The therapeutic efficacy of propranolol in children with recurrent primary epistaxis

Abstract

We hypothesized that some characteristics of beta-blockers, including negative inotropic, peripheral vasoconstrictor, and antiangiogenic effects, might be potentially useful in treating children with epistaxis. From June 2010 to March 2012, a total of seven children with recurrent primary epistaxis resistant to conventional management were observed at our institution. An overall effectiveness of propranolol was noted in all seven children when given a dose of 1.5–2 mg/kg/day (divided into three doses) as a second line therapy for terminating epistaxis. Based on our first experience, we believe that propranolol could be a favorable treatment option for patients with primary epistaxis.

Self-Emulsifying Pellets: Relations Between Kinetic Parameters of Drug Release and Emulsion Reconstitution—Influence of Formulation Variables

“…Because PR with log P 3.5 has greater solubility than the more hydrophilic FS with log P 2.,0 the results in Table are in agreement with this. PR has maximum solubility in the oil/ELP mixtures (63.2 mg/mL for 1.5, w/w ratio), whereas FS in oil/RH40 (40.7 mg/mL for 1.5, w/w ratio), which should be considered during formulation of the drugs into SEDDS for low dose pediatric administration …”

“…PR has maximum solubility in the oil/ELP mixtures (63.2 mg/mL for 1.5, w/w ratio), whereas FS in oil/RH40 (40.7 mg/mL for 1.5, w/w ratio), which should be considered during formulation of the drugs into SEDDS for low dose pediatric administration. 29,30 From Table 2, it also appears that the drug solubility in the oil/surfactant mixtures is greater at low oil/surfactant ratio (1.5) or higher surfactant content, which is attributed to the solubilizing ability of the surfactants. The results of ANOVA presented in Table 6 confirm the significant effects of the drug log P and the less significant effect of oil/surfactant ratio on the solubility (p = 0.007 and p = 0.056, respectively).…”

“…Consequently, any improvement of release in the gastric fluid due to the formulation into SEDDS could improve the drug absorption through redispersion into oil/surfactant droplets . Additionally, PR has recently been recommended in low dose [1.5–2 mg/(kg day)] for children's therapies in hypertension, migraine, and recurrent primary epistaxis and suitable formulations are not available in the market . FS was selected as a drug of low lipophilicity and also because of its reported solubility and permeability problems .…”

“…28 Additionally, PR has recently been recommended in low dose [1.5-2 mg/(kg day)] for children's therapies in hypertension, migraine, and recurrent primary epistaxis and suitable formulations are not available in the market. 29,30 FS was selected as a drug of low lipophilicity and also because of its reported solubility and permeability problems. 31 The optimal hydrophilic-lipophilic balance (HLB) range of surfactants for these systems was suggested to be 10-15 for finer droplet diameter and maximum drug release from SEDDS filled in soft gelatin capsules.…”

Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

“…Peripherally, propranolol decreases lower limb blood flow by increasing leg vascular resistance in severely burned adults [ 7 ]. Induction of peripheral vasoconstriction by propranolol has led to the successful implementation of the β-blocker in the management of infantile hemangiomas, [ 8 , 9 ] variceal bleeding, [ 10 ] and recurrent epistaxis [ 11 ]. An overview of the mechanisms by which propranolol induces peripheral vasoconstriction is presented in Figure 1 .…”