TOLMAR Inc. Fort Collins, CO 80526 for
Sandoz Inc. Princeton, NJ 08540
Rev. 2 09/08
Renal toxicity has also been seen in patients in whom renal prostaglandins have a compensatory role in the maintenance of renal perfusion. In these patients, administration of an NSAID may cause a dose-dependent reduction in prostaglandin formation and, secondarily, in renal blood flow, which may precipitate overt renal decompensation. Patients at greatest risk of this reaction are those with impaired renal function, dehydration, hypovolemia , heart failure, liver dysfunction, those taking diuretics and ACE-inhibitors or ARBs, and the elderly. Discontinuation of NSAID therapy is usually followed by recovery to the pretreatment state.
An ideal topical anesthetic agent would be easy to apply, show high clinical effectiveness over a short time period, exert its effect on intact skin without systemic effects, and cause nominal pain or discomfort during treatment with minimal to no side effects [ 10 , 13 , 14 ]. Topical anesthetics must be able to penetrate the relatively impermeable barrier of the stratum corneum and have minimal systemic absorption [ 10 , 14 ]. Eutectic mixtures allow individual anesthetic compounds, which are normally in the solid state at room temperature, to be combined as liquids. Eutectic mixtures permit higher concentrations of anesthetic to be used safely and facilitate application to the skin [ 9 ].