Equirab

Indications

• Post-exposure prophylaxis following animal bites or exposure to rabies suspected animals
• Pre-exposure prophylaxis for individuals at high risk of rabies exposure, such as veterinarians and animal handlers

Dosage

Children: Refer to specific guidelines for pediatric dosing based on age and weight, as well as the nature of exposure.

Adults: Refer to specific guidelines for post-exposure prophylaxis and pre-exposure prophylaxis, as doses can vary based on the individual's exposure risk and vaccination status.

Mechanism of action

Antirabies vaccines contain inactivated or attenuated strains of the rabies virus, which provoke an immune response. The vaccine triggers the body to produce specific antibodies against the rabies virus glycoprotein, leading to the development of immunological memory. Upon exposure to the virus, the immune system can respond more quickly and effectively.

Pharmacodynamics

The pharmacodynamic action of antirabies vaccines is primarily the induction of an immune response, characterized by the production of neutralizing antibodies. The immune response typically peaks within 2 to 4 weeks after vaccination. The duration of immunity may vary, but it can last for several years in individuals who have received the complete vaccination series.

Pharmacokinetics

The pharmacokinetics of antirabies vaccines involve the intramuscular administration of the vaccine, leading to systemic absorption. The vaccine components are processed by antigen-presenting cells, which subsequently activate T cells and stimulate B cells to produce antibodies. The half-life of the antibodies produced can vary, but they generally remain detectable for an extended period following immunization.

Adverse effects

• Injection site reactions
• Fever
• Headache
• Nausea
• Malaise

Precautions

• Use with caution in individuals with a history of allergic reactions to vaccines
• Monitor for allergic reactions post-administration

Pregnancy

Safety in pregnancy has not been established. Use only if clearly needed.

Breast-feeding

Limited data available, consult healthcare provider before use.

Storage

Store in a refrigerator at 2-8 degrees Celsius. Do not freeze.

Formulations

• Intradermal vaccine
• Intramuscular vaccine

Indications

• Antiseptic
• Disinfectant
• Topical analgesic
• Preservative
• Industrial solvent

Dosage

Children: Refer to specific product guidelines for paediatric dosing, as it varies based on formulation and intended use.

Adults: Refer to specific product guidelines for adult dosing, as it varies based on formulation and intended use.

Mechanism of action

Cresol acts by denaturing proteins and disrupting cellular membranes, which leads to the death of microorganisms. It exhibits broad-spectrum antimicrobial activity against bacteria, fungi, and some viruses. The phenolic structure of cresol contributes to its ability to penetrate lipid membranes, enhancing its efficacy as a disinfectant.

Pharmacodynamics

Cresol demonstrates its antimicrobial effects through cytotoxicity, leading to cell lysis and death. It also has local anesthetic properties, which can provide temporary relief from pain when used in topical formulations. Its antiseptic properties make it effective in reducing microbial load in contaminated wounds or surgical sites.

Pharmacokinetics

Cresol is absorbed through the skin and mucous membranes, and it can be metabolized in the liver to various conjugates. The elimination half-life can vary, but it is generally excreted in urine as glucuronides or sulfates. Due to its lipophilic nature, cresol can accumulate in fatty tissues, which may prolong its effects.

Adverse effects

• Skin irritation
• Respiratory distress
• Gastrointestinal irritation
• CNS depression
• Nausea
• Vomiting
• Headache
• Dizziness

Precautions

• Use with caution in patients with pre-existing respiratory conditions
• Avoid contact with skin and mucous membranes
• Ensure adequate ventilation during use
• Use protective equipment when handling

Pregnancy

Cresol is classified as a category C drug. Its safety in pregnancy has not been established, and it should be used only if the potential benefit justifies the risk to the fetus.

Breast-feeding

It is not known whether cresol is excreted in human milk. Caution should be exercised when it is administered to a nursing woman.

Storage

Store in a cool, dry place away from heat and direct sunlight. Keep container tightly closed and out of reach of children.

Formulations

• Liquid solution
• Topical ointment
• Disinfectant formulations

Indications

• Autism Spectrum Disorders
• Attention Deficit Hyperactivity Disorder (ADHD)
• Post-Traumatic Stress Disorder (PTSD)
• Anxiety Disorders
• Depression
• Cerebral Palsy
• Physical Rehabilitation

Dosage

Children: Refer to the specific therapeutic regimen determined by a healthcare professional, as equine therapy is individualized based on patient needs.

Adults: Refer to the specific therapeutic regimen determined by a healthcare professional, as equine therapy is individualized based on patient needs.

Mechanism of action

Equine therapy operates on several levels. The physical interaction with horses can enhance gross motor skills and encourage physical fitness. Psychologically, the bond formed between horse and human can foster emotional healing, reduce anxiety, and build confidence. The rhythmic motion of riding has been shown to have a calming effect on individuals, mimicking similar movements to those experienced in a therapeutic setting. Moreover, the social interaction involved in caring for and riding horses may improve communication skills and socialization.

Pharmacodynamics

Equine therapy itself does not involve pharmacological agents; however, it may influence the psychobiological pathways in the body. The interactions evoke hormonal responses that can alter levels of cortisol and adrenaline, enhancing relaxation and reducing stress. The therapeutic environment can also promote the release of endorphins, contributing to a sense of well-being and happiness.

Pharmacokinetics

As equine therapy does not involve drugs, pharmacokinetics is not applicable. However, the effects on the body can vary based on individual patient characteristics, the specific condition treated, and the duration and frequency of the therapy sessions. Factors such as age, physical condition, and psychological state can influence therapeutic outcomes.

Pregnancy

Equine products should be used with caution during pregnancy, as there is limited data on their safety. Consultation with a healthcare professional is recommended.

Breast-feeding

Safety during breastfeeding is not well established; therefore, caution is advised when using equine products in nursing mothers.

Storage

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

Indications

• Cancer therapy
• Immunotherapy
• Wound healing
• Hormonal therapies
• Metabolic disorders

Dosage

Children: Dosing for paediatric patients is dependent on the specific fragment and indication; consult pediatric dosing references or clinical guidelines for appropriate dosing.

Adults: Dosing for fragments varies widely based on the specific type and use case; refer to specific product information or clinical guidelines for accurate dosing.

Mechanism of action

The mechanism of action of fragments varies widely depending on the specific fragment in question. Generally, peptide fragments can interact with specific receptors on cell surfaces, modulating signaling pathways and biological responses. For example, some fragments may act as agonists or antagonists at hormone receptors, influencing processes such as metabolism, growth, and immune responses. Additionally, fragments can enhance or inhibit protein-protein interactions, affecting cellular activities.

Pharmacodynamics

Pharmacodynamics of fragments is largely dependent on their structure and the biological targets they engage. Fragments may exhibit dose-dependent effects, and their potency can be influenced by factors such as their affinity for receptors, their ability to penetrate cellular membranes, and their stability in biological systems. The biological activity can range from promoting cellular proliferation and differentiation to inducing apoptosis in cancer cells.

Pharmacokinetics

The pharmacokinetics of fragments can vary considerably. Generally, they may have a shorter half-life compared to full-length proteins due to their smaller size and potential for faster metabolism. Absorption can occur via various routes, including oral, subcutaneous, or intravenous administration, depending on the formulation. Distribution is influenced by their hydrophilicity or lipophilicity, while elimination typically involves renal clearance or degradation by proteolytic enzymes.

Pregnancy

Safety in pregnancy has not been established. Use only if clearly needed.

Breast-feeding

Caution is advised. It is recommended to consult with a healthcare professional before use.

Storage

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

Indications

• Constipation
• Preparation for surgical or diagnostic procedures involving the rectum
• Decreasing intraocular pressure in certain ocular conditions

Dosage

Children: For children aged 2 to 6 years, 2 g to 5 g of glycerin may be used as a suppository. Children aged 6 to 12 years may use 5 g to 10 g as needed. For specific pediatric dosing, please refer to the BNF for Children.

Adults: For rectal use, 4 g to 10 g of glycerin may be administered as a suppository as needed.

Mechanism of action

When administered rectally, glycerin draws water from the tissues into the feces due to its hygroscopic action, which reflexively stimulates bowel evacuation. Additionally, glycerin creates an osmotic gradient that leads to a decrease in intraocular pressure by facilitating fluid movement from the aqueous and vitreous humors into the bloodstream.

Pharmacodynamics

Glycerin is classified as an osmotic laxative, which acts to retain water in the fecal matter, softening stools and making them easier to pass. Its local irritant effects also contribute to its laxative properties. Glycerin suppositories typically produce a bowel movement within 15 to 30 minutes of administration.

Pharmacokinetics

Glycerin is readily absorbed from the gastrointestinal tract when taken orally and is metabolized primarily in the liver. It is distributed widely throughout the body, with excretion occurring primarily via the kidneys. The onset of action for glycerin when used as a laxative is relatively quick, particularly when used rectally.

Contra-indications

• Severe dehydration
• Severe renal impairment
• Intestinal obstruction
• Appendicitis

Adverse effects

• Abdominal cramps
• Diarrhea
• Nausea
• Vomiting
• Electrolyte imbalance

Interactions

• May enhance the effects of other laxatives
• Caution with concurrent use of diuretics due to potential electrolyte imbalance

Precautions

• Use with caution in patients with renal impairment
• Monitor electrolytes in patients with prolonged use
• Not recommended for long-term use

Pregnancy

Glycerin is generally considered safe during pregnancy but should be used under medical advice.

Breast-feeding

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

Storage

Store at room temperature, away from moisture and heat.

Formulations

• Glycerin suppositories
• Glycerin oral solution

Dosage

Children: Refer to specific drug monographs for paediatric dosing information, as grams alone do not provide sufficient context for dosage.

Adults: Refer to specific drug monographs for adult dosing information, as grams alone do not provide sufficient context for dosage.

Mechanism of action

Grams as a measure do not have a mechanism of action. However, the pharmacological effects of the drugs measured in grams depend on the specific active ingredients. Each drug has its own unique mechanism based on its chemical structure and how it interacts with biological systems.

Pharmacodynamics

Pharmacodynamics relates to how drugs affect the body, which is determined by the specific drug being measured in grams. Factors such as receptor binding, dose-response relationships, and therapeutic effects are all influenced by the pharmacological properties of the active ingredient rather than the weight alone.

Pharmacokinetics

Pharmacokinetics involves the absorption, distribution, metabolism, and excretion (ADME) of drugs. This process varies widely among different medications and is not dictated by the mass measured in grams. Each compound has its own profile regarding how quickly it enters the bloodstream, reaches target tissues, is metabolized by the liver, and is eliminated from the body.

Pregnancy

Grams should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Consultation with a healthcare provider is recommended.

Breast-feeding

Grams may be excreted 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.

Indications

• Primary immunodeficiency disorders
• Secondary immunodeficiency (e.g. due to HIV infection)
• Chronic inflammatory demyelinating polyneuropathy (CIDP)
• Immune thrombocytopenic purpura (ITP)
• Kawasaki disease
• Prevention of infections in at-risk populations (e.g. following bone marrow transplant)

Dosage

Children: Refer to the BNF for Children for age-appropriate dosing guidelines; specific doses depend on the clinical condition and patient age.

Adults: Refer to specific guidelines for dosing based on indication; typically varies based on clinical scenario and patient condition.

Mechanism of action

Immunoglobulin exerts its effects primarily through the neutralization of pathogens and toxins, opsonization, and the activation of the complement system. It modulates immune responses by influencing the activity of various immune cells, including B cells, T cells, and macrophages, thereby enhancing antibody production and regulating inflammation.

Pharmacodynamics

The pharmacodynamics of immunoglobulin involve its ability to bind to specific antigens, effectively neutralizing them and facilitating their clearance. It also plays a crucial role in modulating the immune response, providing immediate passive immunity and promoting the establishment of active immunity over time. The diverse mechanisms through which immunoglobulin operates include antibody-dependent cell-mediated cytotoxicity (ADCC) and inhibition of pro-inflammatory cytokines.

Pharmacokinetics

Immunoglobulin is typically administered intravenously or subcutaneously. After administration, it is distributed throughout the extracellular space. The half-life of immunoglobulin varies but is generally in the range of 21 to 30 days, depending on the specific formulation and the patient's individual characteristics. It is primarily eliminated through the reticuloendothelial system, with catabolism occurring in various tissues.

Contra-indications

• Hypersensitivity to immunoglobulin preparations
• Selective IgA deficiency with a history of hypersensitivity
• Severe hyperprolinemia

Adverse effects

• Headache
• Nausea
• Fever
• Chills
• Fatigue
• Rash
• Anaphylactic reactions
• Thromboembolic events

Interactions

• Live attenuated vaccines may be less effective if administered concurrently with immunoglobulin therapy
• Caution is advised when administering with other blood products

Precautions

• Monitor for signs of anaphylaxis during and after administration
• Use with caution in patients with renal impairment
• Hydrate adequately to prevent renal dysfunction
• Consider the risk of thrombosis in patients with a history of thromboembolic events

Pregnancy

Immunoglobulin can be used during pregnancy if indicated, as it is considered safe based on available data.

Breast-feeding

Immunoglobulin is excreted in breast milk, but is generally considered safe during breastfeeding.

Storage

Store at 2-8 degrees Celsius. Do not freeze. Protect from light. Use before expiry date.

Formulations

• Intravenous immunoglobulin (IVIG)
• Subcutaneous immunoglobulin (SCIG)
• Intramuscular immunoglobulin (IMIG)

Indications

• Bacterial infections
• Pneumonia
• Skin infections
• Urinary tract infections
• Sepsis

Dosage

Children: Refer to the BNF for Children for specific dosing information for pediatric patients based on age and weight.

Adults: Refer to the BNF for specific dosing information for adults based on the condition being treated.

Mechanism of action

Micro acts by inhibiting bacterial cell wall synthesis, leading to cell lysis and death. This bactericidal action is primarily due to the disruption of peptidoglycan synthesis, which is essential for maintaining the structural integrity of bacterial cells.

Pharmacodynamics

The pharmacodynamics of Micro involves its interaction with bacterial enzymes responsible for cell wall synthesis. The drug is effective against a wide range of gram-positive and some gram-negative bacteria, making it a versatile option in antimicrobial therapy. It exhibits time-dependent killing, meaning that the duration of time the drug concentration remains above the minimum inhibitory concentration (MIC) is critical for its efficacy.

Pharmacokinetics

Micro is typically well absorbed following oral administration, with peak plasma concentrations occurring within a few hours. The drug is widely distributed throughout body tissues and fluids, including the lungs, kidneys, and skin. It is metabolized in the liver and primarily excreted unchanged in the urine, making it important to monitor renal function in patients receiving this medication.

Pregnancy

Micro can be used during pregnancy if the benefits outweigh the risks, but it is essential to consult a healthcare provider.

Breast-feeding

Micro may be excreted in breast milk, and caution is advised when administered to nursing mothers.

Storage

Store at room temperature, away from moisture and direct light. Keep out of reach of children.

Mechanism of action

When administered rectally, glycerin exerts a hygroscopic and/or local irritant action, drawing water from the tissues into the feces and reflexively stimulating evacuation. Glycerin decreases intraocular pressure by creating an osmotic gradient between the blood and intraocular fluid, causing fluid to move out of the aqueous and vitreous humors into the bloodstream. Glycerin (glycerol) and sorbitol are hyperosmotic laxatives. When administered rectally, glycerin and sorbitol exert a hygroscopic and/or local irritant action, drawing water from the tissues into the feces and reflexly stimulating evacuation. The extent to which the simple physical distention of the rectum and the hygroscopic and/or local irritant actions are responsible for the laxative effects of some of these drugs is not known. Only extremely high oral doses of sorbitol (25 g daily) or glycerin exert laxative action. /Glycerin/ decreases intraocular pressure by creating an osmotic gradient between the blood and intraocular fluid, causing fluid to move out of the aqueous and vitreous humors into the bloodstream. The physicochemical effects of a series of alkanols, alkanediols and glycerol on erythrocyte shape and hemolysis at 4 and 20 degrees C were examined. We calculated the dielectric constant of the incubation medium, Ds, and the dielectric constant of the erythrocyte membrane Dm in the presence of organic solutes. The ratio Ds/Dm = -38.48 at 20 degrees C defines the normal biconcave shape in a medium without hemolytic agents. A decrease in Ds/Dm favors externalization or internalization with consequent hemolysis. Alkanols and alkanediols convert biconcave erythrocytes into echinocytes, which is accompanied by an increase in the projected surface area. Glycerol converts biconcave erythrocytes into stomatocytes, which was accompanied by a marginal decrease in the projected surface area. Progressive externalization in alkanols and alkanediols or internalization in glycerol resulted in a decrease in the projected surface area and the formation of smooth spheres. The degree of shape change induced was related to the degree of hemolysis and the ratio Ds/Dm. A decrease in temperature reduced both the degree of shape change and hemolysis. .../Thus/ physicochemical toxicity may be a result of a temperature dependent hydrophobic interaction between the organic solutes and the membrane and is best interpreted by the ability of the solutes to change Ds and Dm.

Pharmacodynamics

Glycerin is commonly classified as an osmotic laxative but may act additionally or alternatively through its local irritant effects; it may also have lubricating and fecal softening actions. Glycerin suppositories usually work within 15 to 30 minutes.