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- Pharmacology For Gentamicin + clotrimazole + betamethasone dipropionate + lidocaine
Gentamicin + clotrimazole + betamethasone dipropionate + lidocaine Pharmacology
Gentamicin + clotrimazole + betamethasone dipropionate + lidocaine
About Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AMechanism of Action of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/APharmacokinets of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AOnset of Action for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/ADuration of Action for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AHalf Life of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/ASide Effects of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AContra-indications of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/ASpecial Precautions while taking Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/APregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineTreatment of superficial bacterial and fungal infections of the external auditory canal and middle ear, caused by organisms susceptible to the action of Gentamicin and Clotrimazole.
Interactions for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/ATypical Dosage for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/ASchedule of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AStorage Requirements for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AEffects of Missed Dosage of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AEffects of Overdose of Gentamicin + clotrimazole + betamethasone dipropionate + lidocaineN/AGentamicin
About GentamicinAminoglycoside antibiotic.Mechanism of Action of GentamicinGentamicin 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 GentamicinAbsorption: Poorly absorbed orally
Distribution: Distributed extracellularly. CSF penetration & intraocular penetration poor.
Metabolism: Not metabolized
Excretion: Excreted mainly through urine.
Onset of Action for Gentamicin1 hour
Duration of Action for Gentamicin8 hoursHalf Life of Gentamicin2 hoursSide Effects of Gentamicin1. Vestibular damage & Ototoxicity
2. Allergic manifestations
3. Nephrotoxicity
4. Dizziness
5. Nausea
6. Vomiting
7. Seizures
Contra-indications of Gentamicin1. Hypersensitive to the drug or other amino glycosides
2. Along with chloramphenicol or tetracycline
3. Renal impairment
4. Labyrinthine disorders
Special Precautions while taking Gentamicin1. Renal impairment
2. Neuromuscular disorders
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with caution
Breast Feeding Related InformationContraindicated
Children Related InformationUse with caution
Infants : Use with caution
Indications for Gentamicin1. 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 GentamicinAmphotericin 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 GentamicinDosage:
Adults: 2 to 5mg/kg/day; Thrice daily for a week or more
Children: 2 to 2.5mg/kg; Thrice daily.
Schedule of GentamicinHStorage Requirements for GentamicinStore below 30 degree Celsius and protect from light.Effects of Missed Dosage of GentamicinTake 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 GentamicinAn 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.
Clotrimazole
About ClotrimazoleA broad-spectrum antifungal antibiotic, imidazole derivative, Oral Nonabsorbed Antifungal Agent.Mechanism of Action of ClotrimazoleClotrimazole is fungicidal or fungistatic depending on the drug concentrations. It inhibits the conversion of Lanosterol to 14 demethyl Lanosterol by inhibiting the cytochromeP450 enzyme 14 alpha demethylase and impair ergosterol synthesis which is an essential constituent of cell membrane. Inhibition of ergosterol synthesis will alter the membrane permeability of the susceptible fungus and kill or inhibit them.Pharmacokinets of ClotrimazoleAbsorption: Absorption is minimal after topical administration.Onset of Action for ClotrimazoleN/ADuration of Action for Clotrimazole3 hoursHalf Life of ClotrimazoleN/ASide Effects of Clotrimazole1.Stinging
2.Erythema
3.Burning
4.Pruritis
5.Vesication
6.Desquamation
7.Urticaria
8.Burning
9.Peeling
10.Irritation
Contra-indications of ClotrimazoleHypersensitivity to ClotrimazoleSpecial Precautions while taking Clotrimazole1.Avoid contact with eyes, nose and mouth.
2.Do not wear occlusive dress over the medicament.
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationUse with caution.Children Related InformationUse with caution.
NEONATES: contraindicatedIndications for Clotrimazole1.Tinea pedis
2.Tinea cruris
3.Tinea versicolor
4.Tinea corporis
5.Cutaneous candidiasis
6.Vulvovaginal candidiasis
Interactions for ClotrimazolePolyene Antibiotics : Antagonises effects of polyene antibiotics.Typical Dosage for ClotrimazoleTopical: Clotrimazole cream, lotion and solution 1 % is used.
Clean and dry the affected area and apply the medicament with gentle massage 2 -3 times daily for 2 - 4 weeks.
Vaginal candidiasis: Insert 1 applicator full (vaginal cream 1%) intravaginally at night for 1 -2 weeks.
Vaginal tablets 100. 200 and 500mg tablet is available.
Vulvovaginal candidiasis: Insert 100mg tablet intravaginally at bed time for 7 consecutive days or 200 mg tablet for 3 consecutive days or 500 mg tablet for 1 day at night.
Oral lozenge 10 mg is available
Oropharyngeal candidiasis: 1 lozenge orally 5 times daily for 2 weeks
Prophylaxis of Oropharyngeal candidiasis: 1 lozenge is used 3 times daily
Gel: Insert with an applicator intravaginally at night for 1 - 2 weeks.
Powder (1% w/ w): dusted over the body parts as required
Schedule of ClotrimazoleHStorage Requirements for ClotrimazoleStore at room temperature (15 - 25 degree C). Protect from heat and moisture. Keep out of the reach of childrenEffects of Missed Dosage of ClotrimazoleApply 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 ClotrimazoleGive supportive measures and symptomatic treatment.Betamethasone dipropionate
About Betamethasone dipropionateA synthetic glucocorticoid, anti-inflammatory.Mechanism of Action of Betamethasone dipropionateThe 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-alpha, GM-CSF (granulocyte macrophage colony stimulating factor), Gama interferon and suppresses fibroblast proliferation and T-lymphocyte functions and interferes chemotaxis. 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 Betamethasone dipropionateAbsorption: It is absorbed in to the systemic circulation and the amount is depending on the potency, amount applied and the nature of the skin at the site of application. Absorption increases at the site of skin damage, inflammation or occlusion.
Onset of Action for Betamethasone dipropionateN/ADuration of Action for Betamethasone dipropionateN/AHalf Life of Betamethasone dipropionateN/ASide Effects of Betamethasone dipropionate1.Thinning of the skin
2.Loss of elasticity
3.Increased hair growth
4.Acne at the site of application
5.Mild depigmentation
6.Rosacea
Contra-indications of Betamethasone dipropionate1.Hypersensitivity to Betamethasone
2.Untreated bacterial virus or fungal infections
3.Acne vulgaris
4.Peri-oral dermatitis
5.Tuberculosis of the skin
6.Varicose ulcers
7.Skin lesions caused by infections with herpes simplex vaccinia or varicella viruses. fungi (e.g. Candida Tinea) or bacteria (e.g. impetigo)
8.Discoid lupus Erythematosus
Special Precautions while taking Betamethasone dipropionate1.Avoid contact with eyes
2.For external use only
3.Prolonged use
Pregnancy Related InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
NEONATES: contraindicatedIndications for Betamethasone dipropionate1.Eczema
2.Psoriasis
3.Contact dermatitis
4.Anal and vulval Pruritis
5.Inflammation of the skin
Interactions for Betamethasone dipropionateN/ATypical Dosage for Betamethasone dipropionateApply thinly 1 -2 times daily.Schedule of Betamethasone dipropionateHStorage Requirements for Betamethasone dipropionateStore 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 Betamethasone dipropionateApply 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 Betamethasone dipropionateProvide symptomatic treatment and supportive measures.Lidocaine
About LidocaineAmide derivative , Antiarrhythmic(Class Ib) ,Local anesthetic.Mechanism of Action of LidocaineN/APharmacokinets of LidocaineN/AOnset of Action for LidocaineN/ADuration of Action for LidocaineN/AHalf Life of LidocaineN/ASide Effects of LidocaineN/AContra-indications of LidocaineN/ASpecial Precautions while taking LidocaineN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for LidocaineN/AInteractions for LidocaineN/ATypical Dosage for LidocaineN/ASchedule of LidocaineN/AStorage Requirements for LidocaineN/AEffects of Missed Dosage of LidocaineN/AEffects of Overdose of LidocaineN/AHome Delivery for Gentamicin + clotrimazole + betamethasone dipropionate + lidocaine in Your City
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