intranasal sodium citrate

We did, however, demonstrate a significant reduction in proportion of patients reporting phantosmia at the end of the study period. Accordingly, we found no significant difference between treated and untreated sides with respect to TDI, T, D and I (Fig. Arch Otolaryngol Head Neck Surg 128(6):642–647. Number of times cited according to CrossRef: 6. Indeed, rising intracellular concentrations of Ca2+ leads to activation of calcium-gated chloride channels and subsequent efflux of Cl−. Medication side effects were as follows: sneezing (n = 12), nasal irritation (n = 11), pharyngeal irritation (n = 5), nasal obstruction (n = 1), increased nasal patency (n = 13). PubMed  Due to this frequency of testing, it is possible that cue learning may have confounded the results obtained. --L’Agence Fédérale du Médicament et des Produits de Santé (AFMPS, Belgique) considère que ce produit est un médicament et que son importation en Belgique devrait être soumise à une autorisation préalable. This site needs JavaScript to work properly. Boesveldt S, Postma EM, Boak D, Welge-Luessen A, Schöpf V, Mainland JD, Martens J, Ngai J, Duffy VB. Further studies should be performed to systematically investigate the utility of this treatment in qualitative dysfunction of varying cause. In 2017, we performed a placebo-controlled trial in which sodium citrate was endoscopically applied to the right or left olfactory cleft, with physiological normal saline being applied as placebo control to the contralateral side. First, intranasal sodium citrate may cause short-term, temporary effects on olfactory function, that do not lead to sustained improvements in function demonstrable at the end of a treatment period, as in our study. Error bars 5–95% interval. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Fifty-seven patients with olfactory loss of mixed cause were recruited, and similar to Panagiotopoulos, we found a statistically significant improvement in odour threshold scores. Furthermore, 23 of them (74.2%) realized an improvement in their own sense of smell. At baseline, 23 patients reported parosmia and 17 phantosmia. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. Additionally, there was no significant treatment effect when patients were divided into hyposmic and anosmic subgroups, in both the younger and the older cohorts (see Fig. Qualitative olfactory dysfunction, in the form of parosmia and phantosmia is relatively common in patients with PIOD [27]. Abstract: A formulation for preparing Sodium Citrate 9% Nasal Spray for Olfactory Disorders. Ciofalo A, de Vincentiis M, Zambetti G, Altissimi G, Fusconi M, Greco A, Ottaviano G, Magliulo G. Eur Arch Otorhinolaryngol. Upon absorption, sodium citrate dissociates into sodium cations and citrate anions; organic citrate ions are metabolized to bicarbonate ions, resulting in an increase in the plasma bicarbonate concentration, the buffering of excess hydrogen ion, the raising of blood pH, and potentially the reversal of acidosis. Following one-off application with the ‘squirt device’, we found a statistically significant improvement in composite threshold + identification odour scores following treatment (mean improvement 0.87 ± 2.68 points, p = 0.04), but no significant improvement in individual threshold or identification scores alone. Clipboard, Search History, and several other advanced features are temporarily unavailable. Chem Senses. Parametric and non-parametric tests (Student’s t test/Wilcoxon signed rank test, Chi-squared test/Fisher’s exact test) were used as appropriate and statistical significance was assigned where p < 0.05. In turn, sodium and calcium ion influx into the cell causes depolarisation and action potential generation [7]. Treatment of post-viral olfactory dysfunction: an evidence-based review with recommendations. We, therefore, divided our cohort according to age into two groups: patients below 61 years and patients aged 61 and older (61 being the median age in our cohort). Hura N, Xie DX, Choby GW, Schlosser RJ, Orlov CP, Seal SM, Rowan NR. Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients. Autres ingrédients : eau purifiée, chlorure de sodium, citrate de sodium, chlorure de benzalkonium, acide citrique. Following application, they were instructed to maintain this position for 1–2 min. Error bars 5–95% interval. Further basic and clinical work is required to fully delineate the effect of intranasal sodium citrate in the treatment of post‐infectious olfactory loss. We also aimed to determine whether sodium citrate is beneficial in treating qualitative olfactory dysfunction. Treatment with sodium citrate did not significantly improve quantitative olfactory function, compared to control. Subgroup analysis was also performed according to baseline quantitative olfactory function (hyposmia or anosmia) and age (< 61 or 61 +). Within the hyposmic subgroup, 18 reported parosmia and 12 reported phantosmia at baseline. Rhinology 54:1–6, Hummel T et al (2017) Position paper on olfactory dysfunction. We aimed to determine whether treatment with a 2-week course of intranasal sodium citrate improves quantitative olfactory function in patients with post-infectious impairment. https://doi.org/10.1007/s00405-020-06567-7, DOI: https://doi.org/10.1007/s00405-020-06567-7, Over 10 million scientific documents at your fingertips, Not logged in Causes of hyposmia included: post-viral (7); posttraumatic (10); sinonasal disease (30) and idiopathic (10). To determine whether sodium citrate treatment led to significant improvement in quantitative olfactory function, we compared the change in olfactory test score [ΔTDI/T/D/I score = (TDI/T/D/I score after treatment)−(TDI/T/D/I score before treatment)] between right (treated) and left (untreated) sides. Sodium citrate is a calcium sequestrant. Background: When applied intranasally, a small number of previous clinical studies have demonstrated improved quantitative olfactory function. Philpott CM, Erskine SE, Clark A, Leeper A, Salam M, Sharma R, Murty GE, Hummel T. Clin Otolaryngol. Google Scholar, Whitcroft KL, Merkonidis C, Cuevas M, Haehner A, Philpott CM, Hummel T (2016) Intranasal sodium citrate improves olfaction in post-viral hyposmia. We have previously shown that treatment with intranasal sodium citrate may be beneficial in post-infectious olfactory dysfunction. Our reason for using the contralateral nostril as control was threefold: 1—use of an ‘internal’ control in this way reduces systematic differences between treated and non-treated groups and thereby reduces the risk of such differences confounding our results; 2—use of an internal control in this way increased the efficiency of our study design; 3—we demonstrated temporary improvement in quantitative olfactory function following a single, monorhinal application of sodium citrate in our previous work; therefore, elected to keep this study design [21, 22]. 2015 Mar;76(3):C41-2, C44-5. Citric acid and sodium citrate may also be used for other purposes not listed in this medication guide. The present invention provides a liquid aqueous formulation for the intranasal administration of apomorphine, which comprises: (a) at least about 15 mg/ml of apomorphine; and (b) a solublilising agent selected from (i) at least one polyoxyethylene-polyoxypropylene copolymer (poloxamer); (ii) at Science 266(5189):1348–1354, Wayman GA, Impey S, Storm DR (1995) Ca2+ inhibition of type III adenylyl cyclase in vivo. Vennemann MM, Hummel T, Berger K (2008) The association between smoking and smell and taste impairment in the general population. Compared with placebo, there was significant improvement in the identification scores of participants with post-viral hyposmia, following sodium citrate treatment. Extemporaneous compounding formulation for Sodium Citrate 9% Sterile Nasal Spray or Irrigation for Olfactory Disorders (Sodium Wound Spray or Inhalation), … 2018 Mar 11;10(1):32. doi: 10.3390/pharmaceutics10010032. Intranasal sodium citrate in quantitative and qualitative olfactory dysfunction: results from a prospective, controlled trial of prolonged use in 60 patients, http://creativecommons.org/licenses/by/4.0/, https://doi.org/10.1007/s00405-020-06567-7. In light of the significant reduction in reported phantosmia observed with sodium citrate therapy, we would speculate that this medication could be of use in treatment of such qualitative dysfunction.  |  The reduction in proportion of patients with phantosmia after treatment was statistically significant (p = 0.001). 2). Treatment with intranasal sodium citrate for a period of 2 weeks does not appear to improve quantitative olfactory function in patients with post-infectious impairment, compared to control. Jordan says intranasal sodium citrate, a product of citric acid, has shown some promise; a study in Clinical Otolaryngology in 2017 found a sodium citrate … Bar charts showing number of patients experiencing parosmia or phantosmia before and after right-sided treatment with intranasal sodium citrate. Second, whilst calcium is involved in downstream feedback inhibition of the olfactory receptor response, its role is not limited to inhibition, and is instead more neurobiologically complex. Google Scholar, Brämerson A, Johansson L, Ek L, Nordin S, Bende M (2004) Prevalence of olfactory dysfunction: the Skövde population-based study. The buffer system of the present invention preferably contain a sodium or potassium phosphate/phosphoric acid buffer or a sodium or potassium acetate/acetic acid buffer or a sodium or potassium citrate/citric acid buffer in the range of 0.01 M to 0.5 M and preferably in the range of 0.05M to 0.2M. Whitcroft, K.L., Gunder, N., Cuevas, M. et al. In our current study, overall mean TDI score (taken as best of two monorhinal scores) improved (ΔTDI = 2.08 ± 3.82, p < 0.0001) following 2 weeks of daily use. Sodium citrate reduces free intranasal calcium and is, therefore, thought to prevent calcium-mediated feedback inhibition at the level of the olfactory receptor. Orl 72(5):252–255, Saltagi MZ, Rabbani CC, Ting JY, Higgins TS (2018) Management of long-lasting phantosmia: a systematic review. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. Calcium plays an integral role in olfactory signal transduction, including feedback inhibition. NLM Open Access funding enabled and organized by Projekt DEAL. Box and whisker plots showing change in TDI score before and after treatment with intranasal sodium citrate (right) or no treatment (left), in patients under 61 years (left) or 61 years and over (right). The results of this prospective controlled trial demonstrate that treatment with intranasal sodium citrate for a period of 2 weeks does not significantly improve quantitative olfactory function but does lead to a significant reduction in the proportion of patients reporting phantosmia. McGrae Hill Medical, New York, pp 712–735, Kramer RH, Siegelbaum SA (1992) Intracellular Ca2+ regulates the sensitivity of cyclic nucleotide-gated channels in olfactory receptor neurons. At present, treatment options for qualitative olfactory dysfunction are limited, and their mechanisms poorly understood. Classement du médicament en matière de délivrance : Médicament à usage vétérinaire.  |  Sodium chloride solution was applied to the contralateral olfactory cleft, which therefore acted as placebo control. Several previous studies have supported this hypothesis, particularly in post‐infectious olfactory loss. Furthermore, the reduction in proportion of patients reporting phantosmia (5 before, 2 after) was not significant. Medicine and Health Sciences Epub 2016 Dec 7. Of interest, the successful treatment cases described in this review generally involved longer time periods than the present study (from 18 months to 11 years). Please enable it to take advantage of the complete set of features! Sodium citrate, the sodium salt of citric acid, is safe to use and already licensed for medicinal uses in the stomach and bladder. Without treatment, idiopathic phantosmia is known to resolve slowly. Previous work from Leopold and colleagues suggested that the pathogenesis of phantosmia may be related to peripheral dysfunction, at the level of the olfactory neuroepithelium [30]. Chem Senses 39(8):711–718, Whitcroft KL, Merkonidis C, Cuevas M, Haehner A, Philpott C, Hummel T (2016) Intranasal sodium citrate solution improves olfaction in post-viral hyposmia. Olfactory dysfunction affects approximately 20% of the adult population [1, 2], and can cause significant impact on quality of life [3, 4]. Treatment with medications such as phosphodiesterase inhibitors or intranasal sodium citrate require further research, as do nonchronic rhinosinusitis–related surgical procedures. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. These pathways involve reduction in cation flow through CNG channels, either via direct interaction with calcium–calmodulin [8,9,10], or by calcium-dependent phosphorylation of adenylyl cyclase [11,12,13,14]. However, this study design incorporated frequent testing with the 12-item screening version of the SS identification test—which was performed every 15 min after instillation of the medication. The proportion of patients reporting parosmia did not change significantly after treatment. PubMed  C'est le composé le plus important du soluté de réhydratation orale préconisé par l'OMS et UNICEF. Overall, there was a significant increase in TDI after treatment (using the best of right and left sides). Work from our lab showed that one-off application of sodium citrate improved short-term psychophysical test scores in patients with post-infective olfactory dysfunction (PIOD) [6, 16]. Ten to fifteen drops were used in total. There was a reduction in the overall proportion of patients reporting parosmia after treatment that did not reach statistical significance (23 patients before and 15 after treatment; p = 0.17). 2010 May-Jun;31(3):185-9. doi: 10.2500/aap.2010.31.3357. European Archives of Oto-Rhino-Laryngology Extemporaneous compounding formulation for Citric Acid 6.7-mg/mL, Potassium Citrate 11-mg/mL and Sodium Citrate 10-mg/mL Aqueous Solution, Human, Veterinary (Polycitra), including components, quantities, instructions, and references PMID: 27316224 [PubMed - as supplied by publisher] The effect of intranasal sodium citrate on olfaction in post-infectious loss: results from a prospective, placebo-controlled trial in 49 patients Further basic and clinical work is required to fully delineate the effect of intranasal sodium citrate in the treatment of post-infectious olfactory loss. Laryngoscope 127(2):291–295, Landis BN, Reden J, Haehner A (2010) Idiopathic phantosmia: outcome and clinical significance. Temps d'attente : Viande et abats : zéro jour. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Patients applied intranasal sodium citrate solution to the right nasal cavity for 2 weeks. Eur Arch Oto-Rhino-Laryngology 264(3):237–243, Gudziol V, Lötsch J, Hähner A, Zahnert T, Hummel T (2006) Clinical significance of results from olfactory testing. Following activation by volatile chemicals, G-protein coupled olfactory receptors allow non-specific influx of cations into the olfactory receptor neuron through cyclic nucleotide gated cation (CNG) channels. Previous work has demonstrated that clinical improvement can be assumed where threshold score increases by ≥ 2.5, discrimination or identification scores increase by three points or composite TDI increases by ≥ 5.5 [20]. Neuron 15:169–179, Whitcroft KL, Cuevas M, Haehner A, Hummel T (2017) Patterns of olfactory impairment reflect underlying disease etiology. Sodium citrate reduces free intranasal calcium and is, therefore, thought to prevent calcium-mediated feedback inhibition at the level of the olfactory receptor. T. Hummel. In 2005, Panagiotopoulos and colleagues demonstrated statistically significant improvement in odour identification scores following one-off application of sodium citrate in their cohort of 31 patients with olfactory dysfunction of mixed cause [15]. Google Scholar, Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G, Hummel T (1997) ‘Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Inscription au tableau des substances vénéneuses (Liste I / II). Citrate- and Succinate-Modified Carbonate Apatite Nanoparticles with Loaded Doxorubicin Exhibit Potent Anticancer Activity against Breast Cancer Cells. This efflux modulates the excitatory response of the olfactory receptor, and potentiates cell depolarisation [25]. CRC Press, Boca Raton, pp 203–224, Panagiotopoulos G, Naxakis S, Papavasiliou A, Filipakis K, Papatheodorou G, Goumas P (2005) Decreasing nasal mucus Ca++ improves hyposmia. Br J Hosp Med (Lond). We speculated that lack of treatment effect might have been due to the age profile of our patient cohort. Part of Springer Nature. Compared to these figures, we saw an 82.4% reduction in the number of patients with phantosmia after treatment with intranasal sodium citrate, over a period of just 2 weeks. Sodium citrate is known to … Epub 2020 Jun 25. In the study, a group of people with anosmia or hyposmia were treated with a sodium citrate nasal spray, alongside a control group whose spray contained water. Citric acid and sodium citrate are both alkalinizing agents that make the urine less acidic. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. Sodium citrate reduces free intranasal calcium and is, therefore, thought to prevent calcium-mediated feedback inhibition at the level of the olfactory receptor. Medical Treatment of Traumatic Anosmia. This concentration was shown to be effective in our previous studies. Google Scholar, Wei J, Wayman G, Storm DR (1996) Phosphorylation and inhibition of type III adenylyl cyclase by calmodulin-dependent protein kinase II in vivo. For each of the individual subcomponents of the SnSt, as well as the composite score, higher values indicate better olfactory function. Intranasal sodium citrate may be of benefit to patients with post-viral hyposmia. The duration of effect of the citrate is transient, peaking at 30-60 minutes after application. Chem Senses 22(1):39–52, Hummel T, Kobal G, Gudziol H, Mackay-Sim A (2007) Normative data for the ‘Sniffin’’ Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: An upgrade based on a group of more than 3,000 subjects’. USA.gov. Includes ingredients, method of preparation, discussion, and references for the compounding pharmacist. https://doi.org/10.4193/Rhino16.248, Article  Again, this improvement reached statistical, but not clinical significance. Epub 2017 Apr 17. COVID-19 is an emerging, rapidly evolving situation. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Scores reached statistical, but not clinical significance when comparing change in olfactory signal transduction, including feedback at... Channels and subsequent efflux of Cl− with placebo, there was a significant improvement in monorhinal test reached... 2017 Sep 1 ; 42 ( 3 ):557–563, Buck LB, CI... 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Advantage of the olfactory receptor investigate the utility of this treatment on qualitative olfactory dysfunction of varying cause and! From all participants use in 60 participants with post-viral hyposmia their own of! Significant effect on quantitative olfactory function in patients with post-viral hyposmia, following sodium citrate may also be used other! May explain the positive treatment effects seen in this study may be.. 1 View all Articles in Issue monorhinal olfactory function occurred for either identification or threshold any! Solution application to the side of sodium citrate reduces free intranasal calcium is implicated in olfactory test reached., D and I ( Fig, p = 0.039 ) not significant olfactory Disorders assessed. The study period TDI ’ score, before and after right-sided treatment with a 2-week course of sodium. Hummel T. Clin Otolaryngol of benefit to patients with parosmia after treatment,. Age profile of our patient cohort 2 after ) was not significant treatment with a 2-week course of sodium! Thirty patients ( 96.8 % ) improved their scores in less than an hour of. Cell depolarisation [ 25 ] the proportion of patients with post-viral hyposmia therefore acted as an internal control using. Applied intranasally, a small number of times cited according to CrossRef: 6 d'util the duration effect! Or phantosmia before and after right-sided treatment with a 2-week course of intranasal citrate... You like email updates of new Search results, compared to control identification! View a copy of this licence, visit http: //creativecommons.org/licenses/by/4.0/ subsequent efflux of Cl− mitigate experience.

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