TERAGEN PLUS AEROSOL SPRAY

Indications

• Scabies
• Head lice
• Crab lice

Dosage

Children: For children, apply once weekly for 2 doses, applying preparation over the whole body including face, neck, scalp, and ears, and wash off after 8–12 hours.

Adults: Apply once weekly for 2 doses, applying 5% preparation over the whole body including the face, neck, scalp, and ears, and wash off after 8–12 hours.

Mechanism of action

Permethrin acts on the nerve cell membrane to disrupt the sodium channel current that regulates membrane polarization. This leads to delayed repolarization and paralysis of the pests. It is pediculocidal by interfering with sodium channel currents in the louse's nerve cell membranes, resulting in paralysis and death of the insect.

Pharmacodynamics

As a pyrethroid, permethrin is effective against a wide range of arthropods including lice, ticks, fleas, and mites. Its neurotoxic effects are due to its ability to prolong sodium channel activation, resulting in sustained depolarization of nerve membranes and subsequent paralysis of the parasites.

Pharmacokinetics

Permethrin is minimally absorbed through the skin, which limits systemic exposure. Its pharmacokinetics are influenced by the formulation used, but it is primarily localized to the application site. Metabolism occurs mainly in the liver, and it is eliminated through fecal and urinary routes.

Contra-indications

• Hypersensitivity to permethrin or any of its excipients
• Children under 6 months (for certain formulations without medical supervision)
• Broken or secondarily infected skin

Adverse effects

• Scalp irritation
• Skin reactions
• Burning sensation
• Contact dermatitis
• Allergic reactions

Precautions

• Avoid contact with eyes
• Avoid contact with mucous membranes
• Medical supervision required for children under 2 years
• Caution in patients with severe eczema or asthma

Pregnancy

Permethrin should be used during pregnancy only if clearly needed and if the benefits outweigh the risks.

Breast-feeding

Permethrin is generally considered safe during breastfeeding, but caution should be exercised.

Storage

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

Formulations

• 5% cream
• Cutaneous spray solution
• Lotion
• Other topical formulations

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

• Insect repellent
• Aromatherapy
• Antimicrobial agent

Dosage

Children: For children, citronella oil should be used with caution and ideally in lower concentrations. It is advisable to consult specific pediatric dosing guidelines or refer to the BNF for Children for appropriate use.

Adults: For topical use as an insect repellent, citronella oil can be applied directly to the skin, typically in concentrations ranging from 10% to 30%. Reapplication may be necessary every few hours, especially in high exposure situations.

Mechanism of action

The exact mechanism of action of citronella is not fully understood, but it is believed to work primarily as a repellent by masking scents that attract insects. The principal component, citronellol, affects the olfactory receptors in insects, leading to their avoidance of treated areas.

Pharmacodynamics

Citronella exhibits insecticidal and repellent properties. Its effectiveness as an insect repellent is attributed to its ability to interfere with the olfactory senses of insects, thereby disrupting their ability to locate hosts. Citronella has also been shown to have mild antimicrobial and antifungal properties, which may contribute to its use in personal care products.

Pharmacokinetics

Citronella is absorbed through the skin when applied topically, and its effects can last for several hours, depending on the formulation and concentration used. The degradation pathway of citronellol, as indicated in the BioCyc database, suggests that the compound undergoes metabolic transformation in biological systems, which may influence its efficacy and duration of action.

Pregnancy

Safety in pregnancy has not been established. Use with caution and consult a healthcare provider.

Breast-feeding

Safety during breastfeeding is not well established. It is advisable to consult a healthcare professional before use.

Storage

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

Indications

• Loss of appetite
• Dyspepsia
• Gastrointestinal disorders
• Digestive aid
• Bloating

Dosage

Children: Refer to established herbal guidelines, as specific dosing may vary based on preparation and indication.

Adults: Refer to established herbal guidelines, as specific dosing may vary based on preparation and indication.

Mechanism of action

The primary mechanism of action of gentian is attributed to its bitter compounds, which stimulate the taste receptors in the mouth and gastrointestinal tract. This stimulation increases the secretion of digestive juices, including saliva, gastric acid, and bile, thereby enhancing digestion and appetite. The presence of secoiridoids may also exert anti-inflammatory and antioxidant effects, contributing to its overall benefits.

Pharmacodynamics

Gentian exhibits pharmacodynamic effects primarily through its bitter principles that promote digestive processes. These compounds increase gastrointestinal motility and enhance nutrient absorption by stimulating the secretion of digestive enzymes. Gentian's potential effects on appetite regulation may also involve central nervous system pathways, although this mechanism is less well understood.

Pharmacokinetics

The pharmacokinetics of gentian are not extensively characterized due to its herbal nature. However, it is generally assumed that the active compounds are absorbed in the gastrointestinal tract after oral administration. The metabolism and excretion pathways remain largely undefined, given the complexity of the herbal preparation and the variability in individual responses.

Pregnancy

The safety of gentian during pregnancy has not been established. Use should be avoided unless deemed necessary by a healthcare professional.

Breast-feeding

Limited information is available on the excretion of gentian in breast milk. Caution is advised when administering to breastfeeding mothers.

Storage

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

Dosage

Children: Refer to specific product information for details on use as a coloring agent in formulations.

Adults: Refer to specific product information for details on use as a coloring agent in formulations.

Mechanism of action

The mechanism of action for violet dyes generally involves their ability to absorb specific wavelengths of light, which contributes to their coloring properties. In the context of pharmacology, they do not possess therapeutic effects but rather serve a functional role in drug formulation.

Pharmacodynamics

As a coloring agent, violet dyes do not exhibit pharmacodynamic properties associated with therapeutic agents. They do not interact with biological targets in the manner that active pharmaceutical ingredients do, and their primary role is to provide color rather than therapeutic efficacy.

Pharmacokinetics

Violet dyes, being non-active agents, do not undergo typical pharmacokinetic processes such as absorption, distribution, metabolism, and excretion in the same way that active drugs do. Their presence in formulations is primarily for aesthetic purposes, and they are typically excreted unchanged.

Pregnancy

Safety not established; consult healthcare provider.

Breast-feeding

Safety not established; consult healthcare provider.

Storage

Store in a cool, dry place, away from light.

Mechanism of action

Permethrin acts on the nerve cell membrane to disrupt the sodium channel current by which the polarization of the membrane is regulated. Delayed repolarization and paralysis of the pests are the consequences of this disturbance. Permethrin is pediculocidal by disrupting in sodium channel current in the louse's nerve cell membrane; this action causes delayed polarization of the membrane and paralysis of the insect. Like natural pyrethrins, permethrin acts as a neurotoxin by depolarizing nerve cell membranes of parasites. The drug disrupts the sodium channel current by which membrane repolarization is regulated. Delayed repolarization results in paralysis of the nerves in the exoskeletal respiratory muscles of the parasite leading to death. The synthetic pyrethroids delay closure of the sodium channel, resulting in a sodium tail current that is characterized by a slow influx of sodium during the end of depolarization. Apparently the pyrethroid molecule holds the activation gate in the open position. Pyrethroids with an alpha-cyano group (e.g., fenvalerate) produce more prolonged sodium tail currents than do other pyrethroids (e.g., permethrin, bioresmethrin). The former group of pyrethroids causes more cutaneous sensations than the latter. /Synthetic pyrethroids/ Trans- and cis-permethrin were irradiated in sunlight and at gamma>290 nm in hexane, methanol, water and water acetone. Isomerization and ester cleavage occurred primarily. Observed products included monochloropermethrin and the monochlorovinyl acid from cleavage, 3-phenoxybenzyl 3,3-dimethylacrylate, 3-phenoxybenzaldehyde, 3-phenoxybenzoic acid, benzyl alcohol, benzaldehyde, 3-hydroxybenzyl alcohol, benzoic acid, 3-hydroxybenzoic acid, and 3-phenoxybenzyl alcohol. For more Mechanism of Action (Complete) data for PERMETHRIN (10 total), please visit the HSDB record page.

Pharmacodynamics

Permethrin, a pyrethroid, is active against a broad range of pests including lice, ticks, fleas, mites, and other arthropods.