Miconazole + Gentamicin + Betamethasone valerate Pharmacology

Miconazole + Gentamicin + Betamethasone valerate

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

Betamethasone valerate

About Betamethasone valerate
It is a topical steroid
Mechanism of Action of Betamethasone valerate
The 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 valerate
Absorption: 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 valerate
N/A
Duration of Action for Betamethasone valerate
N/A
Half Life of Betamethasone valerate
N/A
Side Effects of Betamethasone valerate
1.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 valerate
1.Untreated bacterial, virus or fungal infections
2.Acne vulgaris,
3.Peri-oral dermatitis,
4.Scabies,
5.Leg ulcers,
6.Tuberculosis of the skin,
7.Varicose ulcers,
8.Skin lesions caused by infections with ring worm,. fungi (e.g. Candida, Tinea) or bacteria (e.g. impetigo)
9.Hypersensitivity to Betamethasone and other corticosteroids.
10.Discoid lupus Erythematosus
Special Precautions while taking Betamethasone valerate
1.Avoid contact with eyes
2.For external use only
3.Prolonged use
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 Betamethasone valerate
1.Psoriasis,
2.Eczema,
3.Otitis externa,
4.Lichen simplex and planus,
5.Anal and vulval Pruritis,
6.Seborrheic dermatitis,
7.Contact dermatitis,
8.Steroidal responsive dermatoses of the scalp
Interactions for Betamethasone valerate
N/A
Typical Dosage for Betamethasone valerate
Topical:
Betamethasone Valerate: Apply to the affected area as thin film 1 - 4 times daily depending upon the severity, skin and rate of absorption.
Dermatoses of the scalp: (Betamethasone Valerate 0.12%): Small amount of foam is applied in to the scalp with gentle massage 2 times a day for up to 2 weeks.
Schedule of Betamethasone valerate
N/A
Storage Requirements for Betamethasone valerate
Store 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 valerate
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 Betamethasone valerate
Provide symptomatic treatment and supportive measures.

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