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Antibiotics Case No 1.Antibiotics Classification

Antibiotic Defination:-All those drug which are used for Bacterial Infection called Antibiotic.

1.Antibiotic General Classe:-

ANTIBIOTC Classification:-

1.Penicillin

2.Amoxicillin

3.Ampicillin

4.Dicloxacillin Or Cloxacillin

5.Methacillin

6.Oxacillin

7.Piperacillin

8.Penicillin V

9.Penicillin G

Antibiotic Uses and Details information:-

1.Penicillin:- Tablet 1:-Penvick DS 500mg AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin)

Indications Of Tablet Penvick Ds 500mg(AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin):-

For the treatment of mild to moderately severe bacterial infections, if these are due to penicillin susceptible pathogens and respond to therapy with oral penicillin, such as:

infections of the ear, nose and throat regions, e.g., tonsillitis, pharyngitis, laryngitis, otitis media, sinusitis.
infections of the lower respiratory tract, e.g., bronchitis and pneumonia, bronchopneumonia.
infections due to beta-hemolytic streptococci of group A, e.g., scarlet fever, erysipelas, rheumatic fever.
skin infections, e.g., pyodermia, furunculosis, phlegmon, erysipeloid, erythema migrans, insofar as the micro-organisms are penicillin-susceptible.
lymphadenitis and lymphangitis of bacterial origin.
infections of the buccal cavity, gums or jaws, e.g., inflammatory infiltrates, delayed dentition stages II and III, antral fistulae, secondary bacterial infection with Gram-positive pathogens following virus-induced gingivitis or stomatitis.

For prophylaxis of scarlet fever; also to prevent recurrences of rheumatic fever. For prophylaxis of infection after dental and oral surgical procedures or dental extractions in certain high risk patients (e.g. with congenital cardiac defects, artificial heart valves, rheumatic endocarditis). In some cases, combination with another appropriate antibiotic may be indicated.

Side Effects Of Tablet Penvick Ds 500mg(AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin):-

Occasionally, hypersensitivity reactions involving the skin (e.g. urticaria, morbilliform or scarlatiniform rashes, pruritus),c eosinophilia or more serious allergic reactions, e.g. drug fever, vasculitis, serum sickness or interstitial nephritis, may develop. Anaphylactic or anaphylactoid reactions accompanied by, e.g- angioneurotic oedema, oedema of the larynx, bronchial spasm and shock may occur.

In the event of signs pointing to anaphylactic/anaphylactoid reactions, the treatment must be terminated immediately. In occasional instances, there may be skin rashes or inflammation of mucous membranes, especially in the region of the mouth (stomatitis); dryness of the mouth and disorders of taste may rarely occur.

The occurrence of severe bullous skin reactions- usually involving the mucosae- has been reported in isolated cases (Stevens-Johnson syndrome, Lyell’s syndrome). Gastrointestinal disturbances with, e.g., nausea, vomiting, abdominal pain, loose stools, or diarrhoea may develop.

Diarrhoea may sometimes be a symptom of enterocolitis which may, in some cases, be haemorrhagic. A particular form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases due to Clostridium diffcile). This must be considered in patients in whom severe, persistent diarrhoea occurs during treatment or in the initial weeks thereafter. Even if pseudomembranous colitis is only suspected, administration of Penvik DS must be halted immediately. This type of colitis requires immediate and appropriate treatment by a physician. Drugs that inhibit intestinal peristalsis must not be taken in such cases. In isolated cases, particularly after high doses and prolonged administration, changes in blood picture such as reduction in the number of white blood cells (e.g.,leucopenia, granulocytopenia, agranulocytosis), erythrocytes (e.g., due to haemolytic anaemia), thrombocytes, or pancytopenia and myelosuppression may occur. During treatment for spirochaetal infections, Herxheimer’s reaction characterized by the occurrence or worsening of general symptoms such as fever, chills, headache, and joint pains may develop. In isolated cases, drug-induced aseptic meningitis may occur.

In extremely rare cases, transient discolouration of the teeth may be seen during treatment with Penvik DS. Administration of antibiotics, especially if prolonged, may lead to the proliferation of resistant micro organisms.

Beta-lactams predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.

Pharmacology:-

Phenoxymethyl penicillin or penicillin V is acid-stable and is absorbed from the upper part of the small intestine. Of different forms of Phenoxymethyl penicillin, the potassium salt of Phenoxymethyl penicillin is best absorbed. This may be given with meals but maximum absorption is achieved when drug is administered orally at least 1 hour before or 2 hours after the meal. Phenoxymethyl penicillin offers a very convenient means of treating Grampositive infections. Phenoxymethyl penicillin has the distinct advantage over penicillin G in resistance to inactivation by gastric acid.

Other component or Preparation of Penicillin:-

1.Injection:Benzapen 12lac units/vial (AS A Benzathine Penicillin Long acting penicillin) Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis

Indications Of .Injection:Benzapen 12lac units/vial (AS A Benzathine Penicillin Long acting penicillin):-

Benzapen is indicated in-

The treatment of penicillin-sensitive infections where initial high blood levels are not required.
The prophylaxis of penicillin-sensitive secondary infections especially in children. It is particularly valuable in continuous prophylaxis against rheumatic fever and streptococcal infections.
Prophylaxis of streptococcal impetigo
Treatment of acute otitis media
Treatment of syphilis
Treatment of diphtheria carriers
Side Effects Of Injection:Benzapen 12lac units/vial (AS A Benzathine Penicillin Long acting penicillin):-
The toxicity of penicillins is generally low, but in a small number of patients penicillin can cause sensitization and allergic reactions. Acute, lifethreatening anaphylactic reactions are rare, but they do occur.

Intramuscular injection of Benzapen can cause moderate burning discomfort, local pain, and deep muscle soreness and tenderness at the site of injection, lasting for one to three days in about 10% of patients. Some patients had low-grade fever (102˚F) associated with local pain and tenderness. This febrile reaction disappeared within 24 to 48 hours.

Pharmacology:-

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs); which in turn inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

2.Powder for suspension:-Penci-v 125mg/5ml 50ml Bottle (AS A Phenoxymethyl Penicillin (Penicillin V). AS A Benzylpenicillin & Phenoxymethyl penicillin)

Indications Of Powder for suspension Penci-v 125mg/5ml 50ml Bottle (AS A Phenoxymethyl Penicillin (Penicillin V). AS A Benzylpenicillin & Phenoxymethyl penicillin)

For the treatment of mild to moderately severe bacterial infections, if these are due to penicillin susceptible pathogens and respond to therapy with oral penicillin, such as:

infections of the ear, nose and throat regions, e.g., tonsillitis, pharyngitis, laryngitis, otitis media, sinusitis.
infections of the lower respiratory tract, e.g., bronchitis and pneumonia, bronchopneumonia.
infections due to beta-hemolytic streptococci of group A, e.g., scarlet fever, erysipelas, rheumatic fever.
skin infections, e.g., pyodermia, furunculosis, phlegmon, erysipeloid, erythema migrans, insofar as the micro-organisms are penicillin-susceptible.
lymphadenitis and lymphangitis of bacterial origin.
infections of the buccal cavity, gums or jaws, e.g., inflammatory infiltrates, delayed dentition stages II and III, antral fistulae, secondary bacterial infection with Gram-positive pathogens following virus-induced gingivitis or stomatitis.

Side Effects Of Powder for suspension Penci-v 125mg/5ml 50ml Bottle (AS A Phenoxymethyl Penicillin (Penicillin V). AS A Benzylpenicillin & Phenoxymethyl penicillin):-

Occasionally, hypersensitivity reactions involving the skin (e.g. urticaria, morbilliform or scarlatiniform rashes, pruritus), eosinophilia or more serious allergic reactions, e.g. drug fever, vasculitis, serum sickness or interstitial nephritis, may develop. Anaphylactic or anaphylactoid reactions accompanied by, e.g- angioneurotic oedema, oedema of the larynx, bronchial spasm and shock may occur.

In the event of signs pointing to anaphylactic/anaphylactoid reactions, the treatment must be terminated immediately. In occasional instances, there may be skin rashes or inflammation of mucous membranes, especially in the region of the mouth (stomatitis); dryness of the mouth and disorders of taste may rarely occur.

The occurrence of severe bullous skin reactions- usually involving the mucosae- has been reported in isolated cases (Stevens-Johnson syndrome, Lyell’s syndrome). Gastrointestinal disturbances with, e.g., nausea, vomiting, abdominal pain, loose stools, or diarrhoea may develop.

Diarrhoea may sometimes be a symptom of enterocolitis which may, in some cases, be haemorrhagic. A particular form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases due to Clostridium diffcile). This must be considered in patients in whom severe, persistent diarrhoea occurs during treatment or in the initial weeks thereafter. Even if pseudomembranous colitis is only suspected, administration of Penci-V must be halted immediately. This type of colitis requires immediate and appropriate treatment by a physician. Drugs that inhibit intestinal peristalsis must not be taken in such cases. In isolated cases, particularly after high doses and prolonged administration, changes in blood picture such as reduction in the number of white blood cells (e.g.,leucopenia, granulocytopenia, agranulocytosis), erythrocytes (e.g., due to haemolytic anaemia), thrombocytes, or pancytopenia and myelosuppression may occur. During treatment for spirochaetal infections, Herxheimer’s reaction characterized by the occurrence or worsening of general symptoms such as fever, chills, headache, and joint pains may develop. In isolated cases, drug-induced aseptic meningitis may occur.

In extremely rare cases, transient discolouration of the teeth may be seen during treatment with Penci-V. Administration of antibiotics, especially if prolonged, may lead to the proliferation of resistant micro organisms.

Beta-lactams predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.

2. Amoxicillin:-Capsule 1:-Moxacil 500mg (AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins). (Amoxicillin is a broad spectrum penicillin. It is effective against a wide range of Gram-positive and Gram-negative bacteria)

Indications Of Capsule :-Moxacil 500mg (AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins). (Amoxicillin is a broad spectrum penicillin. It is effective against a wide range of Gram-positive and Gram-negative bacteria)

Moxacil is indicated in the treatment of infections due to susceptible ß-lactamase negative strains of microorganisms. These infections include:-

Ear, nose and throat infections (i.e. otitis media, sinusitis, tonsillitis, pharyngitis, laryngitis)
Lower respiratory tract infections (i.e. pneumonia, acute and chronic bronchitis lung abscess, empyema, bronchiectasis)
Skin and soft tissue infections (i.e. cellulitis, carbuncles, furunculosis, infected wounds, abscess)
Genito-urinary tract infections (i.e. pyelonephritis, cystitis and urethritis)
Venereal disease (i.e. acute uncomplicated gonorrhoea)
In dental abscess, it is used as short-term therapy.
It is also indicated in combination with Clarithromycin and Lansoprazole (as triple therapy), for the treatment of patients with H. pylori infection and duodenal ulcer disease and to reduce the risk of duodenal ulcer recurrence.

Side Effects of Capsule :-Moxacil 500mg (AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins).

Side effects are mild and transient in nature. This may include diarrhoea, indigestion or occasionally rash. Pseudo-membranous colitis has been reported rarely.

Pharmacology:-

Amoxicillin is a broad spectrum penicillin. It is effective against a wide range of Gram-positive and Gram-negative bacteria. It acts through the inhibition of biosynthesis of cell wall. Amoxicillin is stable in the presence of gastric acid and is rapidly absorbed after oral administration. After an oral dose, peak plasma concentration of Amoxicillin is reached within 1 to 2 hours. Amoxicillin is widely distributed at varying concentration in body tissues and fluids.

Other component or preparation of Amoxicillin:

1.Pediatric Drops:-Moxacil 125mg/1.25ml AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins).

2.Powder For Suspension:-

Moxacil 125mg/5ml 100ml Bottle (AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins).

3.Tablet:-Moxin 875 mg (AS A Amoxicillin Trihydrate AS A Broad spectrum penicillins).

Other Component Amoxicillin:-Tablet 1.Moxaclav (500mg+125mg) AS A (Amoxicillin +Clavulanic Acid) AS A Broad spectrum penicillins. Amoxicillin has a broad spectrum of bactericidal activity against many Gram-positive & Gram-negative microorganisms.

Indications Of Tablet 1.Moxaclav (500mg+125mg) AS A (Amoxicillin +Clavulanic Acid) AS A Broad spectrum penicillins.

Co-amoxiclav is indicated for short-term treatment of bacterial infections at the following sites:

Upper respiratory tract infections (including ENT) e.g.tonsillitis,sinusitis,otitis media.
Lower respiratory tract infections e.g.acute and chronic bronchitis, lobar and bronchopneumonia.
Genito-urinary tract infections e.g.cystitis,urethritis,pyelonephritis.
Skin and soft tissue infections.
Bone and joint infections e.g.osteomyelitis.
Other infections e.g.septic abortion,puerperal sepsis,intra-abdominal sepsis etc.

Side Effects of Tablet 1.Moxaclav (500mg+125mg) AS A (Amoxicillin +Clavulanic Acid) AS A Broad spectrum penicillins.

Side effects, as with Amoxicillin, are uncommon and mainly of a mild and transitory nature. Diarrhoea, pseudomembranous colitis, indigestion, nausea, vomiting and candidiasis have been reported, if gastrointestinal side effects occur with oral therapy, that may be reduced by taking Co-amoxiclav at the start of meals. Hepatitis and cholestatic jaundice have been reported rarely but are usually reversible. Urticarial and erythematous rashes sometimes occur. Rarely erythema multiforme, Stevens-Johnson Syndrome and exfoliative dermatitis have been reported. In common with other beta-lactam antibiotics, angioedema and anaphylaxis have been reported.

Pharmacology:-

Pharmacodynamic properties: Co-amoxiclav is an antibacterial combination consisting of the antibiotic Amoxicillin and the (3-lactamase inhibitor Clavulanic Acid. Amoxicillin has a broad spectrum of bactericidal activity against many Gram-positive & Gram-negative microorganisms but it is susceptible to degradation by (3-lactamases and therefore the spectrum of activity does not include microorganisms, which produce these enzymes. Clavulanic acid possesses the ability to inactivate a wide range of beta-lactamase enzymes commonly found in microorganisms resistant to penicillins and cephalosporins. Thus Clavulanic acid in this preparation protects Amoxicillin from degradation by (3-lactamase enzymes and effectively extends the antibiotic spectrum to embrace a wide range of microorganisms.

Pharmacokinetic properties: The pharmacokinetics of the two components of Co-amoxiclav is closely matched. Peak serum levels of both occur about one hour after oral administration. Absorption of Co-amoxiclav is optimized at the start of a meal. Both clavulanate and Amoxicillin have low levels of serum binding; about 70% remains free in the serum. Doubling the dosage of Co-amoxiclav approximately doubles the serum levels achieved.

Other component or Preparation of Amoxacilline:-

1.Powder for Suspension:-Augment (125mg+31.5mg)/5ml AS A (Amoxicillin +Clavulanic Acid) AS A Broad spectrum penicillins. 100ml bottle.

2.Injection:Augment IV Injection/ (1gm+200mg)20ml 1.2gm vial

AMOXICILLIN+Esomeprazole+Clarithromycin:-

1.Tablet:Maxpro Hp (1000mg+20mg+500mg) AS A AMOXICILLIN+Esomeprazole+Clarithromycin AS A Anti H. pylori drugs.

Indications Of Tablet:Maxpro Hp (1000mg+20mg+500mg) AS A AMOXICILLIN+Esomeprazole+Clarithromycin AS A Anti H. pylori drugs.

Maxpro Hp is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.

Side Effects Of Tablet- Maxpro Hp (1000mg+20mg+500mg) AS A AMOXICILLIN+Esomeprazole+Clarithromycin AS A Anti H. pylori drugs.

H. pylori eradication therapy is generally well tolerated. Adverse events reported during clinical trials were not unexpected given the component substances. Common adverse reactions included diarrhoea and nausea.

Pharmacology:-

Esomeprazole exerts its stomach acid-suppressing effects by preventing the final step in gastric acid production by covalently binding to sulfhydryl groups of cysteines found on the (H+, K+)-ATPase enzyme at the secretory surface of gastric parietal cells. This effect leads to inhibition of both basal and stimulated gastric acid secretion, irrespective of the stimulus. As the binding of esomeprazole to the (H+, K+)-ATPase enzyme is irreversible and new enzyme needs to be expressed in order to resume acid secretion, esomeprazole’s duration of antisecretory effect that persists longer than 24 hours

Amoxicillin is similar to penicillin in its bactericidal action against susceptible bacteria during the stage of active multiplication. It acts through the inhibition of cell wall biosynthesis that leads to the death of the bacteria.

Clarithromycin acts by inhibiting microsomal protein synthesis in susceptible organisms mainly by binding to the donor site on the 50S subunit of the bacterial ribosome and preventing translocation to that site.

Amoxicillin+Rabeprazole+Clarithromycin:-

Tablet1:-Pylotrip-R (1000MG+20MG+500MG) AS A Amoxicillin+Rabeprazole+Clarithromycin AS A Anti H. pylori drugs.

Amoxicilline+Lansoprazole+Clarithromycin:-

Tablet1:-Pylotrip (1000mg+30mg+500mg) AS A Amoxicilline+Lansoprazole+Clarithromycin AS A Anti H. pylori drugs.

Amoxicillin+Vonoprazan+Clarithromycin:-

Tablet1.Vonokit (1000mg+20mg+500mg) AS A Amoxicillin+Vonoprazan+Clarithromycin AS A Anti H. pylori drugs.

3.Ampicillin:-Capsule 1:Acmecilin 250mg (AS A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

Indications Of Capsule 1:Acmecilin 250mg (AS A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

Acmecilin is indicated in the treatment of infections caused by susceptible strains of the designated organism listed below:

Infections of the Genitourinary Tract Including Gonorrhea: E. coli, P. mirabilis, enterococci, Shigella, S. typhosa and other Salmonella, and nonpenicillinase-producing N. gononhoeae.
Infections of the Respiratory Tract: Nonpenicillinase-producing H. influenzae and staphylococci, and streptococci including streptococcus pneumoniae.
Infections of the Gastrointestinal Tract: Shigella, S. typhosa and other Salmonella, E. coli, P. mirabilis, and enterococci.
Meningitis: O. Meningitides.

Bacteriology studies to determine the causative organisms and their sensetivity to ampicillin should be performed. Therapy may be instituted prior to the results of susceptibility testing.

Side Effects Of Capsule 1:Acmecilin 250mg (AS A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

Nausea, vomiting, diarrhoea, erythematous maculo-papular rashes, sore mouth, black/hairy tongue, rash, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, fever, joint pains, serum sickness-like symptoms, haemolytic anaemia, thrombocytopenia, leucopenia, neutropenia, coagulation disorders, prolonged bleeding time and prothrombin time, CNS toxicity (e.g. convulsions); paraesthesia, nephropathy, interstitial nephritis, hepatitis, cholestatic jaundice, moderate and transient increase in transaminases, Anaphylaxis, Clostridium difficile-associated diarrhoea (CDAD).

Pharmacology:-

Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls. Bacteria eventually lyse due to ongoing activity of cell wall autolytic enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.

Other Component or Preparation Of Ampicillin:-

1.Injection:-Acmecilin 500mg/Vial AS A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

2.Injection:-Acmecilin 250mg/Vial AS A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

3.ORAL SUSPENSION:-Acmecilin 125mg/5ml 100ml bottle As A Ampicillin Sodium AS A Ampicillin inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit ).

4.Dicloxacillin OR Cloxacillin:-Capsule1: A Clox 500 mg (AS A Cloxacillin Sodium

AS A Penicillinase-resistant penicillins)

Indications Of Capsule: A Clox 500 mg (AS A Cloxacillin Sodium

AS A Penicillinase-resistant penicillins):-

গ্রাম-পজিটিভ জীবাণু দ্বারা সৃষ্ট সংক্রমণের চিকিৎসায় ক্লক্সাসিলিন নির্দেশিত। পেনিসিলিনেজ উৎপাদনক্ষম স্টেফাইলোকক্কাই জনিত সংক্রমণের চিকিৎসায়ও এটি নির্দেশিত। এ জাতীয় সংক্রমণের মধ্যে রয়েছেঃ

স্কিন ও সফ্‌ট টিস্যু সংক্রমণ: ফোঁড়া (boils), পূজাশয় (abscess), কার্বাংকল, ফারানকুলোসিস, সেলুলাইটিস, সংক্রমিত ক্ষত (infected wounds), সংক্রমিত পোড়া (infected burns), ত্বক প্রতিস্থাপন প্রতিরক্ষা (protection for skin grafts), ত্বকের বিভিন্ন সংক্রমণ যেমন আলসার, একজিমা ও একনি।

রেসপিরেটরী ট্র্যাক্ট, নাক, কান ও গলার সংক্রমণ: নিউমোনিয়া, ফুসফুসের পূজাশয় (lung abscess), এমপায়েমা, সাইনোসাইটিস, ফ্যারিনজাইটিস, টনসিলাইটিস, কুইনসি, অটাইটিস মিডিয়া ও এক্সটারণা।

ক্লক্সাসিলিন–সংবেদনশীল (sensitive), জীবাণু জনিত অন্যান্য সংক্রমণ: অসটিওমায়েলাইটিস, এনটেরাইটিস, এনডোকারডাইটিস, ইউরিনারী ট্র্যাক্ট সংক্রমণ ও সেপটিসেমিয়া।

Side Effects Of Capsule: A Clox 500 mg (AS A Cloxacillin Sodium

AS A Penicillinase-resistant penicillins):-

ক্লক্সাসিলিন এর পার্শ্ব-প্রতিক্রিয়া অন্যান্য পেনিসিলিনের মতই। এগুলো সাধারণতঃ মৃদু ও ক্ষণস্থায়ী হয়ে থাকে। এই সমস্ত পার্শ্ব-প্রতিক্রিয়ার মধ্যে রয়েছে জ্বর, ডায়রিয়া, অজীর্ণ (indigestion), র‍্যাশ-আরটিকারিয়েল অথবা ইরিথিমেটাস জাতীয়। যে কোন ধরণের র‍্যাশে রোগীকে এ ওষুধ দেয়া বন্ধ করতে হবে।

Other Component OR Preparation Of Cloxacillin:-

1.Injection:-A-Clox IM/IV.INJECTION 250MG/VIAL AS A Cloxacillin Sodium

2.Injection:-A-Clox IM/IV Injection 500mg/vial AS A Cloxacillin Sodium

3.Powder for Suspension:-A-Clox 125mg/5ml 100ml bottle AS A Cloxacillin Sodium.

Flucloxacillin:-

1.Capsule:A-Flox (250mg,500mg) AS A Flucloxacillin Sodium (AS A Penicillinase-resistant penicillins) Flucloxacillin is active against Gram-positive organisms including penicillinase producing strains. It has little activity against Gram-negative bacilli. Flucloxacillin acts by inhibiting the formation of cell wall of bacteria.

Indications Of Capsule:A-Flox (250mg,500mg) AS A Flucloxacillin Sodium (AS A Penicillinase-resistant penicillins):-

A-Flox is indicated for the treatment of infections due to Gram-positive organisms, including infections caused by penicillinase producing staphylococci. These indications include:

Skin and soft tissue infections: Boils, abscess, carbuncles, infected skin conditions (e.g. ulcer, eczema, acne, furunculosis, cellulitis, infected wounds, infected burns, otitis media and externa, impetigo).
Respiratory tract infections: Pneumonia, lung abscess, empyema, sinusitis, pharyngitis, tonsillitis, quinsy.
It is also used for the treatment of other infections i.e. osteomyelitis, enteritis, endocarditis, urinary tract infection, meningitis, septicaemia caused by A-Flox-sensitive organisms.
As a prophylactic agent, it is used during major surgical procedures where appropriate; for example, cardiothoracic and orthopedic surgery.

Side Effects Of Capsule:A-Flox (250mg,500mg) AS A Flucloxacillin Sodium (AS A Penicillinase-resistant penicillins):-

There have been some common side effects of gastrointestinal tract such as nausea, vomiting, diarrhoea, dyspepsia and other minor gastrointestinal disturbances. Besides these rashes, urticaria, purpura, fever, interstitial nephritis, hepatitis and cholestatic jaundice have been reported.

Pharmacology:-

Flucloxacillin is active against Gram-positive organisms including penicillinase producing strains. It has little activity against Gram-negative bacilli. Flucloxacillin acts by inhibiting the formation of cell wall of bacteria. Flucloxacillin is isoxazolyl penicillin which combined the properties of resistance to hydrolysis by penicillinase, gastric acid stability and activity against gram-positive bacteria. Flucloxacillin is a bactericidal antibiotic that is particularly useful against penicillinase-producing staphylococci. Flucloxacillin kills bacterial cellwall, thus interfering with peptidoglycan synthesis. Peptidoglycan is a heteropolymeric structure that provides the cell wall with its mechanical stability. The final stage of peptidoglycan synthesis involves the completion of the cross-linking with the terminal glycine residue of the pentaglycin bridge linking to the fourth residue of the pentapeptide (D-alanine). The transpeptidase enzyme that performs this step is inhibited by Flucloxacillin. As a result the bacterial cellwall is weakened, the cell swells and then ruptures. Flucloxacillin resists the action of bacterial penicillinase probably because of the steric hindrance induced by the acyl side chain which prevents the opening of the β- lactam ring.

2.Powder For Suspension:-A-Flox 125mg/5ml 100ml Bottle.

3.Injection:-A-Flox IM/IV Injection 500mg/vial.

5.Methacillin:-

1.Vancomycin: 1.IV Infusion Vanmycin 1gm/vial.AS A Vancomycin Hydrochloride AS A Other antibiotic.

Indications of of IV Infusion Vanmycin 1gm/vial ( AS A Vancomycin Hydrochloride):-

Vancomycin is indicated in potentially life-threatening infections which cannot be treated with other effective, less toxic antimicrobial drugs including the penicillins and cephalosporins.

Vancomycin is useful in the therapy of severe staphylococcal infections in patients who cannot receive or who have failed to respond to the penicillins and cephalosporins or who have infections with staphylococci, resistant to other antibiotics.

Vancomycin is used in the treatment of endocarditis and as prophylaxis against endocarditis in patients undergoing dental or surgical procedures.

Its effectiveness has been documented in other infections due to staphylococci including osteomyelitis, pneumonia, septicemia and soft tissue infections.

Other Componenet or Preparation Vancomycin:
1.CAPSULE:-VANCOMIN 250MG AS A VANCOMYCIN HYDROCHLORIDE.

Pharmacology:-

Vancomycin binds tightly to D-alanyl-D-alanine portion cell wall precursor causing blockage of glycopeptide polymerisation which produces immediate inhibition of cell wall synthesis and secondary damage to the cytoplasmic membrane.

2.Rifampin or Rifampicin:-Tablet 1:Rimactane 450 mg (AS A Rifampicin AS A Anti-Tubercular Antibiotics).

Indications Of Tablet 1:Rimactane 450 mg (AS A Rifampicin AS A Anti-Tubercular Antibiotics):-

In the treatment of both tuberculosis and the meningococcal carrier state, the small number of resistant cells present within large populations of susceptible cells can rapidly become the predominant type. Bacteriologic cultures should be obtained before the start of therapy to confirm the susceptibility of the organism to rifampinand they should be repeated throughout therapy to monitor the response to treatment. Since resistance can emerge rapidly, susceptibility tests should be performed in the event of persistent positive cultures during the course of treatment. If test results show resistance to rifampin and the patient is not responding to therapy, the drug regimen should be modified.

Side Effects Of Tablet :Rimactane 450 mg (AS A Rifampicin AS A Anti-Tubercular Antibiotics):-

Facial flushing and itching, with or without a rash, flu-like syndrome characterised by episodes of fever, chills, headache, dizziness, bone pain, shortness of breath, and malaise; GI adverse effects (e.g. nausea, vomiting, anorexia, diarrhoea, epigastric distress), pseudomembranous colitis, eosinophilia, leucopenia, haemolytic anaemia; alterations in kidney function and renal failure, menstrual disturbances, oedema, myopathy, muscular weakness; orange-red discolouration of the urine, faeces, sweat, saliva, sputum, tears, and other body fluids; thrombophlebitis, local irritation and inflammation after prolonged IV infusion. Rarely, eye irritation and visual disturbances, anaphylaxis or shock.

Pharmacology:-

Rifampicin suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the β subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription.

2.Syrup:- Rifcin 100mg/5ml 60ml Bottle AS A Rifampicin AS A Anti-Tubercular Antibiotics.

Indications Of Syrup:- Rifcin 100mg/5ml 60ml Bottle AS A Rifampicin AS A Anti-Tubercular Antibiotics.

Side Effects Of Of Syrup:- Rifcin 100mg/5ml 60ml Bottle AS A Rifampicin AS A Anti-Tubercular Antibiotics:-

Pharmacology:-

Rifampicin suppresses initiation of chain formation for RNA synthesis in susceptible bacteria by binding to the β subunit of DNA-dependent RNA polymerase, thus blocking RNA transcription.

3.CAPSULE:-Rifcin 150mg AS A Rifampicin AS A Anti-Tubercular Antibiotics.

Other Component or Preparation of Rifampicin:-

1.Rifampicin+Isoniazid+Pyrazinamide+Ethambutol:-

1.Tablet:-Rimstar 4-FDC(150MG+75MG+400MG+275MG) AS A Rifampicin+Isoniazid+Pyrazinamide+Ethambutol AS A Combined anti- Tubercular Preparations.

Indications Of Tablet:-Rimstar 4-FDC(150MG+75MG+400MG+275MG) AS A Rifampicin+Isoniazid+Pyrazinamide+Ethambutol AS A Combined anti- Tubercular Preparations:-

Treatment of both pulmonary and extrapulmonary tuberculosis in the intensive initial phase of treatment.

Side Effects Of Tablet:-Rimstar 4-FDC(150MG+75MG+400MG+275MG) AS A Rifampicin+Isoniazid+Pyrazinamide+Ethambutol AS A Combined anti- Tubercular Preparations:-

Rifampicin: Reddish discolouration of body fluids, asymptomatic increase in liver enzymes, elevations of BUN & uric acid, hemolysis, hematuria, intestinal nephritis, renal insufficiency, Gl discomfort, CNS effects, hematological changes, skin rash, endocrine effects.

Isoniazid: Disturbances of liver function, hepatitis, Gl disturbances, peripheral neuropathy, dizziness, lightheadedness, hematological changes, allergic reactions.

Pyrazinamide: Transient rise in serum transaminases, hepatotoxicity, hepatomegaly, jaundice, hyperuricemia, intestinal nephritis, dysuria, Gl disturbances, hematological changes, allergic reactions.

Ethambutol: Confusion, disorientation, headache, visual disturbances, jaundice, transient liver dysfunction, Gl disturbances, hematological changes, allergic effects, acute gout (rare).

Pharmacology:-

Rifampicin: It is a semisynthetic derivative of rifamycin, suppresses bacterial RNA synthesis by binding to the β-subunit of DNA-dependent RNA polymerase, thus inhibiting the attachment of the enzyme to DNA, blocking RNA transcription and elongation. It does not inhibit the counterpart mammalian enzyme.
Rifampicin has a bactericidal action and a potent sterilizing effect against both intracellular and extracellular tubercle bacilli. Cross-resistance has been shown only with other rifamycin derivatives.

Isoniazid: It kills actively growing tubercle bacilli by inhibiting the biosynthesis of mycolic acids, which are the major components of the bacterial cell wall of Mycobacterium tuberculosis.

Pyrazinamide: Pyrazinamide, an antituberculous drug, is the pyrazine analog of nicotinamide. The precise mechanism of action of pyrazinamide is not known. Its metabolite, pyrazinoic acid, which is less active in vitro may possibly be involved in the in vivo activity of pyrazinamide.

Ethambutol: Ethambutol diffuses slowly into actively growing Mycobacteria cells eg, tubercle bacilli. It inhibits the synthesis of 1 or more metabolites, thus causing impaired cell metabolism, arrest cell multiplication and induce cell death. No cross-resistance with other agents has been demonstrated.

Spectrum of Activity: Rifampicin, isoniazid, pyrazinamide, and ethambutol, at therapeutic levels, have demonstrated bactericidal activity against both intracellular and extracellular Mycobacterium tuberculosis organism.

2. Rifampicin+Isoniazid:-

Tablet1:-Rimactazid 450mg+300mg AS A Rifampicin+Isoniazid Combined anti- Tubercular Preparations.

Indications Of Tablet:-Rimactazid 450mg+300mg AS A Rifampicin+Isoniazid Combined anti- Tubercular Preparations:-

Rifampicin and Isoniazid belongs to a group of medicines called antituberculosis agents. It is a fixed combination of two very effective antituberculosis agents which stop the growth of mycobacteria. These mycobacteria cause tuberculosis. Rifampicin and Isoniazid is used for the continuation phase treatment of tuberculosis.

Side Effects Of Tablet:-Rimactazid 450mg+300mg AS A Rifampicin+Isoniazid Combined anti- Tubercular Preparations:-

Unwanted effects which may occur during continuous daily or intermittent therapy: Rifampicin: Rifampicin may cause reddish discolouration of body fluids and occasionally other body secretions eg, urine, sputum, lacrimal fluid, faeces, saliva and sweat. It may permanently discolour soft contact lenses.

Hepatic Effects: Very common (>10%) is an asymptomatic increase in liver enzymes; severe life-threatening hepatic reactions eg, hepatic failure and acute fulminant hepatitis are uncommon (>0.1% and <1%). In isolated cases (<0.01 %), a fatal outcome was observed.

Renal Effects: Elevations of BUN and serum uric acid, haemolysis, haematuria, interstitial nephritis, renal insufficiency. Gastrointestinal Effects: Nausea, abdominal pains, vomiting or diarrhoea, pseudomembranous colitis.

Central and Peripheral Nervous System Effects: Tiredness, drowsiness, headache, dizziness, ataxia, mental confusion, muscular weakness, visual disturbances. Haematological Changes: Leucopenia, eosinophilia, thrombocytopenia and thrombocytopenic purpura. Effects on Skin and Appendages: Flushing, itching with or without skin rash, urticaria, reddening of the eyes, exudative conjunctivitis or generalised hypersensitivity reactions involving the skin eg, exfoliative dermatitis, Lyell’s syndrome and pemphigoid reactions. Endocrine Effects: Disturbances in the menstrual cycle, induction of crisis in Addison patients. Unwanted effects chiefly occurring during intermittent therapy or upon resumption of treatment after temporary interruption

Pharmacology:-

Rifampicin and isoniazid are active bactericidal anti-TB drugs which are particularly active against the rapidly growing extracellular organisms and also have bactericidal activity intracellularly. Rifampicin inhibits DNA-dependent RNA polymerase activity in susceptible cells. Specifically, it interacts with bacterial RNA polymerase but does not inhibit the mammalian enzyme. Cross-resistance to rifampicin has only been shown with other rifamycins. It has activity against slow-and intermittently-growing M. tuberculosis. Isoniazid acts against actively growing tubercle bacilli.

3.Trimethoprim+Sulfamethoxazole:-Tablet1:Cosat -DS 800MG+160MG (AS A Trimethoprim+Sulfamethoxazole AS A Anti-diarrhoeal Antimicrobial drugs, Sulphonamides & Trimethoprim)

Indications Of Tablet:Cosat-Ds 800mg+160mg (Trimethoprim+Sulfamethoxazole) As a Anti-diarrhoeal Antimicrobial drug:-

Cotrimoxazole is bactericidal in vitro to a wide range of Gram-positive and Gram-negative organisms, including Streptococcus, Staphylococcus, Pneumococcus, Neisseria, B. catarrhalis, Escherichia coli, Klebsiella, Proteus spp., Haemophilus, Salmonella, Shigella, Vibrio cholerae, Brucella, Pneumocystis carinii, Nocardia and Bordetella. A particularly high degree of activity is exhibited against Haemophilus influenzae, E. coli and Proteus spp., making Cotrimoxazole particularly suitable for the treatment of chronic bronchitis and urinary tract infections. Cotrimoxazole exerts its bactericidal action by the sequential blockade of two bacterial enzyme systems in the biosynthesis of Folinic acid in the micro-organisms. The synergy thus produced accounts for the high degree of bactericidal activity.

Indications are :

Respiratory tract infections, including acute and chronic bronchitis (treatment and prophylaxis), bronchiectasis, lung abscess, lobar and broncho-pneumonia, Pneumocystis carinii pneumonitis, sinusitis and otitis media.
Genito-urinary tract infections, including urethritis, acute and chronic cystitis, pyelonephritis, prostatitis and gonorrhoea.
Gastro-intestinal tract infections, caused by Salmonella typhi and Salmonella paratyphi, including the chronic carrier state.
Other infections, caused by a wide range of organisms confirmed to be susceptible to Cotrimoxazole and where the therapeutic benefits are considered to outweigh the possible occurrence of adverse events.
Such infections include acute and chronic osteomyelitis, acute brucellosis, skin infections including pyoderma, abscesses and wound infections, septicaemia, bacillary dysentery and cholera (as an adjuvant to fluid and electrolyte replacement), nocardiosis and mycetoma.

Other component or Preparation of (Trimethoprim+Sulfamethoxazole) As a Anti-diarrhoeal Antimicrobial drug:-

Oral suspension:-1.Cosat (200mg+40mg)/5ml 60ml bottle.

4.Ceftaroline:-1.IV Infusion Zinforo 600mg/vial (AS A Ceftaroline Fosamil AS A Ceftaroline is a cephalosporin with activity against Gram-positive and Gram-negative bacteria).

Indications Of iv infusion Zinforo 600mg/vial (AS A Ceftaroline Fosamil As a Ceftaroline is a cephalosporin):-

Zinforo is indicated for the treatment of the following infections caused by susceptible isolates of the designated microorganisms:

Complicated skin and soft tissue infections (cSSTI)
Community-acquired pneumonia (CAP)

Zinforo is indicated in neonates, infants, children, adolescents and adults.

5.Linezolid:-Tablet1:-Zolivox 400mg,600mg (AS A Linezolid Macrolides AS A Zolivox is not indicated for the treatment of Gram-negative infections).
Powder For Suspension2:-Linzolid `100mg/5ml 100ml bottle.
IV INFUSION 3:-Zoline IV infusion 2mg/5ml 300ml solution.

Indications Of Tablet Zolivox 600mg (As A Linezolid Macrolides)

Zolivox is indicated for the treatment of:-

Nosocomial pneumonia
Community-acquired pneumonia
Complicated skin and skin structure infection including diabetic foot infections, without concomitant osteomyelitis
Uncomplicated skin and skin structure infections
Vancomycin-resistant Enterococcus faecium infections

Limitations of use: Zolivox is not indicated for the treatment of Gram-negative infections. The safety and efficacy of Zolivox given for longer than 28 days have not been evaluated in controlled clinical trials.

Pharmacology:-

Linezolid is a synthetic, antibacterial agent belonging to a new class of antibiotics, the oxazolidinones, with in vitro activity against Gram positive aerobic bacteria, some Gram positive anaerobic bacteria and certain Gram negative bacteria. It selectively inhibits bacterial protein synthesis via a mechanism of action different from that of other antibacterial agents. Linezolid binds to the 23S ribosomal RNA of the 50S subunit of the bacterial ribosome and prevents the formation of a functional 70S initiation complex which is an essential component of the bacterial translation process. The results of time-kill studies have shown Linezolid to be bacteriostatic against enterococci and staphylococci. For streptococci, Linezolid was found to be bactericidal for the majority of strains.

6.Daptomycin Or Mupirocin:-Ointment 1.Dermocin 2%w/w (AS A Mupirocin AS A Topical Antibiotic preparations)

Indications Of Ointment 1.Dermocin 2%w/w (AS A Mupirocin AS A Topical Antibiotics Preparations):-

Dermocin ointment is indicated for the topical treatment of impetigo (skin diseases) due to Staphylococcus aureus and Streptococcus pyogenes. It is also indicated in folliculitis, furunculosis.

7.Clindamycin:-Tablet1:-Clindabac 150 mg (AS A Clindamycin AS A Macrolides)

Pharmacology:-

Mupirocin is a naturally occurring antibiotic. It is an antibacterial agent produced by fermentation using the organism Pseudomonas fluorescens. It is active against a wide range of bacteria those responsible for the majority of skin infections, e.g. Staphylococcus aureus including methicillin-resistant Staphylococcus aureus (MRSA) other staphylococci and streptococci. It is also active against certain gram-negative pathogens, like Escherichia coli and Haemophilus influenzae. Mupirocin inhibits bacterial protein synthesis by reversibly and specially binding to bacterial isoleucyl transfer-RNA synthetase. Due to this unique mode of action, Mupirocin demonstrates no in vitro cross-resistance with other classes of antimicrobial agents. Mupirocin is bactericidal at concentrations achieved by topical administration. However, the minimum bactericidal concentration (MBC) against relevant pathogens is generally eight-fold to thirty-fold higher than the minimum inhibitory concentration (MIC).

Mupirocin is a naturally occurring antibiotic. This antibacterial agent is produced by fermentation using the organism Pseudomonas fluorescens. It is active against a wide range of bacteria (e.g. Staphylococcus aureus including methicillin-resistant strains and Streptococcus pyogenes) those responsible for the majority of skin infections. It is also active against gram-negative pathogens, such as Escherichia coli and Haemophilus influenzae. Mupirocin inhibits bacterial protein synthesis by reversibly and specifically binding to bacterial isoleucyl transfer-RNA synthetase.

Indications Of Tablet:Clindabac 150mg (AS A Clindamycin As a Macrolides):-

Clindabac has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.

Other Component or Preparation of Clindamycin:-

Clindamycin Vaginal Cream:1.Clindacin 2% (AS A Clindamycin AS A Macrolides ):-

Indications Of Vaginal Cream:- Clindacin 2% (AS A Clindamycin AS A Macrolides ):-

Clindacin cream is indicated in the treatment of bacterial vaginosis. Clindacin cream can be used to treat non pregnant women and pregnant women during the second and third trimester.

Side Effects Of Vaginal Cream:- Clindacin 2% (AS A Clindamycin AS A Macrolides ):-

Clindacin may results the following side effects. Genital tract: vaginitis, vulvo-vaginal irritation Central nervous system: dizziness, headache, vertigo.Gastro-intestinal: heartburn, nausea, vomiting, diarrhea, constipation, abdominal pain. Dermatological: rash, exanthema. Hypersensitivity: urticaria.

Pharmacology:-

Clindamycin Phosphate is a water soluble ester that derived from the parent antibiotic Lincomycin. Clindamycin inhibits bacterial protein synthesis by binding preferentially to the 50s ribosomal subunit and affects the process of peptide chain initiation. In vitro Clindamycin is active against most strains of the following organisms that have been reported to be associated with bacterial vaginosis:

Bacteroides spp.
Gardnerella vaginalism
Mobiluncus spp.
Mycoplasma hominis
Peptostreptococcus spp.

Clindamycin Lotion:1.Clindacin 1% (AS A Clindamycin AS A Clindamycin Macrolides).

Indications Of Clindamycin Lotion:-Clindacin 1% (AS A Clindamycin AS A Clindamycin Macrolides).

Clindacin lotion is indicated in the treatment of acne vulgaris. Other uses of topical Clindacin lotion are:

Skin infections such as erythrasma caused by Corynebacterium minutissimum; rosacea, periorificial dermatitis, folliculitis, stasis, chronic lymphaedema and familial pemphigus.
Dermal ulcers.

Side Effects Of Clindamycin Lotion:-Clindacin 1% (AS A Clindamycin AS A Clindamycin Macrolides).

Side effects are usually rare. Possible side-effects may includes skin rash, itching, oily skin, dryness, erythema, burning, change in skin color, diarrhea, colitis, GI disturbance etc.

Pharmacology:-

Clindamycin is a lincosamide antibiotic used in the treatment of infections caused by susceptible microorganisms. Clindamycin is a semisynthetic antibiotic derived from lincomycin. It has antiacne and antibacterial activity. It binds with the 50s subunit of the bacterial ribosome and inhibits the early stage of protein synthesis. It is highly potent against gram positive and anaerobic bacteria.

Microbiology: Aerobic gram-positive cocci, including: Staphylococcus aureus, Staphylococcus epidermidis (penicillinase and non-penicillinase producing strains), Streptococci, Pneumococci. Anaerobic gram-negative bacilli, including: Bacteroides species, Fusobacterium species. Anaerobic gram-positive non-spore forming bacilli, including: Propionibacterium species, Eubacterium species, Actinomyces species. Anaerobic and microaerophilic gram-positive cocci, including: Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci, C. perfringes

Clindamycin Topical Gel:-1.Clindacin Plus (1.2%+0.025%) (AS A Clindamycin+Tretinoin) (AS A Topical antibiotic & retinoid preparations).

Indications of Topical gel :Clindacin Plus (1.2%+0.025%) (AS A Clindamycin+Tretinoin) (AS A Topical antibiotic & retinoid preparations):-

Clindamycin and Tretinoin gel is indicated for the topical treatment of Acne vulgaris.

Side Effects Of Topical gel :Clindacin Plus (1.2%+0.025%) (AS A Clindamycin+Tretinoin) (AS A Topical antibiotic & retinoid preparations):-

Erythema, scaling, nasopharyngitis, dry skin, cough, sinusitis and diarrhea are the common side effects.

Pharmacology:-

This is a combination of lincosamide antibiotic Clindamycin phosphate and retinoid Tretinoin. Clindamycin binds with the 50s ribosomal subunit of susceptible bacteria and prevents elongation of peptide chain by interfering with the peptidyl transfer, thereby suppressing bacterial protein synthesis. Clindamycin inhibits the activity of Propionibacterium acne as reduces the occurrence of acne. Tretinoin decreases the cohesiveness of follicular epithelial cells and increases the turn over thereby brings the comedones out.

Clindamycin Topical GEL:-1.Clindax -B (1%+5%) (AS A Clindamycin+Benzoyl peroxide AS A Benzoyl peroxide, Azelaic acid & other preparations).

Indications of topical gel :Clindax -B (1%+5%) (AS A Clindamycin+Benzoyl peroxide AS A Benzoyl peroxide, Azelaic acid & other preparations):-

This gel is for cutaneous use only. This is indicated for the topical treatment of mild to moderate acne vulgaris, particularly inflammatory lesions, in adults and adolescents aged 12 years and above.

Side Effects Of topical gel :Clindax -B (1%+5%) (AS A Clindamycin+Benzoyl peroxide AS A Benzoyl peroxide, Azelaic acid & other preparations):-

Adverse drug reactions (ADRs) are summarised below for Benzoyl Peroxide 5% & Clindamycin 1% gel as a combination including any additional ADRs that have been reported for the single topical active ingredients, benzoyl peroxide or clindamycin. Adverse drug reactions are listed by MedDRA system organ class and by frequency. Frequencies are defined as: very common (³1/10); common (³1/100 and <1/10); uncommon (³1/1,000 and <1/100); rare (³1/10,000 and <1/1,000) and not known.

Immune system disorders: Allergic reactions including hypersensitivity and anaphylaxis; Not known.
Nervous system disorders: Paraesthesia; Uncommon.
Gastrointestinal disorders: Colitis (including pseudomembranous colitis), haemorrhagic diarrhoea, diarrhoea, abdominal pain; Not known.
Skin and subcutaneous tissue disorders: Erythema, peeling, dryness (Generally reported as ‘mild’ in severity); Very Common, Burning sensation; Common, Dermatitis, pruritus, erythematous rash, worsening of acne; Uncommon, Urticaria; Not known.
General disorders and Administration site conditions: Application site reactions including skin discoloration; Not known.

Pharmacology:-

Clindamycin inhibits bacterial protein synthesis by binding to 23S RNA of the 50S subunit of the bacterial ribosome. It impedes both the assembly of the ribosome and the translation process. The molecular mechanism through which this occurs is thought to be due to clindamycin’s three-dimensional structure, which closely resembles the 3′-ends of L-Pro-Met-tRNA and deacylated-tRNA during the peptide elongation cycle – in acting as a structural analog of these tRNA molecules, clindamycin impairs peptide chain initiation and may stimulate dissociation of peptidyl-tRNA from bacterial ribosomes.

The peroxide bond of benzoyl peroxide is cleaved to form 2 benzoyloxy radicals.1 These radicals interact nonspecifically with bacterial proteins, interfering with their function, and survival of the bacteria. Over time, free radical interactions with bacterial proteins lead to decreased keratin and sebum around follicles. Benzoyl peroxide can also increase the turnover rate of epithelial cells, leading to skin peeling, and breaking down comedones.

8.Doxycycline:-Capsule1.Doxin 100mg (AS A Doxycycline Hydrocholoride Tetracycline group of drugs) Doxycycline Hydrochloride is a semisynthetic tetracycline antibiotic with broad spectrum activity. It is primarily a bacteriostatic antibiotic.

Indications Of capsule Doxin 100mg ((AS A Doxycycline Hydrocholoride Tetracycline group of drugs):-

Doxin is indicated in the following infections caused by susceptible microorganisms:-

Respiratory tract infections: Pneumonia, influenza, sinusitis, bronchitis, tonsillitis, tracheitis.
Gastrointestinal tract infections: Cholera, traveler’s diarrhea, shigella dysentery, acute intestinal amebiasis.
Chlamydial infections: Lympho-granuloma venereum, psittacosis, trachoma.
Sexually transmitted diseases: Non gonococcal urethritis, acute pelvic inflammatory disease, uncomplicated urethral and endocervical or rectal infections, gonorrhoea, syphilis, pyelonephritis, cystitis.
Other infections: Impetigo, furunculosis, inclusion conjunctivitis, brucellosis, tularemia, cellulitis, acne and Q-fever.

Side Effects Of capsule Doxin 100mg ((AS A Doxycycline Hydrocholoride Tetracycline group of drugs):-

Nausea, vomiting, diarrhoea, skin rashes, hemolytic anaemia, eosinophilia may be reported.

Pharmacology:-

Doxycycline Hydrochloride is a semisynthetic tetracycline antibiotic with broad spectrum activity. It is primarily a bacteriostatic antibiotic. It has a similar spectrum of activity to other tetracyclines but in particular is more active against Staphylococcus aureus and Nocardia. The drug is often active against penicillin-resistant strains of Staphylococcus aureus and against strains of those organisms that are resistant to other Tetracyclines. Certain Gram-negative strains of E. coli, Proteus mirabilis and Klebsiella, which are often resistant to Tetracycline, may be sensitive to Doxycycline. In addition, 70-90% of the various anaerobes are sensitive to Doxycycline and Bacteroides fragilis is more likely to be sensitive to Doxycycline than to other tetracyclines.

Doxycycline is active against most strains of Haemophilus influenzaeand is particularly useful for infections with H. ducreyi, Actinomyces, Brucella and Vibrio cholerae. It is also active against Nocardia, Chlamydia, Mycoplasma and a wide range of Rickettsiae. Doxycycline is active against spirochetes such as Borellia recurrentis, Treponema pallidum and Treponema pertenue. It is also active against Plasmodium falciparum.

Powder For Suspension2:Doty Vet (20%+10%) (AS A Tylosin Tartrate+Doxycycline).AS A

Indications Of Powder For Suspension2:Doty Vet (20%+10%) (AS A Tylosin Tartrate+Doxycycline):-

Prevention and treatment of different respiratory, gastrointestinal and urogenital infections such as: Mycoplasmosis, CRD, CCRD, Coryza, Colibacillosis, Yolk sac infection, Salmonellosis, Pasteurellosis, Clostridial infections, Air sacculitis, Synovitis, Enteritis etc. Also in cases of stress due to vaccination, rehousing, transport, feed and weather changes etc.

9.Delafloxacin:- 1.IV Infusion Delameg 300mg/vial AS A Delafloxacin (AS A 4-Quinolone preparations) bacterial DNA topoisomerase IV and DNA gyrase (topoisomerase II)

Indications Of IV Infusion Delameg 300mg/vial (AS A Delafloxacin AS A 4-Quinolone Preparations):-

Acute Bacterial Skin and Skin Structure Infections: Delameg is indicated in adults for the treatment of acute bacterial skin and skin structure infections (ABSSSI) caused by the following susceptible microorganisms: Staphylococcus aureus (including methicillin-resistant [MRSA] and methicillin-susceptible [MSSA] isolates), Staphylococcus haemolyticus, Staphylococcus lugdunensis, Streptococcus agalactiae, Streptococcus anginosus Group (including Streptococcus anginosus, Streptococcus intermedius, and Streptococcus constellatus), Streptococcus pyogenes, Enterococcus faecalis, Escherichia coli, Enterobacter cloacae, Klebsiella pneumoniae, and Pseudomonas aeruginosa.

Community-Acquired Bacterial Pneumonia: Delameg is indicated in adults for the treatment of community-acquired bacterial pneumonia (CABP) caused by the following susceptible microorganisms: Streptococcus pneumoniae, Staphylococcus aureus (methicillin-susceptible [MSSA] isolates only), Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Haemophilus influenzae, Haemophilus parainfluenzae, Chlamydia pneumoniae, Legionella pneumophila, and Mycoplasma pneumoniae.

6.Oxacillin OR Tetracycline or Metronidazole(Orally) :-Capsule 1:-Tetrax 500mg (AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs)

Indications Of Capsule -Tetrax 500mg (AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs):-

Tetrax is the drug of choice in the following infections :

Ricketsial infection (Rocky Mountain spotted fever, endemic and scrub typhus fever and human ehrlichiosis).
Mycoplasma pneumoniae infections in adults. Outbreaks of pneumonia caused by this organism are common in barracks and institutions. Most cases occur in children and young adults. Maculopapular rashes, haemolytic anaemia and meningo-encephalitis occur rarely.
Chlamydial Infections: Chlamydia psittaci: This organism is the cause of psittacosis (ornithosis), a systemic illness contracted from infected birds. The pneumonia associated with it may be extensive, and severe systemic upset and death are common.Headache is a prominent early symptom.
Non-gonococcal or non specific urethritis: Inflammation of the urethra not resulting from gonococcal, chlamydial, or other specific infectious agents.
Lyme disease
Brucellosis
Miscellaneous infections, including granuloma inguinale, cholera, glanders, relapsing fever and V. vulnifians.

Other common uses of tetracycline include the following:

Urinary Tract Infections with susceptible organisms (including the acute urethral syndrome in women).
Bronchitis in patients with known underlying chronic lung diseases.
Pelvic inflammatory disease and other sexually transmitted diseases (STDs) regimen.
Travelers diarrhoea.
Acne vulgaris
Prostatitis.
As an alternative agent in the penicillin allergic patient with syphilis.
Anaerobic infections with susceptible organisms.

Side Effects of Capsule Tetrax 500mg (AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs):-

Teeth and bone: Tetrax can cause depression of bone growth, permanent graybrown discoloration of the teeth and enamel hypoplasia when given during tooth development (i.e. during the later half of pregnancy, during infancy and in childhood).

Hypersensitivity reactions such as anaphylaxis, urticaria and rashes are uncommon. Photosensitivity reactions consisting of a red rash on areas exposed to intense sunlight can occur with Tetrax.

Gastrointestinal effects: Epigastric distress and nausea are commonly seen after oral administration, and these symptoms are somewhat dose related. Vomiting can occur.

Accentuated prerenal azotemia: Tetrax appears to aggravate pre-existing renal failure by inhibiting protein synthesis, which increases the azotemia from amino acid metabolism.

Superinfections with oral and anogenital candidiasis are relatively common in patients taking Tetrax.

Esophageal ulcerations: In most cases, the patients were taking the capsules with little or no fluid before going to bed. To help minimize this, oral doses should be given with adequate amounts of fluid.

Pharmacology:-

Tetracycline has its main mechanism of action on protein synthesis, and an energy-dependent active transport system pumps the drug through the inner cytoplasmic membrane of bacteria. Once inside the bacterial cell, Tetracycline binds specifically to the 30s ribosomes and inhibit bacterial protein synthesis.

Many Gram positive aerobic Cocci are susceptible, but many strains of staphylococci, streptococci and even some pneumococci are resistant to Tetracycline. Thus, tetracycline is not the drug of choice in infections due to gram positive aerobes.

Pseudomonas and many Enterobacteriaceae are resistant. Urinary concentrations are adequate for some community – acquired E. coli and consequently, Tetracycline is still used in uncomplicated initial UTIs. Tetracycline is also active against and is the drug of choice for Brucella species, Calymmatobacterium granulomatis, Vibrio cholerae and V. vulnificus.

Tetracycline is also active against anaerobic species of bacteria and since concentrations of the drug are quite high in the gastrointestinal contents, the enteric flora are usually altered by the drug.

Tetracycline is incompletely absorbed from the gastro-intestinal tract, about 60 to 80% of a dose of tetracycline usually being available. It is widely distributed through the body tissues and fluids.

Tetracycline has a half-life of about 12 hours. It is excreted in the urine and in the faeces.

Other component or preparation of Tetracycline:

Tetracycline Hydrochloride Topical:N/A

Tetracycline Hydrochloride Ophthalmic Ointment:-1. ophthalmic ointment A-Tetra 1% AS A Tetracycline Hydrochloride AS A Ophthalmic antibacterial drugs.

Indications of ointment A-Tetra 1% AS A Tetracycline Hydrochloride AS A Ophthalmic antibacterial drugs:-

A-Tetra ointment is indicated as followings-

Treatment of bacterial conjunctivitis
Treatment of trachoma (by preference use oral azithromycin for this indication)
Prevention of chlamydial and gonococcal neonatal conjunctivitis

Side Effects Of ointment A-Tetra 1% AS A Tetracycline Hydrochloride AS A Ophthalmic antibacterial drugs:-

Burning, irritation, visual disturbances, superinfections, photosensitivity, hypersensitivity.

Pharmacology:-

Tetracycline exhibits its bacteriostatic action by reversibly binding to the 30S subunits of the ribosome, thus preventing protein synthesis and arresting cell growth. It has a broad spectrum of antimicrobial activity including Chlamydiaceae, Mycoplasma spp., Rickettsia spp., spirochaetes, many aerobic and anaerobic gm+ve and gm-ve pathogenic bacteria and some protozoa.

7.Piperacillin:- 1.IV Infusion Tazocilin (4gm+0.5gm)4.5gm vial (AS A Piperacillin+Tazobactam) (AS A Broad spectrum penicillins, Other beta-lactam Antibiotics) Piperacillin, a broad spectrum, semi-synthetic penicillin active against many gram-positive and gram-negative aerobic and anaerobic bacteria broad-spectrum antibiotic and a beta-lactamase inhibitor.

Indications Of IV Infusion Tazocilin (4gm+0.5gm)4.5gm vial (AS A Piperacillin+Tazobactam):-

Piperacillin and tazobactam is a combination product consisting of a penicillin-class antibacterial, piperacillin, and a β-lactamase inhibitor, tazobactam, indicated for the treatment of patients with moderate to severe infections caused by susceptible isolates of the designated bacteria in the conditions listed below.

Intra-abdominal Infections: Appendicitis (complicated by rupture or abscess) and peritonitis caused by β-lactamase producing isolates of Escherichia coli or the following members of the Bacteroides fragilis group: B. fragilis, B. ovatus, B. thetaiotaomicron, or B. vulgatus.

Skin and Skin Structure Infections: Uncomplicated and complicated skin and skin structure infections, including Cellulites, cutaneous abscesses and ischemic/diabetic foot infections caused by β-lactamase producing isolates of Staphylococcus aureus.

Female Pelvic Infections: Postpartum endometritis or pelvic inflammatory disease caused by β-lactamase producing isolates of Escherichia coli.

Community-acquired pneumonia: Community-acquired pneumonia (moderate severity only) caused by β lactamase producing isolates of Haemophilus influenzae.

Nosocomial pneumonia: Nosocomial pneumonia (moderate to severe) caused by β-lactamase producing isolates of Staphylococcus aureus and by piperacillin/tazobactam-susceptible Acinetobacter baumanii, Haemophilus influenzae, Klebsiella pneumoniae, and Pseudomonas aeruginosa (Nosocomial pneumonia caused by P. aeruginosa should be treated in combination with an aminoglycoside).

Side Effects Of IV Infusion Tazocilin (4gm+0.5gm)4.5gm vial (AS A Piperacillin+Tazobactam):-

Adverse events primarily involving the skin, including rash, pruritus and Purpura; the gastrointestinal system including diarrhea, Constipation, nausea, vomiting, Dyspepsia and Abdominal Pain; General disorders and administration site conditions including Fever, Injection site reaction (≤1%) and Rigors. (≤1%), Immune hypersensitivity reactions, anaphylactic/anaphylactoid reactions (including shock) (≤1%), Infections-Candidiasis and Pseudomembranous colitis (≤1%), Metabolism and nutrition disorders- Hypoglycemia (≤1%), Musculoskeletal and connective tissue disorders- Myalgia and Arthralgia (≤1%), Psychiatric disorders Insomnia, Vascular disorders- Phlebitis Thrombophlebitis(≤1%), Hypotension(≤1%), Flushing(≤1%), Respiratory, thoracic and mediastinal disorders- Epistaxis (≤1%).

Pharmacology:-

Piperacillin, a broad spectrum, semi-synthetic penicillin active against many gram-positive and gram-negative aerobic and anaerobic bacteria, exerts bactericidal activity by inhibition of both septum and cell wall synthesis. Tazobactam is a potent inhibitor of many beta-lactamases, including the plasmid and chromosomally mediated enzymes that commonly cause resistance to penicillins. Tazobactam enhances and extends the antibiotic spectrum of Piperacillin to include many beta-lactamase-producing bacteria normally resistant to it. Thus, this infusion combines the properties of a broad-spectrum antibiotic and a beta-lactamase inhibitor.

8. Penicillin V:- Tablet 1:-Penvick DS 500mg AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin)

Tablet:-Penvik 250mg AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin)

Powder For Suspension 2:-Penci-v 125mg/5ml 50ml bottle.

Powder For Suspension 3: Penvik Forte 250mg/5ml 100ml bottle.

Indications Of Tablet Penvick Ds 500mg(AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin):-

For the treatment of mild to moderately severe bacterial infections, if these are due to penicillin susceptible pathogens and respond to therapy with oral penicillin, such as:

infections of the ear, nose and throat regions, e.g., tonsillitis, pharyngitis, laryngitis, otitis media, sinusitis.
infections of the lower respiratory tract, e.g., bronchitis and pneumonia, bronchopneumonia.
infections due to beta-hemolytic streptococci of group A, e.g., scarlet fever, erysipelas, rheumatic fever.
skin infections, e.g., pyodermia, furunculosis, phlegmon, erysipeloid, erythema migrans, insofar as the micro-organisms are penicillin-susceptible.
lymphadenitis and lymphangitis of bacterial origin.
infections of the buccal cavity, gums or jaws, e.g., inflammatory infiltrates, delayed dentition stages II and III, antral fistulae, secondary bacterial infection with Gram-positive pathogens following virus-induced gingivitis or stomatitis.

Side Effects Of Tablet Penvick Ds 500mg(AS A Phenoxymethyl Penicillin (Penicillin V). (Benzylpenicillin & Phenoxymethyl penicillin):-

Occasionally, hypersensitivity reactions involving the skin (e.g. urticaria, morbilliform or scarlatiniform rashes, pruritus), eosinophilia or more serious allergic reactions, e.g. drug fever, vasculitis, serum sickness or interstitial nephritis, may develop. Anaphylactic or anaphylactoid reactions accompanied by, e.g- angioneurotic oedema, oedema of the larynx, bronchial spasm and shock may occur.

In the event of signs pointing to anaphylactic/anaphylactoid reactions, the treatment must be terminated immediately. In occasional instances, there may be skin rashes or inflammation of mucous membranes, especially in the region of the mouth (stomatitis); dryness of the mouth and disorders of taste may rarely occur.

The occurrence of severe bullous skin reactions- usually involving the mucosae- has been reported in isolated cases (Stevens-Johnson syndrome, Lyell’s syndrome). Gastrointestinal disturbances with, e.g., nausea, vomiting, abdominal pain, loose stools, or diarrhoea may develop.

Diarrhoea may sometimes be a symptom of enterocolitis which may, in some cases, be haemorrhagic. A particular form of enterocolitis that can occur with antibiotics is pseudomembranous colitis (in most cases due to Clostridium diffcile). This must be considered in patients in whom severe, persistent diarrhoea occurs during treatment or in the initial weeks thereafter. Even if pseudomembranous colitis is only suspected, administration of Penvik DS must be halted immediately. This type of colitis requires immediate and appropriate treatment by a physician. Drugs that inhibit intestinal peristalsis must not be taken in such cases. In isolated cases, particularly after high doses and prolonged administration, changes in blood picture such as reduction in the number of white blood cells (e.g.,leucopenia, granulocytopenia, agranulocytosis), erythrocytes (e.g., due to haemolytic anaemia), thrombocytes, or pancytopenia and myelosuppression may occur. During treatment for spirochaetal infections, Herxheimer’s reaction characterized by the occurrence or worsening of general symptoms such as fever, chills, headache, and joint pains may develop. In isolated cases, drug-induced aseptic meningitis may occur.

In extremely rare cases, transient discolouration of the teeth may be seen during treatment with Penvik DS. Administration of antibiotics, especially if prolonged, may lead to the proliferation of resistant micro organisms.

Beta-lactams predispose the patient to encephalopathy risk (which may include convulsions, confusion, impairment of consciousness, movement disorders), particularly in case of overdose or renal impairment.

Pharmacology:-

9. Penicillin G:-Injection 1.Benzapen 12lac unites Vial (AS A Benzathine Penicillin AS A Long acting penicillin) Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins (PBPs);

Indications Of Injection 1.Benzapen 12lac unites Vial (AS A Benzathine Penicillin AS A Long acting penicillin) :-

Benzapen is indicated in-

The treatment of penicillin-sensitive infections where initial high blood levels are not required.
The prophylaxis of penicillin-sensitive secondary infections especially in children. It is particularly valuable in continuous prophylaxis against rheumatic fever and streptococcal infections.
Prophylaxis of streptococcal impetigo
Treatment of acute otitis media
Treatment of syphilis
Treatment of diphtheria carriers

Side Effects of Injection 1.Benzapen 12lac unites Vial (AS A Benzathine Penicillin AS A Long acting penicillin):-

The toxicity of penicillins is generally low, but in a small number of patients penicillin can cause sensitization and allergic reactions. Acute, lifethreatening anaphylactic reactions are rare, but they do occur.

Intramuscular injection of Benzapen can cause moderate burning discomfort, local pain, and deep muscle soreness and tenderness at the site of injection, lasting for one to three days in about 10% of patients. Some patients had low-grade fever (102˚F) associated with local pain and tenderness. This febrile reaction disappeared within 24 to 48 hours.

Pharmacology:-

Cephalosporins:- 1^st Generation ANTIBIOTIC:-

1.Cefadroxil(1stGEN):-Capsule1.Fodexil 500mg,1000mg (AS A Cefadroxil Monohydrate First generation Cephalosporins).

Powder For Suspension2:-Adora 125mg/5ml 60ml,100ml bottle.

Pediatric Drops 3:-Adora 125mg/1.25ml 15 ml bottle.

Cefadroxil inhibits bacterial cell wall synthesis by binding to 1 or more of the penicillin-binding proteins (PBPs) which in turn inhibit the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Indications Of Capsule1.Fodexil 500mg (AS A Cefadroxil Monohydrate First generation Cephalosporins).

Fodexil is indicated in the treatment of the following infections.

Streptococcal pharyngitis and tonsillitis
Bronchopneumonia, bacterial pneumonia
Uncomplicated urinary tract infections: pyelonephritis, cystitis
Skin and soft tissue infections: abscesses, furunculosis, impetigo, erysipelas, pyoderma, lymphadenitis.

Side Effects Of Capsule1.Fodexil 500mg (AS A Cefadroxil Monohydrate First generation Cephalosporins):-

Infections and infestations: Uncommon side effects are Vaginal mycoses, thrush. Blood and lymphatic system disorders: Rare side effects are eosinophilia, thrombocytopenia, leucopenia, neutropenia, agranulocytosis and very rarely occurs haemolytic anemia.

Immune system disorders: Rarely occur serum sickness-like reactions, Very rarely occur immediate allergic reaction (anaphylactic shock).

Nervous system disorders: Very rare side effects are Headache, sleeplessness, dizziness, nervousness.

Gastrointestinal disorders: Common side effects are nausea, vomiting, diarrhoea, dyspepsia, abdominal pain, glossitis and very rarely occurs Pseudomenbranous colitis.

Hepatobiliary disorders: Rarely occurs cholestase and idiosyncratic hepatic failure.

Skin and subcutaneous tissue disorders: Pruritus, rash, allergic exanthema, urticaria are common side effects. Very rarely occurs stevens Johnson syndrom and erythema multiforma.

Musculoskeletal and connective tissue disorders: Rarely occur arthralgia. Renal and urinary disorders: Rarely occurInterstitial nephritis.

General disorders: Fever is rare and fatigue is very rare.

Pharmacology:-

2.Cefazolin(1^ST GEN):-Injection1:Zolibac IM/IV 1GM/VIAL

Injection2:-Cefazol IM/IV 500GM/VIAL (AS A Cefazolin sodium AS A First generation Cephalosporins)

Injection 3:-Cefazoline Panpharma IM/IV 1GM/5ML. 1GM VIAL.

(AS A Cefazolin sodium AS A First generation Cephalosporins) AS A Cefazolin is a 1st generation broad spectrum parenteral Cephalosporin antibiotic.It interferes with the synthesis of bacterial cell wall by inhibiting transpeptidase enzyme. As a result the bacterial cell wall is weakened,the cell swells and then ruptures.

Indications Of Injection1:Zolibac IM/IV 1GM/VIAL

(AS A Cefazolin sodium AS A First generation Cephalosporins)

Zolibac is indicated in the treatment of the following serious infections due to susceptible organisms: Respiratory Tract Infections, Urinary Tract Infections, Skin and Skin Structure Infections, Biliary Tract Infections, Bone and Joint Infections, Genital Infections, Septicemia, Endocarditis and Perioperative Prophylaxis.

Side Effects Of Injection1:Zolibac IM/IV 1GM/VIAL

(AS A Cefazolin sodium AS A First generation Cephalosporins):-

Common side effects include:Injection site reactions (pain, swelling, skin rash, or a hard lump), diarrhea, stomach pain, stomach cramps, nausea, vomiting, loss of appetite, skin rash or itching, hives, white patches or sores inside the mouth or on the lips, vaginal itching or discharge,heartburn, gas,rectal itching,confusion, weakness, hypotension, drowsiness, headache and allergic reactions.

Pharmacology:-

Cefazolin is a 1st generation broad spectrum parenteral Cephalosporin antibiotic.It interferes with the synthesis of bacterial cell wall by inhibiting transpeptidase enzyme. As a result the bacterial cell wall is weakened,the cell swells and then ruptures.

3.Cephalaxin(1^ST GEN):-Capsule1:Cefalex 500mg (AS A Cephalaxin AS A First generation Cephalosporins )AS A Cephalexin is a semisynthetic analogue of Cephalosporin C. It kills bacteria by interfering in the synthesis of the bacterial cell wall.

Powder for suspension2:-Cefalex 125mg/5ml 100ml bottle.

Capsule 3:-Acelex 250mg

Indications Of Capsule1:Cefalex 500mg (AS A Cephalaxin AS A First generation Cephalosporins ):-

Cefalex is indicated for the treatment of the following infections when caused by susceptible organisms.

Respiratory tract infections: Acute and chronic bronchitis and infected bronchiectasis.
Genito-urinary tract infections: Acute and chronic nephritis, cystitis, urethritis and prostatitis, prophylaxis of recurrent urinary tract infections.
Skin and soft tissue infections: Caused by staphylococci and/or streptococci.
Ear, Nose and Throat infections: Otitis media, mastoiditis, sinusitis, follicular tonsillitis and pharyngitis.
Bone infections: Caused by staphylococci and/or P. mirabilis.

Side Effects Of Capsule1:Cefalex 500mg (AS A Cephalaxin AS A First generation Cephalosporins ):-

Side effects include nausea, vomiting, diarrhoea and abdominal discomfort. Symptoms of pseudomembranous colitis may appear either during or after antibiotic treatment. Skin rash, angio oedema, rise in serum aminotransferases, eosinophilia, neutropenia have been reported very rarely. Superinfection with resistant micro organisms, particularly candida may follow the treatment.

Pharmacology:-

Cephalexin is a semisynthetic analogue of Cephalosporin C. It kills bacteria by interfering in the synthesis of the bacterial cell wall. Peptidoglycan is a heteropolymeric structure that provides the cell wall with mechanical stability. The final stage in the synthesis of peptidoglycan involves the completion of the cross-linking and the terminal glycine residue of the Pentaglycine Bridge is linked to the fourth residue of the pentapeptide (d-alanin). The transpeptidase enzyme that performs this step is inhibited by penicillins and cephalosporins. As a result the bacterial cell wall is weakened, the cell swells and then ruptures. Cephalexin is a first generation cephalosporin that is active by mouth.

Cephalosporins:- 2^nd Generation ANTIBIOTIC:-

1.Cefaclor(2^nd Gen):-Capsule1:Oticlor 500mg (AS A Cefaclor Monohydrate Second generation Cephalosporins) Cefaclor is a second generation cephalosporin antibiotic which has stability against b-lactamase inactivation and possesses a broad spectrum of activity.

Indications of Capsule1:Oticlor 500mg (AS A Cefaclor Monohydrate Second generation Cephalosporins):-

Oticlor is indicated for the treatment of the following infections:

Respiratory tract infections, including pneumonia, bronchitis, caused by Streptococcus Pneumoniae, Haemophilus Influenzae, and Streptococcus Pyogenes
Otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, Staphylococci, and Streptococcus pyogenes
Pharyngitis and Tonsillitis, caused by Streptococcus pyogenes
Urinary tract infections, including pyelonephritis and cystitis, caused by Escherichia coli, Proteus mirabilis, Klebsiella spp., and coagulase-negative Staphylococci
Skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes.

Side Effects of Capsule1:Oticlor 500mg (AS A Cefaclor Monohydrate Second generation Cephalosporins):-

Gastro-intestinal symptoms may occur include diarrhea, nausea and vomiting in some patients receiving Oticlor. As with some penicillins and some other Cephalosporins, transient hepatitis and cholestatic jaundice have been reported rarely. Fever, abdominal pain, superinfection, renal dysfunction, toxic nephropathy, hemorrhage, elevated LDH and pancytopenia may occur.

Pharmacology:-

Cefaclor is a second generation cephalosporin antibiotic which has stability against b-lactamase inactivation and possesses a broad spectrum of activity. Cefaclor is active against the following organisms in vitro: Alpha and beta haemolytic Streptococci, Staphylococci; including coagulase-positive, coagulase negative and penicillinase-producing strains, Streptococcus pneumoniae, Streptococcus pyogenes (Group A b-haemolytic Streptococci), Branhamella catarrhalis, Escherichia coli, Proteus mirabilis, Klebsiella species Haemophilus influenzae, including ampicillin-resistant strains. Cefaclor is generally effective in the eradication of Streptococci from the nasopharynx.

Other component or preparation of Cefaclor(2^nd gen):-

Powder for suspension:-Oticlor 125mg/5ml 100ml bottle

Pediatric Drops1:Loracef 125MG/1.25ML 15ml bottole( AS A Cefaclor Monohydrate Second generation Cephalosporins)

Indications of Pediatric Drops1:Loracef 125MG/1.25ML 15ml bottole( AS A Cefaclor Monohydrate Second generation Cephalosporins)

Loracef is indicated for the treatment of the following infections:

Respiratory tract infections, including pneumonia, bronchitis, caused by Streptococcus Pneumoniae, Haemophilus Influenzae, and Streptococcus Pyogenes
Otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, Staphylococci, and Streptococcus pyogenes
Pharyngitis and Tonsillitis, caused by Streptococcus pyogenes
Urinary tract infections, including pyelonephritis and cystitis, caused by Escherichia coli, Proteus mirabilis, Klebsiella spp., and coagulase-negative Staphylococci
Skin and skin structure infections caused by Staphylococcus aureus and Streptococcus pyogenes.

Side Effects of Pediatric Drops1:Loracef 125MG/1.25ML 15ml bottole( AS A Cefaclor Monohydrate Second generation Cephalosporins):-

Gastro-intestinal symptoms may occur include diarrhea, nausea and vomiting in some patients receiving Loracef. As with some penicillins and some other Cephalosporins, transient hepatitis and cholestatic jaundice have been reported rarely. Fever, abdominal pain, superinfection, renal dysfunction, toxic nephropathy, hemorrhage, elevated LDH and pancytopenia may occur.

Pharmacology:-

2.Cefproxil(2^nd Gen):- N/A

3.Cefuroxime (2^ND Gen):-1Tablet:-Cefotil 250mg, 500mg (AS A Cefuroxime Axetil AS A Second generation Cephalosporins). Cefuroxime is a well-characterized and effective antibacterial agent, which has broad-spectrum bactericidal activity against a wide range of common pathogens, including β-lactamase producing strains. Cefuroxime has good stability to bacterial β-lactamase and consequently, is active against many ampicillin-resistant and amoxycillin-resistant strains.

2.Powder For suspension:-Cefotil 125mg/5ml 70ml bottle.

3.Injection:-Cefotil IM/IV Injection 750mg/vial.

Indications Of Tablet Cefotil 500mg (AS A Cefuroxime Axetil AS A Second generation Cephalosporins).

It is indicated for the treatment of infections caused by sensitive bacteria.

Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)
Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli
Acute bacterial exacerbation of chronic bronchitis and Secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).
Skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
Urinary tract infections caused by E.coli or Klebsiella pneumoniae.
Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.
Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.

Side Effects Of Tablet Cefotil 500mg (AS A Cefuroxime Axetil AS A Second generation Cephalosporins).

Adverse effects to Cefotil have occurred infrequently and have been generally mild and transient in nature. Effects reported include rashes and gastrointestinal disturbances. As with other antibiotics, prolonged use may result in the overgrowth of non susceptible organisms e.g. Candida.

Pharmacology:-

Cefuroxime is a well-characterized and effective antibacterial agent, which has broad-spectrum bactericidal activity against a wide range of common pathogens, including β-lactamase producing strains. Cefuroxime has good stability to bacterial β-lactamase and consequently, is active against many ampicillin-resistant and amoxycillin-resistant strains.

Other component or preparation of Cefuroxime Axetil:

Injection1:-Cefotil 1.5gm /vial intervenous iv.

Other Component or Preparation of Cefuroxime Axetil+Clavulanic Acid:-

1.Tablet:-Cefotil plus (250mg+62.5mg),(500mg+125mg) AS A Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins.

Indications Of Tablet:-Cefotil plus (250mg+62.5mg),(500mg+125mg) AS A Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins:-

Cefotil Plus is indicated for the treatment of infections caused by sensitive bacteria.

Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)
Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli.
Acute bacterial exacerbation of chronic bronchitis and secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).
Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
Uncomplicated urinary tract infections caused by E.coli or Klebsiella pneumoniae.
Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
Uncomplicated Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.
Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.
Septicemia caused by Staphylococcus aureus, Streptococcus pneumoniae, E.coli, Haemophilus influenzae (including ampicillin-resistant strains) & Klebsiella spp.
Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), Neisseria meningitidis & Staphylococcus aureus (penicillinase and non-penicillinase producing strains)
Switch therapy (Injectable to oral)

Side Effects Of Tablet:-Cefotil plus (250mg+62.5mg),(500mg+125mg) AS A Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins:-

Generally Cefuroxime-Clavulanic Acid is well tolerated. However, a few side effects like nausea, vomiting, diarrhea, abdominal discomfort or pain may occur. As with other broad-spectrum antibiotics, prolonged administration of Cefuroxime and Clavulanic acid combination may result in overgrowth of nonsusceptible microorganisms. Rarely (<0.2%) renal dysfunction, anaphylaxis, angioedema, pruritis, rash and serum sickness like urticaria may appear.

Pharmacology:-

Cefuroxime is a bactericidal second generation cephalosporin antibiotic which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many beta-lactamase producing strains. Cefuroxime inhibits bacterial cell wall synthesis by interfering with the transpeptidation process.

Clavulanic acid is a naturally derived beta lactamase inhibitor produced by Streptomyces clavuligerus. It has similar structure to beta lactam antibiotics which binds irreversibly to beta-lactamase enzymes and inactivates them. Clavulanic acid gives protection of Cefuroxime from degradation by beta lactamase enzymes and provides a solution for the treatment of bacterial infections caused by beta lactam resistant bacteria.

2.POWDER FOR SUSPENSION:-Cefotil Plus 125mg/31.25mg/5ml.AS a Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins:-

Indications Of syrup:- Cefotil Plus 125mg/31.25mg/5ml.AS a Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins:-

Cefotil Plus is indicated for the treatment of infections caused by sensitive bacteria.

Pharyngitis/Tonsillitis caused by Streptococcus pyogenes.
Acute Bacterial Otitis Media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains) or Streptococcus pyogenes.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non beta-lactamase producing strains)
Lower respiratory tract infections including pneumoniae, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, E. coli.
Acute bacterial exacerbation of chronic bronchitis and secondary bacterial infections of Acute bronchitis caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains) or Haemophilus parainfluenzae (beta-lactamase negative strains).
Uncomplicated skin and skin-structure infections caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
Uncomplicated urinary tract infections caused by E.coli or Klebsiella pneumoniae.
Bone and Joint Infections caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
Uncomplicated Gonorrhoea caused by penicillinase-producing and non-penicillinase producing strains of Neisseria gonorrhoeae.
Early Lyme Disease (erythema migrans) caused by Borrelia burgdorferi.
Septicemia caused by Staphylococcus aureus, Streptococcus pneumoniae, E.coli, Haemophilus influenzae (including ampicillin-resistant strains) & Klebsiella spp.
Meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (including ampicillin-resistant strains), Neisseria meningitidis & Staphylococcus aureus (penicillinase and non-penicillinase producing strains)
Switch therapy (Injectable to oral)

Side Effects Of syrup:- Cefotil Plus 125mg/31.25mg/5ml.AS a Cefuroxime Axetil+Clavulanic Acid AS A Second generation Cephalosporins:-

Pharmacology:-

4.Cefoxitin(2^nd Gen):-N/A

3^RD Generation ANTIBIOTIC:-

1.Cefixime(3^rd Gen):-Capsule 1.Cef-3DS 400MG

Capsule2.Cef-3 200mg.

(AS A Cefixime Trihydrate AS A Third generation Cephalosporins) Cefixime is a third generation semisynthetic cephalosporin antibiotic for oral administration, It is bactericidal against a broad spectrum of gram positive and gram negative bacteria at easily achievable plasma concentrations. It kills bacteria by interfering in the synthesis of bacterial cell wall

Indications Of Capsule Cef-3DS 400MG (AS A Cefixime Trihydrate AS A Third generation Cephalosporins)

Cef-3 DS is an orally active cephalosporin antibiotic which has marked in-vitro bactericidal activity against a wide variety of Gram-positive and Gram-negative organism. It is indicated for the treatment of the following acute infections when caused by susceptible microorganisms.

Upper Respiratory Tract Infections (URTI): e.g. otitis media; and other URTI where the causative organism is known or suspected to be resistant to other commonly used antibiotics, or where treatment failure may carry significant risk. Lower Respiratory Tract Infections-e.g. bronchitis.

Urinary Tract Infections: e.g. cystitis, cystourethritis, pyelonephritis. Clinical efficacy has been demonstrated in infections caused by commonly occurring pathogens including Streptococcus pneumonia, Streptococcus pyogenes, Escherichia coli, Proteus mirabilis, Klebsiella species, Haemophilus influenzae (beta-lactamase positive and negative), Moraxella catarrhalis (beta-lactamase positive and negative) and Enterobacter species. Cef-3 DS is highly stable in the presence of beta-lactamase enzymes.

Side Effects Capsule Cef-3DS 400MG (AS A Cefixime Trihydrate AS A Third generation Cephalosporins):-

Cef-3 DS is generally well tolerated. The majority of adverse reactions observed in clinical trials were mild and self limiting in nature. Gastrointestinal disturbances: The most frequent side-effects seen with Cef-3 DS are diarrhoea and stool changes; diarrhoea has been more commonly associated with higher doses. Other gastrointestinal side-effects seen less frequently are nausea, abdominal pain, dyspepsia, vomiting and flatulence. Pseudomembraneous colitis has been reported. Central nervous system: headache and dizziness. Hypersensitivity reactions: allergies in the form of rash, pruritis, urticaria, drug fever and arthralgia have been observed. These reactions usually subsided upon discontinuation of therapy. Hematological and clinical chemistry: thrombocytopenia, leukopenia and eosinophilia have been reported. These reactions were infrequent and reversible. Mild transient change in liver and renal function tests have been observed. Miscellaneous: other possible reactions include genital pruritis and vaginitis.

Pharmacology:-

Cefixime is a third generation semisynthetic cephalosporin antibiotic for oral administration. It is bactericidal against a broad spectrum of gram positive and gram negative bacteria at easily achievable plasma concentrations. It kills bacteria by interfering in the synthesis of bacterial cell wall. It is highly stable in the presence of Beta-lactamase enzyme. As a result, many organisms resistant to penicillins and some cephalsporins due to the presence of beta-lactamases, may be susceptible to Cefixime. Absorption of it is about 40% to 50% whether administered with or without food.

Other component or preparation of Cefixime Trihydrate:-

1.Pediatric Drops:-Cef-3 25mg/ml.21ml Bottle.

2.Powder For Suspension:-Cef-3 100mg/5ml.(30,50,75ml Bottle).

2.Cefatoxime(3^RD Gen):-Capsule 1.Cefaten 400mg (AS A Ceftibuten Dihydrate AS A Third generation Cephalosporins). Ceftibuten exerts its bactericidal action by binding to essential target proteins of the bacterial cell wall. This binding leads to inhibition of cell-wall synthesis.

Indications Of Capsule Cefaten 400mg (AS A Ceftibuten Dihydrate AS A Third generation Cephalosporins).

Cefaten is indicated for the treatment of individuals with mild-to-moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below.

Acute Bacterial Exacerbations of Chronic Bronchitis: Due to Haemophilus influenzae (including β-lactamase producing strains), Moraxella catarrhalis (including (β-lactamase producing strains), or Streptococcus pneumoniae (penicillin-susceptible strains only).
Acute Bacterial Otitis Media: Due to Haemophilus influenzae (including β-lactamase producing strains), Moraxella catarrhalis (including β-lactamase producing strains) or Streptococcus pyogenes.
Pharyngitis and Tonsillitis: Due to Streptococcus pyogenes.

Side Effects of Capsule Cefaten 400mg (AS A Ceftibuten Dihydrate AS A Third generation Cephalosporins):-

Nausea, headache, diarrhea, dyspepsia, dizziness, abdominal pain, vomiting.

Pharmacology:-

Ceftibuten is the dihydrate salt of Ceftibuten, is a semi-synthetic Cephalosporin antibiotic for oral administration. Ceftibuten exerts its bactericidal action by binding to essential target proteins of the bacterial cell wall. This binding leads to inhibition of cell-wall synthesis.

Other component or preparation Ceftibuten Dihydrate:-

1.Powder for suspension:-Cefaten 90mg/5ml.(60ml,100ml Bottale).

3.Cetazidime OR CEFTAZIDIME (3^rd Gen):-1.Injection IM/IV :-Tazid 500mg/vial, Tazid IM/IV 1GM VIAL, Tazid IM/IV 250MG VIAL, AS A CEFTAZIDIME PENTAHYDRATE( AS A Third generation Cephalosporins.) Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic for parenteral administration. Ceftazidime is bactericidal in action exerting its effect by inhibition of enzymes responsible for cell-wall synthesis. A wide range of gram-negative organisms is susceptible to ceftazidime in vitro, including strains resistant to gentamicin and other aminoglycosides.

Indications Of Injection IM/IV :-Tazid 500mg/vial AS A CEFTAZIDIME PENTAHYDRATE( AS A Third generation Cephalosporins.):-

Tazid Injection is indicated for the treatment of patients with infections caused by susceptible strains of the designated organisms in the following diseases:

Lower Respiratory Tract Infections, including pneumonia, caused by Pseudomonas aeruginosa and other Pseudomonas spp., Haemophilus influenzae, including ampicillin-resistant strains; Klebsiella spp.; Enterobacter spp.; Proteus mirabilis; Escherichia coli; Serratia spp.; Citrobacter spp.; Streptococcus pneumoniae; and Staphylococcus aureus (methicillin susceptible strains).

Skin and Skin Structure Infections caused by Pseudomonas aeruginosa; Klebsiella spp.; Escherichia coli; Proteus spp., including Proteus mirabilis and indole-positive Proteus, Enterobacter spp.; Serratia spp.; Staphylococcus aureus (methicillin susceptible strains); and Streptococcus pyogenes (group A beta-hemolytic streptococci).

Urinary Tract Infections, both complicated and uncomplicated, caused by Pseudomonas aeruginosa; Enterobacter spp.; Proteus spp., including Proteus mirabilis and indole-positive Proteus, Klebsiella spp.; and Escherichia coli.

Bacterial Septicemia caused by Pseudomonas aeruginosa, Klebsiella spp., Haemophilus influenzae, Escherichia coli, Serratia spp., Streptococcus pneumoniae and Staphylococcus aureus (methicillin susceptible strains).

Bone and Joint Infections caused by Pseudomonas aeruginosa, Klebsiella spp., Enterobacter spp., and Staphylococcus aureus (methicillin susceptible strains).

Gynecologic Infections, including endometritis, pelvic cellulitis, and other infections of the female genital tract caused by Escherichia coli.

Intraabdominal Infections, including peritonitis caused by Escherichia coli, Klebsiella spp., and Staphylococcus aureus (methicillin susceptible strains) and polymicrobial infections caused by aerobic and anaerobic organisms and Bacteroides spp.

Central Nervous System Infections, including meningitis, caused by Haemophilus influenzae and Neisseria meningitidis, Pseudomonas aeruginosa and Streptococcus pneumoniae.

Side Effects Of Injection IM/IV :-Tazid 500mg/vial AS A CEFTAZIDIME PENTAHYDRATE( AS A Third generation Cephalosporins.):-

The most common side-effects are local reactions following IV injection and allergic and gastrointestinal reactions. Hypersensitivity reactions are pruritus, rash, and fever. Angioedema and anaphylaxis have been reported very rarely. Gastrointestinal symptoms are diarrhea, nausea, vomiting, and abdominal pain. Central nervous system reactions included headache, dizziness, and paresthesia.

Pharmacology:-

Ceftazidime is a semisynthetic, broad-spectrum, beta-lactam antibiotic for parenteral administration. Ceftazidime is bactericidal in action exerting its effect by inhibition of enzymes responsible for cell-wall synthesis. A wide range of gram-negative organisms is susceptible to ceftazidime in vitro, including strains resistant to gentamicin and other aminoglycosides. In addition, ceftazidime has been shown to be active against gram-positive organisms. It is highly stable to most clinically important beta-lactamases, plasmid or chromosomal, which are produced by both gram-negative and gram-positive organisms and, consequently, is active against many strains resistant to ampicillin and other cephalosporins.

Other component or preparation Of CEFTAZIDIME PENTAHYDRATE:-

Ceftazidime + Avibactam

1.IV Infusion:Zavicefta (2gm+0.5gm) AS A Ceftazidime + Avibactam AS A

Indications Of IV Infusion:Zavicefta (2gm+0.5gm) (AS A Ceftazidime + Avibactam AS A 3^rd generation Cephalosporins.)

Zavicefta is indicated in-

Complicated Intra-abdominal Infections (cIAI)
Complicated Urinary Tract Infections (cUTI), including Pyelonephritis
Hospital-acquired Bacterial Pneumonia and Ventilator-associated Bacterial Pneumonia (HABP/VABP)
Side Effects Of IV Infusion:Zavicefta (2gm+0.5gm) (AS A Ceftazidime + Avibactam AS A 3^rd generation Cephalosporins.):-
Adult cIAI, cUTI and HABP/VABP Patients: The most common adverse reactions in cIAI (≥ 5%, when used with metronidazole) patients are diarrhea, nausea and vomiting. The most common adverse reactions (3%) in cUTI patients are diarrhea and nausea. The most common adverse reactions (≥5%) in HABP/VABP patients were diarrhea and vomiting. Pediatric cIAI and cUTI Patients: The most common adverse reactions (>3%) in pediatric patients were vomiting, diarrhea, rash, and infusion site phlebitis.

Pharmacology:-

Ceftazidime inhibits bacterial peptidoglycan cell wall synthesis following binding to penicillin binding proteins (PBPs), which leads to bacterial cell lysis and death. Avibactam is a non β-lactam, β-lactamase inhibitor that acts by forming a covalent adduct with the enzyme that is stable to hydrolysis. It inhibits both Ambler class A and class C β-lactamases and some class D enzymes, including extended-spectrum β-lactamases (ESBLs), KPC and OXA-48 carbapenemases, and AmpC enzymes. Avibactam does not inhibit class B enzymes (metallo-β-lactamases) and is not able to inhibit many class D enzymes.

4.Ceftrixone(3^rd Gen):-Injection 1:-Ceftrix 500mg/vial IM,

Ceftrix IM Injection 250mg/vial,Ceftrix IV Injection 1gm/vial, Ceftrix IV Injection 2GM/VIAL.

AS A Ceftrixone Sodium Third generation Cephalosporins) Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms.

Indications Of Injection -Ceftrix 500mg/vial IM.AS A Ceftrixone Sodium Third generation Cephalosporins):-

Ceftrix injection is indicated for the treatment of the following major infections:

Lower respiratory tract infections
Acute Bacterial Otitis Media
Skin and skin structure infections
Urinary tract infections
Gonorrhea
Bacterial Septicemia
Bone and joint infections
Meningitis
Prevention of postoperative infections
Perioperative prophylaxis of infections associated with surgery

Side Effects Of Injection -Ceftrix 500mg/vial IM.AS A Ceftrixone Sodium Third generation Cephalosporins):-

Ceftrix is generally well tolerated. A few side effects such as gastro-intestinal effects including diarrhea, nausea and vomiting, stomatitis and glossitis; cutaneous reactions including rash, pruritus, urticaria, edema and erythema multiforme; hematologic reactions including eosinophilia, thrombocytopenia, leucopenia, anemia and neutropenia; hepatic reactions including elevations of SGOT or SGPT, bilirubinemia; CNS reactions including nervousness, confusion, sleep disturbances, headache, hyperactivity, convulsion, hypertonia and dizziness were reported. Local phlebitis occurs rarely following intravenous administration but can be minimized by slow injections over 2-4 minutes.

Pharmacology:-

Ceftriaxone is a 3rd generation broad-spectrum parenteral cephalosporin antibiotic. It has potent bactericidal activity against a wide range of Gram-positive and Gram-negative organisms. Like other cephalosporins and penicillins, Ceftriaxone kills bacteria by interfering with the synthesis of the bacterial cell wall. Ceftriaxone has a high degree of stability in the presence of beta lactamases. A remarkable feature of Ceftriaxone is its relatively long plasma elimination half-life of about 6 to 9 hours, which makes single or once-daily dosage of the drug appropriate for most patients. Ceftriaxone is not metabolized in the body. About 40-65% of a dose of Ceftriaxone is excreted unchanged in the urine; the remainder is excreted in the bile and ultimately found in the feces as unchanged drug and microbiologically inactive compound. The drug is highly protein bound (95%).

Other component or preparation of Ceftrixone Sodium:-

1.Injection :-Ceftrix IV injection 1gm/vial AS A Ceftrixone Sodium Third generation Cephalosporins)

2.Injection :Ceftrix IV Injection 2gm/vial AS A Ceftrixone Sodium Third generation Cephalosporins)

4^th Generation Antibiotic:-

1.Cefepime(4^TH Generation):-1.Injection:Ultrapime IM/IV injection 500mg/Vial,

2.Injection:-Ultrapime IM/IV 1GM/VIAL

3. Injection:-Ultrapime IV /2GM/VIAL

(AS A Cefepime Hydrochloride AS A Fourth generation Cephalosporins) Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins). Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin binding proteins (PBPs).

Indications Of Injection:Ultrapime IM/IV injection 500mg/Vial

(AS A Cefepime Hydrochloride AS A Fourth generation Cephalosporins):-

Ultrapime is indicated for the treatment of the following infections caused by susceptible strains of the microorganisms:

Pneumonia (moderate to severe): caused by Streptococcus pneumoniae, including cases associated with concurrent bacteremia, Pseudomonas aeruginosa, Klebsiella pneumoniae, or Enterobacter species.
Febrile Neutropenia: Ultrapime as monotherapy is indicated for empiric treatment of febrile neutropenic patients. In patients at high risk for severe infection (including patients with a history of recent bone marrow transplantation, with hypotension at presentation, with an underlying hematologic malignancy, or with severe or prolonged neutropenia), antimicrobial monotherapy may not be appropriate. Insufficient data exist to support the efficacy of cefepime monotherapy in such patients.
Uncomplicated and Complicated Urinary Tract Infections (including pyelonephritis): caused by Escherichia coli or Klebsiella pneumoniae, when the infection is severe, or caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis, when the infection is mild to moderate, including cases associated with concurrent bacteremia with these microorganisms.
Uncomplicated Skin and Skin Structure Infections: caused by Staphylococcus aureus (methicillin- susceptible strains only) or Streptococcus pyogenes.
Complicated Intra-abdominal Infections (used in combination with metronidazole): caused by Escherichia coli, viridians group streptococci, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter species, or Bacteroides fragilis.

Side Effects Of Injection:Ultrapime IM/IV injection 500mg/Vial

(AS A Cefepime Hydrochloride AS A Fourth generation Cephalosporins):-

Ultrapime is contraindicated in patients who have shown immediate hypersensitivity reactions to cefepime or the cephalosporin class of antibiotics, penicillin, or other betalactum antibiotics.

Pharmacology:-

Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins). Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin binding proteins (PBPs).

Other component or preparation of Cefepime Hydrochloride:-

1.Injection:Ultrapime IM/IV Injection 1gm/vial (AS A Cefepime Hydrochloride AS A Fourth generation Cephalosporins)

2.Injection:Ultrapime IV Injection 2gm/vial (AS A Cefepime Hydrochloride AS A Fourth generation Cephalosporins).

2.Protein Synthesis Inhibitors:-

Tetracycline sub class:-

1.Tetracycline:-Tetracycline HydrochlorideTopical:-N/A

Tetracycline Hydrochloride Oral:-

Capsule 1:-Tetrax 500mg AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs. Tetracycline has its main mechanism of action on protein synthesis, and an energy-dependent active transport system pumps the drug through the inner cytoplasmic membrane of bacteria. Once inside the bacterial cell, Tetracycline binds specifically to the 30s ribosomes and inhibit bacterial protein synthesis.

Many Gram positive aerobic Cocci are susceptible, but many strains of staphylococci, streptococci and even some pneumococci are resistant to Tetracycline. Thus, tetracycline is not the drug of choice in infections due to gram positive aerobes. Tetracycline is also active against anaerobic species of bacteria and since concentrations of the drug are quite high in the gastrointestinal contents, the enteric flora are usually altered by the drug.

Capsule2:-Tetrasina 250mg.

Indications Capsule -Tetrax 500mg AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs.

Tetrax is the drug of choice in the following infections :

Ricketsial infection (Rocky Mountain spotted fever, endemic and scrub typhus fever and human ehrlichiosis).
Mycoplasma pneumoniae infections in adults. Outbreaks of pneumonia caused by this organism are common in barracks and institutions. Most cases occur in children and young adults. Maculopapular rashes, haemolytic anaemia and meningo-encephalitis occur rarely.
Chlamydial Infections: Chlamydia psittaci: This organism is the cause of psittacosis (ornithosis), a systemic illness contracted from infected birds. The pneumonia associated with it may be extensive, and severe systemic upset and death are common.Headache is a prominent early symptom.
Non-gonococcal or non specific urethritis: Inflammation of the urethra not resulting from gonococcal, chlamydial, or other specific infectious agents.
Lyme disease
Brucellosis
Miscellaneous infections, including granuloma inguinale, cholera, glanders, relapsing fever and V. vulnifians.

Other common uses of tetracycline include the following:

Urinary Tract Infections with susceptible organisms (including the acute urethral syndrome in women).
Bronchitis in patients with known underlying chronic lung diseases.
Pelvic inflammatory disease and other sexually transmitted diseases (STDs) regimen.
Travelers diarrhoea.
Acne vulgaris
Prostatitis.
As an alternative agent in the penicillin allergic patient with syphilis.
Anaerobic infections with susceptible organisms.

Side Effects of Capsule -Tetrax 500mg AS A Tetracycline Hydrochloride AS A Tetracycline group of drugs:-

Pharmacology:-

Other component or Preparation of Tetracycline:-

Sub Classe of Tetracycline:- Index.

1.Tetracycline Hydrochloride.

Sub Class of Tetracycline Hydrochloride:-

1.Tetracycline Hydrochloride (Ophthalmic).

2. Tetracycline Hydrochloride(Topical).

3. Tetracycline Hydrochloride(Oral).

2.Lymecycline.

3.Minocycline Hydrochloride.

4.Oxytetracycline.

5. Tetracycline Hydrochloride(orally).

6.Tigecycline.

1.Tetracycline Hydrochloride Ophthalmic:-

Ointment 1:-A-Tetra ophthalmic Ointment 1% 5GM TUBE AS A Tetracycline Hydrochloride AS A Ophthalmic antibacterial drugs.

Indications Of A-Tetra 1% ointment is indicated as followings-:-

Treatment of bacterial conjunctivitis
Treatment of trachoma (by preference use oral azithromycin for this indication)
Prevention of chlamydial and gonococcal neonatal conjunctivitis

Side Effects Of A-Tetra 1% ointment:-

Burning, irritation, visual disturbances, superinfections, photosensitivity, hypersensitivity

Pharmacology:-

2. Tetracycline Hydrochloride(Topical).

N/A.

3. Tetracycline Hydrochloride(Oral).

Capsule 1:A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs).

Indications of Capsule :A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs):-

A-Tetra is the drug of choice in the following infections :

Ricketsial infection (Rocky Mountain spotted fever, endemic and scrub typhus fever and human ehrlichiosis).
Mycoplasma pneumoniae infections in adults. Outbreaks of pneumonia caused by this organism are common in barracks and institutions. Most cases occur in children and young adults. Maculopapular rashes, haemolytic anaemia and meningo-encephalitis occur rarely.
Chlamydial Infections: Chlamydia psittaci: This organism is the cause of psittacosis (ornithosis), a systemic illness contracted from infected birds. The pneumonia associated with it may be extensive, and severe systemic upset and death are common.Headache is a prominent early symptom.
Non-gonococcal or non specific urethritis: Inflammation of the urethra not resulting from gonococcal, chlamydial, or other specific infectious agents.
Lyme disease
Brucellosis
Miscellaneous infections, including granuloma inguinale, cholera, glanders, relapsing fever and V. vulnifians.

Other common uses of tetracycline include the following:

Urinary Tract Infections with susceptible organisms (including the acute urethral syndrome in women).
Bronchitis in patients with known underlying chronic lung diseases.
Pelvic inflammatory disease and other sexually transmitted diseases (STDs) regimen.
Travelers diarrhoea.
Acne vulgaris
Prostatitis.
As an alternative agent in the penicillin allergic patient with syphilis.
Anaerobic infections with susceptible organisms.

Side Effects of Capsule :A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs):-

Teeth and bone: A-Tetra can cause depression of bone growth, permanent graybrown discoloration of the teeth and enamel hypoplasia when given during tooth development (i.e. during the later half of pregnancy, during infancy and in childhood).

Hypersensitivity reactions such as anaphylaxis, urticaria and rashes are uncommon. Photosensitivity reactions consisting of a red rash on areas exposed to intense sunlight can occur with A-Tetra.

Gastrointestinal effects: Epigastric distress and nausea are commonly seen after oral administration, and these symptoms are somewhat dose related. Vomiting can occur.

Accentuated prerenal azotemia: A-Tetra appears to aggravate pre-existing renal failure by inhibiting protein synthesis, which increases the azotemia from amino acid metabolism.

Superinfections with oral and anogenital candidiasis are relatively common in patients taking A-Tetra.

Esophageal ulcerations: In most cases, the patients were taking the capsules with little or no fluid before going to bed. To help minimize this, oral doses should be given with adequate amounts of fluid.

Pharmacology:-

2.Lymecycline:-

Capsule 1:-Lymeclin 408 mg (As a Lymecycline As a Tetracycline group of drugs).

Indications Of Capsule :-Lymeclin 408 mg (As a Lymecycline As a Tetracycline group of drugs):-

Lymeclin capsules belong to a group of medicines called tetracycline antibiotics. It is used to treat acne which appears as blackheads or whiteheads, which people often refer to as pimples or spots.

This medicine can also be used to treat other infections, such as:

Acute sinusitis
Bronchitis
Infections in the abdomen
Some types of eye infections called trachoma
Soft skin infections

Side Effects Of Capsule :-Lymeclin 408 mg (As a Lymecycline As a Tetracycline group of drugs):-

Lymeclin capsules may also cause the following
side effects.

Common (occur in less than 1 in 10 patients):

Feeling sick (nausea)
Abdominal pain
Diarrhoea
Headache

Unknown (frequency cannot be estimated from
available information):

Eyesight disturbances
Dizziness
Being sick (vomiting)
Yellowing of eyes or skin (jaundice)
Increased sensitivity of the skin to sunlight (real or artificial)
Increased pressure in the brain
Changes in type or number of certain blood cells
Pain in the upper part of the abdomen
Changes in some blood tests (liver function tests)
Fever
Itchiness, skin rash, or hives
Inflammation of the intestine

Pharmacology:-

Lymecycline is a tetracycline derivative which blocks the access of bacterial aminoacyl-tRNA to the mRNA-ribosome complex by binding to the 30S ribosome subunit, preventing the addition of amino acids to the growing peptide chain in protein synthesis

2.Doxycycline:-

Capsule 1:-Doxacil 100mg,Doxin 50mg AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs.

Indications Of Capsule Doxacil 100mg AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs:-

Doxacil is indicated in the following infections caused by susceptible microorganisms:

Respiratory tract infections: Pneumonia, influenza, sinusitis, bronchitis, tonsillitis, tracheitis.
Gastrointestinal tract infections: Cholera, traveler’s diarrhea, shigella dysentery, acute intestinal amebiasis.
Chlamydial infections: Lympho-granuloma venereum, psittacosis, trachoma.
Sexually transmitted diseases: Non gonococcal urethritis, acute pelvic inflammatory disease, uncomplicated urethral and endocervical or rectal infections, gonorrhoea, syphilis, pyelonephritis, cystitis.
Other infections: Impetigo, furunculosis, inclusion conjunctivitis, brucellosis, tularemia, cellulitis, acne and Q-fever.

Side Effects Of Capsule -Doxacil 100mg AS A Doxycycline Hydrochloride AS A Tetracycline group of drugs:-

Nausea, vomiting, diarrhoea, skin rashes, hemolytic anaemia, eosinophilia may be reported.

Pharmacology:-

3.Minocycline Hydrochloride:-

Tablet 1:-Minocin 50mg,100mg AS A Minocycline Hydrochloride Tetracycline group of drugs.

Capsule 2:-Minocin 50mg AS A Minocycline Hydrochloride Tetracycline group of drugs.

Indications Of Tablet :-Minocin 50mg,100mg AS A Minocycline Hydrochloride Tetracycline group of drugs:-

Minocin is indicated for oral administration, for the treatment of infections caused by tetracycline sensitive organisms and some tetracycline resistant strains of staphylococci. Indications include: Acne, skin and soft tissue infections, ophthamological infections, acute and chronic bronchitis, bronchiectasis, lung abscess, ear, nose and throat infections, pelvic inflammatory disease, nocardiosis, urinary tract infections, gonorrhoea, non-gonococcal urethritis and prostatitis. Minocin may also be used in prophylactic treatment of asymptomatic meningococcal carriers. Also indicated in pre- and post-operative prophylaxis of infection.

Side Effects Of Indications Of Tablet :-Minocin 50mg,100mg AS A Minocycline Hydrochloride Tetracycline group of drugs:-

Reported side effects are oral and anogenital candidiasis, vulvovaginitis, eosinophilia, leucopenia, neutropenia, thrombocytopenia, haemolytic anaemia, pancytopenia, agranulocytosis, anaphylaxis, anaphylactoid reaction, hypersensitivity, pulmonary infiltrates, anaphylactoid purpura, polyarthritisnodosa, abnormal thyroid function, brown-black discolouration of the thyroid, anorexia, dizziness, headache, hypaesthesia, paraesthesia, intracranial hypertension, vertigo, Bulging fontanelle, convulsions, sedation, impaired hearing, tinnitus, myocarditis, pericarditis, cough, dyspnoea, bronchospasm, exacerbation of asthma, pulmonary eosinophilia, pneumonitis, diarrhoea, nausea, stomatitis, discolouration of teeth, vomiting, dyspepsia, dysphagia, enamel hypoplasia, enterocolitis, oesophagitis, oesophageal ulceration, glossitis, pancreatitis, pseudomembranous colitis, increased liver enzymes, hepatitis, autoimmune hepatotoxicity, hepatic cholestatis, hepatic failure, hyperbilirubinemia, jaundice, autoimmune hepatitis, alopecia, erythema multiforme, erythema nodosum, fixed drug eruption, hyperpigmentation of the skin, photosensitivity, pruritis, rash, urticaria, vasculitis, angioedema, exfoliative dermatitis, hyperpigmentation of nails, Stevens-Johnson syndrome, toxic epidermal necrolysis, Drug reaction with eosinophilia and systemic symptoms (DRESS), arthralgia, lupus-like syndrome, myalgia, arthritis, bone discolouration, cases of systemic lupus erythematous (SLE), joint stiffness, joint swelling, increased serum urea, acute renal failure, interstitial nephritis, balanitis, fever, etc. In some cases involving these syndromes, death has been reported.

Hyperpigmentation of various body sites including the skin, nails, teeth, oral mucosa, bones, thyroid, eyes (including sclera and conjunctiva), breast milk, lacrimal secretions and perspiration has been reported. This blue/black/grey or muddy-brown discolouration may be localised or diffuse. The most frequently reported site is in the skin. Pigmentation is often reversible on discontinuation of the drug, although it may take several months or may persist in some cases. The generalised muddy-brown skin pigmentation may persist, particularly in areas exposed to the sun.

4.Oxytetracycline:-

Capsule 1:-Oxecylin 250mg (As a Oxytetracycline As a Eye Anti-Infectives & Antiseptics, Tetracycline group of drugs, Topical antibiotics for Acne).

Indications Of Capsule :-Oxecylin 250mg (As a Oxytetracycline As a Eye Anti-Infectives & Antiseptics, Tetracycline group of drugs, Topical antibiotics for Acne):-

Oxecylin is indicated in-

Respiratory tract infections
Mycoplasma pneumonia
Urinary tract infections
Sexually transmitted diseases: Infections due to Chlamydia trachomatis including uncom-plicated urethral, endocervical or rectal infections, non gonococcal urethritis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, syphilis
Skin infections: Acne and rosacea
Ophthalmic infections: Trachoma
Rickettsial infections
Other infections: Psittacosis, brucellosis, cholera, acute
intestinal amoebiasis etc.

Side Effects Of Capsule :-Oxecylin 250mg (As a Oxytetracycline As a Eye Anti-Infectives & Antiseptics, Tetracycline group of drugs, Topical antibiotics for Acne):-

Side effects of Oxecylin, which have been reported in some patients, are anorexia, nausea, vomiting, diarrhoea, glossitis, skin rashes and urticaria.

Pharmacology:-

Other component or Preparation Of Oxytetracycline:-

1. Oxytetracycline+Polymixin B Sulphate:-

Ointment 1:-Polytetra (3%+0.013%) 5gm tube (As a Oxytetracycline+Polymixin B Sulphate As a Topical Antibiotic preparations).

Indications Of Ointment :-Polytetra (3%+0.013%) 5gm tube (As a Oxytetracycline+Polymixin B Sulphate As a Topical Antibiotic preparations):-

This is indicated for the prophylaxis and local treatment of superficial ocular infections due to oxytetracycline and polymyxin-sensitive organisms, including infections due to streptococci, rickettsiae, E. coli, and A. aerogenes, such as conjunctivitis, keratitis, pink eye, corneal ulcer, blepharitis in dogs, cats, cattle, sheep, and horses; ocular infections due to secondary bacterial complications of distemper in dogs, and bacterial inflammatory conditions which may occur secondary to other infectious diseases in the above species.

Side Effects Of Ointment :-Polytetra (3%+0.013%) 5gm tube (As a Oxytetracycline+Polymixin B Sulphate As a Topical Antibiotic preparations):-

All medicines may cause side effects, but many people have no, or minor, side effects. When used in small doses, no common side effects have been reported with Polytetra. Seek medical attention right away if any of these severe side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); eye swelling or redness.

Pharmacology:-

Oxytetracycline inhibits cell growth by inhibiting translation. It binds to the 30S ribosomal subunit and prevents the amino-acyl tRNA from binding to the A site of the ribosome. The binding is reversible in nature. Oxytetracycline is lipophilic and can easily pass through the cell membrane or passively diffuses through porin channels in the bacterial membrane.

The broad-spectrum effectiveness of this ointment against both gram-positive and gram-negative organisms is enhanced by the particular effectiveness of polymyxin B against infections associated with gram-negative organisms, especially those due to Pseudomonas aeruginosa, where polymyxin B is the antibiotic of choice. In addition, there is evidence to indicate that polymyxin B sulfate possesses some antifungal activity.

5. Tetracycline Hydrochloride(orally).

Capsule 1:A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs).

Indications of Capsule :A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs):-

A-Tetra is the drug of choice in the following infections :

Ricketsial infection (Rocky Mountain spotted fever, endemic and scrub typhus fever and human ehrlichiosis).
Mycoplasma pneumoniae infections in adults. Outbreaks of pneumonia caused by this organism are common in barracks and institutions. Most cases occur in children and young adults. Maculopapular rashes, haemolytic anaemia and meningo-encephalitis occur rarely.
Chlamydial Infections: Chlamydia psittaci: This organism is the cause of psittacosis (ornithosis), a systemic illness contracted from infected birds. The pneumonia associated with it may be extensive, and severe systemic upset and death are common.Headache is a prominent early symptom.
Non-gonococcal or non specific urethritis: Inflammation of the urethra not resulting from gonococcal, chlamydial, or other specific infectious agents.
Lyme disease
Brucellosis
Miscellaneous infections, including granuloma inguinale, cholera, glanders, relapsing fever and V. vulnifians.

Other common uses of tetracycline include the following:

Urinary Tract Infections with susceptible organisms (including the acute urethral syndrome in women).
Bronchitis in patients with known underlying chronic lung diseases.
Pelvic inflammatory disease and other sexually transmitted diseases (STDs) regimen.
Travelers diarrhoea.
Acne vulgaris
Prostatitis.
As an alternative agent in the penicillin allergic patient with syphilis.
Anaerobic infections with susceptible organisms.

Side Effects of Capsule :A-Tetra 500mg (As a Tetracycline Hydrochloride As a Tetracycline group of drugs):-

Pharmacology:-

6.Tigecycline:-

IV Infusion 1:-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs).

Indications Of IV Infusion :-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs):-

Widebac IV Infusion is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions listed below:

Complicated Skin and Skin structure Infections: Complicated skin and skin structure infections caused by Escherichia coli, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus agalactiae, Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Streptococcus pyogenes, Enterobacter cloacae, Klebsiella pneumoniae and Bacteroides fragilis.

Complicated Intra-Abdominal Infections: Complicated intra-abdominal infections caused by Citrobacter freundii, Enterobacter cloacae, Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterococcus faecalis (vancomycin-susceptible isolates only), Staphylococcus aureus (methicillin-susceptible and -resistant isolates), Streptococcus anginosus grp. (includes S. anginosus, S. intermedius, and S. constellatus), Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides uniformis, Bacteroides vulgatus, Clostridium perfringens, and Peptostreptococcus micros.

Community-Acquired Bacterial Pneumonia: Community-acquired bacterial pneumonia caused by Streptococcus pneumoniae (penicillin-susceptible isolates), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase negative isolates), and Legionella pneumophila.

Side Effects Of IV Infusion :-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs):-

The most common treatment-emergent adverse events are nausea and vomiting which generally occurre during the first 1-2 days of therapy. The following drug-related adverse events are reported infrequently in patients receiving Widebac: Injection site inflammation & pain, septic shock, allergic reaction, chills, thrombophlebitis, bradycardia, tachycardia, vasodilatation, anorexia, dry mouth, hypoglycemia, hyponatremia, prolonged prothrombin time, eosinophilia, thrombocytopenia, vaginal moniliasis, vaginitis, leukorrhea.

Pharmacology:-

Tigecycline, a glycylcycline, inhibits protein translation in bacteria by binding to the 30S ribosomal subunit and blocking entry of amino-acyl tRNA molecules into the A site of the ribosome. This prevents incorporation of amino acid residues into elongating peptide chains. Tigecycline carries a glycylamido moiety attached to the 9-position of minocycline. The substitution pattern is not present in any naturally occurring or semisynthetic tetracycline and imparts certain microbiologic properties to tigecycline. Tigecycline is not affected by the two major tetracycline resistance mechanisms, ribosomal protection and efflux. Accordingly, tigecycline has demonstrated in vitro and in vivo activity against a broad spectrum of bacterial pathogens. There has been no cross resistance observed between tigecycline and other antibiotics. Tigecycline is not affected by resistance mechanisms such as beta-lactamases (including extended spectrum beta-lactamases), target site modifications, macrolide efflux pumps or enzyme target changes (e.g. gyrase/topoisomerase). In vitro studies have not demonstrated antagonism between tigecycline and other commonly used antibacterial drugs. In general, tigecycline is considered bacteriostatic.

3.Macrolides:-

1.Azithromycin:-

1.Azithromycin Orally:-

Tablet1:Zimax 500mg,Rozith 250mg,AS A Azithromycin Dihydrate AS A Macrolides.

Indications Of Tablet:-Zimax 500mg,Rozith 250mg,AS A Azithromycin Dihydrate AS A Macrolides:-

Zimax is indicated for infections (caused by susceptible organisms) in lower respiratory tract infections including bronchitis and pneumonia, in upper respiratory tract infections including sinusitis and pharyngitis/tonsillitis, in otitis media, and in skin and soft tissue infections. In sexually transmitted diseases in men and women, Zimax is indicated in the treatment of non-gonococcal urethritis and cervicitis due to Chlamydia trachomatis.

Side Effects Of Tablet:-Zimax 500mg,Rozith 250mg,AS A Azithromycin Dihydrate AS A Macrolides:-

Zimax is well tolerated with a low incidence of side-effects. Most side-effects observed were mild to moderate in severity. The majority of side-effects were gastrointestinal in origin with nauseas, abdominal discomfort (pain/cramps), vomiting, flatulence, diarrhoea and loose stools being occasionally observed. Allergic reactions such as rash or photosensitivity have occurred and there have also been rare reports of serious hypersensitivity reactions. Reversible elevations in liver transaminases have been seen with a frequency similar to the comparative macrolides and penicillins used in clinical trials. Rarely, cases of cholestatic jaundice have been observed. Transient mild reductions in neutrofil counts have occasionally been observed in clinical trials, although a causal relationship to azithromycin has not been established. Hearing impairment: In investigational studies where higher doses were used for prolonged periods of time, reversible hearing impairment was seen in some patients.

Pharmacology:-

Azithromycin is acid-stable and can therefore be taken orally with no need of protection from gastric acids. It is readily absorbed; its absorption is greater on an empty stomach. Time to peak concentration in adults is 2.1 to 3.2 hours for oral dosage forms. Due to the high concentration in phagocytes, azithromycin is actively transported to the site of infection. During active phagocytosis, large concentrations of azithromycin are released. The concentration of azithromycin in the tissues can be over 50 times higher than in plasma. This is due to ion trapping and the high lipid solubility.

Azithromycin’s half-life allows a large single dose to be administered and yet maintain bacteriostatic levels in the infected tissue for several days. Following a single 500 mg dose, plasma concentrations of azithromycin declined in a polyphasic pattern with a mean apparent plasma clearance of 630 mL/min and a terminal elimination half life of 68 hours. The prolonged terminal half-life is thought to be due to extensive uptake and subsequent release of drug from tissues. Biliary excretion of azithromycin, predominantly unchanged, is a major route of elimination. Over the course of a week, approximately 6% of the administered dose appears as unchanged drug in urine.

Microbiology: Azithromycin acts by binding to the 50S ribosomal subunit of susceptible microorganisms and, thus, interfering with microbial protein synthesis. Nucleic acid synthesis is not affected. Azithromycin has been shown to be active against most isolates of the following microorganisms, both in vitro and in clinical infections:

Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae
Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.
Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci
Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila
Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia

Capsule2:-Zimax 250mg,Azithron 500mg

Powder For Suspension3:-Zimax 200mg/5ml

IV Infusion 4:-Zimax 500mg/vial.

2.Azithromycin Ophthalmic:-

Ophthalmic Soluation 1:-Eye Drop:-AZ 1% 2.5ML Drop AS A Azithromycin Dihydrate AS A Macrolides.

Indications Of Eye Drop:-AZ 1% 2.5ML Drop AS A Azithromycin Dihydrate AS A Macrolides:-

AZ Eye Drops is indicated for the treatment of bacterial conjunctivitis caused by CDC coryneform group G, Haemophilus influenzae, Staphylococcus aureus, Streptococcus mitis group, and Streptococcus pneumonia.

Side Effects Of Eye Drop:-AZ 1% 2.5ML Drop AS A Azithromycin Dihydrate AS A Macrolides:-

Eye irritation, contact dermatitis, corneal erosion, dry eye, punctate keratitis etc.

Pharmacology:-

Aerobic and facultative gram-positive microorganisms: Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus pyogenes
Aerobic and facultative gram-negative microorganisms: Haemophilus ducreyi, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae
Other microorganisms: Chlamydia pneumoniae, Chlamydia trachomatis , Mycoplasma pneumoniae , Betalactamase production should have no effect on azithromycin activity.
Aerobic and facultative gram-positive microorganisms: Streptococci (Groups C,F,G), Viridans group streptococci
Aerobic and facultative gram-negative microorganisms: Bordetella pertussis, Legionella pneumophila
Anaerobic microorganisms: Peptostreptococcus species, Prevotella bivia

2.Clarithromycin:-

1.Clarithromycin:-

Tablet 1:-Remac 500mg,klabid 250mg.AS A Clarithromycin AS A Macrolides.

Indications Of Tablet :-Remac 500mg,klabid 250mg.AS A Clarithromycin AS A Macrolides:-

Remac is indicated for the treatment of-

Acute bacterial exacerbation of chronic bronchitis in adults
Acute maxillary sinusitis
Community-acquired pneumonia
Pharyngitis or tonsillitis
Uncomplicated skin and skin structure infections
Acute otitis media in pediatric patients
Treatment and prophylaxis of disseminated mycobacterial infections
Helicobacter pylori infection and duodenal ulcer disease in adults

Side Effects Of Tablet :-Remac 500mg,klabid 250mg.AS A Clarithromycin AS A Macrolides:-

Remac is generally well tolerated. Side effects include nausea, vomiting, diarrhoea and abdominal pain. Stomatitis and glossitis have also been reported. Other side effects include headache, allergic reactions ranging from urticaria and mild skin reactions to anaphylaxis. Taste perversion may occur. There have been reports of transient central nervous system side effects including anxiety, dizziness, insomnia and hallucination.

Pharmacology:-

Clarithromycin acts by inhibiting microsomal protein synthesis in susceptible organisms mainly by binding to the donor site on the 50S subunit of the bacterial ribosome and preventing translocation to that site. Clarithromycin is active against most Gram-positive bacteria and Chlamydia, some Gram-negative bacteria and Mycoplasmas. Clarithromycin’s activity is the same as, or greater than, that of Erythromycin in vitro against most Gram-positive bacteria. Clarithromycin is more acid-stable than Erythromycin and therefore, is better tolerated. Clarithromycin has twice the activity of Erythromycin against H. influenzae. Most species of Gram-negative bacteria are resistant to Clarithromycin because of failure to penetrate the target.

Powder for Suspension 2:-Remac 125mg/5ml 60ml bottle.

Injection 3:-Klaricid IV Injection 500mg/vial.

2.Other component or Preparation of Clarithromycin:-

1.Esomeprazole+Amoxicillin+Clarithromycin:-

Tablet 1:Esotid Hp (20mg+1000mg+500mg) AS A Esomeprazole+Amoxicillin+Clarithromycin AS A
Anti H. pylori drugs.

Indications Of Tablet :Esotid Hp (20mg+1000mg+500mg) AS A Esomeprazole+Amoxicillin+Clarithromycin AS A
Anti H. pylori drugs:-Esotid HP is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.

Side Effects of Tablet :Esotid Hp (20mg+1000mg+500mg) AS A Esomeprazole+Amoxicillin+Clarithromycin AS A
Anti H. pylori drugs:-

2.Rabeprazole+Amoxicillin+ Clarithromycin:-

Tablet1:-Pylotrip-R (20MG+1000MG+500MG) AS A Rabeprazole+Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs.

Indications Of Tablet:-Pylotrip-R (20MG+1000MG+500MG) AS A Rabeprazole+Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs:-

Amoxicillin, Clarithromycin & Rabeprazol combination is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.

Side Effects Of Tablet:-Pylotrip-R (20MG+1000MG+500MG) AS A Rabeprazole+Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs:-

Adverse reactions which were reported as possibly or probably related to treatment (<3%) in clinical trials when all three components of this therapy were given concomitantly are listed below and divided by body systems.

Digestive system: Nausea, vomiting, diarrhoea, dark stools, dry mouth, glossitis, oral moniliasis, stomatitis, tongue discoloration; Musculoskeletal system: Myalgia;

Nervous System: Confusion, headache, dizziness; Skin: Skin reactions; Urogenital System: Vaginitis, vaginal moniliasis.

3.Lansoprazole+ Amoxicillin+ Clarithromycin:-

Tablet 1:-Pylotrip (30mg+1000mg+500mg) AS A Lansoprazole+ Amoxicillin+ Clarithromycin AS A AS A Anti H. pylori drugs.

Indications Of Tablet :-Pylotrip (30mg+1000mg+500mg) AS A Lansoprazole+ Amoxicillin+ Clarithromycin AS A AS A Anti H. pylori drugs:-

This is indicated for the eradication of H. pylori in active chronic gastric, duodenal and gastric ulcers.

Side Effects Of Tablet :-Pylotrip (30mg+1000mg+500mg) AS A Lansoprazole+ Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs:-

Adverse reactions which were reported as possibly or probably related to treatment (>3%) in clinical trials when all three components of this therapy were given concomitantly are listed below and divided by body systems. Digestive system: Nausea, vomiting, diarrhea, dark stools, dry mouth, glossitis, oral moniliasis, stomatitis, tongue discoloration. Musculoskeletal System: myalgia. Nervous System: confusion, headache, dizziness; Skin: skin reactions. Urogenital System: vaginitis,vaginal moniliasis.

4.Vonoprazan+ Amoxicillin+ Clarithromycin:-

Tablet 1:-Vonokit (20mg+1000mg+500mg) /(40mg+2000mg+1000mg)AS A Vonoprazan+ Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs.

Indications Of Tablet :-Vonokit (20mg+1000mg+500mg) AS A Vonoprazan+ Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs:-

This combination, is a standard triple therapy regimen, is indicated in the eradication of H. pylori in active chronic gastritis, duodenal and gastric ulcers.

Side Effects Of Tablet :-Vonokit (20mg+1000mg+500mg) AS A Vonoprazan+ Amoxicillin+ Clarithromycin AS A Anti H. pylori drugs:-

Most common adverse reactions (>2%) were dysgeusia, diarrhea, vulvovaginal candidiasis, headache, abdominal pain, hypertension and nasopharyngitis.

3.Erythromycin:-

1.Erythromycin Oral:-

Tablet1:-Eromycin Ds 500mg,A-Mycin 250mg.AS A Erythromycin Anti-diarrhoeal Antimicrobial drugs, Macrolides. Erythromycin inhibits microsomal protein synthesis in susceptible organisms by inhibiting the translocation process. Specific binding to the 50S subunit or 70S ribosome occurs in these organisms but there is no binding to the stable 80S mammalian ribosome. Erythromycin is active against many Grampositive bacteria, some Gram-negative bacteria and against mycoplasmas and chlamydia.

Indications Of Tablet:-Eromycin Ds 500mg,A-Mycin 250mg.AS A Erythromycin Anti-diarrhoeal Antimicrobial drugs, Macrolides:-

Eromycin DS is highly effective in the treatment of a wide variety of clinical infections.

Upper respiratory tract infections: Tonsilitis, Peritonsillar abscess, Pharyngitis, laryngitis, Sinusitis. Secondary infections in colds and influenza.
Lower respiratory tract infections: Tracheitis, acute and chronic bronchitis.
Ear infections: Otitis media, otitis externa, mastoiditis.
Eye infections: Blepharitis, established trachoma.
Skin and Soft tissue infections: Boils and carbuncles, impetigo, abscesses, pustular acne, paromychia, cellulitis, erysipelas.
Gastrointestinal tract infections: Cholecystitis, staphylococcal enterocolitis.
Prophylaxis: Pre and post-operative, trauma, burns, rheumatic fever.
Other infections: Osteomyelitis, diptheria, scarlet fever, whooping cough.

Side Effects Of Tablet:-Eromycin Ds 500mg,A-Mycin 250mg.AS A Erythromycin Anti-diarrhoeal Antimicrobial drugs, Macrolides:-

Allergic reactions are rare and mild although anaphylaxis has occurred. Occasionally there is abdominal discomfort after oral administration, sometimes with nausea and vomiting. This discomfort usually subsides after a few days without it being necessary to reduce the dosage.

Pharmacology:-

Erythromycin inhibits microsomal protein synthesis in susceptible organisms by inhibiting the translocation process. Specific binding to the 50S subunit or 70S ribosome occurs in these organisms but there is no binding to the stable 80S mammalian ribosome. Erythromycin is active against many Grampositive bacteria, some Gram-negative bacteria and against mycoplasmas and chlamydia.

Absorption: Erythromycin base is destroyed by acid and is therefore administered in the form of stable ester. The rates of absorption of the base and esters are diminished by the presence of food. The stearate is hydrolyzed in the intestine and the free erythromycin absorbed.

Blood concentration: After an oral dose of 500 mg. of the base of stearate, peak serum concentrations of 0.9 to 1.4 or 0.4 to 1.8 mg/ml. respectively are attained in 1 to 4 hours. Half-life: The serum half-life is 1.2 to 4 hours. In subjects with oliguria, the half-life is about 5 hours.

Distribution: Erythromycin is widely distributed throughout body tissue and fluids with some retention in the liver and spleen, protein binding of erythromycin base is 73%. Erythromycin enters the cerebrospinal fluid when the meninges are inflamed. It also crosses the placenta and is excreted in the milk.

Excretion: 5 to 15 % of the dose of erythromycin is excreted in the urine and large amounts of the unchanged active substance are excreted in the bile.

Powder For Suspension2:-Eromycin 125mg/5ml 100ml Bottle.

Pediatric Drops3:-Eromycin 200mg/5ml

2.Erythromycin Lotion:-

Lotion 1:-Eromycin 3% AS A Erythromycin AS A Topical antibiotics for Acne.

Indications Of Lotion:-Eromycin 3% AS A Erythromycin AS A Topical antibiotics for Acne:-

For topical treatment of acne, pimples & bacterial skin infections susceptible to Eromycin.

Side Effects Of Lotion:-Eromycin 3% AS A Erythromycin AS A Topical antibiotics for Acne:-

Erythema, desquamation, burning sensation, eye irritation, tenderness, dryness, oily skin etc.

Pharmacology:

Erythromycin is a bacteriostatic macrolide antibiotic. But may be bactericidal in high concentrations. Although the mechanism by which Erythromycin acts in reducing the inflammatory lesions of acne vulgaris is unknown, it is presumably due to the antibiotic action of the drug.

4.Protein Synthesis Inhibitors:-

Aminoglycosides:

1.Amikacin:-

Injection 1:-Akicin IM/IV 500MG/2ML ,2ML Ampule,Akicin IM/IV 100MG/2ML 2ML Ampule AS A Amikacin Aminoglycosides.

Indications Of Injection :-Akicin IM/IV 500MG/2ML ,2ML Ampule:-

Akicin is indicated in the short-term treatment of serious infections due to susceptible strains of Gram-negative bacteria. Akicin is effective in bacterial septicemia (including neonatal sepsis); in serious infections of the respiratory tract, bones and joints, central nervous system (including meningitis) and skin and soft tissue; intra-abdominal infections (including peritonitis); and in burns and postoperative infections (including postvascular surgery). Clinical studies have shown Akicin also to be effective in serious complicated and recurrent urinary tract infections due to those organisms.

Akicin was effective in infections caused by gentamicin and/or tobramycin-resistant strains of Gram-negative organisms, particularly Proteus rettgeri, Providencia stuartii, Serratia marcescens, and Pseudomonas aeruginosa.

Akicin has also been shown to be effective in staphylococci infections and may be considered as initial therapy under certain conditions in the treatment of known or suspected staphylococcal disease such as, severe infections where the causative organism may be either a Gram-negative bacterium or a staphylococcus.

Side Effects Injection :-Akicin IM/IV 500MG/2ML ,2ML Ampule:-

The adverse effects have been reported with the use of Akicin are tinnitus, vertigo, partial reversible or irreversible deafness, skin rash, drug fever, headache, paraesthesia, nausea and vomiting.

Pharmacology

Amikacin Sulfate is a semi-synthetic aminoglycoside antibiotic. Amikacin is active in vitro against pseudomonas species, Escherichia coli, Proteus species, Providencia species, Klebsiella-Enterobacter species, Acinetobacter species, and Citrobacter freundii. When strains of the above organisms are found to be resistant to other aminoglycosides, including Gentamicin, TobrAmykin and KanAmykin, many are susceptible to Amikacin. Amikacin sulfate is active in vitro against penicillinase and nonpenicillinase-producing Staphylococcus species including methicillin-resistant strains.

2.Gentamicin:-

1.Gentamicin Sulfate(Ophthalmic):-

Eye/Ear Drop:1.Gentabac 0.3% 10ml drop( AS A Gentamicin Sulfate Ophthalmic antibacterial drugs.)

Indications Of Eye/Ear Drop:-Gentabac 0.3% 10ml drop( AS A Gentamicin Sulfate Ophthalmic antibacterial drugs):-

Blepharitis, blepharoconjunctivitis, conjunctivitis, dacryocystitis, keratitis, keratoconjunctivitis, acute meibomianitis, and corneal ulcers caused by susceptible organisms. Otorrhea associated with external otitis, chronic suppurative otitis media or subacute purulent otitis media; or postoperative otorrhea, such as that following fenestration, mastoidectomy or tympanoplasty.

Side Effects Of Eye/Ear Drop:-Gentabac 0.3% 10ml drop( AS A Gentamicin Sulfate Ophthalmic antibacterial drugs):-

In patients with dermatoses treated with gentamicin, irritation (erythema and pruritus) had been reported in small number of cases. Itching, redness, swelling or other signs of irritation may develop. With the eye/ear drop bacterial and corneal ulcer have developed during treatment with gentamicin. Most frequently reported adverse reactions are ocular burning and irritation upon drug instillation, non specific conjunctivitis, conjunctival epithelial defects, and conjunctival hyperemia.

Pharmacology

Gentamicin sulphate actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30S subunit of bacterial ribosomes and interferes with an initiation complex between mRNA (messenger RNA) and the 30 S subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein.

Eye drops may be absorbed following topical application to the eye. Ear drops may be absorbed following topical application to the ear, especially if the eardrum is perforated or if tissue damage is present.

Gentamicin sulphate is active against many strains of the following microorganisms: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus pneumoniae, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Niesseria gonorrhoea, Pseudomonus aeruginosa, and Serratia marcescens.

Other component or Preparation of Gentamicin:-

1.Betamethasone+Clotrimazole+Gentamicin:-

Cream1:-Aristoderm (0.05%+1%+0.1%) 10GM Tube (AS A Betamethasone+Clotrimazole+Gentamicin AS A Betamethasone & Combined preparations)

Indications Of Cream:-Aristoderm (0.05%+1%+0.1%) 10GM Tube (AS A Betamethasone+Clotrimazole+Gentamicin AS A Betamethasone & Combined preparations):-

This Cream is indicated for the treatment of corticosteroid-responsive dermatoses when complicated by infections caused by bacteria and fungi. This is also effective in the treatment of tinea pedis, tinea cruris & tinea corporis, acute and chronic eczema.

Side Effects Of Cream:-Aristoderm (0.05%+1%+0.1%) 10GM Tube (AS A Betamethasone+Clotrimazole+Gentamicin AS A Betamethasone & Combined preparations):-

Adverse reactions have been reported very rarely and include hypochromia, burning, erythema, exudation etc.

Pharmacology:-

This Cream combines the anti-inflammatory, antipruritic and vasoconstrictive actions of Betamethasone Dipropionate with the broad spectrum antifungal activity of Clotrimazole and the wide-spectrum bactericidal antibiotic activity of Gentamicin Sulfate. Clotrimazole appears to act on the fungal cell membrane, causing leakage of cell contents. Gentamicin provides highly effective topical treatment in primary and secondary bacterial infections of the skin.

Betamethasone Only Single COMPONENT:-

1.Betamethasone:-Tablet 1:-Bet-A 0.5mg AS A Betamethasone AS A Corticosteroid.

Indications Of Tablet :-Bet-A 0.5mg AS A Betamethasone AS A Corticosteroid:-

Bet-A is indicated for-

Suppression of inflammatory and allergic disorders including rheumatoid arthritis, rheumatoid carditis, severe hypersensitivity reactions, bronchial asthma, inflammatory skin disorders;
congenital adrenal hyperplasia;
ear, eye, nose and oral ulceration.

Side Effects Of Tablet :-Bet-A 0.5mg AS A Betamethasone AS A Corticosteroid:-

Side effects include diabetes, osteoporosis (which is a danger in elderly), muscle wasting (proximal myopathy), amenorrhoea and weight gain. High doses of corticosteroids can cause cushing’s syndrome-with moon face, striae, and acne; it is usually reversible on withdrawal of treatment. In children, administration of corticosteroids may result in suppression of growth.

Pharmacology:-

Corticosteroids bind to the glucocorticoid receptor, inhibiting pro-inflammatory signals, and promoting anti-inflammatory signals. Betamethasone phosphate has a short duration of action as it is rapidly hydrolyzed to betamethasone. Corticosteroids have a wide therapeutic window as patients may require doses that are multiples of what the body naturally produces. Patients taking corticosteroids should be counselled regarding the risk of hypothalamic-pituitary-adrenal axis suppression and increased susceptibility to infections.

2.Betamethasone+Clotrimazole:-

Ointment 1:-Topibet-CL 0.1%+1% 10gm Tube (AS A Betamethasone+Clotrimazole AS A Betamethasone & Combined preparations).

Indications Of Ointment :-Topibet-CL 0.1%+1% 10gm Tube (AS A Betamethasone+Clotrimazole AS A Betamethasone & Combined preparations):-

This topical preparation is indicated for the topical treatment of inflammatory dermal infections like-

Tinea pedis
Tinea cruris
Tinea corporis etc.

Side Effects Of Ointment :-Topibet-CL 0.1%+1% 10gm Tube (AS A Betamethasone+Clotrimazole AS A Betamethasone & Combined preparations):-

Adverse reactions reported for the preparation in clinical trials were paresthesia in 1.9% of patients, rash, edema and secondary infection each in less than 1% of patients. Other adverse reactions reported with the preparation were burning and dry skin in 1.6% of patients and stinging in less than 1% of patients.

Pharmacology:-

Clotrimazole is a broad-spectrum antifungal agent used for the treatment of superficial infections caused by species of pathogenic dermatophytes, yeasts and Malassezia furfur. The mechanism of action involves inhibition of the synthesis of ergosterol, a major sterol in the fungal cell membrane. This leads to instability of the cell membrane and eventual death of the fungus. Betamethasone dipropionate is a corticosteroid with anti-inflammatory, antipruritic, and vasoconstrictive properties. But the exact mechanism of action of corticosteroids is not clearly known.

3.Betamethasone+Neomycin Sulphate(Topical):-

Cream 1:-Aristobet-N (0.1%+0.5%) 10gm tube.(AS A Betamethasone+Neomycin Sulphate AS A Aural steroid & antibiotic combined preparations.)

Indications Of Cream :-Aristobet-N (0.1%+0.5%) 10gm tube.(AS A Betamethasone+Neomycin Sulphate AS A Aural steroid & antibiotic combined preparations.):-

This cream is usually useful for the treatment of superficial infections caused by gram-positive and gram-negative microorganisms. It is also useful in burns, regeneration of new skin in wounds and ulceration, otitis externa, postoperative infections, neuro-dermatitis and eczema. It may be used as an adjunct to systemic steroid therapy in special kind of pyoderma.

Side Effects Of Cream :-Aristobet-N (0.1%+0.5%) 10gm tube.(AS A Betamethasone+Neomycin Sulphate AS A Aural steroid & antibiotic combined preparations.):-

Aristobet-N is well tolerated. But prolonged and high doses may cause Cushing’s syndrome, acne, thinning and dilatation of blood vessels, particularly when occlusive dressings are used.

Pharmacology:-

Betamethasone is an active topical corticosteroid, which produces a rapid response in the inflammatory dermatoses and cures psoriasis types of skin diseases. Neomycin Sulfate is a topical broad-spectrum bactericidal amino-glycoside effective against various kinds of gram-positive and gramnegative pathogens such as Proteus vulgaris, Staphylococcus aureus etc. This preparation has effective penetration and uniform distribution capacity, so it is very effective in hairy and intertriginous places. This preparation is very effective for the treatment of wet ulceration of the skin.

4.Betamethasone Dipropionate:-

Cream1:-Betameson 0.05% (AS A Betamethasone Dipropionate AS A Corticosteroid).

Indications Of Cream:-Betameson 0.05% (AS A Betamethasone Dipropionate AS A Corticosteroid):-

Betameson cream and ointment is
indicated for the relief of the inflammatory and pruritic manifestations of resistant or severe corticosteroid-responsive dermatoses. These include-

Atopic eczema
Nummular eczema
Contact dermatitis
Neurodermatitis
Anogenital and senile pruritus
Lichen planus
Psoriasis

Side Effects Of Cream:-Betameson 0.05% (AS A Betamethasone Dipropionate AS A Corticosteroid):-

The most frequent side effects reported with Betameson are mild to moderate transient burning/stinging, dry skin, pruritus, irritation and folliculitis. Rarely reported adverse effects include tingling, prickly skin/tightening or cracking of skin, warm feeling,laminar scaling and perilesional scaling,follicular rash, skin atrophy, erythema, urticaria, vesiculation, telangiectasia, acneiform papules and hyperaesthesia.

Adverse reactions reported with the use of the Betameson ointment pulse dose regimen were mild intermittent hypertension and paraesthesia. Other local adverse reactions that have been reported with the use of topical corticosteroids include: itching, hypertrichosis, hypopigmentation, perioral dermatitis, allergic contact dermatitis, maceration of the skin, secondary infection, striae, miliaria and exacerbation of untreated infections

Pharmacology:-

Betamethasone Dipropionate is a topical corticosteroid with anti-inflammatory, antipruritic and vasoconstrictive properties. Betamethasone Dipropionate induces peptides called lipocortins. Lipocortins antagonize phospholipase A2, an enzyme that causes the breakdown of leukocyte lysosomal membranes to release arachidonic acid. This action decreases the subsequent formation and release of endogenous inflammatory mediators including prostaglandins, kinins, histamine.

Pharmacokinetics: Betamethasone Dipropionate can be absorbed from normal intact skin. Corticosteroids are bound to plasma proteins in varying degrees. Corticosteroids are metabolized primarily in the liver.lt excreted by the kidneys.

5.Betamethasone Sodium Phosphate:-

Ophthalmic Solution:Eye/Ear/Nose Drop 1:-

Eyebet 0.1% 5ml drop (As a Betamethasone Sodium Phosphate as a Corticosteroid).

Indications Of Ophthalmic Solution:Eye/Ear/Nose Drop :-Eyebet 0.1% 5ml drop (As a Betamethasone Sodium Phosphate as a Corticosteroid):-

Eyebet is indicated in short-term treatment of steroid responsive in inflammatory conditions of the eye after clinical exclusion of bacterial, viral or fungal infections. Non-infected inflammatory conditions of the ear or nose.

Side Effects Of Ophthalmic Solution:Eye/Ear/Nose Drop :-Eyebet 0.1% 5ml drop (As a Betamethasone Sodium Phosphate as a Corticosteroid):-

Hypersensitivity reactions may occur leading to irritation, burning, stinging, itching and dermatitis. Topical corticosteroid use may result in corneal ulceration, increased intraocular pressure leading to optic nerve damage, reduced visual acuity. Intensive or prolonged use of topical corticosteroids may lead to formation of posterior subcapsular cataracts. In those diseases causing thinning of the cornea or sclera, corticosteroid therapy may result in thinning of the globe leading to perforation. Mydriasis, ptosis and epithelial punctate keratitis have also been reported following ophthalmic use of corticosteroids.

Pharmacology:-

6.Fusidic Acid+Betamethasone:-

Cream1:-Facid BT (2%+0.1%) 10gm tube.(As a Fusidic Acid+Betamethasone AS a Other Topical corticosteroids).

Indications Of Cream:-Facid BT (2%+0.1%) 10gm tube.(As a Fusidic Acid+Betamethasone AS a Other Topical corticosteroids):-

Facid BT cream is indicated in eczema and dermatitis with secondary infections including atopic dermatitis, allergic and seborrhoeic dermatitis and primary irritant dermatitis.

Side Effects Of Cream:-Facid BT (2%+0.1%) 10gm tube.(As a Fusidic Acid+Betamethasone AS a Other Topical corticosteroids):-

Possible side effects are allergic reactions, headache, skin rash, redness or itching, unusual tiredness or weakness, yellow eyes or skin.

Pharmacology:-

Fusidic acid is only effective against gram-positive bacteria such as Streptococcus, Staphylococcus aureus and Corynebacterium minutissimum. The antibacterial action of fusidic acid results from inhibition of bacterial protein synthesis. The drug interferes with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes. Betamethasone induces lipocortin which inhibits phospholipase A-2 enzyme which results in the inhibition of different inflammartory mediators synthesis like prostaglandins, cinins, histamines.

Pharmacokinetics: Fusidic acid can penetrate intact human skin. As much as 2% of the amount of topically applied fusidic acid penetrates intact skin. The degree of penetration depends on factors such as the duration of exposure to fusidic acid and the condition of the skin. Fusidic acid is excreted mainly in the bile with little excreted in the urine. Dermal absorption and potency of any topical corticosteroid including betamethasone depends on the vehicle in which the steroid is delivere.

7.Betamethasone+Calcipotriol:-

Ointment 1:-Dyvon Plus (0.05%+0.005%) 20gm tube (As a Betamethasone+Calcipotriol As a Betamethasone & Combined preparations).

Indications Of Ointment :-Dyvon Plus (0.05%+0.005%) 20gm tube (As a Betamethasone+Calcipotriol As a Betamethasone & Combined preparations):-

Dyvon Plus topical ointment is indicated for the topical treatment of plaque-type psoriasis vulgaris amenable to topical therapy. Dyvon Plus topical suspension is indicated for the topical treatment of plaque psoriasis of the scalp and body.

Side Effects Of Ointment :-Dyvon Plus (0.05%+0.005%) 20gm tube (As a Betamethasone+Calcipotriol As a Betamethasone & Combined preparations):-

The most common adverse reactions are folliculitis and burning sensation of skin.

Pharmacology:-

Betamethasone Dipropionate is a potent topically-active corticosteroid producing prompt, marked and prolonged anti-inflammatory, antipruritic, vasoconstrictive and immunosuppressive properties, without curing the underlying condition. These effects can be enhanced under occlusive conditions due to increased penetration of stratum corneum (by approximately a factor of 10).

Calcipotriol is a non-steroidal antipsoriatic agent, derived from vitamin D. Calcipotriol exhibits a vitamin D-like effect by competing for the 1,25(OH)₂D₃ receptor. Calcipotriol is as potent as 1,25(OH)₂D₃, the naturally occurring active form of vitamin D, in regulating cell proliferation and cell differentiation, but much less active than 1,25(OH)₂D₃ in its effect on calcium metabolism. Calcipotriol induces differentiation and suppresses proliferation (without any evidence of a cytotoxic effect) of keratinocytes, thus reversing the abnormal keratinocyte changes in psoriasis. The therapeutic goal envisaged with Calcipotriol is thus a normalization of epidermal growth.

8. Betamethasone+Neomycin Sulphate(Eye/Ear):-

Ophthalmic Solution:-Eye/Ear/Nose Drop 1:-

Betacin-N (0.1%+0.5%) 5ml drop.(AS A Betamethasone+Neomycin Sulphate Ophthalmic steroid – antibiotic combined preparations)

Ointment 2:- Betson-N (Ophthalmic ointment) (0.1%+0.5%) 3gm tube. (As a Betamethasone+Neomycin Sulphate AS a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Ophthalmic Solution:-Eye/Ear/Nose Drop :-Betacin-N (0.1%+0.5%) 5ml drop.(AS A Betamethasone+Neomycin Sulphate Ophthalmic steroid – antibiotic combined preparations)

Eye: Inflammatory conditions (eg. uveitis, marginal keratitis, allergic conjunctivitis, blepharitis and episcleritis) where development of bacterial infection is likely.

Ear: Otitis externa and other inflammatory conditions where bacterial infection is present or suspected.

Nose: Inflammatory conditions where infection is present or suspected.

Side Effects Of Ophthalmic Solution:-Eye/Ear/Nose Drop :-Betacin-N (0.1%+0.5%) 5ml drop.(AS A Betamethasone+Neomycin Sulphate Ophthalmic steroid – antibiotic combined preparations) :-

Acute sensitization to neomycin is a rare event but can occur after topical application to the eye. Eye drops containing corticosteroids cause a serious rise in intra-ocular pressure in a small percentage of the population, including most of those with a family history of glaucoma. A milder rise may be experienced by a larger proportion of subjects if treatment is continued for longer than a few weeks. Thinning of the cornea leading to perforation has occurred with use of topical corticosteroids. Cataract is reported to have occurred after unduly prolonged treatment of eye conditions with topical corticosteroids.

Pharmacology:-

Betamethasone is a corticosteroid which is effective in inflammatory dermatoses. It is also effective in less responsive conditions such as psoriasis. Betamethasone has a 16β-methyl group that enhances the anti-inflammatory action of the molecule and reduces the sodium and water retaining properties of the fluorine atom bound at carbon 9.

Neomycin sulfate is bactericidal against many bacteria which are commonly associated with skin infections. Neomycin is a broad spectrum antibiotic which actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30s subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30s subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein.

9.Betamethasone+Phenylephrine+Lignocaine:-

Rectal Ointment:-1.Relitch (0.05%+0.1%+2.5%)

15mg tube.(As A Betamethasone+Phenylephrine+Lignocaine As a 4-Quinolone preparations, Phlebotonic & Vascular protecting preparation ).

Indications Of Rectal Ointment:-Relitch (0.05%+0.1%+2.5%)

15mg tube.(As A Betamethasone+Phenylephrine+Lignocaine As a 4-Quinolone preparations, Phlebotonic & Vascular protecting preparation ).

Relitch rectal ointment is indicated for relief of the symptoms of-

Itching,
Irritation,
Discomfort or pain associated with local non-infective anal or peri-anal conditions such as external hemorrhoids.

Side Effects Of Rectal Ointment:-Relitch (0.05%+0.1%+2.5%)

15mg tube.(As A Betamethasone+Phenylephrine+Lignocaine As a 4-Quinolone preparations, Phlebotonic & Vascular protecting preparation ):-

Signs of hypersensitivity may appear. Prolonged and intensive treatment with highly active corticosteroid preparations may cause local atrophic changes in the skin.

Pharmacology:-

Betamethasone is a corticosteroid with mainly glucocorticoid activity. It induces phospholipase A2 inhibitory lipase (lipocortins) and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.

Phenylephrine is a sympathomimetic with mainly direct effects on alpha-adrenergic receptors and weak beta-adrenergic activity. It causes vasoconstriction of the arterioles of the nasal mucosa and conjunctiva; activates the dilator muscle of the pupil to cause contraction; produces vasoconstriction of arterioles in the body and produces systemic arterial vasoconstriction.

Lidocaine alters signal conduction in neurons by blocking the fast voltage-gated Na+ channels in the neuronal cell membrane responsible for signal propagation. With sufficient blockage, the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential.

10. Betamethasone Dipropionate+Salicylic Acid:-

Scalp Lotion 1.Betamesal (0.05%+2%) 30ml Container. AS A Betamethasone Dipropionate+Salicylic Acid (AS A Topical anti-inflammatory preparations).

Scalp Ointment 2:-Betamesal (0.05%+3%) (As a Betamethasone Dipropionate+Salicylic Acid AS A Topical anti-inflammatory preparations).

Indications Of Scalp Lotion:-Betamesal (0.05%+2%) 30ml Container. AS A Betamethasone Dipropionate+Salicylic Acid (AS A Topical anti-inflammatory preparations):-

This Scalp preparation is used to treat inflammatory, dry and scaly skin disorders, such as Eczema, Psoriasis.

Side Effects Of Scalp Lotion:-Betamesal (0.05%+2%) 30ml Container. AS A Betamethasone Dipropionate+Salicylic Acid (AS A Topical anti-inflammatory preparations):-

Side effects that have been reported with the application of topical corticosteroids include burning, itching, irritation, dryness, hypopigmentation, perioral dermatitis and allergic contact dermatitis.

Pharmacology:-

Betamethasone Dipropionate is a glucocorticoid which have primarily anti-inflammatory and immunosuppressive effects and Salicylic Acid which has keratolytic properties and is applied topically in the treatment of hyperkeratotic. Keratolytic action helps to facilitate the penetration of the corticosteroids easily and Betamethasone Dipropionate is an effective treatment of dermatoses because of their anti-inflammatory, antipruritic and vasoconstrictive actions.

11.Betamethasone Valerate:-

Cream 1:-Aristobet 0.1% 20gm tube (As a Betamethasone Valerate AS a Corticosteroid).

Ointment 2:- Aristobet 0.1% 20gm tube (As a Betamethasone Valerate AS a Corticosteroid).

Indications Of Cream :-Aristobet 0.1% 20gm tube (As a Betamethasone Valerate AS a Corticosteroid):-

Aristobet cream or ointment is indicated for the treatment of-

Eczema in children and adults including atopic
Infantile and descoid eczema
Prurigo nodularis
Psoriasis (excluding wide spread plaque psoriasis)
Neurodermatoses including lichen simplex and lichen planus
Seborrhoic dermatitis
Contact sensitivity reaction
Discoid lupus erythematoses and may be used as adjunct to systemic steroid therapy in generalized erythroderma.

Side Effects Cream :-Aristobet 0.1% 20gm tube (As a Betamethasone Valerate AS a Corticosteroid):-

The following local adverse reactions are more common with the use of high doses, long term use and with the use of occlusive dressings of Cream/Ointment: dryness, itching, burning, skin thinning, local irritation, features of hypercorticolism, telagiectasia, striaea, skin atrophy. hypertrichosis, change in pigmentation, secondary infection, perioral dermatiis, allergic contact dermatitis, maceration of the skin, acneform eruption, exacerbation of symptoms.

Pharmacology:-

Betamethasone Valerate BP is a synthetic adrenocorticosteroid, which is glucocorticoid in nature. It is an analog of prednisolone that also possesses a slight degree of mineral corticosteroid activity. Due to its anti-inflammatory, antipruritic and vasoconstrictive activity, it is very effective and suitable for dermatological use. It is absorbed from the skin and inflammation and/or another disease process in the skin increase percutaneous absorption from the skin. Occlusive dressings substantially increase its percutaneous absorption.

2.Gentamicin +Hydrocortisone Acetate:-

Ear drop1:-Gentabac HC (0.3%+1%). 10ml drop (AS A Gentamicin +Hydrocortisone Acetate Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations)

Cream 2:-Gento-HC (0.3%+1%) 10GM Tube.

Indications Of Ear drop:-Gentabac HC (0.3%+1%). 10ml drop (AS A Gentamicin +Hydrocortisone Acetate Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations):-

Gentabac HC is indicated for the treatment of chronic suppurative otitis media, otitis externa and as prophylactic treatment of otitis externa following trauma. Gentabac HC ear drops is also indicated for post-operative local use in surgery to infected mastoid cavities.

Side Effects Of Indications Of Ear drop:-Gentabac HC (0.3%+1%). 10ml drop (AS A Gentamicin +Hydrocortisone Acetate Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations):-

Ear discomfort, ear irritation may occur in rare cases. Gentamicin may cause irreversible partial or total deafness when given systemically or when applied topically to open wounds or damaged skin.

Pharmacology:-

Gentamicin is an aminoglycoside antibiotic and has a bactericidal action against many Gram-negative and some strains of Gram-positive bacteria. After actively transporting across the bacterial cell membrane, Gentamicin binds to a specific receptor protein on the 30S subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA and the 30S subunit, inhibiting protein synthesis. DNA may be misread, thus producing nonfunctional proteins; polyribosomes are split apart and are unable to synthesize protein. Hydrocortisone depresses formation, release, and activity of endogenous mediators of inflammation as well as modifying immune response.

3.Fluorometholone+Gentamicin:-

Ophthalmic Suspension:-

Eye drop 1:-Fluroid -G (0.1%+0.3%) 5ml drop( AS A Fluorometholone+Gentamicin AS A Ophthalmic steroid – antibiotic combined preparations).

Eye Ointment2:-Fluroid -G (0.1%+0.3%) 3gm tube.

Indications Of Eye drop :-Fluroid -G (0.1%+0.3%) 5ml drop( AS A Fluorometholone+Gentamicin AS A Ophthalmic steroid – antibiotic combined preparations).

Inflammation associated with infections in the anterior segment of the eye due to bacteria susceptible to Gentamicin it is also indicated in postoperative infection.

Side Effects Of Eye drop :-Fluroid -G (0.1%+0.3%) 5ml drop( AS A Fluorometholone+Gentamicin AS A Ophthalmic steroid – antibiotic combined preparations):-

A transient burning sensation may occur after instillation. Rare: Hypersensitivity reactions including eczema of the eyelid and puncture keratitis. Prolonged use of topical steroids may delay wound healing, increase of IOP, develop cataract and cause thinning of cornea & sclera.

Pharmacology:-

Gentamicin belongs to the group of aminoglycoside antibiotics. It covers a broad spectrum of gram-positive and gram-negative pathogens, including Pseudomonas aeruginosa, Staphylococci, Haemophilus influenzae H. aegypticus, Klebsiella, Enterobacteria, Proteus, Escherichia coli, Shigella and Salmonella. It inhibits specifically bacterial protein synthesis. Fluorometholone is a synthetic fluorinated corticosteroid possessing anti-inflammatory properties. The combination brings concomitantly the bacterial treatment or prophylaxis and the anti-inflammatory effect. In addition, the presence of gentamicin protects from a risk of potential aggravation of a bacterial infection due to the steroid.

Other Component Or Preparation Of Fluorometholone:-

1.Fluorometholone+Tetrahydrozoline:-

1.Ophthalmic solution:-Metalone Plus (0.1%+0.025%)

5ml drop (AS a Fluorometholone+Tetrahydrozoline AS a Ophthalmic Steroid preparations).

Indications Of Ophthalmic solution:-Metalone Plus (0.1%+0.025%)

5ml drop (AS a Fluorometholone+Tetrahydrozoline AS a Ophthalmic Steroid preparations):-

Metalone Plus eye drop is indicated in-

Acute and chronic allergic non-infectious conjunctivitis and keratitis with severe swelling and intravascular injection
Non-infectious inflammation of the anterior segment of the eye (including anterior uveitis, episcleritis and scleritis)
Post-operative irritative conditions after strabismus; cataract & glaucoma surgery with supplementary antimicrobial therapy.

Side Effects of Ophthalmic solution:-Metalone Plus (0.1%+0.025%)

5ml drop (AS a Fluorometholone+Tetrahydrozoline AS a Ophthalmic Steroid preparations).

Mild burning sensation, reversible increase in intraocular pressure, reactive hyperemia, cataract & corneal defects, glaucoma, systemic effects (chronic use).

Pharmacology:-

Fluorometholone is thought to act by the induction of phospholipase A2 inhibitory proteins which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. On the other hand, Tetrahydrozoline is an alpha agonist which constricts the conjunctival blood vessels and thereby relieves the redness of the eye.

2. Fluorometholone Acetate:-

Ophthalmic Suspension 1:-Metalone 0.1% 5ml drop (As a Fluorometholone Acetate As a Ophthalmic Steroid preparations).

Indications Of Ophthalmic Suspension :-Metalone 0.1% 5ml drop (As a Fluorometholone Acetate As a Ophthalmic Steroid preparations):-

Metalone ophthalmic suspension is indicated for the treatment of steroid responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.

Side Effects Of Ophthalmic Suspension :-Metalone 0.1% 5ml drop (As a Fluorometholone Acetate As a Ophthalmic Steroid preparations):-

Elevation of intraocular pressure with possible development of glaucoma, loss of visual acuity or defects in fields of vision, eye irritation, ocular hyperaemia, eye pain, visual disturbance, foreign body sensation, eyelid edema, blurred vision, eye discharge, eye pruritus, eye swelling, posterior subcapsular cataract formation, ulcerative keratitis, ocular infection (including bacterial fungal and viral), punctate keratitis, hypersensitivity, rash and delayed wound healing.

Pharmacology:-

Fluorometholone Acetate is a corticosteroid with an excellent anti-inflammatory action to inciting agents of mechanical, chemical or immunological in nature. Fluorometholone is thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. In clinical studies on patient’s eyes treated with both Dexamethasone and Fluorometholone suspensions, Fluorometholone demonstrated a lower propensity to increase intraocular pressure than did Dexamethasone.

2.Gentamicin Hydrocortisone Acetate:-

Gentamicin +Hydrocortisone Acetate:-

Ear drop1:-Gentabac HC (0.3%+1%). 10ml drop (AS A Gentamicin +Hydrocortisone Acetate Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations)

Cream 2:-Gento-HC (0.3%+1%) 10GM Tube.

Ear discomfort, ear irritation may occur in rare cases. Gentamicin may cause irreversible partial or total deafness when given systemically or when applied topically to open wounds or damaged skin.

Pharmacology:-

3.Gentamicin Sulfate(Topical):-

Ointment 1:-Genacyn 0.1% 10gm tube (AS A Gentamicin Sulfate AS A Topical Antibiotic preparations):-

Indications Of Ointment :-Genacyn 0.1% 10gm tube (AS A Gentamicin Sulfate AS A Topical Antibiotic preparations):-

Indicated for Burn, Eczema, Seborrhetic dermatitis, Ecthyma, Excoriation, Folliculitis, Furunculosis, Insect bites and stings, Lacerations and abrasions, Paronychia, Pyoderma gangrenosum, Skin cysts and abscesses, Stasis ulcers and infected skin ulcers, Bacterial, fungal or viral superinfection, Sycosis barbae, minor surgical wounds, infected contact dermatitis caused by susceptible organisms.

Side Effects Of Ointment :-Genacyn 0.1% 10gm tube (AS A Gentamicin Sulfate AS A Topical Antibiotic preparations):-

Itching, redness, swelling or other signs of irritation.

Pharmacology:-

Gentamicin Sulphate is an aminoglycoside antibiotic. It is a proven bactericidal antibiotic active against Gram-positive & Gram-negative pathogens including E. coli, Klebsiella, Proteus, Pseudomonas aeruginosa and penicillin resistant strains of Staph. aureus. In common with other aminoglycoside antibiotics, it appears to interfere with protein synthesis of the bacterial cell.

4.Gentamicin Sulfate Injection:-

Injection 1:-Intamycin 80mg/2ml (2ml ampoule). IM/IV Injection (As a Gentamicin Sulfate AS A Aminoglycosides).

Indications Of Injection :-Intamycin 80mg/2ml (2ml ampoule). IM/IV Injection (As a Gentamicin Sulfate AS A Aminoglycosides):-

Intamycin Injection is indicated in the treatment of serious infections caused by susceptible strains of the microorganisms including: Pseudomonas aeruginosa, Proteus sp, Escherichia coli, Klebsiella, Enterobacter, Serratia and Staphylococcus spp.

Intamycin Injection is used for the treatment of the following conditions when caused by susceptible organisms: Septicaemia, Meningitis, Respiratory tract infections, Infected wounds, Skin and skin structure infection, bone and soft tissue infections including peritonitis, septic abortion and burns complicated by sepsis, urinary tract infections.

Side Effects Of Injection :-Intamycin 80mg/2ml (2ml ampoule). IM/IV Injection (As a Gentamicin Sulfate AS A Aminoglycosides):-

Vestibular damage, reversible nephrotoxicity, auditory ototoxicity may occur. Symptoms are dizziness, vertigo, tinnitus, roaring in the ears, rarely hearing loss. Adverse renal effects may be also caused, more frequently in patients with a history of renal impairment treated with larger doses than recommended.

Pharmacology:-

Gentamicin Sulfate is an aminoglycoside antibiotic. This is a proven bactericidal antibiotic active against a broad spectrum of Gram-negative pathogens including E. coli, Klebsiella, Proteus spp, Enterobacter, Pseudomonas aeruginosa and Serratia species. It is also active against some Gram-positive organisms (e.g. penicillin & methicillin resistant strains of Staphylococcus aureus). In vitro, Gentamicin is also active against Salmonella and Shigella. Gentamicin interferes with bacterial protein synthesis by binding primarily to the 30S sub-units of bacterial ribosomes in susceptible organisms. Cell death results. Other mechanisms of action may contribute to the bactericidal effect of Gentamicin.

Injection 2:- Intamycin 20mg/2ml (2ml ampoule). IM/IV Injection.

3.Neomycin:-

Neomycin Componenent or Other Preparation:-

1.Neomycin Sulphate+Bacitracin Zinc +Polymyxin B Sulphate(Ophthalmic):-N/A

2. Neomycin Sulphate+Bacitracin Zinc +Polymyxin B Sulphate:-

Ointment1:-Nebanol Plus (3.5mg+ 400IU+ 5000IU)/gm.10gm Tube (AS A Neomycin Sulphate+Bacitracin Zinc +Polymyxin B Sulphate As a Topical Antibiotic preparations).

Indications Of Ointment:-Nebanol Plus (3.5mg+ 400IU+ 5000IU)/gm.10gm Tube (AS A Neomycin Sulphate+Bacitracin Zinc +Polymyxin B Sulphate As a Topical Antibiotic preparations):-

This Ointment may be used in the treatment of infected wounds, burns or skin grafts,andit is also of value in the preparation of donor sites for skin grafting and in the prevention of infection of extensive burnsand contaminated wounds. It is of value in the local treatment of chronic varicose or other indolent ulcers. The preparation is also of value, in the treatment of furuncles, carbuncles, pyoderma, sycosis barbae, impetigo and acne. It has also been used in dealing with secondary infected skin lesions of scabies, pediculosis, tinea pedis and contact and allergic dermatitis.

Side Effects Of Ointment:-Nebanol Plus (3.5mg+ 400IU+ 5000IU)/gm.10gm Tube (AS A Neomycin Sulphate+Bacitracin Zinc +Polymyxin B Sulphate As a Topical Antibiotic preparations):-

Common side effects are Nausea; Vomiting; Pain, burning, or swelling; Skin rashes; Possible kidney problems; Hearing loss; Dizziness; Unusual numbness of the skin; Muscle twitching; Seizures; Pain; Redness; Swelling at the injection site.

Pharmacology:-

The combination of Polymyxin B sulfate with Neomycin and Bacitracin zinc most nearly meets the criteria for an ideal topical antibacterial preparation. The spectrum of action encompasses virtually all pathogenic bacteria found topically and the three antibiotics are bactericidal. When used topically Polymyxin B sulphate with Neomycin and Bacitracin zinc are rarely irritating, and absorption from the skin or mucous membrane is insignificant. Polymyxin B sulphate attacks gram-negative bacilli including clinically isolated strains of Pseudomonas aeruginosa. This organism is conspicuously absent from the spectra of most other antibiotic agents, but it is highly susceptible to polymyxin B sulphate, which is acknowledged to be the most effective agent known for the treatment and prophylaxis of Pseudomonas infections. Neomycin provides bactericidal action against various gram-positive organisms and gram-negative organisms including many strains of Proteus. Neomycin is considered by various authorities to be the most effective antibiotic against Staphylococcus aureus which is among the more common aetiological organisms in topical bacterial infections. Bacitracin zinc is highly active against gram-positive bacilli and cocci and extends the spectrum to include haemolytic streptococci, thus completing the anti-bacterial range of this Ointment. There is overlapping of the bactericidal spectra of these three antibiotics, thereby providing increased activity through combined antibiotic action.

3. Neomycin Sulphate+Bacitracin Zinc:-

Ointment 1.Nebanol (5mg/500IU)/gm 2Ogm tube.(AS A Neomycin Sulphate+Bacitracin Zinc As a Ophthalmic and Topical antibacterial products).

Topical Powder 2:-Nebanol (5mg/250Iu)/gm 10gm pack (AS A Neomycin Sulphate+Bacitracin Zinc As a Ophthalmic and Topical antibacterial products).

Indications of Ointment :-Nebanol (5mg/500IU)/gm 2Ogm tube.(AS A Neomycin Sulphate+Bacitracin Zinc As a Ophthalmic and Topical antibacterial products):-

Nebanol is indicated in the treatment of topical bacterial infections. This is particularly effective in atopic, contact stasis and infections, eczematoid dermatitis, neurodermatitis, eczema, anogenital pruritus. It may also be useful as an adjunct in certain pyodermas, such as impetigo, during specific systemic antibiotic therapy for these infections.

Side Effects of Ointment :-Nebanol (5mg/500IU)/gm 2Ogm tube.(AS A Neomycin Sulphate+Bacitracin Zinc As a Ophthalmic and Topical antibacterial products):-

Nebanol is usually well tolerated. In rare cases, allergic reactions may be occurred.

Pharmacology:-

Bacitracin inhibits bacterial cell wall synthesis and is active against many gram-positive bacteria (e.g. staphylococci, streptococci, corynebacteria and Clostridia) and some gram-negative species (e.g. Neisseria and Haemophilus influenzae). They are often found in combinations in topical preparations as broad spectrum antibacterial agents.

Neomycin, an aminoglyoside with antimicrobial spectrum similar to gentamicin, binds to the 30S subunits of the bacterial ribosome, inhibiting protein synthesis and thereby disrupting DNA synthesis. It is active against many gram negative aerobes and against some strains of staphylococci.

4. Neomycin Sulphate+ Polymyxin B Sulphate +Pramoxine:-

Cream1:-Nuprin (3.5mg+10000IU+10mg )/gm (5,10,30gm)tube.(AS a Neomycin Sulphate+ Polymyxin B Sulphate +Pramoxine As a Anti-infective & Anesthetic combined preparations).

Indications of Cream:-Nuprin (3.5mg+10000IU+10mg )/gm (5,10,30gm)tube.(AS a Neomycin Sulphate+ Polymyxin B Sulphate +Pramoxine As a Anti-infective & Anesthetic combined preparations):-

This is a first aid cream. It prevents infections and provides temporary relief of pain or discomfort in minor cuts, scrapes and burns.

Side Effects of Cream:-Nuprin (3.5mg+10000IU+10mg )/gm (5,10,30gm)tube.(AS a Neomycin Sulphate+ Polymyxin B Sulphate +Pramoxine As a Anti-infective & Anesthetic combined preparations):-

Topical antibiotics, particularly Neomycin sulphate, may cause cutaneous sensitization. The manifestations of sensitization to topical antibiotics are usually itching and reddening. When used in small doses, no common side effects have been reported with Nuprin.

Pharmacology:-

This cream is a combination of Neomycin, Polymyxin B and Pramoxine HCl. Neomycin is bactericidal for many gram-positive and gram-negative organisms. It is an aminoglycoside antibiotic that inhibits protein synthesis by binding with ribosomal RNA and causing misreading of the bacterial genetic code. Polymyxin B is bactericidal for a variety of gram-negative organisms. It increases the permeability of the bacterial cell membrane by interacting with the phospholipids components of the membrane. Pramoxine is an external analgesic that provides temporary relief of pain or discomfort.

5.Cinchocaine+Hydrocortisone+Neomycin+Esculin:-

Ointment 1:-Anorel (5mg+5mg+10mg+10mg)/gm 15gm tube (As Cinchocaine+Hydrocortisone+Neomycin+Esculin AS A Compound steroidal preparations, Drugs used in Ano-rectal region).

Suppository 2:-Ariproct (5mg+5mg+10mg+10mg)/gm

Indications Of Ointment :-Anorel (5mg+5mg+10mg+10mg)/gm 15gm tube (As a Cinchocaine+Hydrocortisone+Neomycin+Esculin AS A Compound steroidal preparations, Drugs used in Ano-rectal region):-

This is indicated for-

Internal and external hemorrhoids
Post-partum hemorrhoidal condition
Anal pruritus, peri-anal eczema, anal fissures and proctitis
Post-hemorrhoidectomy application to relieve pain and discomfort

Side Effects Of Ointment :-Anorel (5mg+5mg+10mg+10mg)/gm 15gm tube (As Cinchocaine+Hydrocortisone+Neomycin+Esculin AS A Compound steroidal preparations, Drugs used in Ano-rectal region):-

Side effects which have been reported for individual constituents may occur and appropriate precautions should be taken when using Ariproct.

Pharmacology:-

Cinchocaine is a local anesthetic which relieves severe pain and relaxes sphincteric spasm. Hydrocortisone acts as an anti-inflammatory and anti-pruritic agent and thereby eliminates itching and inflammation. Neomycin is a broad-spectrum antibiotic which eradicates most infections which may already be present or arise in lesions of the anorectal area. Esculin improves skin vasculature and is effective in management of cellulitis.

Other component of Cinchocaine:-

1.Cinchocaine+Hydrocortisone+Framycetin+Esculin:-

Ointment 1:Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube. (AS A

Cinchocaine+Hydrocortisone+Framycetin+Esculin) (As a Compound steroidal preparations, Drugs used in Ano-rectal region).

Supposidory 2:-Erian (5mg+5mg+10mg+10mg)/gm

Indications Of Ointment :Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube. (AS A

Cinchocaine+Hydrocortisone+Framycetin+Esculin) (As a Compound steroidal preparations, Drugs used in Ano-rectal region).

This is indicated for the treatment of-

Internal and external haemorrhoids
Haemorrhoids post-partum
Anal pruritus, peri-anal eczema, anal fissures and proctitis
Post-haemorrhoidectomy application to relieve pain and discomfort

Side Effects Of Ointment :-Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube. (AS A

Cinchocaine+Hydrocortisone+Framycetin+Esculin) (As a Compound steroidal preparations, Drugs used in Ano-rectal region):-

Long-term continuous treatment with topical corticosteroids should be avoided as far as possible as this may cause atrophic changes in the skin leading to thinning, loss of elasticity, dilatation of superficial blood vessels, telangiectasia and ecchymoses. These changes are particularly likely to occur when occlusive dressings are used. Systemic absorption of topically applied corticosteroids may occur, particularly under the following conditions: when large quantities are used or when application is made to wide areas of the body, or to damaged skin; when potent topical corticosteroids are used, and when the occlusive dressing technique is applied. Depression of the hypothalamic-pituitary-adrenal axis with consequent suppression of the adrenal gland may occur. These effects are most likely to be severe in children. Growth may be retarded and a Cushingoid state may be produced. Benign intracranial hypertension has been rarely reported.

Pharmacology:-

The local anaesthetic Cinchocaine Hydrochloride prevents or relieves the severe pain sometimes encountered in strangulated haemorrhoids, fissures and perianal haematomata, whilst the corticosteroid (Hydrocortisone) acts as a decongestant, anti-inflammatory and anti-pruritic agent and by so doing eliminates itching, inflammation and mucous discharge. The broad spectrum antibiotic, Framycetin Sulphate, will eradicate most infections which may already be present or arise in lesions of the anorectal area and Esculin has a skin protective action.

6.Dexamethasone + Neomycin Sulphate+ Polymyxin B Sulphate:-

Ophthalmic Solution:-

Eye drop 1:-Neo-DP (1mg+3500IU+6000IU)/ml 5ml drop

(As a Dexamethasone + Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Eye drop :-Neo-DP (1mg+3500IU+6000IU)/ml 5ml drop

(As a Dexamethasone + Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

Neo-DP is indicated for the short term treatment of steroid responsive conditions of the eye when prophylactic antibiotic treatment is also required, after excluding the presence of fungal and viral disease.

Side Effects Of Eye drop :-Neo-DP (1mg+3500IU+6000IU)/ml 5ml drop

(As a Dexamethasone + Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

Reactions occurring most often are allergic sensitisations. The reactions due to the steroid component are elevation of intraocular pressure (IOP) leading to optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.

Pharmacology:-

Dexamethasone (Corticosteroids) suppress inflammatory response to a variety of agents and they probably delay or slow healing. Since corticosteroid may inhibit the body’s defense mechanism against infection, a concomitant antimicrobial drug may be used when this inhibition is considered to be clinically significant in a particular case. The anti-infective component in the combination is included to provide action against specific organisms susceptible to it.

Neomycin Sulphate is considered active against the following microorganisms: Staphylococcus aureus, Corynebacterium diphtheriae, Streptococcus Viridans, Escherichia coli,Klebsiella pneumoniae, Proteus vulgaris, Aerobacter aerogenes, and Haemophilus influenzae.

Polymyxin B Sulphate is considered active against the following microorganism: Pseudomonas aeruginosa, Aerobacter aerogenes, Escherichia coli, Klebsiella pneumoniae and Koch-Weeks bacillus.

When a decision to administer both a corticosteroid and an antimicrobial is made, the administration of such drugs in combination has the advantage of greater patient compliance and convenience, with the added assurance that the appropriate dosage of both drugs is administered, plus assured compatibility of ingredients when both types of drugs are in the same formulation and, particularly, that the correct volume of drug is delivered and retained.

Other Component or Combination or Preparation Of DEXAMETHASONE:-

1.Calcium Dobesilate+Lidocaine+Dexamethasone:-

Rectal Ointment1:-Cadosil LD (4%+2%+0.025%) 30gm tube (As a Calcium Dobesilate+Lidocaine+Dexamethasone As a Drugs used in Ano-rectal region)

Indications Of Rectal Ointment1:-Cadosil LD (4%+2%+0.025%) 30gm tube (As a Calcium Dobesilate+Lidocaine+Dexamethasone As a Drugs used in Ano-rectal region):-

This rectal ointment is indicated in-

Internal and external hemorrhoids
Anal pruritus
Anal eczema
Anitis
Perianitis
Acute hemorrhoidal thrombosis
Anal fissure
Pre and postoperative treatment in cases of hemorrhoidectomy

A long-lasting treatment is not indicated.

Side Effects Of Rectal Ointment1:-Cadosil LD (4%+2%+0.025%) 30gm tube (As a Calcium Dobesilate+Lidocaine+Dexamethasone As a Drugs used in Ano-rectal region):-

Very rare cases have been reported: Modifications of the intestinal transit, temporary burning sensation and local pain. Hypersensitivity reactions together with skin reactions and/or fever can occur. These reactions can be of allergic origin and in this case, the treatment must be discontinued.

Pharmacology:-

Calcium Dobesilate acts on the capillary walls by regulating their impaired physiological functions- i.e. increased permeability and decreased resistance and on different signs of inflammation. It also has an antithrombotic activity. Lidocaine hydrochloride, a local anesthetic, contributes to relieve pain. Dexamethasone Acetate, a Corticosteroid for topical use, possesses anti-inflammatory and antipruritic actions.

2.Dexamethasone+Chloramphenicol:-

Ophthalmic Solution:-Eye/Ear.

Dexonex-C (0.1%+0.5%) 5ml drop As a Dexamethasone+Chloramphenicol (AS a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Ophthalmic Solution :-Dexonex-C (0.1%+0.5%) 5ml drop As a Dexamethasone+Chloramphenicol (AS a Ophthalmic steroid – antibiotic combined preparations):-

Eye: Dexonex-C is indicated in acute purulent conjunctivitis, fresh inflammation of the superficial and deeper corneal layers and corneal ulceration. It is also used in keratitis disciformis and the more deep-seated forms of post-herpetic keratitis, allergic conjunctivitis, allergic blepharitis, acute and chronic iritis, chronic anterior uveitis and corneal injury from chemical radiation or thermal burns, or penetration of foreign bodies. The combination is used in steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or arisk of bacterial ocular infection exists. The combination can also be used for post-operative inflammation and any other ocular inflammation associated with infection.

Ear: Dexonex-C is indicated in otitis externa, otitis media and chronic suppurative otitis media.

Side Effects Of Ophthalmic Solution Dexonex-C (0.1%+0.5%) 5ml drop As a Dexamethasone+Chloramphenicol (AS a Ophthalmic steroid – antibiotic combined preparations):-

Adverse reactions seen with Chloramphenicol are transient ocular burning or discomfort and other reported reactions include stinging, redness, itching, conjunctivitis, foreign body sensation, photophobia, blurred vision, dryness and eye pain. Allergic sensitization may occur with the local use of Chloramphenicol. Elevation of intraocular pressure with possible development of glaucoma, infrequent optic nerve damage and posterior subcapsular cataract formation.

Pharmacology:-

Dexamethasone is a glucocorticoid. It has an anti-inflammatory and anti-allergic action. It is used topically in the treatment of inflammatory conditions of the anterior segment of the eye. Dexamethasone is absorbed rapidly after oral administration with a half-life of about 190 minutes. Sufficient absorption may occur after topical application to the skin and eye to produce systemic effects.

Chloramphenicol is a broad spectrum bacteriostatic antibiotic active against a wide variety of gram-negative and gram-positive organisms. Chloramphenicol exerts its antibacterial effect by binding to bacterial ribosomes and inhibiting bacterial protein synthesis at an early stage

3.Dexamethasone +Tobramycin:-

Ophthalmic Solution:-

Eye drop/Eye Ointment:-

Eye drop1:-Dextrobac (0.1%+0.3%) 5ml drop (As a Dexamethasone +Tobramycin As a Ophthalmic steroid – antibiotic combined preparations).

Eye ointment 2:-T-Mycin Plus (0.1%+0.3%) 3.5gm tube. (As a Dexamethasone +Tobramycin As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Eye drop:-Dextrobac (0.1%+0.3%) 5ml drop (As a Dexamethasone +Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

Dextrobac is indicated for steroid responsive inflammatory ocular conditions (palpebral and bulbar conjunctiva, cornea and anterior segment of the globe) where superficial bacterial ocular infection exists. It is also indicated in chronic anterior uveities and corneal injury from chemical radiation or thermal burns, or penetration of foreign bodies. The use of combination with an anti-infective component is indicated where the risk of superficial ocular infection is high.

Side Effects Of Eye drop:-Dextrobac (0.1%+0.3%) 5ml drop (As a Dexamethasone +Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

The most frequent adverse reactions to topical ocular Tobramycin are hypersensitivity and localized ocular toxicity including lid itching, swelling and conjunctival erythema. This reaction occurs in less than 4% of patients. The reactions due to the steroid component are; elevation of intraocular pressure with possible development of glaucoma, and infrequent optic nerve damage; posterior sub capsular cataract formation; and delayed wound healing.

Pharmacology:-

Like other amino-glycosides, the bactericidal activity of Tobramycin is accomplished by specific inhibition of normal protein synthesis in susceptible bacteria, but at the present time, very little is known about this action. It is thought that inhibition of protein synthesis is due to an action on ribosome that causes bacterial misreading of messenger RNA. The action of Dexamethasone is to inhibit the phospholipase A2, the first step in prostaglandin synthesis. Also Dexamethasone inhibits the chemo-tactic infiltration of neutrophils into the site of inflammation. The result is that its anti-inflammatory activity is 25 times greater and its overall therapeutic effectiveness 8-10 times greater than that of hydrocortisone.

4.Moxifloxacin Hydrochloride+Dexamethasone:-

Ophthalmic Solution:-

Eye Drop 1:-Iventi-D (0.5%+0.1%) 5ml drop (As a Moxifloxacin Hydrochloride+Dexamethasone AS a Ophthalmic Steroid preparations).

Indications Of Eye Drop :-Iventi-D (0.5%+0.1%) 5ml drop (As a Moxifloxacin Hydrochloride+Dexamethasone AS a Ophthalmic Steroid preparations):-

Moxifloxacin & Dexamethasone eye drop is indicated in the treatment of eye infections caused by susceptible microorganisms and in the prevention of inflammation and bacterial infection that may occur after eye surgery.

Side Effects Of Eye Drop :-Iventi-D (0.5%+0.1%) 5ml drop (As a Moxifloxacin Hydrochloride+Dexamethasone AS a Ophthalmic Steroid preparations):-

Moxifloxacin: Conjunctivitis decreased visual acuity, dry eye, keratitis, Ocular discomfort, hyperemia, pain, Subconjunctival hemorrhage and tearing.

Dexamethasone: Visual acuity & field defects, cataract formation, secondary ocular infection following suppression of host response & perforation of the globe.

Pharmacology:-

Moxifloxacin is a broad spectrum 4th generation fluorinated quinolone. It inhibits both topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.

Dexamethasone is a cortisone derivative that shows high activity due to the presence of methyl group in the 16-alpha position and of a fluorine atom in the 9-alpha position. Like other glucocorticoids, it is anti-allergic, anti-exudative and anti-proliferative. The action of Dexamethasone is to inhibit the phospholipase A2, the first step in prostaglandin synthesis. Also, Dexamethasone inhibits the chemotactic infiltration of neutrophils into the site of inflammation.

Other Component of Moxifloxacin:-

1.Moxifloxacin Hydrochloride(Injection):-

Injection 1:-Iventi IV Infusion 400mg/250ml.(AS a Moxifloxacin Hydrochloride AS a 4-Quinolone preparations).

Indications Of Injection :-Iventi IV Infusion 400mg/250ml.(AS a Moxifloxacin Hydrochloride AS a 4-Quinolone preparations):-

Iventi Injection is indicated for treating following infections in adults >18 years of age caused by designated, susceptible bacteria.

Acute Bacterial Sinusitis
Acute Bacterial Exacerbation of Chronic Bronchitis
Community Acquired Pneumonia
Skin and Skin Structure Infections: Uncomplicated and Complicated
Complicated Intra-Abdominal Infections.

Side Effects Of Indications Of Injection 1:-Iventi IV Infusion 400mg/250ml.(AS a Moxifloxacin Hydrochloride AS a 4-Quinolone preparations):-

Treatment with Iventi (oral, IV or sequential therapy) may cause some side effects. Common (>1%) side effects include headache, nausea, vomiting, diarrhea, constipation, abdominal pain, dyspepsia, dizziness, pyrexia and insomnia etc. Less common (0.1 to <1%) side effects include neutropenia, palpitations, tachycardia, bradycardia, vertigo, tinnitus, dry mouth, gastritis, edema, fatigue, malaise, hyperglycemia, anorexia, hyperlipidemia, hypoglycemia, dehydration, back pain and arthralgia etc.

2. Moxifloxacin Hydrochloride(Tablet):-

Tablet 1:Visomox 400mg (AS a Moxifloxacin Hydrochloride AS A 4-Quinolone preparations)

Indications Of Tablet :Visomox 400mg (AS a Moxifloxacin Hydrochloride AS A 4-Quinolone preparations):-

Visomox is indicated for the treatment of acute bacterial sinusitis, acute exacerbation of chronic bronchitis, community acquired pneumonia, uncomplicated & complicated skin and skin structure infections, complicated intra-abdominal infections and pelvic inflammatory disease.

Side Effects of Tablet :Visomox 400mg (AS a Moxifloxacin Hydrochloride AS A 4-Quinolone preparations):-

Common side effects of Visomox include nausea, vomiting, diarrhea, headache and dizziness.

Pharmacology:-

Moxifloxacin is a 4th generation synthetic broad spectrum, fluoroquinolone class of antibacterial drug. It has activity against a wide range of gram-positive, gram-negative, anaerobic and atypical bacteria including Mycoplasma pneumoniae. It acts by inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV which are necessary for bacterial DNA replication, transcription & repair.

3. Moxifloxacin Hydrochloride(Ophthalmic):-

Eye drop 1.Visomox 0.5% 5ml drop (As a Moxifloxacin Hydrochloride As a Ophthalmic antibacterial drugs).

Eye Ointment2:-Optimox 0.5% 5gm tube (As a Moxifloxacin Hydrochloride As a Ophthalmic antibacterial drugs).

Injection 3:-Moxquin Intraoclur Injection 0.5% (AS A Moxifloxacin Hydrochloride As a Ophthalmic antibacterial drugs).

Indications Of Eye drop :-Visomox 0.5% 5ml drop (As a Moxifloxacin Hydrochloride As a Ophthalmic antibacterial drugs):-

Visomox ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms:

Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumoniae, Streptococcus viridans group.
Aerobic Gram-negative microorganisms: Acinetobacterlwoffii, Haemophilusinfluenzae, Haemophilus parainfluenzae.
Other microorganisms: Chlamydia trachomatis.

Intraocular injection: A highly effective Intraocular Antibiotic to prevent Postoperative Bacterial Endophthalmitis.

Side Effects Of Eye drop :-Visomox 0.5% 5ml drop (As a Moxifloxacin Hydrochloride As a Ophthalmic antibacterial drugs):-

The most frequently reported ocular adverse events were conjunctivitis, decreased visual acuity, dry eye, keratitis, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage, and tearing. These events occurred in approximately 1-6% of patients. Nonocular adverse events reported at a rate of 1-4% were fever, increased cough, infection, otitis media, pharyngitis, rash, and rhinitis.

Pharmacology:-

The antimicrobial action of Moxifloxacin results from inhibition of the topoisomerase II (DNA gyrase) and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division.

4. Moxifloxacin Hydrochloride+Xanthan Gum:-

Ophthalmic Solution:-

Eye Drop1:-Optimox-XG (0.5%+0.4%) 5ml Drop (As a Moxifloxacin Hydrochloride+Xanthan Gum As a Ophthalmic antibacterial drugs).

Indications Of Eye Drop:-Optimox-XG (0.5%+0.4%) 5ml Drop (As a Moxifloxacin Hydrochloride+Xanthan Gum As a Ophthalmic antibacterial drugs):-

This ophthalmic solution is indicated for the treatment of bacterial conjunctivitis caused by susceptible strains of the following organisms-

Aerobic Gram-positive microorganisms: Corynebacterium species, Micrococcus luteus, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri, Streptococcus pneumonia, Streptococcus viridans group.

Aerobic Gram-negative microorganisms: Acinetobacter iwoffii, Haemophilus influenza, Haemophilus parainfluenzae.

Side Effects Of Eye Drop:-Optimox-XG (0.5%+0.4%) 5ml Drop (As a Moxifloxacin Hydrochloride+Xanthan Gum As a Ophthalmic antibacterial drugs):-

In 1-6% patients the most frequently reported ocular adverse events are eye irritation, pyrexia, conjunctivitis, decreased visual acuity, dry eye, ocular discomfort, ocular hyperemia, ocular pain, ocular pruritus, subconjunctival hemorrhage and tearing.

Pharmacology:-

5.Ciprofloxacin + Dexamethasone:-

Ophthalmic Solution:-

Eye/Ear Drop1:-Beuflox-D (0.3%+0.1%) 5ml drop (As a Ciprofloxacin + Dexamethasone As a Aural steroid & antibiotic combined preparations).

Indications of Eye/Ear Drop:-Beuflox-D (0.3%+0.1%) 5ml drop (As a Ciprofloxacin + Dexamethasone As a Aural steroid & antibiotic combined preparations):-

Eye: This is indicated for the treatment of steroid responsive inflammatory ocular conditions where bacterial infections or risk of bacterial infections co-exist. The combination can also be used for post-operative inflammation and any other ocular inflammation associated with infection.

Ear: This is also indicated in the treatment of ear infections accompanied by inflammation such as otitis externa, acute and chronic otitis media etc. The combination may also be used post-operatively in the ear.

Side Effects of Eye/Ear Drop:-Beuflox-D (0.3%+0.1%) 5ml drop (As a Ciprofloxacin + Dexamethasone As a Aural steroid & antibiotic combined preparations):-

Eye: The most frequently reported drug-related adverse reactions seen with Ciprofloxacin are transient ocular burning or discomfort. Other reported reactions include stinging, redness, itching, conjunctivitis/keratitis, periocular/facial edema, foreign body sensation, photophobia, blurred vision, tearing, dryness, and eye pain. Rare reports of dizziness have been received. The reactions due to the steroid component are elevation of intraocular pressure (IOP) with possible development of glaucoma, and infrequent optic nerve damage; posterior subcapsular cataract formation; and delayed wound healing.

Ear: The most common adverse effects are discomfort and ear pain. Others reported reactions are irritability, dizziness, erythema etc.

Pharmacology:-

Dexamethasone is glucocorticoid. It has an anti-inflammatory and anti-allergic action. It is used topically in the treatment of inflammatory conditions of the anterior segment of the eye. It reduces prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Also, Dexamethasone inhibits the chemotactic infiltration of neutrophils into the site of inflammation.

Ciprofloxacin has in vitro activity against a wide range of gram-negative and gram-positive organisms, possessing the greatest antibacterial activity of all quinolones. The bactericidal action of Ciprofloxacin results from interference with the enzyme DNA gyrase which is needed for the synthesis of bacterial DNA.

Other Component Of Ciprofloxacin:

1.Ciprofloxacin:-

Tablet 1:-Ciprocin (250mg,500mg,750mg).AS A Ciprofloxacin (As a 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs).

Indications Of Tablet :-Ciprocin (250mg,500mg,750mg).AS A Ciprofloxacin (As a 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs):-

Ciprocin is indicated for the treatment of single infection or mixed infections caused by two or more susceptible organisms. It can also be used for infections caused by organisms resistant to other antibiotics including Aminoglycosides, Penicillins and Cephalosporins.

As antibacterial concentrations of Ciprocin are obtained in serum and body tissues as well as in the urine following administration by mouth, Ciprocin has been suggested for use in the treatment of a wide range of infections caused by susceptible organisms including infections of the urinary, respiratory and gastrointestinal tracts, gonorrhoea and septicaemia. The extensive tissue penetration of Ciprocin combined with its enhanced antibacterial activity (including antipseudomonal activity), enables Ciprocin to be used alone (pending sensitivity results) or in combination with an Aminoglycoside or with beta lactam antibiotics for instance when severe neutropenia is present or with an antibiotic active against anaerobes where the presence of bacteroides fragilis is suspected. Ciprocin is indicated for the treatment of the following infections caused by sensitive bacteria:

Severe systemic infections: e.g. septicaemia, bacteraemia, peritionitis, infections in immunosuppressed patients with haematological or solid tumors and in patients in intensive care unit with specific problems such as infected burns.
Respiratory tract infections: Lobar and bronchopneumonia, acute and chronic bronchitis, acute exacerbation of cystic fibrosis, bronchiectasis, empyema.
Urinary tract infections: Uncomplicated and complicated urethritis, cystitis, pyelonephritis, prostatitis, epididymitis.
Skin and soft tissue infections: e.g. infected ulcers, wound infections, abscesses, cellulitis, otitis externa, erysipelas, infected burns.
Gastro-intestinal infections: e.g. enteric fever, infective diarrhea.
Infection of the biliary tract: e.g. cholangitis, cholecystitis, empyema of the gall bladder.
Intra abdominal infections: e.g. peritonitis, intra abdominal abscesses.
Bone and joint infection: Osteomyelitis, septic arthritis.
Pelvic infections: e.g. salpingitis, endometritis, pelvic inflammatory diseases.
Eye, ear, nose and throat infections: e.g. otitis media, sinusitis, mastoiditis, tonsillitis.
Gonorrhoea: Including urethral, rectal and pharyngeal gonorrhoea caused by beta-lactamase producing organisms or organisms moderately sensitive to penicillin.

Side Effects Of Tablet :-Ciprocin (250mg,500mg,750mg).AS A Ciprofloxacin (As a 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs):-

Gastrointestinal disturbances e.g. nausea, diarrhoea, vomiting, dyspepsia, abdominal pain. Disturbances of the central nervous system e.g. headache, dizziness, tiredness, confusion, convulsion & risk of retinal detachment. Hypersensitivity reactions e.g. skin rash (very rarely Stevens-Johnson syndrome and toxic epidermal necrolysis), pruritus and possible systemic reactions. The other less reported reactions are joint pain, mild photosensitivity and transient increase in liver enzymes (particularly in patients with previous liver damage), serum bilirubin, urea or creatinine levels. Risk of hypoglycemia & mental health adverse effects.

Pharmacology:-

Ciprofloxacin is a synthetic quinolone anti-infective agent. Ciprofloxacion has broad spectrum of activity. It is active against most gram negative aerobic bacteria including Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin is also active against gram-positive aerobic bacteria including penicillinase producing, non penicillinase producing, and methicillin resistant staphylococci, although many strains of streptococci are relatively resistant to the drug. The bactericidal action of Ciprofloxacin results from interference with the enzyme DNA gyrase needed for the synthesis of bacterial DNA. Following oral administration it is rapidly and well absorbed from the G.I. tract. It is widely distributed into the body tissues and fluids. The half life is about 3.5 hours. About 30% to 50% of an oral dose of Ciprofloxacin is excreted in the urine within 24 hours as unchanged drug and biologically active metabolites.

Powder For Suspension2:-Ciprocin 250mg/5ml 60ml bottle AS a Ciprofloxacin (As a 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs).

Injection 3:-Ciprocin 200mg/100ml 100ml Vial.AS A Ciprofloxacin (As a 4-Quinolone preparations, Anti-diarrhoeal Antimicrobial drugs).

2.Ciprofloxacin(Ophthalmic):-

Ophthalmic Solution:-

Eye Drops1:-Beuflox 0.3% 5ml drop (AS a Ciprofloxacin As a Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs).

Ophthalmic Ointment2:-Bactin 0.3% 3gm tube (AS a Ciprofloxacin As a Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs).

Indications Of Eye Drops:-Beuflox 0.3% 5ml drop (AS a Ciprofloxacin As a Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs):-

Beuflox 0.3% ophthalmic solution is indicated for the treatment of corneal ulcers, conjunctivitis, and blepharitis, which are caused by susceptible strains of bacteria.

Side Effects Of Eye Drops:-Beuflox 0.3% 5ml drop (AS a Ciprofloxacin As a Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs):-

The most frequently reported drug related adverse reaction was local burning or discomfort. In corneal ulcer studies with frequent administration of the drug, white crystalline precipitates were seen in approximately 17% of patients. Other reactions occurring in less than 10% of patients included lid margin crusting, crystals/scales, foreign body sensation, itching, conjunctival hyperemia and a bad taste following instillation. Additional events occurring in less than 1% of patients included corneal staining, keratopathy/keratitis, allergic reactions, lid edema, tearing, photophobia, corneal infiltrates, nausea and decreased vision.

Pharmacology:-

Ciprofloxacin has in vitro activity against a wide range of Gram-negative and Gram-positive organisms. Ciprofloxacin is bactericidal and acts by inhibiting the A subunits of DNA gyrase (topoisomerase) which is essential in the reproduction of bacterial DNA.

3.Ciprofloxacin+Hydrocortisone Acetate:-

Ophthalmic Suspension:-

Ear Drop 1:-Bactin-HC (0.3%+1% ) 10ml drop (As a Ciprofloxacin+Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations).

Indications Of Ear Drop :-Bactin-HC (0.3%+1% ) 10ml drop (As a Ciprofloxacin+Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations):-

This ophthalmic suspension is indicated for the treatment of acute otitis externa in adult and paediatric patients due to susceptible strains of Pseudomonas Aeruginosa, Staphylococcus aureus and Proteus mirabilis.

Side Effects Of Ear Drop :-Bactin-HC (0.3%+1% ) 10ml drop (As a Ciprofloxacin+Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations):-

Rare reports of headache, pruritis, migraine, hyperesthesia, paresthesia, fungal dermatitis, cough, rash, urticaria, and alopecia have been reported.

Pharmacology:-

Ciprofloxacin & Hydrocortisone is a quinolone antibiotic and corticosteroid combination. It works by killing bacteria by stopping the production of essential proteins needed by the bacteria to survive. It also reduces inflammation (redness, swelling, itching).

6.Dexamethasone:-(Orally)

Tablet1:-Dextor 0.5mg (As a Dexamethasone As a glucocorticoid).

Injection 2:-Dexonex IM/IV 5mg/ml 1ml ampoule.(As a Dexamethasone As a glucocorticoid steroid).

Indications Of Tablet:-Dextor 0.5mg (As a Dexamethasone As a glucocorticoid steroid):-

Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis and serum sickness.
Collagen disease: Like lupus erythematosus, rheumatoid arthritis etc.
Dermatologic diseases: Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus and severe erythema multiforme (Stevens-Johnson syndrome).
Endocrine disorders: Primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, hypercalcemia associated with cancer and nonsuppurative thyroiditis.
Gastrointestinal diseases: Regional enteritis and ulcerative colitis.
Hematologic disorders: Acquired (autoimmune) hemolytic anemia, congenital (erythroid) hypoplastic anemia (Diamond-Blackfan anemia), idiopathic thrombocytopenic purpura in adults and selected cases of secondary thrombocytopenia.
Neoplastic diseases: Leukemias and lymphomas.
Nervous system: Acute exacerbations of multiple sclerosis, cerebral edema associated with primary or metastatic brain tumor, craniotomy or head injury.
Ophthalmic diseases: Temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids.
Renal diseases: To induce a diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus.
Respiratory diseases: Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis.
Rheumatic disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute rheumatic carditis, ankylosing spondylitis, psoriatic arthritis, rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy). For the treatment of dermatomyositis, polymyositis, and systemic lupus erythematosus.
Miscellaneous: Diagnostic testing of adrenocortical hyperfunction, trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy.

Side Effects Of Tablet:-Dextor 0.5mg (As a Dexamethasone As a glucocorticoid steroid):-

The following adverse reactions have been associated with prolonged systemic glucocorticoid therapy.

Endocrine and metabolic disturbances: Cushing-like syndrome, hirsutism, menstrual irregularities, premature epiphyseal closure, secondary adrenocortical and pituitary unresponsiveness, decreased glucose tolerance, negative nitrogen and calcium balance.

Fluid and electrolyte disturbances: Sodium and fluid retention, hypertension, potassium loss, hypokalaemic alkalosis.

Musculo-skeletal effects: Myopathy, abdominal distension, osteoporosis, aseptic necrosis of femoral and humeral heads.

Gastro-intestinal effects: Gastric and duodenal ulceration, perforation and haemorrhage.

Dermatological effects: Impaired wound healing, skin atrophy, striae, petechiae and ecchymoses, bruising, facial erythema, increased sweating, acne.

Central Nervous System effects: Psychic disturbances ranging from euphoria to frank psychotic manifestations,convulsions,in children pseudotumor cerebri (benign intracranial hypertension) with vomiting and papilloedema.

Ophthalmic effects: Glaucoma, increased intraocular pressure, posterior subcapsular cataracts.

Immunosuppressive effects: Increased susceptibility to infections, decreased responsiveness to vaccination and skin tests.

Pharmacology:-

Dexamethasone is a synthetic glucocorticoid which decreases inflammation by inhibiting the migration of leukocytes and reversal of increased capillary permeability. It suppresses normal immune response.

7.Dexamethasone (Ophthalmic):-

Ophthalmic Solution:-

Eye drop 1:-Dexon 0.1% 5ml drop (As a Dexamethasone As a corticosteroids).

Ophthalmic Ointment :-

Eye ointment2:-Dexon 0.05% 3gm tube (As a Dexamethasone As a corticosteroids).

Indications Of Eye drop :-Dexon 0.1% 5ml drop (As a Dexamethasone As a corticosteroids):-

Dexon ophthalmic solution or ointment is indicated for the treatment of

Allergic non-infectious blepharitis and conjunctivitis
Non-infectious keratitis, punctate keratitis, disciform keratitis (provided the corneal surface is intact)
Inflammation of the anterior uvea (iritis, iridocyclitis )
Scleritis, episcleritis and myositis
Post-operative management of cataract, strabismus & other ocular surgeries.

Side Effects Of Eye drop :-Dexon 0.1% 5ml drop (As a Dexamethasone As a corticosteroids):-

In predisposed patients, application of corticosteroids for a period of several weeks may cause a reversible rise in intraocular pressure. Pressure measurements at regular intervals are therefore essential.

Pharmacology:-

Dexamethasone is a cortisone derivative whose high activity due to the presence of methyl group in the 16-alpha position and of a fluorine atom in the 9-alpha position. The result is that its anti-inflammatory activity is 30 times greater and its overall therapeutic effectiveness 8-10 times greater than that of hydrocortisone. Like other glucocorticoids, it is anti-allergic, anti-exudative and anti-proliferative. Therapeutic concentrations of Dexamethasone are found in both the cornea and aqueous humor 15-30 minutes after local application of single drop of 0.1% solution. These concentrations persist for 4-6 hours. The action of Dexamethasone is to inhibit the phospholipase A2, the first step in prostaglandin synthesis. Also, Dexamethasone inhibits the chemotactic infiltration of neutrophils into the site of inflammation.

8. Dexamethasone+Levofloxacin:-

Ophthalmic solution:-

Eye drop 1:-Trevox -D (0.1%+0.5%) 5ml drop (As a Dexamethasone+Levofloxacin As a synthetic third-generation fluoroquinolone anti-bacterial agent)

Indications Of Eye drop :-Trevox -D (0.1%+0.5%) 5ml drop (As a Dexamethasone+Levofloxacin As a synthetic third-generation fluoroquinolone anti-bacterial agent):-

Trevox D ophthalmic solution is indicated for prevention and treatment of inflammation and prevention of infection associated with cataract surgery in adults.

Side Effects Of Eye drop :-Trevox -D (0.1%+0.5%) 5ml drop (As a Dexamethasone+Levofloxacin As a synthetic third-generation fluoroquinolone anti-bacterial agent):-

The most commonly reported non-serious adverse reactions are eye irritation, ocular hypertension and headache. An increase of intra-ocular pressure (IOP) of eyes and glaucoma may occur. Diabetics are also more prone to develop subcapsular cataracts following prolonged topical steroid administration. There are some possible adverse reactions related to cornea as like thinning of the cornea, perforation in some cases in cornea.

Pharmacology:-

Levofloxacin is a synthetic third-generation fluoroquinolone anti-bacterial agent that inhibits the supercoiling activity of bacterial DNA gyrase, halting DNA replication. Levofloxacin, the active L-isomer of ofloxacin that inhibits bacterial type II topoisomerases-DNA gyrase and topoisomerase IV. Levofloxacin preferentially targets DNA gyrase in Gram-negative bacteria and topoisomerase IV in Gram-positive bacteria. On the other hand, the action of Dexamethasone Phosphate is to inhibit the phospholipase A 2 , the first step in prostaglandin synthesis. Also, inhibits the chemotactic infiltration of neutrophils into the site of inflammation. Its anti-inflammatory activity is 30 times greater and its overall therapeutic effectiveness 8-10 times greater than that of hydrocortisone. Like other glucocorticoids, it is anti-allergic, anti-exudative & anti-proliferative.

9.Gatifloxacin+ Dexamethasone:

Ophthalmic Solution:-

Eye drop 1:-Orbidex-G (0.3%+0.1%) 5ml drop (As a Gatifloxacin+ Dexamethasone As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Eye drop :-Orbidex-G (0.3%+0.1%) 5ml drop (As a Gatifloxacin+ Dexamethasone As a Ophthalmic steroid – antibiotic combined preparations):-

Orbidex G is indicated for steroid responsive infammatory conditions with involvement of bacteria; such as- Blepharitis, Scleritis, Episcleritis, Iritis, Cyclitis, Iridocyclitis, Choroiditis, Optic neuritis and chronic anterior uveitis. Also useful in disciform and interstitial keratitis, allergic corneal marginal ulcers, corneal injury from chemical radiation or thermal burns.

Side Effects Of Eye drop :-Orbidex-G (0.3%+0.1%) 5ml drop (As a Gatifloxacin+ Dexamethasone As a Ophthalmic steroid – antibiotic combined preparations):-

Frequently reported reactions related to Gatifoxacin include chemosis, redness, dry eye, itching, swelling of the eyelid & reduced visual acuity. The reactions due to Dexamethasone are elevation of intraocular pressure, delayed wound healing and posterior subcapsular cataract formation.

Pharmacology:-

The antibacterial action of Gatifoxacin results from inhibition of DNA gyrase and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division. Through inhibiting this process Gatifoxacin shows bactericidal activity. The action of Dexamethasone is to inhibit the phospholipase A2, the frst step in prostaglandin synthesis. Also, inhibits the chemotactic infltration of neutrophils into the site of infammation. Its anti-infammatory activity is 30 times greater and its overall therapeutic efectiveness 8-10 times greater than that of hydrocortisone. Like other glucocorticoids, it is anti-allergic, anti-exudative and anti-proliferative.

7.Clobetasol Propionate + Neomycin Sulphate+Nystatin:-

Cream 1:-Dermasol -N (0.5mg+5mg+1lac IU)/gm 25gm tube As a Clobetasol Propionate + Neomycin Sulphate+Nystatin (As a Clobetasol / Clobetasone & Combined Preparations).

Ointment 2:- Dermasol -N (0.5mg+5mg+1lac IU)/gm 25gm tube As a Clobetasol Propionate + Neomycin Sulphate+Nystatin (As a Clobetasol / Clobetasone & Combined Preparations).

Indications Of Cream :-Dermasol -N (0.5mg+5mg+1lac IU)/gm 25gm tube As a Clobetasol Propionate + Neomycin Sulphate+Nystatin (As a Clobetasol / Clobetasone & Combined Preparations):-

Dermasol-N is indicated in-

Short courses treatment of recalcitrant eczemas.
Neurodermatoses.
Psoriasis (excluding widespread plaque psoriasis) where secondary bacterial infection or fungal infection is present, suspected or likely to occur.
Other inflammatory conditions which do not respond satisfactorily to less active steroids.

Side Effects Of Cream :-Dermasol -N (0.5mg+5mg+1lac IU)/gm 25gm tube As a Clobetasol Propionate + Neomycin Sulphate+Nystatin (As a Clobetasol / Clobetasone & Combined Preparations):-

As with other topical corticosteroids, prolonged use of large amount or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercortisolism. The effect is more likely to occur in infants and children and if occlusive dressings are used. Prolonged and intensive treatment with highly active corticosteroid preparations may cause local atrophic changes in the skin such as thinning, striae, and dilatation of the superficial blood vessels, particularly when occlusive dressings are used, or when skin folds are involved. There are reports of pigmentation changes and hypertrichosis with topical steroids.

Pharmacology:-

Clobetasol Propionate is a very potent corticosteroid. It is prescribed to treat severe inflammatory skin disorders such as eczema and psoriasis that have not responded to weaker corticosteroids. Neomycin Sulphate is an antibiotic of the aminoglycoside type and is used to treat infections with bacteria. Nystatin is an antifungal that kills fungi and yeasts by interfering with their cell membranes. The mechanism of the topical steroids like Clobetasol, in general, is unclear. However, Clobetasol Propionate is highly active corticosteroid with topical anti-inflammatory activity. The major effect of Clobetasol Propionate on skin is a nonspecific anti-inflammatory response, partially due to vasoconstriction and decrease in collagen synthesis. Neomycin binds to the ribosomal 30s and 50s sub-units of susceptible bacteria and inhibits protein synthesis. Neomycin also causes a misreading of the genetic codes of the mRNA template and this causes incorrect amino acids to be incorporated into the growing polypeptide chain. Nystatin acts by binding to sterols in the cell membrane of the fungus with a resultant change in membrane permeability allowing leakage of intracellular components.

Other component or preparation of Clobetasol:-

1.Clobetasol Propionate.

2. Clobetasol Propionate+Salicylic Acid.

3. Clobetasol Propionate+Ofloxacin+Ornidazole+Terbinafine.

1.Clobetasol Propionate:-

Ointment1:-Dermasol 0.05% 20gm tube (As a Clobetasol Propionate As a Other Topical corticosteroids).

Cream 2:- Dermasol 0.05% 20gm tube (As a Clobetasol Propionate As a Other Topical corticosteroids).

Scalp Lotion 3:- Dermasol-S 0.05% 25ml Bottle (As a Clobetasol Propionate As a Other Topical corticosteroids).

Indications Of Ointment:-Dermasol 0.05% 20gm tube (As a Clobetasol Propionate As a Other Topical corticosteroids):-

Dermasol is indicated for adults, elderly and children over 1 year in following dermatoses.

Psoriasis (excluding widespread plaque psoriasis)
Recalcitrant dermatoses
Lichen planus
Discoid lupus erythematosus
Other skin conditions which do not respond satisfactorily to less potent steroids.

Side Effects Of Ointment:-Dermasol 0.05% 20gm tube (As a Clobetasol Propionate As a Other Topical corticosteroids):-

As with other topical corticosteroids prolonged use of large amounts, or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercorticism.
Prolonged and intensive treatment with a highly active corticosteroid preparation may cause local atrophic changes in the skin such as thinning, striae and dilatation of the superficial blood vessels, particularly when occlusive dressings are used or when skin folds are involved.
In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the disease.
There are reports of pigmentation changes and hypertrichosis with topical steroids. Dermasol is usually well tolerated, but if signs of hypersensitivity appear, application should be stopped immediately. Exacerbation of symptoms may occur.

Pharmacology:-

Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.

2. Clobetasol Propionate+Salicylic Acid:-

Ointment 1:-Dermasol Plus (0.05%+3%) 30gm tube (As a Clobetasol Propionate+Salicylic Acid As a Clobetasol / Clobetasone & Combined Preparations.)

Indications Of Ointment :-Dermasol Plus (0.05%+3%) 30gm tube (As a Clobetasol Propionate+Salicylic Acid As a Clobetasol / Clobetasone & Combined Preparations.):-

This ointment is indicated for the relief of the inflammatory manifestations of hyperkeratotic and dry corticosteroid responsive dermatoses such as, psoriasis, chronic atopic dermatitis, neurodermatitis (licehen Simplex, Chronicus), lichen planus, eczema (including nummular eczema, hand eczema, eczematous dermatitis), seborrheic dermatitis of the scalp, ichthyosis vulgaris and other ichthyotic conditions.

Side Effects Of Ointment :-Dermasol Plus (0.05%+3%) 30gm tube (As a Clobetasol Propionate+Salicylic Acid As a Clobetasol / Clobetasone & Combined Preparations.):-

As with other topical corticosteroids, prolonged use of large amounts of Clobetasol Propionate or treatment of extensive areas can result in sufficient systemic absorption to produce the features of hypercortisolism. This effect is more likely to occur in infants and children, and if occlusive dressings are used. Local atrophy may occur after prolonged treatment. In rare instances, treatment of psoriasis with corticosteroids (or its withdrawal) is thought to have provoked the pustular form of the diseases. Clobetasol Propionate is usually well tolerated, but if signs of hypersensitivity appear, application should be stopped immediately. Possible sensitivity reactions, drying and irritation when using Salicylic Acid.

Pharmacology:-

Clobetasol Propionate high potency corticosteroid. Corticosteroids decrease inflammation by stabilizing leukocyte lysosomal membranes, preventing release of destructive acid hydrolases from leukocytes; inhibiting macrophage accumulation in inflamed areas; reducing leukocyte adhesion to capillary endothelium; reducing capillary wall permeability and edema formation; decreasing complement components; antagonizing histamine activity and release of kinin from substrates; and reducing fibroblast proliferation, collagen deposition, and subsequent scar tissue formation.

Salicylic acid has a potent keratolytic action and a slight antiseptic action when applied topically. It softens and destroys the stratum corneum by increasing endogenous hydration which causes the horny layer of the skin to swell, soften, and then desquamate. At high concentrations, salicylic acid has a caustic effect. It also possesses weak antifungal and antibacterial activity.

3. Clobetasol Propionate+Ofloxacin+Ornidazole+Terbinafine

Cream 1:-Combicid (0.05%+0.75%+2%+1%) 15gm tube( As a Propionate+Ofloxacin+Ornidazole+Terbinafine As a Clobetasol / Clobetasone & Combined Preparations.).

Indications Of Cream :-Combicid (0.05%+0.75%+2%+1%) 15gm tube( As a Propionate+Ofloxacin+Ornidazole+Terbinafine As a Clobetasol / Clobetasone & Combined Preparations.):-

Combicid cream is indicated in the treatment of-

Mixed and complicated Fungal, Protozoal & Bacterial infections,
Mild to moderate vaginitis,
Candidiasis and trichomoniasis,
Pruritus vulvae,
Dermatitis,
Eczema,
Genito-urinary infections.

Side Effects Of Cream :-Combicid (0.05%+0.75%+2%+1%) 15gm tube( As a Propionate+Ofloxacin+Ornidazole+Terbinafine As a Clobetasol / Clobetasone & Combined Preparations.):-

Burning, itching, irritation, dry skin

Pharmacology:-

This cream is a combination cream which exhibits anti-bacterial, anti-fungal, anti-protozoal & anti-inflammatory actions. Ofloxacin is a broad-spectrum antibiotic that acts against many gram-positive & gram-negative bacteria. Ornidazole belongs to the nitroimidazole group of antibiotics and is used to treat amoeba and trichomonas infections. Terbinafine is an Allylamine antifungal that inhibits biosynthesis of Ergosterol (an essential components if fungal cell membrane) via inhibition of Squalene Epoxidase enzyme causing fungal cell death. Clobetasol is a potent corticosteroid which exhibits anti-inflammatory, anti-pruritic and vasoconstrictive properties.

8.Betamethasone+ Neomycin Sulphate(Eye/Ear):-

Cream1:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate Aural steroid & antibiotic combined preparations).

Ointment 2:-Betaderm-N (0.1%+0.5%) 10gm tube (As a Betamethasone+ Neomycin Sulphate Aural steroid & antibiotic combined preparations).

Indications Of Cream:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate Aural steroid & antibiotic combined preparations):-

Side Effects Of Cream:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate Aural

Betameson-N is well tolerated. But prolonged and high doses may cause Cushing’s syndrome, acne, thinning and dilatation of blood vessels, particularly when occlusive dressings are used.

Pharmacology:-

Betamethasone+ Neomycin Sulphate(Eye/Ear):-

Ophthalmic Solution:-Eye/Ear/Nose

Drop 1:- Betacin-N(0.1%+0.5%) 5ml drop (As a Betamethasone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Drop :- Betacin-N(0.1%+0.5%) 5ml drop (As a Betamethasone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

Side Effects Of Drop :- Betacin-N(0.1%+0.5%) 5ml drop (As a Betamethasone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

Pharmacology:-

Ophthalmic Ointment2:-Betson-N (0.1%+0.5%) 3gm tube (As a Betamethasone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations).

9.Fluocinolone Acetonide+ Neomycin Sulphate:-

Cream 1:-Skinalar-N (0.025%+0.5%) 5gm tube (As a Fluocinolone Acetonide+ Neomycin Sulphate As a Fluocinolone & Combined Preparations, Topical Antifungal preparations ).

Ointment 2:- Skinalar-N (0.025%+0.5%) 5gm tube (As a Fluocinolone Acetonide+ Neomycin Sulphate As a Fluocinolone & Combined Preparations, Topical Antifungal preparations ).

Indications Of Cream :-Skinalar-N (0.025%+0.5%) 5gm tube (As a Fluocinolone Acetonide+ Neomycin Sulphate As a Fluocinolone & Combined Preparations, Topical Antifungal preparations ):-

Skinalar-N cream or ointment are suitable for treating a wide variety of local inflammatory, pruritic and allergic disorders of the skin. This is particularly suitable for topical application in:

Eczema and dermatitis: Atopic eczema, seborrhoeic eczema, discoid eczema, otitis externa, contact dermatitis, neurodermatitis.
Prurigo, Psoriasis, lichen planus. Discoid lupus erythematosus.

This is indicated for inflammatory dermatoses, where secondary bacterial infection is present or likely to occur.

Side Effects Of Of Cream :-Skinalar-N (0.025%+0.5%) 5gm tube (As a Fluocinolone Acetonide+ Neomycin Sulphate As a Fluocinolone & Combined Preparations, Topical Antifungal preparations ):-

Side-effects are extremely rare, but as with all topical corticosteroids, patient may show hypersensitivity reaction.

Pharmacology:-

Fluocinolone acetonide is a corticosteroid primarily used in dermatology to reduce skin inflammation and relieve itching. It is a synthetic hydrocortisone derivative. Fluocinolone acetonide was also found to strongly potentiate TGF-β-associated chondrogenesis of bone marrow mesenchymal stem/progenitor cells, by increasing the levels of collagen type II by more than 100 fold compared to the widely used dexamethasone.

Neomycin Sulfate actively transported across the bacterial cell membrane, binds to a specific receptor protein on the 30 S subunit of bacterial ribosomes, and interferes with an initiation complex between mRNA (messenger RNA) and the 30 S subunit, inhibiting protein synthesis.

Other component or preparation Of Fluocinolone:-

1.Clioquinol+Fluocinolone Acetonide.

2. Fluocinolone Acetonide+Hydroquinone+Tretinoin.

3. Fluocinolone Acetonide.

Descriptition:-

1.Clioquinol+Fluocinolone Acetonide:-

Cream1:-Clioquin (0.025%+3%) 30gm tube (As a Clioquinol+Fluocinolone Acetonide As a Fluocinolone & Combined Preparations, Topical Antifungal preparations).

Indications Of Cream:-Clioquin (0.025%+3%) 30gm tube (As a Clioquinol+Fluocinolone Acetonide As a Fluocinolone & Combined Preparations, Topical Antifungal preparations):-

This cream is indicated in inflammatory skin conditions such as eczema, dermatitis or psoriasis that are infected or likely to become infected.

Side Effects Of Of Cream:-Clioquin (0.025%+3%) 30gm tube (As a Clioquinol+Fluocinolone Acetonide As a Fluocinolone & Combined Preparations, Topical Antifungal preparations):-

Medicines and their possible side effects can affect individual people in different ways. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect. The following side effects are known to be associated with this medicine.

Skin irritation at site of application, such as burning, itching and redness.
Allergic inflammation of the skin (contact dermatitis).
Thinning of the skin.
Changes in skin pigmentation.
Stretch marks (striae).
Groupings of fine blood vessels becoming prominent under the skin (telangiectasia).

Pharmacology:-

Fluocinolone is a type of medicine called a topical corticosteroid. Corticosteroids are medicines used for reducing inflammation. Inflammation of the skin happens as a result of allergy or irritation of the skin, and is caused by the release of various substances that are important in the immune system. These substances cause blood vessels to widen and result in the irritated area becoming red, swollen, itchy and painful, such as is seen in dermatitis or eczema.

When fluocinolone is applied to the skin it works by acting inside the cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch.

There is a range of potencies of corticosteroids available for application to the skin. This medicine contains fluocinolone 0.025% and is classed as a potent corticosteroid. It is prescribed to treat various inflammatory skin disorders, such as eczema and dermatitis, that have not responded to milder steroids.

Clioquinol has antifungal and antibacterial actions. It works by preventing the growth and multiplication of the organisms.

The combination of fluocinolone and clioquinol is used to treat inflammatory skin disorders that are either infected or likely to become infected.

This cream is more suitable for moist, weeping areas of skin, while the thicker, more greasy ointment is more suitable for dry, scaly areas of skin.

2. Fluocinolone Acetonide+Hydroquinone+Tretinoin:-

Cream 1:-Melano (0.01%+4%+0.05%) 30gm tube

(As a Fluocinolone Acetonide+Hydroquinone+Tretinoin AS a Hydroquinone Preparations).

Indications Of Cream :-Melano (0.01%+4%+0.05%) 30gm tube

(As a Fluocinolone Acetonide+Hydroquinone+Tretinoin AS a Hydroquinone Preparations):-

This cream is indicated for the short-term treatment of moderate to severe melasma of the face, after starting the treatment avoid presence of sun. Use a sunscreen of at least SPF 30 or more.

Side Effects Of Cream :-Melano (0.01%+4%+0.05%) 30gm tube

(As a Fluocinolone Acetonide+Hydroquinone+Tretinoin AS a Hydroquinone Preparations):-

A very few patients may get severe allergic reactions from this cream. They may have trouble breathing or severe asthma attacks. While patients use this cream, skin may develop mild to moderate redness, peeling, burning, dryness or itching.

Pharmacology:-

This cream contains three active ingredients Fluocinolone Acetonide, Hydroquinone and Tretinoin. All of them are used to treat melasma. However, the mechanism of action of the active ingredients in This cream in the treatment of melasma is unknown but Fluocinolone Acetonide is a corticosteroid for topical dermatological use and is classified therapeutically as an anti-inflammatory. Hydroquinone is classified therapeutically as a depigmenting agent, which may interrupt one or more steps in the tyrosine-tyrosinase pathway of melanin synthesis. Tretinoin is classified therapeutically as a keratolytic agent.

3. Fluocinolone Acetonide:-

Cream 1:Skinalar 0.025% 5gm tube (As a Fluocinolone Acetonide As a Fluocinolone & Combined Preparations).

Ointment 2:- Skinalar 0.025% 5gm tube (As a Fluocinolone Acetonide As a Fluocinolone & Combined Preparations).

Indications Cream :-Skinalar 0.025% 5gm tube (As a Fluocinolone Acetonide As a Fluocinolone & Combined Preparations):-

Skinalar cream or ointment are suitable for treating a wide variety of local inflammatory, pruritic and allergic disorders of the skin. This is particularly suitable for topical application in:

Eczema and dermatitis: Atopic eczema, seborrhoeic eczema, discoid eczema, otitis externa, contact dermatitis, neurodermatitis.
Prurigo, Psoriasis, lichen planus. Discoid lupus erythematosus.

This is indicated for inflammatory dermatoses, where secondary bacterial infection is present or likely to occur.

Side Effects Of Cream :-Skinalar 0.025% 5gm tube (As a Fluocinolone Acetonide As a Fluocinolone & Combined Preparations):-

Side-effects are extremely rare, but as with all topical corticosteroids, patient may show hypersensitivity reaction.

Pharmacology:-

10. Betamethasone+ Neomycin Sulphate(Topical):-

Cream1:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate As a Aural steroid & antibiotic combined preparations).

Ointment1:-Betaderm-N (0.1%+0.5%) 10gm tube (As a Betamethasone+ Neomycin Sulphate As a Aural steroid & antibiotic combined preparations).

Indications Of Cream:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate As a Aural steroid & antibiotic combined preparations):-

Side Effects Of Cream:-Betameson-N (0.1%+0.5%) 15gm tube (As a Betamethasone+ Neomycin Sulphate As a Aural steroid & antibiotic combined preparations):-

Betameson-N is well tolerated. But prolonged and high doses may cause Cushing’s syndrome, acne, thinning and dilatation of blood vessels, particularly when occlusive dressings are used.

Pharmacology:-

11.Gramacidin+Neomycin+Polymyxin B:-

Ophthalmic Solution:-

Eye Drop 1:-Polymix-G (25IU+1700IU+5000IU)ml 5ml drop (As a Gramacidin+Neomycin+Polymyxin B As a Ophthalmic antibacterial drugs).

Indications Of Eye Drop :-Polymix-G (25IU+1700IU+5000IU)ml 5ml drop (As a Gramacidin+Neomycin+Polymyxin B As a Ophthalmic antibacterial drugs):-

Gramicidin, Neomycin and Polymyxin B Sulfates ophthalmic solution is indicated for the topical treatment of superficial infections of the external eye and its adnexa caused by susceptible bacteria. Such infections encompass conjunctivitis, keratitis and keratoconjunctivitis, blepharitis and blepharoconjunctivitis.

Side Effects Of Eye Drop :-Polymix-G (25IU+1700IU+5000IU)ml 5ml drop (As a Gramacidin+Neomycin+Polymyxin B As a Ophthalmic antibacterial drugs):-

Adverse reactions have occurred with the anti-infective components of Polymix G. The exact incidence is not known. Reactions occurring most often are allergic reactions including itching, swelling, and conjunctival erythema . More serious hypersensitivity reactions, including anaphylaxis, have been reported rarely. Local irritation on instillation has also been reported.

Pharmacology:-

Neomycin is bactericidal for many gram-positive and gram-negative organisms. It is an aminoglycoside antibiotic which inhibits protein synthesis by binding with ribosomal RNA and causing misreading of the bacterial genetic code.

Polymyxin B is bactericidal for a variety of gram-negative organisms. It increases the permeability of the bacterial cell membrane by interacting with the phospholipid components of the membrane.

Gramicidin is bactericidal for a variety of gram-positive organisms. It increases the permeability of the bacterial cell membrane to inorganic cations by forming a network of channels through the normal lipid bilayer of the membrane.

12.Prednisolone+Neomycin Sulphate+ Polymyxin B:-

Ophthalmic Solution:-

Eye Drop 1:-Poly-Pred (5mg+3.5mg+ 10000IU).5ml drop (As a Prednisolone+Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Eye Drop :-Poly-Pred (5mg+3.5mg+ 10000IU).5ml drop (As a Prednisolone+Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

This is indicated for the treatment of eye disorders requiring anti-inflammatory therapy and where complications by infection caused by bacteria sensitive to neomycin and/or polymyxin are present or a potential hazard, such as: nonpurulent conjunctivitis and blepharitis, scleritis, nonherpetic keratitis, dacryocystitis, and for prophylactic therapy following eye surgery, foreign body removal, chemical or thermal burns, abrasions, lacerations or other ocular trauma.

Side Effects Of Eye Drop :-Poly-Pred (5mg+3.5mg+ 10000IU).5ml drop (As a Prednisolone+Neomycin Sulphate+ Polymyxin B Sulphate As a Ophthalmic steroid – antibiotic combined preparations):-

Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing.

Fungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid

Other component or Preparation of Prednisolone:-

1.Prednisolone(Orally).

Tablet1:-Cortan 2mg,5mg,10mg,20mg (AS a Prednisolone As a Glucocorticoids)

Oral solution 2:- Cortan 5mg/5ml 50ml.100ml Bottle As a (AS a Prednisolone As a Glucocorticoids)

Indications Of Tablet:-Cortan 2mg,5mg,10mg,20mg (AS a Prednisolone As a Glucocorticoids):-

Cortan is indicated in:

Rheumatic Disorders: Psoriatic arthritis, rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, acute and subacute bursitis, acute nonspecific tenosynovitis, acute gouty arthritis, post-traumatic osteoarthritis.

Endocrine Disorders: Primary or secondary adrenocortical insufficiency, congenital adrenal hyperplasia, nonsuppurative thyroiditis, hypercalcemia associated with cancer.

Dermatologic Diseases: Pemphigus, bullous dermatitis herpetiformis, severe erythema multiforme, exfoliative dermatitis, mycosis fungoides, severe psoriasis.

Allergic States: Seasonal or perennial allergic rhinitis, bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, drug hypersensitivity reactions.

Respiratory Diseases: Symptomatic sarcoidosis, berylliosis, fulminating, aspiration pneumonitis.

Hematologic Disorders: Idiopathic thrombocytopenic purpura, secondary thrombocytopenia, acquired (autoimmune) hemolytic anemia, erythroblastopenia (RBC anemia).

Edematous States: To induce a diuresis or remission of proteinuria in the nephrotic syndrome, without uremia, of the idiopathic type or that due to lupus erythematosus.

Gastrointestinal Diseases: Ulcerative colitis, regional enteritis.

Side Effects Of Tablet:-Cortan 2mg,5mg,10mg,20mg (AS a Prednisolone As a Glucocorticoids):-

Common side effects include increased appetite, indigestion, nervousness or restlessness. Less frequent or rare side effects are darkening or lightening of skin color, dizziness or lightheadedness, flushing of face or cheeks, hiccups, increased sweating, the sensation of spinning.

Pharmacology:-

Prednisolone is a synthetic adrenocortical drug with predominantly glucocorticoid properties. Prednisolone directly inhibits the action of the Phospholipase A2 enzyme which is responsible for the production of different inflammatory mediators like Leukotrienes, SRS-A, Prostaglandins etc. Prednisolone is rapidly and well absorbed from the Gl tract following oral administration. Prednisolone is 70- 90% protein-bound in the plasma and it is eliminated from the plasma with a half-life of 2 to 4 hours. It is metabolized mainly in the liver and excreted in the urine.

2. Prednisolone Acetate(Ophthalmic Solution).

Eye drop 1:-Cortisol 1% 5ml drop (As a Prednisolone Acetate As a Glucocorticoids).

Indications Of Eye drop :-Cortisol 1% 5ml drop (As a Prednisolone Acetate As a Glucocorticoids):-

Cortisol eye drops is indicated for the treatment of steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.

Side Effects Of Eye drop :-Cortisol 1% 5ml drop (As a Prednisolone Acetate As a Glucocorticoids):-

Elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage, posterior subcapsular cataract formation and delayed wound healing. Fungal and viral infections of the cornea are particularly may develop coincidentally with long-term applications of steroid.

Pharmacology:-

Prednisolone decreases inflammation by inhibition of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It suppresses the immune system by reducing the activity and production of the lymphocytes and eosinophils.

3.Methylprednisolone Acetate(Injection):-

Injection 1:-Depomed 40mg/ml (40mg vial As a Methylprednisolone Acetate AS a Glucocorticoids.)

Injection 2:- Depomed 80mg/2ml 80mg vial (As a Methylprednisolone Acetate AS a Glucocorticoids.)

Indications Of Injection :-Depomed 40mg/ml (40mg vial As a Methylprednisolone Acetate AS a Glucocorticoids.):-

Methyl Prednisolone Acetate is indicated in the treatment of asthma, atopic dermatitis, contact dermatitis, bullous dermatitis herpetiformis, mycosis fungoides, pemphigus, severe erythema multiforme, primary or secondary adrenocortical insufficiency, hypercalcemia associated with cancer, nonsuppurative thyroiditis, ulcerative colitis, hematologic disorders, palliative management of leukemias and lymphomas, sympathetic ophthalmia, keratitis, allergic conjunctivitis, Juvenile rheumatoid arthritis, ankylosing spondylitis, symptomatic sarcoidosis, aspiration pneumonitis.

Side Effects Of Of Injection :-Depomed 40mg/ml (40mg vial As a Methylprednisolone Acetate AS a Glucocorticoids.):-

Congestive heart failure in susceptible patients, hypertension, sodium retention, muscle weakness, osteoporosis, peptic ulcer with possible subsequent and hemorrhage, abdominal distention, increased sweating, convulsion, vertigo, headache, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness, increased intraocular pressure, glaucoma, allergic or hypersensitivity reactions, urticaria, hyperpigmentation or hypopigmentation.

Pharmacology:-

Methylprednisolone binds to and activates intracellular glucocorticoid receptors. Activated glucocorticoid receptors bind to promoter regions of DNA (which may activate or suppress transcription). Unbound glucocorticoids cross cell membranes and bind with high affinity to specific cytoplasmic receptors, modifying transcription and protein synthesis. By this mechanism, glucocorticoids can inhibit leukocyte infiltration at the site of inflammation, interfere with mediators of inflammatory response, and suppress humoral immune responses. The antiinflammatory actions of corticosteroids are thought to involve phospholipase A2 inhibitory proteins, lipocortins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.

4. Methylprednisolone Sodium Succinate(Injection):-

Injection 1:-Methsolon IM/IV Injection 500mg/Vial( As a Methylprednisolone Sodium Succinate As a Glucocorticoids).

Injection 2:- Methsolon IM/IV Injection 1gm/vial ( As a Methylprednisolone Sodium Succinate As a Glucocorticoids).

Indications Of Injection :-Methsolon IM/IV Injection 500mg/Vial( As a Methylprednisolone Sodium Succinate As a Glucocorticoids):-

Methsolon IM/IV is indicated in the following conditions:

Endocrine disorder: Primary or secondary adrenocortical insufficiency, acute adrenocortical insufficiency, shock unresponsive to conventional, congenital adrenal hyperplasia, Nonsuppurative thyroiditis. Hypercalcemia associated with cancer.

Rheumatic disorder: Rheumatoid arthritis, including juvenile rheumatoid arthritis, acute and subacute bursitis, epicondylitis, acute nonspecific tenosynovitis, acute gouty arthritis, psoriatic arthritis, ankylosing spondylitis.

Collagen disease: During an exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus; acute rheumatic carditis, systemic dermatomyositis (polymyositis).

Dermatological disease: Pemphigus, severe erythema multiforme (Stevens-Johnson syndrome), exfoliative dermatitis, bullous dermatitis herpetiformis, severe seborrheic dermatitis, severe psoriasis, mycosis fungoides.

Allergic states: Controls bronchial asthma, contact dermatitis, atopic dermatitis, serum sickness, seasonal or perennial allergic rhinitis, drug hypersensitivity reaction, urticarial transfusion reactions, acute noninfectious laryngeal edema (epinephrine is the drug of first choice), anaphylactic reactions.

Ophthalmic disease: Severe acute and chronic allergic and inflammatory processes involving the eye, such as: herpes zoster ophthalmicus, iritis, iridocyclitis, chorioretinitis, diffuse posterior uveitis and chroiditis, optic neuritis, sympathetic ophthalmia, anterior segment inflammation, allergic conjunctivitis, allergic corneal marginal ulcers, keratitis.

Gastrointestinal disease: To tide the patient over a critical period of the disease in: ulcerative colitis (systemic therapy), regional enteritis (systemic therapy), Crohn’s disease.

Respiratory disease: Symptomatic sarcoidosis, berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculosis chemotherapy, Loafer syndrome not manageable by other means, aspiration pneumonitis.

Hematologic disorder: Acquired (autoimmune) hemolytic anemia, idiopathic thrombocytopenic purpura in adults (IV only, IM administration is contraindicated), erythroblastopenia (RBC anemia), congenital (erythroid) hypoplastic anemia, secondary thrombocytopenia in adults.

Neoplastic disease: For palliative management of: leukemias and lymphoma in adults, acute leukemia of childhood.

Edematous state: To induce diuresis or remission of proteinuria in the nephrotic syndrome, without uremia of the idiopathic type or that due to lupus erythematosus.

Miscellaneous: Tuberculous meningitis with subarachnoid block or impending block when used concurrently with appropriate antituberculosis chemotherapy. Trichinosis with neurologic or myocardial involvement.

Side Effects Of Injection :-Methsolon IM/IV Injection 500mg/Vial( As a Methylprednisolone Sodium Succinate As a Glucocorticoids):-

Fluid and Electrolyte Disturbances: Sodium retention, fluid retention, congestive heart failure in susceptible patients, potassium loss, hypokalemic alkalosis, hypertension.

Musculoskeletal: Muscle weakness, steroid myopathy, loss of muscle mass, severe arthralgia, vertebral compression fractures, aseptic necrosis of femoral and humeral heads, pathologic fracture of long bones, osteoporosis.

Gastrointestinal: Peptic ulcer with possible perforation and hemorrhage, pancreatitis, abdominal distention, and ulcerative esophagitis.

Dermatologic: Impaired wound healing, thin fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, may suppress reactions to skin tests.

Neurological: Increased intracranial pressure with papilledema (pseudo-tumor cerebri) usually after treatment, convulsions, vertigo, headache.

Endocrine: Development of Cushingoid state, suppression of growth in children, secondary adrenocortical and pituitary unresponsiveness, particularly in times of stress, as in trauma, surgery or illness, menstrual irregularities, decreased carbohydrate tolerance, manifestations of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic agents in diabetics.

Ophthalmic: Posterior subcapsular cataracts, increased intraocular pressure, glaucoma, exophthalmos.

Others: Negative nitrogen balance due to protein catabolism.

The following additional adverse reactions are related to parenteral corticosteroid therapy: hyperpigmentation or hypopigmentation, subcutaneous and cutaneous atrophy, sterile abscess, anaphylactic reaction with or without circulatory collapse, cardiac arrest, bronchospasm, urticaria, nausea and vomiting, cardiac arrhythmias; hypotension or hypertension.

Pharmacology:-

Methylprednisolone, a naturally occurring glucocorticoid (hydrocortisone and cortisone), which has also salt-retaining properties, is used as replacement therapy in adrenocortical deficiency states. This synthetic analog is primarily used for its potent anti-inflammatory effects in disorders of many organ systems. The intravenous injection of Methylprednisolone Sodium Succinate, demonstrable effects are evident within one hour and persist for a variable period. Excretion of the administered dose is nearly complete within 12 hours. Thus, if constantly high blood levels are required, injections should be made every 4 to 6 hours. This preparation is also rapidly absorbed when administered intramuscularly and is excreted in a pattern similar to that observed after intravenous injection. Its anti-inflammatory potency is greater than prednisolone in the ratio of 5 to 4. It has only minimal mineralocorticoid properties and has less tendency than prednisolone to induce sodium and water retention. It influences carbohydrate, protein, fat and purine metabolism, electrolyte and water balance, and the functional capacities of the cardiovascular system, the kidney, the skeletal muscle, nervous system and other organs and tissues. It exerts a suppressive effect on the immune response.

13.Triamcinolone+Neomycin+Nystatin+Gramicidin:-

Cream 1:-Tetracomb 10gm tube (As a Triamcinolone+Neomycin+Nystatin+Gramicidin AS a Triamcinolone & Combined preparations).

Ointment 2:- Tetracomb 10gm tube (As a Triamcinolone+Neomycin+Nystatin+Gramicidin AS a Triamcinolone & Combined preparations).

Indications Of Cream :-Tetracomb 10gm tube (As a Triamcinolone+Neomycin+Nystatin+Gramicidin AS a Triamcinolone & Combined preparations):-

This medication is a combination antibiotic and steroid used on the skin to treat an infection and relieve associated itching and swelling.

Side Effects Of Cream :-Tetracomb 10gm tube (As a Triamcinolone+Neomycin+Nystatin+Gramicidin AS a Triamcinolone & Combined preparations):-

Prolonged use may cause sensitivity reactions, impaired wound healing, thinning of skin, striae, telangiectasia, hirsutism, hypothalamic-pituitary-adrenal axis suppression, Cushing’s syndrome.

Pharmacology:-

Triamcinolone is a fluorinated corticosteroid with anti-inflammatory, antipruritic and anti-allergic actions.

Nystatin, a polyene antifungal antibiotic, binds to ergosterol and interferes with the permeability of cell membrane of susceptible fungi e.g Candida spp.

Neomycin is an aminoglycoside, often used topically in the infections against susceptible staphylococci and other organisms.

Gramicidin, an antibacterial substance extracted from tyrothricin, is active against many Grampositive bacteria. Used together, this combination provides a wide coverage against gram-positive, gram-negative bacteria and yeast which are responsible for most of the skin infections.

Other Component Or Preparation Of Triamcinolone:-

1.Econazole Nitrate+Triamcinolone Acetonide.

2.Econazole Nitrate.

3. Triamcinolone Acetonide(Injection).

4. Triamcinolone Acetonide (Topical).

5. Triamcinolone Acetonide(Dental Paste).

6. Triamcinolone Acetonide(Nasal Spray).

Description :-

1.Econazole Nitrate+Triamcinolone Acetonide.

Cream1:-Econate Plus (1%+0.1%) 10gm tube (AS a Econazole Nitrate+Triamcinolone Acetonide As a Triamcinolone & Combined preparations).

Indications Of Cream:-Econate Plus (1%+0.1%) 10gm tube (AS a Econazole Nitrate+Triamcinolone Acetonide As a Triamcinolone & Combined preparations):-

Econazole Nitrate & Triamcinolone Acetonide indicated for the treatment of:

Eczematous Mycoses
Psoriasis
Tinea Pedis (Athlete’s foot)
Tinea Corporis (Ring worm)
Tinea Cruris (Jock itch)
Inflammatory Intertrigo
Diaper Dermatitis

Onychomycoses- for the treatment of onychomycoses, local therapy with Econazole/Triamcinolone cream, combined with an oral antimycotic, is recommended.

Side Effects Of Cream:-Econate Plus (1%+0.1%) 10gm tube (AS a Econazole Nitrate+Triamcinolone Acetonide As a Triamcinolone & Combined preparations):-

Rarely, transient local mild irritation, itching & redness may occur immediately after application. Econazole has the minimal allergenic effect and is well tolerated, even by delicate skin. Adrenal suppression on long term continuous topical steroid therapy may occur, particularly in infants or children, or when occlusive dressings are applied. It should be noted that an infant’s napkin may act as an occlusive dressing.

Description Or Pharmacolgy:-

This cream is a broad spectrum antimycotic with anti-inflammatory, anti-pruritic and anti-allergic effects. This cream is composed of Econazole Nitrate, a powerful antifungal and Triamcinolone Acetonide to enforce its antimicrobial effect and the effect of subduing comprehensive inflammations, therefore, it provides remarkable effects on mixed infections of gram-positive and fungus, eczema and recurrent inflammations and shows special effects on bacterial inflammations of skin folds. The range of action of econazole covers all dermatomycoses caused by the following pathogens:- Dermatophytes, such as Trichophyton, Epidermophyton, Microsporum, Cladosporium, Yeasts, such as Candida, Cryptococcus neoformans, Torulopsis, Rhodotorula, Moulds, Fungi, such as Scopulariopsis brevicaulis, Aspergillus flavus, Histoplasma capsulatum, Blastomycosis dermatitidis, and others. As well as Malassezia furfur and Nocardia minutissima.

Moreover, it has antibacterial effect on gram-positive cocci and bacilli, including Streptococcus pyogens and Staphylococcus aureus. It is also effective against Trichomonus vaginalis, versicolor and balanitis. On the other hand Triamcinolone Acetonide is a synthetic steroid which inhibits not only the early phenomena of the inflammatory process but also the later manifestations.

Pharmacological Properties: Econazole Nitrate is only slightly (<0.1%) absorbed from the skin. So no active drug has been detected in the serum. But Triamcinolone Acetonide is well absorbed from sites of local application.

2.Econazole Nitrate:-

Cream 1:-Econate 1% 10gm tube (As a Econazole Nitrate As a Econazole Nitrate As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations).

Vaginal Cream 2:- Econate-G 1% 30gm tube (As a Econazole Nitrate As a Econazole Nitrate As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations).

Vaginal Tablet 3.Econate -VT 150mg (As a Econazole Nitrate As a Econazole Nitrate As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations).

Indications Of Cream :-Econate 1% 10gm tube (As a Econazole Nitrate As a Econazole Nitrate As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations):-

Econate is indicated for topical application-

In the treatment of tinea pedis, tinea cruris, and tinea corporis caused by Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton tonsurans, Microsporum canis, Microsporum audouini, Microsporum gypseum, and Epidermophyton floccosum,
In the treatment of cutaneous candidiasis, and in the treatment of tinea versicolor.

Side Effects Of Cream :-Econate 1% 10gm tube (As a Econazole Nitrate As a Econazole Nitrate As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations):-

During clinical trials, approximately 3% of patients treated with Econate 1% cream reported side
effects thought possibly to be due to the drug, consisting mainly of burning, itching, stinging, and erythema. One case of a pruritic rash has also been reported.

Pharmacology:-

Econazole Nitrate interferes with fungal oxidative enzymes to cause lethal accumulation of H₂O₂. They also reduce the formation of ergosterol, an important constituent of fungal cell wall.

3. Triamcinolone Acetonide(Injection).

Injection 1:-Cenolon IM/IA 40mg/ml 1ml Vial (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Indications Of Injection:-Cenolon IM/IA 40mg/ml 1ml Vial (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations):-

Intramuscular: Where oral therapy is not feasible, injectable corticosteroid therapy, including Cenolon injection is indicated for intramuscular use as follows:

Rheumatic disorders: As adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis; acute rheumatic carditis; ankylosing spondylitis; psoriatic arthritis; rheumatoid arthritis, including juvenile rheumatoid arthritis.

Allergic states: Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions.

Dermatologic diseases: Bullous dermatitis herpetiformis, exfoliative erythroderma, mycosis fungoides, pemphigus, severe erythema multiforme (Stevens-Johnson syndrome).

Endocrine disorders: Primary or secondary adrenocortical insufficiency (hydrocortisone or cortisone is the drug of choice; synthetic analogs may be used in conjunction with mineralocorticoids where applicable; in infancy, mineralocorticoid supplementation is of particular importance), congenital adrenal hyperplasia, hypercalcemia associated with cancer, nonsuppurative thyroiditis.

Gastrointestinal diseases: To tide the patient over a critical period of the disease in regional enteritis and ulcerative colitis.

Hematologic disorders: Acquired (autoimmune) hemolytic anemia, Diamond-Blackfan anemia, pure red cell aplasia, selected cases of secondary thrombocytopenia.

Neoplastic diseases: For the palliative management of leukemias and lymphomas.

Nervous system: Acute exacerbations of multiple sclerosis; cerebral edema associated with primary or metastatic brain tumor or craniotomy.

Ophthalmic diseases: Sympathetic ophthalmia, temporal arteritis, uveitis, and ocular inflammatory conditions unresponsive to topical corticosteroids.

Renal diseases: To induce diuresis or remission of proteinuria in idiopathic nephrotic syndrome or that due to lupus erythematosus.

Respiratory diseases: Berylliosis, fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy, idiopathic eosinophilic pneumonias, symptomatic sarcoidosis.

Miscellaneous: Trichinosis with neurologic or myocardial involvement, tuberculous meningitis with subarachnoid block or impending block when used with appropriate antituberculous chemotherapy.

Intra-articular: The intra-articular or soft tissue administration of Cenolon injection is indicated as adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in acute gouty arthritis, acute and subacute bursitis, acute nonspecific tenosynovitis, epicondylitis, rheumatoid arthritis, synovitis or osteoarthritis.

Side Effects Of Injection:-Cenolon IM/IA 40mg/ml 1ml Vial (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations):-

The following adverse reactions may be associated with corticosteroid therapy:

Allergic reactions: Anaphylactoid reaction, anaphylaxis, angioedema.

Cardiovascular: Bradycardia, cardiac arrest, cardiac arrhythmias, cardiac enlargement, circulatory collapse, congestive heart failure, fat embolism, hypertension, tachycardia, thromboembolism, thrombophlebitis, vasculitis.

Dermatologic: Acne, allergic dermatitis, cutaneous and subcutaneous atrophy, dry scaly skin purpura, rash, sterile abscess, striae, suppressed reactions to skin tests, thin fragile skin, thinning scalp hair, urticaria.

Endocrine: Decreased carbohydrate and glucose tolerance, development of cushingoid state, glycosuria, hirsutism, hypertrichosis, increased requirements for insulin or oral hypoglycemic agents in diabetes, manifestations of latent diabetes mellitus, menstrual irregularities, secondary adrenocortical and pituitary unresponsiveness, suppression of growth in pediatric patients.

Fluid and electrolyte disturbances: Congestive heart failure in susceptible patients, fluid retention, hypokalemic alkalosis, potassium loss, sodium retention.

Gastrointestinal: Abdominal distention, bowel/bladder dysfunction, elevation in serum liver enzyme levels, hepatomegaly, increased appetite, nausea, pancreatitis, peptic ulcer with possible perforation and hemorrhage, perforation of the small and large intestine, ulcerative esophagitis.

Metabolic: Negative nitrogen balance due to protein catabolism.

Musculoskeletal: Aseptic necrosis of femoral and humeral heads, calcinosis, Charcot-like arthropathy, loss of muscle mass, muscle weakness, osteoporosis, pathologic fracture of long bones, post injection flare, steroid myopathy, tendon rupture, vertebral compression fractures.

Neurologic/Psychiatric: Convulsions, depression, emotional instability, euphoria, headache, increased intracranial pressure with papilledema usually following discontinuation of treatment, insomnia, mood swings, neuritis, neuropathy, paresthesia, personality changes, psychic disorders, vertigo. Arachnoiditis, meningitis, paraparesis/paraplegia and sensory disturbances have occurred after intrathecal administration.

Ophthalmic: Exophthalmos, glaucoma, increased intraocular pressure, posterior subcapsular cataracts, rare instances of blindness associated with periocular injections.

Pharmacology:-

Triamcinolone Acetonide occurs as a white to cream-colored, crystalline powder having not more than a slight odor and is practically insoluble in water and very soluble in alcohol. It is a synthetic glucocorticoid corticosteroid with anti-inflammatory action. This formulation is suitable for intramuscular and intra-articular use only.

Glucocorticoids, naturally occurring and synthetic, are adrenocortical steroids that are readily absorbed from the gastrointestinal tract. Naturally occurring glucocorticoids (e.g. hydrocortisone), which also have salt-retaining properties, are used as replacement therapy in adrenocortical deficiency states. Synthetic analogs such as triamcinolone are primarily used for their anti-inflammatory effects in disorders of many organ systems. Triamcinolone injection has an extended duration of effect which may be sustained over a period of several weeks. Studies indicate that following a single intramuscular dose of 60 mg to 100 mg of Triamcinolone Acetonide, adrenal suppression occurs within 24 to 48 hours and then gradually returns to normal, usually in 30 to 40 days. This finding correlates closely with the extended duration of therapeutic action achieved with the drug.

4. Triamcinolone Acetonide (Topical).

Cream 1:-Aristocort 0.1% 10gm tube (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Ointment 2:- Aristocort 0.1% 10gm tube (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations).

Indications Of Cream :-Aristocort 0.1% 10gm tube (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations):-

Aristocort topical preparation is indicated for the relief of the inflammatory and pruritic manifestations of corticosteroid responsive dermatoses including atopic dermatitis, contact dermatitis, eczematous dermatitis, neurodermatitis, seborrheic dermatitis, insect bites, lichen simplex chronicus, exfoliative dermatitis, stasis dermatitis, nummular eczema, psoriasis and pruritus ani and vulvae.

Side Effects Of Cream :-Aristocort 0.1% 10gm tube (As a Triamcinolone Acetonide As a Corticosteroid, Glucocorticoids, Triamcinolone & Combined preparations):-

The following local side effects have been reported with topical corticosteroids, either with or without occlusive dressings: burning, itching, irritation, dryness, folliculitis, hypertrichosis, acneiform eruptions, hypopigmentation, perioral dermatitis and allergic contact dermatitis, maceration of the skin, secondary infection, skin atrophy, striae and miliaria.

Pharmacology:-

Triamcinolone Acetonide (a derivative of Triamcinolone) in a compatible base. Topical steroids are primarily effective because of their anti-inflammatory, antipruritic & vasoconstrictive actions.

5. Triamcinolone Acetonide(Dental Paste).

Oral paste:-1.Cenolon 0.1% 10gm tube (As a Triamcinolone Acetonide(Dental Paste). As a Corticosteroid, Glucocorticoids).

Indications Of Oral paste:-Cenolon 0.1% 10gm tube (As a Triamcinolone Acetonide(Dental Paste). As a Corticosteroid, Glucocorticoids).

Cenolon Dental Paste USP, 0.1% is indicated for adjunctive treatment and for the temporary relief of symptoms associated with oral inflammatory lesions and ulcerative lesions resulting from trauma.

Side Effects Of Oral paste:-Cenolon 0.1% 10gm tube (As a Triamcinolone Acetonide(Dental Paste). As a Corticosteroid, Glucocorticoids).

The following local adverse reactions may occur with corticosteroid-containing dental pastes: burning, itching, irritation, dryness, blistering or peeling not present prior to therapy, perioral dermatitis, allergic contact dermatitis, maceration of the oral mucosa, secondary infection, and atrophy of the oral mucosa.

Pharmacology:-

Like other topical corticosteroids, triamcinolone acetonide has anti-inflammatory, antipruritic, and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of topical steroids, in general, is unclear. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

6. Triamcinolone Acetonide(Nasal Spray).

Nasal Spray 1:-Trispray 55mcg/spray 120 metered sprays.(As a Triamcinolone Acetonide(Nasal Spray).

As a Corticosteroid, Glucocorticoids, Nasal Steroid Preparations)

Indications Of Nasal Spray :-Trispray 55mcg/spray 120 metered sprays.(As a Triamcinolone Acetonide(Nasal Spray)

As a Corticosteroid, Glucocorticoids, Nasal Steroid Preparations):-

Trispray nasal spray is indicated for the treatment and prophylaxis of the nasal symptoms of seasonal and perennial allergic rhinitis in adults and children 6 years of age and older.

Side Effects Of Nasal Spray :-Trispray 55mcg/spray 120 metered sprays.(As a Triamcinolone Acetonide(Nasal Spray)

As a Corticosteroid, Glucocorticoids, Nasal Steroid Preparations):-

The most commonly reported adverse reactions in clinical trials with Trispray included those involving mucous membranes of the nose & throat. The most prevalent adverse reactions considered are rhinitis, headache, & pharyngitis. The nasopharyngeal adverse effects included epistaxis, nasal irritation, dry mucous membrane, naso-sinus congestion and sneezing although these are seen as frequently with placebo. As with other nasally inhaled corticosteroids, nasal septal perforation has been reported.

Pharmacology:-

The antiinflammatory actions of corticosteroids are thought to involve lipocortins, phospholipase A2 inhibitory proteins which, through inhibition of arachidonic acid, control the biosynthesis of prostaglandins and leukotrienes. Firstly, however, these glucocorticoids bind to the glucocorticoid receptors which translocate into the nucleus and bind DNA (GRE) and change genetic expression both positively and negatively. The immune system is suppressed by corticosteroids due to a decrease in the function of the lymphatic system, a reduction in immunoglobulin and complement concentrations, the precipitation of lymphocytopenia, and interference with antigen-antibody binding.

Triamcinolone Acetonide is a more potent derivative of Triamcinolone and is approximately 8 times more potent than prednisone. Corticosteroids are very effective in the treatment of allergic diseases in man. When given by intranasal spray, Triamcinolone Acetonide provides relief from allergy-induced watery nasal discharge (rhinorrhea), nasal congestion, postnasal drip, sneezing, and itching of the back of the throat.

14. Neomycin Sulphate+ Polymyxin B Sulphate+Pramoxine:-

Cream 1:-Nuprin (3.5mg+10000IU+10mg)/gm 5gm,10gm,30gm Tube (As a (Neomycin Sulphate+ Polymyxin B Sulphate+Pramoxine) As a Anti-infective & Anesthetic combined preparations).

Indications Of Cream :-Nuprin (3.5mg+10000IU+10mg)/gm 5gm,10gm,30gm Tube (As a (Neomycin Sulphate+ Polymyxin B Sulphate+Pramoxine) As a Anti-infective & Anesthetic combined preparations):-

This is a first aid cream. It prevents infections and provides temporary relief of pain or discomfort in minor cuts, scrapes and burns.

Side Effects Cream :-Nuprin (3.5mg+10000IU+10mg)/gm 5gm,10gm,30gm Tube (As a (Neomycin Sulphate+ Polymyxin B Sulphate+Pramoxine) As a Anti-infective & Anesthetic combined preparations):-

Pharmacology:-

15.Metronidazole+ Neomycin Sulphate+ Polymyxin B+Nystatin:-

Vaginal supposidory:-1.Gynepro As a (Metronidazole+ Neomycin Sulphate+ Polymyxin B+Nystatin) As a Drugs used in Vaginal and Vulval condition).

Indications Of Vaginal supposidory:-Gynepro As a (Metronidazole+ Neomycin Sulphate+ Polymyxin B+Nystatin) As a Drugs used in Vaginal and Vulval condition):-

Gynepro is indicated in-

Vaginal trichomoniasis
Vaginal leucorrhoeas
Mixed vaginal infections (Fungal or Bacterial).

Side Effects Of Vaginal supposidory:-Gynepro As a (Metronidazole+ Neomycin Sulphate+ Polymyxin B+Nystatin) As a Drugs used in Vaginal and Vulval condition):-

Skin rash, urticaria may occur rarely.

Pharmacology:-

Metronidazole, a nitroimidazole, is active against various anerobic bacteria and protozoa. Nystatin is a polyene antibiotic with antifungal activity. Neomycin is an aminoglycoside. It is bactericidal and active against some gram-positive and gram-negative organisms. Polymyxin is active against gram-negative organisms including Pseudomonas aeruginosa.

Other component Or Preparation of Metronidazole:-

1.Metronidazole(Orally):-

Tablet 1:-Flamyd 250mg,500mg, (As a Metronidazole As a Amoebicides, Anti-diarrhoeal Antiprotozoal.)

Indications Of Tablet :-Flamyd 250mg,500mg, (As a Metronidazole As a Amoebicides, Anti-diarrhoeal Antiprotozoal.):-

Flamyd is indicated in the treatment of following diseases:

The prevention of post-operative infections due to anaerobic bacteria (particularly species of bacteroides and anaerobic streptococci).
The treatment of septicaemia, bacteraemia, peritonitis, brain abscess, pelvic abscess, pelvic cellulitis and post-operative wound infections caused by anaerobes.
In the treatment of urogenital trichomoniasis.
Bacterial vaginosis (also known as non-specific vaginitis).
All forms of amoebiasis (intestinal, extra-intestinal disease and that of symptomless cyst passers).
Giardiasis.
Acute ulcerative gingivitis.
Anaerobically infected leg ulcers and pressure sores.
Acute dental infections due to anaerobic organisms.
Antibiotic associated pseudomembranus colitis.

Side Effects Of Tablet :-Flamyd 250mg,500mg, (As a Metronidazole As a Amoebicides, Anti-diarrhoeal Antiprotozoal.):-

Metallic taste, nausea, vomiting, diarrhoea, drowsiness, rashes may be observed during treatment.

Pharmacology:-

Metronidazole is a member of the imidazole class of antibacterial drug and is classified therapeutically as an antiprotozoal agent. The 5-nitro group of Metronidazole is reduced by anaerobes metabolically. Studies have demonstrated that the reduced form of this drug interacts with DNA and gives bactericidal action of Metronidazole.

IV infusion 2:- Flamyd 500mg/100ml 100ml bottle.

Oral suspension 3:- Flamyd 200mg/5ml 60ml bottle.

Vaginal Gel 4. Flamyd-V 1.3% 5gm tube.

2.Metronidazole+Miconazole Nitrate:-

Vaginal Tablet 1:-Ametrol-VT (100mg+100mg) (As a Metronidazole+Miconazole Nitrate As a Drugs used in Vaginal and Vulval condition).

Indications Of Vaginal Tablet :-Ametrol-VT (100mg+100mg) (As a Metronidazole+Miconazole Nitrate As a Drugs used in Vaginal and Vulval condition):-

Vaginal treatment of female urogenital trichomonas infection, prevention & local therapy of candidiasis.

Side Effects Vaginal Tablet :-Ametrol-VT (100mg+100mg) (As a Metronidazole+Miconazole Nitrate As a Drugs used in Vaginal and Vulval condition):-

Nausea, vomiting, febrile reactions, rash, drowsiness, diarrhoea, anorexia and flushing, hepatitis. Local irritation and sensitisation, contact dermatitis.

Pharmacology:-

Metronidazole is converted to reduction products that interact with DNA to cause destruction of helical DNA structure and strand leading to a protein synthesis inhibition and cell death in susceptible organisms. It is active against most anaerobic protozoa, some gm+ve, gm-ve and facultative anaerobes.

Miconazole inhibits ergosterol synthesis thus damaging fungal cell wall membrane and increases its permeability, allowing leakage of nutrients.

3. Miconazole Nitrate:-

Oral Gel 1:-Candoral 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.)

Indications Of Oral Gel :-Candoral 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.):-

Fungidal oral gel is indicated-

For the treatment of oral and gastrointestinal candidiasis.
For eradication of fungal colonization in the mouth and gastrointestinal tract.
For the treatment of super infections due to gram-positive bacteria.

Fungidal cream is indicated in dermatomycoses, e.g.:

Tinea pedis (Athlete’s foot)
Tinea corporis (Tinea circinata)
Tinea manuum
Tinea cruris due to: Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum audouinii, Epidermophyton floccosum
Candidial infections
Tinea versicolor.
Infections of the skin (e.g. intertrigo)
Perianal infections
Stomatitis angularis (cheilitis)
Balanoposthitis
Otitis externa

In addition miconazole cream has a very rapid alleviating effect on the pruritis which frequently accompanies infection.

Side Effects Oral Gel :-Candoral 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.):-

Occasionally nausea and vomiting, diarrhea with long term use and rarely allergic reactions.

Pharmacology:-

Pharmacodynamics: Miconazole possesses an antifungal activity against the common dermatophytes and yeasts as well as an antibacterial activity against certain gram-positive bacilli and cocci. Its activity is based on the inhibition of a demethylation step in the ergosterol biosynthesis. Ergosterol, the end-product of the biosynthetic pathway and the main sterol in yeast and fungi. The disruption in production of ergosterol disrupts the fungal cell membrane, causing holes to appear in it. These holes allow the essential constituents of the fungal cells to leak out and ultimately the fungal cells die.

Pharmacokinetics: The oral bioavailability of Miconazole is low (25-30%) because there is little absorption of Miconazole from the intestinal tract. Miconazole is systemically absorbed after administration as the oral gel. Absorbed Miconazole is bound to plasma proteins (88.2%), primarily to serum albumin and red blood cells (10.6%). The absorbed portion of Miconazole oral gel is largely metabolized; less than 1% of the administered dose is excreted unchanged in the urine. The terminal plasma half-life is 20-25 hours in most patients. The elimination half-life of Miconazole is similar in any renal impaired patient.

Cream 2:-Fungidal 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.)

Indications Of Cream :- Fungidal 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.):-

Fungidal oral gel is indicated-

For the treatment of oral and gastrointestinal candidiasis.
For eradication of fungal colonization in the mouth and gastrointestinal tract.
For the treatment of super infections due to gram-positive bacteria.

Fungidal cream is indicated in dermatomycoses, e.g.:

Tinea pedis (Athlete’s foot)
Tinea corporis (Tinea circinata)
Tinea manuum
Tinea cruris due to: Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum audouinii, Epidermophyton floccosum
Candidial infections
Tinea versicolor.
Infections of the skin (e.g. intertrigo)
Perianal infections
Stomatitis angularis (cheilitis)
Balanoposthitis
Otitis externa

In addition miconazole cream has a very rapid alleviating effect on the pruritis which frequently accompanies infection.

Side Effects Cream:-Fungidal 2%w/w 15gm tube (As a Miconazole Nitrate As a Aural Anti-fungal preparations.):-

Occasionally nausea and vomiting, diarrhea with long term use and rarely allergic reactions.

Pharmacology:-

Other Component or Preparation Of Miconazole Nitrate :-

1.Miconazole Nitrate+Zinc Oxide+White soft Paraffin:-

Ointment 1:-De-Rash Plus (0.25%+15%+81.35%) 30gm tube As a Miconazole Nitrate+Zinc Oxide+White soft Paraffin As a diaper dermatitis associated with fungal infection.

Indication:-

De-rash^® Plus Ointment is indicated for the treatment of diaper dermatitis associated with fungal infection.

✅ Description:

De-Rash Plus is designed for children to effectively treat diaper rash accompanied by a yeast infection. It works in conjunction with proper diaper area hygiene and frequent diaper changes.

Active Ingredients:

Miconazole: An azole antifungal agent that inhibits the growth of fungus, addressing the underlying yeast infection.
Zinc Oxide and white soft paraffin: These ingredients create a protective barrier on the skin, shielding it from moisture and potential irritation.

De-Rash Plus should not be used as a long-term solution or for the prevention of diaper rash.

Ensure proper hygiene and frequent diaper changes alongside the use of De-Rash Plus.
Prolonged or improper use can diminish its efficacy.
Consult a healthcare professional for persistent or worsening symptoms.

De-Rash Plus should be used with caution, considering potential allergies, interactions, and specific population considerations such as infants, the elderly, and breastfeeding women. Always consult with your doctor before starting or adjusting the medication, especially if you are taking other medicines like Warfarin or Ethinyl Estradiol.

✔️ Side Effects of De-Rash Plus

Serious Side Effects: If you experience any of the following side effects, seek medical attention immediately:

Incidence Not Known:
- Blistering, burning, crusting, dryness, flaking, itching, scaling, or severe redness, soreness, or swelling of the skin.
- Falling off of skin.

Less Serious Side Effects: Some side effects may not require medical attention and might diminish as your body adjusts to the medication. However, if they persist or cause significant discomfort, consult your healthcare professional:

Incidence Not Known:
- Vomiting.

2. Miconazole Nitrate+Hydrocortisone:-

Cream 1:-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations.)

Indications Of Cream:-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations.):-

For the topical treatment of inflamed dermatoses where infection by susceptible organisms and inflammation coexist e.g. intertrigo and infected eczema. For moist or dry eczema or dermatitis including atopic eczema, primary irritant or contact allergic eczema or seborrheic eczema including that associated with acne. Also for interiginous eczema including inflammatory interigo, perianal and genital dermatitis. Organisms which are susceptible to miconazole are dermatophytes and pathogenic yeasts (e.g. Candida spp.): also many Gram-positive bacteria including many strains of Streptococcus and Staphylococcus.

Side Effects Indications Of Cream:-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations.):-

Rarely local sensitivity may occur. Long term use may decrease in the production of natural hormones by the adrenal gland.

Pharmacology:-

Miconazole is a substituted imidazole, is one of the family of azoles useful in treating the superficial candidiasis and of the skin infections dermatophytosis and pityriasis versicolor, acanthameaba, seborrhoic dermatitis. Also active against Aspergillus spp., Cryptococcus neoformans, Pseudalescheria boydii and some gram-positive bacteria including Staphylococci and Streptococci.

Hydrocortisone is a naturally occurring glucocorticoid that’s now prepared synthetically. Its important function is in the skin injury such as inflammation. Also it has antipruritic, antimycotic and vasoconstrictive activity.

Miconazole is imidazole antifungal agents that interfere with ergosterol synthesis and therefore alters the permeability of the cell membrane of sensitive fungi. Thus causes the killing of fungi, when applied to the skin, Hydrocortisone is absorbed into the skin cells. It prevents the release of certain chemicals, which is responsible for inflammation. Thus hydrocortisone reduces inflammation.

16.Fluormetholone+ Neomycin Sulphate:-

Ophthalmic Solutions:-Eye drop1.Flumelone-N (0.1%+0.5%) 5ml drop (As a Fluormetholone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations.)

Indications Of Ophthalmic Solutions:-Eye drop1.Flumelone-N (0.1%+0.5%) 5ml drop (As a Fluormetholone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations.):-

This ophthalmic solution is used for the treatment of conjunctivitis (sticky eyes) due to organisms sensitive to neomycin. This may be used for the treatment of infections at the front of the eye by bacteria sensitive to the antibiotic neomycin. This can be used following removal of something from your eye, as well as before and after surgery, where there is a possibility of infection with susceptible organisms.

Side Effects Of Ophthalmic Solutions:-Eye drop1.Flumelone-N (0.1%+0.5%) 5ml drop (As a Fluormetholone+ Neomycin Sulphate As a Ophthalmic steroid – antibiotic combined preparations.):-

The following side effects may occur: Increased eye pressure (glaucoma), loss of part of the usual field of vision, blurred vision, cataracts (cloudy lens), eye irritation, red eye, eye pain, foreign body sensation, eyelid or eye swelling, itchy or watery eye, ulcers on the surface of the eye, secondary eye infections from fungi or viruses, skin rash, allergic reactions, change in your sense of taste.

Pharmacology:-

There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Their primary target is the cytosolic glucocorticoid receptor. After binding the receptor the newly formed receptor-ligand complex translocates itself into the cell nucleus, where it binds to many glucocorticoid response elements (GRE) in the promoter region of the target genes. The DNA bound receptor then interacts with basic transcription factors, causing the increase in expression of specific target genes.

Like other aminoglycoside antibiotic drugs, neomycin inhibits bacterial ribosomes by binding to the 30S ribosomal subunit of susceptible bacteria and disrupting the translational machinery of bacterial pro

17.Hydrocortisone+ Neomycin Sulphate+ Polymyxin B:-

Ear drop 1:-Polymix-H (10mg+3400unites+10000unites)/ml (As a Hydrocortisone+ Neomycin Sulphate+ Polymyxin B As a

Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations.).

Indications Of Ear drop :-Polymix-H (10mg+3400unites+10000unites)/ml (As a Hydrocortisone+ Neomycin Sulphate+ Polymyxin B As a

Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations.):-

Hydrocortisone, Neomycin Sulphate & Polymixin B ear drops are indicated for the treatment of bacterial ear infections. It will not work for other types of ear infections. Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness.

Side Effects Of Ear drop :-Polymix-H (10mg+3400unites+10000unites)/ml (As a Hydrocortisone+ Neomycin Sulphate+ Polymyxin B As a

Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations.):-

The following side effects rarely may happen with this medicine: seem to get worse instead of better, become red, scaly and itchy.

Pharmacology:-

Polymyxin B sulphate and neomycin sulphate belong to a group of medicines called antibiotics. They kill the germs that can cause ear infections. The anti-infective components in the combination are included to provide action against specific organisms susceptible to them. Neomycin sulfate and polymyxin B sulfate together are considered active against the following microorganisms: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella-Enterobacter species, Neisseria species, and Pseudomonas aeruginosa. This product does not provide adequate coverage against Serratia marcescens and streptococci, including Streptococcus pneumoniae.

Hydrocortisone belongs to a group of medicines called steroids. It helps to reduce the swelling and irritation caused by the infection. Hydrocortisone suppress the inflammatory response to a variety of agents and they may delay healing. Since Hydrocortisone may inhibit the body’s defense mechanism against infection, a concomitant antimicrobial drug may be used when this inhibition is considered to be clinically significant in a particular case.

18.Hydrocortisone Acetate+ Neomycin Sulphate:-

Cream 1:-Remacort-N (0.5%+0.5%) 15gm tube (As a Hydrocortisone Acetate+ Neomycin Sulphate As a Hydrocortisone & Combined preparations, Local Antipruritic)

Indications Of Cream :-Remacort-N (0.5%+0.5%) 15gm tube (As a Hydrocortisone Acetate+ Neomycin Sulphate As a Hydrocortisone & Combined preparations, Local Antipruritic):-

Remacort N is indicated in Allergic skin conditions, Anal or vulvar pruritus, Anal pruritus, Burns, Eczema, Infected wounds & ulcers, Pain and itching caused by sunburn, Pruritic skin conditions, Pruritus, Pruritus and eczema, Pyogenic & seborrhoeic dermatitis, Seborrhoeic dermatitis, Ulcers, Vaginal or rectal irritation, Wounds

Side Effects Of Cream :-Remacort-N (0.5%+0.5%) 15gm tube (As a Hydrocortisone Acetate+ Neomycin Sulphate As a Hydrocortisone & Combined preparations, Local Antipruritic):-

Burning, itching, irritation, hypopigmentaion, skin atrophy, striae.

Pharmacology:-

Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.

Neomycin is an aminoglycoside antibiotic. It binds to 30S ribosomal subunits of bacterial ribosome thus inhibiting protein synthesis and generating errors in genetic code transcription causing cell death. It acts against many gram-negative aerobes and some gram-positive aerobes. It lacks activity against fungi, viruses and most anaerobic bacteria

Other Component or Preparation Of Hydrocortisone:-

Index of Hydrocortisone Sub Class:-

1.Acyclovir+Hydrocortisone.

2.Cinchocaine+ Hydrocortisone+Neomycin+Esculin.

3.Clotrimazole+ Hydrocortisone.

4.Gentamycin+ Hydrocortisone Acetate.

5.Hydrocortisone+Lidocaine.

6. Hydrocortisone.

7. Hydrocortisone Butyrate.

8. Cinchocaine+ Hydrocortisone+ Framycetin +Esculin.

9.Ciprofloxacin+ Hydrocortisone Acetate

10.Fusidic Acid+ Hydrocortisone.

11. Hydrocortisone+Neomycin Sulphate+Polymixin-B.

12. Hydrocortisone Acetate+Benzyl Benzoate+Bismuth Subgallate+Bismuth Oxide+Balsam peru+Zinc Oxide.

13.Miconazole Nitrate+Hydrocortisone.

1.Acyclovir+Hydrocortisone:-

Cream 1:-Virux-HC (5%+1%) 10gm tube (As a Acyclovir+Hydrocortisone As a Hydrocortisone & Combined preparations)

Indications Of Cream :-Virux-HC (5%+1%) 10gm tube (As a Acyclovir+Hydrocortisone As a Hydrocortisone & Combined preparations):-

Acyclovir & Hydrocortisone Cream is indicated for the early treatment of recurrent herpes labialis (cold sores) to reduce the likelihood of ulcerative cold sores and to shorten the lesion healing time in adults and children (6 years of age and older).

Side Effects Of Cream :-Virux-HC (5%+1%) 10gm tube (As a Acyclovir+Hydrocortisone As a Hydrocortisone & Combined preparations):-

The following most common adverse reactions (<1%) were local skin reactions like drying or flaking of the skin; burning or tingling, erythema; pigmentation changes, application site reactions including signs and symptoms of inflammation.

Pharmacology:-

Acyclovir is a synthetic purine nucleoside analogue with inhibitory activity against Herpes simplex viruses type 1 (HSV-1) and type 2 (HSV-2) in cell culture and in vivo. The inhibitory activity of Acyclovir is highly selective due to its affinity for the enzyme thymidine kinase (TK) encoded by HSV. This viral enzyme converts Acyclovir into Acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. In cell culture, Acyclovir Triphosphate stops replication of herpes viral DNA. This inhibition is accomplished in 3 ways:

Competitive inhibition of viral DNA polymerase
Incorporation into and termination of the growing viral DNA chain
Inactivation of the viral DNA polymerase

Hydrocortisone is the main glucocorticoid secreted by the adrenal cortex. It is used topically for its anti-inflammatory effects which suppress the clinical manifestations of the disease in a wide range of disorders where inflammation is a prominent feature.

Other component or Preparation Of Acyclovir:-

1.Acyclovir(Oral):-

Tablet 1:-Virux 200mg,400mg,As a Acyclovir (As a Herpes simplex & Varicella-zoster virus infections)

Indications Of Tablet :-Virux 200mg,400mg,As a Acyclovir (As a Herpes simplex & Varicella-zoster virus infections):-

Aciclovir is indicated for-

The treatment of viral infections due to Herpes simplex virus (type I & II) and Varicella zoster virus (herpes zoster & chicken pox).
The treatment of Herpes simplex virus infections of the skin and mucous membranes including initial and recurrent genital herpes and herpes labialis.
The prophylaxis of Herpes simplex infections in immunocompromised patients

Side Effects Of Tablet :-Virux 200mg,400mg,As a Acyclovir (As a Herpes simplex & Varicella-zoster virus infections):-

Rash, gastrointestinal disturbance, rise in bilirubin and liver-related enzymes, increase in blood urea and creatinine, decrease in hematological indices, headache, neurological reaction, fatigue.

Pharmacology:-

Aciclovir is a synthetic purine derivative. Aciclovir exerts its antiviral effect on Herpes simplex virus (HSV) and Varicella-zoster virus by interfering with DNA synthesis and inhibiting viral replication. In cells infected with herpes virus, the antiviral activity of Aciclovir appears to depend principally on the intracellular conversion of the drug to Aciclovir Triphosphate. Aciclovir is converted to Aciclovir Monophosphate principally via virus coded thymidine kinase; the monophosphate is phosphorylated to the diphosphate via cellular guanylate kinase and then via another cellular enzyme to the triphosphate, which is the pharmacologically active form of the drug. 15-30% of an oral dose of the drug is absorbed from Gl tract. Peak plasma concentrations usually occur within 1.5-2 hours after oral administration. It is widely distributed into body tissues and fluids including the brain, saliva, lungs, liver, muscle, spleen, uterus, vaginal mucosa and secretions, CSF, and herpetic vesicular fluid. Aciclovir is excreted through the kidney by the glomerular filtration & tubular secretion.

Oral suspension 2:-Virux 200mg/5ml 70ml bottle.

2. Acyclovir (Injection).

IV Infusion 1:-Simplovir 250mg,1gm/vial,500mg/vial (As a Acyclovir As a Herpes simplex & Varicella-zoster virus infections)

Indications Of IV Infusion :-Simplovir 500mg/vial (As a Acyclovir As a Herpes simplex & Varicella-zoster virus infections):-

Simplovir intravenous infusion is indicated for the treatment of-

Acute clinical manifestations of Herpes simplex virus in immunocompromised patients
Severe primary or non-primary genital herpes in immune competent patients
Varicella zoster virus infection in immunocompromised patients
Herpes zoster (shingles) in immune competent patients who show very severe acute local or systemic manifestations of the disease
Herpes simplex encephalitis

Side Effects Of IV Infusion :-Simplovir 500mg/vial (As a Acyclovir As a Herpes simplex & Varicella-zoster virus infections):-

Some infrequent adverse reactions are lethargy, obtundation, tremors, confusion, hallucinations, agitation, somnolence, psychosis, convulsions and coma, phlebitis, nausea, vomiting, reversible increases in liver-related enzymes, pruritus, urticaria, rashes, increases in blood urea and creatinine. Local inflammatory reactions may occur if Simplovir IV Infusion is inadvertently infused into extracellular tissues.

Pharmacology:-

Acyclovir exerts its antiviral eects on Herpes simplex virus and Varicella zoster virus by interfering with DNA synthesis and inhibiting viral replication. In cells infected with Herpes virus, the antiviral activity of Acyclovir appears to depend principally on the intracellular conversion of the drug to Acyclovir Triphosphate. Acyclovir is converted to Acyclovir Monophosphate principally via virus coded thymidine kinase, the monophosphate is phosphorylated to diphosphate via cellular guanylate kinase and then via other cellular enzymes to the Triphosphate, which is the pharmacologically active form of the drug.

3. Acyclovir(Ophthalmic).

Ophthalmic Ointment/Eye ointment:-1.Acyvir 3% 5gm tube (As a Acyclovir As a Ophthalmic Anti-viral Products).

Indications Of Ophthalmic Ointment/Eye ointment:-Acyvir 3% 5gm tube (As a Acyclovir As a Ophthalmic Anti-viral Products):-

Acyvir is indicated for the treatment of Herpes simplex keratitis.

Side Effects Of Ophthalmic Ointment/Eye ointment:-Acyvir 3% 5gm tube (As a Acyclovir As a Ophthalmic Anti-viral Products):-

Very common: Superficial punctate keratopathy. This did not necessitate an early termination of therapy and healed without apparent sequelae. Common: Transient mild stinging of the eye occurring immediately following application, conjunctivitis. Rare: Blepharitis.

Pharmacology:-

Acyclovir is an antiviral agent which is highly active in vitro against Herpes simplex (HSV) types I and II and Varicella zoster viruses, but its toxicity to mammalian cells is low. Acyclovir is phosphorylated to the active compound Acyclovir triphosphate after entry into herpes infected cell. The first step in this process requires the presence of the viral-coded thymidine kinase. Acyclovir triphosphate acts as an inhibitor of and substrate for the herpes specified DNA polymerase preventing further viral DNA synthesis without affecting normal cellular processes.

4. Acyclovir(Topical).

Cream 1:-Virux 5% As a Acyclovir As a Topical Antiviral preparations.

Indications Of Cream :-Virux 5% (As a Acyclovir As a Topical Antiviral preparations):-

Virux cream is a herpes simplex virus (HSV) nucleoside analogue DNA polymerase inhibitor indicated for the treatment of recurrent herpes labialis (cold sores) in immunocompetent adults and adolescents 12 years of age and older.

Side Effects Of Cream :-Virux 5% (As a Acyclovir As a Topical Antiviral preparations):-

The most common adverse reactions at the site of topical application were dry lips, desquamation, dryness of skin, cracked lips, burning skin, pruritus, flakiness of skin, and stinging on skin; each adverse reaction occurred in less than 1% of patients receiving Virux cream and placebo. Three patients on Virux cream and one patient on placebo discontinued treatment due to an adverse event.

Pharmacology:-

Acyclovir is an antiviral drug active against herpes simplex virus. Acyclovir is a synthetic purine nucleoside analogue with cell culture and in vivo inhibitory activity against HSV types 1 (HSV-1) and 2 (HSV-2). The inhibitory activity of acyclovir is highly selective due to its affinity for the enzyme thymidine kinase (TK) encoded by HSV. This viral enzyme converts acyclovir into acyclovir monophosphate, a nucleotide analogue. The monophosphate is further converted into diphosphate by cellular guanylate kinase and into triphosphate by a number of cellular enzymes. In cell culture, acyclovir triphosphate stops replication of herpes viral DNA. This inhibition is accomplished in 3 ways: 1) competitive inhibition of viral DNA polymerase, 2) incorporation into and termination of the growing viral DNA chain, and 3) inactivation of the viral DNA polymerase.

2.Cinchocaine+ Hydrocortisone+Neomycin+Esculin.

Ointment 1:-Anorel (5mg+5mg+10mg+10mg) 15gm tube (As a Cinchocaine+ Hydrocortisone+Neomycin+Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region).

Suppository 2:-Ariproct (5mg+5mg+10mg+10mg) (As a Cinchocaine+ Hydrocortisone+Neomycin+Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region).

Indications Of Ointment :-Anorel (5mg+5mg+10mg+10mg) 15gm tube (As a Cinchocaine+ Hydrocortisone+Neomycin+Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region):-

This is indicated for-

Internal and external hemorrhoids
Post-partum hemorrhoidal condition
Anal pruritus, peri-anal eczema, anal fissures and proctitis
Post-hemorrhoidectomy application to relieve pain and discomfort

Side Effects Of Ointment :-Anorel (5mg+5mg+10mg+10mg) 15gm tube (As a Cinchocaine+ Hydrocortisone+Neomycin+Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region):-

Side effects which have been reported for individual constituents may occur and appropriate precautions should be taken when using Anorel.

Pharmacology:-

3.Clotrimazole+ Hydrocortisone:-

Cream 1:-Neosten-HC (1%+1%) 10gm tube,20gm tube As a Clotrimazole+ Hydrocortisone As a Hydrocortisone & Combined preparations.

Indications Of Cream :-Neosten-HC (1%+1%) 10gm tube,20gm tube (As a Clotrimazole+ Hydrocortisone As a Hydrocortisone & Combined preparations):-

The treatment of fungal infections where co-existing symptoms of inflammation e.g. itching, require rapid relief.

All dermatomycoses due to dermatophytes (e.g. Trichophyton species), moulds and other fungi.
All dermatomycoses due to yeasts (Candida species).
Skin diseases showing secondary infection with these fungi
The treatment of nappy rash where infection due to Candida albicans is present.

Side Effects Of Cream :-Neosten-HC (1%+1%) 10gm tube,20gm tube (As a Clotrimazole+ Hydrocortisone As a Hydrocortisone & Combined preparations):-

Rarely local mild burning or irritation may be experienced. Hypersensitivity reactions may occur.

Pharmacology:-

Clotrimazole is a broad-spectrum antifungal agent active on dermatophytes, yeasts and other fungi. Hydrocortisone is a glucocorticoid with both glucocorticoid and to a lesser extent mineralocorticoid activity. Hydrocortisone is used for replacement therapy in adrenocortical insufficiency.

Other component or Preparation of Clotrimazole:-

Sub Class of Clotrimazole:- Index of Clotrimazole:-

1.Clotrimazole(Ear drop).

2.Docusate Sodium (Ear drop).

3. Clotrimazole (Topical).

4. Clotrimazole(Eye Ointment).

5. Clotrimazole(Vaginal Tablet).

6.Beclomethasone Dipropionate+Chloramphenicol+ Clotrimazole+Lidocaine.

7.Betamethasone+Clotrimazole.

8. Betamethasone+Clotrimazole+Gentamicin.

9.Ofloxacin+ Clotrimazole+ Beclomethasone+Lidocaine.

Description:-

1.Clotrimazole(Ear drop).

Ear drop 1:-Clarizol 1% 10ml drop (As a Clotrimazole As a Aural Anti-fungal preparations.)

Indications Of Ear drop :-Clarizol 1% 10ml drop (As a Clotrimazole As a Aural Anti-fungal preparations.):-

Clarizol ear drop is indicated for the treatment of fungal infections of the ear.

Side Effects Of Ear drop :-Clarizol 1% 10ml drop (As a Clotrimazole As a Aural Anti-fungal preparations.):-

Clarizol is generally well tolerated after local application but the few side effects have been reported infrequently like erythema, stinging, edema, pruritus and general irritation.

Pharmacology:-

Clotrimazole kills fungi and yeasts by interfering with their cell membranes. It works by stopping the production of ergosterol, which is an essential component of fungal cell membranes resulting in increased membrane permeability and leakage of essential constituents of the fungal cells.

2.Docusate Sodium (Ear drop).

Ear Drop 1.Waxsol 0.5% 10ml drop (As a Docusate Sodium As a Cerumenolytic).

Indications Of Ear Drop :-Waxsol 0.5% 10ml drop (As a Docusate Sodium As a Cerumenolytic):-

Waxsol ear drops is indicated as an aid in the removal of ear wax.

Side Effects Of Ear Drop :-Waxsol 0.5% 10ml drop (As a Docusate Sodium As a Cerumenolytic):-

Immune system disorders: hypersensitivity/allergic reactions; Skin disorders: contact dermatitis and allergic skin reactions; General disorders: Application site reactions rarely including transient stinging or irritation may occur.

Pharmacology:-

Ear wax which often obstructs the external auditory meatus of the ear contains less than 50% of fatty matter derived from secretions of the sebaceous ceruminous glands. The majority of the wax consists of desquamated epithelium, foreign matter and shed hairs. This non-fatty material forms a matrix holding together the granules of fatty matter to form the ceruminous mass. The addition of oils or solvents binds the mass more firmly together, but aqueous solutions, if they are able to penetrate the matrix, cause a disintegration of the ceruminous mass. Docusate Sodium ear drops, because of their low surface tension and miscibility, rapidly penetrate the dry matrix of the ceruminous mass, reducing the solid ear wax to a semi-solid debris.

3. Clotrimazole (Topical).

Cream 1:-Clarizol 1% 10gm tube (As a Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations).

Topical soultion2:- Clarizol 1% 20ml bottle (As a Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations).

Indications Of Cream :-Clarizol 1% 10gm tube (As a Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

All dermatomycoses due to dermatophytes (e.g.Trichophyton species).
All dermatomycoses due to yeasts (Candida species).
Dermatomycoses due to moulds and other fungi.
Skin diseases showing superinfections with these fungi.

Some examples of skin infections included in above points are interdigital mycoses (e.g. athlete’s foot), paronychias (associated with nail mycoses), mycoses in skin folds, Candida vulvitis, Candida balanitis, Pityriasis versicolor, erythrasma.

Side Effects Of Cream :-Clarizol 1% 10gm tube (As a Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

When applied topically, Clarizol is well tolerated.With external application, systemic effects are not observed. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.

Pharmacology:-

Clotrimazole acts primarily by damaging the permeability barrier in the cell membrane of fungi. Clotrimazole causes inhibition of ergosterol biosynthesis, an essential constituent of fungal cell membranes. If ergosterol synthesis is either completely or partially inhibited, the cell is no longer able to construct an intact and functional cell membrane. Because ergosterol directly promotes the growth of fungal cells in a hormone‐like fashion, rapid onset of the above events leads to dose-dependent inhibition of fungal growth.

Though decreased ergosterol, due to the inhibition of lanosterol 14-demethylase (also known as CYP51) is accepted to be primarily responsible for the antimycotic properties of clotrimazole, this drug also shows other pharmacological effects. These include the inhibition of sarcoplasmic reticulum Ca²⁺ ATPase, depletion of intracellular calcium, and blocking of calcium‐dependent potassium channels and voltage‐dependent calcium channels. The action of clotrimazole on these targets accounts for other effects of this drug that are separate from its antimycotic activities.

4. Clotrimazole(Eye Ointment).

Ophthalmic/Eye ointment:-1.Aristen 1% 4gm tube As a Clotrimazole As a Ophthalmic Anti-fungal Products.

Indications Of Ophthalmic/Eye ointment:-Aristen 1% 4gm tube As a Clotrimazole As a Ophthalmic Anti-fungal Products:-

Aristen sterile eye ointment is indicated for the treatment of fungal keratitis due to filamentous fungi and Candida species.

Side Effects Of Ophthalmic/Eye ointment:-Aristen 1% 4gm tube As a Clotrimazole As a Ophthalmic Anti-fungal Products:-

Rarely patients may experience burning or irritation immediately after applying the ointment.

Pharmacology:-

5. Clotrimazole(Vaginal Tablet).

Vaginal Tablet 1:-Afun-VT 200mg,As a Clotrimazole (As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations).

Indications Of Vaginal Tablet :-Afun-VT 200mg,As a Clotrimazole (As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations):-

Afun VT rectal preparation is indicated in vaginal itching, burning and discharge associated with recurrent vaginal yeast infections (Vaginal candidiasis) and also in viginitis due to Candida species as well as Mycotic infections complicated by other microorganisms sensitive to the drug.

Side Effects Of Vaginal Tablet :-Afun-VT 200mg,As a Clotrimazole (As a Drugs used in Vaginal and Vulval condition, Topical Antifungal preparations):-

Since there is practically no Afun VT absorption through the vaginal skin, no systemic effect is expected. The local tolerance of Afun VT vaginal tablet is generally good. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.

Pharmacology:-

Clotrimazole is a broad-spectrum antifungal agent that is used for the treatment of dermal infections caused by various species of pathogenic dermatophytes, yeasts, moulds and bacteroids. Clotrimazole is also active against certain gram-positive bacteria especially Staphylococci and Tricomonas. Like other imidazoles, Clotrimazole alters the permeability of fungal cell walls by interfering with cell wall lipids. At fungi static levels the main effect is inhibition of ergosterol synthesis but at higher concentrations there is an additional mechanism of membrane damage unrelated to sterol synthesis.

Vaginal Tablet 2:-Dermasim-VT 500mg

6.Beclomethasone Dipropionate+Chloramphenicol+ Clotrimazole+Lidocaine:-

Ear drop 1:-Candibac (0.025%+5%+1%+1.73%) 5ml drop (As a Beclomethasone Dipropionate+Chloramphenicol+ Clotrimazole+Lidocaine As a Anti-fungal or anti-bacterial ear drops.).

Indications Of Ear drop :-Candibac (0.025%+5%+1%+1.73%) 5ml drop (As a Beclomethasone Dipropionate+Chloramphenicol+ Clotrimazole+Lidocaine As a Anti-fungal or anti-bacterial ear drops.):-

Formidable combination for ear infections-

Safe and effective combination in otitis externa & otitis media with the perforated ear.
Shows higher efficacy of Clotrimazole to treat Otomycosis.
Shows excellent pain reduction of lidocaine to treat acute otitis media.

Side Effects Of Ear drop :-Candibac (0.025%+5%+1%+1.73%) 5ml drop (As a Beclomethasone Dipropionate+Chloramphenicol+ Clotrimazole+Lidocaine As a Anti-fungal or anti-bacterial ear drops.):-

The following is a list of possible side effects that may occur from all constituting ingredients of Chloramphenicol Beclomethasone & Clotrimazole Ear Drops. This is not a comprehensive list. These side effects are possible but do not always occur. Some of the side effects may be rare but serious. Consult your doctor if you observe any of the following side effects, especially if they do not go away.

Inflammation Of The Skin
Irritation
Itchy Rash
Blisters
Peeling Or Flaking Of The Skin
Discomfort.

Pharmacology:-

Beclometasone, Chloramphenicol, Clotrimazole & Lidocaine which treats ear infections. Lidocaine is a local anesthetic which works by blocking pain signals from the nerves to brain thereby decreasing pain sensation. Beclometasone is a steroid medicine. It blocks the production of certain chemical messengers (prostaglandins) that make the ear red, swollen and itchy. Clotrimazole is an antifungal which stops the growth of fungi by preventing them from forming their own protective covering. Chloramphenicol is an antibiotic. It stops bacterial growth by preventing synthesis of essential proteins.

7.Betamethasone+Clotrimazole:-

Ointment 1:-Topibet-CL (0.1%+1%) 10gm tube (As a Betamethasone+Clotrimazole As a Betamethasone & Combined preparations.)

Cream 2:- Topibet-CL (0.05%+1%) 10gm tube (As a Betamethasone+Clotrimazole As a Betamethasone & Combined preparations.)

Indications Of Ointment :-Topibet-CL (0.1%+1%) 10gm tube (As a Betamethasone+Clotrimazole As a Betamethasone & Combined preparations.):-

This topical preparation is indicated for the topical treatment of inflammatory dermal infections like-

Tinea pedis
Tinea cruris
Tinea corporis etc.

Side Effects Of – Ointment :-Topibet-CL (0.1%+1%) 10gm tube (As a Betamethasone+Clotrimazole As a Betamethasone & Combined preparations.):-

Adverse reactions reported for the preparation in clinical trials were paresthesia in 1.9% of patients, rash, edema and secondary infection, each in less than 1% of patients. Other adverse reactions reported with the preparation were burning and dry skin in 1.6% of patients and stinging in less than 1% of patients

Pharmacology:-

8. Betamethasone+Clotrimazole+Gentamicin:-

Cream 1:-Aristoderm (0.05%+1%+0.1%)10gm tube (As a Betamethasone+Clotrimazole+Gentamicin As a Betamethasone & Combined preparations.)

Indications Of Cream :-Aristoderm (0.05%+1%+0.1%)10gm tube (As a Betamethasone+Clotrimazole+Gentamicin As a Betamethasone & Combined preparations.):-

Side Effects Cream :-Aristoderm (0.05%+1%+0.1%)10gm tube (As a Betamethasone+Clotrimazole+Gentamicin As a Betamethasone & Combined preparations.):-

Adverse reactions have been reported very rarely and include hypochromia, burning, erythema, exudation etc.

Pharmacology:-

9.Ofloxacin+ Clotrimazole+ Beclomethasone+Lidocaine:-

Ear Drop 1:-Audicare (0.3%+1%+0.025%+2%) 10ml drop As a Ofloxacin+ Clotrimazole+ Beclomethasone+Lidocaine As a Anti-fungal or anti-bacterial ear drops.

Indications Of Ear Drop :-Audicare (0.3%+1%+0.025%+2%) 10ml drop (As a Ofloxacin+ Clotrimazole+ Beclomethasone+Lidocaine As a Anti-fungal or anti-bacterial ear drops):-

This ear drop is indicated for the treatment of superficial bacterial and fungal infections of the external auditory canal and the middle ear, caused by organisms susceptible to the action of Ofloxacin and Clotrimazole.

Side Effects Of Ear Drop :-Audicare (0.3%+1%+0.025%+2%) 10ml drop (As a Ofloxacin+ Clotrimazole+ Beclomethasone+Lidocaine As a Anti-fungal or anti-bacterial ear drops):-

The systemic side-effects are not common with this ear drops. The following adverse reactions may be observed when using Audicare: itching, burning, irritation, dryness, earache, headache, vertigo, dizziness, redness, folliculitis, hypertrichosis, acne form eruptions and hypopigmentation.

Pharmacology:-

It is a combination of an antibacterial, an antifungal, an anti-inflammatory and a topical local anesthetic agent. This ear drop has been specially formulated to maintain the natural environment of the external ear canal.

Ofloxacin is a fluoroquinolone that has a broad spectrum of activity against otic pathogens without ototoxicity. Hence Ofloxacin is preferred to Aminoglycosides for any application within the middle ear space. Ofloxacin exerts antibacterial activity by inhibiting DNA gyrase of bacteria. Ofloxacin has been shown to be active against the following organisms responsible for otic infections: Gram-positive: Staphylococcus aureus, Streptococcus pneumoniae. Gram-negative: Escherichia coli, Haemophilus influenzae, Moraxella catarrhalis, Proteus mirabilis, Pseudomonas aeruginosa.

Clotrimazole is a synthetic imidazole derivative, which is a broad-spectrum antifungal agent that exerts fungicidal activity against fungi responsible for superficial mycotic infections affecting the outer or middle ear including Candida, Microsporum & Trichophyton. Clotrimazole inhibits Cytochrome P-450 synthesis of Ergosterol, which decreases fungal cell wall integrity thus inhibits fungal growth. Clotrimazole also has activity against certain bacteria such as Streptococci and Staphylococci. The antibacterial effect of Clotrimazole is advantageous to treat mixed bacterial-fungal infections.

Beclomethasone Dipropionate is a potent steroid as compared with other topical corticosteroids. Beclomethasone like other topical corticosteroids, has anti-inflammatory, antipruritic, and vasoconstrictive properties. It induces phospholipase A2 and sequentially inhibits the release of arachidonic acid, thereby depressing the formation, release, and activity of prostaglandins, leukotrienes, and other inflammatory mediators.

Lidocaine Hydrochloride is a topical local anesthetic which helps to reduce pain and stinging in the ear.

4.Gentamycin+ Hydrocortisone Acetate:-

Ear drop 1:-Gentabac-HC (0.3%+1%) 10ml drop (As a Gentamycin+ Hydrocortisone Acetate As a Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations).

Cream 2:Gento-HC (0.3%+1%) 10gm tube (As a Gentamycin+ Hydrocortisone Acetate As a Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations).

Indications Of Ear drop :-Gentabac-HC (0.3%+1%) 10ml drop (As a Gentamycin+ Hydrocortisone Acetate As a Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations):-

Side Effects Of Ear drop :-Gentabac-HC (0.3%+1%) 10ml drop (As a Gentamycin+ Hydrocortisone Acetate As a Hydrocortisone & Combined preparations, Ophthalmic steroid – antibiotic combined preparations):-

Ear discomfort, ear irritation may occur in rare cases. Gentamicin may cause irreversible partial or total deafness when given systemically or when applied topically to open wounds or damaged skin.

Pharmacology:-

5.Hydrocortisone+Lidocaine:-

Cream 1:-Anacaine-HC (5mg+30mg)/gm (As a Hydrocortisone+Lidocaine As a Hydrocortisone+Lidocaine As a Drugs used in Ano-rectal region).

Indications Of Cream :-Anacaine-HC (5mg+30mg)/gm (As a Hydrocortisone+Lidocaine As a Hydrocortisone+Lidocaine As a Drugs used in Ano-rectal region):-

Hydrocortisone plus Lidocaine cream is used for the anti-inflammatory and anesthetic relief of itching, pain, soreness and discomfort due to hemorrhoids, anal fissures, pruritus ani and similar conditions of the anal area.

Side Effects Of Cream :-Anacaine-HC (5mg+30mg)/gm (As a Hydrocortisone+Lidocaine As a Hydrocortisone+Lidocaine As a Drugs used in Ano-rectal region):-

Side effects like Rectal bleeding, Swelling of the skin, Adrenal suppression, Anaphylaxis, Angioedema, Cushing syndrome, Hirsutism, Acne, Cutaneous and subcutaneous atrophy, Dry scaly skin, Urticaria.

Pharmacology:-

Hydrocortisone is a corticosteroid used for its anti-inflammatory and immunosuppressive effects. Its anti-inflammatory action is due to the suppression of migration of polymorphonuclear leukocytes and reversal of increased capillary permeability. It may also be used as replacement therapy in adrenocortical insufficiency.

Lidocaine is an amide type local anesthesia. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.

6. Hydrocortisone:-

Tablet 1.Hydrason 10mg,20mg (As a Hydrocortisone As a Glucocorticoids).

Injection 2.Cortef IM/IV 100mg/2ml 100mg vial (As a Hydrocortisone As a Glucocorticoids).

Indications Of Tablet :-Hydrason 10mg,20mg (As a Hydrocortisone As a Glucocorticoids):-

Hydrason is indicated for use in the following conditions:

Primary or secondary adrenocortical insufficiency
Acute adrenocortical insufficiency
Shock unresponsive to conventional therapy
Congenital adrenal hyperplasia
Hypercalcemia associated with cancer
Nonsuppurative thyroiditis
Rheumatic Disorders
Dermatologic Diseases (Allergic States, Severe seborrheic dermatitis, Severe psoriasis, Pemphigus, Severe erythema multiforme)
Control of severe or incapacitating allergic conditions (Bronchial asthma, Contact dermatitis, Atopic dermatitis, Serum sickness, Seasonal or perennial allergic rhinitis, Drug hypersensitivity reactions, Urticarial transfusion reactions, Acute noninfectious laryngeal edema)
Ophthalmic Diseases (Herpes zoster ophthalmicus, Iritis, iridocyclitis, Chorioretinitis, Diffuse posterior uveitis and choroiditis, Optic neuritis)
Gastrointestinal Diseases
Fulminating or disseminated pulmonary tuberculosis when used concurrently with appropriate antituberculous chemotherapy
Loeffler’s syndrome
Aspiration pneumonitis
Hematologic Disorders (Acquired, autoimmune hemolytic anemia, Idiopathic thrombocytopenic purpura in adults, Secondary thrombocytopenia, Erythroblastopenia)
Neoplastic Diseases (Leukemias and lymphomas in adults, Acute leukemia of childhood)
Edematous States
Acute exacerbations of multiple sclerosis

Side Effects Of Tablet :-Hydrason 10mg,20mg (As a Hydrocortisone As a Glucocorticoids):-

Hydrason is generally well tolerated except in prolonged high doses. It may cause cardiac arrhythmia, esophageal candidiasis, menstrual irregularity, decreased carbohydrate & glucose tolerance, fluid retention, increased appetite, weight gain, euphoria, mood swings, depression, insomnia, acne etc.

Pharmacology:-

Hydrocortisone inhibits prostaglandin synthesis by inhibiting the enzyme phospholipase A2. Hydrocortisone reduces various vasoactive agents released during inflammation. It also controls the rate of protein synthesis.

7. Hydrocortisone Butyrate:-

Cream 1:-Eczacort 0.1% 30gm tube (As a Hydrocortisone Butyrate As a Topical corticosteroids).

Ointment 2:- Eczacort 0.1% 15,30gm tube (As a Hydrocortisone Butyrate As a Topical corticosteroids).

Indications Of Cream :-Eczacort 0.1% 30gm tube (As a Hydrocortisone Butyrate As a Topical corticosteroids):-

Eczacort is a topical corticosteroid indicated for relief of the inflammatory and pruritic
manifestations of corticosteroid-responsive dermatoses in adults. The topical treatment of mild to moderate
atopic dermatitis in pediatric patients 3 months to 18 years of age.

Side Effects Of Cream :-Eczacort 0.1% 30gm tube (As a Hydrocortisone Butyrate As a Topical corticosteroids):-

Stinging, burning, itching, irritation, dryness, or redness at the application site may occur when this
medication is first applied to the skin. These effects should disappear in a few days as body adjusts to the
medication.

Pharmacology:-

Topical corticosteroids share anti-inflammatory, antipruritic, and vasoconstrictive properties.
Corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively
called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of
inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor,
arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

8. Cinchocaine+ Hydrocortisone+ Framycetin +Esculin:-

Ointment 1.Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube (As a Cinchocaine+ Hydrocortisone+ Framycetin +Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region).

Supposidory 2:- Erian (5mg+5mg+10.5mg+10mg)/gm (As a Cinchocaine+ Hydrocortisone+ Framycetin +Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region).

Indications Of Ointment:-Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube (As a Cinchocaine+ Hydrocortisone+ Framycetin +Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region):-

This is indicated for the treatment of-

Internal and external haemorrhoids
Haemorrhoids post-partum
Anal pruritus, peri-anal eczema, anal fissures and proctitis
Post-haemorrhoidectomy application to relieve pain and discomfort

Side Effects Of Ointment:-Erian (5mg+5mg+10.5mg+10mg)/gm 15gm tube (As a Cinchocaine+ Hydrocortisone+ Framycetin +Esculin As a Compound steroidal preparations, Drugs used in Ano-rectal region):-

Pharmacology:-

9.Ciprofloxacin+ Hydrocortisone Acetate:-

Ophthalmic Suspension:-Ear drop 1:-Ciprocort (0.3%+1%)10ml drop (As a Ciprofloxacin+ Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations).

Indications Of Ear drop :-Ciprocort (0.3%+1%)10ml drop (As a Ciprofloxacin+ Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations):-

Side Effects Of Ear drop :-Ciprocort (0.3%+1%)10ml drop (As a Ciprofloxacin+ Hydrocortisone Acetate As a Aural steroid & antibiotic combined preparations):-

Rare reports of headache, pruritis, migraine, hyperesthesia, paresthesia, fungal dermatitis, cough, rash, urticaria, and alopecia have been reported.

Pharmacology:-

10.Fusidic Acid+ Hydrocortisone:-

Cream 1:-Fortison (2%+1%) 10gm tube (As a Fusidic Acid+ Hydrocortisone As a Hydrocortisone & Combined preparations).

Indications Of Cream :-Fortison (2%+1%) 10gm tube (As a Fusidic Acid+ Hydrocortisone As a Hydrocortisone & Combined preparations):-

Fortison is indicated in the following skin diseases where bacterial infections are already present or suspected to occur-

Primary irritant dermatitis
Contact allergic dermatitis
Eczema (atopic, infantile, discoid, stasis)
Seborrhoeic dermatitis

Side Effects Of Cream :-Fortison (2%+1%) 10gm tube (As a Fusidic Acid+ Hydrocortisone As a Hydrocortisone & Combined preparations):-

Fusidic Acid has been reported to cause mild irritation at the application site, but did not usually require discontinuation of therapy. Reports of hypersensitivity reactions have been rare. Adverse effects are generally local and include: dryness, itching, burning, local irritation, striae, skin atrophy, atrophy of subcutaneous tissues, telangiectasia, hypertrichosis, change in pigmentation and secondary infection. If applied to the face, acne rosacea or perioral dermatitis can occur.

Pharmacology:-

Fusidic Acid BP 2% & Hydrocortisone Acetate BP 1% combination cream contains the potent topical antibacterial action of Fusidic Acid with the anti-inflammatory & anti-pruritic effects of Hydrocortisone Acetate. When applied topically, Fusidic Acid is effective against Staphylococci, Streptococci, Corynebacteria, Neisseria and certain Clostridia & Bacteroides. Fusidic Acid is an antimicrobial agent that acts as an inhibitor of protein synthesis in the microorganism. It interferes with translocation step by stabilizing the ribosome-guanosine diphosphate elongation factor G-complex. This prevents binding of aminoacyl t-RNA to the ribosome and thereafter stops transfer of additional amino acids to the growing polypeptide. In humans, Hydrocortisone is the principal naturally occurring glucocorticosteroid. In pharmaceutical dosage, its main action is to reduce the response of the skin to injury (i.e. anti-in ammatory). It also has immuno suppressant & anti-mitotic actions.

11. Hydrocortisone+Neomycin Sulphate+Polymixin-B:-

Ear Drop 1:- Polymix-H(10mg+3400unites+10000unites)/ml 5ml drop (As a Hydrocortisone+Neomycin Sulphate+Polymixin-B As a Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations).

Indications Of Ear Drop :- Polymix-H(10mg+3400unites+10000unites)/ml 5ml drop (As a Hydrocortisone+Neomycin Sulphate+Polymixin-B As a Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations):-

Side Effects Of Ear Drop :- Polymix-H(10mg+3400unites+10000unites)/ml 5ml drop (As a Hydrocortisone+Neomycin Sulphate+Polymixin-B As a Ophthalmic steroid – antibiotic combined preparations, Ophthalmic Steroid preparations):-

The following side effects rarely may happen with this medicine: seem to get worse instead of better, become red, scaly and itchy.

Pharmacology:-

12. Hydrocortisone Acetate+Benzyl Benzoate+Bismuth Subgallate+Bismuth Oxide+Balsam peru+Zinc Oxide:-

Ointment 1:-Anosil 30gm tube (As a Hydrocortisone Acetate+Benzyl Benzoate+Bismuth Subgallate+Bismuth Oxide+Balsam peru+Zinc Oxide As a Other Topical corticosteroids).

Indications Of Ointment :-Anosil 30gm tube (As a Hydrocortisone Acetate+Benzyl Benzoate+Bismuth Subgallate+Bismuth Oxide+Balsam peru+Zinc Oxide As a Other Topical corticosteroids):-

This ointment is indicated for the comprehensive symptomatic treatment of internal and external hemorrhoids and pruritus ani.

Side Effects Of Ointment :-Anosil 30gm tube (As a Hydrocortisone Acetate+Benzyl Benzoate+Bismuth Subgallate+Bismuth Oxide+Balsam peru+Zinc Oxide As a Other Topical corticosteroids):-

Prolonged or excessive use may produce systemic corticosteroid effects, and use for periods longer than seven days is not recommended. Rarely, there are sensitivity reactions and Patients may occasionally experience transient burning on application especially if the anoderm is not intact.

Pharmacology:-

This ointment provides antiseptic, astringent, emollient and anti-inflammatory actions. Bismuth oxide, zinc oxide, and bismuth subgallate exert a protective action on mucous membranes They are mildly astringent and are reported to have antiseptic properties Balsam Peru has protective properties and a very mild antiseptic action by virtue of its content of cinnamic and benzoic acids. It is believed to promote the growth of epithelial cells, Benzyl benzoate is used as a solubilizing agent and has mild antiseptic and preservative properties. Hydrocortisone acetate has anti-inflammatory action.

13.Miconazole Nitrate+Hydrocortisone:-

Cream 1:-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations).

Indications Of Cream :-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations):-

Side Effects Of Cream :-Fungidal-HC (2%+1%) 15gm tube (As a Miconazole Nitrate+Hydrocortisone As a Hydrocortisone & Combined preparations):-

Rarely local sensitivity may occur. Long term use may decrease in the production of natural hormones by the adrenal gland.

Pharmacology:-

19.Light Kaolin+Silver Sulfadiazine+Calcium Gluconate+Butane Propellant:-

Topical Spray:-Sofargen 10gm/125ml (125ml can).

AS A Light Kaolin+Silver Sulfadiazine+Calcium Gluconate+Butane Propellant

Indications Of Topical Spray:-Sofargen 10gm/125ml (125ml can).

(AS A Light Kaolin+Silver Sulfadiazine+Calcium Gluconate+Butane Propellant):-

Sofargen spray is indicated for the local treatment of small skin lesions such as abrasions, excoriations, cuts, superficial wounds and dermatological affections in general.

Side Effects Of Topical Spray:-Sofargen 10gm/125ml (125ml can).

(AS A Light Kaolin+Silver Sulfadiazine+Calcium Gluconate+Butane Propellant):-

A temporary irritation or burning sensation may occur, although without consequences and rare local allergic reactions. In the event any undesirable effects occur, consult a physician or pharmacist.

4.Streptomycin:-N/A

5.Tobramycin:-

Respirator Solutions:-1.Intobac 300mg/5ml 5ml ampoule (As a Tobramycin As a Aminoglycosides).

Indications Of Respirator Solutions:-Intobac 300mg/5ml 5ml ampoule (As a Tobramycin As a Aminoglycosides):-

Intobac Respirator Solution is indicated for the management of cystic fibrosis patients with Pseudomonas aeruginosa. Also indicated for severe COPD patients colonized with Pseudomonas aeruginosa. Safety and efficacy have not been demonstrated in patients below the age of 6 years, patients with a forced expiratory volume <25% or >75% predicted, or patients colonized with Burkholderia cepacia.

Side Effects Of Respirator Solutions:-Intobac 300mg/5ml 5ml ampoule (As a Tobramycin As a Aminoglycosides):-

Inhaled Intobac is generally well-tolerated. Voice alterations and tinnitus are more common in the on-drug periods. However all the episodes are transient and resolved without discontinuation of the regimen. Others like dizziness and increase in serum creatinine were similar to those occurring with placebo.

Pharmacology:-

Tobramycin interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal subunits, resulting in a defective bacterial cell membrane.

Other component Or Preparation Of Tobramycin:-

Sub Classes Of Tobramycin:-

Index:-

1.Dexamethasone+Tobramycin.

2. Tobramycin(Ophthalmic).

3.Loteprednol Etabonate+ Tobramycin.

Description:-

1.Dexamethasone+Tobramycin.

Ophthalmic Solution/Eye Drop:-1.Tomycin-D (0.1%+0.3%)5ml drop As a Dexamethasone+Tobramycin As a Ophthalmic steroid – antibiotic combined preparations.

Eye Ointment 2:- Tomycin-D (0.1%+0.3%) 3.5gm tube As a Dexamethasone+Tobramycin As a Ophthalmic steroid – antibiotic combined preparations.

Indications Of Eye Drop:-Tomycin-D (0.1%+0.3%)5ml drop (As a Dexamethasone+Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

Tomycin-D is indicated for steroid responsive inflammatory ocular conditions (palpebral and bulbar conjunctiva, cornea and anterior segment of the globe) where superficial bacterial ocular infection exists. It is also indicated in chronic anterior uveities and corneal injury from chemical radiation or thermal burns, or penetration of foreign bodies. The use of combination with an anti-infective component is indicated where the risk of superficial ocular infection is high.

Side Effects Of Eye Drop:-Tomycin-D (0.1%+0.3%)5ml drop (As a Dexamethasone+Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

Pharmacology:-

2. Tobramycin(Ophthalmic).

Ophthalmic Solution/Eye Drop:-

1.Torcin (0.3%) 5ml drop (As a Tobramycin As a Ophthalmic antibacterial drugs).

Eye Ointment 2:- Torcin (0.3%) 3gm tube (As a Tobramycin As a Ophthalmic antibacterial drugs).

Indications Of Eye Drop:-

Torcin (0.3%) 5ml drop (As a Tobramycin As a Ophthalmic antibacterial drugs):-

Torcin is a topical antibiotic indicated in the treatment of external bacterial infections of the eye caused by susceptible organisms. Such as,

Gram-positive bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Streptococcus spp. of group A beta-hemolytic and some nonhemolytic species.

Gram-negative bacteria: E.coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella spp., Proteusmirabillis, Proteus vulgaris, Haemophilus influenzae, Morganella morganii, Acinetobacter calcoaceticus, Providentia, Serratia, Salmonella spp and some strains of Neisseria.

Side Effects Of Eye Drop:-

Torcin (0.3%) 5ml drop (As a Tobramycin As a Ophthalmic antibacterial drugs):-

The most frequent side effect of Torcin ophthalmic solution is localized ocular toxicity, conjunctival erythema, hypersensitivity including lid itching and swelling.

Pharmacology:-

Like other aminoglycosides, the bactericidal activity of Tobramycin is taken up into sensitive bacterial cells by an active transport process. Within the cell Tobramycin bind to the 30s, and to some extent to the 50s subunits of the bacterial ribosome, inhibiting protein synthesis and generating errors in the transcription of the genetic code. The manner in which cell death is brought about is imperfectly understood, and other mechanisms may contribute, including effects on membrane permeability.

3.Loteprednol Etabonate+ Tobramycin:-

Ophthalmic solution/Eye drop:-1.Lotepro Plus (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+ Tobramycin As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Ophthalmic solution/Eye drop:-Lotepro Plus (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+ Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

Lotepro Plus ophthalmic suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists. Ocular steroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis. It is also indicated in chronic anterior uveitis and corneal injury from chemical, radiation or thermal burns, or penetration of foreign bodies. This is also indicated for the treatment of post-operative inflammation following ocular surgery.

Side Effects Of Ophthalmic solution/Eye drop:-Lotepro Plus (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+ Tobramycin As a Ophthalmic steroid – antibiotic combined preparations):-

Increased intraocular pressure, burning and stinging upon instillation, vision disorders, discharge, itching, lacrimation disorder, photophobia, corneal deposits, ocular discomfort, eyelid disorder, and other unspecified eye disorders may occur. The incidence of non-ocular adverse events (headache) also reported.

Pharmacology:-

Loteprednol is a corticosteroid which is thought to act by the induction of phospholipase A2 inhibitory proteins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid.

Tobramycin is a member of aminoglycoside which shows bactericidal activity by inhibiting protein synthesis of bacteria.

Other component Or preparation Of Loteprednol:-

1.Loteprednol Etabonate:-

Ophthalmic Gel/Eye ointment:-

Eye ointment 1.Lotenol 0.5% 5gm tube (As a Loteprednol Etabonate As a Ophthalmic Steroid preparations).

Ophthalmic suspension/Eye drop:-

Eye drop 2:- Lotenol 0.5% 5ml drop (As a Loteprednol Etabonate As a Ophthalmic Steroid preparations).

Eye ointment 3.Lotenol 0.5% 3gm tube (As a Loteprednol Etabonate As a Ophthalmic Steroid preparations).

Indications Of Eye drop :- Lotenol 0.5% 5ml drop (As a Loteprednol Etabonate As a Ophthalmic Steroid preparations):-

0.5% ophthalmic suspension: Lotenol suspension is indicated in steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of eyeball such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis & cyclitis. It is also effective in post-operative inflammation.

1% ophthalmic suspension: Lotenol suspension is indicated in steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of eyeball such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis & cyclitis. It is also effective in post-operative inflammation.

0.5% ophthalmic ointment: Lotenol ointment is indicated for the treatment of steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, uveitis. Lotenol is also indicated for the treatment of post-operative inflammation and pain following ocular surgery.

0.5% Ophthalmic gel: Lotenol gel is indicated for the treatment of post-operative inflammation and pain following ocular surgery. It is also effective in steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of eyeball such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis & cyclitis.

Side Effects Of Of Eye drop :- Lotenol 0.5% 5ml drop (As a Loteprednol Etabonate As a Ophthalmic Steroid preparations):-

Reactions associated with ophthalmic steroids include elevated intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, secondary ocular infection from pathogens including herpes simplex and perforation of the globe where there is thinning of the cornea or sclera. Ocular adverse reactions occurring in 5%-15% of patients treated with Lotenol sterile ophthalmic suspension. (0.2%-0.5%) in clinical studies included abnormal vision/blurring, burning on instillation, chemosis, discharge, dry eyes, epiphora, foreign body sensation, itching, injection and photophobia. Other ocular adverse reactions occurring in less than 5% of patients include conjunctivitis, corneal abnormalities, eyelid erythema, keratoconjunctivitis, ocular irritation/pain/discomfort, papillae. Non-ocular adverse reactions occurred in less than 15% of patients. These include headache, rhinitis and pharyngitis.

Pharmacology:-

Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. They inhibit the edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen and scar formation associated with inflammation. There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A 2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

2. Loteprednol Etabonate+Gatifloxacin:-

Ophthalmic Suspension/Eye drop:-

Eye drop 1:- Lotepro-G (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+Gatifloxacin As a Ophthalmic Steroid preparations).

Indications Of Eye drop :- Lotepro-G (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+Gatifloxacin As a Ophthalmic Steroid preparations):-

This ophthalmic suspension is indicated for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists. Ocular steroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, and cyclitis. It is also indicated for the treatment of post-operative inflammation following ocular surgery.

Side Effects Of Eye drop :- Lotepro-G (0.5%+0.3%) 5ml drop (As a Loteprednol Etabonate+Gatifloxacin As a Ophthalmic Steroid preparations):-

Adverse reactions have occurred with steroid/anti-infective combination drugs which can be attributed to the steroid component or the anti-infective component, or the combination. Reactions associated with ophthalmic steroids include elevated IOP, which may be associated with infrequent optic nerve damage, visual acuity and field detects, posterior sub capsular cataract formation, delayed wound healing, and secondary ocular infections from pathogens including herpes simplex, and perforation of the globe where there is thinning of cornea or sclera. The most frequently reported adverse effects for gatifloxacin in the overall study population were conjunctival irritation, increased lacrimation, keratitis and papillary conjunctivitis. These events occurred in approximately 5-10% of patients. Other reported reactions occurring in 1-4% of patients were chemosis, conjunctival hemorrhage, dry eye, eye discharge, eye irritation, eye pain, eyelid edema, headache, red eye, reduced visual acuity and taste disturbance. Redness was the most commonly observed adverse event occurring in 6%. Itching, discharge photophobia and blurred vision were seen in less than 2% cases.

Pharmacology:-

Loteprednol (corticosteroids) are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.

Gatifloxacin is an 8-methoxyfluoroquinolone with a 3-methylpiperazinyl substituent at C7. The antibacterial action of gatifloxacin results from inhibition of DNA gyrase and topoisomerase IV. DNA gyrase is an essential enzyme that is involved in the replication, transcription, and repair of bacterial DNA. Topoisomerase IV is an enzyme known to play a key role in the partitioning of the chromosomal DNA during bacterial cell division. The mechanism of action of fluoroquinolones including gatifloxacin is different from that of aminoglycoside, macrolide, and tetracycline antibiotics. Therefore, gatifloxacin may be active against pathogens that are resistant to these antibiotics and these antibiotics may be active against pathogens that are resistant to gatifloxacin. Gatifloxacin has been shown to be active against most isolates of the following organisms both microbiologically and clinically.

Aerobic Gram-Positive Bacteria: Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus mitis group, Streptococcus oralis, Streptococcus pneumoniae.

Aerobic Gram-Negative Bacteria: Haemophilus influenza.

6.Chloramphenicol:-

Sub-Classe of Chloramphenicol:-Index.

1.Chloramphenicol(Orally).

2. Chloramphenicol(Ophthalmic).

3. Chloramphenicol+Lidocaine Hydrochloride.

4.Dexamethasone+ Chloramphenicol.

5.Beclomethasone Dipropionate+ Chloramphenicol+Clotrimazole+ Lidocaine.

Description:-

1.Chloramphenicol(Orally):-

Capsule1:-Ramicol 250mg (As a Chloramphenicol As a Macrolides).

Oral suspension 2:- Ramicol 125mg/5ml 60ml Bottle (As a Chloramphenicol As a Macrolides).

Indications Of Capsule:-Ramicol 250mg (As a Chloramphenicol As a Macrolides):-

Ramicol is an antibiotic that is clinically useful for, and should be reserved for, serious infections caused by organisms susceptible to its antimicrobial effects when less potentially hazardous therapeutic agents are ineffective or contraindicated. However, Ramicol may be chosen to initiate antibiotic therapy on the clinical impression that one of the conditions below is believed to be present. In vitro sensitivity tests should be performed concurrently so that the drug may be discontinued as soon as possible if less potentially dangerous agents are indicated by such tests. The decision to continue use of Ramicol, rather than another antibiotic when both are suggested by in vitro studies to be effective against a specific pathogen, should be based upon severity of the infection, susceptibility of the pathogen to the various antimicrobial drugs, and the efficacy of the various drugs in the infection

Interaction Of Capsule:-Ramicol 250mg (As a Chloramphenicol As a Macrolides):-

Ramicol has been shown to retard the biotransformation of tolbutamide, phenytoin, and dicoumarol in man. Ramicol should be used with caution if administered concomitantly with lincomycin, clindamycin, or erythromycin. In vitro experiments have demonstrated that binding sites for erythromycin, lincomycin, clindamycin and Ramicol overlap and competitive inhibition may occur. Rifampin therapy can reduce Ramicol concentrations.

Pharmacology:-

In vitro, chloramphenicol exerts mainly a bacteriostatic effect on a wide range of Gram-negative and Gram positive bacteria and is active against rickettsiae, the lymphogranuloma-psittacosis group and Vibrio cholerae. It is particularly active against Salmonella typhi and Haemophilus influenzae. The mode of actions is through interference or inhibition of protein synthesis in intact cells and cell-free systems. Antagonism has been demonstrated in vitro between chloramphenicol, erythromycin, clindamycin and lincomycin. Chloramphenicol is rapidly absorbed from the GI tract. Chloramphenicol palmitate is hydrolyzed in the GI tract and is absorbed as free chloramphenicol.

Following oral administration of a single one gram dose of chloramphenicol base to healthy adults, average peak plasma chloramphenicol concentrations of about 11 mcg/ml were attained with 1-3 hours. Cumulative dosing gave a peak of 18 mcg/ml after the fifth dose of one gram, every 6 hours. Mean serum levels were 8-14 mcg/ml over a 48 hour period.

Most of the drug is excreted in the urine. Despite the small proportion of unchanged drug excreted in the urine, the concentration of free chloramphenicol in the urine is relatively high. From 8% to 12% of the antibiotic is excreted as free chloramphenicol. The remainder is excreted as inert metabolites, mainly glucuronate. Small amounts of active drug are found in bile and feces. Chloramphenicol diffuses rapidly, but its distribution is not uniform. Highest concentrations are found in liver and kidney, and lowest concentrations are found in brain and cerebrospinal fluid (CSF). Chloramphenicol enters CSF even in the absence of meningeal inflammation, appearing in concentrations about half of those found in the blood.

2. Chloramphenicol(Ophthalmic).

Ophthalmic Solution/Eye Drop/Ear drop:-

Eye Drop/Ear drop 1.Conicol 0.5% 10ml drop (As a Chloramphenicol As a Ear Anti-Infectives & Antiseptics, Eye Anti-Infectives & Antiseptics, Macrolides).

Ophthalmic Oiantment 2:-

Eye ointment 2:-Conicol 1% 3gm tube (As a Chloramphenicol As a Ear Anti-Infectives & Antiseptics, Eye Anti-Infectives & Antiseptics, Macrolides).

Indications Of Eye Drop/Ear drop:-Conicol 0.5% 10ml drop (As a Chloramphenicol As a Ear Anti-Infectives & Antiseptics, Eye Anti-Infectives & Antiseptics, Macrolides):-

Conicol is indicated for the treatment of ocular infections involving the conjunctiva and/or cornea caused by Conicol-susceptible organisms. Such as Staphylococcus aureus, Streptococcus pneumoniae, E.coli, H. influenzae, Klebsiella/Enterobacter spp, Moraxella lacunata, and Neisseria species.

Side Effects Of Eye Drop/Ear drop:-Conicol 0.5% 10ml drop (As a Chloramphenicol As a Ear Anti-Infectives & Antiseptics, Eye Anti-Infectives & Antiseptics, Macrolides):-

The systemic adverse reaction has not been observed within short-term topical use of Conicol. The most frequently reported adverse reactions have been burning, stinging, conjunctival hyperemia, blood dyscrasia, allergic or inflammatory reactions, vesicular and maculopapular dermatitis.

Pharmacology:-

Chloramphenicol is a broad-spectrum bacteriostatic antibiotic which acts through the inhibition of bacterial protein synthesis by interfering with the transfer of activated amino acids from soluble RNA to ribosomes.

3. Chloramphenicol+Lidocaine Hydrochloride:-

Ear Drop 1:-Supraphen Plus (5%+1%) 10ml drop (As a Chloramphenicol+Lidocaine Hydrochloride As a Aural Anti-bacterial preparations).

Indications Of Ear Drop:-Supraphen Plus (5%+1%) 10ml drop (As a Chloramphenicol+Lidocaine Hydrochloride As a Aural Anti-bacterial preparations):-

Acute bacterial ear infections

Side Effects Of Ear Drop :-Supraphen Plus (5%+1%) 10ml drop (As a Chloramphenicol+Lidocaine Hydrochloride As a Aural Anti-bacterial preparations):-

Ototoxicity.

Pharmacology:-

Chloramphenicol inhibits bacterial protein synthesis by binding to 50s subunit of the bacterial ribosome, thus preventing peptide bond formation by peptidyl transferase. It has both bacteriostatic and bactericidal action against H. influenzae, N. meningitidis and S. pneumoniae.

Lidocaine is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.

4.Dexamethasone+ Chloramphenicol:-

Ophthalmic Solution Eye/Ear Drop:-

Eye/Ear Drop 1:-Dexonex-C (0.1%+0.5%) 5ml drop (As a Dexamethasone+ Chloramphenicol As a Ophthalmic steroid – antibiotic combined preparations).

Indications Of Eye/Ear Drop :-Dexonex-C (0.1%+0.5%) 5ml drop (As a Dexamethasone+ Chloramphenicol As a Ophthalmic steroid – antibiotic combined preparations):-

Side Effects Of Eye/Ear Drop :-Dexonex-C (0.1%+0.5%) 5ml drop (As a Dexamethasone+ Chloramphenicol As a Ophthalmic steroid – antibiotic combined preparations):-

Pharmacology:-

5.Beclomethasone Dipropionate+ Chloramphenicol+Clotrimazole+ Lidocaine:-

Ear Drop 1:- Candibac (0.025%+5%+1%+1.73%) 5ml drop

(As a Beclomethasone Dipropionate+ Chloramphenicol+Clotrimazole+ Lidocaine As a Anti-fungal or anti-bacterial ear drops).

Indications Of Ear Drop :- Candibac (0.025%+5%+1%+1.73%) 5ml drop.

(As a Beclomethasone Dipropionate+ Chloramphenicol+Clotrimazole+ Lidocaine As a Anti-fungal or anti-bacterial ear drops):-

Formidable combination for ear infections-

Safe and effective combination in otitis externa & otitis media with the perforated ear.
Shows higher efficacy of Clotrimazole to treat Otomycosis.
Shows excellent pain reduction of lidocaine to treat acute otitis media.

Side Effects Of Ear Drop :- Candibac (0.025%+5%+1%+1.73%) 5ml drop

(As a Beclomethasone Dipropionate+ Chloramphenicol+Clotrimazole+ Lidocaine As a Anti-fungal or anti-bacterial ear drops):-

Inflammation Of The Skin
Irritation
Itchy Rash
Blisters
Peeling Or Flaking Of The Skin
Discomfort.

Pharmacology:-

7.Clindamycin:-

Sub Class of Clindamycin:- Index of Clindamycin

1.Clindamycin (Lotion).

2. Clindamycin+Benzoyl Peroxide.

3. Clindamycin(Vaginal Cream).

4. Clindamycin+Tretinoin.

5.Clindamycin(Orally).

Description:-

1.Clindamycin (Lotion).

Lotion 1:-Clindacin 1% 25ml bottle (As a Clindamycin As a Macrolides).

Indications Of Lotion :-Clindacin 1% 25ml bottle (As a Clindamycin As a Macrolides):-

Clindacin lotion is indicated in the treatment of acne vulgaris. Other uses of topical Clindacin lotion are:

Skin infections such as erythrasma caused by Corynebacterium minutissimum; rosacea, periorificial dermatitis, folliculitis, stasis, chronic lymphaedema and familial pemphigus.
Dermal ulcers.

Side Effects Of Lotion :-Clindacin 1% 25ml bottle (As a Clindamycin As a Macrolides):-

Side effects are usually rare. Possible side-effects may includes skin rash, itching, oily skin, dryness, erythema, burning, change in skin color, diarrhea, colitis, GI disturbance etc.

Pharmacology:-

2. Clindamycin+Benzoyl Peroxide.

Topical Gel 1:-Clindax-B (1%+5%) 10gm,20gm tube (As a

Clindamycin+Benzoyl Peroxide As a Benzoyl peroxide, Azelaic acid & other preparations).

Indications Of Topical Gel :-Clindax-B (1%+5%) 10gm,20gm tube (As a

Clindamycin+Benzoyl Peroxide As a Benzoyl peroxide, Azelaic acid & other preparations):-

Side Effects Of Topical Gel :-Clindax-B (1%+5%) 10gm,20gm tube (As a

Clindamycin+Benzoyl Peroxide As a Benzoyl peroxide, Azelaic acid & other preparations):-

Pharmacology:-

3. Clindamycin(Vaginal Cream):-

Vaginal Cream 1:-Clindacin 2% 20gm tube (As a Clindamycin As a Macrolides).

Indications Of Vaginal Cream :-Clindacin 2% 20gm tube (As a Clindamycin As a Macrolides):-

Clindacin cream is indicated in the treatment of bacterial vaginosis. Clindacin cream can be used to treat non pregnant women and pregnant women during the second and third trimester.

Side Effects Of Vaginal Cream :-Clindacin 2% 20gm tube (As a Clindamycin As a Macrolides):-

Pharmacology:-

Bacteroides spp.
Gardnerella vaginalism
Mobiluncus spp.
Mycoplasma hominis
Peptostreptococcus spp.

4. Clindamycin+Tretinoin:-

Topical Gel 1:-Clindacin Plus (1.2%+0.025%) 15gm tube (As a Clindamycin+Tretinoin As a Topical antibiotic & retinoid preparations).

Indications Of Topical Gel :-Clindacin Plus (1.2%+0.025%) 15gm tube (As a Clindamycin+Tretinoin As a Topical antibiotic & retinoid preparations):-

Clindamycin and Tretinoin gel is indicated for the topical treatment of Acne vulgaris.

Side Effects Of Topical Gel :-Clindacin Plus (1.2%+0.025%) 15gm tube (As a Clindamycin+Tretinoin As a Topical antibiotic & retinoid preparations):-

Erythema, scaling, nasopharyngitis, dry skin, cough, sinusitis and diarrhea are the common side effects.

Pharmacology:-

5.Clindamycin(Orally):-

Capsule 1:-Climycin 150mg,300mg (As a Clindamycin As a Macrolides).

Injection 2:-Clindacin IM/IV 600mg/4ml 4ml ampoule

Injection 3:- Clindacin IM/IV 300mg/2ml 2ml ampoule

Powder For suspension 4:- Clindacin 75mg/5ml 100 ml bottle.

Indications Of Capsule :-Climycin 150mg,300mg (As a Clindamycin As a Macrolides):-

Climycin has been shown to be effective in the treatment of the following infections when caused by susceptible anaerobic bacteria or susceptible strains of gram positive bacteria such as Streptococci, Staphylococci and Pneumococci; Upper respiratory infections, Lower respiratory infections, Skin and soft tissue infections, Bone and joint infections, Pelvic infections, Intra-abdominal infections, Septicemia and endocarditis, Dental infections. As an alternative therapy when used in combination with quinine or amodiaquine for the treatment of multi-drug resistant Plasmodium falciporum infection.

Side Effects Of Capsule :-Climycin 300mg (As a Clindamycin As a Macrolides):-

The adverse effects have been reported with the use of Climycin are- abdominal pain, oesophagitis and oesophagial ulcer, nausea, vomiting and diarrhoea, pruritus, skin rashes, urticaria.

Contraindications:-

Clindamycin is contraindicated in patients previously found to be sensitive to clindamycin or any of the ingredients of this medicine.

8.Glycylcyclines:-N/A.

9.Tigecycline:-

IV Infusion 1:-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs).

Indications Of IV Infusion :-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs):-

Side Effects Of IV Infusion :-Widebac 50mg/Vial (As a Tigecycline As a Tetracycline group of drugs):-

Pharmacology:-

10.Linezolid:-

Tablet 1.Linzolid 400mg,600mg, (As a Linezolid As a Macrolides).

Powder For suspension 2:- Linzolid 100mg/5ml 100ml bottle. (As a Linezolid As a Macrolides).

IV Infusion 3:- Linzolid 2mg/ml 100ml solution,300ml solution. (As a Linezolid As a Macrolides).

Indications Of Tablet 1:-Linzolid 400mg,600mg, (As a Linezolid As a Macrolides):-

Linzolid is indicated for the treatment of:

Nosocomial pneumonia
Community-acquired pneumonia
Complicated skin and skin structure infection including diabetic foot infections, without concomitant osteomyelitis
Uncomplicated skin and skin structure infections
Vancomycin-resistant Enterococcus faecium infections

Limitations of use: Linzolid is not indicated for the treatment of Gram-negative infections. The safety and efficacy of Linzolid given for longer than 28 days have not been evaluated in controlled clinical trials.

Side Effects Of Of Tablet :-Linzolid 400mg,600mg, (As a Linezolid As a Macrolides):-

Most of the adverse events reported with Linzolid were mild to moderate in intensity. The most common adverse events in patients treated with Linzolid were diarrhea, headache and nausea. Other adverse events includes oral moniliasis, vaginal moniliasis, hypertension, dyspepsia, localized abdominal pain, pruritus, and tongue discoloration.

Pharmacology:-

Raiyyan Tahsan Date 11-23-2024 time 07:31 Pm.