Imovax Polio

Indications

• Warts
• Plantar warts
• Verrucas
• Umbilical granulomas

Dosage

Children: Apply twice daily for up to 3 consecutive days. Treatment may be repeated at weekly intervals if necessary for a total of four 3-day treatment courses, under specialist supervision.

Adults: Apply twice daily to the lesion for a maximum of 3 applications. Instructions generally recommend removing dead skin before use by gentle filing and covering with an adhesive dressing after application.

Mechanism of action

Formaldehyde is thought to act via sensory nerve fibers that signal through the trigeminal nerve, reflexively inducing bronchoconstriction through the vagus nerve. It may also disrupt miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease. Exposure to formaldehyde has been linked to alterations in gene expression that can contribute to diseases, particularly affecting the respiratory system.

Pharmacodynamics

Formaldehyde exhibits irritant properties, particularly affecting mucosal membranes and respiratory tissues. Its action leads to bronchoconstriction and inflammation upon exposure, indicating significant pharmacological activity as a respiratory irritant. Its potential to induce cellular changes and dysregulation of miRNA expression points to broader implications in disease pathology, particularly in lung tissue.

Pharmacokinetics

Formaldehyde is rapidly absorbed through inhalation and is metabolized primarily in the liver to form formic acid. Its short half-life and high reactivity limit its systemic exposure. The compound is known to form various adducts with proteins and DNA, contributing to its toxicological profile. Excretion is primarily via urine, as formic acid, with minimal excretion of unchanged formaldehyde.

Contra-indications

• Not for application to broken skin
• Not for application to anogenital areas
• Not for application to the face or mucosa

Adverse effects

• Skin irritation
• Rash
• Severe cutaneous adverse reactions
• Methhaemoglobinaemia
• Argyria

Precautions

• Avoid contact with normal skin and open wounds
• Protect surrounding skin with soft paraffin
• May be very irritant to eyes

Pregnancy

Avoid use during pregnancy due to potential harmful effects.

Breast-feeding

Avoid use during breastfeeding due to potential harmful effects.

Storage

Store in a cool, dry place away from light.

Formulations

• Formaldehyde solution 4% (Buffered)
• Formaldehyde liquid 10%

Indications

• Rectal and anal disorders
• Haemorrhoids
• Pruritus ani

Dosage

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

Adults: For rectal use using aerosol spray: 1 spray up to 3 times a day for no longer than 7 days without medical advice. For ointment: apply several times daily, for short-term use only.

Mechanism of action

Phenol exerts its effects by acting as a potent proteolytic agent. At concentrations of 5% to 7%, it can dissolve tissue through proteolysis. When injected near a nerve, it produces chemical neurolysis, affecting nerve fibers nonselectively. Local anesthetic effects are typically observed within 5 to 10 minutes of application.

Pharmacodynamics

Phenol's pharmacodynamic properties include its ability to cause tissue dissolution and local anesthesia. The local anesthetic effects result from its action on the nerve fibers, leading to a temporary loss of sensation in the affected area. The proteolytic action can assist in the treatment of various skin and mucosal conditions by facilitating tissue breakdown.

Pharmacokinetics

Phenol is absorbed through mucosal surfaces when applied locally. Its metabolism involves biological oxidation and phase I functionalization, primarily through cytochrome P450 enzymes. The elimination of phenol occurs through metabolic pathways, and it can be detected in urine as a result of its metabolism.

Contra-indications

• Infection
• Known hypersensitivity to phenol or its components

Adverse effects

• Local irritation
• Burning sensation
• Paraesthesia
• Vision disorders
• Skin reactions
• Adrenal suppression

Interactions

• Caution with other local anesthetics due to potential additive effects

Precautions

• Use for short periods only-no longer than a few days
• Avoid excessive application, especially on sensitive areas
• Consult product literature for specific guidelines

Pregnancy

Data on the use of phenol during pregnancy is limited; caution is advised.

Breast-feeding

Limited information available; caution is recommended when used in breastfeeding mothers.

Storage

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

Formulations

• Ointment
• Suppository
• Aerosol spray

Indications

• Vaccination against infectious diseases
• Allergy testing and immunotherapy
• Monoclonal antibody production
• Transplantation to prevent organ rejection

Dosage

Children: Dosing of antigens in children also depends on the specific antigen and the clinical indication. For pediatric vaccinations, refer to the BNF for Children.

Adults: Dosing of antigens is highly variable and depends on the specific antigen and the clinical indication. For vaccine administration, refer to national immunization guidelines.

Mechanism of action

Antigens work by binding to specific receptors on the surface of immune cells, such as B cells and T cells. This binding triggers a cascade of immune responses, including the proliferation of specific immune cell populations and the production of antibodies that target the antigen. This process is crucial for the development of adaptive immunity, allowing the body to remember and respond more effectively to future encounters with the same antigen.

Pharmacodynamics

The pharmacodynamics of antigens involve the interaction with the immune system to elicit a response. The magnitude and quality of this response can vary based on several factors, including the nature of the antigen, the route of exposure, and the host's immune status. Antigens can be classified as T-cell dependent or T-cell independent, influencing the type of immune response generated.

Pharmacokinetics

Antigens are processed by antigen-presenting cells (APCs) that present peptide fragments to T cells. The pharmacokinetics of antigens can vary widely depending on their form (e.g., live attenuated, inactivated, or subunit vaccines). Generally, once introduced into the body, antigens are taken up by APCs, which then migrate to lymph nodes to activate T and B cells. The duration of immune response can be influenced by the type of antigen and the presence of adjuvants.

Pregnancy

Safety during pregnancy depends on the specific type of antigen. Consult relevant guidelines for specific antigens.

Breast-feeding

Safety during breastfeeding varies by antigen type. Consult relevant guidelines for specific antigens.

Storage

Store at controlled room temperature, away from light and moisture. Specific storage conditions may vary based on the type of antigen.

Indications

• Hepatitis A
• Hepatitis B
• Influenza
• Polio
• Rabies
• Typhoid fever

Dosage

Children: Refer to specific product guidelines for paediatric dosing, as it varies by vaccine type and indication.

Adults: Refer to specific product guidelines for adult dosing, as it varies by vaccine type and indication.

Mechanism of action

Inactivated vaccines work by introducing a form of the pathogen that cannot cause disease into the body. This stimulates the immune system to produce antibodies and memory cells specific to the pathogen, allowing for a robust immune response upon future exposure. The immune system recognizes the inactivated pathogen as foreign, leading to the activation of T-cells and B-cells, which are crucial for long-term immunity.

Pharmacodynamics

The pharmacodynamics of inactivated vaccines involve the generation of an adaptive immune response. After vaccination, the body produces specific antibodies against the inactivated pathogen. The response typically includes both humoral immunity, characterized by antibody production, and cellular immunity, involving T-cell activation. The duration of immunity can vary, and booster doses may be required to maintain adequate protection.

Pharmacokinetics

Inactivated vaccines do not have a pharmacokinetic profile like traditional drugs since they do not enter systemic circulation in the same manner. Following administration, the vaccine components are taken up by antigen-presenting cells, which process and present the antigens to T-cells. The immune response is initiated locally at the site of injection and can be influenced by factors such as the route of administration and the presence of adjuvants that enhance the immune response.

Adverse effects

• Injection site reactions (pain, swelling, redness)
• Fever
• Fatigue
• Headache
• Myalgia
• Chills

Precautions

• Assess for allergies to vaccine components
• Monitor for allergic reactions post-administration
• Consider underlying health conditions that may affect immune response

Pregnancy

Inactivated vaccines are generally considered safe during pregnancy, but individual risk-benefit assessment is recommended.

Breast-feeding

Inactivated vaccines can be administered during breastfeeding without concern for adverse effects in the infant.

Storage

Store in a refrigerator at 2°C to 8°C. Do not freeze.

Formulations

• Inactivated viral vaccines
• Inactivated bacterial vaccines

Dosage

Children: Refer to specific product guidelines as dosage will depend on the type of medium and its intended application.

Adults: Refer to specific product guidelines as dosage will depend on the type of medium and its intended application.

Mechanism of action

The mechanism of action for a medium can vary greatly depending on the specific medium being referenced. Generally, media serve to maintain the stability and viability of cells or organisms during culture, enabling metabolic processes to occur. For instance, nutrient media provide essential nutrients, while selective media may inhibit the growth of certain organisms while promoting others.

Pharmacodynamics

Pharmacodynamics is largely dependent on the type of medium used and its components. In tissue cultures, the medium can influence cell growth, differentiation, and physiological responses. The interactions of cells with their environment are critical for cellular signaling and function.

Pharmacokinetics

Pharmacokinetics is not typically applicable to media in the same way it is for active drugs. However, the absorption and distribution of substances within a medium can affect how well the active ingredients are delivered or how organisms interact with the medium. Factors such as pH, osmolarity, and nutrient concentration can all influence these processes.

Pregnancy

Consult a healthcare provider before use, as the safety of medium in pregnancy has not been established.

Breast-feeding

Consult a healthcare provider before use, as it is unknown whether medium passes into breast milk.

Storage

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

Dosage

Children: Paediatric dosing in micrograms is also highly variable based on the drug and the condition being treated. Refer to the BNF for Children for detailed dosing recommendations.

Adults: Dosage in micrograms varies widely depending on the specific medication and its indication. Consult relevant clinical guidelines or the BNF for precise dosing information.

Mechanism of action

The mechanism of action varies depending on the specific drug being measured in micrograms. For example, many drugs operate by binding to specific receptors or enzymes, leading to a physiological response. This can include agonistic or antagonistic effects on neurotransmitter systems, modulation of immune responses, or alteration of metabolic pathways.

Pharmacodynamics

Pharmacodynamics refers to the effects of the drug on the body, including the relationship between drug concentration and effect. Drugs measured in micrograms often have a steep dose-response curve, meaning small changes in dosage can lead to significant changes in therapeutic and adverse effects. The potency of such drugs is typically high, necessitating careful dosing and monitoring.

Pharmacokinetics

Pharmacokinetics involves the study of how the body absorbs, distributes, metabolizes, and excretes a drug. Drugs administered in microgram doses may exhibit rapid absorption and distribution, especially if given intravenously or sublingually. Metabolism often occurs in the liver, and excretion can be renal or via bile, depending on the drug's chemical properties. Understanding the pharmacokinetics is essential for optimizing therapeutic regimens and minimizing side effects.

Pregnancy

Consult a healthcare professional before use. Safety and efficacy during pregnancy have not been established.

Breast-feeding

Consult a healthcare professional before use. It is not known if this drug is excreted in human milk.

Storage

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

Indications

• Prevention of poliomyelitis through vaccination
• Control of polio outbreaks in communities

Dosage

Children: Refer to vaccination schedules for children, typically involving oral polio vaccine (OPV) or inactivated poliovirus vaccine (IPV) according to national immunization guidelines.

Adults: Refer to vaccination guidelines for adults, generally involving inactivated poliovirus vaccine (IPV) administration according to public health recommendations.

Mechanism of action

The poliovirus enters the body through the gastrointestinal tract, where it binds to specific receptors on the surface of motor neurons. Once inside the cell, the virus replicates and disrupts normal cellular function, leading to cell death. This results in the characteristic muscle weakness or paralysis associated with the disease.

Pharmacodynamics

The primary action of the poliovirus is neurotropic, meaning it has a specific affinity for nerve cells, particularly motor neurons. The destruction of these cells leads to the hallmark symptoms of poliomyelitis, including varying degrees of muscle weakness, paralysis, and in some cases, respiratory failure if the diaphragm is affected. The severity of the disease can vary widely from asymptomatic infection to severe paralysis.

Pharmacokinetics

Poliovirus does not undergo traditional pharmacokinetics as it is an infectious agent rather than a pharmacological compound. The virus has a short incubation period, typically ranging from 7 to 14 days, after which symptoms can manifest. The virus can be isolated from the throat or stool of infected individuals, and the duration of viral shedding can vary. Immunity develops after infection or vaccination, providing long-lasting protection against future infections.

Adverse effects

• Muscle weakness
• Paralysis
• Fatigue
• Respiratory issues
• Joint pain

Precautions

• Ensure vaccination in at-risk populations
• Monitor for signs of respiratory distress in affected individuals
• Educate patients about the importance of hygiene to prevent spread

Pregnancy

Poliovirus vaccination is generally considered safe during pregnancy, but live attenuated vaccines are not recommended.

Breast-feeding

Inactivated poliovirus vaccine is safe during breastfeeding.

Storage

Store poliovirus vaccines according to manufacturer's instructions, typically in a refrigerator at 2-8°C. Do not freeze.

Formulations

• Inactivated poliovirus vaccine (IPV)
• Oral poliovirus vaccine (OPV)

Indications

• Prevention of poliomyelitis infection
• Vaccination in children and high-risk populations

Dosage

Children: Refer to the BNF for Children for specific dosages and recommendations for vaccination schedules.

Adults: Refer to specific vaccination guidelines for adults, as dosages may vary based on risk factors and prior vaccination history.

Mechanism of action

Poliovirus enters the body through the oral route, replicating in the oropharynx and gastrointestinal tract before spreading to the central nervous system via the bloodstream. Once inside the CNS, the virus selectively infects motor neurons in the anterior horn of the spinal cord, leading to cell lysis and resulting in muscle weakness or paralysis. The immune response to the virus contributes to inflammation and further neuronal damage.

Pharmacodynamics

The poliovirus's pathogenicity is primarily due to its ability to evade the host's immune response and its selective neurotropism. The destruction of motor neurons leads to flaccid paralysis, with recovery possible in some cases as the motor neurons may regenerate. The severity of the disease correlates with the extent of neuronal involvement, which can vary widely among individuals.

Pharmacokinetics

Poliovirus is an RNA virus that does not undergo traditional pharmacokinetic processes as it is not treated with drugs. Instead, the prevention of polio relies on vaccination strategies. The inactivated poliovirus vaccine (IPV) and the oral poliovirus vaccine (OPV) are used to induce immunity. After administration, the vaccines promote the development of antibodies against the virus without causing disease.

Contra-indications

• Hypersensitivity to the vaccine component
• Severe immunodeficiency
• Acute febrile illness

Adverse effects

• Pain at injection site
• Fever
• Fatigue
• Headache
• Nausea
• Allergic reactions

Interactions

• Immunosuppressive therapies may reduce vaccine efficacy
• Concomitant administration with other vaccines may affect immune response

Precautions

• Use with caution in individuals with moderate to severe acute illness
• Consider history of allergic reactions
• Monitor for signs of anaphylaxis after administration

Pregnancy

Poliomyelitis vaccination is generally considered safe during pregnancy, but consult a healthcare professional.

Breast-feeding

The vaccine is considered safe for breastfeeding mothers.

Storage

Store at 2 to 8 degrees Celsius. Do not freeze. Protect from light.

Formulations

• Inactivated poliovirus vaccine (IPV)
• Oral poliovirus vaccine (OPV)

Dosage

Children: Refer to specific drug guidelines as dosing in units varies based on the drug and its clinical application.

Adults: Refer to specific drug guidelines as dosing in units varies based on the drug and its clinical application.

Mechanism of action

The mechanism of action of drugs measured in units depends on the specific substance. For example, insulin (measured in units) facilitates glucose uptake in cells by binding to insulin receptors, activating a signaling pathway that enhances glucose transporter translocation to the cell membrane. This results in a decrease in blood glucose levels. Similarly, other drugs measured in units may exert their effects through receptor binding, enzyme catalysis, or other biochemical interactions.

Pharmacodynamics

Pharmacodynamics describes the effects of the drug on the body and includes the relationship between drug concentration and effect. For substances measured in units, the pharmacodynamic response may be variable and is often dependent on the individual’s sensitivity to the drug, receptor availability, and other pharmacological factors. For instance, the effect of 1 unit of insulin can vary significantly among individuals based on their insulin sensitivity and metabolic state.

Pharmacokinetics

Pharmacokinetics refers to the absorption, distribution, metabolism, and excretion of drugs. For substances measured in units, the pharmacokinetic profile can differ widely. For instance, insulin is rapidly absorbed when administered subcutaneously, distributed throughout the body, metabolized by the liver and kidneys, and its effects can be observed within minutes. Other drugs may have different absorption rates, half-lives, and routes of elimination.

Pregnancy

Consult a healthcare professional. The safety of this drug during pregnancy has not been established.

Breast-feeding

Consult a healthcare professional. The safety of this drug during breastfeeding has not been established.

Storage

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

Indications

• Prevention of infectious diseases such as measles, mumps, rubella, hepatitis B, influenza, and human papillomavirus (HPV)
• Travel vaccinations for diseases endemic to certain regions
• Vaccination for at-risk populations, such as those with compromised immune systems or specific occupational exposures

Dosage

Children: Dosage varies by vaccine type and age; refer to the BNF for Children for specific dosing information.

Adults: Dosage varies by vaccine type and indication; refer to specific guidelines for each vaccine.

Mechanism of action

Vaccines work by mimicking an infection. They introduce a harmless component of a pathogen (antigen) to the immune system, prompting the body to produce an immune response. This includes the generation of antibodies and memory cells that provide long-term immunity. Upon subsequent exposure to the actual pathogen, the immune system is primed to respond more rapidly and effectively.

Pharmacodynamics

The pharmacodynamics of vaccines involves the activation of both humoral and cellular immunity. Vaccines stimulate B cells to produce antibodies against the pathogen, while T cells are activated to destroy infected cells. This dual response helps to establish immunological memory, which enables a faster and more robust response upon re-exposure to the pathogen.

Pharmacokinetics

Vaccines are administered via various routes, including intramuscular, subcutaneous, and oral. After administration, the antigens are presented to antigen-presenting cells, which activate T cells and stimulate B cell proliferation and differentiation. The half-life of vaccine-induced immunity varies depending on the type of vaccine, with some providing lifelong immunity and others requiring booster doses to maintain protection.

Contra-indications

• Severe allergic reaction (anaphylaxis) to a component of the vaccine
• Severe immunocompromised state for live attenuated vaccines

Adverse effects

• Local reactions at the injection site (pain, redness, swelling)
• Fever
• Fatigue
• Headache
• Muscle pain
• Joint pain
• Nausea

Interactions

• Immunosuppressive medications may reduce vaccine efficacy
• Concurrent administration of some vaccines may require spacing to optimize immune response

Precautions

• History of allergic reactions to vaccines or vaccine components
• Pregnancy (specific vaccines may be contraindicated)
• Moderate to severe acute illness with or without fever

Pregnancy

Consult healthcare provider. Some vaccines are contraindicated during pregnancy, while others are recommended.

Breast-feeding

Generally considered safe, but consult healthcare provider regarding specific vaccines.

Storage

Store in a refrigerator at 2-8°C. Do not freeze. Protect from light.

Formulations

• Liquid suspension for injection
• Lyophilized powder for reconstitution

Dosage

Children: Refer to the specific drug name for dosing information.

Adults: Refer to the specific drug name for dosing information.

Mechanism of action

Formaldehyde is thought to act via sensory nerve fibers that signal through the trigeminal nerve to reflexively induce bronchoconstriction through the vagus nerve. Exposure to formaldehyde, a known air toxic, is associated with cancer and lung disease. Despite the adverse health effects of formaldehyde, the mechanisms underlying formaldehyde-induced disease remain largely unknown. Research has uncovered microRNAs (miRNAs) as key posttranscriptional regulators of gene expression that may influence cellular disease state. Although studies have compared different miRNA expression patterns between diseased and healthy tissue, this is the first study to examine perturbations in global miRNA levels resulting from formaldehyde exposure. We investigated whether cellular miRNA expression profiles are modified by formaldehyde exposure to test the hypothesis that formaldehyde exposure disrupts miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease. Human lung epithelial cells were grown at air-liquid interface and exposed to gaseous formaldehyde at 1 ppm for 4 hr. Small RNAs and protein were collected and analyzed for miRNA expression using microarray analysis and for interleukin (IL-8) protein levels by enzyme-linked immunosorbent assay (ELISA). RESULTS: Gaseous formaldehyde exposure altered the miRNA expression profiles in human lung cells. Specifically, 89 miRNAs were significantly down-regulated in formaldehyde-exposed samples versus controls. Functional and molecular network analysis of the predicted miRNA transcript targets revealed that formaldehyde exposure potentially alters signaling pathways associated with cancer, inflammatory response, and endocrine system regulation. IL-8 release increased in cells exposed to formaldehyde, and results were confirmed by real-time polymerase chain reaction. Formaldehyde alters miRNA patterns that regulate gene expression, potentially leading to the initiation of a variety of diseases. Formaldehyde at high concentrations is a contributor to air pollution. It is also an endogenous metabolic product in cells, and when beyond physiological concentrations, has pathological effects on neurons. Formaldehyde induces mis-folding and aggregation of neuronal tau protein, hippocampal neuronal apoptosis, cognitive impairment and loss of memory functions, as well as excitation of peripheral nociceptive neurons in cancer pain models. Intracellular calcium ([Ca(2+)](i)) is an important intracellular messenger, and plays a key role in many pathological processes. The present study aimed to investigate the effect of formaldehyde on [Ca(2+)](i) and the possible involvement of N-methyl-D-aspartate receptors (NMDARs) and T-type Ca(2+) channels on the cell membrane. METHODS: Using primary cultured hippocampal neurons as a model, changes of [Ca(2+)](i) in the presence of formaldehyde at a low concentration were detected by confocal laser scanning microscopy. Formaldehyde at 1 mmol/L approximately doubled [Ca(2+)](i). (2R)-amino-5-phosphonopentanoate (AP5, 25 umol/L, an NMDAR antagonist) and mibefradil (MIB, 1 umol/L, a T-type Ca(2+) channel blocker), given 5 min after formaldehyde perfusion, each partly inhibited the formaldehyde-induced increase of [Ca(2+)](i), and this inhibitory effect was reinforced by combined application of AP5 and MIB. When applied 3 min before formaldehyde perfusion, AP5 (even at 50 umol/L) did not inhibit the formaldehyde-induced increase of [Ca(2+)](i), but MIB (1 umol/L) significantly inhibited this increase by 70%. These results suggest that formaldehyde at a low concentration increases [Ca(2+)](i) in cultured hippocampal neurons; NMDARs and T-type Ca(2+) channels may be involved in this process. /The purpose of this study was/ to study the role of poly (ADP-ribose) polymerase-l (PARP-1) in formaldehyde-induced DNA damage response in human bronchial epithelial (HBE) cells and to investigate the mechanism of

Mechanism of action

Phenol is a potent proteolytic agent. Concentrations in the 5% to 7% range dissolve tissue on contact via proteolysis. In high concentrations when injected next to a nerve, phenol produces a chemical neurolysis which is nonselective across nerve fiber size and most prominent on its outer aspect. Local anesthetic effects occur within 5-10 minutes. The effects of monoamine depletors and monoamine denervators on phenol induced tremor were studied in mice. The tremor induced by phenol was enhanced by pretreatment with reserpine or tetrabenazine, but not with syrosingopine. However, alpha-methyl-p-tyrosine, p-chlorophenylalanine or 6-hydroxydopamine did not affect the tremor. These results suggest that the depletion of central monoamines as a whole contribute to the enhancement of the tremor induced by phenol.