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Neomycin / Polymyxin B / Bacitracin

Generic Name: Neomycin ( as Sulfate ) / Polymyxin B ( as Sulfate )/ Bacitracin
Trade Name: B.N.P Manufacturer: Ashford Pharmaceutical Laboratories, Inc.
Source of Supply: Vendiz Pharmaceuticals, Inc.
Pharmacologic Classification: Topical Antibiotics
Mechanism of Action: Neomycin: Within the cell they bind to 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. Polymyxin: acts primarily by binding to membrane phospholipids and disrupting the bacterial cytoplasmic membrane. Bacitracin: it interferes with bacterial cell wall synthesis by blocking the function of the lipid carer molecule that transfers cell wall subunits across the cell membrane.
Therapeutic Indication: Used therapeutically for bacterial infections due to susceptible organism as in impetigo, ecthyma, sycosis vulgaris, otitis extema, paronychia, and for secondarily infected dermatoses, such as eczema, herpes or seborthoeic dermatitis. Dosage Forms & Strength : 5mg/ 5,000 units/ 400 units Ointment
Pharmacokinetics: Neomycin: Absorbed in wounds and inflamed skin. Once absorbed it is rapidly Excreted by the kidneys in active form. Polymyxin: it is not absorbed from the gastro-intestinal tract, except in the newbom. It is not also absorbed through the intact skin. It is excreted mainly by the kidneys, up to 60% being recovered in the urine but there is a time lag of 12 to 24 hours before polymyxin is recovered in the urine. Bacitracin: Absorption following topical application is minimal.
Dosage and Administration: The ointment should be applied to the affected area 2-5 times daily, or as directed by the physician. Adverse Reactions: Local application of antibiotics, including neomycin and bacitracin, has been Associated with severe allergic disorders, e.g. generalized itching, swelling of the face, sweating, tightness of the chest and hypotension. The possibility of such reactions should be bome in mind. Prolonged use should be avoided as it may lead to skin sensitation.
Contraindications: Contraindicated to patients with hypersensitivity to any of its components.
Storage Condition: Store below 25°C.

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Generic Name: Hydrocortisone
Trade Name: Hydrotopic
Manufacturer: Ashford Pharmaceutical Laboratories, Inc.
Source of Supply: Vendiz Pharmaceuticals, Inc.
Pharmacologic Classification: Topical Corticosteroids
Mechanism of Action: 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.
Therapeutic Indication: Relief of symptoms in acute & chronic dermatoses example eczema, infantile eczema, contact dermatitis, neurodermatitis, psonasis, pruntus.
Dosage Forms & Strength: 10 mo/g (1% w/w) Cream Pharmacokinetics: Hydrocortisone is absorbed through the skin, particularly in denuded areas. Hydrocortisone is metabolized in the liver and most body tissues to hydrogenated and Degraded forms such as tetrahydrocortisone and tetra hydrocortisol. These are excreted in the urine, mainly conjugated as glucuronides, together with a very small proportion of unchanged hydrocortisone.
Dosage and Administration: Apply into the cleansed affected skin 3 to 4 times daily or as directed by the physician.
Adverse Reactions: Itching, dryness, irritations, acneform eruptions and buming sensations, maceration of the skin, secondary infections, skin atrophy, striae and miliana.
Contraindications: The topical use of Hydrocortisone 10mg/g cream is contraindicated in the presence of skin infections of bacterial or fungal origin. Hypersensitivity to the adrenal corticosteroids is an obvious contraindication.
Storage Condition: Protect from light. Store at temperature not exceeding 30°C.

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Silver Sulfadiazine

TGeneric Name: Silver Sulfadiazine
Trade Name: Stenizol Manufacturer : Ashford Pharmaceutical Laboratories, |nc.
Source of Supply: Vendiz Pharmaceuticals, Inc.
Pharmacologic Classification: Topical Antibiotics Mechanism of Action: Silver sulfadiazine has a broad antimicrobial activity against Gram- negative bacteria including Pseudomonas aeruginosa and some yeast and fungi. It has a bactericidal action; in contrast to sulfadiazine, the silver salt acts primarily on the cell membrane and cell wall and its action Is not antagonized by p-aminobenzoic acid.
Therapeutic Indication: Silver sulfadiazine is a Sulphonamide which is used, in conjunction with debridement, as a 1% cream for the prevention and treatment of infection in severe bums. It is also being used in other skin conditions, such as leg ulcers, where infection may prevent healing and for the prophylaxis of infection in skin grafting.
Dosage Forms & Strength: 10mg/g (1% wiw) Cream
Pharmacokinetics: Silver sulfadiazine is slowly converted to sulfadiazine in contact with wound exudates. Up to about 10% of the sulfadiazine may be absorbed; concentrations in the blood of 10 to 20ug per mL have been reported, although higher concentrations may be achieved when extensive areas of the body is treated. Probably not more than 1% of the silver content is absorbed.
Dosage and Administration: In bums, apply once or twice daily to a thickness of approximately 1/16 inch. In leg ulcers, apply at least 3 times a week or as prescribed by the physician.
Adverse Reactions: Local reactions have been reported in a small percentage of patients. Systemic absorption of Silver Sulfadiazine may occur and prolonged use should be avoided.
Contraindications: Contraindicated for patients with hypersensitivity to sulfonamides.
Storage Condition: Store below 25°C.

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Betamethasone valerate

Generic name: Betamethasone valerate
Trade Name: Steroderm
Manufacturer: Ashford Pharmaceutical Laboratories, Inc.
Source of Supply: Vendiz Pharmaceuticals. Inc.
Pharmacologic Classification: Topical Corticosteroids
Mechanism of Action: Betamethasone is a corticosteroid with mainly glucoccoid activity. It prevents and controls inflammation by controlling the rate ol protein synthesis, depressing the migration of polymcrphonuclear leukocytes and fibroblasts, and reversing capillary permeability and lysosomal
Therapeutic lndication: Effective treatment for more difficult conditions such as psoriasis, and lichen planus. Eczema including atopic, infantile, dlscoid statis eczema and prurigo. Seborheic dermatitis, contact sensitivity reactions and allergies, discoid lupus erythematosus. The anti-inflammatory effect of Betamethasone Valerate cream is useful in the management of: otitis extema, anal and vul’,/al prJitus, lnsect bites, prickly heat, sunburn.
Dosage Forms & Stength: 1mg/g (0.1% Mw) Cream
Pharmacokinetics: Betamethasone when applied topically, particularly under an occlusive dressing or when the skin is broken, sumcient cor costeroids may be absorbed to give syster,ic effects. lt is metabolized in the liver and distributed throughout body tissues; crosses the placenta and enters the breast milk. Excretion is via urine.
Dosage and Administration: A small quantity should be applied gently to the affected area 2-3 times daily until improvement occurs. lt may then be possible to maintain progressive improvement using one application day or even less often. The water- miscible cream may be preferable for moist or weeplng surfaces, but for dry lesions the more emollient ointment is often more satisfactory.
Contraindications: Betamethasone valerate cream is usually well tolerated, but if signs of Hypersensitivity appear, application should stop immediately. Any spread of infection on the skin requires withdrawal of topical corticosteroid therapy. prolonged and intensive treatment with highly active corticosteroids preparations may cause local atrophic
changes in the skin such as striae, thinning and dilation of the superficial blood vessels, particularly when occlusive dressings are used or where skin folds are involved. As with other topical corticosteroids, when extensive areas are treated, sufficient systemic absorption may occur to produce the features of hypercodcism. This effect is more likely to occur in infants and children, and if occlusive dressing are used. In infants, the diapers may act as an occlusive dressing.
Contraindications : Viral diseases of the skin, e.g. herpes simplex. Contraindicated in patients with history of hypersenitivity to any of the components of the preparation.