Gentriboston skin cream treats skin inflammation lesions (10g)

Dosage form Tube
Specifications Clotrimazol, betamethason dipropionate, Gentamicin

Ingredient

Composition information	Content
Clotrimazol	100mg
Betamethason dipropionate	6.4mg
Gentamicin	10mg

Uses

indicated

Gentriboston is used in the following cases:

Treatment of skin inflammation damage with corticosteroids such as eczema, contact dermatitis, skin rash, psoriasis, itching. A synthetic Imidazole derivative has anti -fungal effect, which works on the pathogenic fungus for humans such as skin fungus, yeast and mold. Clotrimazol shows antifungal effects by inhibiting the Ergosterol biosynthesis, an important component in the structure of the fungal cell membrane.

In vitro test shows that Clotrimazol has the effect of restraining and killing fungi depending on the concentration for the Trichophyton Rugbrum, Trichophyton mentagrophytes, Epidermophyton Flocosum, Microsporum Canis and Candida species including Candida Albicans.

betamethason dipropionate is a powerful glucocorticoid, when used on the spot, anti -inflammatory, anti -itching and vasodilation effect. There are many explanations for the effect of Betamethason Dipropionate in particular and corticosteroids in general when used on the spot on the skin.

corticosteroids can be attached to the corticosteroid receptor in the cytoplasm and then passing through the nucleus and interacting on DNA, thereby touching the synthesis of lipocortin - a protein that inhibits the activity of the enzyme phospholipase A2 (PLA2). PLA2 is an enzyme that hydrolyses phospholipids of cells and releases arachidonic acid, which is a precursor to the total meeting of inflammatory chemical mediators such as prostaglandin, leukotrien.

In addition, corticosteroids also reduce mast cell density, reduce the dynamic and activation of eosinophilia, reduce cytokin production by lymphocytes, mono leukemia, mast cells and eosinophilia.

Gentamicin sulfate is an antibiotic belonging to the aminoglycoside group that disinfects the bactericidal effect due to inhibiting bacterial biosome of bacteria. The bactericidal spectrum includes many Gram -negative aerobic bacteria, such as: Brucella, Calymatobacterium, Campylobacter, Citrobacter, Escheria, Entobacter, Francisella, Klebsiella, Proteus, Providencia, Pseudomonas, Serratia, Vibrio and Yersinia; Gram -positive bacteria such as Staphylococcus aureus are highly sensitive to Gentamicin, Listeria Monocytogenes and a few strains of Staph.

Epidermidis is still sensitive to Gentamicin, but Enterococci and Streptococci are often no longer sensitive. Some Actinomycete and Mycoplasma are sensitive to Gentamicin but Mycobacteria is no longer clinically sensitive. Gentamicin no longer works with anaerobic bacteria, beer yeast and anti -drug fungus. Gentamicin has little effect on gonorrhea, streptococcal, pneumococcal, meningococcal brain, citrobacter, Providencia and Enterococci. Mandatory anaerobic bacteria such as Bacteroides, Clostridia are all resistant to Gentamycin. In Vietnam today, the strains of E. Aerogenes, Klebsiella Pneumoniae, Blue Pus bacilli are all resistant to Gentamicin, but Gentamicin still works with H.influenzae, Shigella Flexneri, staphylococcus aureus, S. Epidermidis, especially Staph. Saprophyticus, Salmonella Typhi and E. Coli.

pharmacokinetics

absorption:

Under normal conditions, only a part of betamethason appears in the blood when used on the spot. The permeability and absorption level of the drug is determined by the skin area, the integrity of the skin, the dosage form, the age and the method of using the drug.

Clotrimazol is less absorbed when used in the form of skin topical. The majority of the drug is kept in the horny layer, only a small amount is absorbed into the blood. In a test of 1% clotrimazol cream with radioactive markers, after 6 hours of applying the drug on the skin intact and on acute inflammatory skin, clotrimazol concentration varies from 100 μg/cm3 in the horny layer to 0.5 - 1 μg/cm3 in the thorn layer and only 0.1 μg/cm3 in the lower skin tissue layer.

The amount of drugs appearing in plasma below the detection threshold (0.001 μg/ml), showing that clotrimazol used skin is not capable of leading to a systemic effect or side effects significantly.

Gentamicin does not absorb through the skin if used on intact skin. However, the drug can absorb the whole body like other aminoglycosides after use on the spot on the skin of the skin, burning the skin, burns, wounds and cavities of the body eliminate bladder and joints.

Distribution:

In case the drug is absorbed through the skin and has the whole body absorption, the drug will follow the law of distribution like oral drugs, including:

Betamethason is quickly distributed into all tissues in the body. The drug is over the placenta and can be exported to breast milk in small amounts. During the circulation, Betamethason is mainly linked to globulin, less linked to albumin. The ratio of binding with plasma protein is about 60%.

Gentamicin diffuse mainly into extracellular fluids and easily diffuse into the inner ear fluid. The drug diffuses less into the cerebrospinal fluid and does not achieve effective concentration, even when the meninges are inflamed. The drug diffuses less into the eyes, the drug can pass the placenta but only a small amount of milk. Gentamicin is less attached to plasma proteins, the mounting rate is only about 30%.

Clotrimazol: There is no information about the distribution characteristics of clotrimazol after absorption.

Metabolism:

Betamethason is a prolonged glucocorticoid glucocorticoid with a selling time of about 36 - 54 hours. The drug is metabolized in the liver.

Gentamicin is not metabolized.

Clotrimazol is absorbed and metabolized in the liver.

Era:

betamethason is excreted mainly through the kidney with a metabolic rate of less than 5%.

Gentamicin is eliminated in the form of unchanged urine through the glomerular filter.

Clotrimazol is eliminated through feces and urine.

Pharmacokinetics on special subjects:

Children: Skin absorption is easier in adults due to the incomplete skin structure, thin skin and the ratio of skin area on weight is greater than adults. Betamethason and Gentamicin can easily enter the circulatory system and cause systemic effects.

Patients with liver failure/ renal failure: There is no pharmacokinetic study of gentamicin used on skin on patients with renal impairment.

Before taking Gentriboston skin cream treats skin inflammation lesions (10g)

How to use

Only apply on the skin, apply the cream into a thin layer to the sick skin, use 1-2 times a day. Wash your hands clean before and after applying the drug.

Dosage

Adults and children aged 12 and older:

Apply thin layer of cream to cover the entire skin and surrounding skin, regularly 2 times/day (morning, dark).

Different treatment time depends on the results of clinical examination, microbiological testing and patient response to treatment.

In the case of foot fungal disease: a longer treatment (2-4 weeks) should be considered.

Children from 2 - 12 years old:

Apply a small amount to the skin and gently massage. Use no more than 2 times a day with a period of at least 6 - 12 hours away.

Should only use drugs for the face, neck, scalp, genital area, rectum and skin with folds with the care of a doctor.

The treatment time is limited to 5-7 days.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose?

Overdose:

Applying too much medicine on the skin or long -term use can lose the skin's collagen and atrophy. In some schools, corticosteroids can be absorbed and has a systemic effect such as inhibiting the HPA axis, secondary adrenal insecticide and manifestations of adrenal function, including Cushing syndrome. Excessive or long -lasting Gentamicin or on large skin area can lead to excessive development of unsure microorganisms.

Management:

Use appropriate symptomatic treatments. Treatment of electrolyte balance if necessary. In the case of chronic poisoning, the drug should be stopped slowly. If the growth of microorganisms is not sensitive, stop using drugs and apply appropriate treatment.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using Gentriboston, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Skin and epithelium: Skin itching, local burning pain.

Rare, ADR

Endocrine system: Inhibit the hypothalamus - pituitary - adrenal (hpa = hypothalamus - pituitary - adrenal), Cushing syndrome, slow weight gain in children, osteoporosis, glaucoma, blood glucose, cataract, hypertension, cortisol secretion.

The immune system: Hypersensitivity reaction, skin rash.

Ear/kidney: There is a risk of accumulating toxicity on the ear/kidney when applying the drug on a large scale or applied to open wounds and simultaneously used with other aminoglycosides.

Skin and epithelium: Skin atrophy, capillary dilatation, skin pattern, skin hemorrhage, hemorrhage, acne, oral dermatitis, dry skin, folliculitis, reduced skin pigmentation, temporary dermatitis, allergic dermatitis due to contact, secondary infection, redness, flaking skin, edema, urticaria, hairy.

Instructions on how to handle ADR

Must stop the drug and see the doctor immediately for instructions if one of the symptoms is listed above or any other abnormal signs.

Warnings

contraindicated

Gentriboston drugs contraindicated in the following cases:

Hypersensitivity to betamethason, with other corticosteroids or any ingredients of the drug.

History of sensitivity to aminoglycosides.

People with diabetes, mental illness, in bacterial infections and virus infections, in systemic fungal infections.

Avoid use for people with myasthenia gravis, Parkinson's syndrome or have muscle weakness.

People with skin reactions due to vaccination.

Be cautious when using

If irritated or sensitive to the drug, should stop the drug and apply appropriate treatments.

The risk of body absorption will increase if the drug is used on a large skin area, especially in a long period of time or on damaged skin. At that time, any side effects have been reported when using systemic sugar can occur with local use. Appropriate preventive measures should be taken in these cases, especially for children.

Need closely monitored by a doctor when applying medicine on a large or topical tape.

Avoid applying to open wounds or damaged skin. Do not apply to the eyes.

Patients need to be notified to use only medication as prescribed by a doctor and not share drugs with others.

Be cautious with Gentamicin

It is necessary to consider the risk of accumulating toxicity on the ears and kidneys due to the absorption of the skin when used simultaneously with body aminoglycosides.

There may be cross allergies between aminoglycosides.

Local antibiotic use increases the risk of antibiotic resistance strains, sometimes can lead to over -development of unsure microorganisms. If superinfection occurs during use, the drug should be discontinued and applied appropriate treatments.

Be cautious with clotrimazol

Patients should be asked immediately to the doctor if there is signs of increased irritation in the topical area (red, itching, burns, blisters, swelling) and signs of hypersensitivity.

Avoid sources of infection or re -infection during treatment.

Be cautious with betamethason

corticosteroids can cover the symptoms of allergic reactions on the skin with the ingredients of the drug.

betamethason dipropionate is a powerful corticosteroid, if used on the face or genital area, need special care and a treatment should be limited to 1 week.

If possible, do not take the drug continuously for 2-3 weeks.

Use in children: It is not recommended to use drugs for children under 2 years old. Pediatric patients have a more sensitive corticosteroids than adults because they have thinner skin and the ratio of skin area on a larger body weight.

There has been a report on the effect of inhibiting the hypothalamus activity - pituitary - adrenal glands (HPA), Cushing syndrome, growth slowly, slow weight gain, and increased intracranial pressure in children using local corticosteroids. The manifestations of adrenal insufficiency in children include low plasma cortisol levels and does not respond to adrenal hormone stimulation. The manifestations of increased intracranial pressure include bulging, headache and thorns on both sides.

The ability to drive and operate machinery

has not recorded a adverse reaction report or no research on the effects of the drug on the ability to operate machinery, train drivers, higher people working and other cases.

Pregnancy

Due to the safety of topical corticosteroids used for pregnant women who have not been determined, the drug should only be used when pregnant if the treatment benefits are higher than the risk that can be caused to the fetus. Do not use long or large amounts for pregnant women.

The period of breastfeeding

There is no information about the ability to use local corticosteroids, leading to sufficient body absorption to find drugs in breast milk. Therefore, it is necessary to consider the decision to stop breastfeeding or stopping the drug when noting the importance of the drug for the mother.

Drug interaction

clotrimazol used on the spot may have antagonistic effects on amphotericin and other polygian antibiotics.

Tacrolimus concentration in the serum of people with liver transplant increases when used simultaneously with clotrimazol. Therefore, Tacrolimus dose should be reduced according to demand.

If applying the drug on the genital or anus, the ingredients in the drug can reduce the effectiveness of condom contraception when used simultaneously. Patients should be recommended to use other preventive measures at least 5 days after stopping using this product.

Storage

Where dry, less than 30 ° C, avoid light.

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