As medication development continues to advance in the specialty of Ear, Nose, and Throat (ENT), more patients are...
Articles on "Budesonide"
Budesonide/Tranexamic Acid/Lidocaine: Addressing Post-Tonsillectomy Care & Recovery with Compounded Medication
Tonsillectomy is among the oldest and most frequently performed surgical procedures by ENT specialists.
Post-tonsillectomy recovery is pivotal for patients, focusing on managing discomfort and minimizing complications such as bleeding. A compounded, rinse formulation integrating budesonide, tranexamic acid, and lidocaine presents a potential approach, tailored for individuals and managed by healthcare providers, particularly ENT specialists. Health Dimensions Clinical Pharmacy (HDRx) stands as the ENT compounding experts, working with patients and providers in multiple states for drug combinations that fit specific needs.
HDRx is licensed to ship medications to multiple states with valid prescription: MI, OH, IN, IL, IN, WI, MN.
Understanding Post-Tonsillectomy Challenges
Tonsillectomies, while routine, often result in considerable postoperative discomfort and potential complications. Optimal management of these symptoms is essential for recovery and healing, aiming to improve comfort and prevent problems like bleeding.
“The complication of post-tonsillectomy hemorrhage (PTH) is especially concerning due to its potential severity, delayed presentation, and not manifesting until after post-operative day 1 in 83 % of cases.”
Potential Benefits of a Compounded, Rinse Formulation from HDRx
- Tranexamic Acid for Bleeding Management: As an antifibrinolytic, tranexamic acid may help manage postoperative bleeding by inhibiting enzymes that dissolve blood clots. Research indicates its potential utility in reducing post-tonsillectomy hemorrhage, although further validation is needed.
“Treatment of [post-tonsillectomy hemorrhage] PTH with [Tranexamic Acid] TXA appears to reduce the need for operative control of PTH.”
Source: American Journal of Otolaryngology
2. Budesonide for Reducing Inflammation: Including budesonide may help manage inflammation post-surgery, potentially reducing discomfort associated with recovery.
“Combined anti-inflammatory therapy that consists of oral montelukast and intranasal budesonide effectively improves and/or normalizes respiratory and sleep disturbances in children with residual SDB after [Tonsillectomy and adenoidectomy] T&A.”
Source: Pediatrics
3. Lidocaine for Pain Management: Lidocaine, used as a local anesthetic, may provide temporary relief from postoperative pain, contributing to overall patient comfort.
Application and Dosing
The application of this compounded mixture, ideally under the guidance of an ENT specialist, is tailored to individual patient needs, considering factors such as age and health status. The frequency and dosage require careful adjustment by healthcare professionals.
Collaboration with Compounding Pharmacies
For healthcare providers, partnering with a compounding pharmacy like Health Dimensions Clinical Pharmacy (HDRx) allows for the customization of medications to fit specific patient needs. HDRx provides consultations and collaborates closely with healthcare providers and/or patients to formulate medications following the highest safety and quality standards.
What does being PCAB Accredited mean?
Being PCAB (Pharmacy Compounding Accreditation Board) accredited signifies that a pharmacy has met rigorous standards for compounding medications. This accreditation ensures that the pharmacy adheres to industry-recognized quality and safety guidelines in their compounding processes. It reflects a commitment to maintaining the highest level of competence and performance, which helps in providing patients with safe, high-quality compounded medications. For patients and healthcare providers, choosing a PCAB accredited pharmacy means trusting in a facility that has been thoroughly evaluated and meets comprehensive standards.
While the combination of budesonide, tranexamic acid, and lidocaine offers a potential strategy for improving post-tonsillectomy care, working with your doctor and an experienced team of pharmacists is essential. ENT specialists interested in exploring this compounded option may benefit from partnering with HDRx for the best patient experience.
HDRx is committed to collaborating with healthcare professionals to explore compounded medications that address the unique challenges of post-tonsillectomy recovery.
References
Ikoma, R., Sakane, S., Niwa, K., Kanetaka, S., Kawano, T., & Oridate, N. (2014). Risk factors for post-tonsillectomy hemorrhage. Auris Nasus Larynx, 41(4), 376-379.
Kheirandish, L., Goldbart, A. D., & Gozal, D. (2006). Intranasal steroids and oral leukotriene modifier therapy in residual sleep-disordered breathing after tonsillectomy and adenoidectomy in children. Pediatrics, 117(1), e61-e66.
Spencer, R., Newby, M., Hickman, W., Williams, N., & Kellermeyer, B. (2022). Efficacy of tranexamic acid (TXA) for post-tonsillectomy hemorrhage. American Journal of Otolaryngology, 43(5), 103582.
ENT Doctors Prescribe Compounded Medications for Seasonal and Severe Allergies
As medication development continues to advance in the specialty of Ear, Nose, and Throat (ENT), more patients are finally finding what works for their challenging conditions, especially for those suffering from seasonal allergies, severe allergies, and other conditions.
Health Dimensions Clinical Pharmacy (HDRx), a compounding pharmacy with a robust reputation among ENT practitioners, stands out as the top choice for customized medications for patients. Based in Michigan and serving several states including Ohio, Indiana, Illinois, Wisconsin, Minnesota, and Florida, HDRx combines expertise, innovation, and personalized care to address the unique needs of ENT patients.
Navigating the world of ear, nose, and throat (ENT) health can sometimes feel like a complex puzzle, especially for those battling:
- Chronic Sinusitis
- Allergic Rhinitis
- Ear Infections (Otitis Media and Otitis Externa)
- Tinnitus
- Vertigo and Meniere’s Disease
- Nasal Polyps
- Post-Nasal Drip
- Laryngopharyngeal Reflux (LPR)
- Sore Throat and Tonsillitis
- Pharyngitis and Laryngitis
- Dry Mouth (Xerostomia)
- Burning Mouth Syndrome
- Oral Thrush and other fungal infections
- Eustachian Tube Dysfunction
- Sleep Apnea and Snoring (CPAP intolerance solutions)
- Vocal Cord Nodules
- Epistaxis (Nasal Bleeding)
- Head and Neck Cancer Support (e.g., mucositis management)
- More
HDRx Pharmacist Recommendations for Most Common ENT Conditions
Initially, empiric antibiotic and symptom therapy of chronic or recurrent sinus infections, Budesonide 0.6 mg/Gentamicin 2 0mg/Mupirocin 15 mg sinus irrigation is commonly prescribed.
For polyp reduction or post-operative care, the common Budesonide irrigation dose range is 2–4 mg via sinus rinse.
For patients with allergy related inflammation, Budesonide 1.2 mg sinus rinse is recommended.
Other antibiotic and antifungal combinations can be ordered based on culture and sensitivities of the infection.
Additionally, Acetylcysteine 100 mg can be added to any sinus regimen — acetylcysteine is a documented biofilm breaking agent. The presence of biofilm can make microorganisms 10–100 times more resistant to anti-infectives.
For all sinus rinses we recommend administering the nasal rinse twice daily.
Betahistine and Meniere’s Disease
With a staggering 93% of vertigo cases diagnosed as Meniere’s Disease, the need for medication is clear.
“Meniere’s disease impacts 12 in 1000 people. There are 600,000–750,000 cases of Meniere’s disease in the United State and 45,000–60,000 new cases are diagnosed annually.”
Betahistine has been used since the 1970s and is one of the most frequently prescribed medications for vertigo worldwide. Betahistine is thought to reduce symptoms through its action on vestibular histamine receptors. At HDRx, we provide Betahistine in various regimens, catering to the unique dosing needs of our patients.
Why Are Patients Being Prescribed Betahistine for Meniere’s Disease?
- Betahistine has been in use since the 1970s and is one of the most frequently prescribed medications worldwide for vertigo.
- Betahistine may reduce the symptoms of Meniere’s disease through its action on vestibular histamine receptors.
- Betahistine is generally well tolerated and has a low risk of adverse events.
- Most requested regimens are: 8-mg, 12-mg, 16-mg, or 24-mg capsules, TID (and occasionally bid)
Addressing ENT conditions means having access to a variety of medications and delivery methods to optimize patient outcomes:
- Otic Insufflator: Our Insufflator delivers medication to the ears. Example medications are antibiotics, antifungals, and steroids. Powders are potentially effective in addressing infections and inflammation without adding more moisture into the ear canal.
- Nasal/Sinus Irrigation: Cleanse and moisturize the nasal passages. It’s designed to flush out allergens, irritants, and mucus, helping to reduce nasal congestion, improve sinus drainage, and alleviate symptoms associated with conditions like chronic sinusitis, allergic rhinitis, and post-operative recovery.
- Mouthwash Medication: Mouthwashes address pain and infection post tonsillectomy. The mucositis therapy also addresses mouth sores caused by different forms of chemotherapy/radiation therapy. We have one containing Ketamine to help with managing pain.
- Nasal Sprays: Address a range of nasal and sinus conditions, such as allergic rhinitis, sinusitis, nasal polyps, and nasal congestion. These sprays can deliver steroids, antihistamines, decongestants, or saline solutions directly to the nasal passages, helping to reduce inflammation, alleviate allergic reactions, open blocked nasal passages, and moisturize dry nasal mucosa. By targeting the site of discomfort or infection directly, nasal sprays offer targeted relief and support the overall health of the nasal and sinus cavities.
- Oral Liquids: This form of medication may be particularly beneficial for patients who have difficulty swallowing pills or tablets. Oral liquids can be used to manage symptoms of sore throat, ear infections, tonsillitis, and various other infections or inflammatory conditions of the upper respiratory tract.
- Troches: Type of lozenge designed to dissolve slowly in the mouth, delivering medication directly to the mucous membranes of the oral cavity and throat. These are commonly used to address fungal infections, sore throats, oral thrush, and various other conditions affecting the mouth and throat areas.
Why Choose HDRx for ENT Medication Needs?
Choosing the right pharmacy is a critical decision in your (or your patients’) healthcare journey in finding relief. Trust HDRx to stand by your side, offering not just medication, but elevated support from our experts’ years of knowledge and experience.
Reach out to us to learn more about our PCAB Accredited compounding services in Michigan and beyond, and take the first step towards a life of improved health and comfort.
PHARMACIST RECOMMENDED
Supplements for Allergy Season
Natural D-Hist®
Natural D-Hist® is a targeted blend of flavonoids, antioxidants, proteolytic enzymes and botanicals designed to provide comprehensive support for seasonal challenges caused by common environmental allergens. The formula includes quercetin, bromelain, stinging nettles leaf and N-acetyl cysteine. The powerful combination actively promotes healthy nasal and sinus passages for individuals with elevated histamine and respiratory irritation.
Vitamin D
Vitamin D is a steroid vitamin, a group of fat-soluble pro-hormones that are best known for the role they play in supporting bone health and aiding in the absorption of calcium and phosphate from the gastrointestinal tract. However, a growing body of research highlights its important role in supporting other body systems, including cardiovascular and blood sugar balance as well as increasing musculoskeletal strength, neurological and immune function enabled by its ability to target over 200 different genes throughout the body.
At the same time, deficiency and insufficiency of this important nutrient has reached epidemic proportions around the world, making the achievement of optimal levels extremely important to overall health.
Known as the sunshine vitamin, one of the key roles of vitamin D is maintaining serum calcium and phosphorous balance. The body makes vitamin D by converting vitamin D2 to D3, or cholecalciferol, when the skin is exposed to sunlight. Vitamin D supplements come in two forms, D2 and D3. Studies have found vitamin D3 is the preferable form, as it has been found to maintain active vitamin D levels for a longer period of time.
The Vitamin D formula is delivered as D3 (cholecalciferol) for optimal use by the body, and is available in 1,000 and 5,000 IU capsules to meet a variety of individual needs.
ENT Compounding Pharmacy
We specialize in compounding customized medications for a wide range of ENT conditions, from seasonal allergies to Meniere’s Disease. Our expertise allows us to create sinus irrigations, otic insufflators, and mouthwash medications tailored to each patient’s unique needs. With our commitment to quality, underscored by our PCAB accreditation, patients and ENT doctors alike trust us for solutions.
For more information or to discuss how we can assist with your specific ENT health challenges, stop by or contact us today.
References:
Murdin L, Hussain K, Schilder AG. Betahistine for symptoms of vertigo. Cochrane Database Syst Rev. 2016 Jun 21;2016(6):CD010696. doi: 10.1002/14651858.CD010696.pub2. PMID: 27327415; PMCID: PMC7388750.
Pyykkö I, Nakashima T, Yoshida T, Zou J, Naganawa S. Meniere’s disease: a reappraisal supported by a variable latency of symptoms and the MRI visualisation of endolymphatic hydrops. BMJ Open. 2013 Feb 14;3(2):e001555. doi: 10.1136/bmjopen-2012-001555. PMID: 23418296; PMCID: PMC3586172.
RubĂ©n Ramos Alcocer, JosĂ© Gregorio Ledezma RodrĂguez, Antonio Navas Romero, JosĂ© Luis Cardenas Nuñez, Vicente RodrĂguez Montoya, Jose Junior Deschamps & Jorge Anibal Liviac Ticse (2015) Use of betahistine in the treatment of peripheral vertigo, Acta Oto-Laryngologica, 135:12, 1205-1211, DOI: 10.3109/00016489.2015.1072873.
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