em busca de seus efeitos adversos. MÉTODOS: Privilegiou-se uma abordagem qualitativa em que, através da técnica de análise de conteúdo, os comentários de um grupo reunido em um Serviço de Rede Social (SRS), disponível na rede mundial de computadores (internet), foram analisados. Dados de 385 participantes foram reunidos e utilizados para a identificação do perfil dos indivíduos. RESULTADOS: O perfil encontrado foi de jovens entre 18 e 20 anos, predominantemente do sexo masculino e com escolaridade média. Verificou-se a partir da análise dos comentários, uma tendência ao consumo de 16 a 20 drágeas do medicamento, acompanhadas ou não de álcool, com o predomínio dos seguintes efeitos: alucinações visuais, insônia e distúrbios gastrointestinais. Pôde-se identificar nos diálogos, duas correntes: uma, que incentiva seu uso não-terapêutico e outra, que o desaconselha. CONCLUSÃO: Uma comunidade virtual organizada em torno da discussão de uso não-terapêutico de um medicamento pode contribuir para a sua promoção, principalmente em jovens. Tal fato reforça a necessidade de maiores campanhas de alerta sobre a automedicação e o cumprimento das leis sanitárias pelas farmácias e drogarias.

OBJECTIVE: Discuss the promotion of medicines in the media by the analysis of dialogs from a virtual community, whose members use benzydamine in high doses seeking the collateral effects. METHODS: Opinions from a group in a Social Network Service (SNS) available in the internet were evaluated by the Analysis of Content Technique, whereas data from 385 members from this group were used to identify a profile of the individuals. RESULTS: The profile found was male, age between 18 and 20 years and in high school. Analysis of opinions revealed the consumption of 16 to 20 tablets of the medicine, sometimes along with alcohol and the occurrence of the following symptoms: visual hallucinations, insomnia and gastrointestinal effects. In the dialogs, two discourses were identified: one recommends this non-therapeutic use and the other tries to dissuade individuals from using it. CONCLUSION: A virtual community organized to discuss a non-therapeutic use of a medicine may contribute to its use. This fact reaffirms the necessity of a major campaign to alert individuals about the dangers of self-medication and also the importance of pharmacies and drugstores to comply with the sanitary legislation.

Uso do cloridrato de benzidamina no tratamento de cistos de retenção de penas em canários (Serinus canarius) / Use of benzidamina HCL on feather cysts treatment in canaries (Serinus canarius) / Uso del hidrocloruro de benzidamina en el tratamiento de los quistes de plumas en canarios (serinus canarius)

Os cistos de retenção de penas surgem como nódulos envolvendo um ou vários folículos das penas e sua ocorrência é devida a má formação da pena em crescimento sob a pele. São comuns em canários, principalmente os das raças Norwich e Gloucester. As formas de tratamento preconizadas são relativamente cruentas e susceptíveis a hemorragias. Este artigo descreve a utilizaçào do anti-inflamatório não esteróide, cloridrato de benzidamina, como método adjuvante para o tratamento desta anomalia. Nos últimos três anos, foram tratados 14 canários na Policlínica da Faculdade de Veterinária da Universidade Federal Fluminense (UFF) com a citada medicação, sendo esta administrada por via oral, diretamente no bico ou diluída na água de beber. As aves tratadas apresentaram maturação dos cistos, facilitando assim a remoção de seu conteúdo, sem os indesejáveis riscos de hemorragia.

Feather cysts appear as swellings involving a single or several feather follicles and are due to malformation of a developing feather under the skin. These cysts are particulary common in Norwich and Gloucester canaries. The recommended forms of treatment are relatively traumatic and may cause hemorrhages. This article describes the use of a non steroidal antiinfl amatory (benzidamina HCL) as an alternative method for the treatment of this anomaly. In the last three years, 14 canaries had been treated at the Veterinary Policlinic of the Universidade Federal Fluminense (UFF) with that drug, administered orally, directly in the beak or in the drinking water. Treated birds presented maturation of the cysts, facilitating the removal of their contents, without risks of hemorrhages.

Los quistes de las plumas aparecen como nódulosinvolucrando uno o varios folículos plumíferos, y esto se debe a una malformación en el desarrollo de la pluma debajo de la piel. Estos quistes son frecuentes en canarios, principalmente en las razas Norwich y Gloucester. Los tratamientos recomendados son relativamente cruentos y susceptibles a hemorragias. Este artículo describe la utilización de un anti-infl amatorio no esteroide (hidrocloruro de benzidamina) como método alternativo para el tratamiento de esta anomalía. En los últimos tres años, fueron tratados 14 canarios en la Policlínica de la Facultad de Veterinaria de la Universidade Federal Fluminense (UFF) con la citada medicación, la cual fue administrada oralmente, directamente en el pico o diluida en el agua de bebida. Las aves tratadas presentaron maduración de los quistes, facilitando laremoción de su contenido sin los indeseables riesgos de hemorragia.

The Effect of Oral Care with Normal Saline on Oral State of Patients in Intensive Care Unit / 성인간호학회지

PURPOSE: To investigate the effect of oral care either with normal saline or with tantum solution on the oral state of the patients in intensive care unit as well as the frequency of bacteria occurrence inside their oral cavities. METHOD: The study was performed from March thru May of 2003 on the nonequivalent control group non-synchronized quasi-experimental design. Forty subjects were selected for each group. The data were analyzed using the SPSS 10.0 Win. The pre-experimental homogeneity and post-experimental differences between the two groups were analyzed with t-test. RESULT: There was a significant difference in the oral cavity state between the experimental group that had used normal saline and the control group that had used tantum solution. CONCLUSION: Based on the results described above, it is considered that normal saline is more effective than the tantum solution for the oral care of the patients in intensive care unit.

Effects of acute and chronic administration of benzydamine on the stimulatory effects of ethanol in mice

Acute and chronic effects of benzydamine (BEZ) and its interactions with ethanol (EtOH) were examined on open field locomotion. Male Swiss mice were injected intraperitoneally (i.p.) with 15, 30 or 60 mg kg of BEZ alone or in combination with EtOH (2.0 mg/k, i.p.). Pretreatment with BEZ (60 mg/kg) produced a significant decrease in EtOH-induced behavioral stimulation. Chronic administration of BEZ (15mg/kg/day for 21 days) intensified locomotor response induced by EtOH, suggesting the development of behavioral sensitization. The results show that BEZ can interact with EtOH suggesting that alcohol drinkers should be educated about risks of BEZ toxicity.

Uso näo médico de benzidamina: relato de caso / Nom-medical use of benzidamina: case study

Os autores apresentam um caso de uso recreativo de benzidamina, por um paciente adulto de 20 anos, descrevendo as manifestaçöes clínicas por ele apresentadas bem como tecendo comentários sobre as características farmacocinéneticas e farmacodinâmicas da droga de implicaçäo na prática terapêutica. Chamam a atençäo para as consequências do seu uso inadequado, mesmo com indicaçäo médica, e da facilidade para sua obtençäo sem receita médica, oportunizando seu emprego abusivo