DEBRIDACE TOPICAL GEL (Each gram contains Papun/ Urea

Indications

• Smooth muscle spasms
• Vasospastic disorders
• Angina pectoris
• Cerebral vasospasm
• Peripheral vascular disease

Dosage

Children: Refer to the BNF for Children for appropriate pediatric dosing.

Adults: Refer to clinical guidelines or prescribing information for specific dosing recommendations.

Mechanism of action

Papun inhibits phosphodiesterase enzymes, which results in increased levels of cyclic adenosine monophosphate (cAMP) within cells. Elevated cAMP leads to smooth muscle relaxation and vasodilation by inhibiting calcium influx and promoting the relaxation of the muscle fibers. This mechanism is critical in reducing spasms in various smooth muscle tissues, including those in the gastrointestinal tract and blood vessels.

Pharmacodynamics

Papun exhibits vasodilatory effects, primarily through the relaxation of vascular smooth muscle. The increase in cAMP levels leads to reduced intracellular calcium concentrations, which is essential for muscle contraction. This action helps alleviate symptoms associated with conditions such as angina, cerebral vasospasm, and other vascular disorders.

Pharmacokinetics

Papun is absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 1 to 2 hours after oral administration. It has a bioavailability of approximately 25-50%, which can be affected by first-pass metabolism. The drug is extensively metabolized in the liver, and its metabolites are primarily excreted in urine. The elimination half-life of papaverine is approximately 1-2 hours, but this may vary based on the route of administration and individual patient factors.

Pregnancy

The safety of papun during pregnancy has not been established. Use only if potential benefits justify potential risks to the fetus.

Breast-feeding

It is unknown whether papun is excreted in human milk. Caution is advised when administering to nursing women.

Storage

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

Indications

• Dry skin
• Ichthyosis
• Eczema
• Psoriasis
• Dermatitis

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations for paediatric patients.

Adults: Refer to the specific product information for dosing instructions, as doses may vary based on formulation and intended use.

Mechanism of action

The primary mechanism of ammonia toxicosis appears to be inhibition of the citric acid cycle. There is an increase in anaerobic glycolysis, blood glucose, and blood lactate. Acidosis is manifested. The exact means by which ammonia blocks the citric acid cycle is not known. It is postulated that ammonia saturation of the glutamine-synthesizing system causes a backing-up in the citrate cycle, a decrease in its intermediates, and a decrease in energy production and cellular respiration, which leads to convulsions. The decrease of citrate cycle intermediates is postulated to result from reamination of pyruvic, ketoglutaric, and oxaloacetic acids.

Pharmacodynamics

Urea is a keratolytic emollient that works to treat or prevent dry, rough, scaly, itchy skin. Its emollient properties help to maintain skin hydration and improve the overall condition of the skin.

Pharmacokinetics

Urea is absorbed through the skin and metabolized in the body. It does not have significant systemic effects when used topically, as it primarily acts locally to alter the moisture content of the stratum corneum, thereby enhancing the skin's barrier function and improving hydration.

Adverse effects

• Skin irritation
• Burning sensation
• Dryness
• Redness

Precautions

• Use with caution in individuals with renal impairment
• Avoid contact with eyes
• Discontinue use if severe irritation occurs

Pregnancy

Consult healthcare provider before use, safety in pregnancy not established.

Breast-feeding

Consult healthcare provider before use, safety in breastfeeding not established.

Storage

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

Formulations

• Topical cream
• Topical ointment
• Topical lotion

Mechanism of action

... The primary mechanism of ammonia toxicosis appears to be inhibition of the citric acid cycle. There is an increase in anaerobic glycolysis, blood glucose, and blood lactate ... . Acidosis is manifested. The exact means by which ammonia blocks the citric acid cycle is not known. It is postulated that ammonia saturation of the glutamine-synthesizing system causes a backing-up in the citrate cycle, a decrease in its intermediates, and a decrease in energy production and cellular respiration, which leads to convulsions ... . The decrease of citrate cycle intermediates is postulated to result from reamination of pyruvic, ketoglutaric, and oxaloacetic acids.

Pharmacodynamics

Urea is a keratolytic emollient that works to treat or prevent dry, rough, scaly, itchy skin.