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- Pharmacology For Hydrocortisone Topical + Polymyxin B + Neomycin + Bacitracin
Hydrocortisone Topical + Polymyxin B + Neomycin + Bacitracin Pharmacology
Hydrocortisone Topical + Polymyxin B + Neomycin + Bacitracin
About Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AMechanism of Action of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/APharmacokinets of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AOnset of Action for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/ADuration of Action for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AHalf Life of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/ASide Effects of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AContra-indications of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/ASpecial Precautions while taking Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AInteractions for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/ATypical Dosage for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/ASchedule of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AStorage Requirements for Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AEffects of Missed Dosage of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AEffects of Overdose of Hydrocortisone Topical + Polymyxin B + Neomycin + BacitracinN/AHydrocortisone Topical
About Hydrocortisone TopicalTopical synthetic glucocorticoid, anti-inflammatory and anti-pruritic.Mechanism of Action of Hydrocortisone TopicalThe 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 both glucocorticoid and mineralocorticoid actions.
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-alpha, 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.
Pharmacokinets of Hydrocortisone TopicalAbsorption: Absorption ranges from 1% to 36% after topical application.
Distribution: Distributed throughout the local skin layers. Any drug absorbed in to circulation is rapidly removed from blood and distributed in to muscle, liver, kidney, skin, and intestine.
Metabolism: Metabolized primarily in skin and a small amount absorbed is metabolized in liver.
Excretion: Metabolites are excreted mainly through urine and a small amount is excreted through faeces.
Onset of Action for Hydrocortisone TopicalN/ADuration of Action for Hydrocortisone TopicalN/AHalf Life of Hydrocortisone TopicalN/ASide Effects of Hydrocortisone Topical1. Burning
2. Irritation
3. Pruritus
4. Dryness
5. Erythema
6. Folliculitis
7. Hypertrichosis
8. Acneiform eruptions
9. Allergic contact dermatitis
10. Secondary infections
11. Atrophy
12. Striae
Contra-indications of Hydrocortisone Topical1. Hypersensitivity to the drug
2. Local or systemic infections
3. Fungal or herpetic keratitis
4. Cataract
5. Tubercular or syphilitic lesions
Special Precautions while taking Hydrocortisone Topical1. Occlusive dressings
2. Use of potent preparations should be short term or intermittent
3. Milder drugs should be used in acute lesions and stronger ones are for chronic lesions
4. Avoid sudden discontinuation of the drug.
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES : Contraindicated
Indications for Hydrocortisone Topical1. Treatment of skin disorders: Dermatitis, Eczema,Psoriasis
2. Inflammations of corticosteroid-responsive dermatoses
3. Seborrheic dermatitis of scalp
Interactions for Hydrocortisone TopicalCarbamazepine, Primidone: Decreases efficacy.
Oral contraceptives: Increase concentration of hydrocortisone.
Oestrogens: Decreases clearance of hydrocortisone.
Ketoconazole: Decreases clearance of hydrocortisone.
Rifampicin: Decreases efficacy.
Hydrocortisone effects the actions of the following:
Anticholinesterases: Efficacy antagonised in myasthenia gravis.
Oral anticoagulants: Altered response.
Cyclosporine: Increases efficacy, enhanced toxicity may occur.
Digitalis glycosides: May enhance toxicity.
Isoniazid: Decreases serum levels.
Salicylates: Decreases serum levels.
Diuretics (K sparing): May cause hypokalaemia.
Non-depolarising muscle relaxants: Altered response of either agent may occur.
Somatrem: Growth promoting effect inhibited.
Theophyllines: Altered response of either agent.
Lab. Tests: Increases serum cholesterol levels. Increases urine glucose levels. Decreases Thyroid I131 uptake; Decreases T3 serum levels. Decreases serum potassium.Typical Dosage for Hydrocortisone TopicalCream:
Apply 0.1% to 2.5% 1 to 4 times daily.
Ointment:
0.5% to 2.5% Apply 1 to 4 times as required
Lotion:
0.25% to 2.5% Apply 1 to 4 times as required
Gel:
0.5% to 1% Apply 1 to 4 times as required
Aerosol:
Seborrheic dermatitis of scalp:
0.5% to 1%Apply for only 3seconds. Directly spray in to the affected area from 15 cm apart. No need for massage or rub. Apply 1 to 4 times daily until acute phase is controlled. Then reduce the dosage to 0nce to thrice weekly.
Schedule of Hydrocortisone TopicalHStorage Requirements for Hydrocortisone TopicalStore at room temperature at a range of 15 to 30 degree C. Protect from light and moisture. Keep out of reach of children.Effects of Missed Dosage of Hydrocortisone TopicalApply 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 Hydrocortisone TopicalProvide symptomatic treatment and supportive measures.Polymyxin B
About Polymyxin BBasic polypeptide(Polymyxin)antibiotic, Antibiotic.Mechanism of Action of Polymyxin BPolymixin B is a member of poly peptide antibiotic. Being poly peptide they exert a detergent like effect. They have high affinity for phospholipids. Peptide molecules orient between these phospholipids and cause cell membrane distortion and amino acids and ions come out with in the cell.Polymixin B is useful against gram negative bacteria only.Pharmacokinets of Polymyxin BAbsorption: It is well absorbed after parenteral administration.Distribution: It is very widely distributed in the body.Metabolism: It does not undergo significant metabolism.Excretion: It is excreted mainly through urine.
Onset of Action for Polymyxin BN/ADuration of Action for Polymyxin BN/AHalf Life of Polymyxin B6 hours.Side Effects of Polymyxin B1.Pain at the site of injection
2.Nystagmus
3.Flushing
4.Nausea
5.vomiting
6.Diarrhoea
7.Rash
8.Partial deafness
9. Pruritis
10.Ataxia
11.Vertigo
12.Nephrotoxicity
13.Disturbances of vision
Contra-indications of Polymyxin B1. Hypersensitive to Polymixin B and other polypeptide antibioticSpecial Precautions while taking Polymyxin B1.Myasthenia gravis
2.Renal dysfunctionPregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Polymyxin B1.Skin infection
2.Urinary tract infection
3.Burns
4.Enteric infection
Interactions for Polymyxin BAminoglycosides: Concurrent use may increase risk of respiratory paralysis and renal dysfunction.
Non-depolarising muscle relaxants: Neuromuscular blockade may be enhanced.Typical Dosage for Polymyxin BAdult :( IV) DOSE: 15000 - 25000 units /kg body weight/day in divided dose for 1 - 2 week
Children (IV) dose: 20000 - 40000 units/kg body weight/day in divided dose.
Schedule of Polymyxin BHStorage Requirements for Polymyxin BStore the drug at 10 - 30 degree CelsiusEffects of Missed Dosage of Polymyxin BTake 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 Polymyxin BGive supportive measures and sumptomatic treatment.Neomycin
About NeomycinAn aminoglycoside, Antibiotic, Ammonium Detoxicant.Mechanism of Action of NeomycinThis aminoglycoside cause protein synthesis inhibition by "irreversibly" bind to specific 30S-subunit proteins and 16S rRNA. Specifically Neomycin binds to four nucleotides of 16S rRNA and a single amino acid of protein S12. This interferes with decoding site in the vicinity of nucleotide 1400 in 16S rRNA of 30S subunit. This region interacts with the wobble base in the anticodon of tRNA. This leads to interference with the initiation complex, misreading of mRNA so incorrect amino acids are inserted into the polypeptide leading to nonfunctional or toxic peptides and the breakup of polysomes into nonfunctional monosomes.Pharmacokinets of NeomycinAbsorption- Poorly absorbed after oral administration
Distribution- Rapidly distributed in the body after oral administration. 30% bound to the plasma proteins. It crosses the placenta
Metabolism- Not metabolized
Excretion- Excreted through urine and feces (primarily as unchanged form). It also excreted through breast milk
Onset of Action for Neomycin1 to 4 hr after oral administrationDuration of Action for Neomycin8hrs after oral administrationHalf Life of NeomycinIts plasma half life is 2 to 3 hrsSide Effects of Neomycin1. Rash
2. Diarrhoea
3. Inflammation of the large intestine (colitis)
4. Nausea
5. Vomiting
6. Ototoxicity
7. Damage to the kidneys
8. Damage to vestibular function within the ear
Contra-indications of Neomycin1. Hypersensitivity to the drug or any ingredients of it
2. Hypersensitivity to other amino glycosides
3. Intestinal obstruction
Special Precautions while taking Neomycin1. Impaired renal function
2. Neuromuscular disorder
3. Ulcerative bowel lesions
4. Extensive dermatologic conditions
5. Any other eye infection or condition
6. Glaucoma
7. Cataract surgery
8. Blockage of the bowel
9. Eighth-cranial-nerve disease (loss of hearing and/or balance)
10. Kidney disease
11. Myasthenia gravis
12. Parkinson`s disease
13. Ulcers of the bowel
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Neomycin1. Coma due to liver disease
2. Preventing infection following surgery
3. Topical infections
4. Systemic infections
Interactions for NeomycinN/ATypical Dosage for NeomycinOphthalmic suspension:
Adults-
1 or 2 drops every three or four hours- For eye infection
Oral (solution, tablets):
Adults and teenagers-
1 to 3 grams every six hours for five or six days- coma from liver disease
Adults and teenagers-
1 gram every hour for four hours, then 1 gram every four hours for the rest of a twenty-four hour period; or 1 gram nineteen hours before surgery, 1 gram eighteen hours before surgery, and 1 gram nine hours before surgery- cleaning the bowel before surgery.
Children-
14.7 milligrams mg/kg or 6.7 mg/ pound every four hours for three days
Ear preparation:
Adults and children-
2 to 5 drops into ear canal 3 to 4 times daily for 7 to 10 days- External ear canal infection
Schedule of NeomycinCStorage Requirements for NeomycinEye preparations store in the refrigerator protected from strong light. Do not freeze. Others are stored at <250C. Keep out of reach of children.Effects of Missed Dosage of NeomycinTake 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 NeomycinGive symptomatic and supportive treatment. Provide haemodialysis or peritoneal dialysis to remove the drug. Treated with calcium salts or anticholinesterase to reverses neuromuscular blockade. Administer activated charcoal to prevent the further absorption of drugBacitracin
About BacitracinPolypeptide antibiotic.Mechanism of Action of BacitracinBacitracin is an antibiotic produced by the strain of Bacillus subtilis. It acts by inhibiting bacterial cell wall synthesis. It is active against a variety of gram positive and a few gram negative organisms.Pharmacokinets of BacitracinN/AOnset of Action for BacitracinN/ADuration of Action for BacitracinN/AHalf Life of BacitracinN/ASide Effects of Bacitracin1.Albuminuria
2.Cylindruria
3.Azotemia
4.Rising blood levels without any increase in dosage.
5.Nausea
6.Vomiting
7.Pain at site of injection
8.Burning, Redness, Rash(topical use)
9.Nephrotoxicity (After parenteral use)
Contra-indications of BacitracinHypersensitivity to the drugSpecial Precautions while taking BacitracinHypersensitivity to other antibioticsPregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with cautionIndications for BacitracinLocally used for secondarily infected wounds, ulcers, pyodermas and other superficial skin infections.
In the eye: Superficial infections of the eye
Nasal application: Bacitracin-susceptible infections of the upper and lower respiratory tract
IM: Pneumonia and empyema caused by staphylococci in infantsInteractions for BacitracinN/ATypical Dosage for BacitracinInfants:IM use
For infants under 2.5kg: 900 units/kg/day in 2 or 3 divided doses.
For infants over 2.5kg:1000 units/kg/day in 2 or 3 divided doses.
Local use: Apply locally once or twice daily in the affected area
Schedule of BacitracinN/AStorage Requirements for BacitracinParenteral preapration: Stored at 2 - 8 degree Celsius.Other preaparations should be stored at 15 - 30 degree Celsius
Effects of Missed Dosage of BacitracinApply 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 BacitracinGive supportive measures and symptomatic treatment.Home Delivery for Hydrocortisone Topical + Polymyxin B + Neomycin + Bacitracin in Your City
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Hydrocortisone Topical + Polymyxin B + Neomycin + Bacitracin is a generic medicine name and there are several brands available for it. Some of the brands for hydrocortisone topical + polymyxin b + neomycin + bacitracin might be better known than hydrocortisone topical + polymyxin b + neomycin + bacitracin itself. If the pharmacy that's willing to deliver medicines to your home doesn't have hydrocortisone topical + polymyxin b + neomycin + bacitracin in stock, you can ask for one of the branded alternatives for hydrocortisone topical + polymyxin b + neomycin + bacitracin.