Dentamol

Indications

• Mild to moderate pain
• Fever
• Headaches
• Muscle aches
• Arthritis
• Backaches
• Toothaches
• Colds

Dosage

Adults: For adults, the typical dosage is 500 mg to 1 g every 4 to 6 hours, with a maximum daily limit of 4 g. In cases of intravenous administration, the dosage is 15 mg/kg every

Mechanism of action

Paracetamol is thought to exert its analgesic effects by inhibiting cyclo-oxygenase (COX) enzymes, specifically COX-1 and COX-2, which are involved in the synthesis of prostaglandins responsible for pain sensation. Unlike most NSAIDs, paracetamol does not exhibit peripheral anti-inflammatory effects. Its antipyretic action is believed to result from direct action on heat-regulating centers in the brain, leading to peripheral vasodilation and sweating.

Pharmacodynamics

Paracetamol has been shown to have both antipyretic and analgesic effects, lacking any significant anti-inflammatory activity. It does not interfere with platelet aggregation or disrupt hemostasis, making it a safer option for individuals at risk of bleeding. Allergic reactions to paracetamol are rare. The drug does not affect uric acid secretion or acid-base balance when used at recommended doses.

Pharmacokinetics

Paracetamol is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations typically occurring within 30 to 60 minutes after oral administration. It is primarily metabolized in the liver via conjugation with glucuronide and sulfate, with a minor pathway involving cytochrome P450 enzymes. The elimination half-life ranges from 1 to 4 hours, with renal excretion of metabolites as the primary route of elimination.

Adverse effects

• Nausea and vomiting
• Liver injury
• Renal damage
• Hypersensitivity reactions
• Flushing
• Hypotension
• Anorectal erythema
• Angioedema
• Agranulocytosis
• Thrombocytopenia
• Leukopenia
• Severe cutaneous adverse reactions (SCARs)

Interactions

• Increased risk of methaemoglobinaemia with topical prilocaine
• Increased risk of methaemoglobinaemia with topical anaesthetics
• Increased anticoagulant effect with coumarins
• Increased risk of hepatotoxicity with imatinib
• Decreased exposure with rifampicin
• Decreased exposure with pitolisant

Precautions

• Monitor patients with liver disease or heavy alcohol use for increased risk of hepatotoxicity
• Adjust doses in patients taking enzyme-inducing antiepileptic medications
• Use caution in patients with renal impairment
• Clinical judgement is required for dose adjustment in weight-based dosing

Pregnancy

Paracetamol is generally considered safe to use during pregnancy for pain and fever relief, but should be used at the lowest effective dose for the shortest duration necessary.

Breast-feeding

Paracetamol is excreted in breast milk in small amounts and is considered safe for use while breastfeeding.

Storage

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

Formulations

• Oral tablets (500 mg)
• Oral suspension (120 mg/5 mL, 500 mg/5 mL)
• Rectal suppositories (various strengths)
• Intravenous infusion (various strengths)

Indications

• Low blood volume
• Hypovolemic shock
• Burns
• Cardiopulmonary bypass

Dosage

Children: Initially 10-20 mL per kilogram. Adjust according to the patient's condition and response, using 3.5-4% solution. Use under specialist supervision to mitigate the risk of fluid overload.

Adults: Dose according to requirements, typically administered intravenously. Consult product literature for specific dosing guidance.

Mechanism of action

Gelatin acts as a plasma expander by increasing the oncotic pressure in the vascular compartment, which helps to retain fluid within the bloodstream and restore circulating blood volume. This mechanism aids in maintaining blood pressure and improving tissue perfusion.

Pharmacodynamics

Gelatin solutions increase blood volume and improve hemodynamic stability in patients experiencing hypovolemic conditions. By drawing water into the vascular space, they help to counteract the effects of low blood volume, such as hypotension and compromised organ perfusion.

Pharmacokinetics

Gelatin is administered intravenously, and its effects can be observed relatively quickly. The half-life and the metabolic clearance depend on the formulation and concentration of the solution. Gelatin is gradually metabolized by macrophages and eliminated by the renal system. Close monitoring of fluid balance is essential, particularly in patients with cardiac or renal impairment.

Contra-indications

• Severe liver disease
• History of circulatory disease
• Severe cardiac disease

Adverse effects

• Fever
• Flushing
• Nausea
• Urticaria
• Rare or very rare shock

Interactions

• Calcium salts

Precautions

• Monitor cardiovascular and respiratory function
• Correct dehydration when administering
• Administer slowly to avoid rapid rise in blood pressure and cardiac failure
• Increased capillary permeability

Pregnancy

Consult product literature for specific guidance regarding use in pregnancy.

Breast-feeding

Consult product literature for specific guidance regarding use in breastfeeding.

Storage

Store at controlled room temperature, protect from light. Refer to product-specific storage instructions.

Formulations

• 5% solution for infusion
• 20% solution for infusion
• Concentrated solution (15-25% protein)
• Isotonic solution (3.5-5% protein)

Indications

• Energy source
• Dietary fiber supplement
• Source of vitamins and minerals
• Antioxidant support

Dosage

Children: Corn can be introduced to children as part of a balanced diet. There is no specific paediatric dosage; it should be given according to age-appropriate dietary guidelines.

Adults: Corn can be consumed in various forms as part of a balanced diet. There is no specific adult dosage; intake should be based on dietary preferences and nutritional needs.

Mechanism of action

The primary component of corn is starch, which is a polysaccharide composed of glucose units. Upon ingestion, starch is broken down into glucose by enzymes such as amylase in the digestive system. The glucose is then absorbed into the bloodstream, providing energy to cells throughout the body. Corn also contains antioxidants such as lutein and zeaxanthin, which may help protect against oxidative stress and support eye health.

Pharmacodynamics

Corn is mainly metabolized for energy due to its high carbohydrate content. The dietary fiber in corn aids in digestion and promotes satiety. Additionally, the presence of vitamins and minerals contributes to overall health, supporting various bodily functions including immune response and bone health. The antioxidants in corn may help reduce inflammation and lower the risk of chronic diseases.

Pharmacokinetics

The digestion and absorption of corn depend on its form (whole kernel, cornmeal, corn syrup, etc.). Generally, carbohydrates are digested and absorbed relatively quickly, with glucose appearing in the bloodstream shortly after consumption. The fiber content can slow digestion and help maintain stable blood sugar levels. The bioavailability of nutrients from corn can vary based on processing methods, such as cooking or milling.

Pregnancy

Corn is generally considered safe during pregnancy. It provides essential nutrients such as fiber, vitamins, and minerals, but should be consumed in moderation as part of a balanced diet.

Breast-feeding

Corn is safe for consumption while breastfeeding. It can provide important nutrients, but it's advisable to monitor for any allergic reactions in infants.

Storage

Store corn in a cool, dry place. Fresh corn should be kept in the refrigerator and consumed within a few days for optimal freshness.

Formulations

• Fresh corn
• Canned corn
• Frozen corn
• Cornmeal
• Corn syrup
• Corn oil

Indications

• Food coloring agent
• Pharmaceutical coloring agent
• Diagnostic agent in certain imaging procedures

Dosage

Children: Refer to specific preparations for paediatric dosing as it may vary widely depending on the formulation and intended use.

Adults: Refer to specific preparations for adult dosing as it may vary widely depending on the formulation and intended use.

Mechanism of action

Erythrosine acts as a fluorescent dye, absorbing light in the visible spectrum and emitting it at a different wavelength. It binds to proteins and nucleic acids, which can affect biological processes such as cell division and apoptosis. Erythrosine's mechanism also involves interaction with cellular membranes, potentially influencing membrane integrity and function.

Pharmacodynamics

Erythrosine exhibits properties as a photosensitizer, with its efficacy increasing under light exposure. It can impact cellular activity by generating reactive oxygen species when activated by light, leading to oxidative stress in cells. This mechanism is utilized in certain therapeutic applications, although it is primarily recognized for its colorant properties.

Pharmacokinetics

Erythrosine is absorbed from the gastrointestinal tract when ingested, with peak plasma concentrations occurring shortly after administration. It is distributed throughout the body and is known to cross biological membranes. The compound is primarily excreted via urine, with some metabolites detected, indicating hepatic metabolism. The elimination half-life of erythrosine is variable and influenced by individual physiology and dosage.

Contra-indications

• Hypersensitivity to erythrosine or any of its components
• Thyroid disorders
• Patients with iodine allergy

Adverse effects

• Hypersensitivity reactions
• Thyroid dysfunction
• Nausea
• Vomiting
• Diarrhea
• Skin rashes

Interactions

• May interact with thyroid function tests, leading to false results
• Potential for interactions with other iodine-containing compounds

Precautions

• Use with caution in patients with a history of thyroid disease
• Monitor thyroid function in patients receiving long-term therapy
• Assess for allergic reactions prior to administration

Pregnancy

Erythrosine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consult healthcare professional for advice.

Breast-feeding

It is not known whether erythrosine is excreted in human milk. Use with caution, considering the benefits and risks.

Storage

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

Formulations

• Oral suspension
• Injectable solution

Indications

• Preoperative skin antisepsis
• Wound irrigation and cleansing
• Management of minor cuts and abrasions
• Treatment of minor skin infections
• Disinfection of mucous membranes

Dosage

Children: Refer to specific product guidelines for concentration and application method, as doses may vary by formulation.

Adults: Refer to specific product guidelines for concentration and application method, as doses may vary by formulation.

Mechanism of action

Povidone-iodine exerts its antiseptic effects primarily through the release of free iodine, which penetrates microbial cell walls and disrupts protein and nucleic acid synthesis. This leads to cell lysis and death of a wide variety of pathogens. The mechanism involves the oxidation of essential cellular components, thus rendering microorganisms inactive.

Pharmacodynamics

Povidone-iodine demonstrates rapid bactericidal activity, effectively reducing the microbial load on the skin and in wounds. The antimicrobial efficacy is influenced by factors such as concentration, exposure time, and the presence of organic matter. Its broad-spectrum action makes it effective against gram-positive and gram-negative bacteria, fungi, and viruses, making it a versatile antiseptic.

Pharmacokinetics

Povidone-iodine is not significantly absorbed through intact skin; however, some absorption may occur with large or prolonged applications, especially on compromised skin. The elimination half-life of iodide is approximately 24 hours, with the majority excreted unchanged in the urine. Iodine levels can be temporarily elevated in the serum after application, particularly in patients with pre-existing thyroid conditions.

Contra-indications

• Hypersensitivity to povidone-iodine or any of the excipients
• Thyroid dysfunction
• Use in infants less than 2 months of age

Adverse effects

• Skin irritation
• Burning sensation
• Allergic reactions
• Staining of skin and clothing
• Thyroid dysfunction
• Electrolyte imbalance (with prolonged use)

Interactions

• May interfere with thyroid function tests
• Incompatibility with other antiseptics or disinfectants

Precautions

• Avoid contact with eyes
• Use with caution in patients with thyroid disease
• Not for deep puncture wounds or serious burns

Pregnancy

Generally considered safe for topical use, but should be used with caution. Consult a healthcare professional for guidance.

Breast-feeding

Suitable for topical use, but excessive use should be avoided. Consult a healthcare professional for guidance.

Storage

Store at room temperature, away from direct sunlight. Keep container tightly closed.

Formulations

• Topical solution
• Ointment
• Surgical scrub
• Swab sticks

Indications

• Used as a binder in tablet formulations
• Serves as a disintegrant to improve drug release
• Acts as a thickening agent in liquid formulations
• Enhances bioavailability of poorly soluble drugs

Dosage

Children: Dosage is dependent on the specific formulation and intended use. Refer to formulation guidelines for appropriate concentrations.

Adults: Dosage is dependent on the specific formulation and intended use. Refer to formulation guidelines for appropriate concentrations.

Mechanism of action

Pregelatinised starch acts primarily as a thickening agent and binder in pharmaceutical formulations. When mixed with water, it swells and forms a gel-like consistency, which helps in the uniform distribution of active ingredients and enhances their release and absorption in the gastrointestinal tract. Its ability to gel enables better disintegration of tablets upon administration, facilitating the dissolution of the drug.

Pharmacodynamics

The pharmacodynamics of pregelatinised starch is closely related to its physical properties as a polymer. Upon contact with water, it hydrates and expands, creating a viscous solution that can improve the release profile of drugs. This can lead to enhanced dissolution rates of poorly soluble compounds, improving their bioavailability. Additionally, it can impact the stability and shelf-life of formulations by providing a protective matrix for active ingredients.

Pharmacokinetics

Pregelatinised starch is not absorbed systemically as it primarily acts as an excipient. It undergoes gastrointestinal transit without significant degradation. Its function is to facilitate the release and absorption of the active pharmaceutical ingredients in the formulation rather than exhibiting pharmacokinetic properties of its own.

Pregnancy

Pregelatinised starch is generally considered safe for use during pregnancy, but it is recommended to consult a healthcare provider before use.

Breast-feeding

Pregelatinised starch is considered safe during breastfeeding, but it is advisable to seek medical advice.

Storage

Store in a cool, dry place, away from direct sunlight and moisture.

Formulations

• Powder
• Capsules
• Tablets

Indications

• Preservation of food products
• Preservation of pharmaceutical formulations
• Antimicrobial agent in cosmetic products

Dosage

Children: Refer to specific product guidelines for dosage as it varies by formulation and intended use.

Adults: Refer to specific product guidelines for dosage as it varies by formulation and intended use.

Mechanism of action

Sorbate acts primarily by inhibiting the growth of fungi and some bacteria. It interferes with the microbial cell membrane, disrupting its integrity and function, which leads to cell death. The presence of sorbate alters the pH and osmotic balance within the microbial cell, inhibiting key metabolic processes necessary for reproduction and survival.

Pharmacodynamics

Sorbate exhibits its antimicrobial effects at relatively low concentrations. It is most effective in acidic environments, typically at a pH of 4.5 or lower. The compound is more effective against yeasts and molds compared to bacteria. Its mode of action is primarily through the inhibition of fatty acid synthesis and alteration of membrane permeability in target microorganisms.

Pharmacokinetics

Sorbate is generally regarded as having low toxicity and is rapidly metabolized in the human body. It is absorbed in the gastrointestinal tract when ingested and is then distributed throughout the body. The compound undergoes conversion to various metabolites and is primarily excreted via the urine. Its half-life and specific metabolic pathways can vary depending on the form of administration and individual patient factors.

Pregnancy

There is limited data on the safety of sorbate in pregnancy. Use only if clearly needed and potential benefits justify the risks.

Breast-feeding

There is insufficient information regarding the excretion of sorbate in human milk. Caution is advised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Nutritional supplementation
• Energy source in enteral nutrition
• Excipient in pharmaceutical formulations

Dosage

Children: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Adults: Refer to specific guidelines or product inserts for dosing information, as it can vary based on the context of use.

Mechanism of action

Starch is broken down into glucose units by enzymes such as amylase during digestion. The glucose is then absorbed in the intestines and utilized for energy production in the body's cells. This pathway involves hydrolysis of the glycosidic bonds, converting starch into simpler sugars.

Pharmacodynamics

Starch primarily serves as an energy source. Its digestion and absorption lead to an increase in blood glucose levels, which provides energy for metabolic processes. In this context, it plays a crucial role in maintaining energy homeostasis in the body.

Pharmacokinetics

Starch is not absorbed in its polymeric form; it must first be enzymatically hydrolyzed into simpler sugars such as maltose and glucose. The digestion and absorption of starch occur predominantly in the small intestine, with glucose being readily absorbed into the bloodstream. The rate of absorption can vary depending on the type of starch and its physical form.

Adverse effects

• Allergic reactions
• Gastrointestinal discomfort
• Diarrhea
• Constipation

Precautions

• Use with caution in individuals with known allergies to starch or starch derivatives
• Monitor for gastrointestinal symptoms in patients with a history of digestive disorders

Pregnancy

Starch is generally considered safe for use during pregnancy. However, it should be consumed in moderation as part of a balanced diet.

Breast-feeding

Starch is deemed safe for nursing mothers when used in moderation as part of a balanced diet.

Storage

Store in a cool, dry place away from moisture and direct sunlight.

Formulations

• Powder
• Granules
• Tablets
• Suspensions

Indications

• Demulcent for sore throat
• Soothing agent for gastrointestinal irritation
• Thickening agent in pharmaceutical formulations
• Emulsifier in food products

Dosage

Children: Refer to specific formulations and guidelines, as doses can vary based on the application and formulation.

Adults: Refer to specific formulations and guidelines, as doses can vary based on the application and formulation.

Mechanism of action

The mechanism of action of tragacanth is mainly attributed to its ability to form gels and viscous solutions upon hydration. This property allows it to coat mucous membranes, providing a protective barrier that can soothe irritation. Additionally, its emulsifying properties help stabilize mixtures of oil and water, enhancing the bioavailability of certain compounds in pharmaceutical formulations.

Pharmacodynamics

Tragacanth acts as a mucilage-forming agent, which means that it can absorb water and swell to form a gel-like substance. This characteristic can aid in the relief of symptoms associated with irritation in the gastrointestinal tract and respiratory system. Its soothing and protective effects can also enhance the palatability of oral formulations.

Pharmacokinetics

Tragacanth is not absorbed systemically when ingested. Instead, it remains in the gastrointestinal tract where it exerts its effects locally. The bulk-forming properties of tragacanth may help to regulate bowel movements and promote gastrointestinal health. Its viscosity and gel formation may influence the rate of gastric emptying and intestinal transit time.

Adverse effects

• Gastrointestinal discomfort
• Nausea
• Vomiting
• Diarrhea

Precautions

• Use with caution in patients with gastrointestinal disorders
• Ensure adequate hydration to prevent gastrointestinal blockage

Pregnancy

Tragacanth is generally considered safe during pregnancy, but it's advisable to consult a healthcare provider before use.

Breast-feeding

Tragacanth is likely safe during breastfeeding, but consult a healthcare provider for guidance.

Storage

Store in a cool, dry place, away from direct sunlight.

Formulations

• Powder
• Granules
• Emulsion

Dosage

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

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

Mechanism of action

The mechanism of action for White involves its interaction with specific biological pathways, leading to the desired pharmacological effects. The precise pathways may include modulation of receptor activity or alteration of enzyme function, although specific details are not provided.

Pharmacodynamics

Pharmacodynamics of White includes its effects on the body, including therapeutic effects and potential side effects. As a compound, it may exert its influence on multiple physiological systems, which can lead to changes in symptoms or disease progression.

Pharmacokinetics

Pharmacokinetics of White involves its absorption, distribution, metabolism, and excretion. Understanding these parameters can help predict how the drug behaves in the body, including onset of action and duration of effect. Detailed pharmacokinetic data is not specified.

Mechanism of action

According to its FDA labeling, acetaminophen's exact mechanism of action has not been fully established - despite this, it is often categorized alongside NSAIDs (non-steroidal anti-inflammatory drugs) due to its ability to inhibit the cyclo-oxygenase (COX) pathways. It is thought to exert central actions which ultimately lead to the alleviation of pain symptoms. One theory is that acetaminophen increases the pain threshold by inhibiting two isoforms of cyclo-oxygenase, COX-1 and COX-2, which are involved in prostaglandin (PG) synthesis. Prostaglandins are responsible for eliciting pain sensations. Acetaminophen does not inhibit cyclooxygenase in peripheral tissues and, therefore, has no peripheral anti-inflammatory effects. Though acetylsalicylic acid (aspirin) is an irreversible inhibitor of COX and directly blocks the active site of this enzyme, studies have shown that acetaminophen (paracetamol) blocks COX indirectly. Studies also suggest that acetaminophen selectively blocks a variant type of the COX enzyme that is unique from the known variants COX-1 and COX-2. This enzyme has been referred to as _COX-3_. The antipyretic actions of acetaminophen are likely attributed to direct action on heat-regulating centers in the brain, resulting in peripheral vasodilation, sweating, and loss of body heat. The exact mechanism of action of this drug is not fully understood at this time, but future research may contribute to deeper knowledge. Although further investigation is warranted, the active metabolite of acetaminophen (AM404) was shown to interact with several molecular targets, including the Ca_v3.2 calcium channel, the cannabinoid CB1 receptors, TRPV1 receptors, and Na_v1.8 and Na_v1.7 channels. Acetaminophen produces analgesia and antipyresis by a mechanism similar to that of salicylates. Unlike salicylates, however, acetaminophen does not have uricosuric activity. There is some evidence that acetaminophen has weak anti-inflammatory activity in some nonrheumatoid conditions (e.g., in patients who have had oral surgery). ... Acetaminophen lowers body temperature in patients with fever but rarely lowers normal body temperature. The drug acts on the hypothalamus to produce antipyresis; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. The effects of acetaminophen on cyclooxygenase activity have not been fully determined. Acetaminophen is a weak, reversible, isoform-nonspecific cyclooxygenase inhibitor at dosages of 1 g daily. The inhibitory effect of acetaminophen on cyclooxygenase-1 is limited, and the drug does not inhibit platelet function. Therapeutic doses of acetaminophen appear to have little effect on cardiovascular and respiratory systems; however, toxic doses may cause circulatory failure and rapid, shallow breathing. Acetaminophen (N-acetyl-p-aminophenol (APAP)) is the most common antipyretic/analgesic medicine worldwide. If APAP is overdosed, its metabolite, N-acetyl-p-benzo-quinoneimine (NAPQI), causes liver damage. However, epidemiological evidence has associated previous use of therapeutic APAP doses with the risk of chronic obstructive pulmonary disease (COPD) and asthma. The transient receptor potential ankyrin-1 (TRPA1) channel is expressed by peptidergic primary sensory neurons. Because NAPQI, like other TRPA1 activators, is an electrophilic molecule, /the researchers/ hypothesized that APAP, via NAPQI, stimulates TRPA1, thus causing airway neurogenic inflammation. NAPQI selectively excites human recombinant and native (neuroblastoma cells) TRPA1. TRPA1 activation by NAPQI releases proinflammatory neuropeptides (substance P and calcitonin gene-related peptide) from sensory nerve terminals in rodent airways, thereby causing neurogenic edema and neutrophilia. Single or repeated administration of therapeutic (15-60 mg/kg) APAP doses to mice produces detectable levels of NAPQI in the lung, and increases neutrophil numbers, myeloperoxidase

Pharmacodynamics

Animal and clinical studies have determined that acetaminophen has both antipyretic and analgesic effects. This drug has been shown to lack anti-inflammatory effects. As opposed to the _salicylate_ drug class, acetaminophen does not disrupt tubular secretion of uric acid and does not affect acid-base balance if taken at the recommended doses. Acetaminophen does not disrupt hemostasis and does not have inhibitory activities against platelet aggregation. Allergic reactions are rare occurrences following acetaminophen use.