Miconazole + Neomycin + Fluocinolone acetonide Pharmacology

Miconazole + Neomycin + Fluocinolone acetonide

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

Neomycin

About Neomycin
An aminoglycoside, Antibiotic, Ammonium Detoxicant.
Mechanism of Action of Neomycin
This 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 Neomycin
Absorption- 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 Neomycin
1 to 4 hr after oral administration
Duration of Action for Neomycin
8hrs after oral administration
Half Life of Neomycin
Its plasma half life is 2 to 3 hrs
Side Effects of Neomycin
1. 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 Neomycin
1. Hypersensitivity to the drug or any ingredients of it
2. Hypersensitivity to other amino glycosides
3. Intestinal obstruction
Special Precautions while taking Neomycin
1. 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 Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Neomycin
1. Coma due to liver disease
2. Preventing infection following surgery
3. Topical infections
4. Systemic infections
Interactions for Neomycin
N/A
Typical Dosage for Neomycin
Ophthalmic 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 Neomycin
C
Storage Requirements for Neomycin
Eye 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 Neomycin
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 Neomycin
Give 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 drug

Fluocinolone acetonide

About Fluocinolone acetonide
A synthetic hydrocortisone derivative, Vasoprotective ,reduce skin inflammation.
Mechanism of Action of Fluocinolone acetonide
Fluocinolone is a topical high potency glucocorticoid.
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.
Pharmacokinets of Fluocinolone acetonide
Absorption: Fluocinolone is absorbed( <1 %) through intact skin after topical administration and the amount absorbed is depending on the type of inflammation, vehicle used, area of skin and the epidermal barrier.
Onset of Action for Fluocinolone acetonide
N/A
Duration of Action for Fluocinolone acetonide
N/A
Half Life of Fluocinolone acetonide
N/A
Side Effects of Fluocinolone acetonide
1.Thinning of epidermis
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
Contra-indications of Fluocinolone acetonide
1. Hypersensitivity to Fluocinolone and other corticosteroids
2.Acne vulgaris
3.Acne Rosacea
4.Nappy rash
5. Tuberculosis infection of the skin
6.Viral, fungal or bacterial primary infections
7.Ulcers
Special Precautions while taking Fluocinolone acetonide
1.Avoid application on large surface area
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.
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
NEONATES: contraindicated
Indications for Fluocinolone acetonide
1.Psoriasis
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)
Interactions for Fluocinolone acetonide
N/A
Typical Dosage for Fluocinolone acetonide
Topical: Fluocinolone 0.0025 %, 0.01% cream, ointment, gel or lotion is used. Clean and dry the affected area and apply the medicament thinly and evenly on the affected area for 2 - 3 times daily for 2 weeks.
Schedule of Fluocinolone acetonide
N/A
Storage Requirements for Fluocinolone acetonide
Store at room temperature. Protect from heat and moisture. Keep out of the reach of children
Effects of Missed Dosage of Fluocinolone acetonide
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 Fluocinolone acetonide
Give supportive measures and symptomatic treatment.

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