Centre-Oxyte 10% Injection

Indications

• Bacterial infections (e.g. Chlamydia, Rickettsia, Mycoplasma)
• Acne
• Prophylaxis of asymptomatic meningococcal carrier state (not recommended)

Dosage

Adults: For adult patients, the typical dosage of oxytetracycline for susceptible infections is 100 mg twice daily for 5 days. For other conditions, such as acne, the dosage may be 500 mg twice daily, usually for a duration of 6 to 12 weeks, with the possibility of repeating the course intermittently.

Mechanism of action

Oxytetracycline exerts its antibacterial effects by binding to the 30S ribosomal subunit of bacteria, inhibiting the binding of aminoacyl-tRNA to the mRNA-ribosome complex. This action prevents the synthesis of proteins essential for bacterial growth and replication, leading to the bacteriostatic effect of the drug.

Pharmacodynamics

The pharmacodynamics of oxytetracycline involve its ability to inhibit bacterial protein synthesis, which is critical for the growth and reproduction of bacteria. The drug demonstrates a broad spectrum of activity against both Gram-positive and Gram-negative organisms, as well as some atypical pathogens. Its effectiveness can be influenced by the presence of tetracycline resistance mechanisms in certain bacterial strains.

Pharmacokinetics

Oxytetracycline is well absorbed from the gastrointestinal tract, with peak plasma concentrations occurring approximately 1-2 hours after oral administration. It has a relatively long half-life of about 8-10 hours, allowing for twice-daily dosing. The drug is widely distributed in body tissues and fluids, including the liver, kidneys, and lungs, but is less effective in central nervous system infections due to limited penetration. It is primarily excreted via urine, and dosage adjustments may be necessary in patients with renal impairment.

Contra-indications

• Children under 12 years due to deposition in growing bone and teeth, causing staining and occasionally dental hypoplasia

Adverse effects

• Gastrointestinal disturbances
• Photosensitivity
• Dental discoloration
• Hepatotoxicity
• Renal impairment
• Skin reactions including rash and urticaria
• Ataxia
• Hearing impairment
• Colitis
• Systemic lupus erythematosus exacerbation

Interactions

• Antacids and supplements containing calcium, magnesium, or iron may reduce absorption
• Oral contraceptives may be less effective
• Other tetracyclines
• Warfarin (may increase anticoagulant effect)

Precautions

• Use with caution in patients with renal impairment
• Monitor for hepatic toxicity in long-term use
• Patients should be advised to avoid excessive sunlight exposure
• Discontinue if systemic lupus erythematosus develops or worsens

Pregnancy

Oxytetracycline is contraindicated during pregnancy due to potential harm to fetal development, particularly affecting bone and dental health.

Breast-feeding

Use with caution; oxytetracycline is excreted in breast milk and may affect the infant's dental health.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Oxytetracycline 250 mg tablets
• Oxytetracycline oral suspension
• Oxytetracycline oral solution

Indications

• Warts
• Plantar warts
• Verrucas
• Umbilical granulomas

Dosage

Children: Apply twice daily for up to 3 consecutive days. Treatment may be repeated at weekly intervals if necessary for a total of four 3-day treatment courses, under specialist supervision.

Adults: Apply twice daily to the lesion for a maximum of 3 applications. Instructions generally recommend removing dead skin before use by gentle filing and covering with an adhesive dressing after application.

Mechanism of action

Formaldehyde is thought to act via sensory nerve fibers that signal through the trigeminal nerve, reflexively inducing bronchoconstriction through the vagus nerve. It may also disrupt miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease. Exposure to formaldehyde has been linked to alterations in gene expression that can contribute to diseases, particularly affecting the respiratory system.

Pharmacodynamics

Formaldehyde exhibits irritant properties, particularly affecting mucosal membranes and respiratory tissues. Its action leads to bronchoconstriction and inflammation upon exposure, indicating significant pharmacological activity as a respiratory irritant. Its potential to induce cellular changes and dysregulation of miRNA expression points to broader implications in disease pathology, particularly in lung tissue.

Pharmacokinetics

Formaldehyde is rapidly absorbed through inhalation and is metabolized primarily in the liver to form formic acid. Its short half-life and high reactivity limit its systemic exposure. The compound is known to form various adducts with proteins and DNA, contributing to its toxicological profile. Excretion is primarily via urine, as formic acid, with minimal excretion of unchanged formaldehyde.

Contra-indications

• Not for application to broken skin
• Not for application to anogenital areas
• Not for application to the face or mucosa

Adverse effects

• Skin irritation
• Rash
• Severe cutaneous adverse reactions
• Methhaemoglobinaemia
• Argyria

Precautions

• Avoid contact with normal skin and open wounds
• Protect surrounding skin with soft paraffin
• May be very irritant to eyes

Pregnancy

Avoid use during pregnancy due to potential harmful effects.

Breast-feeding

Avoid use during breastfeeding due to potential harmful effects.

Storage

Store in a cool, dry place away from light.

Formulations

• Formaldehyde solution 4% (Buffered)
• Formaldehyde liquid 10%

Dosage

Children: Refer to the BNF for Children for appropriate dosing information in paediatric cases, especially in instances of overdose.

Adults: Refer to the BNF for specific dosing information based on clinical circumstances, particularly in cases of overdose.

Mechanism of action

Ethylene glycol is metabolized by alcohol dehydrogenase to glycoaldehyde, which is subsequently converted to glycolic, glyoxylic, and oxalic acids. These metabolites contribute to anion gap metabolic acidosis and are responsible for tissue injury through the formation of insoluble calcium oxalate crystals.

Pharmacodynamics

The toxicity of ethylene glycol arises from its metabolites, particularly glycolic and oxalic acids. These compounds induce metabolic acidosis, lead to renal failure through calcium oxalate crystal deposition in the kidneys, and can cause neurological impairment. The anion gap increases due to the accumulation of these acids, leading to complications such as cardiovascular instability and potential multi-organ failure.

Pharmacokinetics

Ethylene glycol is rapidly absorbed after oral ingestion. It undergoes first-pass metabolism primarily in the liver, where it is converted into its toxic metabolites. The elimination half-life of ethylene glycol varies but is generally prolonged in cases of renal impairment. Renal excretion of metabolites contributes to the duration of toxicity, necessitating prompt medical intervention in cases of overdose.

Adverse effects

• Metabolic acidosis
• Renal failure
• CNS depression
• Hypocalcemia
• Cardiovascular collapse
• Pulmonary edema

Precautions

• Use with caution in patients with renal impairment
• Monitor for signs of metabolic acidosis
• Evaluate electrolyte levels, particularly calcium

Pregnancy

There is limited data on the safety of ethylene glycol in pregnancy. It should only be used if clearly needed.

Breast-feeding

It is unknown if ethylene glycol is excreted in human milk. Caution is advised.

Storage

Store in a tightly closed container at room temperature, away from heat and moisture.

Formulations

• Liquid

Indications

• Plant growth regulation
• Agricultural applications as a growth inhibitor

Dosage

Children: Not applicable.

Adults: Refer to the relevant agricultural guidelines for specific applications.

Mechanism of action

In an in vitro study, propylene acts as a plant growth inhibitor by inhibiting the oxidation of indole-3-acetic acid by peroxidase in the presence of superoxide anion radicals. This inhibition is linked to the activation of an iron complex (compound III) shuttle, which enhances the reaction rate between superoxide and peroxidase, ultimately affecting plant growth processes. Propylene is a less effective inhibitor compared to ethylene.

Pharmacodynamics

The pharmacodynamic effects of propylene are primarily observed in its role as a growth inhibitor in plants. By modulating the oxidation of phytohormones like indole-3-acetic acid, propylene can influence various growth responses in plants, potentially affecting processes such as cell elongation and division.

Pharmacokinetics

Information on the pharmacokinetics of propylene in humans is not well-documented, as its primary uses are industrial and agricultural. Its metabolism may be influenced by environmental factors, and its effects are primarily studied in the context of plant biology rather than human pharmacology.

Indications

• Mood disorders
• Anxiety disorders
• Neurotransmitter modulation

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing information.

Adults: Refer to the BNF for specific dosing guidance as it may vary based on the condition being treated.

Mechanism of action

Sulfoxylate acts as a modulator of neurotransmitter systems, specifically influencing the activity of monoamines such as serotonin and norepinephrine. It may exert its effects by altering synaptic transmission and enhancing the release of these neurotransmitters, contributing to its therapeutic effects in mood and anxiety disorders.

Pharmacodynamics

The pharmacodynamics of sulfoxylate involve its interaction with receptors and transporters in the central nervous system. By enhancing neurotransmitter availability, it can lead to improved mood and anxiety levels. The precise dose-response relationship and the time course of its effects may vary among individuals, necessitating careful monitoring in clinical use.

Pharmacokinetics

The pharmacokinetics of sulfoxylate are not extensively characterized in the available literature. However, it is expected to be absorbed following administration, with distribution occurring throughout the body, particularly in tissues rich in serotonin and norepinephrine receptors. Metabolism and excretion pathways remain to be fully elucidated, and further studies are required to clarify these aspects.

Pregnancy

Consult with a healthcare professional before use. Limited data available on safety during pregnancy.

Breast-feeding

Consult with a healthcare professional before use. Limited data available on safety during breastfeeding.

Storage

Store in a cool, dry place away from light.

Indications

• Topical treatment of skin conditions
• Emulsifying agent in pharmaceutical formulations
• Alkalizing agent in topical preparations

Dosage

Children: Refer to the BNF for Children for appropriate paediatric dosing, as it will provide specific guidance based on age and condition.

Adults: Refer to the specific product guidelines for adult dosing as it may vary based on formulation and intended use.

Mechanism of action

As an amine, trolamine can accept a hydrogen ion to form hydroxide and a conjugate acid, thereby increasing the pH of the solution. As a surfactant, it reduces interfacial tension, which helps to prevent the separation of emulsions or the precipitation of compounds out of solution.

Pharmacodynamics

Trolamine acts as a surfactant or alkalizing agent, facilitating the emulsification and solubilization of compounds. Its ability to raise the pH of a solution enhances the stability and effectiveness of various formulations.

Pharmacokinetics

Information specific to the pharmacokinetics of trolamine is not provided. Generally, the absorption, distribution, metabolism, and excretion of surfactants and alkalizing agents can vary based on formulation and route of administration. For topical applications, systemic absorption may be minimal.

Pregnancy

There is limited data on the use of trolamine during pregnancy. It should be used only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Trolamine is not expected to be excreted in significant amounts in breast milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Topical cream
• Topical gel

Mechanism of action

Formaldehyde is thought to act via sensory nerve fibers that signal through the trigeminal nerve to reflexively induce bronchoconstriction through the vagus nerve. Exposure to formaldehyde, a known air toxic, is associated with cancer and lung disease. Despite the adverse health effects of formaldehyde, the mechanisms underlying formaldehyde-induced disease remain largely unknown. Research has uncovered microRNAs (miRNAs) as key posttranscriptional regulators of gene expression that may influence cellular disease state. Although studies have compared different miRNA expression patterns between diseased and healthy tissue, this is the first study to examine perturbations in global miRNA levels resulting from formaldehyde exposure. We investigated whether cellular miRNA expression profiles are modified by formaldehyde exposure to test the hypothesis that formaldehyde exposure disrupts miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease. Human lung epithelial cells were grown at air-liquid interface and exposed to gaseous formaldehyde at 1 ppm for 4 hr. Small RNAs and protein were collected and analyzed for miRNA expression using microarray analysis and for interleukin (IL-8) protein levels by enzyme-linked immunosorbent assay (ELISA). RESULTS: Gaseous formaldehyde exposure altered the miRNA expression profiles in human lung cells. Specifically, 89 miRNAs were significantly down-regulated in formaldehyde-exposed samples versus controls. Functional and molecular network analysis of the predicted miRNA transcript targets revealed that formaldehyde exposure potentially alters signaling pathways associated with cancer, inflammatory response, and endocrine system regulation. IL-8 release increased in cells exposed to formaldehyde, and results were confirmed by real-time polymerase chain reaction. Formaldehyde alters miRNA patterns that regulate gene expression, potentially leading to the initiation of a variety of diseases. Formaldehyde at high concentrations is a contributor to air pollution. It is also an endogenous metabolic product in cells, and when beyond physiological concentrations, has pathological effects on neurons. Formaldehyde induces mis-folding and aggregation of neuronal tau protein, hippocampal neuronal apoptosis, cognitive impairment and loss of memory functions, as well as excitation of peripheral nociceptive neurons in cancer pain models. Intracellular calcium ([Ca(2+)](i)) is an important intracellular messenger, and plays a key role in many pathological processes. The present study aimed to investigate the effect of formaldehyde on [Ca(2+)](i) and the possible involvement of N-methyl-D-aspartate receptors (NMDARs) and T-type Ca(2+) channels on the cell membrane. METHODS: Using primary cultured hippocampal neurons as a model, changes of [Ca(2+)](i) in the presence of formaldehyde at a low concentration were detected by confocal laser scanning microscopy. Formaldehyde at 1 mmol/L approximately doubled [Ca(2+)](i). (2R)-amino-5-phosphonopentanoate (AP5, 25 umol/L, an NMDAR antagonist) and mibefradil (MIB, 1 umol/L, a T-type Ca(2+) channel blocker), given 5 min after formaldehyde perfusion, each partly inhibited the formaldehyde-induced increase of [Ca(2+)](i), and this inhibitory effect was reinforced by combined application of AP5 and MIB. When applied 3 min before formaldehyde perfusion, AP5 (even at 50 umol/L) did not inhibit the formaldehyde-induced increase of [Ca(2+)](i), but MIB (1 umol/L) significantly inhibited this increase by 70%. These results suggest that formaldehyde at a low concentration increases [Ca(2+)](i) in cultured hippocampal neurons; NMDARs and T-type Ca(2+) channels may be involved in this process. /The purpose of this study was/ to study the role of poly (ADP-ribose) polymerase-l (PARP-1) in formaldehyde-induced DNA damage response in human bronchial epithelial (HBE) cells and to investigate the mechanism of

Mechanism of action

Ethylene glycol is metabolized by alcohol dehydrogenase to glycoaldehyde, which is then metabolized to glycolic, glyoxylic, and oxalic acids. These acids, along with excess lactic acid are responsible for the anion gap metabolic acidosis. Oxalic acid readily precipitates with calcium to form insoluble calcium oxalate crystals. Tissue injury is caused by widespread deposition of oxalate crystals and the toxic effects of glycolic and glyoxylic acids.

Mechanism of action

In an in vitro study of the mechanism of action of ethylene as a plant growth inhibitor, the effects of ethylene and some of its analogs, including propylene, on the oxidation of indole-3-acetic acid were examined. Ethylene and its analogs inhibited the oxidation of indole-3-acetic acid by peroxidase under conditions where the iron complex (compound III, an oxy-ferrous complex of peroxidase) shuttle was activated. Inhibition occurred only in the presence of the superoxide anion radical 02(-). Spectral and kinetic data indicated that ethylene and its analogs enhanced the rate of reaction of 02(-) with peroxidase; ie, the iron complex (compound III) shuttle, resulting in the formation of compound III. Propylene was a less effective inhibitor than ethylene.

Mechanism of action

As an amine, trolamine is capable of accepting a hydrogen to form hydroxide and a conjugate acid. This raises the pH of the solution. As a surfactant, it can lower the interfacial tension in a mixture or solution to prevent separation of emulsions or precipitation of a compound out of solution.

Pharmacodynamics

Acts as a surfactant or alkalizing agent to aid in emulsification and solubilizing of compounds or in raising the pH of a solution