CN1748699A - Albendazole new form for treating allergic rhinitis - Google Patents

Albendazole new form for treating allergic rhinitis Download PDF

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CN1748699A
CN1748699A CN 200410078473 CN200410078473A CN1748699A CN 1748699 A CN1748699 A CN 1748699A CN 200410078473 CN200410078473 CN 200410078473 CN 200410078473 A CN200410078473 A CN 200410078473A CN 1748699 A CN1748699 A CN 1748699A
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nasal
allergic rhinitis
albendazole
treatment
rhinitis
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王鹤尧
郑文婕
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Jiangsu Simcere Pharmaceutical R&D Co Ltd
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Abstract

The present invention relates to the preparation process of nebula, aerosol, powder spraying agent and nose drop of albendazole and their application in treating allergic rhinitis.

Description

The Albendazole new form of treatment of allergic rhinitis
The present invention relates to use albendazole to prepare spray, aerosol, powder spray and nasal drop, and these contain spray, aerosol, powder spray and the nasal drop application in treatment of allergic rhinitis of albendazole.
One, allergic rhinitis brief introduction I
Rhinitis is meant that inflammation appears in nasal membrane, shows as hyperemia or edema, and the patient nasal obstruction occurs through regular meeting, stream clear water tears, rhinocnesmus, throat's discomfort, symptoms such as cough.
The excretory wash sample of nasal cavity material is called nasal mucus or nasal secretion, and its effect is to help dust out, and antibacterial is to keep the health of pulmonary.Generally, be drawn to throat behind the nasal mucus of mixed cell and dust and finally enter gastric, because of its secretory volume seldom, generally can not attract much attention.
When inflammation appearred in intranasal, nasal cavity can be secreted a large amount of nasal mucus, and can cause cough when flowing through throat because of the infection yellowing, and the nasal mucus amount very can also flow out through prenaris for a long time.
Allergic rhinitis is a kind of of rhinitis, and rhinitis also comprises chronic rhinitis and acute rhinitis, and the latter is often referred to flu.Chronic rhinitis comprises the hypertrophic rhinitis that slight simple rhinitis of symptom and nasal obstruction can be clearly, and two kinds of chronic rhinitiss can be passed through different Therapeutic Method mitigation symptoms.
Owing to body is called allergic rhinitis (Allergic Rhinitis) to the irritated rhinitis that causes of certain material, and can cause that a series of allergic conditions occur.Allergic rhinitis is called allergic rhinitis again.
If allergic rhinitis has only seasonality to show effect every year, common reason is owing to pollen, Semen Salicis babylonicae cum pilus etc., the rhinitis of this moment is called seasonal allergic rhinitis (seasonal allergic rhintis), be called " pollinosis " or " Hay Fever " again (hayfever), how relevant with seasonal outdoor environment.
Allergic rhinitis (perennial allergic rhintis) is meant the no obvious seasonal variation of morbidity all the year round, and its irritated factor comprises: dirt demodicid mite, mycete, cold air, mist, the dandruff of animal, cigarette, perfume, food and other chemical substance etc., how relevant with indoor environment.
Cause that the various factors of allergic rhinitis such as pollen, Semen Salicis babylonicae cum pilus, dirt demodicid mite, mycete etc. are called anaphylactogen (allergen), anaphylactogen can be divided into imbedibility and food anaphylactogen, they produce certain chemical substance by stimulating health, thereby cause corresponding allergic symptom.
Seasonal rhinitis's patient is generally due to heredity or the gene, be subjected to produce IgE under a certain pollen stimulation, (a kind of antibody that resists foreign substance), IgE can cause the release of histamine after being upset once more, because different pollen is arranged all over the world, they can stimulate generation IgE, want that therefore it sometimes is unpractical escaping allergic rhinitis by the change environment.
How many possibilities of zones of different pollen are different, and mycete all existed in a large number in the different regional different time, and are outdoor as soil, indoor as loft in vegetable and the septic wood, basement, and carpet, refrigerator and toilet and refuse bin etc. are located.The distribution of atmospheric effect pollen and mycete, in rainy and calm day at cloudy day, allergic conditions is much better, and fine and windy weather then can increase the weight of allergic rhinitis.
Because the cause of disease of allergic rhinitis is extensive, and can cause very uncomfortable symptom, therefore, paid attention to by increasing people's medical science personage and patient.By the consulting profession personnel, the inspection of the anaphylactogen of can being correlated with changes the guidance of corresponding living environment and rational use of drug, and novel antihistamine drug has effective and the low characteristics of side effect, has been widely used in clinical.Decongestant can effectively be alleviated nasal obstruction, the cough that some medicines also cause allergy and breathe heavily to inhale obvious effects is arranged.
Successful treatment seasonal rhinitis comprises early discovery and avoids anaphylactogen as far as possible, the methods such as medication of full reason.Stand allergic rhinitis for a long time and may cause otitis media, sinusitis, therefore asthma and other anaphylactic disease should remove hospital admission, as early as possible to alleviate misery.
As previously mentioned, various factors that causes allergic rhinitis etc. is called anaphylactogen (allergen) or allergen, and common anaphylactogen comprises:
1, inhalant allergens:, cause the outbreak of long-term property as indoor and outdoor dust, dirt demodicid mite, fungus, animal skin, feather, Cotton Gossypii wadding etc. more; The plant pollen causer mostly is seasonal outbreak.
2, food anaphylactogen: as fish and shrimp, egg, milk, flour, Semen arachidis hypogaeae, Semen sojae atricolor etc.Particularly some medicine all can cause a disease as sulfa drugs, quinine, antibiotic etc.
3, contactant such as cosmetics, gasoline, paint, ethanol etc.
Other may be some antibacterial and toxin thereof, physical factor (as cold and hot variation, temperature is uncomfortable), and the causes of disease such as endocrine disturbance or body fluid acid base imbalance all can be caused a disease.Also can be owing to multiple factor exists simultaneously or successively.
Two, the pathogeny of allergic rhinitis:
Anaphylactogen makes body discharge histamine, and histamine is the main material that can cause a series of allergic symptoms.
(1) anaphylactogen such as pollen enters nasal cavity and trachea; (2) stimulate body to produce specificity antibody IgE; (3) IgE antibody combines with mastocyte; (4) anaphylactogen such as pollen enters in the body once more, causes that mastocyte discharges materials such as histamine; (5) histamine causes sneeze, stream clear water tears and rhinocnesmus and nasal obstruction symptom.
Three, the symptom of allergic rhinitis
(1) symptom of common allergic rhinitis comprises:
1, eyes are rubescent itches and sheds tears; 2, rhinocnesmus, nasal mucus is many, mostly is the clear water tears, is the pus tears during infection; 3, nasal cavity stuffiness, ear is vexed; 4, sneeze (normally unexpected and violent); 5, black eye (due to often rubbing one's eyes) under the eye socket; 6, mouth breathing; 7, olfactory sensation descends or disappears; 8, giddy, headache; 9, the child can anaphylaxis occur and salutes and levy (allergic salute) owing to rubbing nose.
(2) common merging symptom:
1, insomnia; 2, sinusitis, the i.e. infection of nasal sinuses; 3, otitis media, promptly middle ear are infected; 4, epistaxis.
Above-mentioned is the common classical symptom of allergic rhinitis, and the symptom that everyone occurs may be different, and the patient of property rhinitis also seasonal outbreak can occur simultaneously all the year round.The patient of part allergic rhinitis may be simultaneously with nasal polyp, asthma, and symptoms such as snoring need to carry out detailed inspection to hospital this moment.
Four, the inspection of allergic rhinitis
(1) asoscope is checked down: can check after Allergic Rhinitis is gone to a doctor and see pale, light white, the greyish white or lavender of nasal mucosa, edematous turbinates, visible thin nasal discharge or sticking tears at the bottom of meatus nasi communis and the nasal cavity.As concurrent infection, mucous hyperemia then, the bilateral concha nasalis inferior is dark red, and secretions is sticking purulence or purulence.Medical history is long, symptom is sent out the author repeatedly, and polypoid becomes or hypertrophic inferior turbinate in the visible middle nose.About 30% patient is associated with allergic asthma, and part patient can find nasal polyp, PollinosisThe patient can be with conjunctival congestion in stage of attack.
(2) nasal secretion plate coating checking: between stage of attack, visible eosinophil leucocyte increases in the nasal discharge, also can look into and see more eosinophil leucocyte or mastocyte in allergy.
(3) allergia provocative test: generally use tuerculoderma (cut, Intradermal and contact method etc.), principle is the allergic effect material that multiple supposition is arranged, and makes with after body contacts, and looks to have or not reaction to occur, and can assist diagnosis.
According to above-mentioned typical classical symptom and check result, promptly can make the diagnosis of allergic rhinitis.
Five, the Differential Diagnosis of allergic rhinitis
Allergic rhinitis generally need be distinguished with following disease when diagnosis mutually:
(1) vasomotor rhinitis
The patient can cause lightening outbreak once touching nose sometimes slightly, and outbreak disappears soon suddenly.Symptom is similar to allergic rhinitis, but how intranasal do not itch, and the oral cold drug symptom can be eased.Change (getting up) as cold and hot variation, position, can bring out primary disease when excited.
(2) Oncocytosis's property nose is many
Symptom is similar to the catarrhus perennialis, and is though the cause of disease is not bright, irrelevant with allergy.The patient intermittent nasal obstruction companion's sneeze often occurs repeatedly, starches the mucus nasal mucus in a large number, and dizziness and tinnitus, weak, old General Symptoms such as property cough are often arranged.
(3) flu
The patient of allergic rhinitis thinks oneself flu through regular meeting, and both differences are that the latter can be with general malaises such as heatings, and can find that nasal membrane is very red and swollen.
Six, Chinese Medical Association's otolaryngology branch is about the diagnostic criteria of allergic rhinitis
(1), perennial allergic rhinitis 1. condition of keeping the score: 1. perennial onset, have sneeze (each continuous more than 3), snivel and three main clinical manifestation of nasal mucosa swelling, morbidity number of days accumulative total surpasses 6 months in 1 year, and disease time accumulative total was above 0.5 hour in one day; 2. the course of disease is at least one year.2. the standard of keeping the score: clear and definite inhalation (inhalatio) sensitinogen clue is arranged, a guy and/or family's anaphylactic disease history,, there are typical symptoms and sign stage of attack, and each remembers 1 fen, totally 3 minutes.The positive reaction of allergen tuerculoderma has at least a kind of for (++) or more than (++); Specific IgE antibody detects the positive or the allergen nasal provocation test positive, and meets with tuerculoderma and medical history, each gets totally 4 minutes 2 fens.The nasal smear inspection eosinophilic granulocyte positive and/or nasal mucosa scraping blade mastocyte (basophil) are positive to be got 1 fen.Score was diagnosed as the perennial allergic rhinitis in 6~8 minutes, and 3~5 are divided into suspicious allergic rhinitis, may be the anallergic rhinitis in 0~2 minute.
(2), the seasonal morbidity of pollinosis 1., annual morbidity season basically identical, and be consistent with sensitization pollen pollinating period; At least two years in same morbidity in season.2., there are typical clinical symptoms and sign stage of attack.3. stage of attack nasal discharge (and/or conjunctiva scraping blade) the eosinophilic granulocyte positive, or nasal mucosa scraping blade mastocyte (basophil) positive.4. the pollen allergen tuerculoderma is positive, and at least a is (++) or more than (++), or the allergen nasal provocation test positive, the eye conjunctival butter positive.
(3) the symptom classification standard of keeping the score
Classification sneeze (one-time continuous number) watery nasal discharge (blowing the nose number of times every day) the nasal obstruction rhinocnesmus of keeping the score
Idol had interruption in 1 minute 3~9≤4
2 minutes 10~14 5~9 ant row senses that fall between, but can stand
3 minutes 〉=16 〉=10 almost whole day mouthful ant row senses, unbearably
Breathe
Seven, the treatment of allergic rhinitis:
Allergic rhinitis can not reach the effect of curing (cure) fully usually, and best bet is prevention.
The purpose of treatment is the disease time of prevention, relief of symptoms and minimizing allergic rhinitis.
(1) Drug therapy
The mechanism of different pharmaceutical treatment may be different, and local application and systemic administration are arranged.Below list medicine commonly used clinically.
Medicament categories common drug title action principle purposes points for attention
To antihistaminic, body can cause drowsiness at the thorn chlorphenamine of anaphylactogen, the driver,
The antihistaminic hismanal, chlorphenamine, the prevention and
Swash and to discharge histamine down, and then cause that one is forbidding such as pilot, hismanal etc.
Treatments such as thing Acrivastine
The row allergic symptom.There is not drowsiness effect.
Sodium cromoglicate eye liquid reaches
Mastocyte is surely having under the situation of anaphylactogen, stops body
Oral medicine, the Qu Nisi prevention can cause drowsiness.
Decide the agent tissue and discharge histamine.
Special
Ephedrine must lead to, and uses and is no more than 3 days, and is the longest by one
Short-term is controlled
The Decongestant epinephrine, the furan fiber crops alleviate congestion.Week.Life-time service can cause medicine
Treat
The mixture rhinitis.
Bromide reduces the many symptoms of tears that caused by histamine.Treatment is of little use clinically.
Life-time service may cause hormone
Dexamethasone ophthalmic,
Alleviate the reaction of anaphylactogen and suppress scorching systemic side effects, but general secondary the work
Hormone medicine uncle gram sodium, Reynolds is examined treatment
The property reaction.With slightly, be used for especially recently
Special
Clinical medicine.
Help alleviates that the stiff secretions of nasal cavity is auxiliary to be controlled
The nose wetting agent
And crust.Treat
(2) other Therapeutic Method of allergic rhinitis
General Drug therapy can play better therapeutic effect to allergic rhinitis, but for serious allergic rhinitis, can adopt other relevant Therapeutic Method.
Significantly the symptom of nasal obstruction can be used laser, and microwave or plasma radiofrequency are treated and reached satisfied effect, and by the sensitivity that lowers the nasal cavity nerve sneeze and snivel is had certain benefit.Be used for the existing report of clinical low-temperature plasma system recently allergic rhinitis especially severe allergic rhinitis is had obvious effects, because it is little to mucosa injury, non-evident effect, its clinical meaning has begun to be paid attention to by some doctors, can be as substituting laser and microwave optimum selection in the treatment of allergic rhinitis, but price is more expensive is its shortcoming, and Nanjing Aug. 1st hospital hals,Nasen und Ohrenheilkunde utilizes the heavier allergic rhinitis of this technology treatment numerical example, has obtained very satisfied effect.
Desensitization therapy, with the allergic effect original work desensitizer of having found out, beginning all adopts low dose to make subcutaneous injection, and increases dosage gradually, changes maintenance dose into during to the maximum amount of standing, till transference cure.Patient through this method treatment can produce a large amount of specific IgG blocking antibodies in the body, antigen capable of blocking combines with IgE antibody, reduces the sensitivity of medium cell, thereby plays therapeutical effect, but because anaphylactogen may be a lot, often limited its effect.
Should carry out polypous hands art under the endoscope with polypous patient; For reducing the parasympathetic irritability of nasal cavity, can implement vidianneurectomy or rock great superficial petrosal nerve amputation, it is reported certain therapeutic effect, but because of misery is bigger, and certain risk arranged, still do not advocate to adopt this operation.
Eight, Chinese Medical Association's otolaryngology branch is about the efficacy assessment standard of allergic rhinitis
(1) in order to evaluate curative effect exactly, objectively, should carry out: symptom classification (subordinate list) and sign classification.The sign classification: at the bottom of concha nasalis inferior and the nose, nasal septum near, can not see middle nasal concha, or middle nasal concha mucosal polyp sample becomes, polyp forms, and is recorded as 3 fens; Concha nasalis inferior and nasal septum (or at the bottom of nose) near, small gap is still arranged between (or nasal septum) at the bottom of concha nasalis inferior and the nose, be recorded as 2 fens; Still as seen concha nasalis inferior mild swelling, nasal septum, middle nasal concha are recorded as 1 fen.
Should establish matched group when (two) clinical research is with the data of summary.
(3) sum total of keeping the score according to sings and symptoms before and after the treatment, the percentage rate that improves is evaluated perennial allergic rhinitis's curative effect by following formula: total points * 100% 〉=51% is a produce effects before total points before the treatment-treatment back total points/treatment, 50%~21% is that effectively≤2% is invalid.
(4) during perspective study before and after the pollinosis treatment sings and symptoms keep the score and should compare with pollen quantity and kind local, that fly away in the air then.Efficacy evaluation is divided into (except the desensitization treatment) and late result in the recent period, and short term effect is evaluation when treatment finishes, and late result finishes evaluation in back a year in treatment at least.Subtract quick treatment curative effect and evaluate (not containing the tachysnthsis treatment) at continued treatment after 2 years.
Nine, albendazole brief introduction
Albendazole, english common name are Albendazole; Generic name is: Albendazole, Albendazole, 5-rosickyite-2-Carbendazim, rosickyite reach azoles, the third mercapto imidazoles, albendazole etc.Be broad-spectrum de-worming medicine.Can influence the multiple biochemical metabolism approach of polypide.This medicine can suppress the picked-up of Enterozoa to glucose, causes the intravital glycogen depletion of worm; Also can combine and suppress micropipe aggregation with the polypide tubulin, thus transhipment of secretion inhibitor granule and the motion of other subcellular organelle; Also can suppress polypide mitochondrion fumaric reductase system, reduce ATP and generate, thereby disturb polypide existence and breeding and cause its death.This medicine is the high-efficiency broad spectrum anthelmintic, is the strongest a kind of of insecticidal action in the benzimidazole medicine.Oral absorption is slow.The 2.5-3 hour blood drug level peaking in oral back, 15mg/kg on the one are at twice or divide three oral area under curve that reach (AUC) identical.This medicine bioavailability is distributed in liver, kidney, muscle in vivo and can sees through blood-cerebrospinal fluid barrier, so finite concentration is also arranged in the cerebral tissue less than 5%.This medicine is converted into Albendazole-sulfoxide and Albendazole-sulfone in liver, the former is an insecticidal constituent.Gland medicine and the sulfone derivative concentration in blood is extremely low, can not measure, and the concentration change of Albendazole-sulfoxide is very big, does not wait from 0.04 μ g/mL to 0.55 μ g/mL, average 0.16 μ g/mL.Former medicine and metabolite thereof had 87% with homaluria in 24 hours, the kidney clearance rate is 0.16-0.81L/h, and 13% drains through digestive tract.Half-life is 8.5-10.5 hour.Medicine does not have depot action in vivo.Do not removed by hemodialysis.。
Ten, so far, all do not see any report or document record that albendazole is used for the treatment of allergic rhinitis both at home and abroad as yet.
The present invention is made into compound recipe with albendazole as independent effective ingredient or with other medicines, makes the dosage form of nasal-cavity administration, and these dosage forms include, but are not limited to: nasal drop, spray, aerosol and powder spray.
Indication with albendazole or the nasal drop made from the compound recipe that contains albendazole, spray, aerosol and powder spray of the present invention, include, but are not limited to following disease: allergic rhinitis, nasal polyp or nasal polyp, rhinitis, pharyngitis, tracheitis and bronchitis.
Use of the present inventionly with albendazole or the nasal drop made from the compound recipe that contains albendazole, spray, aerosol and powder spray, for Allergic Rhinitis, directly nasal-cavity administration can be alleviated relevant symptom effectively.
Nasal drop of the present invention, spray, aerosol and powder spray all meet the definition of the Pharmacopoeia of the People's Republic of China (version was two ones in 2000) about nasal drop, spray, aerosol and powder spray.
Allergic rhinitis of the present invention is that those skilled in the art is known, has it to define accurately in the modern medical book.Its pathological change as previously mentioned.
By the preparation of following examples, and be described with the application of albendazole nasal drop, spray, aerosol and powder spray treatment of allergic rhinitis to albendazole nasal drop of the present invention, spray, aerosol and powder spray.It should be noted that, following embodiment just is used for explanation and unrestricted the present invention, well-known to those skilled in the artly by other administration route albendazole is used for the treatment of nasal polyp or nasal polyp, rhinitis, pharyngitis, tracheitis and bronchitic technology all within the scope of the invention.
The preparation of embodiment 1 albendazole nasal mist
In ten thousand grades of environment, albendazole is dissolved in normal saline, be prepared into the solution of 1mg/ml, add geramine, the concentration that makes geramine is 0.02%.In the nasal mist bottle, the spray valve of screwing on promptly gets the albendazole nasal mist with this liquid medicine filling.
The preparation of embodiment 2 albendazole nasal aerosol
In ten thousand grades of environment, albendazole is dissolved in normal saline, be prepared into the solution of 1mg/ml, add geramine, the concentration that makes geramine is 0.02%.This liquid medicine filling in the nasal aerosol bottle, is added propellant, load onto aerosol valve, promptly get the albendazole nasal aerosol.
The preparation of embodiment 3 albendazole nasal cavity powder sprays
In ten thousand grades of environment, with albendazole 20mg, hydroxypropyl cellulose (HPC) 980mg, Benasept 0.1mg co-blended, the albendazole that obtains homogeneous is the powder body of 1 μ g/mg, and diameter of particle should be 30~150 μ m, be filled in the hard capsule, get nasal-cavity administration albendazole powder spray.Per nasal sprays into administration with the dust cloud device during use.
The preparation of embodiment 4 albendazole nasal drop
In ten thousand grades of environment, albendazole is dissolved in normal saline, be prepared into the solution of 1mg/ml, add geramine, the concentration that makes geramine is 0.02%.This liquid medicine filling in the nasal drop bottle, is promptly got the albendazole nasal drop.
Embodiment 5 albendazole spray treatment of allergic rhinitis
Albendazole treatment of allergic rhinitis 15 examples have obtained significant clinical effectiveness.Allergic rhinitis 15 examples that outpatient service is gone to a doctor all meet the allergic rhinitis diagnostic criteria, wherein male 10 examples, women 5 examples, 27 years old mean age (14~46 years old).
Method: adopt the treatment of albendazole spray, nasal-cavity administration spray every day secondary, be 10 days the course of treatment, during other Claritins of forbidding and various types of nasal drop.Observe symptoms such as patient's rhinocnesmus, watery nasal discharge, nasal obstruction and sneeze, with 10 days be produce effects with interior each transference cure, symptom is partly alleviated to effectively, symptom do not have be improved as invalid.
Result: produce effects 10 examples, effective 4 examples, invalid 1 example, obvious effective rate not 66.7%.
Embodiment 6 albendazole treatment by aerosol allergic rhinitises
Certain woman, 23 years old, the main suit: nasal obstruction, olfactory sensation is obviously gone down, rhinocnesmus, sneeze, stream clear water tears show effect repeatedly, are diagnosed as allergic rhinitis, use local treatment, continuous use 5 days, the transference cure of sucking of the capable nose of " embodiment 2 " described albendazole aerosol.
Embodiment 3 albendazole nasal drop treatment of allergic rhinitis
Certain man, 30 years old.Surplus because of nasal obstruction, watery nasal discharge, sneeze, rhinocnesmus 3 years, come the hospital outpatient inspection, be diagnosed as allergic rhinitis.Previously once obeying multiple Claritin does not all prove effective.With the treatment of " embodiment 4 " described albendazole nasal drop, once a day, continue 5 days, clinical symptoms obviously alleviated symptom complete obiteration in the 4th day on the 1st day after medication.Continuous use is 5 days then, and recurrence is not seen in follow-up observation 10 days.
Embodiment 4 albendazole powder spray treatment of allergic rhinitis
One women, 43 years old, be diagnosed as allergic rhinitis, with " embodiment 3 " described albendazole powder spray treatment, once a day, continue 5 days, from medication the 2nd day, symptom alleviated day by day.Continue medication, check after 10 days, symptom complete obiteration.

Claims (2)

1. the dosage form of the nasal-cavity administration that albendazole is made as effective ingredient, these dosage forms comprise:
1. nasal drop;
2. spray;
3. aerosol;
4. powder spray.
2. the application of albendazole in the production of the nasal drop that is used as treatment of allergic rhinitis, spray, aerosol, powder spray.
CN 200410078473 2004-09-14 2004-09-14 Albendazole new form for treating allergic rhinitis Pending CN1748699A (en)

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