Tolnaftate + Gentamicin + Dexamethasone Pharmacology

Tolnaftate + Gentamicin + Dexamethasone

About Tolnaftate + Gentamicin + Dexamethasone
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Mechanism of Action of Tolnaftate + Gentamicin + Dexamethasone
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Pharmacokinets of Tolnaftate + Gentamicin + Dexamethasone
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Onset of Action for Tolnaftate + Gentamicin + Dexamethasone
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Duration of Action for Tolnaftate + Gentamicin + Dexamethasone
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Half Life of Tolnaftate + Gentamicin + Dexamethasone
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Side Effects of Tolnaftate + Gentamicin + Dexamethasone
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Contra-indications of Tolnaftate + Gentamicin + Dexamethasone
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Special Precautions while taking Tolnaftate + Gentamicin + Dexamethasone
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Tolnaftate + Gentamicin + Dexamethasone
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Interactions for Tolnaftate + Gentamicin + Dexamethasone
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Typical Dosage for Tolnaftate + Gentamicin + Dexamethasone
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Schedule of Tolnaftate + Gentamicin + Dexamethasone
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Storage Requirements for Tolnaftate + Gentamicin + Dexamethasone
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Effects of Missed Dosage of Tolnaftate + Gentamicin + Dexamethasone
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Effects of Overdose of Tolnaftate + Gentamicin + Dexamethasone
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Tolnaftate

About Tolnaftate
Thiocarbamate derivative, Antifungal.
Mechanism of Action of Tolnaftate
Tolnaftate is a reversible noncompetitive inhibitor of Squalene epoxidase enzyme of fungi. This epoxidase enzyme is useful for the conversion of Squalene to sterols. Inhibition of Squalene epoxidase enzyme will leads to a deficiency of sterols (ergosterol) and distort the hyphae and to stunt mycelial growth in susceptible organisms.
Pharmacokinets of Tolnaftate
Absorption: The absorption after topical application is negligible.
Onset of Action for Tolnaftate
N/A
Duration of Action for Tolnaftate
N/A
Half Life of Tolnaftate
N/A
Side Effects of Tolnaftate
1. Irritation
2. Redness
3. Stinging
4. Sensitisation
5. Contact dermatitis
6. Pruritis
Contra-indications of Tolnaftate
1. Hypersensitivity to Tolnaftate
2. Nail and scalp infections
3. Deep infections
Special Precautions while taking Tolnaftate
1. Avoid contact with eyes mouth vagina and nose.
2. Stop the use of medication if irritation occurs
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Below 2 years: contraindicated
Indications for Tolnaftate
1. Dermatophytosis
2. Tinea corporis (ringworm of the body)
3. Tinea cruris (ringworm of the groin; jock itch)
4. Tinea pedis (ringworm of the foot; athlete`s foot)
5. Tinea versicolor
6. Tinea barbae
Interactions for Tolnaftate
None reported.
Typical Dosage for Tolnaftate
1% cream, gel, powder and topical solution are used.
Clean and dry the affected and surrounding area. Apply the medicament with gentle massage and cover it with surgical gauze 2 - 3 times daily for 2 - 6 weeks. Wash hands before and after use.
Aerosol Powder: Spray liberally from a distance of 15 to 25 cm between toes and on feet, in shoes, socks or on affected area.
Solution: 1 - 2 drops for cover the area of hand; 2 - 3 drops cover the toes. Apply to each lesion and massage gently, then allow drying.
Schedule of Tolnaftate
N/A
Storage Requirements for Tolnaftate
Store at 15 - 25 degree C. Protect from heat and moisture. Keep out of the reach of children.
Effects of Missed Dosage of Tolnaftate
Apply the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Tolnaftate
Give supportive measures and symptomatic treatment.

Gentamicin

About Gentamicin
Aminoglycoside antibiotic.
Mechanism of Action of Gentamicin
Gentamicin exerts its bactericidal action against gram negative organisms & some of gram positive organisms by inhibiting bacterial protein synthesis. The process involves 1. Penetration of bacterial cell membrane & binding directly to the bacterial ribosome, 2. Misleading of m-RNA codon by bacterial ribosome, 3. Formation of peptide chains with wrong amino acid sequence which gets incorporated into bacterial cell membrane and alters its permeability, 4. Bacterial cell lysis. Some bacterial strains resistant to other amino glycosides are sensitive to Gentamicin.
Pharmacokinets of Gentamicin
Absorption: Poorly absorbed orally
Distribution: Distributed extracellularly. CSF penetration & intraocular penetration poor.
Metabolism: Not metabolized
Excretion: Excreted mainly through urine.

Onset of Action for Gentamicin
1 hour
Duration of Action for Gentamicin
8 hours
Half Life of Gentamicin
2 hours
Side Effects of Gentamicin
1. Vestibular damage & Ototoxicity
2. Allergic manifestations
3. Nephrotoxicity
4. Dizziness
5. Nausea
6. Vomiting
7. Seizures
Contra-indications of Gentamicin
1. Hypersensitive to the drug or other amino glycosides
2. Along with chloramphenicol or tetracycline
3. Renal impairment
4. Labyrinthine disorders

Special Precautions while taking Gentamicin
1. Renal impairment
2. Neuromuscular disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Infants : Use with caution
Indications for Gentamicin
1. Infections caused by staphylococci, pseudomonas, proteous, klebsiella, enterobacter & serratia.
2. Meningitis.
3. Endocarditis
4. Urinary Tract Infections.
5. Otitis & Ocular infections.
6. Infections of burns & Skin ulcers
Interactions for Gentamicin
Amphotericin B, Cisplatin, Cephalosporin, Vancomycin, Methoxyflurane, Frusemide, Bumetanide: Increased nephrotoxicity.
Anaesthetics, Neuromuscular blocking agents (Tubocurarine): Risk of neuromuscular blockade and respiratory paralysis.
Penicillin, Cephalosporins, Carbenicillin, Ticarcillin: Exert antibiotic synergism, especially useful in Pseudomonas infections.
Loop diuretics: Concurrent use of these agents may increase the risk of respiratory paralysis and renal dysfunction.
Lab Tests: Aminoglycoside serum levels: Guard against in vitro inactivation of aminoglycosides by b-lactum antibiotics in patients on combination therapy.
Typical Dosage for Gentamicin
Dosage:
Adults: 2 to 5mg/kg/day; Thrice daily for a week or more
Children: 2 to 2.5mg/kg; Thrice daily.
Schedule of Gentamicin
H
Storage Requirements for Gentamicin
Store below 30 degree Celsius and protect from light.
Effects of Missed Dosage of Gentamicin
Take the missed dose as soon as noticed and if it is the time to next dose then skip the missed dose.Continue the regular schedule. Do not double the dose.
Effects of Overdose of Gentamicin
An overdose results in ototoxicity, nephrotoxicity, neuromuscular disorders & hypersensitivity manifestations.Treatment includes removal of drug by dialysis or by treatment with anticholinesterase like neostigmine and by administration of Ca , Prednisolone etc.

Dexamethasone

About Dexamethasone
A potent synthetic glucocorticoid, Antiasthmatic, anti-inflammatory and immunosuppressant.
Mechanism of Action of Dexamethasone
The drug exerts it`s pharmacological action by penetrating and binding to cytoplasmic receptor protein and causes a structural change in steroid receptor complex. This structural change allows it`s migration in to the nucleus and then binding to specific sites on the DNA which leads to transcription of specific m-RNA and which ultimately regulates protein synthesis. It exerts highly selective glucocorticoid action. It stimulates the enzymes needed to decrease the inflammatory response.
The drug exerts anti-inflammatory and immunosuppressant actions as follows: - 1) Induce lipocortins in macrophages, endothelium, and fibroblasts which inhibits phospholipase A2 and thus decreases the production of Prostaglandins, leukotriens (LT), and platelet activating factor, 2) Causes negative regulation of genes for cytokines in macrophages, endothelial cells and lymphocytes and thus decreases the production of interleukins (IL-1, IL-2, IL-3, IL-6), TNF-a, GM-CSF (granulocyte macrophage colony stimulating factor), Gama interferon and suppresses fibroblast proliferation and T-lymphocyte functions and interferes chemo taxis. 3) Decreases the production of acute phase reactants from macrophages and endothelial cells and interferes complement function. 4) Decreases the production of ELAM-1(Endothelial leukocyte adhesion molecule-1) and ICAM-1(intracellular adhesion molecule-1) in endothelial cells. 5) Inhibit IgE mediated histamine and LT-C4 release from basophiles and the effects of antigen-antibody reaction is not mediated 6) Reduces the production of collagenase and stromolysin and thus prevents tissue destruction.
Dexamethasone has antiemetic properties, particularly against acute and delayed vomiting induced by cancer chemotherapy. It may be used alone for prevention of acute symptoms associated with moderately-emetogenic treatment and is combined with a 5-HT3 antagonist for highly-emetogenic treatment. Dexamethasone is also effective for the prevention of postoperative nausea and vomiting, and may be used to manage nausea and vomiting in palliative care.
Pharmacokinets of Dexamethasone
Absorption: Well absorbed orally, Distribution: Distributed in to muscle, liver, kidney, skin, and intestine. It crosses the placenta and also secreted in breast milk, Metabolism: Metabolized in liver in to inactive metabolites by glucuronide and sulfate conjugation. Excretion: Metabolites are excreted mainly through urine and a small amount is excreted through faeces.
Onset of Action for Dexamethasone
1 to 2hours
Duration of Action for Dexamethasone
2 or more days
Half Life of Dexamethasone
36 to 54 hours
Side Effects of Dexamethasone
1.Susceptibility to infection
2.Peptic ulcer
3.Haemorrhage
4.Glycosuria
5.Hyperglycaemia
6.Osteoporosis
7.Atrophy of adrenal cortex(on prolonged therapy)
8.Suppression of adrenocorticotropic hormone
9.Cushing`s syndrome
10.Inhibition of growth in children
11.Amenorrhoea
12.Behavioral disturbances
13.Thromoembolic disorders
14.Myopahy
15.Weaknss
16.Lymphocytopenia
17.Muscle wasting
18.Gastrointestinal discomfort
19.Increased appetite
20.Delayed wound healing
21.Headache
22.Euphoria
23.Insomnia
24.Seizures
25.Heart failure
26.Arrhythmias
27.Posterior sub capsular cataract
28.Glaucoma
29.Hirsutism
30.Increased intracranial pressure
Eye preparation:
1.Burning
2.Redness
3.Stinging in the eye
4.Blurred vision


Contra-indications of Dexamethasone
1.Hypersensitivity to the drug
2.Psychosis
3.Tuberculosis
4.Untreated infections
5.Systemic fungal infections
6.Osteoporosis
7.Congestive heart failure
8.Renal impairment
Special Precautions while taking Dexamethasone
1.Avoid sudden discontinuation of the drug
2.Use lower dosages as much as possible
3.Ocular herpes simplex
4.Primary glaucoma
5.Peptic ulcer
6.Epilepsy
7.Recent myocardial infarction
8.Heart failure
9.Diabetes mellitus
10.Hypothyroidism
11.Cirrhosis
12.Stress
13.Sepsis
14.Hypertension
15.Myasthenia gravis
16.Hepatic impairment
17.Non specific Ulcerative colitis
18.Diverticulitis
19.Recent intestinal anastomosis
20.Thromboembolic disorders
Eye preparation:
1.Cataracts
2.Contact lens wearer
3.Diabetes
4.Glaucoma



Pregnancy Related Information
Contraindicated.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Use with caution.
Children Related Information
Use with caution.
Neonates: Contraindicated
Indications for Dexamethasone
1.Inflammatory conditions
2.Allergic reactions
3.Shock
4.Anaphylaxis
5.Intra-articular and soft tissue inflammation
6.Asthma
7.Rheumatoid arthritis
8.Adrenal insufficiency
9.Tuberculous meningitis
10.Respiratory diseases
11.Malignancies
12.Cerebral oedema.
13.Acute gout
14.Nausea and vomiting induced by cancer chemotherapy
15. Pemphigus
Interactions for Dexamethasone
ENDOCRINE SYSTEM: Barbiturates: Decreases efficacy of dexamethasone.
Carbamazepine, Primidone: Decreases efficacy.
Oral contraceptives: Increases efficacy of dexamethasone.
Ephedrine: Decrease efficacy of dexamethasone.
Oestrogens: Decrease efficacy of dexamethasone
Hydantoins: Decrease efficacy of dexamethasone
Ketoconazole: Increase efficacy of dexamethasone
Rifampicin: Decreases efficacy.
Dexamethasone effects the actions of the following:
Anticholinesterases: Efficacy antagonised in myasthenia gravis.
Oral anticoagulants: Altered response.
Cyclosporine: Increased cyclosporine efficacy leading to enhanced toxicity.
Digitalis glycosides: Increased toxicity associated with hypokalaemia.
Isoniazid: Decreased serum levels of isoniazid.
Salicylates: Decreased serum levels of salicylates.
Diuretics: Increase efficacy may cause increased hypokalaemia and increased hyperglycemia.
Non-depolarising muscle relaxants: Altered response.
Theophyllines: Altered response of either agent.
IUCDs: contraceptive failure.
Lab. Tests: a) Increases serum cholesterol levels.
Increases urine glucose levels.
Decreases Thyroid I131 uptake. Decreases T3 serum levels. Decreases serum potassium.
Brain Scan: Dexamethasone alters result of brain scan due to decreased uptake of radioactive material.

Typical Dosage for Dexamethasone
Oral: 0.5 to 10mg/day depending up on the severity of the condition.
I.M. or I.V.: 0.5 to 20mg/day I.M. or as slow I.V. injection depending up on the severity of the condition; repeated as required up to 80mg/day.
Antiemetic: 4 to 8 mg by mouth immediately before moderately-emetogenic chemotherapy and 20 mg by intravenous injection for more severely emetogenic chemotherapy.
Children: 100mcg to 500mcg/kg/day
Schedule of Dexamethasone
H
Storage Requirements for Dexamethasone
Store at room temperature in a well closed light resistant container. Protect from excess heat and moisture. Keep out of reach of children.
Effects of Missed Dosage of Dexamethasone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Dexamethasone
Provide symptomatic treatment and supportive measures.

Home Delivery for Tolnaftate + Gentamicin + Dexamethasone in Your City

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