Clotrimazole + Framycetin + Dexamethasone Pharmacology
Clotrimazole + Framycetin + Dexamethasone
2.Do not wear occlusive dress over the medicament.
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
Putting the drops directly into the eye allows the Framycetin to act directly on the bacteria which produces infection.
2.If irritation occurs then discontinue the use of medicaments
3.Avoid contact lenses
Serious eye infections: Apply 1 - 2 drops to affected eye every 1-2 hours for 2-3 days and then reduce the frequency to 3 -4 times daily.
Do not use more than 1 month after opening.
Framycetin Eye Ointment:
2-3 applications of the ointment in the eye daily, or at bedtime if eye drops have been used during the day.
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-a, 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.
Dexamethasone has antiemetic properties, particularly against acute and delayed vomiting induced by cancer chemotherapy. It may be used alone for prevention of acute symptoms associated with moderately-emetogenic treatment and is combined with a 5-HT3 antagonist for highly-emetogenic treatment. Dexamethasone is also effective for the prevention of postoperative nausea and vomiting, and may be used to manage nausea and vomiting in palliative care.
7.Atrophy of adrenal cortex(on prolonged therapy)
8.Suppression of adrenocorticotropic hormone
10.Inhibition of growth in children
20.Delayed wound healing
27.Posterior sub capsular cataract
30.Increased intracranial pressure
3.Stinging in the eye
5.Systemic fungal infections
7.Congestive heart failure
2.Use lower dosages as much as possible
3.Ocular herpes simplex
7.Recent myocardial infarction
17.Non specific Ulcerative colitis
19.Recent intestinal anastomosis
2.Contact lens wearer
5.Intra-articular and soft tissue inflammation
14.Nausea and vomiting induced by cancer chemotherapy
Carbamazepine, Primidone: Decreases efficacy.
Oral contraceptives: Increases efficacy of dexamethasone.
Ephedrine: Decrease efficacy of dexamethasone.
Oestrogens: Decrease efficacy of dexamethasone
Hydantoins: Decrease efficacy of dexamethasone
Ketoconazole: Increase efficacy of dexamethasone
Rifampicin: Decreases efficacy.
Dexamethasone effects the actions of the following:
Anticholinesterases: Efficacy antagonised in myasthenia gravis.
Oral anticoagulants: Altered response.
Cyclosporine: Increased cyclosporine efficacy leading to enhanced toxicity.
Digitalis glycosides: Increased toxicity associated with hypokalaemia.
Isoniazid: Decreased serum levels of isoniazid.
Salicylates: Decreased serum levels of salicylates.
Diuretics: Increase efficacy may cause increased hypokalaemia and increased hyperglycemia.
Non-depolarising muscle relaxants: Altered response.
Theophyllines: Altered response of either agent.
IUCDs: contraceptive failure.
Lab. Tests: a) Increases serum cholesterol levels.
Increases urine glucose levels.
Decreases Thyroid I131 uptake. Decreases T3 serum levels. Decreases serum potassium.
Brain Scan: Dexamethasone alters result of brain scan due to decreased uptake of radioactive material.
I.M. or I.V.: 0.5 to 20mg/day I.M. or as slow I.V. injection depending up on the severity of the condition; repeated as required up to 80mg/day.
Antiemetic: 4 to 8 mg by mouth immediately before moderately-emetogenic chemotherapy and 20 mg by intravenous injection for more severely emetogenic chemotherapy.
Children: 100mcg to 500mcg/kg/day
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