Neomycin + Fluocinolone acetonide Pharmacology
Neomycin + Fluocinolone acetonide
Neomycin
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
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
2. Hypersensitivity to other amino glycosides
3. Intestinal obstruction
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
2. Preventing infection following surgery
3. Topical infections
4. Systemic infections
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
Fluocinolone acetonide
The drug exerts its 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, leukotrienes (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-?, 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.
Fluocinolone also has immunosuppressant and antimitotic actions.
2.Burning
3. Itching
4.Irritation
5.Atrophy (Dermal changes)
6.Telangiectasia
7.Striae
8. Hypopigmentation
9.Contact dermatitis
10.Perioral dermatitis
11.Stinging
12.Cataract,Glaucoma, Corneal ulcers caused by application around eyelids and surrounding skin
13. Hypertrichosis
14. Dryness
15. Acne
2.Acne vulgaris
3.Acne Rosacea
4.Nappy rash
5. Tuberculosis infection of the skin
6.Viral, fungal or bacterial primary infections
7.Ulcers
2. Prolonged use
3.Psoriasis
4.Avoid contact with eyes
5. Avoid occlusive dressing
6.Not used more than 5 days on the face or in the children
7. If irritation or hypersensitivity occurs avoid the use of medicaments.
NEONATES: contraindicated
2.Eczema
3.Otitis externa
4.Lichen simplex and planus
5.Anal and vulval pruritis
6.Contact dermatitis
7.Seborrheic dermatitis
8. Dermatoses (secondary infected)
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