Pledget

Meissel, m. chisel cutting tool bit stylus Med.) pledget. 

Tupfer, m. pledget, tampon swab. Tupf-probe, /. spot test, drop test, -reaktion, /. spot reaction. 

USA Cleocin (Pharmacia Upjohn 1970) Clinda-Derm (Paddock) Clindets Pledgets (Stiefel)... 

Adapalene (Differin) is a third-generation retinoid with comedolytic, kera-tolytic, and antiinflammatory activity, ft is available as 0.1% gel, cream, alcoholic solution, and pledgets. A 0.3% gel formulation is also available. 

Fill ear canal and insert saturated pledget tid-qid prn pain. 

Brand Name(s) Cleocin HCl, Cleocin Ovules, Cleocin Phosphate, Cleocin T, Cleocin Vaginal, Clinda-Derm, Clindagel, Clindamax, Clindesse, Clindets Pledget Cfiemical Class Lincomycin derivative... 

For diabetes insipidus, vasopressin solution for injection maybe administered in-tranasallyon cotton pledgets, by nasal spray, orby dropper dose must be individualized... 

These are the preparations used for temporary relief of toothache by application of a small pledget of cotton soaked with the product into the tooth cavity. Certain local anaesthetic compounds, e.g. benzocaine. 

CLEOCIN T topical solution and CLEOCIN T topical lotion contain clindamycin phosphate at a concentration equivalent to 10 mg clindamycin per milliliter. CLEOCIN T topical gel contains clindamycin phosphate at a concentration equivalent to 10 mg clindamycin per gram. Each CLEOCIN T topical solution pledget applicator contains... 

Ointment with cliquinol TLC Add acetone, warm on steam bath, filter with pledget glass wool Silica Benzene-MeOH (9 1) 254 nm USP23. p. 1113 HPLC [10,581,776,908] stability [1104] [ ]... 

Cardiovascular Disease. Patients with systemic hypertension, arteriosclerosis, and other cardiovascular diseases may be at risk when high concentrations of topically administered adrenergic agonists such as phenylephrine are used. Repeated topical doses or soaked cotton pledgets placed in the conjunctival sac have been associated with adverse cardiovascular effects. Likewise, P-blockers should be avoided or used cautiously in patients with congestive heart disease, severe bradycardia, and high-grade atrioventricular block. Topical P-blockers, however, may be used safely in patients with cardiac pacemakers. 

Figure 3-14 Cotton pledget positioned in the inferior conjunctival fornix.

The clinical use of pledgets is usually reserved for administration of mydriatic solutions such as phenylephrine. This method of drug delivery allows maximum mydriasis in attempts to break posterior synechiae or dilate sluggish pupils. Mydriasis of the inferior pupillary quadrant for intentional sector dilation of the pupil can also be achieved (see Chapter 20). 

Prolonged irrigation, application with a conjunctival pledget, or subconjimctiv injection of the 10% solution is not recommended. 

Figure 19-3 Anesthetic-soaked cotton pledget may be appUed to the punctum for 1 to 2 minutes before procedures involving the nasolacrimal system.

Various ocular conditions may benefit from medication delivered via a subconjimctival injection. Applications include recalcitrant uveitis, cystoid macular edema, felling trabeculectomy, and severe corneal ulcer in a noncompli-ant patient. One to two drops of topical anesthesia should be instilled. Additionally, an anesthetic-soaked pledget of 4% lidocaine applied to the area of injection may enhance comfort, particularly if the conjunctiva is to be lifted with forceps before introducing the needle into the subconjunctival space (Figure 19-4). 

The excision of small superficial conjimctival lesions, such as concretions, can usually be achieved with topical anesthesia alone.Two or three drops instilled at 1-minute intervals allow sufficient anesthesia for this purpose. Alternatively, a cotton pledget or cotton-tipped applicator soaked in anesthetic solution may be applied for 1 to 2 minutes before surgery.This local application allows anesthesia of deeper portions of the conjimctiva. 

Figure 19-4 Lifting the conjunctiva with tissue forceps exposing the subconjunctival space before injection is better tolerated if an anesthetic-soaked cotton pledget is applied to the area first.

Cotton pledgets saturated Time required to produce with L in water/IPA/ anaesthetic effect glycerine... 

Pseudomonas bacteremia has been attributed to the use of material in open-heart surgery that was stored in accidentally contaminated benzalkonium solutions, and after cardiac catheterization caused by inadequate disinfection of the catheters with benzalkonium solutions. In 1961, about 15 patients were reported with Pseudomonas infections caused by cotton pledgets kept in a contaminated aqueous solution used for skin antisepsis before intravenous and intramuscular injection (8). In 1976 there were outbreaks of Pseudomonas cepacia infections in two American general hospitals (9) and pseudobacteremia Pseudomonas cepacia or Enterobacter) caused by contamination of blood cultures in 79 patients in whom contaminated aqueous benzalkonium solutions were used for skin and antisepsis before venepuncture and due to contamination of the samples (SEDA-11, 490) (10). 

Phenylephrine is seldom given systemically but is still commonly used as a mydriatic for both diagnostic and therapeutic purposes. Ocular application of phenylephrine 10% in pledget form is used to produce hemostasis in laser-assisted in-situ keratomileusis (LASIK) surgery and other ophthalmic surgical procedures. Phenylephrine is in some countries available in a non-prescription concentration of 0.12% for use as an ocular decongestant. Phenylephrine (up to 10 mg intramuscularly) has similar properties and uses to other alpha-adrenoceptor agonists. 

The incidence of adverse effects is high with 10% phenylephrine, but less with lower concentrations. Systemic reactions also increase with increased frequency of use and when phenylephrine is applied in a pledget. The package inserts for 10% phenylephrine in the USA and Australia require that the drug should not be used more often than once an hour. A large number of severe... 

Fraunfelder FW, Fraunfelder FT, Jensvold B. Adverse systemic effects from pledgets of topical ocular phenylephrine 10%. Am J Ophthalmol 2002 134(4) 624-5. 

Hecker RB, Hays JV, Champ JD, Rubai BJ. Myocardial ischemia and stunning induced by topical intranasal phenylephrine pledgets. Mil Med 1997 162(12) 832-5. 

Another indication for this technique is evaluation for a CSF leak after. surgery or trauma. One variation of evaluating fur a leak is to put cotton pledgets in the nostrils fur 24 hours and check for abnormal radioactivity on (he pledgets. 

Note May administer intranasally on cotton pledgets, by nasal spray individualize dosage. 

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