CHILDRENS IRON TONIC 1.56-1.89%M/V AS FE ORAL LIQUID

Indications

• Acne
• Psoriasis
• Dandruff
• Calluses
• Corns
• Keratosis pilaris
• Warts
• Plantar warts

Dosage

Adults: Refer to the specific product formulation and BNF guidelines for adult dosing of salicylic acid preparations. Generally, topical applications should follow instructions provided on the product label.

Mechanism of action

Salicylic acid directly and reversibly inhibits COX-1 and COX-2 enzymes, decreasing the conversion of arachidonic acid to precursors of prostaglandins and thromboxanes. This inhibition contributes to its analgesic and anti-inflammatory activities. Additionally, salicylic acid promotes the shedding of epidermal cells and has keratolytic effects at higher concentrations, making it useful for treating various skin conditions.

Pharmacodynamics

Salicylic acid enhances the desquamation of skin cells, preventing acne formation by keeping pores clear. It possesses keratoplastic activity in low concentrations, correcting abnormal keratinization, while at higher concentrations, it exhibits keratolytic activity, promoting skin peeling. The compound also demonstrates mild antiseptic properties when applied topically. Furthermore, in combination with bismuth, subsalicylate (from salicylic acid) aids in gastrointestinal relief by managing symptoms such as diarrhea and nausea.

Pharmacokinetics

Salicylic acid is absorbed topically through the skin, with systemic absorption being minimal when used in low concentrations. It is metabolized primarily in the liver, undergoing conjugation to form salicyluric acid and other metabolites. The elimination half-life can vary significantly based on the dose and route of administration, with renal excretion being a primary route for metabolites. Local applications may lead to localized effects without significant systemic involvement.

Adverse effects

• Skin irritation
• Dryness
• Peeling
• Erythema
• Hypopigmentation
• Hyperpigmentation

Precautions

• Use with caution in patients with asthma due to potential for bronchospasm
• Not recommended for use on large areas of the body or on broken skin
• Caution in patients with renal impairment

Pregnancy

Salicylic acid is categorized as a pregnancy category C drug. Its use should be avoided during pregnancy unless clearly needed, as it may pose risks to the fetus.

Breast-feeding

Salicylic acid is excreted in breast milk. Caution is advised when using during breastfeeding, particularly in large amounts or over large areas.

Storage

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

Formulations

• Topical solutions
• Creams
• Gels
• Shampoos
• Ointments

Mechanism of action

Salicylic acid directly and reversibly inhibits COX-1 and COX-2 to decrease conversion of arachidonic acid to precursors of prostaglandins and thromboxanes. Salicylate's use in rheumatic diseases is due to it's analgesic and anti-inflammatory activity. Salicylic acid is a key ingredient in many skin-care products for the treatment of acne, psoriasis, calluses, corns, keratosis pilaris, and warts. Salicylic acid allows cells of the epidermis to more readily slough off. Because of its effect on skin cells, salicylic acid is used in several shampoos used to treat dandruff. Salicylic acid is also used as an active ingredient in gels which remove verrucas (plantar warts). Salicylic acid competitively inhibits oxidation of uridine-5-diphosphoglucose (UDPG) with nicotinamide adenosine dinucleotide (NAD) and noncompetitively with UDPG. It also competitively inhibits the transferring of the glucuronyl group of uridine-5-phosphoglucuronic acid (UDPGA) to a phenolic acceptor. Inhibition of mucopoly saccharide synthesis is likely responsible for the slowing of wound healing with salicylates. Salicylic acid has a potent keratolytic action and a slight antiseptic action when applied topically to the skin. In low concentrations, the drug has keratoplastic activity (correction of abnormal keratinization) and in higher concentrations (i.e., 1% or higher, depending on the vehicle), the drug has keratolytic activity (causes peeling of skin). Salicylic acid softens and destroys the stratum corneum by increasing endogenous hydration (water concentration), probably because of decreased pH, which causes the cornified epithelium (horny layer) of the skin to swell, soften, and then desquamate.

Pharmacodynamics

Salicylic acid treats acne by causing skin cells to slough off more readily, preventing pores from clogging up. This effect on skin cells also makes salicylic acid an active ingredient in several shampoos meant to treat dandruff. Use of straight salicylic solution may cause hyperpigmentation on unpretreated skin for those with darker skin types (Fitzpatrick phototypes IV, V, VI), as well as with the lack of use of a broad spectrum sunblock. Subsalicylate in combination with bismuth form the popular stomach relief aid known commonly as Pepto-Bismol. When combined the two key ingredients help control diarrhea, nausea, heartburn, and even gas. It is also very mildly anti-biotic.