SALICURE

Indications

• Metabolic acidosis
• Lactic acidosis
• Support in shock or severe dehydration
• Exercise physiology research

Dosage

Children: Refer to clinical guidelines for specific dosing recommendations based on the clinical condition being treated.

Adults: Refer to clinical guidelines for specific dosing recommendations based on the clinical condition being treated.

Mechanism of action

Lactic acid primarily functions by contributing to the acid-base balance in the body. It can serve as a substrate for gluconeogenesis in the liver and is utilized in the Cori cycle, where it is converted back to glucose. Furthermore, lactic acid can act as a signaling molecule in various physiological processes, influencing metabolism and cellular responses during hypoxic conditions.

Pharmacodynamics

Lactic acid dissociates into lactate and hydrogen ions in solution, which can lead to a decrease in pH (acidosis) when produced in excess. Its accumulation in the body is indicative of anaerobic metabolism, often observed during intense exercise or in conditions of oxygen deprivation. The body can buffer the effects of lactic acid through bicarbonate and other mechanisms, maintaining homeostasis.

Pharmacokinetics

Lactic acid is rapidly absorbed and distributed throughout the body. It is metabolized primarily in the liver, where it can be converted to glucose or further metabolized to carbon dioxide and water. The elimination half-life of lactate varies depending on the metabolic state of the individual and the presence of underlying conditions. Renal function also plays a role in the clearance of lactate from the body.

Adverse effects

• Nausea
• Vomiting
• Abdominal pain
• Diarrhea
• Hypersensitivity reactions

Precautions

• Use with caution in patients with renal impairment
• Monitor for signs of metabolic acidosis
• Caution in patients with liver disease

Pregnancy

Lactic acid is generally regarded as safe, but clinical use should be evaluated on a case-by-case basis during pregnancy.

Breast-feeding

Considered safe for use during breastfeeding, but consult healthcare provider for individual cases.

Storage

Store at room temperature, away from direct sunlight and moisture.

Formulations

• Lactic acid injection
• Lactic acid oral solution

Indications

• Acne vulgaris
• Psoriasis
• Warts
• Seborrheic dermatitis
• Dandruff
• Hyperkeratosis

Dosage

Adults: For topical application, salicylic acid is typically applied once or twice daily, depending on the formulation and condition being treated. Specific dosing guidelines should be followed as per the BNF.

Mechanism of action

Salicylic acid exerts its effects by penetrating the skin and exfoliating the stratum corneum through keratolytic action, which helps in the dissolution of keratin and the removal of dead skin cells. This action facilitates the clearance of pores and can reduce acne lesions. Additionally, salicylic acid has anti-inflammatory properties that can help to decrease swelling and redness associated with various skin conditions. The compound is also known to inhibit the activity of enzymes involved in the synthesis of prostaglandins, which are mediators of inflammation.

Pharmacodynamics

The pharmacodynamics of salicylic acid involve its ability to enhance the turnover of skin cells and reduce the cohesiveness of keratinocytes in the stratum corneum. This leads to increased desquamation and a reduction in the formation of microcomedones in acne. Its anti-inflammatory effects are mediated through the inhibition of cyclooxygenase enzymes, leading to decreased production of pro-inflammatory mediators. This contributes to the reduction of inflammation and pain in affected areas.

Pharmacokinetics

Salicylic acid is absorbed percutaneously when applied topically, with systemic absorption increasing with higher concentrations and prolonged application. Once absorbed, it is metabolized predominantly in the liver to various conjugates, which are then excreted by the kidneys. The elimination half-life can vary based on the formulation and concentration used. For topical applications, significant first-pass metabolism may occur, limiting systemic exposure and reducing potential systemic side effects.

Pregnancy

Salicylic acid is classified as pregnancy category C. Its use should be avoided during pregnancy unless the potential benefits outweigh the risks.

Breast-feeding

Salicylic acid is excreted in breast milk, and caution is advised when using it during breastfeeding.

Storage

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

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.