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Trauma workers may be at risk of secondary traumatic stress (STS) through indirect exposure to traumatic material, especially if they have experienced personal trauma. This is the first study to ask whether past trauma resolution influences STS and was examined in 64 volunteer crisis workers, a greatly ignored population. Those with nonresolved personal trauma had higher scores on an STS measure than volunteers whose trauma histories were resolved, while the latter showed less STS than the sample as a whole. STS was unrelated to volunteer experience, exposure to victims, or the type of cases found most distressing, indicating that accepted STS risk factors may not apply to volunteers. Findings have resounding implications for the popular view of trauma history as an STS risk factor: this may double as both a significant peril and a protection, depending on whether the past trauma is resolved. [ABSTRACT FROM AUTHOR]

Objective: The aim of these studies was to determine the absolute bioavailability in healthy volunteers of inhaled fluticasone propionate (FP) administered as a single dose via the Diskhaler and Diskus powder devices, and the pharmacokinetics of inhaled FP after repeated administration via the Diskhaler device.Methods: In 2 of the studies, single inhaled doses of FP were administered via the Diskhaler and the Diskus powder devices, and, in the third study, repeated doses of FP were administered via the Diskhaler. In the single dose studies, 12 healthy volunteers were randomised to receive FP 1000 microg by inhalation and FP 250 microg intravenously, using a double-blind crossover design. In the repeated dose study, 24 healthy volunteers received FP 1000 microg twice daily for 7.5 days.Results: Systemic exposure to FP after administration of a single 1000 microg inhaled dose of FP via the 2 powder devices was similar; the area under the plasma FP concentration-time curve (AUC) to infinite time (AUCinfinity) was 2.08 microg/L x h [95% confidence intervals (CI): 1.63-2.64] for Diskhaler and 2.49 microg/L x h (95% CI: 2.09-2.96) for Diskus. Maximum plasma FP concentration (Cmax) was 0.34 microg/L for both devices. Mean bioavailability values via the Diskhaler and Diskus were 11.9% (95% CI: 9.0-15.7%) and 16.6% (95% CI: 13.6-20.3%), respectively. No clinically significant reductions in urinary cortisol excretion were recorded in these 2 studies. After repeated administration with the Diskhaler, steady state was achieved by dose 3 (i.e. day 2) onwards. After dose 15, the AUC up to 12 hours (AUC12h) was 2.25 microg/L x h and Cmax was 0.38 microg/L. The mean steady-state to single dose accumulation ratio after twice-daily administration was 1.49 (95% CI: 1.36-1.62).Conclusion: The pharmacokinetics of FP administered by the 2 powder devices are similar in healthy volunteers, although systemic bioavailability was greater with the Diskus. [ABSTRACT FROM AUTHOR]

Objective: The pharmacokinetic profile of a single dose of inhaled fluticasone propionate (FP) administered via a metered-dose inhaler (MDI), containing either a chlorofluorocarbon (CFC) or hydrofluoroalkane (HFA) propellant was investigated in healthy volunteers.Methods: Two randomised, double-blind, crossover studies were conducted, each in 12 male volunteers. Both studies compared pharmacokinetic data after a single inhaled dose of FP 1000 microg from a MDI containing either CFC (CFC MDI) or HFA (HFA MDI) with a single intravenous dose of FP 250 microg.Results: The maximum plasma FP concentrations after inhalation via the 2 types of MDI were almost identical (0.56 and 0.54 microg/L for CFC MDI and HFA MDI, respectively); bioavailability values of inhaled FP from the 2 MDIs were also similar (geometric mean values: 26.4% via the CFC MDI and 28.6% via the HFA MDI). Inhalation of FP via both MDI formulations produced similar reductions in urinary cortisol excretion over 12 and 24 hours postdose.Conclusion: The bioavailability values of FP after inhalation via a CFC MDI and an HFA MDI are similar. The 2 formulations deliver comparable amounts of FP, and systemic exposures to FP from the 2 devices, measured by urinary cortisol excretion, are not significantly different. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the absolute oral bioavailability of fluticasone propionate (FP) in healthy volunteers.Methods: A 3-period incomplete block crossover design was used. On separate occasions, 21 male volunteers received a single 250 microg intravenous dose of FP (n = 21) and twice daily oral doses of either micronised FP 0.1 mg (n = 9), 1 mg (n = 12), 10 mg (n = 11) or placebo (n = 9) for 4 days.Results: FP was not measurable in the plasma after twice daily oral administration of a 0.1 mg dose. FP concentrations just above the limit of quantification could be measured in only 5 volunteers, and only at some time points, after administration of FP 1 mg twice daily. At a dose of 10 mg twice daily the absolute oral bioavailability of the drug was <1% when a liquid chromatography-mass spectrometry assay was used to assess plasma concentrations. Only oral doses of FP 10 mg twice daily, 10 times greater than the recommended maximum inhaled dose, produced any detectable change in urinary cortisol excretion.Conclusion: The results of this study confirm that oral absorption of FP into the systemic circulation is negligible. The swallowed portion of an inhaled dose of FP is unlikely to increase the systemic exposure to the drug, thus decreasing the likelihood of adverse systemic effects. [ABSTRACT FROM AUTHOR]