Systemic Absorption of Ocular Scopolamine in Patients

Lahdes, K; Huupponen, Risto; Kaila, Timo; Salminen, Leena; Iisalo, E

doi:10.1089/jop.1990.6.61

“…Based on the special structural characteristics of the eye and the fact that drugs can enter the rest of the body through a variety of routes after io administration (Hornof et al., 2005), we believe that drugs can be absorbed directly into the systemic circulation through io administration and therefore treat systemic diseases. Previous studies (Baba et al., 1983; Kumar et al., 1985; Novack et al., 1987; Lahdes et al., 1988, 1990; Kaila et al., 1989; Lahdes et al., 1994; Lanzl et al., 2016) have shown that the blood concentration of many eye drops, such as betamethasone and atropine, are high after io administration, which indicates that the drug can enter the systemic circulation through the eyes. Chiou (Chiou, 1994) explored the possibility of the systemic administration of insulin via io administration.…”

Section: Introductionmentioning

confidence: 95%

Intraocular administration of tetramethylpyrazine hydrochloride to rats: a direct delivery pathway for brain targeting?

Mao

¹

,

Li

²

,

Ma

³

et al. 2019

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The purpose of this study was to compare the pharmacokinetic profile of tetramethylpyrazine hydrochloride (TMPH) in rat plasma and tissues following intravenous (iv), intragastric (ig) and intraocular (io) administration. After io, ig and iv administration of a single dose at 10 mg/kg, tissue and plasma samples drawn from the femoral artery were collected at timed intervals. The concentration of TMPH in the samples was analyzed using high-performance liquid chromatography (HPLC). The area under the concentration–time curve ( AUC ) and the drug targeting efficiency percentage ( DTE (%)) were calculated to evaluate the targeting efficiency of the drug with the three different administration routes. After io administration, TMPH was rapidly absorbed to reach its peak plasma and brain concentration within 5 min. The systemic bioavailability obtained with io administration was greater than that obtained through the ig route (63.22% vs. 16.88%). The AUC t rank order of the iv administration group was AUC kidney > AUC heart > AUC liver > AUC brain > AUC spleen > AUC lung ; that of the ig administration group as AUC kidney > AUC liver > AUC heart > AUC spleen > AUC brain > AUC lung ; while that of the io administration group was AUC kidney > AUC brain > AUC heart > AUC liver > AUC spleen > AUC lung . The ratio of the AUC brain value between the io route and iv injection was 1.05, which was greater than that obtained after ig administration (0.30). The DTE after io administration was calculated: brain (165.72%), heart (97.76%), liver (113.06%), spleen (105.31%), lung (163.40%) and kidney (135.31%). The io administration group showed obvious drug transport to the brain. These results indicate that TMPH is rapidly absorbed from the eye into the systemic circulation, and there may be a direct translocation pathway for TMPH from the eye to the brain. Therefore, io administration of TMPH could be a promising alternative to intravenous and oral approaches.

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“…Clinical effects are especially seen in children poisoned by mistake 3 and in adolescents abusing homemade drugs for their hallucinating effects 2 . Systemic effects after topical ophthalmic applications of large doses of hyoscine have been described 4 . Absorption from the conjunctiva and, after nasolacrimal delivery, from nasal mucosa bypass the ®rst-pass effect of the liver 4 .…”

Section: Commentmentioning

confidence: 99%

“…Systemic effects after topical ophthalmic applications of large doses of hyoscine have been described 4 . Absorption from the conjunctiva and, after nasolacrimal delivery, from nasal mucosa bypass the ®rst-pass effect of the liver 4 . Other circumstances in which unilateral mydriasis has resulted from local drugs are treatment of airway disease with nebulized ipratropium bromide 5 and prevention of motion sickness with transdermal hyoscine 6 .…”

Section: Commentmentioning

confidence: 99%

“…In at least half the cases there are serious acute complications such as ventriculitis, cerebral abscesses and subdural effusions; up to 71% of patients have permanent neurological sequelae, including hydrocephalus, seizures and mental retardation 3 . Because of the severity of the infection and risk of relapse, at least three weeks' intravenous treatment with a third-generation cephalosporin (usually cefotaxime or ceftriaxone) is advised 4 .…”

mentioning

confidence: 99%

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Salmonella meningitis and a green iguana

Sam

¹

,

Mackay²

2000

J R Soc Med

6

0

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Salmonella species are a rare cause of bacterial meningitis, affecting mainly infants and the immunocompromised. Human salmonellosis associated with exotic pets has increased 1. CASE HISTORY A 27-day-old baby boy was seen with an 8-hour history of irritability and poor feeding. His birth had been uncomplicated and he had been well since. On examination, he was lethargic and febrile (38.78C) and had a diffuse erythematous rash. His fontanelle was normal. The white cell count was 12.5610 9 /L (neutrophils 66%). Sepsis was suspected and intravenous saline and cefotaxime were started. Cerebrospinal¯uid showed 1500 polymorphs and 100 lymphocytes/mL, no red cells, no organisms on the Gram stain, protein 1.4 g/L, and glucose 2.7 mmol/L (serum glucose 7.4 mmol/L). Ampicillin and gentamicin were added to cover Listeria monocytogenes. The next day, culture of the cerebrospinal¯uid grew a Salmonella species. Treatment was continued with cefotaxime alone. The baby lived with his parents and eight-year-old brother; no one had recently had diarrhoea and stool cultures from all four family members yielded no pathogens. The Laboratory of Enteric Pathogens in Colindale, UK, identi®ed the organism as Salmonella poona, a serotype found mainly in reptiles. Further questioning of the family revealed that they owned a green iguana (Iguana iguana), which was handled only by the father and not allowed out of its tank. The iguana was healthy but was excreting S. poona indistinguishable from the ®rst isolate. Environmental swabs taken in the family home grew S. poona from the vacuum cleaner and the iguana tank. The baby recovered clinically and completed a 22-day course of intravenous antibiotics. Repeat lumbar puncture

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“…In this context, further physical symptoms may occur due to the very rapid systemic absorption at higher concentrations [15].…”

Section: Introductionmentioning

confidence: 99%