Miconazole + Gentamicin Pharmacology

Miconazole + Gentamicin

About Miconazole + Gentamicin
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Mechanism of Action of Miconazole + Gentamicin
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Pharmacokinets of Miconazole + Gentamicin
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Onset of Action for Miconazole + Gentamicin
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Duration of Action for Miconazole + Gentamicin
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Half Life of Miconazole + Gentamicin
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Side Effects of Miconazole + Gentamicin
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Contra-indications of Miconazole + Gentamicin
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Special Precautions while taking Miconazole + Gentamicin
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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 Miconazole + Gentamicin
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Interactions for Miconazole + Gentamicin
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Typical Dosage for Miconazole + Gentamicin
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Schedule of Miconazole + Gentamicin
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Storage Requirements for Miconazole + Gentamicin
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Effects of Missed Dosage of Miconazole + Gentamicin
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Effects of Overdose of Miconazole + Gentamicin
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Miconazole

About Miconazole
An imidazole derivative, Broad spectrum Antifungal.
Mechanism of Action of Miconazole
Miconazole is fungicidal or fungistatic depending on the drug concentrations. I t inhibits the conversion of Lanosterol to 14 demethyl Lanosterol by inhibiting the cytochromeP450 enzyme 14 alpha demethylase and impair ergosterol synthesis
Pharmacokinets of Miconazole
Absorption: Oral absorption of Miconazole is poor. Distribution: It is distributed in the body in protein bound form Metabolism: It undergoes metabolism in the liver. Excretion: It is excreted in urine and faeces.
Onset of Action for Miconazole
N/A
Duration of Action for Miconazole
N/A
Half Life of Miconazole
1 day
Side Effects of Miconazole
1.Vulvovaginal burning
2.Burning
3.Irritation
4.Pruritis
5.Maceration
6.Dermatitis
Contra-indications of Miconazole
1.Hypersensitivity to Miconazole and other Azole antifungals
Special Precautions while taking Miconazole
1.Hepatic dysfunction
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Miconazole
1.Tinea versicolor
2.Vulvovaginal candidiasis
3.Tinea pedis
4.Tinea corporis
5.Tinea cruris
6.Otomycosis
7.Onychomycosis
8.Oral candidiasis
9.Intestinal candidiasis
10.Diaper dermatitis
Interactions for Miconazole
Benzoyl peroxide: Antibacterial synergism.
Typical Dosage for Miconazole
Adult: Topical use:
Cutaneous infections: Apply the cream twice daily on the affected part for about 1 month
Tinea versicolor: Apply the cream once daily on the affected part
Vaginal use: Insert 300 mg suppository at bed time for 3 days or Insert 100 mg suppository at bed time for 7 days

CHILDREN:
Topical use:
Cutaneous infections: Apply the cream twice daily on the affected part for about 1 month
Tinea vericolor: Apply the cream once daily on the affected part

Schedule of Miconazole
H
Storage Requirements for Miconazole
The drug should be stored at 15 - 30 degree C.
Effects of Missed Dosage of Miconazole
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 Miconazole
Give supportive measures and 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.

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