• Journal of Dental Anesthesia and Pain Medicine
• /
• 제16권1호
• /
• pp.25-29
• /
• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• Journal of Ginseng Research
• /
• 제18권3호
• /
• pp.165-174
• /
• 1994

To investigate the significant indicators Improving the undisturbed memory in animal behavior, we employed several behavioral methods (learning, relearning in radial maze, and active avoidance) with ginseng components. Results showed that the repeated intranasal administration of $Rb_1$ and total saponins from Korean red ginseng induced direct effects on the brain mechanisms in rats, and improved the spatial memory during the learning, relearning and retention in the 12-arm radial maze test. The intranasal treatment of the total saponins also effectively improved the disturbed memory (amnesia) by pentylentetrazole, and simultaneously protected the brain by decreasing the severity of motor epileptic seizures. The intraperitonial administration of polysaccharide fraction of Korean red ginseng could improve avoidance behavior (amount of the total ecapes) in the active-avoidance test. In addition, local changes of the temperature and resistance of skin observed after Rb, administration were suggested to reflect some action of sympathetic nerve Key words Memory, intranasal administration, pentylenetetrazole, Korea red ginseng.

• Journal of Pharmaceutical Investigation
• /
• 제22권2호
• /
• pp.77-96
• /
• 1992

In recent years intranasal administration of drugs has received great attention as a convenient and efficent method of drug delivery because of its potential to improve the systemic effect of substances with a poor oral bioavailability. In addition to offering advantages such as rapid absorption, fast onset of action and avoiding the first -pass effect, it provides for delivery of drugs from very lipophilic drugs such as steroids to polar and hydrophilic drugs such as peptides and proteins. However, little is still known about the nature of various barriers existing in the nasal mucosae as well as mechanism by which these molecules are absorbed. This review article therefore intends to discuss nasal physiology, experimental methods and evaluation of absorption from the nasal cavity, factors influencing nasal absorption, mechanism of nasal absorption, approaches to improve the residence time and to obtain the sustained-release effect of intranasally administered drugs, promoters and mechanism for the enhancement of nasal absorption, Several examples for intranasal delivery of various systemically effective drugs will be reviewed and illustrated. Drug metabolism in the nasal mucosae and problems associated with intranasal administration of drugs will be also discussed.

• 대한소아치과학회지
• /
• 제25권4호
• /
• pp.772-781
• /
• 1998

The purpose of this study was to assess the sedative effect of intranasal spray with midazolam for management of the uncooperative 20 children aged from 24 months to 92 months who required extensive treatment. The patients were given randomly a dose of 0.2mg/kg of intranasal placebo, intranasal spray with midazolam, and intranasal drop with midazolam. All the children were restrained in a pediwrap and were monitored with pulse oximeter for assessing the pulse rate and peripheral oxygen saturation. According to Fukuta's behavior rating scale, behavior was checked for evaluation of the clinical sedative effect. The obtained results were as follows: 1. Behavior score of intranasal spray with midazolam was lower than intranasal drop with midazolam(P<0.01). 2. Pulse rate was a significant change as a function of dental procedure(P<0.001), however the peripheral oxygen saturation was not influenced significantly by either adiministration route of drug or dental procedure. Clinically, intranasal spray with midazolam were safe and effective sedation in young children undergoing pediatric dental procedures.

• Biomolecules & Therapeutics
• /
• 제25권2호
• /
• pp.149-157
• /
• 2017

The interleukin-1 receptor antagonist (IL-1RA) is a potential stroke treatment candidate. Intranasal delivery is a novel method thereby a therapeutic protein can be penetrated into the brain parenchyma by bypassing the blood-brain barrier. Thus, this study tested whether intranasal IL-1RA can provide neuroprotection and brain penetration in transient cerebral ischemia. In male Sprague-Dawley rats, focal cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) for 1 h. The rats simultaneously received 50 mg/kg human IL-1RA through the intranasal (IN group) or intraperitoneal route (IP group). The other rats were given 0.5 mL/kg normal saline (EC group). Neurobehavioral function, infarct size, and the concentration of the administered human IL-1RA in the brain tissue were assessed. In addition, the cellular distribution of intranasal IL-1RA in the brain and its effect on proinflammatory cytokines expression were evaluated. Intranasal IL-1RA improved neurological deficit and reduced infarct size until 7 days after MCAO (p<0.05). The concentrations of the human IL-1RA in the brain tissue 24 h after MCAO were significantly greater in the IN group than in the IP group (p<0.05). The human IL-1RA was confirmed to be co-localized with neuron and microglia. Furthermore, the IN group had lower expression of $interleukin-1{\beta}$ and tumor necrosis $factor-{\alpha}$ at 6 h after MCAO than the EC group (p<0.05). These results suggest that intranasal IL-1RA can reach the brain parenchyma more efficiently and provide superior neuroprotection in the transient focal cerebral ischemia.

• Biomolecules & Therapeutics
• /
• 제27권5호
• /
• pp.450-456
• /
• 2019

Taurine has a number of beneficial pharmacological actions in the brain such as anxiolytic and neuroprotective actions. We explored to test whether taurine could be transported to the central nervous system through the intranasal route. Following intranasal administration of taurine in mice, elevated plus maze test, activity cage test and rota rod test were carried out to verify taurine's effect on anxiety. For the characterization of potential mechanism of taurine's anti-anxiety action, mouse convulsion tests with strychnine, picrotoxin, yohimbine, and isoniazid were employed. A significant increase in the time spent in the open arms was observed when taurine was administered through the nasal route in the elevated plus maze test. In addition, vertical and horizontal activities of mice treated with taurine via intranasal route were considerably diminished. These results support the hypothesis that taurine can be transported to the brain through intranasal route, thereby inducing anti-anxiety activity. Taurine's anti-anxiety action may be mediated by the strychnine-sensitive glycine receptor as evidenced by the inhibition of strychnine-induced convulsion.

• 대한소아치과학회지
• /
• 제25권4호
• /
• pp.782-787
• /
• 1998

Midazolam의 비강내 분무를 이용한 소아치과 환자의 의식진정하 치과치료 결과, 아래와 같은 특징들이 발견되었으며, 기존의 비강내 점적의 대표적인 단점인 posterior dripping이 대부분 제거되었음에도 불구하고, 상기도감염 등의 경우 보이는 비강내 충혈, 잦은 비루등의 경우에서는 이의 사용이 제한됨을 알 수 있었다. 1. 투여시 불편감의 감소 2. 점적의 경우보다 빠른 약효의 발현 및 회복 3. 점적시 보였던 rhinorrhea등 부작용의 감소 4. 점적시보다 개선된 행동양상의 표현

• Biomolecules & Therapeutics
• /
• 제24권3호
• /
• pp.244-251
• /
• 2016

Understanding the developmental mechanisms of humoral immunity against intranasal antigens is essential for the development of therapeutic approaches against air-borne pathogens as well as allergen-induced pulmonary inflammation. Follicular helper T (Tfh) cells expressing CXCR5 are required for humoral immunity by providing IL-21 and ICOS costimulation to activated B cells. However, the regulation of Tfh cell responses against intranasal antigens remains unclear. Here, we found that the generation of Tfh cells and germinal center B cells in the bronchial lymph node against intranasal proteinase antigens was independent of $TGF-{\beta}$. In contrast, administration of STAT3 inhibitor STA-21 suppressed the generation of Tfh cells and germinal center B cells. Compared with wild-type OT-II T cells, STAT3-deficient OT-II T cells transferred into recipients lacking T cells not only showed significantly reduced frequency Tfh cells, but also induced diminished IgG as well as IgE specific for the intranasal antigens. Cotransfer study of wild-type OT-II and STAT3-deficient OT-II T cells revealed that the latter failed to differentiate into Tfh cells. These findings demonstrate that T cell-intrinsic STAT3 is required for the generation of Tfh cells to intranasal antigens and that targeting STAT3 might be an effective approach to ameliorate antibody-mediated pathology in the lung.

• 대한소아치과학회지
• /
• 제31권3호
• /
• pp.431-438
• /
• 2004

Midazolam은 현재 치과에서 널리 사용되고 있는 의식하 진정용 약물이다. 그러나 주로 경비투여로 사용될 뿐 경구투여 특히 소아에서 경구투여에 대한 지침이 언어 본 연구를 통해 midaaolam의 경구투여 시 진정효과에 대해 알아보고자 하였다. 전신상태가 양호하며 2회 이상의 치료가 필요한 남아 15명 여아 13명, 총 28명의 환아를 대상으로 midazolam($Dormicum^{(R)}$, Roche)을 경비투여 (0.2mg/kg)와 경구투여 (0.5m/kg)하여 치과치료를 시행한 후 치료과정을 6단계로 구분하여 각 단계별로 수면지수와 울음지수, 움직임지수, 전반적인 행동지수를 측정, 비교하여 다음과 같은 결과를 얻었다. 1. 전체 치료과정동안 수면지수와 울음지수, 움직임지수, 전반적인 행동지수 비교 시 I군(경비투여)과 II군(경구투여) 사이에 유의한 차이가 없었다(p>0.05). 2. 보호자 설문조사 결과 I군에서는 67.8%의 보호자가 투여 시 아이가 고통스러워한다고 답하였으며 T군에서는 17.8%의 보호자가 투여에 어려움이 있다고 답하였다. 3. 귀가 후 행동양상에 대한 질문에서 '평상시와 비슷하다'가 I군에서는 78.6%, II군에서는 57.1%로 경비투여 시 더 빠른 회복을 보이는 것으로 나타났다. 위와 같은 결과를 종합하여 볼 때 midazolam의 경구투여는 경비투여와 유사한 적절한 진정효과를 가지면서 환자에게 더 잘 받아들여지는 투여방법으로 생각된다.

• 대한소아치과학회지
• /
• 제27권2호
• /
• pp.283-291
• /
• 2000

경희대학교 치과병원 소아치과에 내원한 환자중 3회 이상의 치료가 필요한 어린이 22명으로 남아 8명, 여아 14명을 대상으로 하였다. 환자는 ASA I에 해당되었으며 첫 내원시 Frankl 행동분류로 negative 13명, definitely negative 9명이었다. 동일어린이에 대해 midazolam(Dormicum, 한국로슈)을 근육내 투여 (I군, 0.15mg/kg), 비강내 점적 (II군, 0.20mg/kg), 비강내 분무(III군, 0.20mg/kg)를 순서에 무관하게 내원시마다 투여한 후 투여방법과 치료과정에 따른 진정 효과, 심박동수 및 동맥혈 산소포화도 변화의 차이를 비교하여 평가한 후 다음과 같은 결과를 얻었다. 1. 심박동수와 동맥혈 산소포화도는 모든 치료과정에서 안정적이었으며, 약물의 투여방법과 치료과정에서 통계학적으로 유의한 차이를 보이지 않았다(P>0.05). 2. 수면효과에서는 비강내 분무, 비강내 점적, 근육내 투여의 순서로 효과가 크게 나타났으며(P<0.0001), 러버댐 장착기와 충전기를 제외한 모든 치료과정 에서 비강내 분무가 가장 효과적 이었다. 3. 울음, 움직임, 전반적 행동평가에서 비강내 점적, 비강내 분무, 근육내 투여의 순서로 효과가 크게 나타났으며 (P<0.0001), 치료의 모든 과정에서 비강내 점적이 가장 효과적이었다.