Solution instillation

Two drops of a 10% solution instilled in rabbit eyes caused immediate pain, and the epithelium turned gray within seconds the conjunctivae were hyperemic with moderate discharge and corneas were opaque at 2 days. Corneal clouding gradually, but not completely, cleared with in 6 weeks. 

Cystitis, candidal - Irrigate bladder with a 50 mcg/mL solution, instilled periodically or continuously for 5 to 10 days. 

Solutions - Instill 1 to 2 drops into the conjunctival sac every hour during the day and every 2 hours during the night as initial therapy. When a favorable response is observed, reduce dosage to 1 drop every 4 hours. Further reduction in dosage to 1 drop 3 or 4 times daily may suffice to control symptoms. 

Treatment of viscid mucus secretions in patients with a tracheostomy Intratracheal 1 -2 ml of 10% or 20% solution instilled into tracheostomy q 1 -4h. 

Uveitis (posterior synechia) Topical Instill 1 drop of 10% solution in eye 3 or more times dailywith atropine sulfate. In general, the 2.5% solution is preferred in elderly to avoid adverse cardiac reactions. Intranasal Apply 2-3 drops or 1-2 sprays of a 0.25% to 0.5% solution instilled in each nostril or a small quantity of 0.5% nasal jelly applied into each nostril. Apply every 4 hours as needed. The 1% solution maybe used inpatients with severe congestion. 

Little, J.B., McGrandy, R.B., and Kennedy, A.R. (1978). Intaactions between Polonium 210 irradiation, benzo[a]pyrene, arid 0.9% NaCl solution instillations in the induction of experimental lung cancer, Cancer Res. 38,1929. 

Alternatively, antibiotics such as trimethoprim-polymyxin B (Polytrim), gentamicin, or tobramycin solution, instilled as one drop four times daily for 5 to 7 days, or prior generation fluoroquinolones such as ciprofloxacin, ofloxacin, or levofloxacin, dosed four times daily for 5 to 7 days, may be prescribed. Bacitracin-polymyxin B (Polysporin), erythromycin, gentamicin, tobramycin, or ciprofloxacin ointment may be used at bedtime as supplemental therapy or four times daily in children or other patients who are not comfortable with eyedrops. 

Neither the uptake nor the transfer of mercury from a lO -M solution instilled into an isolated loop of rat intestine was significantly altered by the presence of a lO -M solution of dehydroascorbate (58). Thus, with 100-fold molar excesses of ascorbic acid the intestinal absorption of either cadmium or mercury was not aflFected, but at some internal location, ascorbic acid apparently counteracts the toxic activity of cadmium. 

Using solutions, instill sufficient only to fill the lower conjunctival fornix. Excess is wasteful and may accelerate elution of the drug from the eye by capillary action. 

At lOPs greater than 60 mm Hg, the iris may be ischemic and unresponsive to miotics as the pressure drops and the iris responds, miosis occurs. During this time, the urge to use excessive amounts of pilocarpine must be resisted. The dose of pilocarpine commonly used is a 1 % or 2% solution instilled every 5 minutes for two or three doses and then every 4 to 6 hours. However, many practitioners withhold application of pilocarpine until the lOP has been reduced by other... 

Ketorolac, a nonsteroidal antiinflammatory agent (one drop of 0.5% solution instilled in the conjunctival sac), is nsed for relief of ocular itching caused by seasonal allergic conjunctivitis (see also Table 3). 

The simplest synthetic mydriatic of the series is phenylisopropylamine or benzedrine (C6H6CH2CH(CH3)NH2) a 1 % solution, instilled into the conjunctival sac, causes complete pupillary dilatation within an hour, the effect wearing off in about 2 hours. Paredrine (4-HOC6H4CH2CII(CH3)-NH2) is even more effective and is probably the most effective synthetic mydriatic of the sympathomimetic drugs. It causes no significant increase in intraocular pressure and can be safely combined with atropine or hom-atropine if paralysis of accommodation is also required. 

Dose Topical, for open-angle glaucoma, 0.1 ml of a 0.25 to 5% solution instilled into the conjunctival sac 2 or 4 times daily ... 

An interactive effect of cadmium (0.18 mg portions of particles < 60 pm in diameter suspended in 0.4 ml sterile Tyrode s solution instilled intratrache-ally) with UICC standard reference chrysotile B (1.82 mg) or with N-nitrosoheptamethyleneimine in the induction of pulmonary hyperplasias or tumours in rats could not be evaluated (Harrison... 

Phenol orthopedic kit sterile solution Instillation at bone tumors... 

The maximum volume of solution the lower conjunctival sac can accommodate is about 30 microlitres. After instillation the normal volume of the precorneal tear film (7-10 microlitres) is established again due to drainage of the extra volume of fluid present. The drainage rate is directly proportional to the volume of ophthalmic solution instilled. A high percentage of hydrophilic active substances are eliminated and lost to the eye. The drained active substance reaches, via the nasolachrymal duct, the nasal mucosae and after absorption enters the systemic circulation. As lipophilic substances are absorbed much more rapidly, these systemic effects are less prominent. 

This study assesses the safety and feasibility of hexaminolevulinate (HAL)-based PDT as adjuvant treatment after transurethral resection of the bladder in patients with intermediate- or high-risk urothelial cell carcinoma of the bladder. Seventeen patients received 50 mL of either a 16 mM (4 patients) or 8mM HAL (13 patients) solution instilled intravenously. Bladder wall irradiation was performed using an incoherent white light source coupled via a quartz fibre assembled into a flexible transurethral irrigation catheter. 

Sites, C.K., Jensen, B.A., Glock, J.L., Blackman, J.A., Badger, G.J., Johnson, J.V., Brumsted, J.R. Transvaginal ultrasonographic assessment of hyskon or lactated ringer s solution instillation after laparoscopy randomized, controlled study. J. Ultrasound Med. 16(3), 195-199 (1997)... 

Educating the Patient and Family The nurse gives the patient or a family member instructions or a demonstration of the instillation technique of an otic preparation. The following information may be given to the patient when an ear ointment or solution is prescribed ... 

Educating the Patient and Famiiy The patient or a family member will require instruction in die technique of instilling an ophthalmic preparation (see Home Care Checklist Instilling an Ophthalmic Preparation). In addition, die nurse may give the following information to die patient and family member when an eye ointment or solution is prescribed ... 

What is the rationale for warming an otic solution that has been refrigerated before instilling die drops into die patient s ear ... 

A. Squeeze the eyes tightly after the solution is instilled. 

Diazomethane In a distillation flask equipped with an distillation funnel and a cooler, place a solution of 5 g of potassium hydroxide in 8mL of water and 25 mL of ethanol. Warm the distillation flask to 65 °C in a water-bath. Add a solution of 21.5g (0.1 mol) of A-methyl-lV-nitroso-p-toluenesulfamide in 130 mL of diethyl ether through the instillation funnel in 5 min. If the distillation funnel becomes empty, pour 20 mL of diethyl ether into the funnel, and distill it gradually. Continue distillation until the distilled ether solution becomes colorless. About 3 g of diazomethane is contained in the whole resultant ether distillate. Caution these procedures should be conducted in a laboratory hood Orbencarb, methyl 2-chlorobenzylsulfone (I), 2-chlorobenzoic acid (II), methyl 2-chlorobenzoate analytical standard materials (Ihara Chemical Industries Co., Ltd) Orbencarb and I standard solution for gas chromatography 1.0 qgmL in acetone Methyl 2-chlorobenzoate standard solution for gas chromatography 0.1 qgmL" in n-hexane... 

Peritoneal dialysis (PD) utilizes similar principles as hemodialysis in that blood is exposed to a semipermeable membrane against which a physiologic solution is placed. In the case of PD, however, the semipermeable membrane is the peritoneal membrane, and a sterile dialysate is instilled into the peritoneal cavity. The peritoneal membrane is composed of a continuous single layer of mesothelial cells that covers the abdominal and pelvic walls on one side of the peritoneal cavity, and the visceral organs, including the GI tract, liver, spleen, and diaphragm on the other side. The mesothelial cells are covered by microvilli that increase the surface area of the peritoneal membrane to approximate body surface area (1 to 2 m2). 

In contrast, parenteral suspensions have relatively low solids contents, usually between 0.5 and 5%, with the exception of insoluble forms of penicillin in which concentrations of the antibiotic may exceed 30%. These sterile preparations are designed for intramuscular, intradermal, intralesional, intraarticular, or subcutaneous injection. Syringeability is an important factor to be taken into consideration with injectable dosage forms. The viscosity of a parenteral suspension should be sufficiently low to facilitate injection. Common suspending vehicles include preserved isotonic saline solution or a parenterally acceptable vegetable oil. Ophthalmic and optic suspensions that are instilled into the eye/ear must also be prepared in a sterile manner. The vehicles are essentially isotonic and aqueous in composition. The reader should refer to Chapter 12 for further discussion on parenteral products. 

The USP has numerous requirements, e.g., ophthalmic solutions [need be] essentially free from foreign particles, suitably compounded and packaged for instillation into the eye, or ophthalmic suspensions [need contain] solid particles dispersed in liquid vehicle intended for application to the eye [1]. Ophthalmic suspensions are required to be made with the insoluble drug in a micronized form to prevent irritation or scratching of the cornea. A finished ophthalmic ointment must be free from large particles and must meet the requirements for leakage and for metal particles under ophthalmic ointments . These and other requirements will be discussed further in subsequent sections. 

Gel-Forming Solutions. One disadvantage of solutions is their relatively short residence time in the eye. This has been overcome to some degree by the development of solutions that are liquid in the container and thus can be instilled as eyedrops but gel on contact with the tear fluid and provide increased contact time with the possibility of improved drug absorption and increased duration of therapeutic effect. 

Silver and its compounds have long been used as antimicrobial agents in medicine. The mechanisms of silver toxicity as they relate to human exposure to pharmaceuticals have been reviewed (328). Silver is active at low concentrations and has a low toxicity. The practice of instilling the eyes of infants with 1% of AgN03 solution immediately after birth is still common in some countries, for prevention of opthalmia neonatorum (329). Silver sulfadiazine 77 is clinically used as a topical antimicrobial and antifungal agent and applied as a cream to prevent bacterial infections in cases of severe burns. It is an insoluble polymeric compound and releases Ag(I) ions slowly. 

The design of vaginal, rectal, and nasal irritation studies is less formalized, but follows the same basic pattern as the primary dermal irritation test. The rabbit is the preferred species for vaginal and rectal irritation studies, but the monkey and dog have also been used for these (Eckstein et al., 1969). Both the rabbit and rat have commonly seen use for nasal irritation evaluations. Defined quantities (typically 1.0 ml) of test solutions or suspensions are instilled into the orifice in question. For the vagina or rectum inert bungs are usually installed immediately thereafter to continue exposure for a defined period of time (usually the same period of hours as future human exposure). The orifice is then flushed clean, and 24 h after exposure it is examined and evaluated (graded) for irritation using the scale in Table 11.1. 

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