1.
Inflammation
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The classical signs of inflammation are heat, pain, redness, swelling, and loss of function. Inflammation is a response, and therefore it is considered as a mechanism of innate immunity, as compared to adaptive immunity. Too little inflammation could lead to tissue destruction by the harmful stimulus. In contrast, chronic inflammation may lead to a host of diseases, such as hay fever, periodontitis, atherosclerosis, rheumatoid arthritis, Inflammation is therefore normally closely regulated by the body. Inflammation can be classified as acute or chronic. Acute inflammation is the response of the body to harmful stimuli and is achieved by the increased movement of plasma. A series of biochemical events propagates and matures the inflammatory response, involving the vascular system, the immune system. Inflammation is not a synonym for infection, Inflammation on the other hand describes purely the bodys immunovascular response, whatever the cause may be. But because of how often the two are correlated, words ending in the suffix -itis are sometimes described as referring to infection. There are also situations where microbial invasion does not result in classic inflammatory response—for example, parasitosis. Acute inflammation is a process, usually appearing within a few minutes or hours. It involves a coordinated and systemic mobilisation response locally of various immune, endocrine, in a normal healthy response, it becomes activated, clears the pathogen and begins a repair process and then ceases. It is characterized by five signs, An acronym that may be used to remember the key symptoms is PRISH, for pain, redness, immobility, swelling. Loss of function has multiple causes, Acute inflammation of the lung does not cause pain unless the inflammation involves the parietal pleura, which does have pain-sensitive nerve endings. PAMPs are compounds that are associated with pathogens, but which are distinguishable from host molecules. DAMPs are compounds that are associated with host-related injury and cell damage, at the onset of an infection, burn, or other injuries, these cells undergo activation and release inflammatory mediators responsible for the clinical signs of inflammation. Vasodilation and its resulting increased blood flow causes the redness and increased heat, increased permeability of the blood vessels results in an exudation of plasma proteins and fluid into the tissue, which manifests itself as swelling. Some of the released mediators such as increase the sensitivity to pain
2.
Tablet (pharmacy)
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A tablet is a pharmaceutical dosage form. Tablets may be defined as the solid unit dosage form of medicament or medicaments with or without suitable excipients and it comprises a mixture of active substances and excipients, usually in powder form, pressed or compacted from a powder into a solid dose. The compressed tablet is the most popular form in use today. About two-thirds of all prescriptions are dispensed as solid dosage forms, a tablet can be formulated to deliver an accurate dosage to a specific site, it is usually taken orally, but can be administered sublingually, buccally, rectally or intravaginally. The tablet is just one of the forms that an oral drug can take such as syrups, elixirs, suspensions. Medicinal tablets were made in the shape of a disk of whatever color their components determined. Tablets are often stamped with symbols, letters, and numbers, sizes of tablets to be swallowed range from a few millimeters to about a centimeter. Pills are thought to date back to around 1500 BC, earlier medical recipes, such as those from 4000 BC, were for liquid preparations rather than solids. The first references to pills were found on papyruses in ancient Egypt, medicinal ingredients, such as plant powders or spices, were mixed in and formed by hand to make little balls, or pills. In ancient Greece, such medicines were known as katapotia, and the Roman scholar Pliny, Pills have always been difficult to swallow and efforts long have been made to make them go down easier. In medieval times, people coated pills with slippery plant substances, another approach, used as recently as the 19th century, was to gild them in gold and silver, although this often meant that they would pass through the digestive tract with no effect. In the 1800s sugar-coating and gelatin-coating was invented, as were gelatin capsules, in 1843, the British painter and inventor William Brockedon was granted a patent for a machine capable of Shaping Pills, Lozenges and Black Lead by Pressure in Dies. The device was capable of compressing powder into a tablet without use of an adhesive, today, pills include tablets, capsules, and variants thereof like caplets—essentially anything with medication that can be digested, minus the liquid forms, colloquially falls into the pill category. A caplet is a smooth, coated, oval-shaped medicinal tablet in the shape of a capsule. Many caplets have a running down the middle so they may be split in half easier. An orally disintegrating tablet or orodispersible tablet, is a dosage form available for a limited range of over-the-counter. In the tablet-pressing process, it is important that all ingredients be fairly dry, powdered or granular, somewhat uniform in particle size, content uniformity ensures that the same API dose is delivered with each tablet. Some APIs may be tableted as pure substances, but this is rarely the case, normally, a pharmacologically inactive ingredient termed a binder is added to help hold the tablet together and give it strength
3.
Oxygen
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Oxygen is a chemical element with symbol O and atomic number 8. It is a member of the group on the periodic table and is a highly reactive nonmetal. By mass, oxygen is the third-most abundant element in the universe, after hydrogen, at standard temperature and pressure, two atoms of the element bind to form dioxygen, a colorless and odorless diatomic gas with the formula O2. This is an important part of the atmosphere and diatomic oxygen gas constitutes 20. 8% of the Earths atmosphere, additionally, as oxides the element makes up almost half of the Earths crust. Most of the mass of living organisms is oxygen as a component of water, conversely, oxygen is continuously replenished by photosynthesis, which uses the energy of sunlight to produce oxygen from water and carbon dioxide. Oxygen is too reactive to remain a free element in air without being continuously replenished by the photosynthetic action of living organisms. Another form of oxygen, ozone, strongly absorbs ultraviolet UVB radiation, but ozone is a pollutant near the surface where it is a by-product of smog. At low earth orbit altitudes, sufficient atomic oxygen is present to cause corrosion of spacecraft, the name oxygen was coined in 1777 by Antoine Lavoisier, whose experiments with oxygen helped to discredit the then-popular phlogiston theory of combustion and corrosion. One of the first known experiments on the relationship between combustion and air was conducted by the 2nd century BCE Greek writer on mechanics, Philo of Byzantium. In his work Pneumatica, Philo observed that inverting a vessel over a burning candle, Philo incorrectly surmised that parts of the air in the vessel were converted into the classical element fire and thus were able to escape through pores in the glass. Many centuries later Leonardo da Vinci built on Philos work by observing that a portion of air is consumed during combustion and respiration, Oxygen was discovered by the Polish alchemist Sendivogius, who considered it the philosophers stone. In the late 17th century, Robert Boyle proved that air is necessary for combustion, English chemist John Mayow refined this work by showing that fire requires only a part of air that he called spiritus nitroaereus. From this he surmised that nitroaereus is consumed in both respiration and combustion, Mayow observed that antimony increased in weight when heated, and inferred that the nitroaereus must have combined with it. Accounts of these and other experiments and ideas were published in 1668 in his work Tractatus duo in the tract De respiratione. Robert Hooke, Ole Borch, Mikhail Lomonosov, and Pierre Bayen all produced oxygen in experiments in the 17th and the 18th century but none of them recognized it as a chemical element. This may have been in part due to the prevalence of the philosophy of combustion and corrosion called the phlogiston theory, which was then the favored explanation of those processes. Established in 1667 by the German alchemist J. J. Becher, one part, called phlogiston, was given off when the substance containing it was burned, while the dephlogisticated part was thought to be its true form, or calx. The fact that a substance like wood gains overall weight in burning was hidden by the buoyancy of the combustion products
4.
Otorhinolaryngology
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Otorhinolaryngology /oʊtoʊˌraɪnoʊˌlærənˈɡɒlədʒi/ is a surgical subspecialty within medicine that deals with conditions of the ear, nose, and throat and related structures of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, ENT doctors, ENT surgeons, or head and neck surgeons. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, and for the surgical management of cancers and benign tumors of the head and neck. The term is a combination of New Latin combining forms derived from four Ancient Greek words, οὖς ous, ear, ῥίς rhis, nose, λάρυγξ larynx, larynx and -λογία logia, study. Otorhinolaryngologists are physicians who, in the United States, complete at least five years of residency training. This is composed of six months of general surgical training and four, in Canada and the United States, practitioners complete a five-year residency training after medical school. Following residency training, some otolaryngologist-head & neck surgeons complete an advanced sub-specialty fellowship, in the United States and Canada, otorhinolaryngology is one of the most competitive specialties in medicine in which to obtain a residency position following medical school. In the United Kingdom entrance to otorhinolaryngology higher surgical training is highly competitive and involves a rigorous national selection process
5.
Concha bullosa
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A concha bullosa is a pneumatized cavity within a turbinate in the nose. Bullosa refers to the cavity within the turbinate. It is a normal anatomic variant seen in up to half the population, occasionally, a large concha bullosa within a turbinate may cause it to bulge sufficiently to obstruct the opening of an adjacent sinus, possibly leading to recurrent sinusitis. In such a case the turbinate can be reduced in size by endoscopic nasal surgery, the presence of a concha bullosa is often associated with deviation of the nasal septum toward the opposite side of the nasal cavity. Although it is thought that sinusitis or sinus pathology has relation to concha bullosa, no strong statistical correlation has been demonstrated
6.
Allergen
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An allergen is a type of antigen that produces an abnormally vigorous immune response in which the immune system fights off a perceived threat that would otherwise be harmless to the body. In technical terms, an allergen is a capable of stimulating a type-I hypersensitivity reaction in atopic individuals through Immunoglobulin E responses. Most humans mount significant Immunoglobulin E responses only as a defense against parasitic infections, however, some individuals may respond to many common environmental antigens. This hereditary predisposition is called atopy, in atopic individuals, non-parasitic antigens stimulate inappropriate IgE production, leading to type I hypersensitivity. Sensitivities vary widely from one person to another, a very broad range of substances can be allergens to sensitive individuals. Allergens can be found in a variety of sources, such as dust mite excretion, pollen, Food allergies are not as common as food sensitivity, but some foods such as peanuts, nuts, seafood and shellfish are the cause of serious allergies in many people. Officially, the United States Food and Drug Administration does recognize eight foods as being common for reactions in a large segment of the sensitive population. These include peanuts, tree nuts, eggs, milk, shellfish, fish, wheat and their derivatives, see the FDA website for complete details. Canada recognizes all eight of the allergens recognized by the US, and also recognizes sesame seeds, the European Union additionally recognizes celery. Various trees and wood products such as paper, cardboard, MDF etc. can also cause mild to severe allergy symptoms through touch or inhalation of sawdust such as asthma, other common causes of serious allergy are wasp, fire ant and bee stings, penicillin, and latex. An extremely serious form of a reaction is called anaphylaxis. This depends on the kind of tree or grass, for instance, some trees such as oak, elm, and maple pollinate in the spring, while grasses such as Bermuda, timothy and orchard pollinate in the summer. Grass allergy is generally linked to hay fever because their symptoms, symptoms include rhinitis, which causes sneezing and a runny nose, as well as allergic conjunctivitis, which includes watering and itchy eyes. Also an initial tickle on the roof of the mouth or in the back of the throat may be experienced, also, depending on the season, the symptoms may be more severe and people may experience coughing, wheezing, and irritability. A few people even become depressed, lose their appetite, or have problems sleeping, moreover, since the sinuses may also become congested, some people experience headaches. The immune system also has influence on seasonal allergies, since it reacts differently to diverse allergens like pollen. When an allergen enters the body of an individual that is predisposed to allergies, it triggers an immune reaction and these allergen antibodies migrate to mast cells lining the nose, eyes and lungs. Some symptoms that differentiate allergies from a cold include, No fever, mucous secretions are runny and clear
7.
Nasal spray
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Nasal sprays are used as local treatments for conditions such as nasal congestion and allergic rhinitis. In some situations, nasal delivery route is preferred because it provides an alternative to injection or pills. Substances can be assimilated extremely quickly and directly through the nose, many pharmaceutical drugs exist as nasal sprays for systemic administration. Other applications include hormone replacement therapy, treatment of Alzheimers disease, nasal sprays are seen as a more efficient way of transporting drugs with potential use in crossing the blood–brain barrier. Antihistamines work by competing for receptor sites to block the function of histamine and they can reduce inflammation and histamine production in the nasal passages, and have been shown to relieve nasal congestion, runny nose, itchy nose and sneezing. Side effects may include headaches, nausea and nose bleeds, ketorolac tromethamin is the first and only NSAID nasal spray which is an effective non-narcotic alternative for patients who require pain relief at the opioid level. Saline sprays are typically non medicated, a mist of saline solution containing sodium chloride is delivered to help moisturize dry or irritated nostrils. This is a form of nasal irrigation and they can also relieve nasal congestion and remove airborne irritants such as pollen and dust thereby providing sinus allergy relief. Three types of nasal sprays preparations of sodium chloride are available including hypertonic, isotonic and hypotonic, isotonic solutions have the same salt concentration as the human body, whereas hypertonic solutions have a higher salt content and hypotonic solutions have a lower salt content. Isotonic saline nasal sprays are used in infants and children to wash out the thick mucus from the nose in case of allergic rhinitis. Hypertonic solutions may be useful at drawing moisture from the mucous membrane. Natural nasal sprays that include chemical complexes derived from plant sources such as ginger, capsaicin, there is however, no trial-verified evidence that they have a measurable effect on symptoms. Prolonged use of types of sprays can damage the delicate mucous membranes in the nose. This causes increased inflammation, a known as rhinitis medicamentosa or the rebound effect. As a result, decongestant nasal sprays are advised for use only, preferably 5 to 7 days at maximum. Some doctors advise to use them 3 days at maximum, a recent clinical trial has shown that a corticosteroid nasal spray, may be useful in reversing this condition. List of combination nasal sprays, Azelastine together with fluticasone propionate Xylometazoline together with cromoglicic acid
8.
Blood vessel
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The blood vessels are the part of the circulatory system that transports blood throughout the human body. The word vascular, meaning relating to the vessels, is derived from the Latin vas. A few structures do not contain blood vessels and are labeled, tunica media, circularly arranged elastic fiber, connective tissue, polysaccharide substances, the second and third layer are separated by another thick elastic band called external elastic lamina. The tunica media may be rich in smooth muscle, which controls the caliber of the vessel. Veins dont have the external elastic lamina, but only an internal one, tunica adventitia, entirely made of connective tissue. It also contains nerves that supply the vessel as well as nutrient capillaries in the blood vessels. Capillaries consist of more than a layer of endothelium and occasional connective tissue. When blood vessels connect to form a region of diffuse vascular supply it is called an anastomosis, anastomoses provide critical alternative routes for blood to flow in case of blockages. There is a layer of muscle surrounding the arteries and the veins which help contract and this creates enough pressure for blood to be pumped around the body. Blood vessels are part of the system, together with the heart. They are roughly grouped as arterial and venous, determined by whether the blood in it is flowing away from or toward the heart. The term arterial blood is used to indicate blood high in oxygen. This is because they are carrying the blood to and from the lungs, respectively, blood vessels do not actively engage in the transport of blood, but arteries—and veins to a degree—can regulate their inner diameter by contraction of the muscular layer. This changes the flow to downstream organs, and is determined by the autonomic nervous system. Vasodilation and vasoconstriction are also used antagonistically as methods of thermoregulation, oxygen is the most critical nutrient carried by the blood. In all arteries apart from the artery, hemoglobin is highly saturated with oxygen. In all veins apart from the vein, the hemoglobin is desaturated at about 75%. The blood pressure in blood vessels is traditionally expressed in millimetres of mercury, in the arterial system, this is usually around 120 mmHg systolic and 80 mmHg diastolic
9.
Naphazoline
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Naphazoline is the common name for 2--2-imidazoline hydrochloride. It is an agent with marked alpha adrenergic activity. It is a vasoconstrictor with an action in reducing swelling when applied to mucous membrane. It acts on alpha-receptors in the arterioles of the conjunctiva to produce constriction and it is an active ingredient in several over-the-counter formulations including Clear Eyes and Naphcon eye drops. The non-hydrochloride form of Naphazoline has the molecular formula C14H14N2 and a mass of 210.28 g/mol. The HCl salt form has a mass of 246.73 g/mol. Extended use may cause rhinitis medicamentosa, a condition of rebound nasal congestion, a possible association with stroke has been suggested
10.
Oxymetazoline
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Oxymetazoline is a selective α1 adrenergic receptor agonist and α2 adrenergic receptor partial agonist. It is a decongestant, used in the form of oxymetazoline hydrochloride. It was developed from xylometazoline at E, merck Darmstadt by Fruhstorfer in 1961. Oxymetazoline is generally available as a nasal spray, due to its vasoconstricting properties, oxymetazoline is also used to treat nose bleeds and eye redness due to minor irritation. It is recommended that not be used for more than three days, as rebound congestion, or rhinitis medicamentosa, may occur. Patients who continue to use oxymetazoline beyond this point may become dependent on the medication to relieve their chronic congestion, some studies have found that benzalkonium chloride, a common additive to oxymetazoline nasal sprays, may damage nasal epithelia and exacerbate rhinitis medicamentosa. However, the majority of studies find benzalkonium chloride to be a safe preservative, the Food and Drug Administration places oxymetazoline in category C, indicating risk to the fetus cannot be ruled out. While it has shown that a single dose does not significantly alter either maternal or fetal circulation. If accidentally ingested, standard methods to remove unabsorbed drugs should be considered, there is no specific antidote for oxymetazoline, although its pharmacological effects may be reversed by α adrenergic antagonists such as phentolamine. In children, oxymetazoline may produce profound central nervous system due to stimulation of central α2 receptors and imidazoline receptors. Oxymetazoline is a sympathomimetic that selectively agonizes α1 and, partially, since vascular beds widely express α1 receptors, the action of oxymetazoline results in vasoconstriction. Vasoconstriction of vessels results in relief of congestion in two ways, first, it increases the diameter of the airway lumen, second, it reduces fluid exudation from postcapillary venules. It can reduce nasal airway resistance up to 35. 7%, imidazolines are sympathomimetic agents, with primary effects on α adrenergic receptors and little if any effect on β adrenergic receptors. Effects on α receptors from systemically absorbed oxymetazoline hydrochloride may persist for up to 7 hours after a single dose, the elimination half-life in humans is 5–8 hours. It is excreted unchanged both by the kidneys and in feces, the oxymetazoline brand Afrin was first sold as a prescription medication in 1966. After finding substantial early success as a medication, it became available as an over-the-counter drug in 1975. Schering-Plough did not engage in advertising until 1986. From the late 1980s to mid 1990s, Afrin featured in many television advertisements
11.
Xylometazoline
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Xylometazoline, also spelled xylomethazoline, is a medication which is used to improve symptoms of nasal congestion, allergic rhinitis, and sinusitis. Use is not recommended for more than seven days, use is also not recommended in those less than three months of age and some say not less than 6 years of age. It is used directly in the nose as a spray or drops, side effects include trouble sleeping, irritation of the nose, nausea, and headache. Long term use is not recommended due to a rhinitis medicamentosa when stopped, use is not recommended during pregnancy. Xylometazoline is in the decongestant and alpha-adrenergic agonist families of medication, xylometazoline was patented in 1956 and came into medical use in 1959. It is on the World Health Organizations List of Essential Medicines, xylometazoline is available as a generic medication. The wholesale cost in the world is about 0.75 USD for a 10 ml bottle. In the United Kingdom that dose costs the NHS about 2.10 pounds, the drug works by stimulating adrenergic receptors on the lamina propria of blood vessels in the nose. The decongestant effect is due to constriction of large veins in the nose which swell up during the inflammation of any infection or allergy of the nose, the smaller arteries are also constricted and this causes the colour of the nasal epithelium to be visibly paler after dosage. Xylometazoline is a derivative which is designed to mimic the molecular shape of adrenaline. It binds to α1 and α2 adrenergic receptors in the nasal mucosa, due to its sympathomimetic effects, it should not be used by people with high blood pressure, or other heart problems. Extended usage of xylometazoline can result in decreased effectiveness or a buildup of tolerance against the drug, the number of receptors decreases, and when the administration of the drug is ceased, chronic congestion can occur, this is called rhinitis medicamentosa, commonly referred to as rebound congestion. Moreover, long-term overdosing can cause changes in nasal mucous membranes that pose another health problem. The standard adult solution strength is 0. 1% w/v xylometazoline, and the dose for children under 12 is usually 0. 05%
