Abstract:
:Intranasal corticosteroids and intranasal antihistamines are efficacious topical therapies in the treatment of allergic rhinitis. This review addresses their relative roles in the management of this disease, focusing on their safety and tolerability profiles. The intranasal route of administration delivers drug directly to the target organ, thereby minimising the potential for the systemic adverse effects that may be evident with oral therapy. Furthermore, the topical route of delivery enables the use of lower doses of medication. Such therapies, predominantly available as aqueous formulations following the ban of chlorofluorocarbon propellants, have minimal local adverse effects. Intranasal application of therapy can induce sneezing in the hyper-reactive nose, and transient local irritation has been described with certain formulations. Intranasal administration of corticosteroids is associated with minor nose bleeding in a small proportion of recipients. This effect has been attributed to the vasoconstrictor activity of the corticosteroid molecules, and is considered to account for the very rare occurrence of nasal septal perforation. Nasal biopsy studies do not show any detrimental structural effects within the nasal mucosa with long-term administration of intranasal corticosteroids. Much attention has focused on the systemic safety of intranasal application. When administered at standard recommended therapeutic dosage, the intranasal antihistamines do not cause significant sedation or impairment of psychomotor function, effects that would be evident when these agents are administered orally at a therapeutically relevant dosage. The systemic bioavailability of intranasal corticosteroids varies from <1% to up to 40-50% and influences the risk of systemic adverse effects. Because the dose delivered topically is small, this is not a major consideration, and extensive studies have not identified significant effects on the hypothalamic-pituitary-adrenal axis with continued treatment. A small effect on growth has been reported in one study in children receiving a standard dosage over 1 year, however. This has not been found in prospective studies with the intranasal corticosteroids that have low systemic bioavailability and therefore the judicious choice of intranasal formulation, particularly if there is concurrent corticosteroid inhalation for asthma, is prudent. There is no evidence that such considerations are relevant to shorter-term use, such as in intermittent or seasonal disease. Intranasal therapy, which represents a major mode of drug delivery in allergic rhinitis, thus has a very favourable benefit/risk ratio and is the preferred route of administration for corticosteroids in the treatment of this disease, as well as an important option for antihistaminic therapy, particularly if rapid symptom relief is required.
journal_name
Drug Safjournal_title
Drug safetyauthors
Salib RJ,Howarth PHdoi
10.2165/00002018-200326120-00003keywords:
subject
Has Abstractpub_date
2003-01-01 00:00:00pages
863-93issue
12eissn
0114-5916issn
1179-1942pii
26123journal_volume
26pub_type
杂志文章,评审相关文献
DRUG SAFETY文献大全abstract:BACKGROUND:Depressive disorders and use of antidepressants are associated with adverse effects on sexual function. In pharmacoepidemiological studies, sexual disorders are reported by more than 50 % of patients taking serotonin reuptake inhibitors (SRIs). OBJECTIVE:The aim of this study was to determine the reporting ...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.1007/s40264-013-0069-z
更新日期:2013-07-01 00:00:00
abstract::In August 2015, the US Food and Drug Administration (FDA) made the controversial decision to approve flibanserin (Addyi®) for women experiencing hypoactive sexual desire disorder. A number of factors contributed to disagreements regarding the FDA's decision, including the product's two prior failed FDA reviews, the un...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.1007/s40264-015-0389-2
更新日期:2016-05-01 00:00:00
abstract::The available antihyperlipidaemic drugs are generally safe and effective, and major systemic adverse effects are uncommon. However, because of their complex mechanisms of action, careful monitoring is required to identify and correct potential drug interactions. Bile acid sequestrants are the most difficult of these a...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-199411050-00002
更新日期:1994-11-01 00:00:00
abstract::Current key challenges and controversies encountered in the identification of potentially hepatotoxic drugs and the assessment of drug-induced liver injury (DILI) are covered in this article. There is substantial debate over the classification of DILI itself, including the definition and validity of terms such as 'int...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.1007/BF03261997
更新日期:2012-12-01 00:00:00
abstract::All national guidelines for the management of hypertension recommend angiotensin receptor blockers (ARBs) as an initial or add-on antihypertensive therapy. The eight available ARBs have variable clinical efficacy when used for control of hypertension. Additive blood pressure-lowering effects have been demonstrated whe...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.1007/s40264-014-0239-7
更新日期:2015-01-01 00:00:00
abstract::Recent evidence from animal studies has raised the possibility that immunisation by vaccines can influence the pathogenesis of type I (insulin-dependent) diabetes mellitus. In non-obese diabetic mice and biobreeding rats, complete Freund's adjuvant and bacillus Calmette-Guérin (BCG) vaccine have successfully been used...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-199920030-00001
更新日期:1999-03-01 00:00:00
abstract::Benzodiazepine drugs have been shown to suppress respiratory function in patients with chronic obstructive pulmonary disease (COPD). We designed a placebo-controlled crossover study to compare the effects of a new benzodiazepine, estazolam ('ProSom'), with those of flurazepam ('Dalmane') on cardiopulmonary function in...
journal_title:Drug safety
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2165/00002018-199207020-00006
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVES:Difficulty sleeping is a recognised tobacco withdrawal symptom, but sleep problems, like application site reactions, are commonly reported as adverse reactions to transdermal nicotine therapy. However, no studies have examined potential predictive factors associated with the occurrence of expected adverse ex...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.2165/00002018-199920060-00007
更新日期:1999-06-01 00:00:00
abstract::Histone deacetylases (HDACs) are expressed at increased levels in cells of various malignancies, and the use of HDAC inhibitors has improved outcomes in patients with haematological malignancies (T-cell lymphomas and multiple myeloma). However, they are not as effective in solid tumours. Five agents are currently appr...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.1007/s40264-018-0773-9
更新日期:2019-02-01 00:00:00
abstract::As the variety and range of pharmaceutical agents available to the medical profession continues to expand, one unavoidable effect will be an increase in drug-induced disease, including cardiovascular disorders. However, given the high rates of cardiovascular disease and prevalence of recognised cardiovascular risk fac...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200730090-00005
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Checkpoint inhibitor drugs including ipilimumab have been reported to induce intestinal injury. OBJECTIVE:We aimed to evaluate the risk of chronic (> 6 weeks) enterocolitis following ipilimumab administration, and the likelihood that an enteritis vs colitis or enterocolitis is seen. PATIENTS AND METHODS:...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.1007/s40264-020-00979-4
更新日期:2020-12-01 00:00:00
abstract::The term 'benefit-risk ratio' is often used as a general term linked to the use of a medicine. To balance risk and benefit is, however, a very complex exercise. For most medicines the benefits are limited to a few indications and for an individual patient there is usually only a single benefit sought but the potential...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.2165/00002018-199615010-00001
更新日期:1996-07-01 00:00:00
abstract::Rhythm control in atrial fibrillation (AF) can be achieved using pharmacological therapy. Amiodarone is the most efficacious anti-arrhythmic agent; however, its use is limited due to an unfavourable safety profile, including pro-arrhythmia, thyroid, liver, skin and pulmonary complications. Dronedarone, which is struct...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.1007/s40264-012-0012-8
更新日期:2013-02-01 00:00:00
abstract::Quinolones are a class of antibacterial agents for the treatment of several infectious diseases (e.g. urinary and respiratory tract infections). They are used worldwide due to their broad spectrum of activity, high bioavailability and good safety profile. The safety profile varies from quinolone to quinolone. The aim ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/11587280-000000000-00000
更新日期:2011-06-01 00:00:00
abstract::After 2002, an association between stroke and antipsychotic use was reported in clinical trials and large database studies. This review considers previous quantitative reviews, newly published clinical trials, and recent observational cohort and case-control studies, and focuses on the clinical significance of the ris...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/11319120-000000000-00000
更新日期:2010-04-01 00:00:00
abstract::The clinician prescribing beta-blockers for his or her patients is faced with an often difficult situation. There are many beta-blockers, each with its own pharmacological profile. Patients are often taking multiple medications, thus increasing the risk of both anticipated and unexpected drug interactions. Reports of ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-199513060-00005
更新日期:1995-12-01 00:00:00
abstract::Although heart failure is predominantly caused by cardiovascular conditions such as hypertension, coronary heart disease and valvular heart disease, it can also be an adverse reaction induced by drug therapy. In addition, some drugs have the propensity to adversely affect haemodynamic mechanisms in patients with an al...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200629070-00003
更新日期:2006-01-01 00:00:00
abstract::Adverse drug effects are manifold and heterogenous. Many situations may hamper the signalling (i.e. the detection of early warning signs) of adverse effects and new signals often differ from previous experiences. Signals have qualitative and quantitative aspects. Different categories of adverse effects need different ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-199716060-00002
更新日期:1997-06-01 00:00:00
abstract::Drug eruptions are among the most common adverse drug reactions, affecting approximately 3% of hospitalised patients. Although the rate of severe cutaneous adverse reactions to medications is low, these reactions can affect anyone who takes medication, and can result in death or disability. Two general patterns can be...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200730110-00003
更新日期:2007-01-01 00:00:00
abstract::Lipodystrophy complications, including lipoatrophy (pathological fat loss) and metabolic complications, have emerged as important long-term toxicities associated with antiretroviral therapy in the current era. The wealth of data that has accumulated over the past 6 years has now clarified the contribution of specific ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200528120-00002
更新日期:2005-01-01 00:00:00
abstract::In general, the selective estrogen receptor modulators (SERMs) currently indicated for the treatment and prevention of breast cancer, i.e. tamoxifen and toremifene, are fairly well tolerated. However, tamoxifen has been shown to induce hepatocellular carcinomas in rats, but not in humans, and can increase the risk of ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200124140-00003
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:For many regularly used drugs, evidence for safe use in pregnancy has not been established. Despite this, international studies have identified high levels of drug prescribing among pregnant women. OBJECTIVE:To investigate the patterns of prescribing of drugs to women who gave birth in Tayside, Scotland, in...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.2165/11532330-000000000-00000
更新日期:2010-07-01 00:00:00
abstract::Drug-induced QT interval prolongation is now a major concern in safety pharmacology. Regulatory authorities such as the US FDA and the European Medicines Agency require in vitro testing of all drug candidates against the potential risk for QT interval prolongation prior to clinical trials. Common in vitro methods incl...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200427110-00002
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Macrolides are a group of commonly prescribed antibiotics. There is some doubt surrounding the use of the newer macrolides in pregnancy. OBJECTIVE:The present study aimed to compare outcomes of pregnancies exposed to the new macrolides clarithromycin, azithromycin and roxithromycin with non-teratogenic prep...
journal_title:Drug safety
pub_type: 杂志文章,多中心研究
doi:10.2165/11630920-000000000-00000
更新日期:2012-07-01 00:00:00
abstract::The prognosis is generally poor for patients who experience a cardiac arrest. The most common causes of sudden cardiac arrest are massive pulmonary embolism (PE) and acute myocardial infarction (MI). While thrombolysis is a first-line treatment option in massive PE and acute MI, cardiopulmonary resuscitation (CPR) has...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200326060-00001
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:As asthma medications are frequently prescribed for children, knowledge of the safety of these drugs in the paediatric population is important. Although spontaneous reports cannot be used to prove causality of adverse events, they are important in the detection of safety signals. OBJECTIVE:Our objective w...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.1007/s40264-019-00870-x
更新日期:2020-01-01 00:00:00
abstract::This review evaluates the benefits and potential health risks of the currently used drugs that are approved for the pharmacological treatment of obesity. Analysis of several long term clinical trials indicates that all of these drugs are efficient in reducing excess bodyweight, and that the majority of them allow the ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-199920020-00003
更新日期:1999-02-01 00:00:00
abstract::Current antiretroviral therapy has lead to longer survival in patients infected with HIV, but it is also associated with new and important problems. Body fat redistribution and metabolic abnormalities, the so-called lipodystrophy syndrome, are among the most prevalent and worrisome ones. While an increasing number of ...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.2165/00002018-200124030-00001
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Selective serotonin reuptake inhibitors (SSRIs) are frequently prescribed in the elderly due to a more favorable risk profile than other antidepressants (ADs). However, SSRIs are associated with an increased risk of gastrointestinal bleeding, while evidence on the risk of hemorrhagic stroke (HS) ...
journal_title:Drug safety
pub_type: 杂志文章
doi:10.1007/s40264-019-00837-y
更新日期:2019-09-01 00:00:00
abstract::Probiotics have seen widespread use for a variety of gastrointestinal problems, especially in two common disorders: irritable bowel syndrome and inflammatory bowel disease. Since a wide variety of probiotic preparations has been used, and despite a large number of studies performed, a great deal of heterogeneity exist...
journal_title:Drug safety
pub_type: 杂志文章,评审
doi:10.1007/s40264-015-0349-x
更新日期:2016-04-01 00:00:00